BACKGROUND Leptospirosis is an emerging zoonosis that affects humans and animals. Immunochromatography rapid test is widely used for early diagnosis of leptospirosis, but with low sensitivity and specificity. OBJECTIVES To evaluate Leptospira interrogans insoluble fraction as a potential antigen source for lateral flow immunochromatography. METHODS Insoluble fraction derived from the crude bacterial extract was obtained by serial centrifugation. The polypeptide profile was determined using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Immune reactivity of this fraction was assessed by Western Blotting and lateral flow immunochromatography (LFI). It was tested 160 microagglutination test (MAT)-positive sera from patients in the acute phase, 100 MAT-negative sera from patients with acute febrile illness, and 45 patients with other infectious diseases. FINDINGS There was a predominance of low molecular mass-polypeptide bands, ranging from 2 to 37 kDa. The antibody reactivity of theses polypeptides was found to range from 13-50%, especially between 10 and 38 kDa. Among MAT-positive sera of patients with leptospirosis in the acute phase, 97% were also positive in LFI, indicating high sensitivity. Among MAT-negative sera, all were negative in LFI, indicating high specificity. Only 2% of cross-reactivity was detected. CONCLUSION The insoluble fraction can be a valuable antigen source for development of point-of-care diagnosis test for leptospirosis.

This paper aims at replying critical commentaries made by Leite, F. P., Aggio, G. O. e Angeli, E. (this Review, 2009) on two Author's theses. The first one states that, if public deficit is to be financed, then either interest rate applied is negative or government invests as if it where a profit-making business enterprise. Otherwise, public debt will mathematically follow an explosive trend. The second one says that if there is no debt and public deficit is paid with money issuing, then the monetary stock will tend to an equilibrium level.

O presente trabalho descreve o isolamento e a identificação estrutural de seis triterpenos (acetato de ±-amirina, cicloartenona, 3²,19±,23-triidroxi-urs-12-eno e os ácidos ursólico, 3-²-O-²-D-glicopiranosilquinóvico e 3²,6²,19±,23-tetraidroxi-urs-12-en-28-óico), além de um fitoesteróide (sitostenona) de extratos das folhas, cascas do caule e caule de Guettarda grazielae M.R.V. Barbosa (Rubiaceae). Os compostos isolados, exceto o ácido 3-²-O-²-D-glicopiranosilquinóvico, estão sendo descritos pela primeira vez no gênero Guettarda e foram identificados com base na análise de dados espectrais de RMN, incluindo APT e DEPT, bem como pela comparação com dados da literatura.

This work describes the isolation and structural identification of six triterpenes (a-amyrin acetate, cycloartenone,3²,19±,23-trihydroxyurs-12-ene,andursolic,3-²-O-²-D-glucopyranosylquinovic, 3²,6²,19±,23-tetrahydroxyurs-12-en-28-oic acids), beside a phytosteroid (sitostenone) from leaves, stem barks and stems of Guettarda grazielae (Rubiaceae). All isolated compounds, except 3-²-O-²-D-glucopyranosylquinovic acid, are being described for the first time in the genus Guettarda and were identified on basis of the spectral NMR data, including APT and DEPT, as well as by comparison with data of the literature.

This paper suggests a reconsideration of the principle that public deficits should be financed by public debt. Two main reasons are offered. First, it is admitted that public debt is an economic variable whose time behaviour is better described by a first difference equation instead of an accounting identity. The convergence condition thus obtained requires either a nominal negative interest rate or that government bonds are used to raise tax income, hypotheses not theoretically granted. As a consequence, if primary surplus is not sufficient to match interests' payment, it will be observed an explosive trend in the public debt, the due interests and the money issuing. Therefore, it lacks support to the idea that public debt prevents inflation. Second, it is shown that financing public deficit through money issuing leads to a stable equilibrium money stock. The general conclusion is that, in order to simultaneously promote economic growth and inflation control, money issuing is preferable to public debt.

Bons problemas são fundamentais em um currículo que utiliza o Aprendizado Baseado em Problemas. Escrevê-los requer conhecimento sobre os elementos básicos que devem fazer parte da estrutura do problema e também os fatores fundamentais que devem ser levados em consideração para que os objetivos sejam alcançados. Neste trabalho foram revistos alguns artigos da literatura com sugestões sobre a estrutura de problemas para uso em atividades tutoriais. São também apresentados princípios que devem ser respeitados e o modelo de estrutura de um problema, tal como têm sido sugeridos para os grupos de planejamento dos módulos temáticos e tutoriais do curso de Medicina da Universidade Estadual de Londrina além de exemplos de erros, observados em nossa experiência de 10 anos com este modelo de currículo, e que devem ser evitados.

