Localized Necrotizing Periodontitis: A Possible Oral Manifestation of COVID-19

We investigated an unusual report of localized necrotizing periodontitis coinfection in patients with mild COVID-19. Male patient, 30 years old, with previous medical history of hypovitaminosis, immunized with two doses of the Pfizer® vacci ne, attended in a dental college in northern Brazil with an acute dental emergency reporting itching, halitosis, intense gingival p ain and spontaneous bleeding, mild fever of 37.8ºC, dry cough, muscle pain and nausea. Metronidazole and chlorhexidine were prescribed to improve the necrotizing condition, to treat periodontitis scaling and root planing (SRP) were performed associated with chlo rhexidine irrigation and oral hygiene instructions, which treated the patients conditions. COVID-19 coinfections are possible, specially, oral bacterial infections which is demonstrated in this report, so correct treatment is necessary for both infections. This letter d escribes the first known occurrence of severe localized necrotizing periodontitis in the urban area of Brazil's Amazon region.

Investigamos un reporte inusual de coinfección de periodontitis necrotizante localizada en pacientes con COVID-19 con síntomas leves: Paciente masculino, de 30 años, con antecedentes médicos de hipovitaminosis, inmunizado con dos dosis de la vacuna Pfizer®, atendido en una facultad de odontología en el norte Brasil, con urgencia dental aguda reportando prurito, halitosis, dolor gingival intenso y sangrado espontáneo, fiebre leve de 37,8 ºC, tos seca, mialgias y náuseas. Se prescribió metronidazol y clorhexidina para mejorar el cuadro necrosante, para tratar la periodontitis se realizó raspado y alisado radicular (SRP) asociado a irrigación con clorhexidina e instrucciones de higiene oral. Las coinfecciones por COVID- 19 son posibles, especialmente las infecciones bacterianas orales, lo cual se demuestra en este reporte, por lo que es necesario un correcto tratamiento de ambas infecciones. Esta carta describe la primera aparición conocida de periodontitis necrotizante severa de un paciente del área urbana de la región amazónica de Brasil.

Pathological findings and morphologic correlation of the lungs of autopsied patients with SARS-CoV-2 infection in the Brazilian Amazon using transmission electron microscopy

Abstract INTRODUCTION: Electron microscopy (EM) is a rapid and effective tool that can be used to create images of a whole spectrum of virus-host interactions and, as such, has long been used in the discovery and description of viral mechanisms. METHODS: Electron microscopy was used to evaluate the pulmonary pathologies of postmortem lung sections from three patients who died from infection with SARS-associated coronavirus 2 (SARS-CoV-2), a new member of the Coronaviridae family. RESULTS: Diffuse alveolar damage (DAD) was predominant in all three patients. The early exudative stage was characterized principally by edema and extravasation of red blood cells into the alveolar space with injury to the alveolar epithelial cells; this was followed by detachment, apoptosis, and necrosis of type I and II pneumocytes. The capillaries exhibited congestion, exposure of the basement membrane from denuded endothelial cells, platelet adhesion, fibrin thrombi, and rupture of the capillary walls. The proliferative stage was characterized by pronounced proliferation of type II alveolar pneumocytes and multinucleated giant cells. The cytopathic effect of SARS-CoV-2 was observed both in degenerated type II pneumocytes and freely circulating in the alveoli, with components from virions, macrophages, lymphocytes, and cellular debris. CONCLUSIONS: Viral particles consistent with the characteristics of SARS-CoV-2 were observed mainly in degenerated pneumocytes, in the endothelium, or freely circulating in the alveoli. In the final stage of illness, the alveolar spaces were replaced by fibrosis.

Confirmed Invasive Pulmonary Aspergillosis and COVID-19: the value of postmortem findings to support antemortem management

Abstract We present postmortem evidence of invasive pulmonary aspergillosis (IPA) in a patient with severe COVID-19. Autopsies of COVID-19 confirmed cases were performed. The patient died despite antimicrobials, mechanical ventilation, and vasopressor support. Histopathology and peripheral blood galactomannan antigen testing confirmed IPA. Aspergillus penicillioides infection was confirmed by nucleotide sequencing and BLAST analysis. Further reports are needed to assess the occurrence and frequency of IPA in SARS-CoV-2 infections, and how they interact clinically.

