Resumo Este estudo desenvolveu e testou géis experimentais contendo íons fluoreto (F-) e estanho (Sn2+) para o controle da erosão dentária. Os espécimes polidos, de esmalte e dentina, foram previamente erodidos (solução de ácido cítrico a 1%, 10 min) e alocados aleatoriamente em 5 grupos (n = 10): Placebo - gel de hidroxipropilmetilcelulose (HMC); F + Sn + HMC - 7.500 ppm F- / 15.000 ppm Sn2+; F + HMC - 7.500 ppm F-; Gel de flúor fosfato acidulado comercial (12.300 ppm F-); e Controle - sem tratamento. Após o tratamento (aplicado por 60 s), os espécimes foram submetidos a uma ciclagem de erosão-remineralização (5 min em solução de ácido cítrico a 0,3%, 60 min em saliva artificial, 4 × / dia, 20 dias). A perda de superfície (SL, em µm) foi determinada após o 5º, 10º e 20º dias de ciclagem (α = 0,05). Para o esmalte, após 5 e 10 dias, o F + Sn + HMC apresentou a menor PS, não diferindo do gel comercial. Após 20 dias, não foram encontradas diferenças entre os grupos comercial, F + HMC e F + Sn + HMC. O placebo não diferiu do controle em nenhum momento, e ambos os grupos apresentaram a maior PS, comparado aos demais grupos. Para dentina, no 5º dia , F + Sn + HMC, F + HMC e comercial não diferiram significativamente, apresentando menor PS que o grupo controle e placebo. No 10º dia, F+Sn+HMC e comercial apresentaram a menor PS comparado ao grupo controle e placebo. No 20º dia, apenas o gel comercial apresentou PS menor que o controle e o placebo. Assim, o gel experimental F + Sn + HMC foi capaz de controlar a progressão da erosão dentária.

Abstract: This study synthesized and tested experimental gels containing fluoride (F-) and stannous (Sn2+) ions for the control of dental erosion. Enamel and dentin polished specimens were eroded (1% citric acid solution, 10 min) and randomly allocated into 5 groups (n=10): Placebo - Hydroxypropyl Methylcellulose (HMC) gel; F+Sn+HMC - 7,500 ppm F- / 15,000 ppm Sn2+; F+HMC - 7,500 ppm F-; Commercial acidulated phosphate fluoride gel (12,300 ppm F-); and Control - no treatment. After treatment (applied for 60 s), specimens underwent an erosion-remineralization cycling (5 min in 0.3% citric acid solution, 60 min in artificial saliva, 4×/day, 20 days). Surface loss (SL, in µm) was determined after the 5th, 10th and 20th days of cycling (α=0.05). For enamel, after 5 and 10 days, F+Sn+HMC presented the lowest SL, which did not differ from the commercial gel. After 20 days, no differences were found between commercial, F+HMC, and F+Sn+HMC groups. Placebo did not differ from the control at any time points, and both groups presented the highest SL when compared to the other groups. For dentin, on the 5th day, F+Sn+HMC, F+HMC and commercial did not differ significantly, showing lower SL than the control and the placebo. On the 10th day, F+Sn+HMC and commercial presented the lowest SL compared to control and placebo. After 20 days, only the commercial gel showed lower SL than the control and placebo. Thus, the experimental F+Sn+HMC gel was able to control the progression of tooth erosion.

Abstract Objectives To analyze the effect of 5 toothpastes containing different percentages of S-PRG fillers compared to NaF toothpaste and NaF varnish on the dentin hydraulic conductance (Lp). Methodology Dentin disks (1.0±0.2 mm thickness) were cut from third molars, and their Lp values were evaluated using Flodec. The specimens were allocated into 7 groups (n=8). The minimum (smear layer) and the maximum (after acid etching) Lp values were recorded. Lp was also assessed after treatment with either a 0wt.%, 1wt.%, 5wt.%, 20wt.%, or 30wt.% S-PRG toothpaste, a NaF toothpaste, or a NaF varnish. Toothpastes were applied by brushing for 15 s, allowing it to settle for 1 min, and rinsing with deionized water. The NaF varnish was applied for 4 min and was removed with a probe. Specimens were exposed to citric acid (6%, pH 2.1, 1 min) and their final Lp was recorded. The pH of all products was recorded (n=3) and specimens from each group were analyzed by Laser Scanning Confocal Microscopy (LSCM). Data were subjected to 2-way repeated measures ANOVA and post-hoc Bonferroni (a=0.05). Results The highest Lp reduction was noticed for the 5wt.% S-PRG toothpaste, NaF toothpaste, and NaF varnish. However, the toothpastes containing 5wt.%, 20wt.%, and 30wt.% of S-PRG were similar to all toothpastes but differed from the NaF varnish. After erosion, all groups retrieved their maximum Lp values, except for the NaF varnish. The LSCM evidenced deposits on the surface of specimens treated with 5%, 20%, and 30% S-PRG-based toothpastes and NaF toothpaste. Even more deposits were observed for the NaF varnish. After the erosive challenge, the deposits were diminished in all groups. Conclusion Toothpastes containing 5wt.%, 20wt.%, and 30wt.% of S-PRG fillers behaved similarly to a conventional NaF toothpaste, even after an erosive challenge. The NaF varnish promoted better reduction of the Lp, but its effect was also diminished after erosion.

