Abstract Among the diseases which can afflict the nasal cavities of small ruminants, oestrosis stands out. In Brazil, more specifically in its South-East region, the reports are limited only to the State of São Paulo and to the municipality of Araxá, Minas Gerais. Therefore, it has been sought to assess the parasitic prevalence of Oestrus ovis in sheep farmed in the municipality of Ituiutaba, Minas Gerais-Brazil, while correlating the larval size and stage, and its anatomical localization. Eighty-eight hemiheads of healthy Santa Inês/Dorper crossbreds Ovis aries have been used at random. The larvae in view were then collected and fixated to be quantified and analyzed in regard of size and stage of development. It is concluded that the oestrosis is an existing problem in the municipality of Ituiutaba, this being the first complete study on the prevalence of this parasite in the State of Minas Gerais. By anatomical distribution, only the differences of total larval averages between the frontal sinus and the ventral nasal meatus, the common nasal meatus and the nasopharynx have been significant. In size, the significant difference has been there only upon comparison between the size and the larval stage, information that is crucial for a better understanding of the cyclic progression, of the clinical symptomatology, and animal prophylaxis.
Resumo Dentre as doenças que podem atingir as cavidades nasais dos pequenos ruminantes, destaca-se a oestrose. No Brasil, mais especificamente na região Sudeste, os relatos estão limitados ao estado de São Paulo e ao município de Araxá, Minas Gerais. Assim, procurou-se avaliar a prevalência parasitária do Oestrus ovis em ovinos criados no município de Ituiutaba, Minas Gerais-Brasil, correlacionando ao mesmo tempo o tamanho e estágio larval com a sua localização anatômica. Oitenta e oito hemicabeças de Ovis aries mestiços Santa Inês com Dorper saudáveis foram utilizadas aleatoriamente. As larvas visualizadas foram então coletadas e fixadas para serem quantificadas e analisadas em relação ao seu tamanho e estágio de desenvolvimento. Conclui-se que a oestrose é um problema existente no município de Ituiutaba, sendo este o primeiro estudo completo sobre a prevalência deste parasito no estado de Minas Gerais. Por distribuição anatômica, apenas as diferenças das médias larvais totais entre o seio frontal e o meato nasal ventral, meato nasal comum e a nasofaringe foram significativas - o que confirma a preferência das larvas por essa região. Em tamanho, a diferença significativa só ocorreu mediante a comparação entre o tamanho e estágio das larvas, informação crucial para uma melhor compreensão da progressão cíclica, sintomatologia clínica e profilaxia dos animais.
ABSTRACT Symptomatic forms of toxoplasmosis are a serious public health problem and occur in around 10-20% of the infected people. Aiming to improve the molecular diagnosis of symptomatic toxoplasmosis in Brazilian patients, this study evaluated the performance of real time PCR testing two primer sets (B1 and REP-529) in detecting Toxoplasma gondii DNA. The methodology was assayed in 807 clinical samples with known clinical diagnosis, ELISA, and conventional PCR results in a 9-year period. All samples were from patients with clinical suspicion of several features of toxoplasmosis. According to the minimum detection limit curve (in CT), REP-529 had greater sensitivity to detect T. gondii DNA than B1. Both primer sets were retrospectively evaluated using 515 DNA from different clinical samples. The 122 patients without toxoplasmosis provided high specificity (REP-529, 99.2% and B1, 100%). From the 393 samples with positive ELISA, 146 had clinical diagnosis of toxoplasmosis and positive conventional PCR. REP-529 and B1 sensitivities were 95.9% and 83.6%, respectively. Comparison of REP-529 and B1 performances was further analyzed prospectively in 292 samples. Thus, from a total of 807 DNA analyzed, 217 (26.89%) had positive PCR with, at least one primer set and symptomatic toxoplasmosis confirmed by clinical diagnosis. REP-529 was positive in 97.23%, whereas B1 amplified only 78.80%. After comparing several samples in a Brazilian referral laboratory, this study concluded that REP-529 primer set had better performance than B1 one. These observations were based after using cases with defined clinical diagnosis, ELISA, and conventional PCR.
