Sentinel node biopsy using blue dye and technetium99 in advanced gastric cancer: anatomical drainage and clinical application

Lymph node metastases are an independent prognosis factor in gastric carcinoma (GC) patients. Radical lymphadenectomy can improve survival but it can also increase surgical morbidity. As a principle, sentinel node (SN) navigation surgery can avoid unnecessary lymphadenectomy without compromising prognosis. In this pilot study, 24 patients with untreated GC were initially screened for SN navigation surgery, of which 12 were eligible. Five patients had T2 tumors, 5 had T3 tumors and 2 had T1 tumors. In 33% of cases, tumor diameter was greater than 5.0 cm. Three hundred and eighty-seven lymph nodes were excised with a median of 32.3 per patient. The SN navigation surgery was feasible in all patients, with a median of 4.5 SNs per patient. The detection success rate was 100%. All the SNs were located in N1 and N2 nodal level. In 70.9% of cases, the SNs were located at lymphatic chains 6 and 7. The SN sensitivity for nodal staging was 91.6%, with 8.3% of false negative. In 4 patients who were initially staged as N0, the SNs were submitted to multisection analyses and immunohistochemistry, confirming the N0 stage, without micrometastases. In one case initially staged as negative for nodal metastases based on SN analyses, metastases in lymph nodes other than SN were found, resulting in a 20% skip metastases incidence. This surgery is a reproducible procedure with 100% detection rate of SN. Tumor size, GC location and obesity were factors that imposed some limitations regarding SN identification. Results from nodal multisection histology and immunohistochemistry analysis did not change initial nodal staging.

Sistema de vigilancia epidemiológica comunitaria bonis: estado actualy proyecciones futuras / Community epidemiological surveillance system bonis: current status and future projections

El sistema actual de vigilancia epidemiológica en la zona del Centro de Ayuda Mutua y Salud para Todos (CAMSAT) del Bañado Sur, de Asunción, se basa en la búsqueda rutinaria de posibles casos febriles mediante visitas domiciliarias, realizadas por las agentes comunitarias adscritas a la Unidad de Salud Familiar (USF). Cada una de las diezagentes comunitarias de CAMSAT tiene asignada 150 hogares, y los resultados de susvisitas domiciliarias quedan recogidos en planillas que se reportan mediante medios tradicionales (papel, correo interno, fax, etc.) a la DGVS del Ministerio de Salud. La consecuencia de este modo de trabajo es que muchas veces las acciones de bloqueo de la transmisión llegan tarde con el coste social y económico que ello significa. El sistema Bonis introduce la telefonía móvil como elemento catalizador para transformar la búsqueda rutinaria de posibles casos febriles en una acción proactiva, y también la utilización de tecnologías web y bases de datos para el registro de pacientes y su correspondiente seguimiento por el personal sanitario. La utilización de estas tecnologíasde la información y comunicación (TICs) transforman el sistema de vigilancia epidemiológica en un caso de estudio de e-Salud en Paraguay. Se describe el estado actual y proyecciones futuras del sistema de vigilancia epidemiológica comunitaria “Bonis”,que utiliza las TICs para prevenir, alertar, supervisar y controlar la expansión de síndromes febriles en un área de influencia del Hospital Barrio Obrero (HBO), en la Unidad de Atención Primaria en Salud del Centro de Ayuda Mutua y Salud para Todos, Asunción,Paraguay.

The current system of epidemiologic surveillance in the area of Mutual Aid Centre and Health for All (CAMSAT in Spanish) in the “Bañado Sur” in Asuncion is based on routine screening of possible febrile cases through home visits made by community agents fromthe Primary Health Care Unit (USF in Spanish). Each of the ten community agents are assigned to 150 households and the results of these home visits are recorded on sheets that are reported through traditional means (paper, internal mail, fax, etc.) to the DGVSof the Ministry of Health. The consequence of this working system is that often the blocking actions arrive late with the social and economic costs that this implies. The Bonis system uses the mobile phone as a catalyst to transform the routine screening ofpotential feverish cases in a proactive action and the web technology and databases for patient records and appropriate follow-up by health personnel. The use of theseinformation and communication technologies of (ICTs) transforms the Epidemiological Surveillance System in a study case of e-Health in Paraguay. This document describes the current status and future projections of the community epidemiological surveillancesystem Bonis which uses Information and Communication Technologies (ICTs) to prevent, warn, monitor and control the spread of febrile syndromes in a catchment area of Barrio Obrero Hospital (HBO), Unit of Primary Health Care Center Mutual Aid and Health for All, Asuncion, Paraguay.