Good problems are crucial for the development of a Problem-Based Learning curriculum. Writing good problems requires discipline and knowledge of the basic principle of the structure and fundamental features that have been considered to achieve the goals. Herein, the authors reviewed some of the rules suggested by the medical literature, and presented a model of written problems that are suggested for the tutorial planning groups of the Medical Course at the State University of Londrina, Brazil. Examples of errors observed in our 10-year experience in Problem-Based Learning are commented.

From December 1999 to December 2001, many cases of hepatitis A were notified in the county of Belford Roxo involving individuals aged 0 to 79 years. Serum samples were collected to evaluate the prevalence of anti-hepatitis A virus (HAV) antibodies, to detect HAV-RNA and to correlate with possible risk factors of HAV infection. Serum samples were screened by commercial IgM and total anti-HAV antibody ELISA and HAV-RNA was isolated and subsequently amplified by reverse transcription-polymerase chain reaction (RT-PCR) at VP1/2A region, sequenced and analyzed. Total anti-HAV prevalence was 87.9% (203/231) and IgM anti-HAV prevalence was 38.7% (89/231). Multivariate analysis showed that individuals under 20 years old are risks groups to acquire the infection suggesting that hygienic habits of young subjects are the principal factor of transmission and so they could be the target for vaccine programs. HAV-RNA was amplified from 29 (32.5%) IgM anti-HAV positive patients and 26 samples were sequenced and classified into subgenotypes IB (8 isolates) and IA (18 isolates). Isolates classified into subgenotype IB were identical representing one distinct strain. We could observe both subgenotypes circulating during the study which suggests different sources of infection. Prophylactic measures as vaccination strategies added to improvements in hygienic and sanitary conditions would be highly effective to reduction of infection.

Avaliou-se neste estudo a imunogenicidade de três vacinas recombinantes contra a hepatite B (HB), uma brasileira (Butang, do Instituto Butantan) e duas coreanas (Euvax-B, da LG Chemical Ltd. e Hepavax-Gene, da Greencross Vaccine Corp.), administradas a jovens com 17 a 19 anos, por via intramuscular, em três doses de 10 µg (que correspondem a 50% da quantidade do antígeno contida na vacina usada rotineiramente em adultos), com intervalos de um mês entre a primeira e a segunda, e de quatro meses entre a segunda e a terceira doses. Foram vacinadas 316 pessoas nas quais não foi encontrado nenhum marcador sorológico de infecção pelo vírus da HB: 77 (24,4%) com a Butang, 71 (22,5%) com a Euvax-B, 85 (26,9%) com a Hepavax-Gene e, para comparação, 83 (26,2%) com a Engerix-B. A eficiência da vacina recombinante contra a hepatite B produzida pela GlaxoSmithKline (Engerix-B), em adultos jovens, na dose que usamos, já tinha sido comprovada em pesquisas anteriormente realizadas. Neste estudo, as taxas de soroconversão (anti-HBs > 10 mUI/mL, cerca de um mês depois da terceira dose) obtidas com as vacinas Butang, Euvax-B, Hepavax-Gene e Engerix-B foram semelhantes, iguais respectivamente a 96,2%, 98,6%, 96,5% e 97,6%. A freqüência de bons respondedores (anti-HBs > 100 mUI/mL) foi também semelhante entre os que receberam as quatro vacinas (85,8%, 91,6%, 89,4% e 89,2%, respectivamente). A média geométrica dos títulos séricos de anti-HBs obtidos cerca de um mês depois da terceira dose, com essas vacinas, foi igual a 727,78 ± 6,46 mUI/mL, 2.009,09 ± 7,16 mUI/mL, 1.729,82 ± 8,85 mUI/mL e 2.070,14 ± 11,69 mUI/mL, respectivamente. As médias geométricas dos títulos séricos de anti-HBs induzidos pela Euvax-B e pela Engerix-B foram maiores que a média geométrica do título sérico de anti-HBs induzido pela Butang (p < 0,05); essa diferença não foi estatisticamente significativa quando se compararam, duas a duas, as outras vacinas. Não se registrou nenhuma queixa espontânea dos vacinados sobre eventos adversos que tivessem atribuído à aplicação de qualquer dose das quatro vacinas.

