This study was conducted to analyse the course and the outcome of the liver disease in the co-infected animals in order to evaluate a possible synergic effect of human parvovirus B19 (B19V) and hepatitis A virus (HAV) co-infection. Nine adult cynomolgus monkeys were inoculated with serum obtained from a fatal case of B19V infection and/or a faecal suspension of acute HAV. The presence of specific antibodies to HAV and B19V, liver enzyme levels, viraemia, haematological changes, and necroinflammatory liver lesions were used for monitoring the infections. Seroconversion was confirmed in all infected groups. A similar pattern of B19V infection to human disease was observed, which was characterised by high and persistent viraemia in association with reticulocytopenia and mild to moderate anaemia during the period of investigation (59 days). Additionally, the intranuclear inclusion bodies were observed in pro-erythroblast cell from an infected cynomolgus and B19V Ag in hepatocytes. The erythroid hypoplasia and decrease in lymphocyte counts were more evident in the co-infected group. The present results demonstrated, for the first time, the susceptibility of cynomolgus to B19V infection, but it did not show a worsening of liver histopathology in the co-infected group.

To examine the underlying processes of an innovative mind-body practice, Mindful Body Awareness, this exploratory study involved four case studies analyzed phenomenologically using the dialogal method. Mindful Body Awareness combines manual (touch-based) and verbal processing, and is focused on facilitation of client body awareness. Four individuals were recruited to receive weekly 1.25 hour sessions over four weeks. The Helpfulness Aspects of Therapy (HAT) form was administered immediately after each session to access participants' perceptions of the therapy experience. In addition, the Scale of Body Connection was used to examine pre- and post-body awareness and bodily dissociation. Analysis involved phenomenology and descriptive statistics. The overall perceived helpfulness of the intervention was evident in the four themes that emerged from the analysis. These themes were gaining interoceptive awareness, personal agency, therapist trust and conceptual framing, and transformation. The participants' responses were also used to investigate the therapy process across time. A pattern of increased interoceptive depth was apparent, as was a concomitant progression in embodied sense of self. Improvements in body awareness and bodily dissociation were evident for two of the four participants. These findings help to identify primary components of Mindful Body Awareness and suggest the role of these components in the embodiment process.

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OBJECTIF: Évaluer la performance d'un test sur le lieu de soin (POCT - Pointof- care testing) récemment développé, pour la détection d'anticorps IgM, caractéristiques de la rougeole, dans les échantillons de fluides sériques et oraux et évaluer si l'acide nucléique viral de la rougeole peut être récupéré sur les bandelettes POCT utilisées. MÉTHODES: Le POCT a été utilisé pour tester 170 échantillons de sérum prélevés lors de programmes de surveillance ou de vaccination contre la rougeole, en Éthiopie, Malaisie et Fédération de Russie: 69 étaient positifs aux anticorps immunoglobulines M (IgM) de la rougeole, 74 étaient positifs aux anticorps IgM de la rubéole et 7 étaient positifs aux deux. On a également testé 282 échantillons de fluides oraux du programme de surveillance de la rougeole, des oreillons et de la rubéole (ROR) du Royaume-Uni de Grande-Bretagne et d'Irlande du Nord. Le test immuno-enzymatique de capture d'IgM de la rougeole Microimmune a été l'étalon-or de la comparaison. Un panel de 24 fluides oraux a été utilisé pour étudier si les gènes hémagglutinine (H) et nucléocapside (N) du virus de la rougeole pouvaient être amplifiés par réaction en chaîne par polymérase, directement à partir des bandelettes POCT utilisées. RÉSULTATS: Avec du sérum POCT, les résultats ont montré une sensibilité et une spécificité de 90,8% (69/76) et de 93,6% (88/94), respectivement. Avec les fluides oraux, la sensibilité et la spécificité ont été de 90% (63/70) et de 96,2% (200/208), respectivement. Les gènes H et N ont été détectés de manière fiable dans les bandelettes POCT, et les gènes N ont pu être séquencés pour le génotypage. Les gènes du virus de la rougeole ont pu être récupérés sur des bandelettes POCT après un stockage de 5 semaines à 20-25 ºC. CONCLUSION: Le POCT a la sensibilité et la spécificité requises d'un test sur le terrain pour le diagnostic de la rougeole. Cependant, son rôle dans les programmes globaux de lutte contre la rougeole nécessite une évaluation plus poussée.