Telemedicina: metas y aplicaciones / Telemedicine: fine and applicability

La atención sanitaria ha ido variando en las últimas décadas, pasando de una asistenciaenfocada a la enfermedad, a una atención dirigida al ciudadano, más global dondeconceptos como calidad, costes, equidad y continuidad cobran nuevos valores. El enfoquede atención no es sólo tratar cuando la enfermedad llega, sino crear y promover hábitossaludables de vida y prevención de la enfermedad. En la actualidad las tecnologías deinformación y comunicación se han combinado para dar lugar a la telemedicina a fin debrindar asistencia médica a quien la requiera en sitios distantes, se incluye dentro de estecampo a la educación para la salud, salud pública y comunitaria, el desarrollo deprogramas de salud y de prevención, estudios epidemiológicos entre otros. Así mismo, laamplia utilización de Internet ha contribuido a masificar el uso de estos servicios, es asícomo ha nacido un nuevo término conocido como “e-health”, el cual acuña cualquierpráctica de la telemedicina usando esta red. En este artículo se desea incorporarinformación sobre esta disciplina que se encuentra entre medicina y tecnología, la mismapuede proveer un apoyo importante pero su aprovechamiento dependerá de losdiferentes actores envueltos en la implementación.

Implementación de un Sistema de Telemedicina/Telesalud en el Institutode Investigaciones en Ciencias de la Salud (IICS). Estudio Piloto / Implementation of a Telemedicine/Telehealth system at the Institute of

Los procesos de reforma del sector salud orientados hacia una mayor equidad en laprestación de servicios, mayor preocupación por la efectividad y utilidad de lastecnologías para la salud, han contribuido para que la telemedicina sea considerada en lospaíses industrializados y en vías de desarrollo como una herramienta para mejorar laatención de la salud de poblaciones remotas que no tienen acceso a los especialistas. Esteestudio observacional y descriptivo realizado por el Dpto. de Ingeniería Biomédica eImágenes, con el apoyo de la División de Informática del IICS y el Centro Nacional deComputación de la UNA para relevar y analizar las imágenes de 294 pacientes e informestransmitidos por las áreas de ecografía, medicina nuclear y electrocardiografía, incluidosen el proyecto piloto. De los cuales, 254 (86,4 por ciento) correspondieron al servicio de MedicinaNuclear (Centellografía) y completan el grupo los estudios por imágenes ecográficas yelectrocardiográficas. El 49 por ciento fueron gammagrafía de tiroides, 22 por ciento gammagrafías óseas,habiéndose realizado también renogramas isotópicos, gammagrafía hepática, ecografíasde tiroides, abdominales. El tiempo empleado en todo el proceso desde el ingreso delpaciente hasta el informe medico varió en un promedio de 107 a 123 minutos según tipode estudio solicitado.

Dengue y leptospirosis compartiendo el mismo nicho ecológico en la localidad ribereña de Carmen del Paraná (Itapúa) / Dengue and leptospirosis share the same ecological niche in Carmen del Paraná (Itapua), a riverside locality

Para conocer la prevalencia de dengue y leptospirosis en pobladores de Carmen del Paraná (Itapúa) realizamos un estudio transversal descriptivo. Aplicamos un cuestionario y toma de muestras sanguíneas, mediante un muestreo por hogares. Los jefes de familia fueron informados sobre la metodología, beneficios, posibles riesgos a fin de decidir su participación o de sus familiares en el estudio. Por el método de ELISA determinamos la presencia de anticuerpos IgG anti-leptospira en 211 mujeres y 107 varones, contra el virus del dengue en 255 mujeres y 142 varones. Hallamos una seroprevalencia de dengue de 25% (IC 95%:20,7-29,4), no habiendo diferencia entre varones y mujeres. La prevalencia de leptospirosis fue de 24,1% (IC95%:19,6-29,2), siendo mayor en mujeres que en varones (28,4% vs 15,9%; p <0,05). La seroprevalencia de dengue fue más alta en los mayores de 35 años (36% vs 17%, p<0,001), mientras que la leptospirosis lo fue en menores de 15 años (48% vs 21,6%, p<0,001). El 8% de los individuos tenía serología positiva tanto para leptospira como para dengue. En esta comunidad, un importante número de individuos tiene riesgo de desarrollar dengue hemorrágico. La coexistencia de dengue y leptospirosis en el mismo nicho ecológico es importante porqueal presentar características clínicas semejantes, implican un problema para el médico al momento de establecer el diagnóstico oportuno y el tratamiento apropiado, entonces sería importante el desarrollo de estrategias integrales de vigilancia epidemiológica, prevención y control de estas enfermedades que se basen en la participación conjunta del personal de salud, autoridades y comunidad.

