O exame parasitológico de fezes frente a campanhas de desparasitação em massa ­ novos desafios e alternativas / The parasitological stool examination in front of mass deworming campaigns - new challenges and alternatives

Com a ampliação e a frequência das campanhas de desparasitação contra os geo-helmintos Ascaris lumbricoides, Trichuris trichiura, ancilostomídeos e Strongyloides stercoralis, ocorreu, como esperado, a redução da prevalência e da morbidade associada a estas parasitoses. Entretanto, alterações no perfil parasitológico das populações com redução dos helmintos e aumento significativo das protozooses intestinais se tornaram evidentes em todo o mundo. Além disso, a redução de carga parasitária tem dificultado o diagnóstico de rotina por meio de técnicas microscópicas de baixa sensibilidade. Neste artigo trazemos atualizações sobre algumas técnicas diagnósticas, como a Técnica de Sedimentação Espontânea em Tubo (SSTT), FLOTAC/Mini-FLOTAC e a otimização do método de Kato-Katz, além de alternativas viáveis para aumentar a sensibilidade dos métodos e tornar o diagnóstico das parasitoses intestinais mais preciso.

With the expansion and increased frequency of deworming against soil-transmitted helminths Ascaris lumbricoides, Trichuris trichiura, hookworms and Strongyloides stercoralis, there was, as expected, a reduction in the prevalence and morbidity associated with these diseases. However, changes in the parasitological profile of populations, with a reduction in helminths and a significant increase in intestinal protozoa, became evident worldwide. In addition, the reduction in the parasitic burden has made routine diagnosis difficult through low-sensitivity microscopic techniques. In this article we bring updates on diagnostic techniques, such as spontaneous sedimentation technique in tube (SSTT), FLOTAC/Mini-FLOTAC and optimization of Kato-Katz technique, as well as viable alternatives to increase the sensitivity of methods and make the diagnosis of intestinal parasites more accurate.

Prevalence of Klebsiella pneumoniae carbapenemase - and New Delhi metallo-beta-lactamase-positive K. pneumoniae in Sergipe, Brazil, and combination therapy as a potential treatment option

Abstract INTRODUCTION: Carbapenem-resistant Klebsiella pneumoniae infection lacks treatment options and is associated with prolonged hospital stays and high mortality rates. The production of carbapenemases is one of the most important factors responsible for this multi-resistance phenomenon. METHODS: In the present study, we analyzed the presence of genes encoding carbapenemases in K. pneumoniae isolates circulating in one of the public hospitals in the city of Aracaju, Sergipe, Brazil. We also determined the best combination of drugs that display in vitro antimicrobial synergy. First, 147 carbapenem-resistant K. pneumoniae isolates were validated for the presence of blaKPC, bla GES, bla NDM, bla SPM, bla IMP, bla VIM, and bla OXA-48 genes using multiplex polymerase chain reaction. Thereafter, using two isolates (97 and 102), the role of double and triple combinational drug therapy as a treatment option was analyzed. RESULTS: Seventy-four (50.3%) isolates were positive for bla NDM, eight (5.4%) for bla KPC, and one (1.2%) for both bla NDM and bla KPC. In the synergy tests, double combinations were better than triple combinations. Polymyxin B and amikacin for isolate 97 and polymyxin B coupled with meropenem for isolate 102 showed the best response. CONCLUSIONS: Clinicians in normal practice use multiple drugs to treat infections caused by multi-resistant microorganism; however, in most cases, the benefit of the combinations is unknown. In vitro synergistic tests, such as those described herein, are important as they might help select an appropriate multi-drug antibiotic therapy and a correct dosage, ultimately reducing toxicities and the development of antibiotic resistance.

