Geographic distribution of hepatitis C virus genotypes in Brazil

Brazil is a country of continental dimension with a population of different ethnic backgrounds. Thus, a wide variation in the frequencies of hepatitis C virus (HCV) genotypes is expected to occur. To address this point, 1,688 sequential samples from chronic HCV patients were analyzed. HCV-RNA was amplified by the RT-PCR from blood samples collected from 1995 to 2000 at different laboratories located in different cities from all Brazilian States. Samples were collected in tubes containing a gel separator, centrifuged in the site of collection and sent by express mail in a refrigerated container to Laboratório Bioquímico Jardim Paulista, São Paulo, SP, Brazil. HCV- RNA was extracted from serum and submitted to RT and nested PCR using standard procedures. Nested PCR products were submitted to cycle sequencing reactions without prior purification. Sequences were analyzed for genotype determination and the following frequencies were found: 64.9 percent (1,095) for genotype 1, 4.6 percent (78) for genotype 2, 30.2 percent (510) for genotype 3, 0.2 percent (3) for genotype 4, and 0.1 percent (2) for genotype 5. The frequencies of HCV genotypes were statistically different among Brazilian regions (P = 0.00017). In all regions, genotype 1 was the most frequent (51.7 to 74.1 percent), reaching the highest value in the North; genotype 2 was more prevalent in the Center-West region (11.4 percent), especially in Mato Grosso State (25.8 percent), while genotype 3 was more common in the South (43.2 percent). Genotypes 4 and 5 were rarely found and only in the Southeast, in São Paulo State. The present data indicate the need for careful epidemiological surveys throughout Brazil since knowing the frequency and distribution of the genotypes would provide key information for understanding the spread of HCV.

Ocorrência da infecção pelo vírus da hepatite B (VHB) e delta (VHD) em sete grupos indígenas do Estado do Amazonas / The occurrence of hepatitis B and delta virus infection within seven Amerindian ethnic groups in the Brazilian western Amazon

HBV and HDV infections are a major health problem in the Amazon. This study evaluates the prevalence of these viruses within Indians groups, measuring the frequency of serological markers. The prevalence of past infection was 54.5% and HBsAg was found in 9.7%. An important variation of those markers was detected between villages, inclusively within the same ethnic group. None showed evidence of an acute infection. All HBeAg reactive were Apurinã, living in the same village and three of them from the same family. The prevalence of anti-HDT was 13.4% in HBsAg positive individuals. The authors observed high prevalence of HBV and HDV infection with the following pattern: low degree of infectivity, marked transmission in early ages, intra-familial dissemination, and lack of importance of vertical transmission. However, the results suggest that these viruses were not yet introduced effectively in some of the studied groups.

A infecção pelo VHB e VHD são importantes problemas de saúde na Amazônia. Este estudo avalia a prevalência da infecção por esses agentes em sete grupos indígenas do Estado do Amazonas. A taxa de infecção passada pelo VHB encontrada foi de 54,5% e a de portadores do AgHBs de 9,7%. Observa-se variação importante destes marcadores entre as aldeias, inclusive da mesma etnia. Não evidenciamos marcador de infecção aguda, os quatro AgHBe reativos eram todos Apurinã, da mesma aldeia, e três da mesma família. O VHD foi encontrado em 13,4% dos AgHBs reativos. O padrão de infecção pelo VHB e VHD encontrado possui as seguintes características: endemicidade elevada, baixo potencial de infectividade, transmissão marcada em idade precoce, provável transmissão familiar, e pouca importância da transmissão vertical. Entretanto, também sugere que esses vírus não tenham sido ainda introduzidos efetivamente em algumas das etnias estudadas

Eficacia de las maniobras de reposición canicular en el tratamiento del vértigo postural paroxístico benigno / Efficacy of canalicular replacement procedures in the treatment of benign paroxysmal postural vertigo

Se estudiaron 12 pacientes con diagnóstico de vértigo postural paroxístico benigno del canal semicircular posterior que cumplieran con los requisitos clínicos a éste y que tuvieran maniobra de Dix-Hallpike positiva, en el período comprendido entre octubre de 1999 y enero del año 2000. Todos los pacientes fueron de sexo femenino, con un promedio de edad de 46 años y de evolución de los síntomas de 20 meses. Nueve pacientes (75 por ciento) presentaban afección del canal semicircular del oído derecho y tres pacientes (25 por ciento) del lado izquierdo. Se practicaron las maniobras de reposición canalicular a la totalidad de los pacientes siendo necesario realizar una sesión en tres pacientes, dos sesiones a 8 pacientes y tres a un paciente, para la resolución completa de los síntomas y la negativización de la maniobra de Dix-Hallpike

Evaluación de las secuelas neurológicas de los traumatismos vértebromedulares / Evaluation of neurological sequels of vertebral spine injuries

Para los peritos se dan datos para la evaluación porcentual de las secuelas neurológicas de los accidentes vértebro-medulares, según el Baremo/1994 de ANSES en los rubros de: 1- Fractura y luxación de la columna verteral; 2-conmoción y contusión; 3-Hematomelia; 4-Compresión del cono medular; 5- compresión de la cauda equina