This cross-sectional descriptive study was carried out to know the prevalence of dengue and leptospirosis in the inhabitants of Carmen del Paraná (Itapúa). Through a house hold sampling, we applied a questionnaire and collected blood samples. The heads of the families were informed about the methodology, benefits and possible risks so that they could decide about the participation of their families in the study. The presence of anti-leptospira IgG antibodies was determined by ELISA method in 320 individuals (211women and 107 men) and anti-dengue virus antibodies in 399 individuals (255 women and 142 men). We found a dengue virus seroprevalence 25% (IC 95 %:20.7-29.4) without any differences between men and women. The prevalence of leptospirosis was24.1% (IC95 %:19.6-29.2), higher in women than in men (28.4 % vs. 15.9 %; p value <0.05). Dengue seroprevalence was higher in the age group older than 35 years old(36% vs. 17%, value of p <0.001), where as leptospirosis was more prevalent in those younger than 15 years old (48% vs 21.6%, p value <0.001). Eight percent of the individuals who were leptospira positive were also dengue positive. In this community, there is an important number of individuals who has a risk of developing hemorrhagicdengue. The coexistence of dengue and leptospirosis in the same ecological niche is important because both diseases presented similar clinical characteristics, implying a problem for the physician at the time of determining the appropriate diagnosis andtreatment. Therefore, it would be important to develop integral strategies of epidemiological surveillance, prevention and control of these diseases, based on the jointparticipation of healthcare personnel, authorities and community.

Análise da distribuição da região dos ferimentos provocados por morcegos hematófagos Desmodus rotundus (Geoffroy, 1810) em bovinos sob condições de campo / Topographic analysis of wounds caused by the vampire bat Desmodus rotundus (Geoffroy, 1810) in cattle under field conditions

Existem diversas espécies de morcegos no Brasil, sendo somente três hematófagas. O morcego Desmodus rotundus (Geoffroy, 1810), conhecido como "morcego vampiro comum", apresenta-se amplamente distribuído por todo território brasileiro e é encontrado em maior número do que as outras espécies de morcegos hematófagos. É responsável pela transmissão de diferentes doenças a outros mamíferos, especialmente a raiva nos herbívoros. Com o objetivo de avaliar regionalmente os ferimentos causados pelo D. rotundus em bovinos sob condições de campo, foram estudadas 12 propriedades rurais no período de março de 2005 a março de 2006 no Município de Valença, RJ. De um total de 580 bovinos examinados, foram observados 101 com ferimentos provocados por morcegos hematófagos (D. rotundus). Após análise dos resultados, pôde-se concluir que D. rotundus utiliza diferentes locais para se alimentar nos bovinos e as regiões corporais que apresentaram maior número de ferimentos foram a ântero e a póstero-superior. O elevado número de ferimentos encontrados, na metade superior dos bovinos (85,87%), justifica a adoção de metodologias de controle populacional de morcegos hematófagos que utilizem o contato corporal desses morcegos com o dorso do animal.

Brazil possesses a large amount of bat species, only 3 of which are haematophagous. The most abundant species, Desmodus rotundus (Geoffroy, 1810), is widely distributed throughout the Brazilian territory and it is involved in the transmission of several diseases to other animals, notably to herbivorous species, in the case of rabies. This study presents the topographical analysis of wounds caused by D. rotundus in bovines from 12 different rural properties in the county of Valença, state of Rio de Janeiro, where 101 bovines out of 580 examined in a year showed wounds caused by haematophagous bats. Analysis of the results leads to the conclusion that D. rotundus uses different sites to feed from the bovine's body and that the superior body region was the most frequently used. The increased number of wounds found in the bovine's superior half region (85.87%) will justify the use of bat population control methodologies which take into consideration the bat's corporal contact with the dorsal region of bovines.

La reactogenicidad y los aspectos inmune específicos de la vacuna pentavalente combinada: DTPw-HepB-Hib en el lactante menor de un año en el Hospital Distrital de Lambaré, Paraguay en 2007-2008 / The reactogenicity and specific immune aspects of the combined pentavalent vaccine: DTPw-HepB-Hib in breastfed babies under one year of age that attended the District Hospital of Lambaré, Paraguay in 2007 and 2008