OBJECTIVE: To evaluate the performance of a newly developed point-of-care test (POCT) for the detection of measles-specific IgM antibodies in serum and oral fluid specimens and to assess if measles virus nucleic acid could be recovered from used POCT strips. METHODS: The POCT was used to test 170 serum specimens collected through measles surveillance or vaccination programmes in Ethiopia, Malaysia and the Russian Federation: 69 were positive for measles immunoglobulin M (IgM) antibodies, 74 were positive for rubella IgM antibodies and 7 were positive for both. Also tested were 282 oral fluid specimens from the measles, mumps and rubella (MMR) surveillance programme of the United Kingdom of Great Britain and Northern Ireland. The Microimmune measles IgM capture enzyme immunoassay was the gold standard for comparison. A panel of 24 oral fluids was used to investigate if measles virus haemagglutinin (H) and nucleocapsid (N) genes could be amplified by polymerase chain reaction directly from used POCT strips. FINDINGS: With serum POCT showed a sensitivity and specificity of 90.8% (69/76) and 93.6% (88/94), respectively; with oral fluids, sensitivity and specificity were 90.0% (63/70) and 96.2% (200/208), respectively. Both H and N genes were reliably detected in POCT strips and the N genes could be sequenced for genotyping. Measles virus genes could be recovered from POCT strips after storage for 5 weeks at 20-25 ºC. CONCLUSION: The POCT has the sensitivity and specificity required of a field-based test for measles diagnosis. However, its role in global measles control programmes requires further evaluation.

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OBJETIVO: Evaluar el funcionamiento de una prueba en el punto de atención (POCT, por sus siglas en inglés), recientemente desarrollada, para la detección de anticuerpos IgM específicos para sarampión en muestras de suero y de saliva, así como evaluar si el ácido nucleico viral del sarampión se podría recuperar de las tiras reactivas utilizadas en las POCT. MÉTODOS: Se utilizó la POCT para analizar 170 muestras de suero extraídas mediante programas de vigilancia o de vacunación del sarampión en Etiopía, Malasia y la Federación Rusa: 69 de estas muestras ofrecieron un resultado positivo para los anticuerpos Igm o inmunoglobulina M para el sarampión, 74 fueron positivas para anticuerpos IgM para la rubeola y 7 positivas para ambos.También se realizaron pruebas en 282 muestras de saliva obtenidas en el programa de vigilancia de sarampión, paperas y rubéola (MMR, por sus siglas en inglés) del Reino Unido de Gran Bretaña y de Irlanda del Norte. El estándar de oro para la comparación fue el Ensayo por inmunoabsorción ligado a enzimas para la detección de Igm específica para sarampión. Se empleó un conjunto de 24 muestras de saliva para investigar si los genes de la hemaglutinina (H) del virus del sarampión y de la nucleocápsida (N) se podrían amplificar mediante una reacción en cadena de la polimerasa directamente, a partir de tiras reactivas utilizadas en la POCT. RESULTADOS: En el caso del suero, la POCT mostró una sensibilidad y especificidad del 90,8% (69/76) y del 93,6% (88/94), respectivamente; en el caso de la saliva, la sensibilidad y la especificidad fueron del 90,0% (63/70) y del 96,2% (200/208), respectivamente. Ambos genes H y N fueron detectados de manera fiable en las tiras POCT y los genes N pudieron secuenciarse para su genotipado. Los genes del virus del sarampión se pudieron recuperar de las tiras de POCT tras su almacenaje durante 5 semanas a unos 20-25 º C. CONCLUSIÓN: La POCT registró la sensibilidad y la especificidad requeridas en una prueba de campo para el diagnóstico del sarampión. No obstante, su función en los programas de control global del sarampión requiere que se lleve a cabo una evaluación exhaustiva.

