Imunogenicidade da proteína M recombinante de Streptococcus equi subsp. equi coadministrada com um adjuvante molecular / Immunogenicity of recombinant M protein of Streptococcus equi subsp. equi co administered with a molecular adjuvant

The strangles is an infectious disease that affects horses from all ages and causes important economic losses in the equine-related business. The aim of this work was to evaluate the immunogenicity of the recombinant M protein from Streptococcus equi (rSeM) co-administered with the recombinant heat-labile enterotoxin B subunit from Escherichia coli (rLTB) in mice and horses. A total of 72 female Balb-c mice were divided into eight groups and 18 horses were divided into six groups. The animals were inoculated by intramuscular (IM) or intranasal (IN) routes with different treatments of rSeM, rLTB and/or Al(OH)3. The results obtained in both species, independent of administration routes, demonstrated that rSeM + rLTB had higher levels of specific serum immunoglobulins, however, in mucosal immunity the increase was not identified. Thus, the use of rSeM as vaccine antigen and rLTB as adjuvant can be a potential tool in the control of equine strangles.(AU)

Neonatal screening for cystic fibrosis in São Paulo State, Brazil: a pilot study

Cystic fibrosis is one of the most common autosomal recessive hereditary diseases in the Caucasian population, with an incidence of 1:2000 to 1:3500 liveborns. More than 1000 mutations have been described with the most common being F508del. It has a prevalence of 23-55 percent within the Brazilian population. The lack of population-based studies evaluating the incidence of cystic fibrosis in São Paulo State, Brazil, and an analysis concerning the costs of implantation of a screening program motivated the present study. A total of 60,000 dried blood samples from Guthrie cards obtained from April 2005 to January 2006 for neonatal screening at 4 reference centers in São Paulo State were analyzed. The immunoreactive trypsinogen (IRT)/IRT protocol was used with the cut-off value being 70 ng/mL. A total of 532 children (0.9 percent) showed IRT >70 ng/mL and a 2nd sample was collected from 418 (80.3 percent) of these patients. Four affected children were detected at two centers, corresponding to an incidence of 1:8403. The average age at diagnosis was 69 days, and 3 of the children already showed severe symptoms of the disease. The rate of false-positive results was 95.2 percent and the positive predictive value for the test was 8 percent. The cost of detecting an affected subject was approximately US$8,000.00 when this cystic fibrosis program was added to an existing neonatal screening program. The present study clearly shows the difficulties involved in cystic fibrosis screening using the IRT/IRT protocol, particularly in a population with no long-term tradition of neonatal screening.

How frequently should a patient taking amiodarone be screened for thyroid dysfunction?

Amiodarone-induced thyroid dysfunction (AITD) is a common complication of amiodarone therapy and its prevalence varies according to iodine intake, subclinical thyroid disorders and the definition of AITD. There is no consensus about the frequency of screening for this condition. We evaluated 121 patients on chronic regular intake of amiodarone (mean intake = 248.5 ± 89 mg; duration of treatment = 5.3 ± 3.9 years, range = 0.57-17 years) and with stable baseline cardiac condition. Those with noAITD were followed up for a median period of 3.2 years (range: 0.6-6.7) and the incidence rate of AITD, defined by clinical and laboratorial findings as proposed by international guidelines, was obtained (62.8 per 1000 patients/year). We applied the Coxproportional hazard model to adjust for potential confounding factors and used sensitivity analysis to identify the best screening time for follow-up. We detected thyroid dysfunction in 59 (48.7%) of the 121 patients, amiodarone-induced hypothyroidism in50 (41.3%) and hyperthyroidism in 9 (7.5%). Compared with patients without AITD, there was no difference regarding dosage or duration of therapy, heart rhythm disorder or baseline cardiac condition. During the follow-up of the 62 patients without AITD at baseline evaluation, 11 developed AITD (interquartile range, IR: 62.8 (95%CI: 31.3-112.3) cases per 1000 patients/year), 9 of them with hypothyroidism - IR: 11.4 (95%CI: 1.38-41.2), and 2 hyperthyroidism - IR: 51.3 (95%CI: 23.4-97.5). Age, gender,dose, and duration of treatment were not significant after adjustment. During the first 6 months of follow-up the incidence rate for AITD was 39.3 (9.2-61.9) cases per 1000 patients/year. These data show that AITD is quite common, and support the need for screening at 6-month intervals, unless clinical follow-up dictates otherwise or further information regarding the prognosis of untreated subclinical AITD is available.

Memories and history of Hansens disease in Brazil told by witnesses (1960-2000)

Este trabalho é um resultado preliminar de pesquisa sobre a memória e história da hanseníase, deseenvolvida pela Fundação Oswaldo Cruz (Fiocruz) e Universidade Federal do Rio de Janeiro (UFRJ), através de depoimentos de quem padeceu da doença ou atuou contra ela. Apresenta as opções metodológicas adotadas pelos autores, um sucinto histórico da hanseníase no Brasil e dados a respeito do estágio em que se encontra a pesquisa, com extratos de depoimentos que constituem o acervo gerado. Na década de 1980 houve avanços, como a adoção do tratamento através da poliquimioterapia, que provocou a redução do índice de prevalência da doença, que passou de 16,3 casos por dez mil habitantes em 1985, para 4,57 casos para dez mil habitantes em 2000, em nosso país. A gênese e as atividades do Movimento de Reintegração das Pessoas Atingidas pela Hanseníase (Morban) são reveladas pelos testemunhos de Thomas Frist, cientista social norte-americano que trabalhou no Brasil nas décadas de 1970 e 1980, período de reestruturação das antigas colônias, e pelo de Cristiano Torres, ex-paciente, com passagens por preventórios e leprosários no Pará, personagem atuante, inclusive na proposição de políticas de controle da hanseníase

Depressed respiratory sinus arrhythmia: additional evidence for impairment of vagal activity in human hyperthyroidism

The efferent activity of the parasympathetic component of the autonomic nervous system was evaluated by measuring the magnitude of the respiratory sinus arrhythmia in 3 female patients with hyperthyroidism (Basedow-Graves' disease) before and after treatment. The heart rate variations induced by the test increased in all patients after treatment of thyrotoxicosis (from 15 + or - 2.9 to 28.3 + or - 6.6 beats/min; mean + or - SEM) with propylthiouracil (600 mg/day). This result confirms our previous observations indicating an important and reversible impairment of the efferent vagal activity in human hyperthyroidism

Dados sobre 508 casos de doença do pânico e respostas ao tratamento com alprozolam, clomipramina, imipramina e tranilcipromina / Data about 508 cases of panic disorders and response of treatment with alprazolam, clomipramine, imipramine and tranylcypromine

Quinhentos e oito casos de Doenças do Pânico foram estudados. A evitaçäo fóbica está correlacionada freqüentemente aos ataques de pânico. Em apenas 23% dos pacientes, o diagnóstico de depressäo maior, no passado ou presente, foi dado. Em 238 casos, Alprazolam, Clomipramina, Imipramina e Tranilcipromina foram efetivos em doses mais baixas do que as citadas na literatura. Como cada uma das medicaçöes tem alguns inconvenientes específicos, nenhuma foi considerada superior às outras