Screening of bacterial extracellular xylanase producers with potential for cellulose pulp biobleaching

In this study, two hundred fifty-seven bacterial isolates from a suppressive soil library were screened to study their secretion of alkali-thermostable xylanases for potential use in cellulose pulp biobleaching. Xylanase activity was evaluated in solid and liquid media using xylan as the carbon source. Isolates were initially evaluated for the degradation of xylan in solid media by the congo red test. Selected strains were evaluated in liquid media for enzymatic activity and determination of total protein concentration using a crude protein extract (CPE). An isolate identified as Bacillus species TC-DT13 produced the highest amount of xylanase (1808 U mL-1). The isolate was active and stable at 70°C and pH 9.0, conditions which are necessary for the paper industry. This isolate can grow and produce xylanase in medium containing wheat fiber as a substrate. The CPE of this isolate was used in preliminary testing on cellulose pulp bleaching; enzyme treatment of the pulp resulted in a 5% increase of whiteness.

Elevated prevalence of high-risk HPV in healthy oral mucosa of users and nonusers of drugs in Northeastern Brazil

Abstract: Variable rates of HPV infection have been reported in healthy oral mucosa worldwide. The main objective of this study was to detect and genotype HPV infection in users and nonusers of drugs with clinically healthy mucosa from the Northeast Brazil. Samples from 105 patients were amplified using the primers MY09/MY11 and GP5+/GP6+, and genotyping was performed by multiplex-PCR for HPV-6/11, 16 and 18. A total of 81.9% samples were positive. Among drug users, 84.5% presented the virus and 20.4% showed multiple infections. Among non-drug users, 78.7% were positive and 13.5% had multiple infections. Limited information is available on oral HPV in Brazilian population, especially for drug users, and our results showed higher HPV infection rates in both users and nonusers of drugs. More studies and researches focused on drug users including factors like sexual behavior, nutrition and cultural habits are necessary to enhance the comprehension of this relationship, and develop preventive strategies.

Variation in temephos resistance in field populations of Aedes aegypti (Diptera: Culicidae) in the State of Sergipe, Northeast Brazil

Abstract INTRODUCTION The organophosphate temephos was first used in Brazil in the 1960s for the control of Aedes aegypti. Because of its extensive and longstanding use worldwide, selection for mosquito populations resistant to the chemical has been observed not only in different regions of Brazil but also in several parts of the world. The objective of this study was to evaluate the susceptibility of Ae. aegypti to the organophosphate temephos, a larvicide used in vector control activities in Sergipe/Northeast Brazil. METHODS This study included mosquito populations from seven municipalities of Sergipe and was carried out from October 2010 to August 2011. Qualitative bioassays of diagnostic dose and dose responses were performed. The resistance ratio was calculated based on lethal concentrations for mosquitoes of the susceptible Rockefeller strain. RESULTS: All populations were classified as resistant to temephos. The resistance ratio ranged from 22.2 to 297.9, the lowest being seen in Aracaju, a coastal area of the state, and the highest in Pinhão, a semi-arid region, 96.6km from Aracaju. CONCLUSIONS: High levels of temephos resistance were observed in the Ae. aegypti populations of Sergipe. The variation between regions indicates that there have been different regimes of insecticide use and also points to the potential of small cities to generate and spread insecticide resistance.

High prevalence of human papillomavirus (HPV) in oral mucosal lesions of patients at the Ambulatory of Oral Diagnosis of the Federal University of Sergipe, Northeastern Brazil

Abstract The role of human papillomavirus (HPV) in oral carcinogenesis is still controversial as detection rates of the virus in oral cavity reported in the literature varies greatly. Objective The aim of this study was to evaluate the frequency of HPV infection and its genotypes in patients with oral lesions at the Ambulatory of Oral Diagnosis of the Federal University of Sergipe, Brazil. Material and Methods We conducted a molecular study with 21 patients (15 females) aged from two to 83 years with clinically detectable oral lesions. Samples were collected through exfoliation of lesions and HPV-DNA was identified using MY09/11 and GP5+/6+ primers. Genotyping was performed by multiplex PCR. Results Benign, premalignant and malignant lesions were diagnosed by histopathology. HPV was detected in 17 samples. Of these, HPV-6 was detected in 10 samples, HPV-18 in four and HPV-16 in one sample. When samples were categorized by lesion types, HPV was detected in two papilloma cases (2/3), five carcinomas (5/6), one hyperplasia (1/1) and nine dysplasia cases (9/11). Conclusion Unlike other studies in the literature, we reported high occurrence of HPV in oral lesions. Further studies are required to enhance the comprehension of natural history of oral lesions.

