Molecular diversity of human parvovirus B19 during two outbreaks of erythema infectiosum in Brazil

Abstract This study was conducted to provide information on the genetic diversity of human parvovirus B19 (B19V) circulating in the municipality of Niterói, Rio de Janeiro, Southeast Brazil during 1996-2006, a period with two distinct outbreaks of B19V infection: 1999-2000 and 2004-2005. A total of 27 sera from patients with erythema infectiosum and five sera from HIV-infected patients that tested positive for B19V DNA during the study period were analyzed. To genotype B19V strains, a semi-nested PCR for partial amplification of the capsid gene was performed and sequence analysis revealed that 31 sequences belonged to subgenotype 1a (G1a) of the main genotype 1 and one sequence was characterized as subgenotype 3b (G3b). The phylogenetic tree supported the division of the G1a into two well-defined clades with 1.3% of divergence. The low diversity of the G1a strains may be explained by the fact that all patients had acute B19V infection and 30/32 sera were collected during two distinct outbreaks. The G3b strain was from an HIV-infected patient who seroconverted to anti-B19 IgG antibodies in September/2005. This is the first report of G3b in the state of Rio de Janeiro.

Cytotoxic effects of the novel isoflavone, phenoxodiol, on prostate cancer cell lines.

Phenoxodiol is an isoflavone derivative that has been shown to elicit cytotoxic effects against a broad range of human cancers. We examined the effect of phenoxodiol on cell death pathways on the prostate cell lines LNCaP, DU145 and PC3, representative of different stages of prostate cancer, and its effects on cell death pathways in these cell lines. Cell proliferation assays demonstrated a significant reduction in the rate of cell proliferation after 48 h exposure to phenoxodiol (10 and 30 μM). FACS analysis and 3′-end labelling indicated that all three prostate cancer cell lines underwent substantial levels of cell death 48 h after treatment. Mitochondrial membrane depolarization, indicative of early-stage cell death signalling, using JC-1 detection, was also apparent in all cell lines after exposure to phenoxodiol in the absence of caspase-3 activation. Caspase inhibition assays indicated that phenoxodiol operates through a caspase-independent cell death pathway. These data demonstrate that phenoxodiol elicits anti-cancer effects in prostate cancer cell lines representative of early and later stages of development through an as-yet-unknown cell death mechanism. These data warrant the further investigation of phenoxodiol as a potential treatment for prostate cancer.

Economic value of disability-adjusted life years lost to violence: estimates for WHO Member States / Valor económico de los años de vida ajustados por discapacidad perdidos por la violencia: cálculos para los Estados Miembros de la OMS

Violence is an important public health challenge with substantial economic consequences for the affected individuals, families, and communities. Using data from the World Health Organization (WHO) and the World Bank, the economic value of disability-adjusted life years (DALYs) lost due to violence in 2002 was estimated for WHO Member States and presented as a percentage of gross domestic product (GDP). Results indicated an estimated 48.4 million DALYs were lost as a result of 1.6 million deaths due to violence in 2002, for a total estimated economic value of US$ 151 billion (in constant US$ for the year 2000). Expressed as a percentage of GDP, the economic value of DALYs lost due to violence ranged from 0.04 percent to 5.1 percent across the 193 Member States. Much more is needed in terms of quantifying the economic burden of violence globally, particularly in low- and middle-income countries, where the burden of violence is greatest.

La violencia es un importante reto para la salud pública y conlleva considerables consecuencias económicas para las personas afectadas, sus familias y la comunidad. A partir de datos de la Organización Mundial de la Salud (OMS) y del Banco Mundial se estimó el valor económico de los años de vida ajustados por discapacidad (AVAD) perdidos en 2002 por la violencia. Los datos de los Estados Miembros de la OMS se presentan como porcentajes de su producto interno bruto (PIB). Según los resultados, se perdieron 48,4 millones de AVAD como resultado de 1,6 millones de muertes por violencia en el año 2002, para un valor económico total estimado de US$ 151 000 millones (en dólares estadounidenses de 2002). El valor económico de los AVAD perdidos por la violencia en los 193 Estados Miembros de la OMS varió de 0,04 por ciento a 5,1 por ciento de su PIB. Se debe hacer un mayor esfuerzo en la cuantificación de la carga económica de la violencia en el mundo, particularmente en los países de ingresos bajos y medios, donde la carga de la violencia alcanza los mayores valores.

Costs of injuries due to interpersonal and self-directed violence in Thailand, 2005.

