Destruction of immunobiologicals and their disposal

The guidelines of the Brazilian National Health System (SUS) state that the municipal authorities are responsible for the vaccination of the population. The present study examined the types of immunobiologicals, amounts and reasons for their destruction and disposal by the Municipal Health Secretariat in the city of Bauru, São Paulo state, Brazil, between 2008 and 2009. This study comprises a descriptive, exploratory and retrospective work that employed search of bibliographic data, collection of secondary data from forms of immunobiologicals disposal and interview of the agent responsible for the disposal of these products in the municipality. It was observed that the total numbers of unused vaccines in 2008 and 2009 were similar (4523 and 4395, respectively), being the most discarded: the diphtheria, tetanus and pertussis (DTP) vaccine in 2008 and DTP, BCG and influenza in 2009. It was found that the amount of discarded vaccines could be reduced since the reasons for that were predictable. Moreover, the current study emphasized that although there is a municipal regulation for the disposal of immunobiologicals, the city still requires a better structure to handle such problem.

Treatment of venous ulcers with fibrin sealant derived from snake venom

Venous ulcers of the lower limbs complicated by infection or chronicity represent a serious public health problem. The elevated number of those afflicted burdens the health services, interferes in quality of life and causes absenteeism. Although there are 2,500 items on the market, ranging from the simplest dressing up to the most complex types of dressing, treatment remains a challenge. Among the substances used, fibrin sealant is the one that promotes diminution of bacterial colonization and of edema, controls hemorrhaging, alters the pain threshold by protecting the nerve endings, hydrates the wound bed and forms granulation tissue that favors healing. Its disadvantages include higher cost and utilization of human fibrinogen that can transmit infectious diseases. The Center for the Study of Venoms and Venomous Animals (CEVAP) at São Paulo State University (UNESP) developed a new sealant made up of fibrinogen extracted from large animals and from an enzyme obtained from snake venom. The present study, developed in the Health Education Clinic (CEPS) of Sacred Heart University (USC) aimed to evaluate the effect of the new sealant on the healing process of venous ulcers in 24 adult patients, seven of whom were male and 17 female. Two study groups were formed as follows: Group 1 (G1) - control group of 11 patients treated with essential fatty acid (EFA) and Unna's boot, and Group 2 (G2) - 13 patients treated with essential fatty acid (EFA), fibrin sealant and Unna's boot. The follow-up lasted eight weeks and the sealant was applied at only the first and fourth weeks. The results showed that Group 2 presented worse lesion conditions as to healing, but, when comparing the two groups, it was noteworthy that the the sealant was effective in healing venous ulcers...

Putative new heat-stable cytotoxic and enterotoxic factors in culture supernatant of Escherichia coli isolated from drinking water

Enteric infections caused by the ingestion of contaminated water, especially by Escherichia coli, are important to define the virulence properties of these bacteria. Due to frequent infantile diarrhea in the city of Ouro Preto, Minas Gerais state, Brazil, the phenotypic and genotypic diarrheagenic properties of E. coli isolated from drinking water were studied. The culture supernatants of 39 (40 percent) among a total of 97 E. coli isolates from drinking water were positive by suckling mouse assay and induced cytotoxic effects on Vero cells. The enterotoxic and cytotoxic activities were present in the fraction with less than 10 kDa and were not lost when heated up to 60¨¬C and 100¨¬C for 30 minutes. PCR assays showed that among these 39 Vero cytotoxigenic E. coli, four (10.2 percent) were positive for ST II (estB) and two (5 percent) positive for ¥áHly (hlyA). Gene amplification of SLT (stx 1, stx 2), ST I (estA), LT (eltI, eltII), EAST1 (astA), EHly (enhly) and plasmid-encoded enterotoxin (pet) were not observed. This heat-stable cytotoxic enterotoxin of E. coli is probably a new putative diarrheagenic virulence factor, as a toxin presenting these characteristics has not yet been described.