Doença de Alzheimer como fator de risco à doença periodontal: uma revisão de literatura / Alzheimer's disease as a risk factor to periodontal disease: a literature review

Introdução: A medicina periodontal é a área da periodontia que investiga a interação fisiológica e patológica entre a saúde do periodonto e/ou a Doença Periodontal na saúde sistêmica do individuo. Atualmente estudos evidenciaram possíveis correlações entre a Doença Periodontal e o Alzheimer, nestes trabalhos os autores consideram que estas patologias dividem fatores de risco e/ou modificadores em comum podendo haver uma relação bidirecional entres estas. Objetivo: Realizar uma revisão da literatura para descrever uma correlação entre o Alzheimer e a doença periodontal através dos fatores pro-inflamatórios, imunológicos e periodontopatogênicos. Materiais e Métodos: Foi realizada uma busca na literatura nas bases de dados: Google Acadêmico, PubMed, EBSCO e Scielo, contendo artigos científicos de 2000 até 2019, nos idiomas inglês e português usando os termos de pesquisa e descritores: "Periodontite Crônica" E/OU "Doença de Alzheimer" E/OU "Microbiologia periodontal" E/OU "Citocinas", como critérios de inclusão tivemos estudos de caso-controle, case series e estudos clínicos com criteriosa metodologia, aspectos metodológicos bem organizados estruturalmente e protocolos de pesquisa bem delineados. Conclusão: Consideramos que periodontistas e cirurgiões-dentistas devem estar atentos as possíveis associações entre o Alzheimer e a doença periodontal e durante os atendimentos estar atento aos sinais e sintomas do Alzheimer e orientar a pacientes, familiares e cuidadores quanto a correta higienização bucal, prevenção e tratamento da doença periodontal. (AU)

Introduction: Periodontal medicine is the area of periodontics that investigates the physiological and pathological interaction between periodontal health and / or periodontal disease in the individual's systemic health. Currently, studies have shown possible correlations between Periodontal Disease and Alzheimer's, in these studies, the authors consider that these pathologies divide risk factors and / or modifiers in common, and there may be a bidirectional relationship between them. Objective: To perform a literature review to describe a correlation between Alzheimer's disease and periodontal disease through pro-inflammatory, immunological and periodontopathogenic factors. Materials and Methods: A literature search was performed in the databases: Google Scholar, PubMed, EBSCO and Scielo, containing scientific articles from 2000 to 2019, in the English and Portuguese languages using the search terms and descriptors: "Chronic Periodontitis" E / OR "Alzheimer's Disease" AND / or "Periodontal Microbiology" AND / or "Cytokines", as inclusion criteria we had case-control studies, case series and clinical studies with methodological criteria, well structured methodological aspects and research protocols well outlined. Conclusion: We believe that periodontists and dental surgeons should be aware of the possible associations between Alzheimer's disease and periodontal disease, and during the visits to be alert to the signs and symptoms of Alzheimer's disease and to guide patients, family members and caregivers about correct oral hygiene, prevention and treatment of periodontal disease (AU)

Multi-enzyme complex of white rot fungi in saccharification of lignocellulosic material

ABSTRACT The multi-enzyme complex (crude extract) of white rot fungi Pleurotus ostreatus, Pleurotus eryngii, Trametes versicolor, Pycnosporus sanguineus and Phanerochaete chrysosporium were characterized, evaluated in the hydrolysis of pretreated pulps of sorghum straw and compared efficiency with commercial enzyme. Most fungi complexes had better hydrolysis rates compared with purified commercial enzyme.

Absence of cytomegalovirus in gingivitis and chronic periodontitis in HIV-1 patients in Northern Brazil

Abstract INTRODUCTION The influence of cytomegalovirus (CMV) on the progression of chronic periodontitis in HIV patients is poorly investigated. METHODS ELISA was used for anti-CMV antibody IgG titer measurements and real-time polymerase chain reaction for qualitative and quantitative CMV detection. Data on the CD4 + T lymphocyte count and plasma HIV viral load were obtained from patient records. RESULTS CMV DNA was detected in samples of subgingival biofilm in only three individuals, two of them with chronic periodontitis (4%) and one with gingivitis (3.3%). CONCLUSIONS The prevalence of CMV is very low both in HIV-1 patients with gingivitis and chronic periodontitis.

JC virus/human immunodeficiency virus 1 co-infection in the Brazilian Amazonian region

Abstract JC virus (JCV) is a member of the Polyomaviridae family and is associated to a severe disease known as progressive multifocal leukoencephalopathy, PML, which is gradually increasing in incidence as an opportunistic infection among AIDS patients. The present study aimed to investigate the occurrence of JCV among HIV-1 carriers including their types and molecular subtypes and the possible association with disease. Urine samples from 66 HIV-1 infected subjects were investigated for the presence of the virus by amplifying VP1 (215 bp) and IG (610 bp) regions using the polymerase chain reaction. JCV was detected in 32% of the samples. The results confirmed the occurrence of type B (subtype Af2); in addition, another polyomavirus, BKV, was also detected in 1.5% of samples of the HIV-1 infected subjects. Apparently, there was no significant difference between mono- (HIV-1 only) and co-infected (HIV-1/JCV) subjects regarding their TCD4+/TCD8+ lymphocyte counts or HIV-1 plasma viral load. Self admitted seizures, hearing and visual loses were not significantly different between the two groups.

