Brazilian national bariatric registry - pilot study / Registro nacional de dados em cirurgia bariátrica - estudo piloto

ABSTRACT Introduction: Brazil is a world leader in bariatric surgery. However, the actual number of surgeries performed in the country is still unknown. It is necessary to implement an instrument to monitor the quality of care provided. This study evaluated the implementation of a Bariatric Surgery Data Registry in Brazil. Methodology: the registry was developed with Dendrite Clinical Systems Ltd., with data collected prospectively on an internet-based software. Seven centers were selected based on surgical volume and data entry commitment. The project covered three years after system implementation. Results: 1,363 procedures performed by 17 surgeons were included. Most patients were female (67.2%), with average age of 39 years old and average baseline BMI of 41.5kg/m2. Diabetes mellitus was present in 34.5%, and hypertension in 40.1%. Roux-en-Y gastric bypass was performed in 79.3%, 95.5% by laparoscopy. There was one in-hospital death of cardiovascular cause. The average hospital stay was 2.03 days. The surgery-related complication rate was 0.97% in the first month, with three reoperations. Short-term follow-up was recorded in 75.6% and one-year follow-up in 21.64%. Total body weight loss was 10% in 30 days, rising to 33.3% after one year, with no difference between surgical techniques. Conclusions: the population profile was in accordance with the global registry of the International Federation for the Surgery of Obesity and Metabolic Disorders. The main difficulty encountered was low postoperative data entry. The experience acquired in this project will help advance data collection and knowledge of the safety and effectiveness of bariatric surgery in Brazil.

RESUMO Introdução: o Brasil é líder mundial em cirurgia bariátrica. No entanto, o número de cirurgias realizadas no país ainda é desconhecido. É necessário um instrumento para monitorar a qualidade da assistência prestada. Este estudo avaliou a implantação de um Registro de Dados de Cirurgia Bariátrica no Brasil. Metodologia: O registro foi desenvolvido com a Dendrite Clinical Systems Ltd., com dados coletados prospectivamente em software na internet. Sete centros foram selecionados, baseado no volume cirúrgico e compromisso de inserção de dados. O projeto abrangeu três anos após implementação. Resultados: foram incluídos 1.363 procedimentos realizados por 17 cirurgiões. A maioria dos pacientes eram mulheres (67,2%), com idade média de 39 anos e IMC basal médio de 41,5kg/m2. Diabetes mellitus estava presente em 34,5% e hipertensão em 40,1%. Bypass gástrico em Y de Roux foi realizado em 79,3%, 95,5% por laparoscopia. Houve um óbito hospitalar de causa cardiovascular. A média de permanência hospitalar foi de 2,03 dias. A taxa de complicações relacionadas à cirurgia foi 0,97% no primeiro mês, com três reoperações. Seguimento de curto prazo foi registrado em 75,6% e de um ano em 21,64%. A perda de peso corporal total foi de 10% em 30 dias, aumentando para 33,3% após um ano, sem diferença entre técnicas cirúrgicas. Conclusões: o perfil populacional está de acordo com o registro global da IFSO. A principal dificuldade encontrada foi a baixa inserção de dados pós-operatórios. A experiência adquirida neste projeto ajudará no conhecimento da segurança e eficácia da cirurgia bariátrica no Brasil.

Detección molecular de Toxoplasma gondii en carnes para consumo humano en Ibagué, Colombia / Molecular detection of Toxoplasma gondii in meat for human consumption in Ibague, Colombia

Introducción. Toxoplasma gondii es un parásito con gran potencial zoonótico que puede infectar un amplio rango de huéspedes de sangre caliente, incluidos los animales del sector pecuario, lo que causa pérdidas a la industria. En el humano, es patógeno en personas inmunosuprimidas y afecta el desarrollo del feto en infecciones congénitas. Además, se asocia con diversos trastornos del comportamiento en personas sanas. El humano puede adquirir T. gondii al consumir carnes contaminadas mal cocidas. Objetivo. Determinar la positividad de T. gondii en carnes de consumo humano (res, pollo y cerdo) en Ibagué, Colombia. Materiales y métodos. Se utilizó la PCR convencional anidada y la secuencia del gen B1 de T. gondii como blanco de amplificación. Se tomaron 186 muestras de carne comercializada en la zona urbana de Ibagué (62 de res, 62 de pollo y 62 de cerdo) y se obtuvo el porcentaje de positividad en cada tipo de carne evaluada. Resultados. Se encontró un porcentaje de positividad de 18,8 % en las muestras, siendo la carne de cerdo la del mayor porcentaje (22,5 %; 14/62), seguida por las muestras de carne de res (19,3 %; 12/62) y de pollo (14,5 %; 9/62). Los mejores productos amplificados fueron secuenciados en Macrogen, y alineados con las secuencias del gen B1 depositadas en el GenBank, con lo que se confirmó su identidad. Conclusiones. Este es el primer estudio sobre prevalencia de T. gondii en carnes para consumo humano en Ibagué y el departamento del Tolima. Se demostró que los tres tipos de carne representan un riesgo para la infección en humanos a nivel local.

Introduction: Toxoplasma gondii is a parasite with great zoonotic potential. It can infect a broad range of warm-blooded hosts (including livestock) and causes significant losses in the industry. In humans, it has been described as a pathogen in immunosuppressed people, it affects the fetus development in congenital infections, and is associated with various behavioral disorders in healthy people. Humans can acquire T. gondii by consuming undercooked, contaminated meat. Objective: To determine T. gondii positivity (currently unknown) in meat for human consumption (i.e., beef, chicken, and pork) in the city of Ibague, Colombia. Materials and methods: We used conventional nested PCR and the T. gondii B1 gene sequence as amplification target. We collected samples of meat (N=186) sold in the urban area of Ibagué (62 beef, 62 chicken, and 62 pork samples) and determined the T. gondii positivity percentage for each type of meat. Results: The study found an average of 18.8% positivity for all meat samples, pork having the highest percentage (22.5%; 14/62), followed by beef (19.3%; 12/62) and chicken (14.5%; 9/62). The best-amplified products were sequenced by macrogen and aligned with the B1 gene sequences in GenBank, thereby confirming their identity. Conclusions: This is the first study of T. gondii prevalence in meat for human consumption carried out in the city of Ibagué and the department of Tolima. All three types of meat sampled represent a risk for local human infection.