Abstract Oral manifestations are common findings in human immunodeficiency virus (HIV) infected patients and frequently influence the overall health. Oral hairy leukoplakia (OHL) is strongly associated with HIV infection demonstrating its relationship with the individual’s immune status and progression of immunosuppression. This study aims to retrospectively evaluate OHL in HIV patients, analyzing its incidence, demographic aspects and possible changes in clinical and epidemiological profile of the disease over 17 years. The records of 1600 HIV-infected patients were reviewed. The data were correlated and analyzed, considering HIV exposure category, age, gender, harmful habits, CD4 level, use and type of antiretroviral. OHL was observed in 215 (13.4%) patients. Most were men in the fourth decade of life, 171 (79.5%) and 112 (52,1%) respectively, but an increase in the incidence of OHL among female patients and those in the fifth decade of life was observed. Tobacco smoking was the most frequent harmful habit reported by 114 (68%) patients. OHL occurred mostly in patients with CD4 counts between 200 and 500 cells/mm3 35 (55.5%). The lower incidence of OHL was found among patients using at least one non-nucleoside reverse transcriptase inhibitor (NNRTI). OHL is related to CD4 count, use of ARVT and tobacco smoking and is also more prevalent in men in the fourth decade of life. These characteristics were recognized in absolute values, but when verifying the behavior over the years we noticed that the incidence of OHL is decreasing and its epidemiological characteristics changing.
Introduction: in Brazil, chronic hepatitis C in patients coinfected with the human immunodeﬁciency virus (HIV) is treated with pegylated interferon (Peg-IFN) and ribavirin (RBV). However, few studies have evaluated the effectiveness of this treatment in this particular population. The identiﬁcation of the factors that predict sustained virological response (SVR) under current clinical practice would enable clinicians to more accurately estimate the probability of achieving an SVR and therefore utilize the appropriate therapeutics, especially in the era of direct-acting antiviral (DAA) agents.Aims: the primary aim of our study was to determine the SVR rate under current clinical practice. The secondary aims were as follows: (1) to determine the factors before and during treatment that predict SVR; and (2) to identify the causes of treatment interruption.Methods:within a cohort of HIV/hepatitis C virus (HCV)-coinfected patients in Brazil, we performed a retrospective analysis of those individuals treated with Peg-IFN and RBV.Results:among the 382 analyzed patients, SVR was observed in 118 [30.9% (95% conﬁdence interval (CI): 26.3-35.8)], which included 25.9% (75/289) of the patients with genotypes 1 and 4 and 48.2% (41/85) of those with genotypes 2 and 3. After multivariate analyses the independent positive predictors for SVR after treatment for chronic hepatitis C with PegIFN and RBV were: absence of an AIDS-deﬁning illness (p= 0.001), HCV viral load lower than 600,000 IU/mL at the onset of treatment (p= 0.003), higher liver enzyme levels (p= 0.039) at baseline, infection with genotypes 2 or 3 (p= 0.003), and no transient treatment interruption (p= 0.001). The treatment was interrupted in 25.6% (98/382) of the patients because of adverse events (11.3%, 43/382), virologic failure (7.8%, 30/382), and dropout (6.5%, 43/382). The main adverse events were cytopenia and psychiatric disorders.Conclusions:in our Brazilian case series, the SVR rate under current clinical practice conditions was similar to that reported in other studies. There was a correlation between an SVR and being infected by genotypes 2 and 3, low viral load, high ALT levels at the onset of treatment, and absence of an AIDS-deﬁning illness. Cytopenia and psychiatric disorders were the major causes of treatment interruption. Efforts should be focused on optimizing management of side effects and counseling to improve adherence and to keep patients on treatment.
