Underreporting of unfavorable outcomes of congenital syphilis on the Notifiable Health Conditions Information System in the state of São Paulo, Brazil, 2007-2018

OBJECTIVE

to describe the frequency of underreporting of unfavorable outcomes of congenital syphilis in the state of São Paulo, Brazil, 2007-2018.

METHODS

this was a descriptive study of cases of abortion, fetal and non-fetal deaths due to congenital syphilis reported on the Notifiable Health Conditions Information System (Sistema de Informação de Agravos de Notificação - SINAN), and those of congenital syphilis registered in any line in the Death Certificate, on the Mortality Information System (Sistema de Informações sobre Mortalidade - SIM), by means of probabilistic and deterministic linkage.

RESULTS

of the 27,713 cases of congenital syphilis reported, 1,320 progressed to death (871 fetal deaths, 449 infant deaths) and were matched to the SIM; 355 deaths (259 fetal deaths, 96 infant deaths) were not included on SINAN; there was an increase in unfavorable outcomes,11.4% for infant deaths due to congenital syphilis, 3.0% for fetal deaths and 1.9% for abortions.

CONCLUSION

the use of different relationship techniques proved to be adequate to identify the frequency of underreporting of unfavorable outcomes of congenital syphilis in the state of São Paulo.

Investigation of Leishmania (Viannia) braziliensis Infection in Wild Mammals in Brazil

PURPOSE

Leishmaniasis are infectious and zoonotic diseases and present in cutaneous and visceral forms. Cutaneous leishmaniasis is endemic and widely distributed throughout the state of Espírito Santo, Brazil. Several cases of cutaneous leishmaniasis in humans and dogs associated with Leishmania (Viannia) braziliensis have been reported in the state. This study aimed to investigate the occurrence of natural infection by Leishmania(Viannia) braziliensis in wild mammals found dead (by trampling or natural death) in the Sooretama Biological Reserve, Espírito Santo State.

METHODS

From January 2018 to December 2019, 60 animals were collected. Of these, 47 animals from 12 different species were analyzed. The results were demonstrated using descriptive analysis of the observations to calculate the absolute and relative frequencies of the data.

RESULTS

In the PCR, using specific primers for the genus Leishmania (D1, D2, and D3) and the species Leishmania (Viannia) braziliensis (ISVB/ISVC), 4 positive animals (8.5%) were detected: 1 Cuniculus paca (paca) (25%) and 3 Callithrix geoffroyi (white-faced marmoset) (25%). In the histopathological analysis, the parasitic amastigote form was not observed.

CONCLUSIONS

The natural infection, detected by PCR, by Leishmania (Viannia) braziliensis in Cuniculus paca (paca) and Callithrix geoffroyi (white-faced marmoset) constitutes the first report of infection of this rodent and primate species in the literature. Despite the confirmation of Leishmania (Viannia) braziliensis infection in rodents and primates, the role of these species in the transmission of this zoonosis still needs further observational studies to identify their seasonal variation, transmissibility, infection stability, and the effects of a given parasite on the population and/or individual.

Detection of Leishmania (Viannia) braziliensis in bats from Espírito Santo, Brazil (2018-2019)

Studying the occurrence of Leishmania in bats would help toward clarifying the role of these animals in epidemiological cycles. Therefore, the objective of this study was to detect Leishmania spp. in bats from the Brazilian State of Espírito Santo. In total, 105 bats from 11 species which had been collected from 17 municipalities of Espírito Santo were obtained from the IDAF Rabies Diagnostic Laboratory between December 2018 and June 2019. DNA was extracted from the bone marrow, skin, and spleen samples and analysed using conventional PCR, with primers specific for the kinetoplastic DNA minicircle of the parasitic species Leishmania (Viannnia) braziliensis, Leishmania (Leishmania) infantum, and Leishmania (Leishmania) amazonensis. To identify the Leishmania species, the positive PCR products were analysed using PCR-RFLP with the HaeIII enzyme and 8% polyacrylamide gel electrophoresis. Positivity for L. (V.) braziliensis was observed in five (4.76%) bats: namely, one male Eumops glaucinus from Vitória (in a skin sample), one male Artibeus lituratus from Vila Velha and one female Eumops glaucinus from Vitória (both in bone marrow samples), and one male A. lituratus from Vitória and one male Molossus rufus from Guarapari (both in the spleen samples). To our best knowledge, this is the first report of the detection of Leishmania in bats from Espírito Santo as well as of Leishmania DNA in the bone marrow of bats.