Abstract Objective To evaluate the effect of a toothpaste containing calcium silicate/sodium phosphate/fluoride associated or not to the boost serum (BS) against erosive tooth wear (ETW) on enamel and dentin. Methodology Bovine enamel and dentin specimens were subjected to an erosion-abrasion cycling model (1% citric acid - pH 3.6 -2 min / artificial saliva – 60 min, 4×/day, 5 days). Toothbrushing was performed for 15 s (2 min exposed to slurry), 2×/day, with the toothpastes (n=10): control without fluoride (Weleda), Arg/Ca/MFP (Colgate Pro-Relief), Si/PO4/MFP (Regenerate-Unilever), and Si/PO4/MFP/BS (Si/PO4/MFP with dual BS – Advanced Enamel Serum-Unilever). The effect of treatments on the eroded tissues was assessed by surface microhardness in the first day, and surface loss (SL) resulting from ETW was evaluated by profilometry (μm) after three and five days. Additional dentin specimens (n=5/group) were subjected to 20,000 brushing cycles to verify the abrasivity of the toothpastes. Data were subjected to ANOVA and correlation tests (5%). Results For enamel, no difference in microhardness was observed among the treated groups, and similar SL was obtained after 5 days. For dentin, Si/PO4/MFP/BS resulted in higher microhardness values, but none of the groups presented significantly lower SL than the control. There was no significant correlation between SL and abrasiveness. Conclusion The calcium silicate/sodium phosphate toothpaste and serum increased microhardness of eroded dentin, but they did not significantly reduce enamel and dentin loss compared to the non-fluoride control toothpaste. The abrasiveness of the toothpastes could not predict their effect on ETW.

ABSTRACT Chikungunya virus (CHIKV) causes a self-limiting disease characterized by the onset of fever, skin rash and persistent arthralgia. In the last decade, it has emerged as a serious public health problem causing several outbreaks around the world. Here, we report the CHIKV genotype characterization during the 2016 CHIKV outbreak in Alagoas State, Brazil. Partial E1 sequence from CHIKV-positive samples coming from different cities of Alagoas were submitted to DNA sequencing followed by phylogenetic analysis thus characterizing the virus genotype. The circulating CHIKV virus in Alagoas during 2016 outbreak belongs to the East-Central South African genotype. In this way, virus genotyping to monitoring the spread of CHIKV is needed to continued surveillance supporting the development of prevention strategies, mainly in endemic areas of mosquitoes and arboviruses co-circulation.

Abstract INTRODUCTION: Hantavirus cardiopulmonary syndrome (HCPS) is rare in Northeastern Brazil. METHODS: Prospective surveillance was conducted over a two-year period in Alagoas State, Northeastern Brazil. The prevalence of anti-hantavirus N-antigen IgM and IgG in human serum samples was determined by enzyme-linked immunosorbent assay testing. RESULTS: High avidity IgG was found in nine of 476 serum samples tested (from 102 patients with clinical manifestations compatible with HCPS, 124 patients with leptospirosis, and 250 healthy rural workers). CONCLUSIONS: Serologic evidence of past hantavirus infection in residents of Alagoas State indicates that hantaviruses are present in northeastern Brazil, even in areas silent for HCPS.

