The first case report of trypanosomiasis caused by Trypanosoma evansi in Uruguay.

Trypanosoma evansi, the causal agent of Surra, is a salivarian African trypanosoma introduced in America during the 15th century. In this study we report the first case of African trypanosomiasis in Uruguay. We describe clinical signs and the evolution of the disease on an Uruguayan Cimarron dog, as well as the isolation and molecular characterization of the Trypanosoma evansi reported strain. This constitutes the first case of Surra in Uruguay, showing the expansion of the parasite to the south of the American continent. Future work is needed to identify the vector and possible reservoirs in order to avoid the spread of the disease. The epidemiological relevance of the findings are discussed.

Results of a venous thromboembolism prophylaxis program for hospitalized patients.

INTRODUCTION: Venous thromboembolism (VTE) is the leading cause of preventable death in hospitalized patients. However, existing prophylaxis guidelines are rarely followed. OBJECTIVE: The aim of the study was to present and discuss implementation strategies and the results of a VTE prophylaxis program for medical and surgical patients admitted to a large general hospital. PATIENTS AND METHODS: This prospective observational study was conducted to describe the strategy used to implement a VTE prophylaxis program in hospitalized medical and surgical patients and to analyze the results in terms of the risk assessment rate within the first 24 hours after admission, adequacy of the prophylaxis prescription, and prevalence of VTE in the discharge records before and after program implementation. We used the Mantel-Haenszel chi-square test for the linear trend of the data analysis and set the significance level to P<0.05. RESULTS: With the support of an institutional VTE prophylaxis committee, a multiple-strategy approach was used in the implementation of the protocol, which included continuing education, complete data recording using computerized systems, and continuous auditing of and feedback to the medical staff and multidisciplinary teams. Approximately 90% of patients were evaluated within the first 24 hours after admission, and no significant difference in this percentage was observed among the years analyzed. A progressive increase in adherence to protocol recommendations, from 63.8% in 2010 to 75.0% in 2014 (P<0.001), was noted. The prevalence of symptomatic VTE in the discharge records of patients decreased from 2.03% in 2009 to 1.69% in 2014 (P=0.033). CONCLUSION: The implementation of a VTE prophylaxis program targeting adult patients admitted to a large hospital employing a multiple-strategy approach achieved high rates of risk assessment within 24 hours of admission, improved the adherence to prophylaxis recommendations in high-risk patients, and reduced the rate of VTE events in the discharge records.

Listeria monocytogenes, E. coli O157, Salmonella spp. e microrganismos indicadores em carcaças bovinas para exportação / Listeria monocytogenes, E. coli O157, Salmonella spp., micro-organism indicators in export cattle carcasses

Foram colhidas amostras de 100 carcaças em um frigorífico exportador, localizado no interior do estado de São Paulo, amostradas ao longo de um ano, por meio do método de esponjas, aplicado na região do peito do animal. As amostras foram colhidas em três pontos, denominados A, B e C, sendo cada carcaça amostrada nos três pontos, localizados nas etapas: pós-sangria (A); pós-esfola (B) e pós-lavagem (C). Foram realizadas pesquisas de Listeria sp., E. coli O157, Salmonella spp. e microrganismos indicadores (Petrifilms® AC, EC e EB). Não foram isolados Listeria ou E. coli O157 em nenhuma das 300 amostras. Salmonella spp. foi isolada em nove, sendo oito no ponto A e uma no ponto B. Para mesófilos, as contagens variaram de 0 a 6,8 log UFC/cm², para coliformes totais, de 0 a 4,57 log UFC/cm², e para E. coli, de 0 a 4,38 log UFC/cm². Diante dos resultados obtidos e em comparação com a literatura, conclui-se que o estabelecimento estudado apresenta qualidade, tanto sanitária (devido às baixas prevalências dos patógenos) quanto higiênica (devido à acentuada diminuição da carga microbiana de indicadores ao longo da linha).

