Reproductive health syndemics impact retention in care among women living with HIV in Rio de Janeiro, Brazil

ABSTRACT Syndemic psychosocial and reproductive factors affecting women's retention in HIV care remain understudied. We analyzed correlates of non-retention in a cohort of women with HIV in Brazil from 2000-2015. Participants self-reported exposure to physical/sexual violence, illicit drug use, adolescent pregnancy, or induced abortion. Lifetime history of these psychosocial stressors were used to create a syndemic score based on the presence or absence of these conditions. All dichotomous variables were summed (range 0 to 4), with greater scores indicating more syndemic factors experienced. Logistic regression models identified predictors of non-retention, defined as < 2 HIV viral load or CD4 results within the first year of enrollment. Of 915 women, non-retention was observed for 18%. Prevalence of syndemic factors was adolescent pregnancy (53.2%), physical/sexual violence (38.3%), induced abortion (27.3%), and illicit drug use (17.2%); 41.2% experienced > 2 syndemic conditions. Syndemic scores of 2 and 3 were associated with non-retention, as well as low education, years with HIV and seroprevalent syphilis. Psychosocial and reproductive syndemics can limit women's retention in HIV care. Syphilis infection predicted non-retention and could be explored as a syndemic factor in future studies.

Effects of glutamine alone or in combination with zinc and vitamin A on growth, intestinal barrier function, stress and satiety-related hormones in Brazilian shantytown children

OBJECTIVE: To determine the impact of supplemental zinc, vitamin A, and glutamine alone or in combination on growth, intestinal barrier function, stress and satiety-related hormones among Brazilian shantytown children with low median height-for-age z-scores. METHODS: A randomized, double-blind, placebo-controlled trial was conducted in children aged two months to nine years from the urban shanty compound community of Fortaleza, Brazil. Demographic and anthropometric information was assessed. The random treatment groups available for testing (a total of 120 children) were as follows: (1) glutamine alone, n = 38; (2) glutamine plus vitamin A plus zinc, n = 37; and a placebo (zinc plus vitamin A vehicle) plus glycine (isonitrogenous to glutamine) control treatment, n = 38. Leptin, adiponectin, insulin-like growth factor (IGF-1), and plasma levels of cortisol were measured with immune-enzymatic assays; urinary lactulose/mannitol and serum amino acids were measured with high-performance liquid chromatography. ClinicalTrials.gov: NCT00133406. RESULTS: Glutamine treatment significantly improved weight-for-height z-scores compared to the placebo-glycine control treatment. Either glutamine alone or all nutrients combined prevented disruption of the intestinal barrier function, as measured by the percentage of lactulose urinary excretion and the lactulose:mannitol absorption ratio. Plasma leptin was negatively correlated with plasma glutamine (p = 0.002) and arginine (p = 0.001) levels at baseline. After glutamine treatment, leptin was correlated with weight-for-age (WAZ) and weight-for-height z-scores (WHZ) (p≤0.002) at a 4-month follow-up. In addition, glutamine and all combined nutrients (glutamine, vitamin A, and zinc) improved the intestinal barrier function in these children. CONCLUSION: Taken together, these findings reveal the benefits of glutamine alone or in combination ...

Factors associated with thrombocytopenia in severe leptospirosis (Weil's disease)

OBJECTIVE: This study was conducted to investigate factors associated with thrombocytopenia in a large cohort of patients with leptospirosis in an endemic area. METHODS: This retrospective study included 374 consecutive patients with leptospirosis who were admitted to tertiary hospitals in Fortaleza, Brazil. All patients had a diagnosis of severe leptospirosis (Weil's disease). Acute kidney injury was defined according to the RIFLE criteria. Thrombocytopenia was defined as a platelet count <100,000/mm3. RESULTS: A total of 374 patients were included, with a mean age of 36.1±15.5 years, and 83.4% were male. Thrombocytopenia was present at the time of hospital admission in 200 cases (53.5%), and it developed during the hospital stay in 150 cases (40.3%). The patients with thrombocytopenia had higher frequencies of dehydration (53% vs. 35.3%, p = 0.001), epistaxis (5.7% vs. 0.8%, p = 0.033), hematemesis (13% vs. 4.6%, p = 0.006), myalgia (91.5% vs. 84.5%, p = 0.038), hematuria (54.8% vs. 37.6%, p = 0.011), metabolic acidosis (18% vs. 9.2%, p = 0.016) and hypoalbuminemia (17.8% vs. 7.5%, p = 0.005). The independent risk factors associated with thrombocytopenia during the hospital stay were lengthy disease (OR: 1.2, p = 0.001) and acute kidney injury (OR: 6.6, p = 0.004). Mortality was not associated with thrombocytopenia at admission (12.5% vs. 12.6%, p = 1.000) or during the hospital stay (12.6% vs. 11.3%, p = 0.748). CONCLUSIONS: Thrombocytopenia is a frequent complication in leptospirosis, and this condition was present in more than half of patients at the time of hospital admission. Lengthy disease and acute kidney injury are risk factors for thrombocytopenia. There was no significant association between thrombocytopenia and mortality. .