The caries experience and dentistry following evaluation of children submitted to antineoplastic therapy

Aim: To evaluate the caries experience and the dentistry following of children submitted to antineoplastic therapy of a reference Hospital to this type of treatment in Para state, Brazil. Material and Methods: The sample consisted of 46 children. It was included children in the ages of 2 to 12 years diagnosed with cancer that would be submitted to chemotherapy treatment. The evaluation was performed before the chemotherapy treatment and consisted of anamnesis and oral clinical examination. In order to decrease the interexaminer diagnosis variability and increase the data surveys confidentiality, a previous training and calibration was performed before the beginning of the examination. Results: There was a higher prevalence of childish cancer among male gender children. The age group more affected was between 8 to 12 years. There was a bigger percentage of patients that didn't go to the dentist before the chemotherapy treatment. The children caries experience was evaluated by the CPO-D and medium Ceo-d indexes, obtaining respectively the values of 4,75 and 0,47. Conclusions: The initial caries experience was high comparing to the international and Brazil average. Most of researched children didn't have a previous dentistry care before the beginning of antineoplastic therapy.

Toll-like receptor 3 gene polymorphisms are not associated with the risk of hepatitis B and hepatitis C virus infection

INTRODUCTION: The present study investigated the prevalence of two single-nucleotide polymorphisms (SNPs) in the Toll-like receptor 3 (TLR3) gene in patients infected with hepatitis B virus (HBV) and hepatitis C virus (HCV). METHODS: Samples collected from HCV (n = 74) and HBV (n = 35) carriers were subjected to quantitative real-time PCR (qPCR) to detect the presence of the SNPs rs5743305 and rs3775291 in TLR3 and to measure the following biomarkers: alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), and prothrombin time (PT). A healthy control group was investigated and consisted of 299 HCV- and HBV-seronegative individuals. RESULTS: No significant differences in allele, genotype and haplotype frequencies were observed between the investigated groups, and no association was observed between the polymorphisms and histopathological results. Nevertheless, genotypes TA/AA (rs5743305) and GG (rs3775291) appear to be associated with higher levels of ALT (p<0.01), AST (p<0.05) and PT (p<0.05). In addition, genotypes TT (rs5743305; p<0.05) and GG (rs3775291; p<0.05) were associated with higher GGT levels. CONCLUSIONS: This genetic analysis revealed the absence of an association between the polymorphisms investigated and susceptibility to HBV and HCV infection; however, these polymorphisms might be associated with a greater degree of biliary damage during the course of HCV infection. .

Risco cardiovascular em policiais militares de uma cidade de grande porte do Nordeste do Brasil / Cardiovascular Risk among Military Policemen of a Large City in Northeastern Brazil / Riesgo cardiovascular en Policía Militar de una gran ciudad del Nordeste de Brasil

A pesquisa estimou prevalência e fatores associados ao risco cardiovascular elevado (RCE), a partir da obesidade abdominal, em uma amostra de 316 policiais militares (PMs) de uma cidade de grande porte do Nordeste do Brasil. Os preditores selecionados foram: sexo, idade, situação conjugal, graduação, função e tempo na polícia, nível de atividade física e tabagismo. Empregou-se a regressão logística de Poisson, com variância robusta, para avaliar a associação entre RCE e fatores sociodemográficos, comportamentais e relacionados ao trabalho policial. O RCE ocorreu em 32,3% dos PMs pesquisados. Na análise ajustada, sexo (RP: 2,39; IC95%: 1,20-4,77), tempo na polícia (RP: 1,74; IC95%: 1,17-2,58) e nível de atividade física (RP: 1,36; IC95%: 1,00-1,83) foram associados com o RCE entre os policiais, ajustados por graduação.

This research estimated the prevalence and factors associated with high cardiovascular risk (HCR), evaluating from abdominal obesity in a sample of 316 military policemen of a large city in Northeastern Brazil. Predictors: gender, age, marital status, graduation, function and time in the police, level of physical activity and smoking. We used the Poisson regression with robust variance to assess the association between HCR and sociodemographic, behavioral and work-related factors. The HCR occurred in 32.3% of subjects surveyed. In the adjusted analysis, gender (OR: 2.39, IC95%: 1.20-4.77), time in the police (OR: 1.74, IC95%: 1.17-2.58) and physical activity level (OR: 1.36, IC95%: 1.00-1.83) were associated with HCR among subjects, adjusted for graduation.