Effects of the submerged macrophyte Ceratophyllum demersum (Ceratophyllaceae) and the cladoceran Moina micrura (Cladocera: Moinidae) on microalgal interactions / Efectos de un macrófito sumergido Ceratophyllum demersum (Ceratophyllaceae) y un cladócero Moina micrura (Cladocera: Moinidae) sobre las interacciones de microalgas

Abstract Introduction: Cyanobacterial blooms in tropical water bodies are increasingly common, because of eutrophication and rising temperatures. Consequently, many freshwater systems are affected, by reducing water quality, biodiversity, and ecosystem services. With the increased frequency of harmful algal blooms, the development of biological tools to improve water quality is an urgent issue. Objective: To evaluate the effects of a submerged macrophyte and a cladoceran on the microcystin-producing cyanobacteria Microcystis aeruginosa (NPLJ-4) and the chlorophyte Raphidocelis subcapitata (BMIUFRPE-02) in mixed cultures. Methods: Two parallel experiments were carried out for ten days to evaluate the effects of the submerged macrophyte Ceratophyllum demersum and the cladoceran Moina micrura on microalgal interactions. Microalgal strains were cultivated in the ASM1 culture medium, under controlled laboratory conditions. The first experiment presented four treatments: M (C. demersum), Z (M. micrura), MZ (C. demersum and M. micrura), and C (control). Meanwhile, the second experiment consisted of five treatments, in which the microalgae were cultivated together at different Microcystis:Raphidocelis ratios: 1:0, 3:1, 1:1, 1:3, and 0:1. Biomass and growth rates of the strains were evaluated every two days, which were statistically treated with three-way or two-way repeated-measures ANOVA. Results: In the first experiment, M. aeruginosa was significantly inhibited in M and MZ treatments from the second day, and Z from the fourth, while R. subcapitata showed no reduction in its biomass in any treatment. On the other hand, R. subcapitata was stimulated from the eighth and tenth days in M treatment and only on the eighth day in Z treatment. In the second experiment, M. aeruginosa was significantly inhibited when cultivated with R. subcapitata in low ratios (Microcystis:Raphidocelis ratio of 1:3) throughout the experiment, while the chlorophyte was stimulated in that treatment. Conclusions: The coexistence of a cyanobacterium with a green alga did not alter the main negative response of M. aeruginosa to the submerged macrophyte and zooplankton but stimulated the green alga. Accordingly, the introduction of submerged macrophytes and cladocerans already adapted to eutrophic conditions, both isolated and combined, proved to be a good method to control cyanobacterial blooms without negatively affecting other coexisting phytoplankton species.

Resumen Introducción: Las proliferaciones de cianobacterias en los cuerpos de agua tropicales son cada vez más comunes, debido a la eutrofización y al aumento de las temperaturas. En consecuencia, muchos sistemas de agua dulce se ven afectados por la reducción de la calidad del agua, la biodiversidad y los servicios de los ecosistemas. Con el aumento de la frecuencia de la proliferación de algas nocivas, el desarrollo de herramientas biológicas para mejorar la calidad del agua es urgente. Objetivo: Evaluar los efectos de una macrófita sumergida y un cladócero sobre la cianobacteria productora de microcistina llamada Microcystis aeruginosa (NPLJ-4) y la clorofita Raphidocelis subcapitata (BMIUFRPE-02) en cultivos mixtos. Métodos: Se realizaron dos experimentos paralelos durante diez días para evaluar los efectos de la macrófita sumergida Ceratophyllum demersum y el cladócero Moina micrura sobre las interacciones microalgales. Se cultivaron cepas de microalgas en el medio de cultivo ASM1, en condiciones controladas de laboratorio. El primer experimento presentó cuatro tratamientos: M (C. demersum), Z (M. micrura), MZ (C. demersum y M. micrura) y C (control). El segundo experimento consistió en cinco tratamientos, en el que las microalgas se cultivaron juntas en diferentes proporciones de Microcystis:Raphidocelis: 1:0, 3:1, 1:1, 1:3 y 0:1. La biomasa y las tasas de crecimiento de las cepas se evaluaron cada dos días, y se trataron estadísticamente con ANOVA de medidas repetidas de dos o tres factores. Resultados: En el primer experimento, M. aeruginosa se inhibió significativamente en los tratamientos M y MZ a partir del segundo día, y en Z a partir del cuarto, mientras que R. subcapitata no mostró reducción de su biomasa en ningún tratamiento. Por otro lado, R. subcapitata fue estimulada a partir del octavo y décimo día en el tratamiento M y solo en el octavo día en el tratamiento Z. En el segundo experimento, M. aeruginosa se inhibió significativamente cuando se cultivó con R. subcapitata en proporciones bajas (proporción de Microcystis:Raphidocelis de 1:3) durante todo el experimento, mientras que la clorófita se estimuló en ese tratamiento. Conclusiones: La coexistencia de una cianobacteria con un alga verde no alteró la principal respuesta negativa de M. aeruginosa a la macrófita sumergida y al zooplancton, sino que estimuló al alga verde. En consecuencia, la introducción de macrófitos y cladóceros sumergidos ya adaptados a las condiciones eutróficas, tanto aislados como combinados, resultó ser un buen método para controlar las proliferaciones de cianobacterias sin afectar negativamente a otras especies de fitoplancton coexistentes.