Zinc, vitamin A, and glutamine supplementation in Brazilian shantytown children at risk for diarrhea results in sex-specific improvements in verbal learning

OBJECTIVE: To identify the impact of supplemental zinc, vitamin A, and glutamine, alone or in combination, on long-term cognitive outcomes among Brazilian shantytown children with low median height-for-age z-scores. METHODS: A randomized, double-blind, placebo-controlled trial was conducted in children aged three months to nine years old from the urban shanty compound community of Fortaleza, Brazil. Demographic and anthropometric information was assessed. The random treatment groups available for cognitive testing (total of 167 children) were: (1) placebo, n = 25; (2) glutamine, n = 23; (3) zinc, n = 18; (4) vitamin A, n = 19; (5) glutamine+zinc, n = 20; (6) glutamine+vitamin A, n = 21; (7) zinc+vitamin A, n = 23; and (8) glutamine+zinc+vitamin A, n = 18. Neuropsychological tests were administered for the cognitive domains of non-verbal intelligence and abstraction, psychomotor speed, verbal memory and recall ability, and semantic and phonetic verbal fluency. Statistical analyses were performed using SPSS, version 16.0. ClinicalTrials.gov: NCT00133406. RESULTS: Girls receiving a combination of glutamine, zinc, and vitamin A had higher mean age-adjusted verbal learning scores than girls receiving only placebo (9.5 versus 6.4, p = 0.007) and girls receiving zinc+vitamin A (9.5 versus 6.5, p = 0.006). Similar group differences were not found between male study children. CONCLUSIONS: The findings suggest that combination therapy offers a sex-specific advantage on tests of verbal learning, similar to that seen among female patients following traumatic brain injury.

Valores positivos e desenvolvimento do adolescente: perfil de jovens paulistanos / Valores positivos y el desarrollo del adolescente: perfil de jóvenes paulistanos / Positive values and adolescent development: a profile in São Paulo city

A presente pesquisa é parte do projeto "Os valores positivos e o desenvolvimento do adolescente", que se iniciou com a adaptação cultural do questionário Search Institute Profiles of Student Life. Seu objetivo foi mapear valores positivos presentes em adolescentes paulistanos, visando gerar informações que permitam planejar ações de promoção de saúde para jovens, suas famílias e comunidades. O instrumento adaptado foi aplicado em 2725 jovens paulistanos, de 11 a 19 anos, de ambos os sexos, provenientes de todas as regiões da cidade de São Paulo, categorizados de acordo com o Índice Paulista de Vulnerabilidade Social. Os resultados indicaram a presença um número baixo de valores, diferenças associadas mais à idade e ao sexo do que ao IPVS e, principalmente, a necessidade de revisão de nossas estratégias de promoção de saúde, que poderiam basear-se no desenvolvimento de valores positivos.

This research is part of the project "The positive values and the adolescent development: from vulnerability to responsibility" that begun with the cultural adaptation of Search Institute Profiles of Student Life: Attitudes and Behaviors, an instrument that aims to access the developmental assets present in adolescents of specific groups, proven to be very useful as a base from where to start planning actions to promote better lives to communities, families and their children. The adapted form of the instrument has been applied in a sample of 2725 adolescents from all regions of SP City, males and females, from 11 to 19 years, categorized by their social vulnerability (IPVS, SEADE, 2005) to design a map of positive values present in this population. The data showed that young people present a low number of positive values and that its variability is linked to sex and age, more than to social vulnerability. It also turns evident the necessity to review our health promotion strategies based in risk taking behaviors and grounded it in the promotion of positive values.

La presente pesquisa es parte de lo proyeto "Los valores positivos y el desarrollo del adolescente" , que se ha iniciado com la adaptación cultural de lo instrumento Search Institute Profiles of Student Life. Lo objetivo fue mapear valores positivos presentes en jóvenes de la ciudad de São Paulo, para el desarrollo de acciones promotoras de salud para los jóvenes, sus famílias y comunidad. Lo instrumento adaptado fue aplicado a 2725 adolescentes, de 11 a 19 años, de ambos los sexos y en tres niveles de vulnerabilidad social: baja, mediana y alta. Los resultados han indicado la presencia de bajo número de valores positivos, diferencias más associadas a la edad y sexo y menos a la vulnerabilidad social y, especialmente, la necesidad de uma revisión de nuestras estratégias para la promoción de la salud, que podrían estar basadas en el desarrollo de valores positivos.