Molecular basis for porcine parvovirus detection in dead fetuses

Reproductive failures are still common grounds for complaint by commercial swine producers. Porcine parvovirus (PPV) is associated with different clinical reproductive signs. The aim of the present study was to investigate PPV fetal infection at swine farms having ongoing reproductive performance problems. The presence of virus in fetal tissues was determined by nested-polymerase chain reaction assay directed to the conserved NS1 gene of PPV in aborted fetuses, mummies and stillborns. Fetuses show a high frequency of PPV infection (96.4%; n = 28). In 60.7% of the fetuses, PPV were detected in all tissue samples (lung, heart, thymus, kidney, and spleen). Viral infection differed among fetal tissues, with a higher frequency in the lung and heart (p < 0.05). Fetuses with up to 99 days of gestational age and from younger sows showed a higher frequency of PPV (p < 0.05). No significant difference in the presence of PPV was detected among the three clinical presentations. The results suggest that PPV remains an important pathogenic agent associated with porcine fetal death.

Hiperparatiroidismo primario (HPTP) / Primary Hyperparathyroidism (PHPT)

Se revisa el hiperparatiroidismo primario (HPTP) en sus diferentes aspectos. Se destaca su prevalencia entre el conjunto de las hipercalcemias (20 por ciento). Se analiza la dificultad de establecer su diagnostico en pacientes asintomaticos. Se describen las diferentes formas de presentacion clinica asi como su evolucion. Se establece su anatomia patologica con 85 por ciento de adenomas; 10-15 por ciento de hiperplasia de celulas principales y 1-3 por ciento de carcinoma. Se describe su estudio paraclinico, teniendo en cuenta el costo-beneficio, proponiendose un algoritmo de estudio. Se discute el tratamiento medico-quirurgico entre formas asintomaticas y sintomaticas

Teste de coaglutinaçäo para detecçäo de rotavirus / Coagglutination assay for detection of rotaviruses

Resumo: O teste de coaglutinaçäo foi utilizado para a detecçäo de rotavírus em fezes de origem humana e de suínos. Suspensäo de Staphylococcus aureos, produtor de proteina A, foi sensibilizada com uma diluiçäo seriada de antissoro anti-rotavirus do grupo A mostrando que quando foi utilizada a diluiçäo a 1:20, o teste foi capaz de detectar tanto antígeno SA11 como também o extrato fecal, ambos diluídos. Um total de 89 amostras de fezes absorvidas com S. aureus foram testadas por coaglutinaçäo e por um ensaio imunoenzimático. A análise estatística dos resultados obtidos mostrou uma concordância de 0,91 entre os dois testes o que levou-nos a conluir que a coaglutinaçäo é um método simples, rápido, sensível e pouco dispendioso para a detecçäo de rotavírus diretamente do material fecal. Além da utilizaçäo do soro diluído para a sensibilizaçäo de s> aureus ficou demonstrado também que, esta mistura, quando estocada a 4 graus C pode ser utilizada por até 6 meses após o seu preparo, sem implicar em resultados falso-positivos (au)

Comparison of indirect immunofluorescencee with agar gel immunodiffusion for the diagnosis of bluetongue virus infection

Sera from 190 cows and from 72 sheep were examined to compare the results obtained with the agar gel immundiffusion (AGIP) and indirect immunofluorescence (IIF) tests for the diagnosis of bluetongue (BT) disease. In the AGIP test, 96 of 190 (50.5%) cattle serum samples and 38 of 72 (52.7%) sheep serum samples were positive, for a total of 134 out of 262 (51.1%) sera. In the IIF test, 98 of 190 (51.6%) cattle serum samples and 39 of 72 (54.2%) sheep serum samples were positive, for a total of 137 out of 262 (52.3%) sera. The fluorescence of the IIF test presented a granular cytoplasmic aspect, which in some cells was observed only on the cell membranes. Statistical analysis of the data showed close agreement between the two techniques, regardless of the kind of sera examined. The IIF test showed high sensitivity (93.8% and 92.1%), specificity (91.4% and 88.2%) and positive (91.8% and 89.7%) and negative (93.48% and 90.9%) predictive values for cattle serum and sheep serum, respectively. The results obtained with obtained with IIF were comparable to those obtained with the AGIP test, indicating that both techniques can be used routinely in epidemiologic studies of BT. However, the IIF offers the additional advantages that it can be used for antibody quantification and for the detection of viral antigens in BT-infected cell lines