Resumo Introdução Este trabalho serve como um alerta para dentistas e pesquisadores, que alguns cimentos resinosos duais podem não polimerizar completamente sob alguns tipos de coroas protéticas. Objetivo Analisar o grau de polimerização de cimentos resinos duais, sob barreiras protéticas, por teste de microdureza. Material e método Três cimentos: Bistite II, RelyX ARC e Variolink II, foram fotopolimerizados através da interposição de vários tipos de barreiras, interpostas entre o cimento e a fonte de luz, formando os grupos: G1: sem barreira; G2: Resina composta Cesead; G3: Inceram alumina/Allceram; G4: IPS Empress; G5: Inceram zircônia/Allceram; G6: fragmento dental. Utilizou-se a luz halógena (650 mW/cm2) para fotoativação e a microdureza foi avaliada: 50gf durante 15s (MicrohardnessTester FM 700), em dois períodos (30min e 24h) pós ativação. Os dados foram submetidos à ANOVA e teste de Tukey (5%). As interposições de Inceram alumina e Inceram zircônia resultaram na polimerização deficiente dos cimentos, impossibilitando a realização dos ensaios. Resultado Para o fator cimento, o Bistite revelou a maior microdureza, seguido do RelyX e do Variolink (p<0,05). A barreira influenciou a microdureza, sendo que os maiores valores foram obtidos sem barreira, seguida do dente. Empress e Cesead proporcionaram os menores valores de microdureza e não diferiram entre si. Conclusão A barreira afetou negativamente a microdureza dos cimentos resinosos duais; o período de avaliação não afetou os valores de microdureza para quase todas as condições testadas; existe um fator limitante do ativador químico na polimerização de alguns cimentos resinosos duais, e seu desempenho é dependente do produto.

Abstract Introduction This study serves as a warning to dentists and researchers that dual-cured resin cements may not polymerize completely under some prosthetic crowns. Objective The aim of this study was to analyse the polymerization degree of dual-cured resin cements under prosthetic barrier, by microhardness test. Material and method Three cements (Bistite II, RelyX ARC and Variolink II) were light-cured through different barriers, placed between the cement and the light source: G1: without barrier; G2: composite resin (Cesead); G3: Inceram alumina; G4: IPS Empress; G5: Inceram zirconia; G6: tooth fragment. Photopolymerization was carried out using a halogen light unit (650 mW/cm2); microhardness was evaluated using the Microhardness Tester FM 700, under a load of 50gf with a dwell time of 15s, at two evaluation times (30min and 24h). Result The results were submitted to ANOVA and Tukey tests (5%). Both Inceram alumina and Inceram zirconia ceramic barriers hindered polymerization. Bistite, followed by RelyX and Variolink, exhibited the highest microhardness values (p<0.05). As the highest values were obtained without a barrier, it was determined that the barrier, followed by the tooth, influenced microhardness. Both Empress and Cesead had the smallest microhardness values but with no statistically significant difference between them. Conclusion The barrier negatively affected the microhardness of dual-cured resin cements; evaluation time did not affect microhardness values for most of the conditions tested. There is a limited effect of the chemical activator on the polymerization of some dual-cured cements, and their performance is product specific.

Resumo Tem-se verificado, nas últimas décadas, uma redução substancial nos níveis de atividade física (AF), com o consequente aumento da prevalência de sobrepeso/obesidade e fatores de risco metabólico entre jovens. O presente estudo teve por objetivos identificar os níveis de AF e as prevalências de sobrepeso/obesidade e risco metabólico, e associar o índice ponderal com os níveis de AF e risco metabólico em jovens portugueses. A amostra foi composta por 212 jovens portugueses (12-16 anos). Estatura e peso foram mensurados. AF foi estimada a partir do recordatório de 3 dias de Bouchard e pelo uso do pedômetro (durante 5 dias). Os indicadores de risco metabólico considerados foram: glicose, triglicerídeos, HDL-colesterol, tensão arterial sistólica e perímetro da cintura. Os sujeitos foram classificados consoante índice ponderal a partir do índice de massa corporal, enquanto que o estatuto maturacional foi estimado a partir do offset maturacional. Score contínuo de risco metabólico (zRM) foi calculado, e a AF foi dividida em tercis. Os testes estatísticos utilizados foram o Qui-quadrado, teste t independente e ANOVA, as análises foram conduzidas no SPSS 18.0 e WinPepi (p<0,05). Observou-se uma prevalência moderada a elevada de sobrepeso/obesidade e HDL-colesterol, uma elevada prevalência de risco para tensão arterial, e níveis de AF baixos a moderados entre jovens portugueses. A relação entre índice ponderal e zRM mostrou que adolescentes obesos apresentam maior zRM comparativamente aos adolescentes normoponderais ou com sobrepeso. Incrementos nos níveis de AF e redução da prevalência de sobrepeso/obesidade podem ter um papel relevante na redução de fatores de risco metabólico.