Clinical presentation and renal evaluation of human visceral leishmaniasis (kala-azar): a retrospective study of 57 patients in Brazil

Visceral leishmaniasis is an endemic disease caused by various species of Leishmania. We made a retrospective study of 57 consecutive patients with visceral leishmaniasis in Brazil. Patients with visceral leishmaniasis were identified using the registries of the São José Infectious Diseases Hospital. The sample was divided into two groups: patients with serum creatinine (Scr) <1.3mg/dL and Scr > 1.3mg/dL. We compared these two groups for differences in clinical manifestations and laboratory features. Patients' mean age was 28 ± 18 years old; 74 percent were male. The main clinical symptoms and signs presented in the initial evaluation were: fever (97 percent), splenomegaly (96.4 percent), weight loss (95.5 percent), pallor (93.6 percent), cough (89.7 percent), hepatomegaly (87.2 percent), asthenia (83.3 percent), anorexia (82.9 percent) and vomiting (73.9 percent). Acute renal failure was found in 15 patients (26.3 percent) and eight of these patients had ARF before amphotericin B administration. The mean age was higher in the group with Scr > 1.3mg/dL. Death occurred in three cases; all deaths occurred with Scr > 1.3mg/dL. There were no significant differences in the frequencies of the clinical symptoms and signs between the two groups. The laboratory data and demographic characteristics were significantly worse in the Scr > 1.3mg/dL group. Renal dysfunction is an important feature of this disease; it is associated with important morbidity and can increase mortality.

Aloimunidade contra antígenos HLA de classe I em pacientes com síndromes mielodisplásicas e anemia aplástica / Aloimmunity against HLA class I antigens in patients with myelodisplastic syndrome and aplastic anemia

As síndromes mielodisplásicas (SMD) e a anemia aplástica (AA) apresentam citopenias periféricas necessitando, com freqüência, de reposições transfusionais contínuas de concentrados de hemácias e/ou de concentrados de plaquetas. O objetivo do presente estudo foi verificar a ocorrência de anticorpos anti-HLA de classe I em pacientes portadores das SMD e AA atendidos no ambulatório de Hematologia do Hemoce/UFC. Foram analisados 110 pacientes, sendo 70 com SMD e 40 com AA. A pesquisa de anticorpos anti-HLA de classe I foi realizada frente a um painel (PRA), utilizando-se a técnica de microlinfocitotoxicidade dependente do complemento. Vinte (28,6 por cento) dos 70 pacientes com as SMD e 18 (45 por cento) dos 40 pacientes com AA desenvolveram anticorpos anti-HLA contra o PRA. Esses pacientes que receberam uma carga de antígenos estranhos advindos de múltiplas transfusões de vários doadores de CH e/ou CP, geralmente desenvolvem aloanticorpos contra os antígenos HLA presentes na superfície das plaquetas e dos leucócitos que contaminam esses concentrados. A produção desses anticorpos pode trazer sérias complicações para o tratamento dos pacientes com SMD e AA. As avaliações sistemáticas para detecção de anticorpos anti-HLA após a reposição transfusional podem ser valiosas para adoção de estratégias transfusionais mais adequadas para esta população de pacientes.

Patients with myelodysplastic syndromes (MDS) or aplastic anemia (AA) present peripheral cytopenias and require continuous transfusions of red cell and/or platelet concentrates. The objective of this study is to verify the existence of anti-HLA class 1 antibodies in patients with MDS and AA treated at the hematology Out patient Clinic of Hemoce/UFC. A total of 110 patients were analyzed, 70 with MDS and 40 with AA. Anti-HLA class 1 antibody detection was achieved with an antibody reactivity panel using the complement-dependent microlymphocytotoxicity technique. A total of 20 (28.6 percent) of the 70 patients with MDS and 18 (45 percent) of the 40 patients with AA developed anti-HLA antibodies against the antibody panel. In general, patients who received a load of foreign antigens originating from multi-donor red cell and platelet concentrate transfusions, developed alloantibodies against the HLA antigens that exist on the surface of platelets and on white blood cells that contaminate these concentrates. The production of these antibodies may cause serious complications in the treatment of MDS and AA patientss.

Valores positivos e desenvolvimento do adolescente: uma perspectiva dos pais / Positive values and adolescent development: a parents' perspective

A presente pesquisa é parte do projeto Os valores positivos e o desenvolvimento do adolescente. Foi planejada com o objetivo de compreender se os valores que os pais julgavam importante transmitir aos adolescentes, estavam em consonância com aqueles propostos pelo Questionário Profiles of Student Life: Attitudes and Behaviors. Para tanto, os pais foram questionados sobre o que julgavam importante transmitir aos filhos, as estratégias utilizadas e os resultados esperados e percebidos. Foram realizadas entrevistas semi-estruturadas com mães e pais paulistanos, categorizados de acordo com seu índice de vulnerabilidade social. Os resultados indicaram que os valores que os pais buscavam transmitir aos adolescentes estavam em consonância com aqueles propostos pelo referido questionário. Utilizando-se de estilos parentais classificados como democráticos e/ou autoritários, os pais avaliaram haverem sido bem sucedidos como educadores, posição esta que se refletiu na imagem positiva que ofereceram dos filhos. Os resultados também evidenciaram que, além da família, independentemente de seu índice de vulnerabilidade social, faz-se necessário o envolvimento da comunidade no processo de desenvolvimento de estratégias que visam a promover valores positivos nos jovens.