Seroprevalence of Brucella ovis-epididymitis, smooth-Brucella, leptospirosis, toxoplasmosis, and Maedi-Visna in sheep slaughtered in Minas Gerais State, Brazil / Soroprevalência de Brucella ovis, Brucella lisa, leptospirose, toxoplasmose e Maedi-Visna em ovinos abatidos em Minas Gerais, Brasil

The present study aimed to estimate the prevalence of antibodies against Brucella ovis-epididymitis, smooth-Brucella, leptospirosis, toxoplasmosis and Maedi-visna in sheep slaughtered in Minas Gerais, Brazil and to study their simultaneous occurrence, including caseous lymphadenitis, at sheep and flock levels. The study was conducted at a sheep slaughterhouse with Federal Inspection Service. Sera from 594 animals from 21 flocks were collected, in 2007. The agar gel immunodiffusion (AGID) was employed to detect anti-B. ovis and anti-Maedi Visna antibodies, whereas Rose Bengal (RB) and the 2-mercaptoethanol test (2ME) were used to test anti-smooth Brucella antibodies. For the detection of anti-Leptospiraantibodies, sera were examined by microscopic agglutination test (MAT), while for the detection of IgG antibodies to Toxoplasma gondii ELISA was used. Prevalence of antibodies against smooth Brucella, B. ovis-epididimitis, Leptospiraspp., toxoplasmosis and Maedi-Visna found in sheep from Minas Gerais was 0.00%, 24.04%, 25.96%, 10.46% and 3.08%, respectively; whereas the seroprevalence in flocks was 0.00%, 80.95%, 90.48%, 71.43% and 23.81%, respectively. Moreover, when data on antibodies anti-Corynebacterium pseudotuberculosis, previously obtained, were included, about 60% of the flocks showed animals that were exposed to four or more of the studied agents. However, only 25.47% of the sheep exhibited simultaneously antibodies against more than one pathogen. Thus, data from the present study on sheep slaughtered in Minas Gerais, Brazil, showed no antibodies to smooth-Brucella and a low frequency of antibodies anti-Maedi Visna lentivirus, and a high and widespread seroprevalence of B. ovis, Leptospira spp., and T. gondii among animals and flocks.(AU)

O presente estudo teve como objetivo estimar a prevalência de anticorpos contra Brucella ovis (epididimite ovina), Brucellalisa, leptospirose, toxoplasmose e Maedi-visna em ovinos abatidos em Minas Gerais, Brasil, e estudar sua ocorrência simultânea, incluindo linfadenite caseosa, nos ovinos e nos rebanhos. O estudo foi realizado em um abatedouro de ovinos com Serviço de Inspeção Federal. Soros de 594 animais de 21 rebanhos foram coletados, em 2007. A imunodifusão em gel de ágar (IDGA) foi empregada para detectar anticorpos anti-B. ovis e anticorpos anti-Maedi Visna, enquanto o teste do antígeno acidificado tamponado (AAT) e o teste de 2-mercaptoetanol (2ME) foram utilizados para testar anticorpos anti-Brucella lisa. Para a detecção de anticorpos anti-Leptospira, os soros foram examinados pelo teste de aglutinação microscópica (MAT), enquanto que para a detecção de anticorpos IgG para Toxoplasma gondii, foi usado o ELISA. A prevalência de anticorpos anti-Brucella lisa, B. ovis, Leptospira spp., toxoplasmose e Maedi-Visna encontrados em ovinos de Minas Gerais foi de 0,00%, 24,04%, 25,96%, 10,46% e 3,08%, respectivamente; enquanto a soroprevalência em rebanhos foi de 0,00%, 80,95%, 90,48%, 71,43% e 23,81%, respectivamente. Além disso, quando dados de anticorpos anti-Corynebacterium pseudotuberculosis, previamente obtidos, foram incluídos, cerca de 60% dos rebanhos apresentaram animais expostos a quatro ou mais dos agentes estudados. No entanto, apenas 25,47% dos ovinos exibiram simultaneamente anticorpos contra mais de um patógeno. Assim, os dados do presente estudo sobre ovinos abatidos em Minas Gerais, Brasil, mostram que ausência de anticorpos anti-Brucella lisa e baixa frequência de anticorpos anti-Maedi Visna, e uma soroprevalência alta e generalizada de B. ovis, Leptospira spp. e T. gondii entre animais e rebanhos.(AU)

Surto de toxoplasmose no município de Gouveia, Minas Gerais / Outbreak of toxoplamosis in Goveia, Minas Gerais

Objetivo: investigar surto de toxoplasmose no município de Gouveia-MG, no período entre fevereiro e maio de 2015. Método: foram realizados estudos descritivo e caso-controle, com análise multivariada (regressão logística) e nível de significância de 5%. Definiu-se como caso o indivíduo com toxoplasmose aguda, confirmada laboratorialmente (IgM e/ou IgG reagentes e baixa avidez de IgG), e controle o indivíduo susceptível (IgM e IgG não reagentes). Resultado: o estudo contemplou 50 casos e 68 controles, sendo a maioria dos casos do sexo masculino (43 pacientes, 86%). Os casos tiveram 10 vezes mais chance de tomar água procedente do Manancial (IC95%: 2,8-37,4; p=0,01), 5,1 vezes mais chance de ingerir linguiça (IC95%: 1,2-20,4; p=0,02) e 4,5 vezes mais chance de ser do sexo masculino (IC95%: 1,2-16,7; p=0,02), quando comparados aos controles. Conclusão: foi confirmado um surto de toxoplasmose aguda, em Gouveia - MG, de transmissão hídrica e/ou alimentar. A maior ocorrência no sexo masculino pode estar relacionada a hábitos de risco, envolvidos na transmissão da doença. Foram propostas medidas que resultaram na diminuição e no controle dos casos da doença.

Objective: to investigate the outbreak of toxoplasmosis in the municipality of Gouveia-MG, between February and May 2015. Methods: Descriptive and case control study, with multivariate analysis (logistic regression) and level of significance of 5%. For the purpose of the study, a case was defined on an individual with laboratory which confirmed acute toxoplasmosis (IgM and/or IgG with low IgG avidity) and a control was a susceptible individual (nonreactive IgM and IgG). Results: The study comprised 50 cases and 68 controls, with most cases being male (43 patients, 86%). When compared to controls, cases had 10 times greater odds of having drunk water from Stream A (IC95%: 2,8-37,4; p=0,01), 5,1 times greater odds of having ingested sausage (IC95%: 1,2-20,4; p=0,02) and 4.5 times greater odds of being of male sex (IC95%: 1,2-16,7; p=0,02). Conclusion: A water/foodborne outbreak of acute toxoplasmosis was confirmed in Gouveia-MG, affecting predominantly men. This may be associated with habits regarding disease transmission. Measures that resulted in the reduction and control of cases of this disease have been proposed.