La vacunación rutinaria de difteria, pertussis y tétanos a células enteras (DPTw) está presente desde 1940 y con elevadas coberturas en muchos países del mundo. La Organización Mundial de la Salud ha aprobado el uso universal de la vacuna anti-hepatitis B (HB) y combinaciones con DPT, en los últimos años ha sido incorporada la vacuna anti-Haemophilus influenzae tipo b (Hib) en programas de vacunación del niño. Es aplicada en Paraguay desde el 2002 a través del Programa Ampliado de Inmunizaciones del Ministerio de Salud Pública y Bienestar Social. Determinamos la reactoinmunogenicidad secundaria a la vacunación primaria pentavalente combinada en infantes concurrentes al Hospital Distrital de Lambaré­Paraguay en los años 2007-2008. Estudio longitudinal, observacional prospectivo de los efectos secundarios y los aspectos inmune- específicos de la vacuna Berna DTPw-HepB-Hib (QUINVAXEMTM) en lactantes menores de un año, a los 2 meses de edad, datos basales y post vacunales (1 mes luego de 3ª dosis). Efectos locales: 30(75%); rubor 17 (42.5%); tumefacción (menos 20 mm); 13 (32.5%); calor local 11 (27.5%). Efectos generales: fiebre: 37 (92.5%) llanto fuerte y persistente: 32(80%); irritabilidad: 23 (57.5%); hiporreactividad 16 (40%), anorexia 8 (20%); Inmunogenicidad: antes de la 1ª dosis; antitetánica IgG (+) 38/40 (95%), anti-difteria (+) IgG 29/40 (72.5%); anti-HBsAg 0/40 (0%) negativos. Respuesta post-vacuna penta comb. (7m. edad): antitetánica IgG 14/14 (100%) (+); anti-difteria IgG 12/14 (83%) (+); anti-HBsAg 14/14 (100%) positivos. Se evidencia la reactogenicidad de grado variable y decreciente. Niveles de anticuerpos de los componentes DT, satisfactorios y la Hep B excelentes

The combined cellular pentavalent vaccine is one the greatest achievements of human kind in the 20th century and is still successful in the 21st century. It is made up of five components and protects against the following diseases: diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type b. The vaccine provides specific active immunization against infections caused by Corynebacterium diphtheriae, Clostridium tetani, Bordetella pertussis, Haemophilus influenzae type B and the Hepatitis B virus in children from six weeks of age. In Paraguay, it has been used since 2002 through the Widened Program of Immunization (PAI in Spanish) of the Ministry of Public Health. The objective of this work was to determine the secondary reactoinmunogenicity to the primary combined pentavalent vaccination in children attending the District Hospital of Lambaré, Paraguay in 2007 and 2008. This is a longitudinal, prospective observational study to evaluate the secondary effects and immune-specific aspects of the Berna DTPw-HepB-Hib combined pentavalent vaccine (QUINVAXEMTM) applied to breastfed babies under one year old, of both sexes, all races, origins and nutrition statuses in the Hospital of Lambaré. The vaccination was free, according to PAI's guidelines and by consecutive sampling previous written consent of the parents, at 2 months of age. Data were collected at baseline an post-vaccination after one month and a third dose. In a total population of 40 breastfed babies, good nutrition was found in 36 (90%). Local effects were seen in 30 (75%) distributed as follows: blush in 17 (42.5%), tumefaction (less than 20 mm) in 13 (32.5%) and local heat in 11 (27.5%). General effects were distributed as follows: fever in 37 (92.5%), loud and persistent cry in 32 (80%), irritability in 23 (57.5%), hyporeactivity in 16 (40%), anorexia in 8 (20%), hypotonicity and allergy, 2 each (5%), convulsions and paralysis in none. The effects are an average after the three doses with a decreasing trend at the end. The immunogenicity basal data before the 1st dose were as follows: antitetanic IgG (+) 38/40 (95%), antidiphtheria IgG (+) 29/40 (72.5%) and anti HBs Ag (-) 0/40 (0%). Post - vaccination responses (at 7 months old) were as follows: antitetanic IgG (+) 14/14 (100%), antidiphtheria IgG (+) 12/14 (83%) and anti HBs Ag (+) 14/14 (100%). These results show a reactogenicity of variable and decreasing degree. The antibodies levels of the DT components were satisfactory and those of Hep B excellent

Normal flow-mediated vasodilatation of the brachial artery and carotid artery intima-media thickness in subclinical hypothyroidism