Células dendríticas foliculares: imunofenotipagem no linfoma de Hodgkin clássico esclerose nodular / Dendritic follicular cells: immunophenotyping in classic Hodgkin's lymphoma nodular sclerosis

O linfoma de Hodgkin clássico esclerose nodular (LHCEN), de origem linfóide da célula B do centro germinativo (CG), apresenta agregados de células dendríticas foliculares (CDF), célula Hodgkin/Reed Sternberg e variantes, células B formando complexos relacionados ao CG, sugerindo uma associação entre esclerose nodular e formação do centro germinativo. O objetivo desse estudo foi avaliar a célula dendrítica folicular, por imunofenotipagem com o anticorpo fascina, em biópsia de linfonodo periférico ou massa do mediastino de pacientes com LHCEN previamente diagnosticados, procurando identificar critérios como fatores prognósticos. Foram selecionados 38 pacientes, 55,2 por cento do sexo masculino com relação M:F de 1,23: 1 e a idade com média de 29,3 anos; 52,6 por cento em estádios clínicos I-II, sendo 68,4 por cento com sintomas B. Foram analisados 38 espécimes de biópsias, sendo 57,9 por cento do subtipo esclerose nodular II. O estudo imuno-histoquímico mostrou 100 por cento de positividade para o CD30 e 68,4 por cento para o CD15. As CDFs foram identificadas pelo anticorpo fascina, considerado padrão-ouro, através da técnica imunoenzimática indireta peroxidase-anti-peroxidase estreptavidina-avidina-biotina (PAP-Strept ABC), realizada em lâminas pré-tratadas do material de biópsia incluído em blocos de parafina. Foi evidenciado padrão CDF1 em 7,9 por cento, CDF2 em 47,4 por cento e CDF3 em 44,7 por cento. Não houve relação entre a presença da CDF e sexo, idade, estádio clínico e resposta ao tratamento, mas foi demonstrada uma tendência para associação (p=0,056) entre CDF os subtipos LHCEN. Os pacientes com presença de célula dendrítica folicular foram acompanhados por maior período, com média de 32,9 meses, com associação estatisticamente significativa (p=0,001).

Classic nodular sclerosis HodgkinÆs lymphoma (CNSHL) is a lymphoid neoplasm of germinal center (GC) B cells, presenting with aggregates of follicular dendritic cells (FDC), Hodgkin/Reed Sternberg cells and variants and B cells forming complexes related to the GC. This suggests an association between nodular sclerosis and GC formation. The goal of this study was to evaluate the follicular dendritic cells by immunophenotyping with fascin from lymph node or mediastinal mass biopsies of patients previously diagnosed as having CNSHL, in order to attempt to identify criteria as prognostic factors. Thirty-eight patients were selected. A total of 55.2 percent were male with a M:F ratio of 1.23:1 and a mean age of 29.3 years. 52.6 percent were in clinical stage I-II and 68.4 percent had symptoms B. Thirty-eight biopsy specimens were analysed and 57.9 percent were nodular sclerosis II. Immuno­phenotyping showed 100 percent positivity for CD30 and 68.4 percent for CD15. The FDC were identified by fascin, using the peroxidase-antiperoxidase streptavidin-avidin-biotin indirect immuno­enzimatic technique, which was performed on pre-treated slides with the biopsy specimens embedded in paraffin blocks. Fascin was considered to be the gold-standard. The CDF1 pattern was present in 7.9 percent, CDF2 in 47.4 percent and CDF3 in 44.7 percent. There was no association between the presence of the FDC and gender, age, clinical stage, response to treatment, but a tendency for association (p=0.056) between the subtypes of CNSHL. Patients with FDC present in their biopsies were followed up for a longer period of time - about 32.9 months. This enabled a significant statistical association (p=0.001) between the presence of FDC and length of follow-up.

Comparison of sweat rate during graded exercise and the local rate induced by pilocarpine

Centrally stimulated sweat rate produced by graded exercise until exhaustion was compared to the local sweat rate induced by pilocarpine, often used as a sweating index for healthy individuals. Nine young male volunteers (22 ± 4 years) were studied in temperate environment in two situations: at rest and during progressive exercise with 25 W increases every 2 min until exhaustion, on a cycle ergometer. In both situations, sweating was induced on the right forearm with 5 ml 0.5 percent pilocarpine hydrochloride applied by iontophoresis (1.5 mA, 5 min), with left forearm used as control. Local sweat rate was measured for 15 min at rest. During exercise, whole-body sweat rate was calculated from the body weight variation. Local sweat rate was measured from the time when heart rate reached 150 bpm until exhaustion and was collected using absorbent filter paper. Pharmacologically induced local sweat rate at rest (0.4 ± 0.2 mg cm-2 min-1) and mean exercise-induced whole-body sweat rate (0.4 ± 0.1 mg cm-2 min-1) were the same (P > 0.05) but were about five times smaller than local exercise-induced sweat rate (control = 2.1 ± 1.4; pilocarpine = 2.7 ± 1.2 mg cm-2 min-1), indicating different sudorific mechanisms. Both exercise-induced whole-body sweat rate (P < 0.05) and local sweat rate (P < 0.05) on control forearm correlated positively with pilocarpine-induced local sweat rate at rest. Assuming that exercise-induced sweating was a result of integrated physiological mechanisms, we suggest that local and whole-body sweat rate measured during graded exercise could be a better sweating index than pilocarpine.