Toxoplasma gondii: isolation, biological and molecular characterisation of samples from free-range Gallus gallus domesticus from countryside Southeast Brazil / Toxoplasma gondii: isolamento, caracterização biológica e molecular de amostras de Gallus gallus domesticus no interior do Sudeste brasileiro

Abstract Toxoplasma gondii presents a high prevalence worldwide, infecting several animals. Felines are considered the definitive hosts and among the intermediate hosts we highlight mammals and birds. The man can become infected by ingesting tissue cysts present in birds and mammals. Biological and molecular aspects of T. gondii allows a better understanding of the epidemiology of toxoplasmosis. This work is a serologic screening of 58 chickens grown (Gallus gallus domesticus) for human consumption in Espírito Santo State, by means of indirect haemagglutination assay (IHA). Thirteen chickens tested positive for anti-T. gondii antibodies. The heart and brain of five positive chickens were harvested, treated with pepsin and inoculated separately, in two Swiss mice, intraperitoneally. Tachyzoites were observed in the peritoneum of all the animals, between seven and 10 days after the inoculum. Ten isolates were obtained and biologically characterised in BALB/c mice inoculated with 101 to 104 tachyzoites. All isolates were classified as virulent or intermediately virulent. Isolates were genotyped by means of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis, revealing three different genotypes. None of the isolates exhibited the clonal type I, II or III genotype. No genotypic differences were observed between the isolates from the brain or heart from the same bird.

Resumo Toxoplasma gondii apresenta alta prevalência mundial, capaz de infectar diversos animais. Felinos são considerados os hospedeiros definitivos e entre os hospedeiros intermediários destacamos os mamíferos e as aves. O homem pode se infectar ingerindo cistos teciduais presentes na carne das aves e mamíferos. O conhecimento dos aspectos biológicos e moleculares do parasito possibilitam melhor entendimento da epidemiologia da toxoplasmose. Neste trabalho foi realizada triagem sorológica por hemaglutinação indireta (HI) em 58 galinhas caipiras (Gallus gallus domesticus) utilizadas para consumo humano, provenientes do estado do Espírito Santo, Brasil. Treze galinhas apresentaram sorologia positiva para T. gondii. O coração e o cérebro de cinco galinhas positivas foram colhidos, tratados com pepsina e inoculados separadamente, em dois camundongos Swiss, por via intraperitoneal. Observou-se taquizoítos no peritônio de todos os camundongos, entre sete e 10 dias após o inóculo. Foram obtidos 10 novos isolados de T. gondii os quais foram estudados em camundongos BALB/C inoculados com 101 a 104 taquizoítos por animal. Todos os isolados foram considerados virulentos ou de virulência intermediária. A caracterização molecular dos isolados, realizada por PCR-RFLP, demonstrou a ocorrência de três genótipos distintos. Nenhum isolado apresentou genótipo clonal ou linhagem clonal do Brasil. Não foi observada diferença molecular (PCR-RFLP) entre os isolados obtidos a partir do cérebro ou do coração da mesma ave. Dois isolados já haviam sido relatados na literatura como causadores de doenças em humanos.

Seroprevalence and risk factors for human toxoplasmosis in northeastern Brazil

Toxoplasmosis is one of the most prevalent parasitic infections in humans, causing severe clinical complications in immunocompromised patients or in foetuses. Estimates on the toxoplasmosis seroprevalence in human populations vary widely, even within the same region. This study aimed to estimate the prevalence of Toxoplasma gondii infection in the municipality of Santa Cruz, State of Rio Grande do Norte, Brazil, and identify the risk factors for toxoplasmosis. T. gondii IgG antibodies were measured in 66.2% of the studied population. The factors associated with infection were as follows: age above 45 years (OR = 7.4; 95% CI = 3.7-14.8); illiteracy (OR = 2.8; 95% CI = 1.6-5.0); the presence of more than three cats in the home (OR 2.0; 95% CI = 1.2-3.5); no water tank (OR = 2.0; 95% CI = 1.4-3.1); and consumption of raw or unpasteurized milk (OR = 2.0; 95% CI = 1.3-3.0). The risk factors identified were predominantly related to the ingestion of oocysts. This study may contribute to public health knowledge of toxoplasmosis and the definition of control programs, particularly for pregnant women from regions similar to the area studied.

Pathogenicity and phenotypic sulfadiazine resistance of Toxoplasma gondii isolates obtained from livestock in northeastern Brazil

Toxoplasma gondii is the causative protozoan agent of toxoplasmosis, which is a common infection that is widely distributed worldwide. Studies revealed stronger clonal strains in North America and Europe and genetic diversity in South American strains. Our study aimed to differentiate the pathogenicity and sulfadiazine resistance of three T. gondii isolates obtained from livestock intended for human consumption. The cytopathic effects of the T. gondii isolates were evaluated. The pathogenicity was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) using a CS3 marker and in a rodent model in vivo. Phenotypic sulfadiazine resistance was measured using a kinetic curve of drug activity in Swiss mice. IgM and IgG were measured by ELISA, and the dihydropteroate synthase (DHPS) gene sequence was analysed. The cytopathic effects and the PCR-RFLP profiles from chickens indicated a different infection source. The Ck3 isolate displayed more cytopathic effects in vitro than the Ck2 and ME49 strains. Additionally, the Ck2 isolate induced a differential humoral immune response compared to ME49. The Ck3 and Pg1 isolates, but not the Ck2 isolate, showed sulfadiazine resistance in the sensitivity assay. We did not find any DHPS gene polymorphisms in the mouse samples. These atypical pathogenicity and sulfadiazine resistance profiles were not previously reported and served as a warning to local health authorities.

Molecular phylogeny of Toxoplasmatinae: comparison between inferences based on mitochondrial and apicoplast genetic sequences / Filogenia molecular de Toxoplasmatinae: comparação entre inferências baseadas em sequências genéticas mitocondriais e de apicoplasto

Abstract Phylogenies within Toxoplasmatinae have been widely investigated with different molecular markers. Here, we studied molecular phylogenies of the Toxoplasmatinae subfamily based on apicoplast and mitochondrial genes. Partial sequences of apicoplast genes coding for caseinolytic protease (clpC) and beta subunit of RNA polymerase (rpoB), and mitochondrial gene coding for cytochrome B (cytB) were analyzed. Laboratory-adapted strains of the closely related parasites Sarcocystis falcatula and Sarcocystis neurona were investigated, along with Neospora caninum, Neospora hughesi, Toxoplasma gondii (strains RH, CTG and PTG), Besnoitia akodoni, Hammondia hammondiand two genetically divergent lineages of Hammondia heydorni. The molecular analysis based on organellar genes did not clearly differentiate between N. caninum and N. hughesi, but the two lineages of H. heydorni were confirmed. Slight differences between the strains of S. falcatula and S. neurona were encountered in all markers. In conclusion, congruent phylogenies were inferred from the three different genes and they might be used for screening undescribed sarcocystid parasites in order to ascertain their phylogenetic relationships with organisms of the family Sarcocystidae. The evolutionary studies based on organelar genes confirm that the genusHammondia is paraphyletic. The primers used for amplification of clpC and rpoB were able to amplify genetic sequences of organisms of the genus Sarcocystisand organisms of the subfamily Toxoplasmatinae as well.