Violence, a serious public health problem in Thailand, remains largely unknown for its economic costs. This study is a national-level economic cost-estimates of injury from interpersonal and self-directed violence for Thailand during 2005 using the World Health Organization-US Centers for Disease Control and Prevention's guidelines. Direct medical costs from self-directed violence totaled 569 million Baht (THB) while the cost of interpersonal violence was THB 1.3 billion. Productivity losses for injuries due to self-directed violence were estimated at THB 12.2 billion and those for interpersonal violence were THB 14.4 billion. The total direct medical cost, thus, accounted for about 4% of Thailand's total health budget while the productivity losses accounted for approximately 0.4% of Thailand s GDP In summary, interpersonal and self-directed violence caused a total loss of 33.8 billion baht for Thailand in 2005. More than 90% of the economic loss was incurred from productivity loss and about four-fifths came from men.

Mejoría de la función ventricular sistólica en pacientes pediátricos y/o portadores de cardiopatías congénitas sometidos a resincronización cardíaca / Cardiac resynchronization therapy is associated with improved systolic ventricular function in pediatrics and congenital heart disease

Antecedentes: Diversas publicaciones han validado el uso terapéutico de resincronización cardíaca en adultos portadores de insuficiencia cardíaca, pero la experiencia en pacientes pediátricos y en pacientes portadores de cardiopatías congénitas es limitada. Objetivo: Determinar los resultados de resincronización cardíaca en pacientes pediátricos y/o portadores de cardiopatías congénitas.Método: Revisión retrospectiva de los antecedentes clínicos, ecocardiogramas y electrocardiogramas en 40 pacientes consecutivos con disfunción ventricular, tratados con resincronización cardíaca entre septiembre 2002 y julio 2006 en el Children's Hospital Boston.Resultados: Al momento del implante la mediana de edad fue 16,4 años (4 meses-47años). Cinco pacientes teníancorazón estructuralmente normal, 33 eran portadores de cardiopatía congénita y 2 tenían diagnóstico de miocardiopatía. Dieciocho pacientes (45 por ciento) tenían marcapaso definitivo. La mediana de seguimiento fue 1,7 años (2 meses-4 años). Cinco pacientes no usan su sistema de estimulación biventricular. La función ventricular mejoró en 30/35 pacientes (85,7 por ciento). La fracción de eyección aumentó de 31,4 a 41,5 por ciento, principalmente como consecuencia de disminución del volumen ventricular izquierdo de fin de sístole, con mínima disminución del volumen ventricular izquierdo de fin de diástole. Cinco pacientes no respondieron y no se identificaron factores predictores de los no respondedores. Análisis por intención de tratar reflejamejoría en 30/40 pacientes (75 por ciento). Conclusión: La resincronización cardíaca produce mejoría de la función ventricular en un porcentaje significativo de unapoblación seleccionada de pacientes pediátricos y/o portadores de cardiopatías congénitas, predominantemente asociada con disminución del volumen ventricular izquierdo de fin de sístole. Estos hallazgos pueden tener importante relevancia en el tratamiento a largo plazo de este grupo de pacientes.

Anestesia Regional en el paciente anticoagulado: Definición de riesgos / Regional anesthesia in the patient one anticoagulado: Definition of risks

Se ha documentado en numerosos estudios clínicos la seguridad de administrar anestesia y analgesia neuroaxial en pacientes anticoagulados. El manejo de estos pacientes se basa en la relación entre el momento apropiado para colocar la aguja y retirar el catéter, con el tiempo en que se administró el fármaco anticoagulante. La familiaridad con la farmacología de los anticoagulantes, con los estudios clínicos realizados en pacientes que recibieron bloqueo neuroaxial estando bajo tratamiento con estos fármacos, y los reportes de casos de hematoma espinal, son los factores que deben guiar al clínico en la toma de decisiones. Han surgido nuevos retos en el manejo de pacientes anticoagulados que van a ser sometidos a bloqueo neuroaxial, a medida que se han establecido los protocolos para la prevención del tromboembolismo venoso perioperatorio. Igualmente, la introducción en el mercado de nuevos fármacos anticoagulantes y antiplaquetarios más eficaces ha ocasionado que el manejo de estos pacientes sea más complejo. En respuesta a estos tópicos que afectan la seguridad de estos pacientes, la Sociedad Americana de Anestesia Regional y Medicina del Dolor (ASRA) reunió la Segunda Conferencia de Consenso de Opinión sobre Anestesia Neuroaxial y Anticoagulación. Es importante hacer notar que aún cuando las declaraciones del Consenso se basan en una evaluación completa de la información disponible, en algunos aspectos la información es escasa. El desacuerdo con las recomendaciones contenidas en este documento puede ser aceptable si está basado en el buen juicio del anestesiólogo responsable. Las conclusiones del Consenso están diseñadas para fomentar la seguridad y la calidad del cuidado del paciente, pero no pueden garantizar un resultado específico. Ellas están sujetas a una revisión periódica, en la medida que la evolución de la información y de la práctica lo justifiquen. Finalmente, la información actual se enfoca en el bloqueo neuroaxial y los anticoagulantes; el riesgo que existe con la administración de técnicas regionales periféricas o de plexos en pacientes anticoagulados aun no se ha definido. Provisionalmente, las conclusiones de este Consenso de Opinión de Anestesia Neuroaxial y Anticoagulación pueden aplicarse de manera conservadora en las técnicas regionales periféricas y de plexos. Sin embargo, estas recomendaciones pueden ser más restrictivas de lo necesario...