Samples were collected from 100 carcasses in a slaughterhouse exporter, located within the State of São Paulo, sampled over a year through the sponge method, applied to the chest of the animal. Samples were taken at three points, denominated A, B and C, each carcass sampled at three points located in the following steps: after bleeding (A) after skinning (B) and after washing (C). Research was conducted for Listeria sp., E. coli O157, Salmonella spp. and Micro-organism (Petrifilms ® AC, EC and EB). Listeria or E. coli O157 were not isolated in any of the 300 samples. Salmonella spp. was isolated in nine, eight at point A and one at point B. For Mesophiles, scores ranged from 0 to 6.8 log UFC/cm²; for Total coliforms, 0 to 4.57 log UFC/cm² and E. coli from 0 to 4.38 log UFC/cm². With the results obtained and compared with the literature, it is concluded that the establishment in this study has both sanitary quality (due to the low prevalence of pathogens) and hygienic quality (due to the sharp decrease in the microbial load of indicators along the line.

Identification of Staphylococcus spp. isolated during the ripening process of a traditional minas cheese / Identificação de Staphylococcus spp. isolados durante o processo de maturação de um queijo-de-minas tradicional

The population dynamics of Staphylococcus spp. was studied during the ripening of Canastra Minas cheese at three farms located in the State of Minas Gerais, Brazil. The presence of coagulase (coa), thermonuclease (nuc), and enterotoxin (sea, seb, sec, and sed) genes was investigated in Staphylococcus strains isolated during the 60-day cheese-ripening period. The presence of the staphylococcal enterotoxins A, C, and D was also investigated in the cheese samples. Cheese samples that were matured for 0, 7, 15, 30, and 45 days presented staphylococci counts from 10³ to 10(8)cfu/g. All isolates considered coagulase-positive by physiological tests had the coa gene. However, no association was observed between the results obtained with biochemical tests and those obtained by PCR using gene-specific primers for coagulase-negative strains. Coagulase and thermonuclease genes occurred simultaneously in 41.3 percent of Staphylococcus spp. tested. None of the investigated Staphylococcus strains expressed enterotoxins SEA, SEB, SEC, and SED. Enterotoxins A, C, and D were not detected in any of the cheese samples.

Estudou-se a dinâmica das populações de Staphylococcus spp. durante a maturação do queijo Canastra, em três fazendas localizadas no estado de Minas Gerais. A presença dos genes que codificam para a produção das enzimas coagulase (coa), termonuclease (nuc) e produção de enterotoxinas (sea, seb, sec e sed), em linhagens de Staphylococcus isoladas durante os 60 dias de maturação do queijo foi analisada. Também foi investigada a presença de enterotoxina estafilocócica A, C e D nas amostras de queijo. As amostras de queijo com 0, 7, 15, 30 e 45 dias de maturação apresentaram contagens de Staphylococcus spp. entre 10³ e 10(8)ufc / g. Todos os isolados coagulase positivo nos testes fisiológicos apresentaram o gene coa. Não foi observada associação entre os resultados obtidos com os testes bioquímicos e aqueles obtidos com a PCR usando iniciadores gene-específicos para linhagens coagulase negativa. Os genes da coagulase e termonuclease ocorreram simultaneamente em 41,3 por cento dos Staphylococcus spp. testados. Nenhum dos isolados de Staphylococcus apresentou os genes que codificam para a produção das enterotoxinas SEA, SEB, SEC ou SED. As enterotoxinas A, C ou D não foram detectadas em nenhuma das amostras de queijo analisadas.

Diversity and frequency of yeasts from the dorsum of the tongue and necrotic root canals associated with primary apical periodontitis.