Este estudio estima la prevalencia y los factores asociados con alto riesgo cardiovascular (RCV) de la obesidad abdominal en una muestra de 316 policía militar de una gran ciudad en el noreste de Brasil. Los predictores: género, edad, estado civil, la graduación, la función y el tiempo en la policía, el nivel de actividad física y el tabaquismo. Se utilizó la regresión de Poisson con varianza robusta para evaluar la asociación entre RCV y los predictores socio demográficos, conductuales y relacionados con el trabajo policial. El RCV se produjo en el 32,3% de los sujetos. En el análisis ajustado, género (RP: 2.39; IC95%: 1,20-4.77), tiempo en policía (RP: 1.74; IC95%: 1,17-2.58) y el nivel de actividad física (RP: 1,36; IC95%: 1,00-1.83) se asociaron con RCV entre los sujetos, ajustado para la graduación.

Investigação do vírus Epstein-Barr em pacientes com Periodontite Crônica / Investigation of the Epstein-Barr virus in patients with chronic periodontitis

Introdução: Nos últimos anos, um número crescente de estudos sugere a participação dos herpesvírus na doença periodontal. Objetivo: Este trabalho investiga a relação entre a presença do herpesvírus Epstein-Barr (EBV) e a infecção periodontal em pacientes com periodontite crônica. Metodologia: Foram coletadas amostras de biofilme subgengival de sítios com profundidades de sondagem de 4 a 6 mm e > 7 mm, de 28 pacientes com periodontite crônica. Como controles, foram incluídos 16 indivíduos, sistemicamente saudáveis e sem doença periodontal. Adicionalmente, parâmetros clínicos de profundidade de sondagem (PS), nível clínico de inserção (NCI) e índice de sangramento à sondagem (SS) foram registrados. Resultado: Os resultados demonstraram médias de 2,7 mm PS, 1,7 mm NCI e 0,3% dos sítios apresentaram SS. A investigação do EBV no biofilme subgengival dos grupos foi realizada por meio da reação em cadeia da polimerase com primer espécie-específico. Os resultados da análise viral indicaram ausência de EBV em todas as amostras subgengivais analisadas. Conclusão: A partir destes resultados, não foi encontrada relação entre a presença do herpesvírus Epstein-Barr e a periodontite crônica.

Introduction: In recent years, a growing number of studies have suggested the participation of the herpes virus in periodontal disease. Objective: this study investigates the relationship between the presence of the Epstein-Barr herpes virus and periodontal infection in patients with chronic periodontitis. Methodology: subgingival biofilm samples were collected of subgingival sites with probing depths of 4 mm to 6 mm, and > 7 of 28 patients with chronic periodontitis. The control group consisted of 16 healthy subjects without clinical evidence of chronic periodontitis. Additionally, clinical parameters of probing depth, attachment level and Bleeding index were recorded. Result: the results showed averages of 2 mm probing depth, 1, 7 mm attachment level and 0.3 % bleeding on probing. Investigation of the herpes virus in the subgingival biofilm of the groups was performed using polymerase chain reaction with species-specific primer. Results of viral analysis indicated the absence of EBV in all subgingival samples analyzed. Conclusion: these results found no relationship between the presence of the Epstein-Barr herpes virus and chronic periodontitis.

Revision of Infected Total Knee Arthroplasty: Two-Stage Reimplantation Using an Antibiotic-Impregnated Static Spacer

BACKGROUND: A two-stage revision remains as the "gold standard" treatment for chronically infected total knee arthroplasties. METHODS: Forty-five septic knee prostheses were revised with a minimum follow-up of 5 years. Static antibiotic-impregnated cement spacers were used in all cases. Intravenous antibiotics according to sensitivity test of the culture were applied during patients' hospital stay. Oral antibiotics were given for another 5 weeks. Second-stage surgery was undertaken after control of infection with normal erythrocyte sedimentation rate and C-reactive protein values. Extensile techniques were used if needed and metallic augments were employed for bone loss in 32 femoral and 29 tibial revisions. RESULTS: The average interval between the first-stage resection and reimplantation was 4.4 months. Significant improvement was obtained with respect to visual analog scale pain and clinical and functional scores, and infection was eradicated in 95.6% of cases following a two-stage revision total knee arthroplasty. Radiographic evaluation showed suitable alignment without signs of mechanical loosening. CONCLUSIONS: This technique is a reasonable procedure to eradicate chronic infection in knee arthroplasty and provides proper functional and clinical results. However, it sometimes requires extensile surgical approaches that could imply arduous surgeries. Metallic augments with cementless stems available in most of the knee revision systems are a suitable alternative to handle bone deficiencies, avoiding the use of bone allografts with its complications.