Subclinical hypothyroidism (SHT) is a disease for which exact therapeutic approaches have not yet been established. Previous studies have suggested an association between SHT and coronary heart disease. Whether this association is related to SHT-induced changes in serum lipid levels or to endothelial dysfunction is unclear. The aim of this study was to determine endothelial function measured by the flow-mediated vasodilatation of the brachial artery and the carotid artery intima-media thickness (IMT) in a group of women with SHT compared with euthyroid subjects. Triglycerides, total cholesterol, HDL-C, LDL-C, apoprotein A (apo A), apo B, and lipoprotein(a) were also determined. Twenty-one patients with SHT (mean age: 42.4 ± 10.8 years and mean thyroid-stimulating hormone (TSH) levels: 8.2 ± 2.7 µIU/mL) and 21 euthyroid controls matched for body mass index, age and atherosclerotic risk factors (mean age: 44.2 ± 8.5 years and mean TSH levels: 1.4 ± 0.6 µIU/mL) participated in the study. Lipid parameters (except HDL-C and apo A, which were lower) and IMT values were higher in the common carotid and carotid bifurcation of SHT patients with positive serum thyroid peroxidase antibodies (TPO-Ab) (0.62 ± 0.2 and 0.62 ± 0.16 mm for the common carotid and carotid bifurcation, respectively) when compared with the negative TPO-Ab group (0.55 ± 0.24 and 0.58 ± 0.13 mm, for common carotid and carotid bifurcation, respectively). The difference was not statistically significant. We conclude that minimal thyroid dysfunction had no adverse effects on endothelial function in the population studied. Further investigation is warranted to assess whether subclinical hypothyroidism, with and without TPO-Ab-positive serology, has any effect on endothelial function.

La reactogenicidad y los aspectos inmune específicos de la vacuna pentavalente combinada: DTPw-HepB-Hib en el lactante menor de un año en el Hospital Distrital de Lambaré, Paraguay en 2007-2008 / The reactogenicity and specific immune aspects of the combined pentavalent vaccine: DTPw-HepB-Hib in breastfed babies under one year of age that attended the District Hospital of Lambaré, Paraguay in 2007-2008

La vacunación rutinaria de difteria, pertussis y tétanos a células enteras (DPTw) está presente desde 1940 y con elevadas coberturas en muchos países del mundo. La Organización Mundial de la Salud ha aprobado el uso universal de la vacuna anti-hepatitis B (HB) y combinaciones con DPT, en los últimos años ha sido incorporada la vacuna anti-Haemophilus influenzae tipo b (Hib) en programas de vacunación del niño. Es aplicada en Paraguay desde el 2002 a través del Programa Ampliado de Inmunizaciones del Ministeriode Salud Pública y Bienestar Social. Determinamos la reactoinmunogenicidad secundaria a la vacunación primaria pentavalente combinada en infantes concurrentes al Hospital Distrital de Lambaré–Paraguay en los años 2007-2008. Estudio longitudinal,observacional prospectivo de los efectos secundarios y los aspectos inmune- específicos de la vacuna Berna DTPw-HepB-Hib (QUINVAXEMTM) en lactantes menores de un año, a los 2 meses de edad, datos basales y post vacunales (1 mes luego de 3ª dosis). Efectoslocales: 30(75%); rubor 17 (42.5%); tumefacción (menos 20 mm); 13 (32.5%); calor local 11 (27.5%). Efectos generales: fiebre: 37 (92.5%) llanto fuerte y persistente: 32(80%); irritabilidad: 23 (57.5%); hiporreactividad 16 (40%), anorexia 8 (20%); Inmunogenicidad: antes de la 1ª dosis; antitetánica IgG (+) 38/40 (95%), anti-difteria (+) IgG 29/40 (72.5%); anti-HBsAg 0/40 (0%) negativos. Respuesta post-vacuna pentacomb. (7m. edad): antitetánica IgG 14/14 (100%) (+); anti-difteria IgG 12/14 (83%) (+); anti-HBsAg 14/14 (100%) positivos. Se evidencia la reactogenicidad de grado variable y decreciente. Niveles de anticuerpos de los componentes DT, satisfactorios y laHep B excelentes.

The combined cellular pentavalent vaccine is one the greatest achievements of human kind in the 20th century and is still successful in the 21st century. It is made up of fivecomponents and protects against the following diseases: diphtheria, tetanus, pertussis, hepatitis B and Haemophilus influenzae type b. The vaccine provides specific active immunization against infections caused by Corynebacterium diphtheriae, Clostridium tetani, Bordetella pertussis, Haemophilus influenzae type B and the Hepatitis B virus in children from six weeks of age. In Paraguay, it has been used since 2002 through the Widened Program of Immunization (PAI in Spanish) of the Ministry of Public Health. Theobjective of this work was to determine the secondary reactoinmunogenicity to the primary combined pentavalent vaccination in children attending the District Hospital of Lambaré, Paraguay in 2007 and 2008. This is a longitudinal, prospective observational study to evaluate the secondary effects and immune-specific aspects of the Berna DTPw- HepB-Hib combined pentavalent vaccine (QUINVAXEMTM) applied to breastfed babies under one year old, of both sexes, all races, origins and nutrition statuses in the Hospitalof Lambaré. The vaccination was free, according to PAI's guidelines and by consecutive sampling previous written consent of the parents, at 2 months of age. Data were collected at baseline an post-vaccination after one month and a third dose. In a total population of 40 breastfed babies, good nutrition was found in 36 (90%). Local effectswere seen in 30 (75%) distributed as follows: blush in 17 (42.5%), tumefaction (less than 20 mm) in 13 (32.5%) and local heat in 11 (27.5%). General effects were distributed as follows: fever in 37 (92.5%), loud and persistent cry in 32 (80%),irritability in 23 (57.5%), hyporeactivity in 16 (40%), anorexia in 8 (20%), hypotonicity and allergy, 2 each (5%), convulsions and paralysis in none. The effects are an average after the three...