Resumo A filogenia da subfamília Toxoplasmatinae tem sido amplamente investigada com diversos marcadores moleculares. Neste estudo, a filogenia molecular da subfamília Toxoplasmatinae foi analisada através de genes de apicoplasto e mitocondriais. Foram analisadas sequências parciais de genes de apicoplasto codificadores da protease caseinolítica (clpC), e da subunidade beta da RNA polimerase (rpoB) e de gene mitocondrial codificador de citocromo B (cytB). Foram investigadas cepas adaptadas em laboratório de Sarcocystis neurona eSarcocystis falcatula, parasitos estreitamente relacionados, além de Neospora caninum, Neospora hughesi, Toxoplasma gondii (cepas RH, CTG e PTG),Besnoitia akodoni, Hammondia hammondi e duas linhagens geneticamente divergentes de Hammondia heydorni. A análise molecular, baseada em genes de organelas, não diferenciou claramenteN. caninum de N. hughesi, porém foi possível confirmar as duas linhagens de H. heydorni. Foram encontradas pequenas diferenças entre as cepas adaptadas em laboratório deS. falcatula e S. neurona em todos os marcadores moleculares avaliados. Concluindo, filogenias congruentes foram reconstruídas com os três diferentes genes que podem ser úteis em triagem de parasitos sarcocistídeos não identificados, para identificar sua relação com organismos da família Sarcocystidae. Os estudos evolutivos com genes organelares confirmam que o gênero Hammondia é parafilético. Osprimers utilizados para amplificação declpC e rpoB foram capazes de amplificar sequências genéticas de organismos do gênero Sarcocystis e da subfamília Toxoplasmatinae.

Occurrence of anti-Toxoplasma gondii antibodies in meat and dairy goat herds in Rio Grande do Norte, Brazil / Ocorrência de anticorpos anti-Toxoplasma gondii em rebanhos caprinos de corte e leiteiros do Rio Grande do Norte, Brasil

Toxoplasmosis is caused by Toxoplasma gondii, which is the main causative agent of abortion in small ruminants. Goats are among the animals that are most susceptible to this protozoon, and the disease that it causes leads to significant economic losses and has implications for public health, since presence of the parasite in products of goat origin is one of the main sources of human infection. Because of the significant economic impact, there is an urgent need to study the prevalence of T. gondii infection among goats in Sertão do Cabugi, which is the largest goat-producing region in Rio Grande do Norte. In the present study, the ELISA assay was used to test 244 serum samples from nine farms, located in four different municipalities in the Sertão do Cabugi region, which is an important goat-rearing region. The results showed that the prevalence of anti-T. gondii antibodies was 47.1% and that there was a significant association between positivity and the variables of age (≥ 34 months), location (Lajes, Angicos and Afonso Bezerra) and farm (all the farms). The avidity test was applied to all the 115 ELISA-positive samples to distinguish between acute and chronic infection. One hundred and three samples (89.6%) displayed high-avidity antibodies, thus indicating that most of the animals presented chronic infection, with a consequent great impact on the development of the goat production system and a risk to human health.

A toxoplasmose é causada pelo Toxoplasma gondii, principal agente causador de aborto em pequenos ruminantes. Os caprinos são uns dos animais mais suscetíveis a esse protozoário, levando a perdas econômicas significativas e implicações para a saúde pública, uma vez que a presença do parasito em produtos de origem caprina é uma das principais fontes de infecção humana. Devido ao impacto econômico significativo torna-se urgente estudar a prevalência da infecção, pelo T. gondii, entre caprinos do Sertão do Cabugi, a maior região produtora de caprinos no Rio Grande do Norte. O presente estudo utilizou o ELISA para testar 244 amostras de soro de 9 fazendas, situadas em 4 diferentes cidades na região do Sertão do Cabugi; uma importante região de criação de cabras. Os resultados mostraram uma prevalência de 47,1% para anticorpos anti- T. gondii e uma significativa associação entre a positividade e as variáveis idade (≥ 34 meses), localização (Lajes, Angicos e Afonso Bezerra e propriedade (todas as fazendas). O teste de avidez foi aplicado a todas as 115 amostras positivas pelo ELISA para discriminar entre infecção aguda e crônica. Cento e três amostras (89,6%) apresentaram anticorpos de alta avidez; indicando que a maioria dos animais estavam em infecção crônica, gerando um grande impacto sobre o desenvolvimento do sistema de produção em cabras e um risco para a saúde humana.

Soroprevalência e fatores associados à infecção por Toxoplasma gondii em caprinos de propriedades rurais do município de Mossoró, RN / Seroprevalence and factors associated with Toxoplasma gondii infection in goats on farms in the municipality of Mossoró, Rio Grande do Norte, Brazil

O município de Mossoró/RN, no Nordeste do Brasil, tem como destaque a criação de caprinos. A toxoplasmose é uma zoonose que é mais patogênico para os caprinos do que para os demais animais de abate. Em caprinos, o protozoário frequentemente é responsável por problemas reprodutivos e perdas econômicas. Com o objetivo de identificar a soroprevalência e os fatores de risco da toxoplasmose em caprinos de propriedades rurais do Município de Mossoró, amostras de soro de 338 animais (320 fêmeas e 18 machos) de 15 unidades produtoras foram testados pelo Ensaio Imunoenzimático (ELISA). Das 15 propriedades, 14 apresentaram animais soropositivos para toxoplasmose, e nestas o total de animais positivos foram de 125 (123 fêmeas e 2 machos), obtendo uma prevalência de 37,0%. Houve uma relação significativa (p<0,05) entre a prevalência e o sexo, e entre a prevalência e raça dos animais. As chances de ocorrer (OR) mais importantes associados à infecção por Toxoplasma gondii foram: fonte de água (OR=2,635), vasilhames para a água dos animais localizado fora das instalações da propriedade (OR=3,121) e a exploração do tipo leiteira (OR=2,546). Pela análise do ELISA de avidez, foram encontradas fêmeas em idade reprodutiva na fase aguda da infecção.