Influência do polimorfismo I/D do gene da eca na HPE de jovens normotensos / Influence of I/D polymorphism of the ace gene on PEH in normotensive young men / Influencia del polimorfismo I/D del gen de la eca en la HPE de jóvenes normotensos

INTRODUÇÃO: A hipotensão pós-exercício (HPE) é considerada uma estratégia não farmacológica adotada para redução da pressão arterial (PA). Ademais, sabe-se que a presença de alguns polimorfismos genéticos influencia a resposta pressórica, como o I/D do gene da enzima conversora da angiotensina (ECA). Objetivo: Analisar a influência do polimorfismo I/D da ECA sobre a HPE após três diferentes intensidades de exercício em jovens normotensos e fisicamente ativos.MÉTODOS: Vinte e seis jovens saudáveis (DD = 11; ID/II = 15) realizaram uma sessão máxima de 1.600 metros, na pista de atletismo e outras três sessões experimentais (Sessão Moderada: 6% abaixo do limiar anaeróbio, Sessão Intensa: 6% acima do limiar anaeróbio e Sessão de Controle), com aferições prévias da PA, por 20 minutos e posteriores ao exercício por 60 minutos.RESULTADOS: Observou-se que o exercício moderado ocasionou HPE independentemente do grupo genotípico, sendo mais evidente para a pressão arterial sistólica nos momentos 45 minutos e 60 minutos (p ≤ 0,05). Verificou-se também que a característica gênica exerceu influência sobre a área abaixo da curva pressórica (p ≤ 0,005) sobre a pressão arterial diastólica, formada 1 hora após o exercício.CONCLUSÃO: Conclui-se que o exercício moderado ocasiona HPE em jovens normotensos e fisicamente ativos, independentemente do polimorfismo I/D no gene da ECA, sendo que esse polimorfismo exerce influência sobre a hipotensão diastólica, e os indivíduos portadores do alelo I apresentam maior decaimento da PA diastólica (PAD).

INTRODUCTION: The post-exercise hypotension (PEH) is considered a non-pharmacological strategy adopted for lowering blood pressure (BP). Moreover, it is known that the presence of some genetic polymorphisms, such as the I/D of the angiotensin converting enzyme (ACE) gene, can influence the blood pressure response. Objective: Analyze the influence of the ACE I/D polymorphism on PEH after three different exercise intensities in normotensive and physically active young people.METHODS: Twenty-six healthy young men (DD=11; ID/II=15) performed a maximal 1600 meters running session in a athletics track and another three experimental sessions (Moderate Session: 6% below the anaerobic threshold, Intense Session: 6% above the anaerobic threshold, and a Control Session) with previous measurements of BP for 20 minutes and after the exercise for 60 minutes.RESULTS: It was observed that moderate exercise has brought on PEH, regardless of genotype group, being more evident for systolic blood pressure at 45 minutes and 60 minutes (p≤0.05). It was also found that the genic characteristics has influence on the area under the pressure curve (p≤0.005) for the diastolic blood pressure, formed 1 hour after exercise.CONCLUSION: It is concluded that moderate exercise causes PEH in normotensive and physically active young men, regardless of I/D polymorphism in the ACE gene, that this polymorphism influences the diastolic blood pressure, and that subjects with the I allele have a greater drop in diastolic BP (DBP).