Em pacientes com miosite, é comum o comprometimento pulmonar, e a presença de anticorpos anti-aminoacil-RNAt sintetase (anti-ARS) é preditora da presença ou do desenvolvimento de doença pulmonar intersticial (DPI). Uma entidade clínica distinta - a síndrome antissintetase - é caracterizada pela presença de anticorpos anti-ARS, miosite, DPI, artrite, fenômeno de Raynaud e "mãos de mecânico". O mais comum anticorpo anti-ARS é o anti-Jo-1. Anticorpos anti-ARS mais recentemente descritos podem conferir um fenótipo que é distinto daquele de pacientes com positividade para anti-Jo-1, sendo caracterizado por uma menor incidência de miosite e uma maior incidência de DPI. Nos pacientes com DPI relacionada à síndrome antissintetase, a resposta a medicações imunossupressoras é em geral favorável.

In patients with myositis, the lung is commonly involved, and the presence of anti-aminoacyl-tRNA synthetase (anti-ARS) antibodies marks the presence or predicts the development of interstitial lung disease (ILD). A distinct clinical entity-antisynthetase syndrome-is characterized by the presence of anti-ARS antibodies, myositis, ILD, fever, arthritis, Raynaud's phenomenon, and mechanic's hands. The most common anti-ARS antibody is anti-Jo-1. More recently described anti-ARS antibodies might confer a phenotype that is distinct from that of anti-Jo-1-positive patients and is characterized by a lower incidence of myositis and a higher incidence of ILD. Among patients with antisynthetase syndrome-related ILD, the response to immunosuppressive medications is generally, but not universally, favorable.

Embora diagnósticos de fibrose pulmonar idiopática continuem sendo devastadores, avanços recentes têm melhorado nossa compreensão a respeito de muitas das facetas desta doença. Estas descobertas, juntamente com o aumento da disponibilidade geral de ensaios terapêuticos, encerram a promessa de um futuro mais promissor para pacientes com fibrose pulmonar idiopática. Por exemplo, nós temos agora uma compreensão mais abrangente a respeito dos critérios diagnósticos e da história natural da doença. Vários estudos têm mostrado que a mensuração simples da fisiologia pulmonar ou troca gasosa pode ser usada para prever a sobrevida do paciente. Através da identificação de várias vias moleculares que têm papéis importantes na patogênese da fibrose pulmonar idiopática, os pesquisadores têm produzido uma lista crescente de possíveis novos alvos terapêuticos para a doença. Vários ensaios terapêuticos prospectivos e controlados têm sido realizados. Outros estão em andamento ou ainda estão em fase de planejamento. Estes esforços têm avançado nosso conhecimento atual sobre fibrose pulmonar idiopática e levantado novas questões importantes, assim como têm gerado o interesse e o impulso necessários para avançar terreno na luta contra esta doença desafiadora. Este artigo oferece ao leitor um panorama dos avanços recentes nas pesquisas sobre fibrose pulmonar idiopática, tendo como foco a história natural, patogênese e tratamento.

Although idiopathic pulmonary fibrosis remains a devastating diagnosis, recent advances have improved our understanding of many facets of this disease. These breakthroughs, combined with the increased general availability of therapeutic trials, hold the promise of a brighter future for idiopathic pulmonary fibrosis patients. For example, we now have a more comprehensive understanding of the diagnostic criteria and natural history of the disease. Several studies have shown that simple measurement of pulmonary physiology or gas exchange can be used to predict patient survival. By identifying several molecular pathways that play significant roles in the pathogenesis of idiopathic pulmonary fibrosis, investigators have produced a growing list of novel potential therapeutic targets for the disease. Several prospective, controlled therapeutic trials have been conducted. Others are ongoing or are still in the planning stages. These efforts have advanced our current knowledge of idiopathic pulmonary fibrosis and have raised new important questions, as well as having generated the interest and momentum needed to gain additional ground in the fight against this challenging disease. This article offers the reader a view of the recent advances in idiopathic pulmonary fibrosis research, with a focus on natural history, pathogenesis and treatment.