Abstract It has been reported, in the last decades, a significant decrease in physical activity (PA) levels, with a consequent increase in obesity and metabolic risk factors among youth. The aims of this study were to describe PA levels, the prevalence of overweight/ obesity and metabolic risk factors, and to examine the association between PA and body mass index (BMI) with metabolic risk among Portuguese youth. The sample comprises 212 Portuguese adolescents (12-16 years old). Height and weight were measured. PA was estimated with the Bouchard questionnaire (3 days recall), as well as with the use of a pedometer (used for 5 consecutive days). Metabolic risk factors comprised fasting glucose, triglycerides, HDL-cholesterol, systolic blood pressure and waist circumference. Subjects were classified as normal weight, overweight or obese according to BMI; the maturational status was indirectly estimated with the maturity offset procedure. A continuous metabolic risk score was computed (zMR) and PA values were divided into tertiles. Quisquare test, t-test and ANOVA were used in statistical analyses. SPSS 18.0 and WinPepi softwares were used and p<0.05. A moderate to high prevalence of overweight/obesity and HDL-cholesterol was found, as well as a high prevalence of high blood pressure and low to moderate PA levels among Portuguese youth. The relationship between BMI and zMR showed that obese adolescents have higher zMR when compared to normal weight or overweight adolescents. This finding suggests that increased levels of PA and reduction in the prevalence of overweight/obesity may have a positive role against the development of metabolic risk factors.

ABSTRACT Introduction: The wound healing process is immediate and dynamic in order to restore anatomical and functional continuity, and there must be conditions for this process, which include a normal nutritional state. Among the existing supplemental formulas, immuno-enhancing diets have been proposed to improve the wound healing process and patients’ clinical conditions. The influence of an immunomodulating diet (Impact®) on different variables of the skin healing process was evaluated. Method: Healthy adult rats were randomly divided into four groups of diet supplementation or control. Two groups received their diets only pre-operatively while the other two groups received theirs perioperatively. Rats were subjected to three types of skin lesions. We evaluated the following aspects: changes in weight, development of raw areas, tensiometry of incisional wounds, re-epithelialization rates, and histological parameters. Results: There was no difference in weight changes. There was better closing rates of excisional wounds in groups supplemented with Impact® beginning on the fifth day after surgery (p = 0.02). The groups receiving the dietary supplements obtained the best results in tensiometry (p = 0.03), re-epithelialization rates (p = 0.04), differential cell counts (p < 0.001), and total amount of collagen (p < 0.001). Conclusions: The study diet (Impact®) promoted better closure rates of raw wounds, faster re-epithelialization, scars with a greater tensile strength, and greater amounts of total collagen in wounds. There was no difference in any of the parameters analyzed compared with the groups supplemented with Impact® preand perioperatively.

RESUMO Introdução O processo de cicatrização é imediato e dinâmico, com o objetivo de restaurar a continuidade anatômica e funcional, e devem existir condições para esse processo, o que inclui um estado nutricional adequado. Dentre as fórmulas de suplementação existentes, as imunomoduladoras têm sido implicadas na melhora do processo cicatricial e das condições clínicas dos pacientes tratados. Foi avaliada a influência da dieta imunomoduladora (Impact®) sobre diferentes variáveis do processo de cicatrização cutânea. Método Ratos adultos e nutridos foram divididos aleatoriamente em quatro grupos, a serem suplementados com a dieta em estudo e com a dieta controle. Dois grupos receberam as respectivas dietas apenas pré-operatoriamente e os outros dois grupos as receberam no perioperatório. Os ratos foram submetidos a três tipos de lesões cutâneas. Foram avaliados os seguintes aspectos: evolução dos pesos, evolução das áreas cruentas, tensiometria das feridas incisionais, taxas de reepitelização e parâmetros histológicos. Resultados Não houve diferença na evolução dos pesos. Houve melhores índices de fechamento de feridas excisionais nos grupos suplementados com Impact®, a partir do quinto dia de pós-operatório (p=0,02). Os grupos suplementados com a dieta em estudo obtiveram melhores resultados em tensiometria (p = 0,03), taxas de reepitelização (0,04), contagem diferencial de células (p<0,001) e quantidade de colágeno total (p<0,001). Conclusões A dieta em estudo (Impact®) promove melhores taxas de fechamento de feridas cruentas, reepitelização mais rápida, cicatrizes com maior resistência tênsil e maiores quantidades de colágeno total nas feridas. Não houve diferença em nenhum dos parâmetros analisados em comparação dos grupos suplementados com Impact® pré e perioperatoriamente.