The role of IFN-gamma and IL-4 in gastric mucosa inflammation associated with Helicobacter heilmannii type 1 infection

Although Helicobacter heilmannii infection is less common than H. pylori infection in humans, it is considered to be of medical importance because of its association with gastritis, gastric ulcer, carcinoma, and mucosa-associated lymphoid tissue lymphoma of the stomach. However, there have been no studies evaluating the role of the Th cell response in H. heilmannii gastric infection. We evaluated the participation of pro-inflammatory and anti-inflammatory cytokines, IFN-gamma and IL-4, in H. heilmannii gastric infection in genetically IFN-gamma- or IL-4-deficient mice. The serum IFN-gamma and IL-4 concentrations were determined by ELISA. The gastric polymorphonuclear infiltrate was higher (P = 0.007) in H. heilmannii-positive than in H. heilmannii-negative wild-type (WT) C57BL/6 mice, whereas no significant inflammation was demonstrable in the stomach of H. heilmannii-positive IFN-gamma-/- C57BL/6 mice. The degree of gastric inflammatory cells, especially in oxyntic mucosa, was also higher (P = 0.007) in infected IL-4-/- than in WT BALB/c mice. Serum IFN-gamma levels were significantly higher in IL-4-/- than in WT BALB/c mice, independently of H. heilmannii-positive or -negative status. Although no difference in serum IFN-gamma levels was seen between H. heilmannii-positive (11.3 ± 3.07 pg/mL, mean ± SD) and -negative (11.07 ± 3.5 pg/mL) WT BALB/c mice, in the group of IL-4-/- animals, the serum concentration of IFN-g was significantly higher in the infected ones (38.16 ± 10.5 pg/mL, P = 0.04). In contrast, serum IL-4 levels were significantly decreased in H. heilmannii-positive (N = 10) WT BALB/c animals compared to the negative (N = 10) animals. In conclusion, H. heilmannii infection induces a predominantly Th1 immune response, with IFN-gamma playing a central role in gastric inflammation.

Valores de referencia del antígeno prostático específico / Refence values of prostate specific antigen

En el presente estudio se determinaron los valores de referencia del PAS (antígeno prostático específico) en individuos en estado de salud para patologías prostáticas, teniendo en cuenta la falta de información en individuos en estas condiciones. Se incluyeron en el estudio, 618 individuos del sexo masculino, con edades comprendidas entre 40 y 69 años, que concurrieron al laboratorio “Medical Center” entre 1999 y 2001, procedentes de consultorios urológicos, con solicitudes de estudios laboratoriales. Para la selección de los individuos se siguieron las recomendaciones del Panel de Expertos en Teoría de los Valores de Referencia de la IFCC (Federación Internacional de Química Clínica). Individuos sin patología prostática, clínicamente sin dificultad en la micción y examen dígito rectal normal, con resultados negativos a los auxiliares de diagnóstico citoscopía y ecografía. Se realizó la medición con el método inmunoensayo de partículas (MEIA), IMX Abbott, USA. En primer término se analizó el tipo de distribución de los valores de concentración de PAS de todos los individuos, empleando el test de Kolmogorov ­ Smirnov. Los valores de referencia de PAS obtenidos, entre los percentiles 2,5% y 97,5% mostraron diferencias de valores por grupo etário, con aumento progresivo (Kruskall­Wallis, p<0,0001). Los valores de referencia del PAS en ng/mL, fueron: de 40 a 49 años de 0,25 a 2; de 50 a 59 años de 0,64 a 3,24; de 60 a 69 años de 0,54 a 3,7. Los valores obtenidos servirán de guía para aplicar criterios de medicina preventiva que ayudaran al profesional de la salud en el diagnóstico precoz de patología prostática.

