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RESUMO Os canabinoides compreendem os endocanabinoides, fitocanabinoides e os canabinoides sintéticos e desempenham ações no sistema nervoso central e periférico. Uma quantidade enorme de publicações tem sido lançada nos últimos anos, embora a cannabis seja conhecida por milênios. Os Departamentos Científicos da Academia Brasileira de Neurologia descreveram as evidências do uso médico em suas áreas. A literatura está em constantes mudanças e possíveis novas evidências podem surgir nos próximos dias ou meses. A prescrição dessas substâncias deve ser discutida com os pacientes e suas famílias, com conhecimento sobre eventos adversos e sua eficácia.

ABSTRACT Cannabinoids comprehend endocannabinoids, phytocannabinoids, and synthetic cannabinoids, with actions both in the central and peripherical nervous systems. A considerable amount of publications have been made in recent years, although cannabis has been known for over a thousand years. Scientific Departments from the Brazilian Academy of Neurology described evidence for medical use in their areas. Literature is constantly changing, and possible new evidence can emerge in the next days or months. Prescription of these substances must be discussed with patients and their families, with knowledge about adverse events and their efficacy.

https://doi.org/10.1590/0004-282x-anp-2020-0432 1049 downloads

Use of PET/CT to aid clinical decision-making in cases of solitary pulmonary nodule: a probabilistic approach
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Mourato, Felipe Alves

; Brito, Ana Emília Teixeira

; Romão, Monique Sampaio Cruz

; Santos, Renata Guerra Galvão

; Almeida, Cristiana Altino de

; Almeida Filho, Paulo José de

; Leal, Aline Lopes Garcia

Radiologia Brasileira

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feb 2020, Volume 53 N. 1 Pages 1 - 6

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: Determinar a frequência em que a PET/CT com FDG-18F muda a classificação de probabilidade de malignidade do nódulo pulmonar solitário. Materiais e Métodos: Foi realizada análise retrospectiva de todas as PET/CTs com FDG-18F realizadas entre maio/2016 e maio/2017 num serviço de medicina nuclear, cuja indicação era a avaliação de nódulo pulmonar solitário. Foram analisados os prontuários e os exames de PET/CT para coleta das informações necessárias para o cálculo da probabilidade pré-teste de malignidade pelo modelo de Swensen e pelo modelo de Herder. Probabilidade menor que 5% foi considerada como baixa, maior que 65% foi definida como alta, e os casos restantes, como intermediária. Os casos classificados como intermediários pelo modelo de Swensen foram reclassificados de acordo com o modelo de Herder. Resultados: Trinta e três pacientes foram incluídos neste estudo, 17 (51,5%) deles eram do gênero masculino, e a média de idade foi 68,63 anos (± 12,20 anos). Em relação à classificação da probabilidade de malignidade pelo modelo de Swensen, 23 (69,7%) apresentaram probabilidade intermediária de malignidade. Destes, o modelo de Herder classificou 6 casos (26,1%) como probabilidade baixa e 8 casos (34,8%) como probabilidade alta de malignidade. Conclusão: A PET/CT com FDG-18F foi capaz de modificar a classificação probabilística do nódulo pulmonar solitário em mais da metade dos casos.

Abstract Objective: To determine the frequency with which 18F-FDG-PET/CT findings change the probability of malignancy classification of solitary pulmonary nodules. Materials and Methods: This was a retrospective analysis of all 18F-FDG-PET/CT examinations performed for the investigation of a solitary pulmonary nodule between May 2016 and May 2017. We reviewed medical records and PET/CT images to collect the data necessary to calculate the pre-test probability of malignancy using the Swensen model and the Herder model. The probability of malignancy was classified as low if < 5%, intermediate if 5-65%, and high if > 65%. Cases classified as intermediate in the Swensen model were reclassified by the Herder model. Results: We reviewed the records for 33 patients, of whom 17 (51.5%) were male. The mean age was 68.63 ± 12.20 years. According to the Swensen model, the probability of malignancy was intermediate in 23 cases (69.7%). Among those, the application of the Herder model resulted in the probability of malignancy being reclassified as low in 6 (26.1%) and as high in 8 (34.8%). Conclusion: 18F-FDG-PET/CT was able to modify the probability of malignancy classification of a solitary pulmonary nodule in more than 50% of the cases evaluated.