INTRODUÇÃO: Hantaviroses são zoonoses de roedores silvestres que causam doenças graves em seres humanos. Este trabalho mostra inquérito sorológico para hantavírus em população rural e periurbana do município de Turvo, Estado de Santa Catarina e a correlação da presença de anticorpos anti-hantavírus com a história mórbida pregressa dos indivíduos. MÉTODOS: Investigaram-se os 257 participantes do estudo quanto à presença de anticorpos IgG séricos anti-hantavírus Araraquara, por método imunoenzimático. RESULTADOS: A prevalência de anticorpos anti-hantavírus na população foi de 2,3%. Os soropositivos possuíam antecedente nosológico sugestivo de hantavirose pregressa. CONCLUSÕES: Os achados mostram a ocorrência de infecções por hantavírus no extremo sul de Santa Catarina.

INTRODUCTION: Rodent-borne hantaviruses cause severe human diseases. We completed a serological survey of hantavirus infection in rural inhabitants of Turvo County, in the southern State of Santa Catarina, Brazil, in which seropositivity for hantavirus was correlated to previous disease in the participants. METHODS: The levels of IgG antibodies to hantavirus Araraquara in the sera of 257 individuals were determined using an immunoenzymatic assay. RESULTS: IgG antibodies to hantavirus were found in 2.3% of the participants. All seropositive participants reported previous disease with symptoms suggestive of hantavirus cardiopulmonary syndrome. CONCLUSIONS: Human infections causing unreported cardiopulmonary syndrome probably occur in the southern State of Santa Catarina.

Corantes encontrados em bebidas diminuem a estabilidade de cor de resinas compostas, reduzindo assim a sua longevidade. Este estudo in vitro tem como objetivo avaliar o efeito do meio de imersao na estabilidade de cor de sete diferentes resinas compostas encontradas no mercado. (Solidex - Shofu, Resilab - Wilcos, Signum-Heraeus, Epricord - Tokuyama, Adoro- IvoclarVivadent, Admira - Voco e Sinfony - 3M ESPE). Quinze corpos de prova de cada resina composta foi preparado usando uma matriz cilindrica de 2 mm de espessura e 10 mm de diametro fabricada em teflon, polimerizadas de acordo com as recomendacoes do fabricante e divididos aleatoriamente em tres grupos (n=5) de acordo com o meio de imersao: cafe, refrigerante a base de cola e agua. Um spectrofotometro Easy Shade (VITA) foi usado para avaliar as alteracoes de cor apos 7 dias de imersao em cada solucao, sendo que os corpos de prova foram armazenados em estufa bacteriologica a 37°C. Os valores medidos foram analisados pelo testes ANOVA e Tukey (p<0,05) e mostraram diferenca significante para as variavies meio, resina e interacao. Os menores valores foram observados na Admira (ΔE=3.934±0.814) e Resilab(ΔE= 3.993±0.735), seguidos por Adoro (ΔE=4.044±1.001), Epricord (ΔE=4.049±1.234), Signum (ΔE=4.260±1.785), Solidex (ΔE=5,122�±0.534) e Sinfony (ΔE=5.126�±0.838). Conclusao: Todas as resinas compostas testadas foram sensiveis ao manchamento pelas substancias presentes no cafe e refrigerante a base de cola, exceto a resina Adoro quando armazenada em refrigerante por sete dias e as menores medias de ΔE foram obtidas com a Admira.