Background Healthcare Associated Infections constitute an important problem in Neonatal Units and invasive devices are frequently involved. However, studies on risk factors of newborns who undergo surgical procedures are scarce. Objective To identify risk factors for laboratory-confirmed bloodstream infection in neonates undergoing surgical procedures. Methods This case–control study was conducted from January 2008 to May 2011, in a referral center. Cases were of 21 newborns who underwent surgery and presented the first episode of laboratory-confirmed bloodstream infection. Control was 42 newborns who underwent surgical procedures without notification of laboratory-confirmed bloodstream infection in the study period. Information was obtained from the database of the Hospital Infection Control Committee Notification of infections and related clinical data of patients that routinely collected by trained professionals and follow the recommendations of Agência Nacional de Vigilância Sanitária and analyzed with Statistical Package for Social Sciences. Results During the study period, 1141 patients were admitted to Neonatal Unit and 582 Healthcare Associated Infections were reported (incidence-density of 25.75 Healthcare Associated Infections/patient-days). In the comparative analysis, a higher proportion of laboratory-confirmed bloodstream infection was observed in preterm infants undergoing surgery (p = 0.03) and use of non-invasive ventilation was a protective factor (p = 0.048). Statistically significant difference was also observed for mechanical ventilation duration (p = 0.004), duration of non-invasive ventilation (p = 0.04), and parenteral nutrition duration (p = 0.003). In multivariate analysis duration of parenteral nutrition remained significantly associated with laboratory-confirmed bloodstream infection (p = 0.041). Conclusions Shortening time on parenteral nutrition whenever possible and preference for non-invasive ventilation in neonates undergoing surgery should be considered in the assistance of these patients, with the goal of reducing Healthcare Associated Infections, especially laboratory-confirmed bloodstream infection.
Background: Tolerance and response to antiviral HCV treatment is poor in advanced fibrosis. The aim of this study was to assess SVR rate and its predictive factors in HCV advanced fibrosis patients treated in real life with full dose PEG-IFN plus RBV and to evaluate the adverse events related to treatment. Methods: A multicentric, retrospective study was conducted at six university hospitals. METAVIR F3 and F4 HCV monoinfected patients who were treated with PEG-IFN and RBV had their data analyzed. A stepwise logistic regression analysis was performed to identify the variables independently related to SVR. Adverse events were recorded during treatment. Results: 308 patients were included, 75% genotype 1 and 23% genotype 3. METAVIR F3 was present in 39% and F4 in 61% of patients. The median Child Pugh score for F4 patients was 5 (5–9). The global SVR rate was 34%, 11% were relapsers and 55% were nonresponders. SVR rates were similar between patients treated with PEG-IFN alfa 2a or alfa 2b (p = 0.24). SVR rates according to Child–Pugh score were 26% (Child A) and 18% (Child B). The independent factors related to SVR in F4 patients were genotype 3, RVR and fewer Child Pugh score points. Treatment interruption occurred in 31% patients and death occurred in 1.9%, all with liver cirrhosis. Conclusion: Treatment of HCV in patients with advanced fibrosis should not be postponed. However, a very careful evaluation of cirrhotic patients must be performed before treatment is indicated and careful monitoring is required during treatment.
This paper presents a procedure for studying the mechanical behavior of three soils from the cellulose company CENIBRA S. A. located in the city of Belo Oriente, the state of Minas Gerais, Brazil, to be used as a surface course, sub-grade reinforcing layer and sub-base on forest roads. The mechanical stabilization technique named textural proportioning was used throughout the study. The laboratory testing program encompassed the use of different amounts of soils in order to determine the most efficient combination of two of them to be used in the CENIBRA S. A. forest road system. Soil mixtures were produced using sand contents of 60, 70 and 80% and clayey soils contents of 20, 30 and 40%. Soils and mixtures specimens were compacted at the modified Proctor compaction effort. The best mechanical response was associated to the 80% sand and 20% yellow clay mixture, which presented bearing capacity via ISC of 63%.
Este artigo apresenta um procedimento para estudo do comportamento mecânico de três solos oriundos da empresa CENIBRA S. A., localizada na cidade de Belo Oriente, Minas Gerais, Brasil, para fins de emprego em revestimento primário, reforço de subleito e sub-base de estradas florestais, classificados como argila amarela, argila vermelha e areia. Empregou-se, nesta investigação, a técnica de estabilização mecânica de solos com correção granulométrica. O programa de ensaios de laboratório englobou o uso de várias composições percentuais de solos, com base na mistura entre dois deles, de modo a obter um produto final eficiente para aplicações nas estradas florestais da CENIBRA S. A. Trabalhou-se com os percentuais de 60, 70 e 80% de areia e de 20, 30 e 40% das argilas nas composições das misturas, compactando estas na energia do ensaio Proctor Modificado. A melhor resposta mecânica foi obtida pela mistura de 80% de areia e 20% de argila amarela, com capacidade de carga representada pelo ISC de 63%.