Caracterização química da castanha de sapucaia (Lecythis pisonis Cambess. ) da região da zona da mata mineira / Chemical characterization of sapucaia nuts (Lecythis pisonis Cambess. ) from zona da mata mineira region

Atualmente as castanhas têm recebido atenção especial, pois são fontes naturais de vitaminas, minerais, proteínas e ácidos graxos essenciais, podendo assim contribuir para a dieta humana e de animais. Pesquisas recentes confirmam que esses alimentos são fontes ainda de compostos bioativos, os quais podem trazer benefícios significativos à saúde humana. Este trabalho teve como objetivo avaliar a composição química de castanhas da espécie sapucaia (Lecythis pisonis Cambess.) localizadas na zona da mata mineira. Foram analisadas a composição centesimal (lipídios, proteínas, carboidratos, cinzas e umidade), teor de minerais por espectrometria de plasma e perfil lipídico por cromatografia gasosa. A composição centesimal revelou 54,8% de lipídios; 26,82% de proteínas; 5,01% de carboidratos; 3,17% de cinzas e 10,2% de umidade. Quanto ao perfil lipídico, 43,1% eram ácidos graxos polinsaturados, 41,7% ácidos graxos monoinsaturados e 15,2% ácidos graxos saturados. Os minerais fósforo, magnésio e manganês se destacaram pelos elevados teores, 941; 343 e 4,8 mg.100-1, respectivamente. A castanha de sapucaia é uma potencial fonte energéticoprotéica e de minerais importantes para a saúde, mas deve ter sua toxicidade avaliada.

Currently the nuts have received special attention of researchers because they are natural sources of vitamins, minerals, protein and essential fatty acids, could also contribute to the diet of humans and animals. Recent research confirms that these foods are also sources of bioactive compounds, which can bring significant benefits to human health through regular consumption. This study evaluated the chemical composition of sapucaia nut (Lecythis pisonis Cambess.) of the state of Minas Gerais. We analyzed the chemical composition (lipids, proteins, carbohydrates, ash and moisture), and the mineral content by mass spectrometry, and the lipid profile by gas chromatography. The chemical composition showed 54,8% lipids; 26,82% protein; 5,01% carbohydrates; 3,17% ash and 10,2% moisture. The lipid, 43,1% were polyunsaturated fatty acids, monounsaturated fatty acids 41,7% and 15,2% saturated fatty acids. The minerals phosphorus, magnesium and manganese are highlighted by high levels, 941; 343 and 4,8 mg.100-1, respectively. Sapucaia nut is a potential protein-energy and minerals source, but its toxicity must be evaluated.

Nível de atividade física e barreiras percebidas para a prática de atividades físicas entre policiais militares / Level of physical activity and perceived barriers to practice physical activities among military police / Nivel de actividad física y barreras percibidas para la práctica de actividades físicas entre los policía militares

O estudo descreveu o nível de atividade física e as barreiras percebidas para a prática de atividades físicas em uma amostra de 316 policiais militares de Feira de Santana, Bahia. Houve 37% de indivíduos insuficientemente ativos, sem diferença significante entre os sexos e a idade. Entre as barreiras percebidas para a prática de atividade física destacaram-se: compromissos familiares (39,2%), jornada de trabalho (36,7%), falta de equipamento (30,4%), ambiente inseguro (26,9%), falta de companhia (25,6%), tarefas domésticas (20,6%) e falta de recursos financeiros (20,3%). A prevalência de policiais insuficientemente ativos foi maior entre os que percebem barreiras pessoais, ajustado pelo sexo, idade e pelas barreiras ambientais, sociais e financeiras (RP: 1,5; IC95%: 1,00-2,26).

This research describes levels of physical activity and perceived barriers to physical activities of military police in Feira de Santana, Bahia. This is a cross sectional study, with a sample of 316 subjects. The results showed that in regard to physical activity, 37% of the military police are inactive, no significant difference related to gender and age. Among perceived barriers to practice physical activity stood out: family commitments (39.2%), the workday (36.7%), lack of equipment (30.4%), unsafe environment (26.9%), lack of company (25.6%), housework (20.6%) and lack of financial resources (20.3%). The prevalence of inactive police was higher among those who perceived personal barriers, adjusted by gender, age, and by environmental, social and financial barriers (OR: 1.5; CI95%: 1.00-2.26).

El objetivo del estudio fue describir el nivel de actividad física y barreras percibidas a practicar actividades físicas en una muestra de 316 policía militar de Feira de Santana, Bahia. Hubo 37% de los oficiales de policía con el nivel de actividad física insuficiente, pero ninguna diferencia significativa entre los sexos y la edad. Entre las barreras percibidas para la práctica de actividad física se situó: compromisos com la familia (39.2%), la jornada laboral (36.7%), falta de equipo (30.4%), entorno inseguro (26.9%), carencia de la compañía (25.6%), tarefas del hogar (20.6%) y la falta de recursos financieros (20.3%). La prevalencia actividad física insuficiente fue mayor entre los que se dan cuenta de las barreras personales, ajustadas por sexo, edad y por barreras ambientales, sociales y financieras (RP: 1.5; IC95%: 1.00-2.26).