Community prevalence of antibodies to human immunodeficiency virus in rural and urban Vellore, Tamil Nadu.

BACKGROUND: Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are becoming increasingly common in India. Currently, antenatal prevalence is a surrogate marker for HIV prevalence in the community. The association between antenatal and community prevalence of HIV needs to be validated so that estimates can be verified or adjusted appropriately. METHODS: A probability proportional to size cluster survey was conducted in the Kaniyambadi block of Vellore district and in the urban wards of Vellore town to estimate the prevalence of antibodies to rubella from August 1999 to February 2000. All personal identifier data from the serum samples were removed to yield a collection for which only the age and sex were known. Estimation of antibodies to HIV in sera from individuals between 15 and 40 years of age, was carried out by one screening ELISA and the reactive sera were further subjected to a supplementary test. RESULTS: We tested 1512 serum samples from subjects residing in rural areas and 1358 samples from those residing in urban areas. The seropositivity among rural samples was 0.66% and among urban samples 1.4%. The prevalence was almost equal among men and women and the youngest infected individual was 15 years old. CONCLUSION: The prevalence of HIV during the period of study was similar to the national surveillance data for Tamil Nadu based on antenatal women. HIV prevalence differs in urban and rural Tamil Nadu, with urban areas having a higher burden of the disease.

Quantitation of HCV RNA in liver of patients with chronic hepatits C

Background/Aims - Liver HCV RNA has been quantitated in few studies and the feasibility and the role of this parameter in the evaluation of patients with chronic HCV hepatitis still warant study. Our aim was to determine the concentrations of HCV RNA in the liver of cronic HCV patients and the correlate the results with serum viral load. We also studied the relation of leves of HCV RNA in the liver with serum aminotransferase levels and with the presence of cirrhosis. Methods-Twenty patients (14 males, aged 28 to 61 years) were studied. Twelve were infected by HCV type 1, six by type 3 and one by type 5. Percutaneos liver biopsy samples were obtained from 14 patients, and the remaider from liver explant in patients undergoing OLT. Twelve had chronic hepatitis and eight cirrhosis.HCV RNA levels were determined by bDNA. Results- HCV RNA levels below the detection limit were found in one liver and in five serum samples. HCV RNA ( mean +/- SD) was 2.1x10 8 +/- 2.2x10 8 Eq/gm in the liver and 94x10 5 +/- 93x10 5 Eq/gL in serum, with a significantly correlation between these values (r=0.89; P<0.0001). Serum HCV RNA levels were significantly lower (P=0.001) in cirrhotic than in chronic hepatitis patients, while the groups did not differ in liver HCV RNA levels. No correlation was observed between liver or serum HCV RNA and serum ALT or AST. Conclusions- Quantitation of HCV RNA is possible even en small liver samples. Although averange levels are more than one log higher than those observed in serum, hepatic concentrations correlate with those observed in serum. The application of this technology to monitoring antiviral therapy and understanding the pathogenesis of the disease remains to be determined.

Diagnosis of rubella infection by detecting specific immunoglobulin M antibodies in saliva samples: a clinic-based study in Niterói, RJ, Brazil

Este estudo foi realizado para avaliar a validade da utilizaçäo da saliva no diagnóstico laboratorial da rubéola. Quarenta e cinco amostras pareadas de sangue e de saliva, coletadas de 1 a 29 dias após o início da doença, foram testadas para detecçäo de imunoglobulina (Ig) M específica por radioimunoensaio com captura (MACRIA). Anticorpos IgM específicos contra rubéola foram detectados em todas as amostras sanguíneas e em 38 (84,4 por cento) das amostras de saliva. A especificidade do teste na saliva foi de 96 por cento. Estes resultados indicam que a utilizaçäo da saliva pode ser uma alternativa válida para obtençäo de espécimens clínicos na investigaçäo de casos recentes de rubéola, especialmente nas atividades de vigilância epidemiológica e controle da virose