The municipality of Mossoró, RN, Northeastern Brazil, is featured on goat rearing. Toxoplasmosis is a zoonosis which is more pathogenic for goats when compared with other animals for slaughter. In this species, the protozoan is often responsible for reproductive problems and economic losses. In order to identify the seroprevalence and risk factors of toxoplasmosis in goats of farms in this municipality, serum samples from 338 animals (320 females and 18 males) of 15 production units were tested by enzyme immunoassay (ELISA). Of the 15 farms, 14 had animals positive for Toxoplasma gondii, and in these the total number of seropositive animals were 125 (123 females and 2 males), yielding a prevalence of 37.0%. There was a significant relationship (p<0.05) between prevalence and sex, and between the prevalence and breed of animals. The most important risk factors associated with T. gondii infection were: water supply with odds ratio (OR=2.635), containers for water animals located outside the premises of property (OR=3.121) and the exploitation of dairy type (OR=2.546). For the analysis of the avidity ELISA, was found females of reproductive age in the acute phase of infection.

Study of the correlation between blood cholinesterases activity, urinary dialkyl phosphates, and the frequency of micronucleated polychromatic erythrocytes in rats exposed to disulfoton

Organophosphates (OPs) are widely used as pesticides, and its urinary metabolites as well as the blood cholinesterases (ChEs) activity have been reported as possible biomarkers for the assessment of this pesticide exposure. Moreover, the OPs can induce mutagenesis, and the bone marrow micronucleus test is an efficient way to assess this chromosomal damage. This paper reports a study carried out to verify the correlation among the disulfoton exposure, blood ChEs activity, urinary diethyl thiophosphate (DETP), and diethyl dithiophosphate (DEDTP), as well as micronucleated polychromatic erythrocytes (MNPCEs) frequency. Four groups of rats (n=12) were exposed to disulfoton at 0, 2.8, 4.7, and 6.6 mg kg-1 body weight. The blood ChEs activity, urinary DETP and DEDTP concentrations, and MNPCEs frequency were determined. It was observed that the plasmatic and erythrocytary ChEs activity decreased from 2.9% to 0.5% and from 35.9 to 3.3%, respectively, when the disulfoton dose was increased from 0 to 6.6 mg kg-1 (correlation of 0.99). Urinary DETP and DEDTP concentrations, as well as the MNPCEs frequency, increased from 0 to 6.58 µg mL-1, from 0 to 0.04 µg mL-1, and from 0 to 1.4%, respectively, when the disulfoton dose was increased from 0 to 6.58 mg kg-1 body weight.

Os organofosforados (OPs) são amplamente usados como praguicidas e a atividade da colinesterase sanguínea bem como os metabólitos urinários desses praguicidas têm sido reportados como biomarcadores eficazes para avaliar casos de exposição. Além disso, os OPs podem induzir mutagênese e o teste de micronúcleo de medula óssea é uma boa alternativa para avaliar os danos cromossômicos. Esse artigo reporta um estudo sobre a correlação entre a exposição a dissulfoton, a atividade da colinesterase sanguínea, a excreção urinária de dietil tiofosfato e dietil ditiofosfato e a frequência de micronúcleos em eritrócitos policromáticos. Quatro grupos de ratos (n=12) foram expostos a dissulfotom nas doses de 0, 2,8, 4,7, e 6,6 mg kg-1 de peso corpóreo. A atividade da colinesterase sanguínea as concentrações urinárias de dietil tiofosfato e dietil ditiofosfato e a frequência de micronúcleos foram determinadas. Os resultados demonstraram que as atividades da colinesterase plasmática e eritrocitária diminuíram de 2,9 para 0,5% e de 35,9 para 3,3% , respectivamente, quando a dose de dissulfoton foi aumentada de 0 para 6,6 mg kg-1 (correlação de 0,99). As concentrações urinárias de dietil tiofosfato e dietil ditiofosfato bem como a frequência de micronúcleos aumentaram de 0 a 6,56 µg mL-1, 0 a 0.04 µg mL-1 e de 0 a 1.4%, respectivamente, quando a dose de dissulfotom foi aumentada de 0 a 6,58 mg kg-1.

Early diagnosis of congenital toxoplasmosis in newborn infants using IgG subclasses against two Toxoplasma gondii recombinant proteins

The aim of this work was to evaluate the utility of ELISA-based testing of total IgG (IgGt) antibodies and its subclasses (IgG1, IgG2, IgG3 and IgG4) against soluble (STAg) and recombinant (rSAG1 and rMIC3) antigens of Toxoplasma gondii for diagnosing congenital toxoplasmosis. Sera from 217 newborns initially testing positive for specific IgM in filter paper dried blood spots were tested for specific IgM and IgG by ELFA-VIDAS®. Congenital toxoplasmosis was confirmed in 175 and ruled out in 42 infants. The validity of the ELISA tests was determined using the persistence of IgG antibodies (ELFA-VIDAS® kit) at the end of 12 months, which is considered the reference test for the diagnosis of congenital toxoplasmosis. The frequency of positivity with IgGt against STAg, rSAG1 and rMIC3 was found in 97.2%, 96.3% and 80.2%, respectively, of the newborns with confirmed congenital toxoplasmosis. IgG1 reacted with all three antigens, while IgG3 and IgG4 reacted preferentially with rMIC3. Higher mean values of reactivity (sample optical density/cut-off) were found for all subclasses when using rMIC3. All of the antigens showed high sensitivity and low specificity in detecting anti-T. gondii IgGt and IgG1 and low sensitivity and high specificity in detecting IgG3 and IgG4. In conclusion, the combined detection of IgG antibody subclasses against recombinant toxoplasmic antigens may be useful for the early diagnosis of congenital toxoplasmosis.