Seleção de Trichogramma spp., para o controle de Ecdytolopha aurantiana, com base na biologia e exigências térmicas / Biology and thermal requirements to Trichogramma spp. selection for Ecdytolopha aurantiana control

O objetivo deste trabalho foi avaliar o potencial de utilização de Trichogramma atopovirilia Oatman & Platner, 1983 e T. pretiosum Riley, 1879 como agentes de controle de Ecdytolopha aurantiana (Lima, 1927) (Lepidoptera: Tortricidae), importante praga da citricultura paulista. Foram realizados estudos de biologia em diferentes temperaturas, exigências térmicas e capacidade de parasitismo, visando fornecer subsídios a programas de controle biológico com estes parasitóides. A razõo sexual não foi afetada pelas temperaturas estudadas (18, 20, 22, 25, 28, 30 e 32ºC), porém, a longevidade de fêmeas das duas espécies foi maior a 22 e 25ºC. Para a porcentagem de emergência e longevidade de fêmeas, a temperatura que tendeu a ser mais adequada foi a de 25ºC. A duração do período ovo-adulto para as duas espécies foi inversamente relacionada com o aumento da temperatura, sendo as exigências térmicas dessas espécies muito próximas, em torno de 108 GD. O hospedeiro natural, E. aurantiana, ou o alternativo, Anagasta kuehniella (Zeller, 1879) (Lepidoptera, Pyralidae), nõo afetaram o número de ovos parasitados por fêmea de Trichogramma. Porém, a porcentagem de parasitismo e o número de adultos emergidos por ovo, quando provenientes de ovos de E. aurantiana, foram maiores do que os criados sobre ovos de A. kuehniella. A porcentagem de emergência foi, no entanto, maior quando os parasitóides foram provenientes de ovos de A. kuehniella. As duas espécies de Trichogramma estudadas poderão ser testadas em campo para controle do bicho-furão-dos-citros, havendo uma indicação de que as exigências térmicas também podem servir como um bom parâmetro para seleção de espécies e/ou linhagens de Trichogramma, aliadas ao estudo de capacidade de parasitismo.

A supressao do Aleitamento materno e o HIV / Breast feeding suppression and HIV

O crescimento da epidemia de AIDS entre as mulheres levou, consequentemente, ao aumento do numero de casos em criancas, pois a grande maioria e devido a transmissao vertical do hiv, cuja probalidade de ocorrencia foi demonstrada em varios estudos. Foi evidenciado que a maioria dos casos, cerca de 65 porcento, ocorre durante o trabalho de parto e no parto propriamente dito e os 35 porcento restantes ocorrem intra-utero, principalmente nas ultimas semanas de gestacao; o aleitamento materno representa risco adicional de transmissao de 7 porcento a 22 porcento. A evidencia de transmissao do HIV pela amamentacao levou o Ministerio da Saude a contra-indicar o aleitamento materno por mulheres portadoras do HIV, assim como o aleitamento cruzado (feito por outra mulher). O presente artigo apresenta consideracoes sobre a utilizacao do teste rapido para pesquisa do HIV nas parturientes e sobre a importancia da supressao da lactacao nas mulheres HIV+, descrevendo os metodos que podem ser recomendados

Biodiversity of frugivorous flies (Diptera: Tephritoidea) captured in citrus groves, Mato Grosso do Sul, Brazil / Biodiversidade das moscas frugívoras (Diptera: Tephritoidea) capturadas em pomares de citros, Mato Grosso do Sul

This paper presents a faunistic analysis of the frugivorous species of Tephritoidea (Diptera) captured in three citrus groves in the municipalities of Anastácio (Chácara Laranjal, 20º 31' 36'' S, 55º 50' 12'' W, 170 m) and Terenos (Chácara Suzuki, 20º 26' 12" S, 55º 04' 54'' W, 308m), MS, Brazil, during a 25 month period. McPhail traps with 5 percent hydrolyzed corn protein were hung in Citrus sinensis (L.) and C. reticulata (L.) trees, spaced 30 m apart. The Tephritidae species caught were: Anastrepha alveatoides Blanchard, A. bezzii Lima, A. castanea Norrbom, A. daciformis Bezzi, A. dissimilis Stone, A. distincta Greene, A. fraterculus (Wied.), A. grandis (Macquart), A. haywardi Blanchard, A. leptozona Hendel, A. macrura Hendel, A. montei Lima, A. obliqua (Macquart), A. pickeli Lima, A. punctata Hendel, A. rheediae Stone, A. serpentina (Wied.), A. sororcula Zucchi, A. striata Schiner, A. turpiniae Stone, A. undosa Stone, A. zenildae Zucchi, three undescribed species - Anastrepha sp.1, Anastrepha sp.2; Anastrepha sp.3 and Ceratitis capitata (Wied.). The frugivorous Lonchaeidae caught were: Dasiops sp.; D. inedulis Steyskal, Lonchaea sp. and Neosilba spp. The Mediterranean Fruit Fly, C. capitata, was the most abundant and frequent, being the dominant species in the groves of both municipalities. In the Citrus grove in Anastácio the most abundant species were: Anastrepha daciformis, A. obliqua, A. pickeli, A. punctata, A. sororcula and A. fraterculus. In the Citrus groves in Terenos, A. dissimilis, A. punctata, A. sororcula, A. daciformis, A. striata and A. pickeli were the most abundant species.