AIMS: To determine the frequency and diversity of yeasts from the dorsum of the tongue and necrotic root canals with teeth associated with primary apical periodontitis. METHODOLOGY: Detailed medical and dental histories of 168 patients were recorded. The samples were collected from the dorsum of tongue and from 168 teeth with root canals contained necrotic pulps. Yeasts were isolated on Sabouraud agar with 100 mg L(-1) chloramphenicol, purified and characterized by standard methods. Identification was confirmed by EI1 PCR fingerprint technique. Yeast isolates of uncertain identity or with a different genetic fingerprint profile from the reference strains were identified by sequencing the D1/D2 variable domains of the large subunit rDNA. RESULTS: Yeasts were isolated from 22.6% of teeth sampled and from 45.8% of tongue samples. Candida albicans was the most frequently isolated species at both investigated sites but other species were also found. Saccharomyces cerevisiae and Kluyveromyces lactis were recovered from the tongue. CONCLUSIONS: Although the detection of yeasts in the root canal does not imply an involvement in the disease process, the study suggests a frequency of Candida spp. in primary endodontic infections that deserves further clarification.

Alterações comportamentais em crianças portadoras de enfermidades crônicas e suas repercussões na família: Hospital da Criança - Obras Sociais de Irmã Dulce, Salvador, BA / Mannering alterations in carrying children of chronic diseases and its repercussions in the family: Hospital of the Child - Social Workmanships of Sister Dulce, Salvador, BA

Trata-se de um estudo piloto que envolve 15 crianças internadas no Hospital da Criança: Obras Sociais de Irmã Dulce, Salvador, Bahia, realizado com o objetivo de investigar a percepção da família perante o paciente pediátrico, portador de enfermidade crônica. Para tanto, o responsável pelo paciente respondeu a um questionário que abordou questões referentes a perfil sociodemográfico, grau de conhecimento da família em relação à doença, percepção quanto a alterações comportamentais ocorridas na criança e na família, além da impressão quanto ao prognóstico e serviços médicos prestados à população pesquisada. Os resultados desta pesquisa evidenciaram que toda a população avaliada apresentou algum tipo de alteração comportamental, sendo mais freqüentes os sintomas: tristeza, ansiedade, isolamento e sonolência. Os pais referiram como manifestações mais comuns, após o surgimento da doença: maior união familiar, sentimento de medo, ansiedade e preocupação com seqüelas físicas. No que diz respeito ao padrão de assistência hospitalar, revelaram-se satisfeitos com a qualidade e eficiência do serviço médico prestado. Entretanto, consideram insuficiente o suporte psicológico à criança e à família no enfrentamento da doença crônica. A próxima fase deste estudo deverá possibilitar uma análise mais consistente e abrangente acerca do tema proposto.

Tau protein abnormalities associated with the progression of alzheimer disease type dementia.

The degree to which neurofibrillary tangles (NFT), the hallmark lesions of Alzheimer disease (AD), contribute to the development of the cognitive symptoms of AD has been debated. NFTs are comprised of abnormally phosphorylated and conformationally altered tau proteins. Conformational changes in tau have been proposed to be among the earliest neurobiological changes in AD. This study examined whether conformational changes detected by antibodies MC1 and TG3 represent early abnormalities in the disease process by assessing their presence at different stages of dementia in multiple brain regions. Postmortem specimens from several neocortical regions were examined for conformational changes in tau by ELISA in subjects [n=81] who died at different stages of cognitive impairment. Concentrations of conformationally altered tau increased with increasing dementia severity and the levels of MC1 immunoreactivity increased in the frontal cortex of mildly demented subjects before the appearance of NFT bearing neurons, suggesting that conformational alterations in tau occur early in the course of AD and its cognitive symptoms and may precede histologically identified NFTs.

Case studies in international tobacco surveillance: cigarette smuggling in Brazil.