We evaluated the immunogenicity of three recombinant hepatitis B vaccines, one Brazilian (Butang, Instituto Butantan) and two Korean vaccines (Euvax-B, LG Chemical Ltd. and Hepavax-Gene, Greencross Vaccine Corp.), administered intramuscularly to students aged 17 to 19 years in three 10-µg doses (corresponding to half the amount of antigen routinely used for adult vaccination) at intervals of one month between the first and second dose, and of four months between the second and third dose. A total of 316 students non-reactive for any serological marker of hepatitis B virus infection were vaccinated: 77 (24.4%) with the Butang vaccine, 71 (22.5%) with Euvax-B, 85 (26.9%) with Hepavax-Gene and, for comparison, 83 (26.2%) with Engerix-B (GlaxoSmithKline), whose efficacy in young adults at the dose used here has been confirmed in previous studies. Similar seroconversion rates (anti-HBs > 10 mIU/mL about one month after application of the third dose) were obtained for the Butang, Euvax-B, Hepavax-Gene and Engerix-B vaccines (96.2%, 98.6%, 96.5% and 97.6%, respectively). The frequency of good responders (anti-HBs > 100 mIU/mL) was also similar among students receiving the four vaccines (85.8%, 91.6%, 89.4% and 89.2%, respectively). The geometric mean titers (GMT) of anti-HBs about one month after the third dose obtained with these vaccines were 727.78 ± 6.46 mIU/mL, 2009.09 ± 7.16 mIU/mL, 1729.82 ± 8.85 mIU/mL and 2070.14 ± 11.69 mIU/mL, respectively. The GMT of anti-HBs induced by the Euvax-B and Engerix-B vaccines were higher than those obtained with the Butang vaccine (p < 0.05); this difference was not significant when comparing the other vaccines two-by-two. No spontaneous adverse effects attributable to the application of any dose of the four vaccines were reported.

Resumo: Objetivo: registrar as ações desenvolvidas pela comissão de capacitação docente (CC) do curso médico na Universidade Estadual de Londrina (UEL, no sentido de sensibilizar e treinar professores durante a implementação da ABP. Método: Consulta ao arquivo dos registros das ações da CC e análise das atividades desenvolvidas. Resultados: Entre 1977 e 2001, foram realizados cursos de sensibilização, de aprofundamento em ABP; de elaboração de problemas, de construção de módulo temático, fóruns de tutores e cursos de capacitação de tutores com dois desenhos. As atividades desenvolvidas nossos cursos influenciaram: observar e vivenciar grupos tutoriais; elaborar problemas; planejar módulos temáticos; discutir os passos da dinâmica tutorial e os problemas surgidos no desempenho da avaliação. Conclusão: o programa de capacitação docente em Londrina foi construído a partir de demandas surgidas com a implementação da nova metodologia de acordo com o grau de inscrição e resistência dos docentes ao processo. Avalia-se compositivo o trabalho desenvolvido e aponta-se como pertinente um programa de capacitação mais abrangente, que envolva as instâncias gerenciais, profissionais e pedagógicas do processo.

Abstract: Objective: To record the activities conducted by the Teacher Qualification Committee (TQC) at the School of Medicine of the State University in Londrina, Paraná, Brazil (UEL), in order to sensitize and train professors during the implementation of problem-based learning (PBL). Method: Consult the Committee file, and analyze the activities conducted by it. Results: From 1997 to 2001, awareness raising courses were held on the in-depth use of PBL; elaboration of problems development of a thematic module; forums of tutors; and training courses for tutors with to different designs. Activities in the courses included: observing and experiencing tutor groups; elaborating problems planning thematic modules; discussing steps in tutorial dynamics and problems emerging in performing the tutor's role; training in skills and activities in course-community interaction; and the evaluation system. Conclusion: The teacher training program in Londrina was designed and implemented on the basis of demand emerging from the implementation of the new methodology, and according to the degree of the teacher participation (or resistance to) the process. The work received a positive assessment and identified the importance of a broader training program involving the management professional, and pedagogical tiers in the process.