Este trabalho apresenta uma análise faunística das espécies frugívoras de Tephritoidea (Diptera), capturadas em três pomares de citros dos municípios de Anastácio e Terenos-MS, durante 25 meses. Armadilhas plásticas McPhail com proteína hidrolisada de milho a 5 por cento foram penduradas em plantas de Citrus sinensis (L.) e C. reticulata (L.) a 1,70 m do nível do solo e espaçadas a 30 m. As espécies de Tephritidae capturadas foram: Anastrepha alveatoides Blanchard, A. bezzii Lima, A. castanea Norrbom, A. daciformis Bezzi, A. dissimilis Stone, A. distincta Greene, A. fraterculus (Wied.), A. grandis (Macquart), A. haywardi Blanchard, A. leptozona Hendel, A. macrura Hendel, A. montei Lima, A. obliqua (Macquart), A. pickeli Lima, A. punctata Hendel, A. rheediae Stone, A. serpentina (Wied.), A. sororcula Zucchi, A. striata Schiner, A. turpiniae Stone, A. undosa Stone, A. zenildae Zucchi; três espécies não-descritas - Anastrepha sp.1, Anastrepha sp.2, Anastrepha sp.3 e Ceratitis capitata (Wied.). Os Lonchaeidae capturados foram: Dasiops sp.; D. inedulis Steyskal, Lonchaea sp. e Neosilba spp. A mosca-do-mediterrâneo, C. capitata foi a espécie mais abundante e freqüente, sendo dominante nos pomares de ambos os municípios. No pomar do município de Anastácio, as espécies mais abundantes foram: Anastrepha daciformis, A. obliqua, A. pickeli, A. punctata, A. sororcula e A. fraterculus. Nos pomares de Terenos, A. dissimilis, A. punctata, A. sororcula, A. daciformis, A. striata e A. pickeli foram as espécies mais abundantes.

Western blot seroindeterminate individuals for Human T-lymphotropic Virus 1/2 (HTLV-1/2) in Fortaleza (Brazil): a serological and molecular diagnostic and epidemiological approach

How to handle Western blot (WB) seroindeterminate individuals for Human T-lymphotropic Virus 1/2 (HTLV-1/2) constitutes a challenge for blood banks and fam ilies. We made a cross-sectional study of 191 enzyme linked immunoassay (EIA) reactive individuals from the hematological center (HEMOCE) of Fortaleza (Brazil), examining their serological (WB) and molecular (PCR) diagnosis, and demographic profiles, as well as a possible association of their condition with other infectious pathologies and risk factors. Ethical institutional approval and personal consent were obtained. Out of 191 EIA reactive individuals, 118 were WB seroindeterminate and 73 were seropositive for HTLV-1/2. In the PCR analysis of 41 WB seroindeterminate individuals, 9 (22 percent) were positive and 32 (78 percent) were negative for HTLV-1/2. The demographic analysis indicated a trend towards a predominance of males among the seroindeterminate individuals and females in the seropositive ones. The seroindeterminate individuals were younger than the seropositive ones. We did not find any association of these conditions with syphilis, Chagas disease or HIV or hepatitis, and with risk factors such as breast-feeding, blood transfusion, STD (syphilis) and IDU

Populational fluctuation of frugivorous flies (Diptera: Tephritoidea) in two orange groves in the State of Mato Grosso do Sul, Brazil / Flutuação populacional de moscas frugívoras (Diptera: Tephritoidea) em dois pomares de laranjas do Estado de Mato Grosso do Sul

This paper evaluated the capture of frugivorous flies (Tephritidae and Lonchaeidae) with plastic McPhail traps, in two commercial citrus groves, located in the municipalities of Anastácio and Terenos, in the state of Mato Grosso do Sul, Brazil. The aim of this work was to determine the populational fluctuation of adult frugivorous flies, and to study its relationship with the damaged fruits in the groves. The traps were placed about 30 m apart over the entire area in both groves, hung up approximately 1.70 m high from soil, in the canopy of the citrus plants. Eight traps were installed (two traps/ha) at Anastácio and 21 traps in Terenos (one trap/ha). The traps were baited with the hydrolyzed corn protein (5 percent) TephritidTM (food bait). Evaluations were carried out from March 22, 1994 to March 23, 1996. Ceratitis capitata (Wiedemann) and 25 species of Anastrepha were caught during several months in both orange groves, but no fruit fly species were found infesting oranges. Neosilba sp. was caught from the traps during all the experiment and was also reared from the damaged oranges, thus suggesting that that fly can be a pest. The predominant species of frugivorous flies caught in the traps were: Neosilba sp., C. capitata, Anastrepha punctata Hendel and A. sororcula Zucchi. There was no correlation between adult frugivorous flies caught in the traps and the number of larvae and adult flies reared from the infested oranges collected in the groves.