INTRODUCCIÓN: La hipotensión post-ejercicio (HPE) es considerada una estrategia no farmacológica aprobada para bajar la presión arterial (PA). Además, se sabe que la presencia de determinados polimorfismos genéticos, tales como el polimorfismo I/D del gen de la enzima convertidora de angiotensina (ECA), influyen en la respuesta de la presión. Objetivo: Analizar la influencia del polimorfismo I/D del gen de la ECA en la HPE después de tres intensidades diferentes de ejercicio en los jóvenes normotensos y físicamente activos.MÉTODOS: Veintiséis jóvenes sanos (DD = 11; ID / II = 15) realizaron una sesión máxima de 1.600 metros en pista de atletismo y tres sesiones experimentales (Sesión Moderada: 6% por debajo del umbral anaeróbico, Sesión Intensa: 6% por encima del umbral anaeróbico y una Sesión de Control), con mediciones anteriores de PA durante 20 minutos y después del ejercicio, durante 60 minutos.RESULTADOS: Se observó que el ejercicio moderado ha producido HPE independientemente del grupo de genotipo, siendo más evidente para la presión arterial sistólica en 45 minutos y 60 minutos (p ≤ 0,05). También se encontró que la característica génica ejerce influencia en el área bajo la curva de presión (p ≤ 0,005) para la presión arterial diastólica, formada 1 hora después del ejercicio.CONCLUSIÓN: Se concluye que el ejercicio moderado provoca HPE en jóvenes normotensos y físicamente activos, independientemente del polimorfismo I/D del gen de la ECA, y que este polimorfismo tiene influencia en la presión arterial diastólica y los portadores del alelo I presentan mayor deterioro PA diastólica (PAD).

Risk of dengue occurrence based on the capture of gravid Aedes aegypti females using MosquiTRAP

We assessed the risk classification of dengue fever based on the capture of Aedes aegypti adults using MosquiTRAP, a type of sticky trap, in comparison with traditional larval infestation indices. A total of 27 MosquiTRAPs were installed, with one trap per block, and were inspected weekly between November 2008-February 2009. Infestation baseline data were obtained from a survey conducted prior to trap installation. The index generated by MosquiTRAP and house index (HI) classified the area "in alert situation". The set for risk of dengue occurrence proposed by the use of MosquiTRAP classify areas in the same way of the traditional HI.

Morbidity due to Schistosoma mansoni - Entamoeba histolytica coinfection in hamsters (Mesocricetus auratus)

Data on Schistosoma mansoni-Entamoeba histolytica coinfection are scarce in the literature. In the present study, hamsters that had been infected for 70 days with Schistosoma mansoni (LE strain) were inoculated via the portal vein with two strains of trophozoites of Entamoeba histolytica: ICB-EGG (highly virulent) and ICB-RPS (non-virulent). The most evident result of coinfection was increased morbidity and mortality, in comparison with either of the infections alone. Histologically, there were no evident signs of interaction between these two infections. The morphological findings of schistosomal granuloma and amoebic abscesses in the liver were similar to those seen in the respective single-infection controls. However, there was severe wasting of the animals with both infections and greater numbers of amoebic lesions in their livers. The results obtained indicated that schistosomiasis aggravates the course of amoebiasis in hamsters.

Dados sobre a co-infecção Schistosoma mansoni-Entamoeba histolytica são escassos na literatura. No presente estudo, hamsters com 70 dias de infecção por Schistosoma mansoni (cepa LE) foram inoculados com trofozoítos de Entamoeba histolytica, cepa ICB-EGG (virulenta) e cepa ICB-RPS (não virulenta), via veia porta. O mais evidente resultado da co-infecção foi o aumento da morbidade e mortalidade, quando comparado com os animais com somente uma das infecções. Histologicamente, não houve sinais evidentes da interação entre as duas infecções. O aspecto morfológico do granuloma esquistossomótico e do abcesso hepático amebiano são similares aos observados nos controles, com somente uma infecção. Entretanto, foi observado que os animais co-infectados apresentavam-se mais debilitados e com maior número de lesões amebianas no fígado. Os resultados obtidos indicam que a esquistossomose agrava o curso da infecção amebiana em hamsters.