Characterization of mannose-binding lectin plasma levels and genetic polymorphisms in HIV-1-infected individuals / Caracterização dos polimorfismos genéticos e dos níveis plasmáticos da lectina ligante de manose em indivíduos infectados pelo HIV-1

INTRODUCTION: The present study investigated the association between mannose-binding lectin (MBL) gene polymorphism and serum levels with infection by HIV-1. METHODS: Blood samples (5mL) were collected from 97 HIV-1-infected individuals resident in Belém, State of Pará, Brazil, who attended the Special Outpatient Unit for Infections and Parasitic Diseases (URE-DIPE). CD4+ T-lymphocyte count and plasma viral load were quantified. A 349bp fragment of exon 1 of the MBL was amplified via PCR, using genomic DNA extracted from controls and HIV-1-infected individuals, following established protocols. MBL plasma levels of the patients were quantified using an enzyme immunoassay kit. RESULTS: Two alleles were observed: MBL*O, with a frequency of 26.3 percent in HIV-1-infected individuals; and the wild allele MBL*A (73.7 percent). Similar frequencies were observed in the control group (p > 0.05). Genotype frequencies were distributed according to the Hardy-Weinberg equilibrium in both groups. Mean MBL plasma levels varied by genotype, with statistically significant differences between the AA and AO (p < 0.0001), and AA and OO (p < 0.001) genotypes, but not AO and OO (p = 0.17). Additionally, CD4+ T-lymphocytes and plasma viral load levels did not differ significantly by genotype (p > 0.05). CONCLUSIONS: The results of this study do not support the hypothesis that MBL gene polymorphism or low plasma MBL concentrations might have a direct influence on HIV-1 infection, although a broader study involving a large number of patients is needed.

INTRODUÇÃO: O presente estudo investigou a associação entre o polimorfismo no gene da lectina ligante de manose (MBL) e os níveis séricos da proteína com a infecção pelo HIV-1. MÉTODOS: As amostras de sangue (5mL) foram coletadas de 97 indivíduos infectados pelo HIV-1 residentes em Belém, Estado do Pará, Brasil, que frequentavam a Unidade de Referência Especial para Doenças Infecciosas e Parasitárias Especiais (URE-DIPE). Os níveis de linfócitos T CD4+ e da carga viral plasmática foram quantificados. Um fragmento de 349pb do exon 1 da MBL foi amplificado via PCR, utilizando DNA genômico extraído das amostras controles e dos indivíduos portadores do HIV-1, seguindo protocolos previamente estabelecidos. O nível plasmático de MBL nos pacientes foi quantificado usando kit de ensaio imunoenzimático. RESULTADOS: Dois alelos foram observados - MBL*O, com uma frequência de 26,3 por cento em indivíduos infectados e o alelo selvagem MBL*A (73,7 por cento). Frequências similares foram observadas no grupo controle (p > 0,05). As frequências genotípicas estavam em equilíbrio de Hardy-Weinberg em ambos os grupos. A média dos níveis plasmáticos MBL variou por genótipo, com diferenças significativas entre os genótipos AA e AO (p < 0,0001), e AA e OO (p < 0,001), mas não entre AO e OO (p=0,17). Além disso, os linfócitos T CD4+ e os níveis plasmáticos de carga viral não diferiram significativamente de acordo com o genótipo (p>0,05). CONCLUSÕES: Os resultados deste estudo não apoiam a hipótese de que o polimorfismo no gene MBL ou baixa concentração plasmática de MBL poderia ter uma influência direta sobre a infecção pelo HIV-1, embora um estudo com número maior de pacientes seja necessário.

Predisposição para desenvolver resistência insulínica em policiais militares / Selfdetermination theory: applications in the context of physical exercise practices for adolescents

O objetivo deste estudo foi estimar a prevalência de predisposição para a resistência insulínica (PRI), através da circunferência da cintura (CC) em um grupo de Policiais Militares (PM). Trata-se de um estudo transversal, realizado com uma amostra de 316 PM. Variável dependente: PRI, avaliada pela CC. Co-variáveis: idade, estado civil, nível habitual de atividade física (NHAF), tempo de serviço, graduação e função na polícia. Os resultados revelaram 37% de policiais sedentários ou irregularmente ativos (S /IA). Na análise bruta, a PRI foi mais prevalente entre os PM mais velhos, com maior graduação, maior tempo de serviço e entre os S/ IA. Após o ajuste feito pela regressão logística múltipla, apenas a idade e o NHAF permaneceram associados à PRI entre os PMS.