OBJECTIVE: The objective of this paper is to describe HIV prevention programs conducted by nongovernmental organizations (NGO) that are meeting this challenge. METHODS: One NGO undertaking HIV prevention programs was evaluated in each of the 23 countries participating in the Global AIDS Intervention Network (GAIN) Project throughout Latin America and the Caribbean. A two-stage selection process was used: (1) a search in databases and other information sources; (2) identification of NGOs that were best established and most actively engaged in HIV prevention activity. Executive directors were questioned about staffing, budget issues, populations served and barriers faced by these entities. RESULTS: The 23 NGOs conducted 58 direct-service programs and had been conducting HIV prevention activities for a mean of 8 years (SD = 4.45; range 1-18 years). Average annual program budget was US$ 205 393 (range: US$ 10 000 to US$ 1 440 000). The NGOs reported a mean of 4.5 full-time employees (range 0-15, SD = 4.7). Many relied on volunteers (median = 10, mean = 51, range 0-700, SD = 150) to conduct HIV prevention activities. The NGOs provided prevention services for the general community (82.6%), children and adolescents (34.8%) and men who have sex with men (30.4%). Activities conducted by NGOs included train-the-trainer activities (43.5%) and face-to-face prevention activities (34.8%). Obstacles cited included lack of funding (60.9%) and HIV-related stigma and discrimination (56.5%). CONCLUSION: The strategies used by NGOs to overcome barriers to prevention are a testament to their ingenuity and commitment, and serve as examples for NGOs in other world regions.

OBJETIVO: Describir los programas de prevención de la infección por VIH y el sida de algunas organizaciones no gubernamentales (ONG). MÉTODOS: Estudiamos, en cada una de los 23 países que participan en el proyecto Global AIDS Intervention Network (GAIN) en América Latina y el Caribe, una ONG que lleva a cabo programas de prevención. La muestra se seleccionó mediante un proceso bietápico: 1) una búsqueda en bases de datos y otras fuentes; 2) la identificación de las ONG mejor establecidas y más activas en el campo de la prevención de la infección por VIH, según fuentes autorizadas. A los directores ejecutivos se les hizo preguntas acerca de los programas de prevención, el personal, los presupuestos, las poblaciones con las que trabajaban y las barreras a su trabajo. RESULTADOS: Las 23 ONG llevaban a cabo 58 programas de servicio directo y tenían un promedio de 8 años de estar proveyendo programas de prevención. El promedio anual del presupuesto era de US$ 205 393 (intervalo de US$ 10 000 a US$ 1 440 000), y el número promedio de empleados a tiempo completo era de 4,5 (intervalo de 0-15, DE = 4,7.) Muchas ONG dependían de los voluntarios para los programas de prevención (mediana = 10, promedio = 51, intervalo de 0-700, DE = 150). Las ONG ofrecían programas de prevención dedicados a la comunidad en general (82,6%), a jóvenes y adolescentes (34,8%), y a hombres que tienen relaciones sexuales con otros hombres (30,4%). Las actividades de las ONG consistían en entrenar a los entrenadores para todo tipo de actividades (43,5%) y en realizar programas de prevención cara a cara con los participantes (34,8%). Se citaron como obstáculos la falta de fondos (60,9%) y la discriminación y estigma relacionados con la infección por el VIH (56,5%). CONCLUSIONES: Las estrategias que emplean estas ONG para sobrepasar las barreras a la prevención son prueba de su inventiva y dedicación y sirven como ejemplo para las ONG en otras regiones del mundo.

Amostras de soros coletadas da população do Rio de Janeiro durante os anos de 1985/1986 foram examinadas para a presença de anticorpos da classe IgG contra o parvovirus humano B19. Nenhuma diferença foi encontrada com relação ao sexo. A prevalência de anticorpos aumenta a partir de 35% em crianças menores que 5 anos de idade até 80% nos indivíduos na faixa etária entre 11 e 15 anos. A prevalência de anticorpos seguiu aumentando ate mais de 90% entre os indivíduos acima de 50 anos de idade.

During 1985 and 1986 serum samples were collected from the Rio de Janeiro population and examined for the presence of IgG antibody to human parvovirus B19. No difference in prevalence was found between males and females. Antibody prevalence rose from 35% in children less than five years old to almost 80% in children aged eleven to fifteen years. The antibody prevalence in individuals over 50 years old was over 90%.