https://doi.org/10.1590/0100-3984.2019.0034 1105 downloads

A systematic scoping review of the genetic ancestry of the Brazilian population
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Souza, Aracele Maria de

; Resende, Sarah Stela

; Sousa, Taís Nóbrega de

; Brito, Cristiana Ferreira Alves de

Genetics and Molecular Biology

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sep 2019, Volume 42 N. 3 Pages 495 - 508

Abstract: En | Text: En | PDF: En

Abstract The genetic background of the Brazilian population is mainly characterized by three parental populations: European, African, and Native American. The aim of this study was to overview the genetic ancestry estimates for different Brazilian geographic regions and analyze factors involved in these estimates. In this systematic scoping review were included 51 studies, comprehending 81 populations of 19 states from five regions of Brazil. To reduce the potential of bias from studies with different sampling methods, we calculated the mean genetic ancestry weighted by the number of individuals. The weighted mean proportions of European, African, and Native American ancestries were 68.1%, 19.6%, and 11.6%, respectively. At the regional level, the highest European contribution occurred in the South, while the highest African and Native American contributions occurred in the Northeastern and Northern regions, respectively. Among states in the Northeast region, Bahia and Ceará showed significant differences, suggesting distinct demographic histories. This review contributes for a broader understanding of the Brazilian ancestry and indicates that the ancestry estimates are influenced by the type of molecular marker and the sampling method.

https://doi.org/10.1590/1678-4685-gmb-2018-0076 6099 downloads

Plasmodium infection and its association with biochemical and haematological parameters in free-living Alouatta guariba clamitans (Cabrera, 1940) (Primates: Atelidae) in Southern Brazil
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Nunes, Ana Júlia Dutra

; Alvarenga, Denise Anete Madureira de

; de Souza Junior, Julio Cesar

; Peruchi, Amanda Rezende

; Gonçalves, Gustavo Henrique Pereira

; Hirano, Zelinda Maria Braga

; Brito, Cristiana Ferreira Alves de

; Cremer, Marta Jussara

Memórias do Instituto Oswaldo Cruz

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2019, Volume 114 elocation e190210

Abstract: En | Text: En | PDF: En

BACKGROUND The influence of Plasmodium spp. infection in the health of Southern brown howler monkey, Alouatta guariba clamitans, the main reservoir of malaria in the Atlantic Forest, is still unknown. OBJECTIVES The aim of this study was to investigate the positivity rate of Plasmodium infection in free-living howler monkeys in an Atlantic Forest fragment in Joinville/SC and to associate the infection with clinical, morphometrical, haematological and biochemical alterations. METHODS Molecular diagnosis of Plasmodium infection in the captured monkeys was performed by Nested-polymerase chain reaction (PCR) (18S rRNA and coxI). Haematological and biochemical parameters were compared among infected and uninfected monkeys; clinical and morphometrical parameters were also compared. FINDINGS The positivity rate of Plasmodium infection was 70% among forty captured animals, the highest reported for neotropical primates. None statistical differences were detected in the clinical parameters, and morphometric measures comparing infected and uninfected groups. The main significant alteration was the higher alanine aminotransferase (ALT) levels in infected compared to uninfected monkeys. MAIN CONCLUSIONS Therefore, Plasmodium infection in howler monkeys may causes haematological/biochemical alterations which might suggest hepatic impairment. Moreover, infection must be monitored for the eco-epidemiological surveillance of malaria in the Atlantic Forest and during primate conservation program that involves the animal movement, such as translocations.

https://doi.org/10.1590/0074-02760190210 424 downloads

Detection of Plasmodium in faeces of the New World primate Alouatta clamitans
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Assis, Gabriela Maíra Pereira de