In this study, we aimed at estimating how the predisposition to insulin resistance (PIR) prevails, by using waist circumference (WC) for a group of military police (MP). This is a transversal study, performed with a sample of 316 PM, consisting of (a) dependent variable: PIR, assessed by WC; (b) covariates: age, marital status, habitual physical activity level (HPAL), length of service, university degree, police function. The results showed 37 % of sedentary or irregularly active MP. For the gross analysis, the PIR was more prevalent among the older MP and sedentary orirregularly active MP. The older PM also showed higher degree level and length of service. After the adjustment by multiple logistic regression, only the age and HPAL remained linked to PIR among the MP.

El objetivo de este estudio fue estima el predominio del predisposition para la resistencia al insulina (PRI), con la circunferencia de la cintura (cc) en un grupo de Policías Militares (P.M.). Es uno estudio transversal, llevado a través con una muestra de 316 P.M. Variable dependiente: PRI, evaluado para el cc. CoVariables: edad, estado civil, nivel habitual de la actividad física (NHAF), época del servicio, graduación y función en la policía. Los resultados habían divulgado el 37% de los P.M. sedentarios o irregularmente activos (S/IA). En el análisis grosero, el PRI fue más frecuente entre el P.M. más viejo, con una graduación más grande, mayor tiempo del servicio y entre el S/IA. Después del ajuste hecho para la regresión logística múltiple, solamente sigues habiendo la edad y el NHAF como asociados al PRI entre el P.M.

Caracterização molecular do HTLV-1/2 em doadores de sangue em Belém, Estado do Pará: primeira descrição do subtipo HTLV-2b na região Amazônica / Molecular characterization of HTLV-1/2 among blood donors in Belém, State of Pará: first description of HTLV-2b subtype in the Amazon region

Este trabalho objetivou a caracterização molecular do vírus linfotrópico de células T humanas infectando doadores de sangue atendidos na Fundação Centro de Hemoterapia e Hematologia do Pará. Amostras de DNA de 79 indivíduos soropositivos para o vírus linfotrópico de células T humanas foram analisadas por meio da reação em cadeia da polimerase para as regiões genômicas pX, env e 5'LTR, de polimorfismos de comprimento de fragmentos de restrição e do seqüenciamento da região 5LTR, com posterior análise filogenética, definindo o tipo e o subtipo do HTLV circulante na população estudada. Observou-se uma maior prevalência de HTLV-1 (71 por cento) em relação ao HTLV-2 (29 por cento). As amostras de HTLV-1 sequenciadas foram classificadas como pertencentes ao subtipo Cosmopolita, subgrupo Transcontinental, sendo as de HTLV-2 identificadas como HTLV-2c. A análise de polimorfismos de comprimento de fragmentos de restrição da região env e do sequenciamento da região 5'LTR, identificou, pela primeira vez na Amazônia Brasileira, uma amostra de HTLV-2b, enfatizando a necessidade de estudos moleculares contínuos na região para melhor entendimento da epidemiologia de transmissão do HTLV na população e permitir a vigilância epidemiológica da emergência de novos tipos e subtipos.

This study aimed to perform molecular characterization on the human T-cell lymphotropic virus (HTLV) infecting blood donors attended at the Hematology and Hemotherapy Center-Foundation of Pará. DNA samples from 79 HTLV-seropositive individuals were analyzed by means of the polymerase chain reaction on the pX, env and 5'LTR genomic regions; restriction fragment length polymorphism analysis; and sequencing of the 5'LTR region with subsequent phylogenetic analysis. From this, the HTLV types and subtypes circulating in the study population were defined. There was higher prevalence of HTLV-1 (71 percent) than of HTLV-2 (29 percent). HTLV-1 samples were classified as belonging to the Cosmopolitan subtype, Transcontinental subgroup; and the HTLV-2 samples as HTLV-2c. Analysis on the restriction fragment length polymorphisms of the env region and sequencing of the 5'LTR region identified a sample of HTLV-2b, for the first time in the Brazilian Amazon region. This emphasizes the need for ongoing molecular studies in this region, in order to have better understanding of the epidemiology of HTLV transmission in the population, and to enable epidemiological surveillance of the emergence of new types and subtypes.

Avaliação qualitativa sobre o que os psiquiatras brasileiros esperam das classificações diagnósticas / A qualitative analysis on what Brazilian psychiatrists expect from current diagnostic classifications