OBJECTIVE: This article is the first in a series of international case studies developed by the American Cancer Society to illustrate use of publicly available surveillance data for regional tobacco control. DESIGN: A descriptive analysis of Brazil and Paraguay cigarette production and trade data from official sources. METHODS: Per capita cigarette consumption for Brazil and its neighbour was calculated from 1970 to 1998 using data on production, imports, and exports from NATIONS, the National Tobacco Information Online System. RESULTS: A 63% decrease was observed in the estimate of per capita consumption of cigarettes in Brazil between 1986 and 1998 (from 1913 cigarettes per person in 1986 to 714 cigarettes per person in 1998) and a 16-fold increase in Paraguay was observed during the same period (from 678 cigarettes per person in 1986 to 10 929 cigarettes per person in 1998). Following Brazil's 1999 passage of a 150% cigarette export tax, cigarette exports fell 89% and Brazil's estimated per capita consumption rose to 1990 levels (based on preliminary data). Per capita consumption in Paraguay also fell to 1990 levels. CONCLUSIONS: These trends coincide with local evidence that large volumes of cigarettes manufactured in Brazil for export to Paraguay are smuggled back and consumed as tax-free contraband in Brazil. It is hoped that this case study will draw wider public attention to the problems that smuggling presents for tobacco control, help identify other countries confronting similar issues, and stimulate effective interventions.

Thermogenesis in birds.

The article discusses the importance of avian skeletal muscle as a source for heat generation by means of both shivering and non-shivering. Non-shivering thermogenesis in birds is still a polemic issue. Recent evidence at the molecular/cellular level indicates, however, that this type of heat generation may also exist among birds. The involvement of the sarcoplasmic reticulum calcium ATPase in non-shivering thermogenesis is discussed in-depth.

Cloning and functional characterization of an uncoupling protein homolog in hummingbirds.

The cDNA of an uncoupling protein (UCP) homolog has been cloned from the swallow-tailed hummingbird, Eupetomena macroura. The hummingbird uncoupling protein (HmUCP) cDNA was amplified from pectoral muscle (flight muscle) using RT-PCR and primers for conserved domains of various known UCP homologs. The rapid amplification of cDNA ends (RACE) method was used to complete the cloning of the 5' and 3' ends of the open reading frame. The HmUCP coding region contains 915 nucleotides, and the deduced protein sequence consists of 304 amino acids, being approximately 72, 70, and 55% identical to human UCP3, UCP2, and UCP1, respectively. The uncoupling activity of this novel protein was characterized in yeast. In this expression system, the 12CA5-tagged HmUCP fusion protein was detected by Western blot in the enriched mitochondrial fraction. Similarly to rat UCP1, HmUCP decreased the mitochondrial membrane potential as measured in whole yeast by uptake of the fluorescent potential-sensitive dye 3',3-dihexyloxacarbocyanine iodide. The HmUCP mRNA is primarily expressed in skeletal muscle, but high levels can also be detected in heart and liver, as assessed by Northern blot analysis. Lowering the room's temperature to 12-14 degrees C triggered the cycle torpor/rewarming, typical of hummingbirds. Both in the pectoral muscle and heart, HmUCP mRNA levels were 1.5- to 3.4-fold higher during torpor. In conclusion, this is the first report of an UCP homolog in birds. The data indicate that HmUCP has the potential to function as an UCP and could play a thermogenic role during rewarming.

Uncoupling proteins 1 and 3 are regulated differently.