Coloring in drinks decreases the color stability of composite restorations, reducing their longevity. The purpose of this in vitro study was to evaluate the effect of immersion media on color stability of seven different composite resins (Solidex - Shofu, Resilab- Wilcos, Signum - Heraeus, Epricord - Tokuyama, Adoro - Ivoclar Vivadent, Admira - Voco and Sinfony - 3M ESPE). Seven resin-based composite specimens were prepared using a cylindrical teflon mold 2 mm thick and 10 mm in diameter. Fifteen specimens of each resin were light-cured according to manufacturers´ instructions and randomized into 3 groups (n=5) according to immersion media: coffee, cola beverage and water. A digital spectrophotometer Easy Shade (VITA) was used to evaluate the color changes at baseline and 7 days after immersion in each solution. Specimens were stored in the different staining media for 24 h/day during one week. The color differences were analyzed by two-way ANOVA and Tukey´s test (p<0.05). Color change was observed after one week of immersion and there were statistical differences in staining, composite and interaction factors. The least staining was observed in Admira (ΔE=3.934±0.814) and Resilab (ΔE= 3.993±0.735), followed by Adoro (ΔE=4.044±1.001), Epricord (ΔE=4.049±1.234), Signum (ΔE=4.260�±1.785), Solidex (ΔE=5,122±0.534) and Sinfony (ΔE=5.126±0.838). All of the composites tested except Adoro were susceptible to staining by substances present in coffee and cola, when stored in beverage for seven days. The lowest ΔE means were obtained with Admira.

INTRODUÇÃO: O presente estudo buscou identificar os efeitos adversos e o efeito protetor da vacina contra influenza, em idosos acima de 60 anos, aplicada pela rede pública no município de Tubarão, Santa Catarina. MÉTODOS: Foi realizada uma coorte prospectiva de pacientes durante o período de maio a setembro de 2008. Foram recrutados 341 idosos, sendo 289 vacinados na rede pública (VSUS) e 52 não vacinados (NV). A incidência do efeito protetor foi verificada através da comparação dos grupos VSUS com os NV. RESULTADOS: Um percentual de 22,5% de pacientes apresentou pelo menos um efeito adverso. Comparando o grupo VSUS e NV quanto à incidência de sintomas gripais durante o inverno, a presença de pelo menos um sintoma foi verificada em 47% e 28,8% (RR = 1,11; 1,02-1,22; p = 0,0156), respectivamente. CONCLUSÕES: Os resultados apontam uma baixa incidência de efeitos adversos. A maior incidência de sintomas gripais no grupo VSUS comparado ao NV pode estar relacionado às características da população que costuma fazer a vacina contra influenza.

INTRODUCTION: The aim of this study was to investigate the incidence of adverse effects and protective effects from influenza vaccine among elderly individuals who were vaccinated through the public healthcare system in the municipality of Tubarão, State of Santa Catarina. METHODS: A prospective cohort study was conducted between May and September 2008. A group of 341 patients was recruited, among whom 289 had been vaccinated through the public system (VSUS) and 52 had not been vaccinated (NV). The incidence of protective effects was observed by comparing the VSUS and NV groups. RESULTS: It was observed that 22.5% of the vaccinated subjects exhibited at least one adverse effect. Comparing the VSUS and NV groups in relation to the incidence of flu symptoms presented during the winter, at least one symptom was observed in 47% and 28.8% (RR = 1.11; 1.02-1.22; p = 0.0156), respectively. CONCLUSIONS: These findings demonstrate that the incidence of adverse effects was low. The high incidence of flu symptoms in the VSUS group, in comparison with NV, may be related to the profile of subjects who are in the habit of getting vaccinated against influenza.

INTRODUÇÃO: A síndrome pulmonar e cardiovascular por hantavírus é uma doença grave emergente nas Américas. Os hantavírus, Bunyaviridae, são os agentes causadores desta síndrome, causadas, principalmente, pela inalação de aerossóis dos dejetos de roedores silvestres. Na região de Ribeirão Preto, a SPCVH, causada pelo vírus Araraquara, tem sido diagnosticada, desde 1998. O roedor-reservatório do ARAV é o Necromys lasiurus. Este tem como objetivo mostrar os resultados de diagnósticos da infecção de humanos e roedores obtidos no Centro de Pesquisa em Virologia da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, durante o período de 2005 a 2008. MÉTODOS: A síndrome pulmonar e cardiovascular por hantavírus foi diagnosticada, por ELISA e/ou RT-PCR, em 11 (21,2%) dos 52 casos suspeitos e destes, 54,4% foram casos fatais. Além disso, também, de 2005 a 2008, foram capturados 595 roedores silvestres, Necromys lasiurus, Akodon sp, Calomys tener e Oligoryzomys sp. RESULTADOS: Quinze (2,5%) destes roedores apresentaram anticorpos para hantavírus. As soropositividades intraespécie ou gênero foram 4% para Necromys lasiurus, 1,9% para Calomys tener e 1,5% para Akodon sp. Sequências nucleotídicas, obtidas pela RT-PCR de um paciente com SPCVH e de um roedor Calomys tener, foram comparadas com sequências de hantavírus do GenBank, o que mostrou que ambas tinham homologia com o ARAV. CONCLUSÕES: Este trabalho corrobora outros estudos que mostram que o ARAV é o hantavírus causador da SPCVH, na região de Ribeirão Preto, além de mostrar que roedores infectados por hantavírus representam um risco constante de transmissão desses vírus para o homem.