; Alvarenga, Denise Anete Madureira de

; Costa, Daniela Camargos

; Souza Junior, Júlio César de

; Hirano, Zelinda Maria Braga

; Kano, Flora Satiko

; Sousa, Taís Nóbrega de

; Brito, Cristiana Ferreira Alves de

Memórias do Instituto Oswaldo Cruz

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sep 2016, Volume 111 N. 9 Pages 570 - 576

Abstract: En | Text: En | PDF: En

Abstract Plasmodium falciparum and Plasmodium vivax have evolved with host switches between non-human primates (NHPs) and humans. Studies on the infection dynamics of Plasmodium species in NHPs will improve our understanding of the evolution of these parasites; however, such studies are hampered by the difficulty of handling animals in the field. The aim of this study was to detect genomic DNA of Plasmodium species from the faeces of New World monkeys. Faecal samples from 23 Alouatta clamitans from the Centre for Biological Research of Indaial (Santa Catarina, Brazil) were collected. Extracted DNA from faecal samples was used for molecular diagnosis of malaria by nested polymerase chain reaction. One natural infection with Plasmodium simium was identified by amplification of DNA extracted from the faeces of A. clamitans. Extracted DNA from a captive NHP was also used for parasite genotyping. The detection limit of the technique was evaluated in vitro using an artificial mixture of cultured P. falciparum in NHP faeces and determined to be 6.5 parasites/µL. Faecal samples of New World primates can be used to detect malaria infections in field surveys and also to monitor the genetic variability of parasites and dynamics of infection.

https://doi.org/10.1590/0074-02760160222 1687 downloads

Plasmodium simium/Plasmodium vivax infections in southern brown howler monkeys from the Atlantic Forest
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Costa, Daniela Camargos

; Cunha, Vanessa Pecini da

; Assis, Gabriela Maria Pereira de

; Souza Junior, Júlio César de

; Hirano, Zelinda Maria Braga

; Arruda, Mércia Eliane de

; Kano, Flora Satiko

; Carvalho, Luzia Helena

; Brito, Cristiana Ferreira Alves de

Memórias do Instituto Oswaldo Cruz

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aug 2014, Volume 109 N. 5 Pages 641 - 653

Abstract: En | Text: En | PDF: En

Blood infection by the simian parasite, Plasmodium simium, was identified in captive (n = 45, 4.4%) and in wild Alouatta clamitans monkeys (n = 20, 35%) from the Atlantic Forest of southern Brazil. A single malaria infection was symptomatic and the monkey presented clinical and haematological alterations. A high frequency of Plasmodium vivax-specific antibodies was detected among these monkeys, with 87% of the monkeys testing positive against P. vivax antigens. These findings highlight the possibility of malaria as a zoonosis in the remaining Atlantic Forest and its impact on the epidemiology of the disease.

https://doi.org/10.1590/0074-0276130578 2109 downloads Cited 3 times in SciELO

The Duffy binding protein as a key target for a Plasmodium vivax vaccine: lessons from the Brazilian Amazon
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Sousa, Taís Nóbrega de

; Kano, Flora Satiko

; Brito, Cristiana Ferreira Alves de

; Carvalho, Luzia Helena

Memórias do Instituto Oswaldo Cruz

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aug 2014, Volume 109 N. 5 Pages 608 - 617

Abstract: En | Text: En | PDF: En

Plasmodium vivax infects human erythrocytes through a major pathway that requires interaction between an apical parasite protein, the Duffy binding protein (PvDBP) and its receptor on reticulocytes, the Duffy antigen/receptor for chemokines (DARC). The importance of the interaction between PvDBP (region II, DBPII) and DARC to P. vivax infection has motivated our malaria research group at Oswaldo Cruz Foundation (state of Minas Gerais, Brazil) to conduct a number of immunoepidemiological studies to characterise the naturally acquired immunity to PvDBP in populations living in the Amazon rainforest. In this review, we provide an update on the immunology and molecular epidemiology of PvDBP in the Brazilian Amazon - an area of markedly unstable malaria transmission - and compare it with data from other parts of Latin America, as well as Asia and Oceania.