Este trabalho avaliou a captura de moscas frugívoras (Tephritidae e Lonchaeidae) com armadilhas plásticas McPhail, em dois pomares comerciais de citros, localizados nos municípios de Anastácio e Terenos, Estado de Mato Grosso do Sul. Os objetivos foram estudar a flutuação populacional dos adultos capturados nas armadilhas e verificar qual a relação entre as espécies amostradas nas armadilhas com os frutos danificados. As armadilhas foram distanciadas cerca de 30 m entre si sobre toda a área, penduradas a aproximadamente 1,70 m de altura, na copa das plantas de citros. Foram instaladas oito armadilhas (duas armadilhas/ha) no pomar em Anastácio e 21 armadilhas em Terenos (uma armadilha/ha). As armadilhas foram iscadas com a proteína hidrolizada de milho (5 por cento) TephritidMR (atrativo alimentar). As avaliações foram feitas no período de 22 de março de 1994 a 23 de março de 1996. A mosca-do-mediterrâneo Ceratitis capitata (Wiedemann) e 25 espécies de Anastrepha foram capturadas em vários meses nas armadilhas, mas não infestaram laranjas. Neosilba sp. foi capturada ininterruptamente durante os 25 meses e foi encontrada, também, nos frutos danificados amostrados nos pomares. Isso sugere que Neosilba sp. pode ter importância econômica em citros. As espécies de moscas frugívoras predominantes foram Neosilba sp., C. capitata, Anastrepha punctata Hendel e A. sororcula Zucchi. Não houve correlação entre o número de adultos de moscas frugívoras capturadas nas armadilhas com o número de larvas e de adultos criados das laranjas infestadas colhidas nos pomares.

Soroprevalência e perfil imunofenotípico de células linfóides T em indivíduos soropositivos para o vírus linfotrópico de células T humanas / Seroprevalence and immunophenotypic profile of T lymphocyte cells in human T lymphotropic virus seropositive individuals

O vírus linfotrópico de células T humana (HTLV) é transmitido por transfusões, uso compartilhado de agulhas contaminadas, aleitamento e contato sexual. A prevalência varia de acordo com a região geográfica, grupo racial e população estudada. Cerca de 1 por cento a 4 por cento dos indivíduos infectados desenvolvem algum tipo de doença em decorrência da infecção. É reconhecida a associação entre o HTLV-I e leucemia de células T do adulto e paraparesia espástica tropical (PET). Embora a maioria dos portadores permaneça assintomática, existem evidências de comprometimento funcional da resposta imune celular. Os objetivos desse trabalho foram avaliar a prevalência de soropositividade para HTLV-I/II na população de doadores de sangue do HEMOCE e analisar o perfil imunofenotípico de células linfóides circulantes em 26 doadores soronegativos, 11 soropositivos para HTLV-I sintomáticos e 24 assintomáticos, comparando-os entre si. A prevalência da soropositividade para HTLV-I/II foi de 0,66 por cento. No grupo de indivíduos contaminados pelo HTLV-I houve predomínio do sexo feminino e a maior média de idade. O grupo soropositivo apresentou menor valor de hemoglobina e o grupo sintomático evidenciou contagem de neutrófilos significativamente mais elevada. A contagem média de linfócitos não diferiu entre os grupos. A análise imunofenotípica mostrou que os valores médios de células CD3+, CD4+, CD8+ e relação CD4/CD8 não diferiram significativamente entre os grupos. Uma elevação de células CD8+ no grupo soropositivo foi observada embora não alcançasse significância estatística. A ativação de linfócitos CD8+ está envolvida na patogênese das doenças associadas ao HTLV-I. A definição do valor preditivo desse achado requer confirmação posterior

Human T lymphotropic virus (HTLV) can betransmitted by transfusions of cellular blood products,shared use of contaminated syringes, breast feedingand sexual intercourse. The prevalence of the infectionvaries according to geographic region, racial group,and population under risk. About 1% to 4% of theinfected individuals develop some form of infectionrelateddisease. The association of HTLV-I with AdultT-Cell Leukaemia, as well as the Tropical SpasticParaparesis, is presently well recognised. Although mostHTLV-I-infected individuals remain asymptomatic,there are indications that cellular immune responsesare functionally impaired. The aims of this study wereto determine the prevalence of HTLV-I/II seropositivityamong blood donors in HEMOCE and analyse theimmunophenotypic profile of peripheral lymphocytesin 26 HTLV-I seronegative blood donors, 11symptomatic and 24 asymptomatic HTLV-I seropositiveindividuals. The prevalence of HTLV-I/II was 0,66%. Inthe infected group a predominance of females wasobserved as well as a higher average age. The meanhemoglobin value was found to be significantly lowerin this group and the mean polymorphonuclearneutrophil count was significantly higher among thesymptomatic individuals. The mean lymphocyte andplatelet count were not significantly different betweenthe groups. Immuno-phenotyping evaluation revealedthat the mean CD3+, CD4+, CD8+ T cell counts, aswell as the CD4+/CD8+ ratio were not significantlydifferent between the groups. A slightly higher meanCD8+ T lymphocyte count was observed in theseropositive individuals, although it did not reachstatistical significance. The activation of CD8+ subsetis known to be part of pathogenesis of HTLV-I-relateddiseases. The predictive value of this immunologicalfinding needs further and long-range studies.