Simultaneous detection of three antineoplastic drugs on gloves by liquid chromatography with diode array detector

The aim of this study was to develop a method for simultaneous detection of antineoplastic drugs on gloves since, in occupational exposure, the main contamination route is through dermal contact, which may occur via prolonged contact with contaminated surfaces or materials. The assay was performed by liquid chromatography using the following conditions for the detection of 5-fluorouracil (5-FU), methotrexate (MTX) and paclitaxel (TAX): diode array detection and UV quantification at 195 nm for TAX, at 265 nm for 5-FU and at 302 nm for MTX; ODS column (250 x 4 mm, 5 μm) with a similar guard column; mobile phase consisted of water (pH 4)-methanol-acetonitrile (35:15:50, v/v/v) with a flow rate of 1 mL min-1. The method presented a linear range from 0.25 to 20 μg mL-1 with r² higher than 0.99. Repeatability was <15% and satisfactory extraction efficiency was obtained when liquid-liquid extraction with ethyl acetate was used for 5-FU and TAX. Satisfactory solid phase extraction was also achieved with C18 cartridges and elution with methanol for MTX. The diode array detector allowed drug quantification at a concentration > 0.25 μg mL-1 in samples, although detection was possible in samples that presented values of around 0.1 μg mL-1. The results obtained suggest that the method developed can be applied for the simultaneous determination of the drugs studied and can be considered useful in exposure assessment for health care workers.

O objetivo deste estudo foi desenvolver um método para a detecção simultânea de antineoplásicos em luvas, uma vez que, em exposições ocupacionais, a principal via de introdução é a dérmica, por meio de contato prolongado com superfícies e/ou materiais contaminados com tais fármacos. A tecnica de detecção utilizada foi a cromatografia líquida de alta eficiência, com detector de aranjo de diodos, nas seguintes condições: para a detecção de 5-fluorouracila (5-FU), metotrexato (MTX) e paclitaxel (TAX): detecção e quantificação de TAX a 195 nm, de 5-FU a 265 nm e de MTX a 302 nm; coluna ODS (250 x 4 mm, 5 μm), com pré-coluna similar; fase móvel constituída de água (pH 4)-metanol-acetonitrila (35:15:50, v/v/v), na vazão de 1 mL min-1. O método apresentou uma faixa linear de 0,25-20 mg mL-1, com r² > 0,99. O desvio-padrão relativo, para a avaliação da repetibilidade foi < 15%; a recuperação foi satisfatória, empregando extração líquido-líquido, com acetato de etila, para a 5-FU e TAX e extração em fase sólida, com cartuchos de C18 e eluição com metanol, para MTX. O detector de arranjo de diodos permitiu a quantificação dos fármacos, quando presentes nas amostras em concentração > 0,25 mg mL-1, embora a detecção foi possível nas amostras que apresentaram valores em torno de 0,1 mg mL-1. Os resultados obtidos sugerem que o método desenvolvido pode ser aplicado para a determinação simultânea dos fármacos estudados, constituindo ferramenta útil na avaliação da exposição dos trabalhadores as fármacos antineoplásicos.

IgG and IgM western blot assay for diagnosis of congenital toxoplasmosis

The aim of this study was to evaluate the utility of western blot (WB) analysis as a diagnostic tool for congenital toxoplasmosis in 215 newborn infants. The children were submitted to clinical examinations to assess macular, neurological and hearing signals. The WB results obtained were compared to the persistence of IgG antibodies at the end of 12 months, which is regarded as the "gold standard" diagnosis of congenital toxoplasmosis. Association between the WB results and the clinical signs presented by the infants was also assessed. Of the 215 children, 177 had a confirmed congenital toxoplasmosis diagnosis and 38 were uninfected. IgG-WB showed a sensitivity of 73.5 percent and a specificity of 97.4 percent. IgM-WB showed a sensitivity of 54.8 percent and a specificity of 94.7 percent. The IgG-WB and IgM-WB combination increased the sensitivity to 86.5 percent. The IgM-WB-positive children had a 1.4-fold greater risk of presenting active macular lesions than did those that were IgM-WB-negative. This study showed that the WB assay is a useful tool to confirm a diagnosis of congenital toxoplasmosis and that the IgM-WB-positive results can indicate active macular lesions in newborn infants.

Prevalência de alcoolemia em óbitos por acidente de transporte e por outras causas externas / Prevalence of alcoholemy in deaths from traffic accidents and other external causes

Introdução: Trauma é a principal causa de óbitos em indivíduos entre 18 e 44 anos de vida no Brasil. Por mais de um século, o álcool tem sido reconhecido como um dos principais fatores de risco para acidentes fatais, desempenhando um importante papel na etiologia do trauma. O objetivo deste estudo foi comparar o diagnóstico de alcoolemia entre mortos por acidentes de trânsito e outras causas externas (afogamento, homicídio e suicídio). Métodos: Foi realizado um estudo transversal onde se utilizaram dados secundários do Departamento de Medicina Legal de Porto Alegre no período de janeiro a dezembro de 2001. As variáveis estudadas foram o nível de alcoolemia e óbitos por causas externas. Resultados: Foram analisados 1.588 óbitos. Os homicídios ocorreram na faixa etária entre 19 e 45 anos, representando 80% dos casos. As causas externas ocorrem com mais frequência em homens e a maior causa de óbitos entre mulheres foi por acidente de trânsito, com menor alcoolemia. Os pacientes que apresentam alcoolemia positiva tiveram uma razão de prevalência de 1,18 (IC 95%:1,05 a 1,32) em relação ao óbito por acidente de trânsito em comparação ao suicídio. Conclusão: Este estudo demonstra que o álcool é fator contribuinte de morte por causas externas, especialmente aquelas causadas por acidentes de trânsito e homicídio

Introduction: Trauma is the leading cause of death in individuals between 18 and 44 years of age living in Brazil. For over a century, alcohol has been recognized as a major risk factor for fatal accidents, playing an important role in the etiology of trauma. The aim of this study was to compare the diagnosis of alcoholemy in individuals who died in traffic accidents and from other external causes (drowning, homicide and suicide). Methods: We conducted a cross-sectional study based on secondary data from the Department of Forensic Medicine of Porto Alegre from January to December 2001. The variables were blood alcohol content (BAC) and deaths from external causes. Results: We analyzed 1,588 deaths. The murders occurred between the ages of 19-45 years, accounting for 80% of the cases. External causes occur more frequently in men, and traffic accidents are the leading cause of death among women, with lower blood alcohol levels. Patients with positive blood alcohol content had a prevalence ratio of 1.18 (95% CI: 1.05 to 1.32) in relation to death by traffic accidents as compared to suicide. Conclusion: This study demonstrates that alcohol is a contributing factor of death from external causes, especially those caused by traffic accidents and homicide