https://doi.org/10.1590/0074-0276130592 4290 downloads

Submicroscopic malaria parasite carriage: how reproducible are polymerase chain reaction-based methods?
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Costa, Daniela Camargos

; Madureira, Ana Paula

; Amaral, Lara Cotta

; Sanchez, Bruno Antônio Marinho

; Gomes, Luciano Teixeira

; Fontes, Cor Jésus Fernandes

; Limongi, Jean Ezequiel

; Brito, Cristiana Ferreira Alves de

; Carvalho, Luzia Helena

Memórias do Instituto Oswaldo Cruz

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feb 2014, Volume 109 N. 1 Pages 21 - 28

Abstract: En | Text: En | PDF: En

The polymerase chain reaction (PCR)-based methods for the diagnosis of malaria infection are expected to accurately identify submicroscopic parasite carriers. Although a significant number of PCR protocols have been described, few studies have addressed the performance of PCR amplification in cases of field samples with submicroscopic malaria infection. Here, the reproducibility of two well-established PCR protocols (nested-PCR and real-time PCR for the Plasmodium 18 small subunit rRNA gene) were evaluated in a panel of 34 blood field samples from individuals that are potential reservoirs of malaria infection, but were negative for malaria by optical microscopy. Regardless of the PCR protocol, a large variation between the PCR replicates was observed, leading to alternating positive and negative results in 38% (13 out of 34) of the samples. These findings were quite different from those obtained from the microscopy-positive patients or the unexposed individuals; the diagnosis of these individuals could be confirmed based on the high reproducibility and specificity of the PCR-based protocols. The limitation of PCR amplification was restricted to the field samples with very low levels of parasitaemia because titrations of the DNA templates were able to detect < 3 parasites/µL in the blood. In conclusion, conventional PCR protocols require careful interpretation in cases of submicroscopic malaria infection, as inconsistent and false-negative results can occur.

https://doi.org/10.1590/0074-0276140102 2728 downloads

Genetic diversity of Leishmania infantum field populations from Brazil
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Segatto, Marcela

; Ribeiro, Lucas Secchim

; Costa, Dorcas Lamounier

; Costa, Carlos Henrique Nery

; Oliveira, Márcia Rosa de

; Carvalho, Sílvio Fernando Guimarães

; Macedo, Andréa Mara

; Valadares, Helder Magno Silva

; Dietze, Reynaldo

; Brito, Cristiana Ferreira Alves de

; Lemos, Elenice Moreira

Memórias do Instituto Oswaldo Cruz

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feb 2012, Volume 107 N. 1 Pages 39 - 47

Abstract: En | Text: En | PDF: En

Leishmania infantum (syn. Leishmania chagasi) is the etiological agent of visceral leishmaniasis (VL) in Brazil. The epidemiology of VL is poorly understood. Therefore, a more detailed molecular characterization at an intraspecific level is certainly needed. Herein, three independent molecular methods, multilocus microsatellite typing (MLMT), random amplification of polymorphic DNA (RAPD) and simple sequence repeats-polymerase chain reaction (SSR-PCR), were used to evaluate the genetic diversity of 53 L. infantum isolates from five different endemic areas in Brazil. Population structures were inferred by distance-based and Bayesian-based approaches. Eighteen very similar genotypes were detected by MLMT, most of them differed in only one locus and no correlation was found between MLMT profiles, geographical origin or the estimated population structure. However, complex profiles composed of 182 bands obtained by both RAPD and SSR-PCR assays gave different results. Unweighted pair group method with arithmetic mean trees built from these data revealed a high degree of homogeneity within isolates of L. infantum. Interestingly, despite this genetic homogeneity, most of the isolates clustered according to their geographical origin.

4175 downloads

10.