Species Diversity of Frugivorous Flies (Diptera: Tephritoidea) from Hosts in the Cerrado of the State of Mato Grosso do Sul, Brazil / Diversidade de Espécies de Moscas Frugívoras (Diptera: Tephritoidea) em Hospedeiros do Cerrado do Estado de Mato Grosso do Sul

Neste trabalho foram amostradas 35 espécies de frutos do cerrado em sete municípios do estado de Mato Grosso do Sul (janeiro de 1993 a março de 1997) para avaliar a infestação por moscas frugívoras. Ocorreram espécies de seis gêneros de Tephritoidea - Anastrepha Schiner, Ceratitis MacLeay (Tephritidae); Dasiops Rondani, Lonchaea Fallén, Neosilba McAlpine (Lonchaeidae) e Notogramma Loew (Otitidae), em 29 espécies de frutos. As moscas-das-frutas (Tephritidae) colonizaram 19 hospedeiros e foram representadas por 11 espécies: Anastrepha fraterculus (Wied.), A. grandis (Macquart), A. montei Lima, A. obliqua (Macquart), A. pickeli Lima, A. sororcula Zucchi, A. striata Schiner, A. turpiniae Stone, A. zenildae Zucchi, Anastrepha sp. n. e Ceratitis capitata (Wied.). De Lonchaeidae foram obtidos: Dasiops inedulis Steyskal, Dasiops spp., Lonchaea spp., Neosilba zadolicha McAlpine e Neosilba spp. As espécies de Neosilba foram as mais abundantes moscas frugívoras, ocorrendo em 22 hospedeiros. Notogramma foi o único gênero de Otitidae obtido. É discutida a associação entre moscas frugívoras e frutos hospedeiros.

Thirty-five fruit species were sampled in seven municipalities located in the cerrado of the state of Mato Grosso do Sul (January 1993 to March 1997) in a study to evaluate the infestation by frugivorous flies. Species of six genera of Tephritoidea were reared from 29 host fruits: Anastrepha Schiner, Ceratitis MacLeay (Tephritidae); Dasiops Rondani, Lonchaea Fallén, Neosilba McAlpine, (Lonchaeidae) and Notogramma Loew (Otitidae). Fruit flies (Tephritidae) were found in 19 host fruits and were represented by 11 species: Anastrepha fraterculus (Wied.), A. grandis (Macquart), A. montei Lima, A. obliqua (Macquart), A. pickeli Lima, A. sororcula Zucchi, A. striata Schiner, A. turpiniae Stone, A. zenildae Zucchi, Anastrepha n. sp. and Ceratitis capitata (Wied.). From Lonchaeidae were reared: Dasiops inedulis Steyskal, Dasiops spp., Lonchaea spp., Neosilba zadolicha McAlpine and Neosilba spp. The species of Neosilba were the most abundant, occourring in 22 host fruits. Notogramma was the only genus of Otitidae obtained. The association between frugivorous flies and the fruit species is discussed.

O sonho da eterna juventude: percepção do envelhecimento de uma perspectiva de gênero / Dreaming about being young forever: the aging process from a gender perspective

A partir da constatação da crescente medicalização do climatério feminino (prática que vem sendo estendida também aos homens), cuja ideologia implica poder controlar o fantasma da velhice, focaram-se neste estudo as inter-relações do discurso médico com a construção da identidade feminina e masculina na meia-idade. Homens e mulheres entre 40 e 55 anos foram perguntados sobre como se percebiam nessa fase da vida. Os resultados evidenciaram diferenças na maneira de perceber-se e construir-se, demonstrando marcante tendência de conteúdos negativos referidos pelas mulheres. Uma revisão da literatura demonstrou que o climatério feminino vem sendo historicamente construído de forma negativa, ao contrário do discurso que se refere aos homens. Se o ser humano constitui-se como self, apropriando-se de significados culturais, conceber a interpretação dos processos fisiológicos através de uma interação dialógica complexa entre a pessoa, o outro e fatores socioculturais, possibilita conceber a mudança através de novos significados, na promoção de novas formas de subjetividade. Neste sentido, uma revisão desses discursos facilitaria esse processo, ao ressignificar os assim chamados tormentos femininos, como obstáculo ao desenvolvimento das mulheres.