Correção da lesão de Bankart por cirurgia artroscópica comparada com a cirurgia aberta: uma revisão sistemática / The Bankart lesion repaired by arthroscopic surgery versus open surgery: a systematic review

Introdução: A instabilidade anterior traumática do ombro é uma doença ortopédica comum que acomete pacientes jovens e/ou atletas. Na maioria das vezes, a lesão de Bankart encontra-se associada. Nesta situação o tratamento cirúrgico é comumente indicado. O objetivo deste estudo é comparar, através de revisão sistemática da literatura, a taxa de insucesso da técnica de Bankart, via artroscópica, com a técnica de Bankart aberta, através da taxa de insucesso de ambas as técnicas nos artigos revisados. Métodos: Através do MEDLINE/Pubmed, pesquisaram-se as palavraschave: a) anterior shoulder instability; b) Bankart lesion; c) traumatic recurrent anterior shoulder instability; d) open Bankart repair; e) arthroscopic Bankart repair; f ) arthroscopic versus open Bankart repair em artigos publicados entre 1998 a 2008, que comparavam a técnica aberta com a técnica artroscópica, exclusivamente operados pela técnica de Bankart. Sete artigos preencheram os critérios de seleção. Entre as variáveis estudadas estavam o número de pacientes e ombros operados por cada técnica, o sexo, o tipo de escore de avaliação e o desfecho. Resultados: Foram abarcados 478 pacientes, 481 ombros, dos quais 54,9% foram operados pela técnica de Bankart contra 45,1% pela técnica aberta. 84,7% (405) eram homens, 15,3% (73) eram mulheres. O escore de Rowe foi mencionado em todos os artigos avaliados. A taxa de insucesso na técnica artroscópica foi de 10,6% contra 7,8% na técnica aberta. Conclusão: As técnicas artroscópica e aberta produziram bons resultados para o tratamento da instabilidade anterior traumática de ombro. Ambas as técnicas apresentaram resultados similares na taxa de insucesso

Introduction: The traumatic anterior instability of the shoulder is a common orthopedic disease that affects young patients and/or athletes. Most often the Bankart lesion is associated. In this situation surgery is usually indicated. The aim of this study is to compare, through a systematic review of the literature, the Bankart technique via arthroscopy with the open Bankart technique through the failure rates of both techniques in the reviewed articles. Methods: Using the MEDLINE/PubMed databases, the following keywords were searched: a) anterior shoulder instability; b) Bankart lesion; c) traumatic recurrent anterior shoulder instability; d) open Bankart repair; e) arthroscopic Bankart repair, and f ) arthroscopic versus open Bankart repair, in articles published from 1998 to 2008 comparing the open technique with the arthroscopic technique performed exclusively with the Bankart technique. Seven articles met the selection criteria. Among the variables studied were the number of patients and shoulders operated by each technique, sex, type of evaluation score, and outcome. Results: The study covered 478 patients, 481 shoulders, of which 54.9% were operated by the Bankart technique against 45.1% by the open technique. 84.7% (405) were men and 15.3% (73) were women. The Rowe score was mentioned in all of the reviewed articles. The failure rate in the arthroscopic technique was 10.6% versus 7.8% in the open technique. Conclusion: The open and arthroscopic techniques have produced good results for the treatment of traumatic anterior shoulder instability. Both techniques showed similar results in the failure rate

Aleitamento materno exclusivo: análise desta prática na região sul do Brasil / Exclusive breastfeeding: analysis of practice in southern Brazil

Introdução: O ato do aleitamento materno representa a forma natural de alimentar uma criança nos primeiros meses de vida, sendo inquestionável o relevante papel que esta prática desempenha no crescimento e no desenvolvimento infantil. Os objetivos deste estudo foram: Estudar o tempo do aleitamento materno exclusivo em duas regiões do Rio Grande do Sul RS, estudar a associação entre o aleitamento materno e a escolaridade materna, trabalho materno e renda familiar. Metodologia: Estudo observacional, transversal e descritivo realizado em cinco idades do Rio Grande do Sul (Porto Alegre, Canoas, São Leopoldo, Caxias do Sul e Flores da Cunha). Para análise dos dados, com relação ao aleitamento materno exclusivo até os 6 meses, a amostra foi dividida em 2 grupos com 100 crianças, além da análise geral dessa variável. Esta divisão levou em consideração a localização de residência das mesmas. Resultados: Separando a amostra por regiões, verificou-se que na região serrana 60% das crianças receberam leite materno exclusivamente até os 6 meses de idade. Na região metropolitana, constatou-se que 30% receberam leite materno exclusivo até os 6 meses de idade. Conclusão: Constatamos que o aleitamento materno exclusivo até os 6 meses foi o dobro na região da serra riograndense, em comparação com a região metropolitana.

Introduction: Breastfeeding is the natural way of feeding a child in the first months of life, and the relevant role played by this practice in child growth and development is undisputed. The aims of this study were to study the length of exclusive breastfeeding in two regions of Rio Grande do Sul (RS), and to assess the association of maternal breastfeeding with mother schooling, maternal employment, and family income. Methods: Observational, cross-sectional descriptive study performed in 5 cities of RS (Porto Alegre, Canoas, São Leopoldo, Caxias do Sul and Flores da Cunha). For data analysis, regarding exclusive maternal breastfeeding until 6 months, the sample was divided in two groups with 100 children, besides the general analysis of this variable. Results: By analyzing the sample by region, we found that 60% of the infants in the countryside (Caxias do Sul and Flores da Cunha) were exclusively breastfed until 6 months of age. In the metropolitan region (Porto Alegre, Canoas, São Leopoldo), this proportion was 30%. Conclusion: We found that exclusive breastfeeding until 6 months of age in the “Região Serrana” was twice as common as in the metropolitan region