Introdução: Pretende-se analisar o perfil de respostas qualitativas a um questionário padronizado anônimo, com itens abertos e fechados, sobre a percepção dos psiquiatras brasileiros acerca do uso dos sistemas diagnósticos multiaxiais CID-10 e DSM-IV e de suas expectativas quanto às próximas revisões (CID-11 e DSM-V). Método: O questionário, elaborado por Graham Mellsop (Nova Zelândia), foi traduzido e enviado para 1.050 psiquiatras afiliados à Associação Brasileira de Psiquiatria. Resultados: Retornaram 160 questionários (15,2%). Nestes, 71,1% das questões abertas foram respondidas. As principais qualidades julgadas necessárias ou desejadas em uma classificação psiquiátrica foram: simplicidade, clareza de critérios, objetividade, compreensibilidade, confiabilidade e facilidade de uso. O eixo I da CID-10 foi citado como o mais utilizado pelo caráter instrumental e pelo fato de ser a classificação oficial, inclusive para fins burocráticos e legais. O DSM-IV também é bastante utilizado no cotidiano, sobretudo para ensino e pesquisa, por psiquiatras com afiliações acadêmicas. O uso menos frequente de sistemas multiaxiais foi justificado pela falta de treino e de familiaridade, pela sobrecarga de informações e pelo fato de não serem obrigatórios. Avaliou-se que algumas categorias diagnósticas, entre outras, devem ser revistas, como: retardo mental, transtornos alimentares, de personalidade, do sono, da infância e adolescência, quadros ansiosos, afetivos, esquizoafetivos. Conclusão: O material fornece um panorama sobre as opiniões e expectativas dos psiquiatras a respeito dos instrumentos diagnósticos dos quais se servem ativamente em sua prática diária e cujas revisões estão em pleno processo de elaboração.

Introduction: The objective of the present study was to analyze the qualitative answers of an anonymous standardized survey including qualitative and quantitative questions about the Brazilian psychiatrists’ perceptions on their use of the multiaxial diagnostic systems ICD-10 and DSM-IV and about their expectations regarding future revisions of these classifications (ICD-11 and DSM-V). Method: The questionnaire, elaborated by Graham Mellsop (New Zealand), was translated into Portuguese and sent through mail to 1,050 psychiatrists affiliated to the Brazilian Psychiatry Association. The quantitative analysis is presented elsewhere. Results: One hundred and sixty questionnaires returned (15.2%). From these, 71.1% of the open questions where answered. The most needed and/or desirable qualities in a psychiatric classification were found to be: simplicity, clarity of criteria, objectivity, comprehensibility, reliability, and ease to use. Axis I of the ICD-10 was reported to be the most used due to its instrumental character in addition to being the official classification also for legal and bureaucratic purposes. The DSM-IV was also used in the everyday practice, mostly for education and research purposes, by psychiatrists with academic affiliations. The less frequent use of the multiaxial systems was explained by the lack of training and familiarity, the overload of information and by the fact they are not mandatory. Based on the respondents’ answers, we concluded that some diagnostic categories must be revised, such as: mental retardation, eating disorders, personality disorders, sleeping disorders, child and adolescent disorders, affective, and schizoaffective disorders. Conclusion: This material offers a systematic overview of the psychiatrists’ opinions and expectations concerning the diagnostic instruments used in their daily practice.

Soroprevalência de infecções por vírus da hepatite B e vírus da hepatite C em indivíduos do Estado do Pará / Seroprevalence of hepatitis B virus and hepatitis C virus infections among individuals in the State of Pará

As hepatites B e C continuam sendo um importante problema de saúde pública no Brasil. Neste estudo, determinou-se a prevalência de marcadores sorológicos para as hepatites B e C em indivíduos do Estado do Pará, atendidos no Laboratório Central de Saúde Pública do Pará, no período de janeiro de 2002 a dezembro de 2005. Foram realizados 11.282 exames para a pesquisa do HBsAg, 2.342 para o anti-HBc e 5.542 para o anti-vírus da hepatite C. A prevalência de HBsAg foi de 3,6 por cento e predominou na faixa etária de 20 a 29 anos, enquanto que o anti-HBc foi observado em 37,7 por cento dos indivíduos. A prevalência do antivírus da hepatite C foi de 3,6 por cento e predominou entre indivíduos acima de 50 anos. Assim, as freqüências dos marcadores encontradas no Pará foram mais altas que em vários outros estados do país, sugerindo a necessidade de medidas de saúde publica mais eficazes no combate a estes agravos na região.

Hepatitis B and C continue to be important public health problems in Brazil. In this study, the prevalence of serological markers for hepatitis B and C in individuals from the State of Pará, attended at the Central Public Health Laboratory of Pará between January 2002 and December 2005, was determined. 11,282 tests to investigate HBsAg, 2,342 for anti-HBc and 5,542 for anti-HCV were performed. The prevalence of HBsAg was 3.6 percent and it was predominantly found in the age range of 20 to 29 years old, while anti-HBC was observed in 37.7 percent of the subjects. The prevalence of anti-hepatitis C virus was 3.6 percent and it was predominantly found in individuals over 50 years old. Thus, the frequencies of the markers found in Pará were higher than many other states in Brazil, hence suggesting that there is a need for public health measures of greater effectiveness for combating these illnesses in this region.