A majority of Brazilian patients with rheumatoid arthritis HLA-DRB1 alleles carry both the HLA-DRB1 shared epitope and anti-citrunillated peptide antibodies

The objective of the present study was to evaluate the contribution of the shared epitope (SE), the rheumatoid arthritis (RA) protection model, and the occurrence of anti-cyclic citrullinated peptide (anti-CCP) antibodies in RA patients from a genetically diverse population. One hundred and forty Brazilian RA patients and 161 matched controls were typed for HLA-DRB1 alleles using amplified DNA hybridized with sequence-specific oligonucleotide probes or primers. Patients were stratified according to the presence or absence of SE (DRB1*0401, *0404, *0405, *0101, *1001, and *1402), of the DERAA alleles (DRB1*0103, *0402, *1102, *1103, *1301, *1302, and *1304), and X (all other alleles). Anti-CCP antibodies were measured by ELISA. The combined frequency of SE-positive alleles was significantly greater (76.4 vs 23.6 percent, P < 0.0001) than the controls. The SE/SE and SE/X genotypes were over-represented (P < 0.0001, OR = 6.02) and DERAA/X was under-represented in RA patients (P < 0.001, OR = 0.49), whereas the frequencies of the SE/DERAA, X/X and X/DERAA genotypes were not significantly different from controls. The frequency of anti-CCP antibodies was higher in SE-positive patients than in SE-negative patients (64.6 vs 44.7 percent, P = 0.03; OR = 2.25). Although the Brazilian population is highly miscegenated, the results of this study support the findings observed in most genetically homogeneous populations with RA; however, they are not mutually exclusive but rather complementary. The participation of DRB1-DERAA alleles in protection against RA was also observed (OR = 0.4; 95 percentCI = 0.23-0.68).

Infecçäo urinária hospitalar por leveduras do gênero Candida / Nosocomial urinary tract infections by Candida species

OBJETIVO: O isolamento de leveduras na urina näo indica necessariamente infecçäo, porém a infecçäo do trato urinário por Candida constitui um problema hospitalar crescente. Neste estudo, o significado clínico da candidúria foi investigado em hospital universitário brasileiro. MÉTODOS: Em 1998, Candida spp. foi isolada na urina de 166 pacientes internados no Hospital das Clínicas da Faculdade de Medicina de Ribeiräo Preto-SP. Os prontuários médicos de 100 destes pacientes, com candidúria detectada depois de três ou mais dias de hospitalizaçäo, foram revisados sobre aspectos microbiológicos, epidemiológicos e clínicos referentes a esse episódio. RESULTADOS: C. tropicalis foi isolada em 53 por cento e C. albicans em 36 por cento dos casos. Em 76 por cento do doentes, a urocultura mostrou mais de 20.000 colônias de leveduras/mL. Doenças subjacentes crônicas, como neuropatias, cardiopatias e outras neoplasias e trauma foram freqüentes. Dos pacientes, 25 por cento tinham diabetes mellitus. Os principais fatores predisponentes associados com candidúria foram: antibioticoterapia prévia (93 por cento), sonda vesical de demora (83 por cento), cirurgia nos últimos 60 dias (48 por cento), insuficiência renal (32 por cento), infecçäo bacteriana simultânea (28 por cento) e uso de corticosteróides (20 por cento) ou imunossupressores (10 por cento). Apenas 43/100 pacientes foram tratados, 42 com fluconazol ou anfotericina B. No período de 60 dias após o episódio de candidúria, 40 por cento dos doentes faleceram. CONCLUSÖES: Na presente casuística, as espécies näo-albicans de Candida foram os principais agentes de candidúria, sendo considerados patógenos emergentes do trato urinário em pacientes gravemente enfermos. Foram, ainda, observadas doenças subjacentes, fatores de risco e alta mortalidade comumente associados com a candidíase do trato urinário

Eggplant (Solanum melongena) infusion has a modest and transitory effect on hypercholesterolemic subjects

Eggplant (Solanum melongena) is consumed extensively in Brazil. It has been believed that infusion of a powdered preparation of the fruit may reduce serum cholesterol. However, there are few documented reports on its effects on cholesterol metabolism and its possible hypocholesterolemic effect has not been proved by well-controlled studies. The aim of the present study was to observe the effects of S. melongena on the serum cholesterol and triglycerides of 38 hypercholesterolemic human volunteers ingesting S. melongena infusion for five weeks. Thirty-eight hypercholesterolemic subjects receiving either S. melongena infusion (N = 19) or placebo (N = 19) participated in two clinical experiments in which the effect of S. melongena infusion was studied with (N = 16) or without (N = 38) dietary orientation. Total cholesterol and its fractions, triglycerides, and apolipoproteins A and B were measured in blood at the beginning of the experiment and three and five weeks thereafter. No differences were observed compared to control. Intraindividual analysis showed that S. melongena infusion significantly reduced the blood levels of total and LDL cholesterol and of apolipoprotein B. After dietary orientation, no intra- or intergroup differences were seen for any of the parameters analyzed. The results suggest that S. melongena infusion had a modest and transitory effect, which was not different from that obtained with standard orientation for dyslipidemia patients (diet and physi

Characterization of the fishes and of subsistence fishing in the Pantanal of Mato Grosso, Brazil

Fishing is one of the oldest human activities in the Pantanal of Mato Grosso in Central Brazil. In the of Bento Gomes River Basin (Pantanal of Poconé) the presence of fishermen is very common. The objective of this study is to describe the fishing activity in the basin in view of the elaboration of proposals for the sustainable use of this natural resource. Of the 256 fishermen that were registered most are fishing for their subsistence (92 percent) and the rest (8 percent) are occasional fishermen (locally called "de lufada" fishermen). "Traíra" (Hoplias gr. malabaricus) and "piranhas" (Serrasalmus marginatus, Serrasalmus spilopleura and Pygocentrus nattereri) were the species most frequently captured for human consumption. The fishing is more intensive during the ebb season and at the beginning of the drought season, when the waters begin to recede for the river channel, as the catch is facilitated by the concentration of fishes at the river margin. The fishermen and their families consume fish three to four times a week, twice a day. Fish meat is one of the only means of obtaining animal protein for dozens of poor families in the area. The number of fishermen, as well as the actual number of catches do not appear to compromise the natural fish stocks, although no specific capture criteria is obeyed by the fishing activity