Molecular markers and genetic diversity of Plasmodium vivax
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Brito, Cristiana Ferreira Alves de

; Ferreira, Marcelo Urbano

Memórias do Instituto Oswaldo Cruz

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aug 2011, Volume 106 Suppl. 1 Pages 12 - 26

Abstract: En | Text: En | PDF: En

Enhanced understanding of the transmission dynamics and population genetics for Plasmodium vivax is crucial in predicting the emergence and spread of novel parasite phenotypes with major public health implications, such as new relapsing patterns, drug resistance and increased virulence. Suitable molecular markers are required for these population genetic studies. Here, we focus on two groups of molecular markers that are commonly used to analyse natural populations of P. vivax. We use markers under selective pressure, for instance, antigen-coding polymorphic genes, and markers that are not under strong natural selection, such as most minisatellite and microsatellite loci. First, we review data obtained using genes encoding for P. vivax antigens: circumsporozoite protein, merozoite surface proteins 1 and 3α, apical membrane antigen 1 and Duffy binding antigen. We next address neutral or nearly neutral molecular markers, especially microsatellite loci, providing a complete list of markers that have already been used in P. vivax populations studies. We also analyse the microsatellite loci identified in the P. vivax genome project. Finally, we discuss some practical uses for P. vivax genotyping, for example, detecting multiple-clone infections and tracking the geographic origin of isolates.

8914 downloads

11.

Analysis of the genetic variability of PvMSP-3α among Plasmodium vivax in Brazilian field isolates
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Ribeiro, Ricardo Souza

; Ladeira, Luisa

; Rezende, Antonio Mauro

; Fontes, Cor Jesus Fernandes

; Carvalho, Luzia Helena

; Brito, Cristiana Ferreira Alves de

Memórias do Instituto Oswaldo Cruz

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aug 2011, Volume 106 Suppl. 1 Pages 27 - 33

Abstract: En | Text: En | PDF: En

Reliable molecular markers are essential for a better understanding of the molecular epidemiology of Plasmodium vivax, which is a neglected human malaria parasite. The aim of this study was to analyze the genetic diversity of P. vivax isolates from the Brazilian Amazon using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis of the highly polymorphic merozoite surface protein-3alpha (PvMSP-3α) gene. To accomplish this, 60 isolates of P. vivax from different endemic areas in the Brazilian Amazon were collected. The PvMSP-3α gene was amplified by nested-PCR. Three major types of the PvMSP-3α locus were detected at different frequencies: type A (68%), B (15%) and C (17%). A single sample showed two PCR fragments, which corresponded to infection with types A and C. PCR-RFLP analysis using the HhaI restriction enzyme for 52 isolates clearly identified 11 haplotypes, eight of which were from type A, two from type B and only one from type C. Seven other isolates did not show a clear pattern using PCR-RFLP. This result might be due to multiple clone infections. This study showed a high diversity of the PvMSP-3α gene among P. vivax isolates from the Brazilian Amazon, but also indicated that the detection performance of PCR-RFLP of the PvMSP-3α gene may not be sufficient to detect multiple clone infections.

2543 downloads

12.

Vaccination against schistosomiasis and fascioliasis with the new recombinant antigen Sm14: potential basis of a multi-valent anti-helminth vaccine?
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Tendler, Miriam

; Vilar, Monica Magno

; Brito, Cristiana Alves

; Freire, Nicolau Maués da Serra

; Katz, Naftale

; Simpson, Andrew

Memórias do Instituto Oswaldo Cruz

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apr 1995, Volume 90 N. 2 Pages 255 - 256

Abstract: En | Text: En | PDF: En

Molecular cloning of components of protective antigenic preparations have suggested that related parasite fatty acid binding proteins could form the basis of the well documented protective, immune cross reactivity between the parasitic trematode worms Fasciola hepatica and Schistosoma mansoni. We have now confirmed the cross protective potential of parasite fatty acid binding proteins and suggest that it may be possible to produce a single vaccine that would be effective against at least two parasites, F. hepatica and S. mansoni of veterinary and human importance respectively.

1360 downloads Cited 4 times in SciELO

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