INTRODUCTION: Hantavirus pulmonary and cardiovascular syndrome (HPCS) is an emerging serious disease in the Americas. Hantaviruses (Bunyaviridae) are the causative agents of this syndrome and are mainly transmitted through inhalation of aerosols containing the excreta of wild rodents. In the Ribeirão Preto region (state of São Paulo, Brazil), HPCS has been reported since 1998, caused by the Araraquara virus (ARAV), for which Necromys lasiurus is the rodent reservoir. This study aimed to show diagnostic results relating to infection in humans and rodents, obtained at the Virology Research Center of the Ribeirão Preto School of Medicine, University of São Paulo, between 2005 and 2008. METHODS: HPCS was diagnosed by means of ELISA and/or RT-PCR in 11 (21.2%) out of 52 suspected cases, and 54.4% of these were fatal. Furthermore, 595 wild rodents (Necromys lasiurus, Akodon sp, Calomys tener and Oligoryzomys sp) were caught between 2005 and 2008. RESULTS: Fifteen (2.5%) of these rodents presented antibodies for hantavirus, as follows: Necromys lasiurus (4%), Calomys tener (1.9%) and Akodon sp (1.5%). Nucleotide sequences obtained through RT-PCR from one HPCS patient and one Calomys tener rodent were compared with hantavirus sequences from GenBank, which showed that both were homologous with ARAV. CONCLUSIONS: This work corroborates previous studies showing that ARAV is the hantavirus causing HPCS in the Ribeirão Preto region. It also shows that rodents infected with hantavirus represent a constant risk of transmission of this virus to man.

A síndrome pulmonar e cardiovascular por hantavírus é doença causada pela aspiração de aerossóis dos dejetos de roedores silvestres contaminados por vírus da família Bunyaviridae. Estudamos manifestações clínicas e laboratoriais de 70 casos ocorridos de 1998 a 2007 na região de Ribeirão Preto, SP. A freqüência de sintomas foi dispnéia (87%), febre (81%), tosse (44%), cefaléia (34%), taquicardia (81%), hipotensão arterial (56%), hipóxia (49%), acidose metabólica (57%), linfocitopenia (51%), hematócrito >45% (70%), leucocitose com desvio à esquerda (67%), creatinina (51%) e uréia (42%) séricas elevadas. A letalidade (54,3%) ocorreu principalmente no 4o dia. Insuficiência respiratória, hipotensão arterial e choque ocorreu 24-48 horas; o hematócrito elevado e a plaquetopenia são sinais fortemente sugestivos da doença. A hipótese diagnóstica de pneumonia atípica associada a bom prognóstico (p:0,0136); a infusão hídrica >2.000ml e hipotensão arterial associadas a mau prognóstico (p:0,0286 e p:0,0453).

Pulmonary and cardiovascular syndrome due to hantavirus is a disease caused by inhalation of aerosols from the excreta of wild rodents contaminated by viruses of the Bunyaviridae family. We studied the clinical and laboratory manifestations of 70 cases that occurred in the region of Ribeirão Preto, SP, Brazil, between 1998 and 2007. The frequency of symptoms was as follows: dyspnea (87%), fever (81%), coughing (44%), headache (34%), tachycardia (81%), low arterial blood pressure (56%), metabolic acidosis (57%), lymphocytopenia (51%), hematocrit > 45% (70%), leukocytosis with left deviation (67%), creatinine (51%) and urea (42%). Mortality (54.3%) occurred mainly on the fourth day. Respiratory insufficiency, low arterial blood pressure and shock occurred after 24 to 48 hours. High hematocrit and decreased platelet levels were signs strongly suggestive of the disease. The diagnostic hypothesis of atypical pneumonia was associated with a good prognosis (p = 0.0136). Fluid infusion greater than 2,000 ml and arterial hypotension were associated with a poor prognosis (p = 0.0286 and p = 0.0453).