Development of prostate hyperplasia is an almost universal phenomenon in aging men. The PSA levels in serum are useful in the clinical evaluation in men over the age of 45. The objective of this study was to establish the reference values of prostate specific antigen (PSA) in serum in a selected Paraguayan population by microparticle enzimoimmunoassay MEIA. Six hundred eighteen people were evaluated with ages ranging from 40 to 69 years old who attended to “Laboratory Medical Center” in Asunción, Paraguay during 1999­2001. All were subjected to digital rectal examination, biopsy and echograph to assure the prostate disease free state. The International Federation of Chemical Chemistry (IFCC) reference value guidelines were used for individual selection. PSA concentrations were determined by microparticle enzimoimmunoassay (Autoanalyzer IMXABBOT/USA). The PSA concentration was presented as percentiles since neither the values nor the logarithms fitted into a normal distribution (Kolmogorov­Smirnov Test). Therefore, a nonparametric test (Kruskal­Wallis) was used for the estimation of differences between datum groups. According to age, our data showed statistical differences (p<0,0001). At increasing levels of PSA: 40 ­ 49 years old the serum value ranged from 0.25 ­ 2.0 ng/mL, 50 ­ 59 years old from 0.64 to 3.24 ng/mL and 60 ­ 69 from 0.54 to 3.7 ng/mL. These data represented the percentiles 2.5% and 97.5%. These PSA reference values will serve in screening programs as tools to detect prostate diseases in our population.

Hemagglutinating and fusogenic activities of Newcastle disease virus: studies on receptor binding specificity and pH-induced conformational changes

Vaccinal and wild strains of Newcastle Disease virus (NDV) were analyzed for cell receptor binding and fusogenic biological properties associated with their HN (hemagglutinin-neuraminidase) and F (fusion protein) surface structures respectively. The evaluation of the biological activities of HN and F was carried out respectively by determination of hemagglutinating titers and hemolysis percentages, using erythrocytes from various animal origins at different pH values. Significant differences in hemagglutination titers for some strains of NDV were detected, when interacting with goose, sheep, guinea-pip and human "O" group erythrocytes at neutral pH. Diversity of hemolysis percentagens was observed between different NDV strains at acid pH. These analysis were developed to evaluate particular aspects of the actual influence of the receptor specifity and pH on the receptor binding and fusogenic processes of Newcastle Disease viruses.

The role of antigenically different virus neuraminidases as structures implicated in receptor-binding processes

Influenza A viruses exhibit segmented nucleic acid coding for eight different proteins, two of them as glycoproteins exposed on their lipoprotein envelopes, hemagglutinin (HA) and neuraminidase (NA). Hemagglutinin exhibits recptor-binding activity while neuraminidase develps sialidase cleavage activity which acts on cell receptors. Influenza A strains responsible for human, avian, equine and porcine respiratory infections all over the world present antigenically different hemagglutinin (H1 to H14) and neutraminidase (N1 to N9) structures on their surface. The objective of the present investigation was study the role of N2, N8 and N9, anti-genically diverse neuraminidase structures of human (N2) and animal (N8 and N9) influenza viruses, in the receptor-binding process. REceptor-binding activity of N2 and N8 was anlyzed by crossed tests using H3N2 and H3N8 antisera and the hemagglutination inhibition test as a model. Hemangglutinating activity of antigenically different N2 and N8 structures was demonstrable and was inhibited by homologous antisera (N2-H3N2, N8-H3N8) but not by heterologous antisera (N2-H3-N8,N8-H3-N2). This previously demonstrated N9 hemagglutinating activity was analysed for receptor-binding specificity using hemagglutination test and NeuAc alpha2,3Gal and NeuAc alpha2,6Gal derivatized erythrocytes. This highly purified N9 strain was obtained from a virus strain isolated from terns by Dr. Peter Colman (CSIRO Division of Biomolecular Engineering, Parkville, Victoria, Australia)...

Comparative evaluation of a simple and sensitive assay for detection of orthomyxo and paramyxoviruses

Studies were done to evaluate comparatively the traditional HA assay and a more recently introduced lectin-neuraminidase (LN) methodologyin search of a simple and sensitive assay for virus detection during laboratorial diagnosis. The results proved the value of LN assay as a sensitive methodologyfor detection of virus particles, presenting results at least equal to those obtained by HA (hemagglutination) assay, with significant values of accumulated frequencies for LN/HA factors (ratios between LN and HA titers) higher than two. The accumulated values of frequencies for LN/HA factors as high as four were very significant, 72.7 (per cent) for influenzavirus and 60.7 (per cent) for Newcastle disease virus (NDV), moreover accumulated frequencies for LN/HA factors even as high as 32 were due to influenzavirus (45.4 per cent) and NDV (7.2 per cent) samples. After the storage period, most of those concentraded samples that even did not present HA titers could be detected through LN assay, demonstrating a lower threshold for virus detection

Hemagglutinating and sialidase activities of subpopulations of influenza A viruses