Using a heterologous yeast expression system, we have previously found a marked discordance between the effects of uncoupling protein (UCP) 1 and UCP3L on basal O(2) consumption in whole yeast versus isolated mitochondria. In whole yeast, UCP3L produces a greater stimulation of basal O(2) consumption, while in isolated mitochondria, UCP1 produces a much greater effect. As shown previously and in this report, UCP3L, in contrast to UCP1, is not inhibited by purine nucleotides. In the present study, we addressed two hypothetical mechanisms that could account for the observed discordance: (i) in whole yeast, purine nucleotides inhibit UCP1 but not UCP3L and (ii) preparations of isolated mitochondria lack an activator of UCP3L that is normally present in vivo. By use of a mutant of UCP1 that lacks purine nucleotide inhibition, it is demonstrated that cytosolic concentrations of purine nucleotides present in yeast effectively inhibit UCP1 activity. This suggests that the lower activity of UCP1 compared to UCP3L in whole yeast is due to purine nucleotide inhibition of UCP1 but not UCP3L. As potential activators of UCP3L we tested free fatty acids in whole yeast and isolated mitochondria. While UCP1 was strongly activated by free fatty acids, no stimulatory effect on UCP3L was observed. In summary, this study indicates that UCP1 and UCP3L differ in their regulation by purine nucleotides and free fatty acids. This different regulation may be related to different physiological functions of the two proteins.

[Quality assessment of drug use in the elderly]. / Avaliação da qualidade do uso de medicamentos em idosos.

INTRODUCTION: The objective is to evaluate the quality of medication utilization through the analysis of the pattern of usage, the degree of compliance to essential drug lists, therapeutic value and by drug interactions found among women over 60 years of age. METHODS: Six hundred thirty-four women enrolled at the Open University of the Third Age were studied. Data was collected through pattern-oriented, tested questionnaires. The variables examined were related to drugs and to drug utilization. The units of analysis used were the drugs and the individual. RESULTS: Of 634 women that participated in the study, 9,1% did not use drugs. The number of medications taken vary from 1 to 17. The average is 4,0 drugs/woman. Among the 2.510 pharmaceutical specialties mentioned by the interviewed, 538 different substances were identified. About 26% of the medications were in agreement with the recommendations of the World Health Organization and 17% with recommendations of the "Relação Nacional de Medicamentos Essenciais". Seventeen percent of the drugs are inappropriate for use in seniors; 14,1% of the women may suffer consequences for taking drugs of the same therapeutic class, and 15, 5% are exposed to interactions. CONCLUSIONS: The data suggest that the pattern of the medication utilization is considerably influenced by the medical prescription and that their quality is harmed by the low selectiveness of the pharmaceutical market

cAMP-dependent protein kinase phosphorylations on tau in Alzheimer's disease.

To elucidate the role cAMP-dependent protein kinase (PKA) phosphorylations on tau play in Alzheimer's disease, we have generated highly specific monoclonal antibodies, CP-3 and PG-5, which recognize the PKA-dependent phosphorylations of ser214 and ser409 in tau respectively. The present study demonstrates by immunohistochemical analysis, CP-3 and PG-5 immunoreactivity with neurofibrillary pathology in both early and advanced Alzheimer's disease, but not in normal brain tissue and demonstrates that cAMP-dependent protein kinase phosphorylations on tau precede or are coincident with the initial appearance of filamentous aggregates of tau. Studies using heat-stable preparations demonstrate that neither site appears to be phosphorylated to any appreciable extent in normal rodent or human brain. Further analysis demonstrates that the beta catalytic subunit of PKA (Cbeta), the beta II regulatory subunit of PKA (RIIbeta), and the 79 kDa A-kinase-anchoring-protein (AKAP79), are tightly associated with the neurofibrillary pathology, positioning cAMP-dependent protein kinase to participate directly in the pathological hyperphosphorylation of tau seen in Alzheimer's disease.

Single coronary arteries: two cases with distinct and previously undescribed angiographic patterns.

Single coronary artery is a rare congenital anomaly, sometimes associated with myocardial ischemia. We present the clinical and angiographic features of two symptomatic patients with documented myocardial ischemia and with distinct and previously undescribed patterns of single right coronary arteries. These cases are new variants of the types R-I and R-II-A, in which the most probable mechanisms of ischemia are the insufficient blood supply, due to the long trajectories of the single arteries and the presence of underdeveloped vessels. Also, our second case presented with a fistulae from the LCX to the left ventricle, which is another determinant of myocardial ischemia.