The present study was conducted to investigate the characteristics of two samples of influenza A/England/42/72 (H3N2) virus, one of them selected by an adsorption-elution technique, to determine the possible existence of virus variants or subpopulations. Based on specificity of virulence-related cell receptor-binding and sialidase activities, this selection technique using human O group erythrocytes revealed the presence of variants within a standard virus sample with diversity for their hemagglutinating and sialidase activities. The standard-like (E1) sample exhibited titers of 4 and 32 HAU (hemagglutinating units in 25 microliters) with human O group and chicken erythrocytes, respectively, while the sample obtained by the adsorption-elution process (E2) exhibited titers of 32 and 4 HAU, respectively, with these same types of erythrocytes. The E2 sample showed higher sialidase activity at pH values between 5.4 and 6.6 with human erythrocytes (128-256 HAU), but the E1 sample did not exhibit significant sialidase activity with either human or chicken erythrocytes. The different pH optima for hemolysis (5.2) and sialidase (5.4-6.6) activities and the higher hemolysis indexes present in samples with sialidase activity inhibited by heating (at 56 degrees C for 30 min) or by treatment with EDTA (dilution in buffer containing 2 mM EDTA, a chelating agent on calcium-dependent sialidase activity) demonstrate the independence of these activities in the selected sample: native E2 (absorbance = 0.18), EDTA-treated native E2 (absorbance = 0.28), heated E2 (absorbance = 0.26), EDTA-treated heated E2 (absorbance = 0.41).(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of low pH on hemagglutinating and hemolytic activities of west equine encephalomyelitis virus

1. The hemagglutinating (HA) and hemolytic (HL) activities mediated by egg-propagated west equine encephalomyelitis (WEE) virus preparations were investigated. 2. The purified virus preparation exhibited the best HA and HL activity at pH 6.0 and 6.0-6.2, respectively, as observed in the HA and HL tests. 3. In the virus preparations, both HA and HL activities were completely lost upon pretreatment at low pH (6.0). 4. The present results suggest that the alphavirus-mediated HA and HL activities against chicken erythrocytes can be considered to be a fusion from without

Análise da incidência de doenças psicofìsicas numa populaçäo de presidiários confinados em cárceres superpopulosos / Analisys of incidence of psychophysical diseases in a prisoners' population confined in crowded conditions

Neste estudo procuramos fazer uma análise da incidência de doenças psicofìsicas numa populaçäo de 62 presidiários confinados em cárceres superpopulosos na regiäo de Campinas - SP. Como método usamos uma anamnese-questionário e uma escala avaliatória de traços e de comportamentos de agressividade. Nesta anamnese procuramos saber dos 62 indivìduos do Grupo Controle, quais as doenças somáticas tidas nos últimos dez anos, salientando aquelas tidas durante o perìodo deste último encarceramento. Verificamos que há uma incidência variável de doenças nos dois grupos, tanto em nìvel qualitativo quanto quantitativo. No grupo Controle salientam-se as doenças cardiovasculares, gastrointestinais, os processos cirúrgicos e os acidentes de trabalho e quedas. No Grupo de Estudos destacam-se as doenças venéreas e os acidentes de trânsito. Estas constataçöes nos levam a pensar que os indivìduos que contêm mais a agressividade, tendem a somatizar de forma diferente do que aqueles que liberam a agressividade. Nos primeiros, os processos psicossomáticos säo mais auto-agressivos, enquanto que nos últimos säo tanto auto-agressivos como hetero-agrssivos

Algumas caracterìsticas de personalidade de presidiários, em comparaçäo com as de um grupo controle sem antecedentes criminais / Some characteristics of prisoners' personality in comparison with those of control group without criminal antecedents

Neste trabalho analisamos as caracterìsticas de personalidade de 62 presìdiários confinados em cárceres superpopulosos, comparando-as com as caracteristicas de 50 componentes de um grupo controle. Como método utilizamos uma anamnese-questionário, onde constavam questöes fechadas (tipo sim ou näo) e questöes abertas, que facilitassem a verbalizaçäo da história de vida dos entrevistados. Nos dois grupos encontramos traços neuróticos na infância, principalmente enurese noturna, roer unhas, gagueira e terrores noturnos. Na personalidade pré-mórbida dos presidiários destacam-se caracterìsticas como: agressividade, ambiçäo, ciúmes e baixas tolerância a frustraçöes. Numa análise mais aprofundada da história de vida destes seres e destas caracterìsticas de personalidade, somos favoráveis a enquadrá-los näo apenas como indivìduos anti-sociais, mas também com caracterìsticas tipo bordeline (intermediária entre a neurose e a psicose)