Notes on Fomitiporia Murrill in Amazon region: a list of species and new records

Twenty-three specimens of the fungi genus Fomitiporia Murrill collected during the rainy season in the Amazonian region of Amazonas and Roraima states, Brazil. Eight species were listed, namely F. apiahyna s. l. (Speg.) Robledo, Decock & Rajchenb., F. calkinsii (Murrill) Vlasák & Kout, F. conyana Alves-Silva & Drechsler-Santos, F. impercepta Morera, Robledo & Urcelay, F. langloisii Murrill, F. maxonii Murrill, F. murrillii Alves-Silva, R.M. Silveira & Drechsler-Santos, and F. neotropica Camp.-Sant., Amalfi, R.M. Silveira, Robledo & Decock.  Our new data includes the first records of species from the Amazonian region, Brazil, and the Americas.

Long bone fractures in Cerdocyon thous: macroscopic and microstructural evaluation

Abstract The aim of the present study was to perform the macroscopic and microstructural morphological classification of long bone fractures of Cerdocyon thous. Eighteen cadavers of the species were necropsied, and subjected to radiographic and microscopical evaluation when long bone fractures were detected. Among the 18 cadavers, eight (44%) had fractures equally distributed (33.33%) in the femur, humerus, or tibia. More frequently (61.54%), the fractures were simple and affected the diaphysis, and in smaller proportions (23.08%) reached the physeal line. In diaphyseal and metaphyseal fractures, microscopical evaluation revealed cortical bone tissue, with longitudinal osteons that contained longitudinal and intermediate collagen fibres and lamellae with a delamination aspect. On the other hand, in epiphyseal fractures, trabecular bone tissue was more frequently observed, consisting of trabeculae with disorganised collagen fibres and absence of osteons. In both cases low activity, osteocytes, and low coverage of osteoblasts on the bone surface were noted. It was concluded that the frequency of fractures in the long bones of C. thous was 44%, with females being more predisposed. The findings support the hypothesis that fractures in such animals are caused by being run over by automobiles. The present study contributes significantly in alerting clinicians and surgeons to the types of fractures that C. thous is more predisposed to, its places of greatest occurrence, and its microstructure. Thus, there is a need for joint actions aimed at reducing the number of cases of wild animals being run over by automobiles.

Notes on the gross anatomy of the heart of the broad-snouted caiman, Caiman latirostris (Daudin, 1802)

The broad-snouted caiman, Caiman latirostris (Daudin, 1802), is one of the six crocodilian species from Brazil. The topography, morphology and morphometry of the broad-snouted caiman heart were studied. Data were obtained from the necropsy of four adult animals, three females and one male. The hearts were removed from the coelomic cavity and fixed in 10% formalin for 48 hr for morphological and morphometric description. The heart is in the cranial mediastinum. It is caudally involved by the liver cranial margins, and ventrally by the ribs, intercostal muscles, and sternum and dorsally by the lungs. The four-chambered morphology is typical with two (right and left) atria and ventricles. Right and left aortic, pulmonary and subclavian arteries branch from the truncus arteriosus. Gubernaculum cordis is present as ligamentous folds uniting the heart apex to the pericardium. Main morphometric means are the apex-to-base length (49.86 mm), circumference (105.25 mm) and heart weight (45.03 g). The right atrium is craniocaudally longer with thicker walls, whereas the left ventricle is narrower. The topography, morphology and morphometry of the heart of C. latirostris are consistent with the anatomy of other crocodilian species.

Syphilis in the state of São Paulo, Brazil, 2011‒2017

OBJECTIVE

To analyze how syphilis detection rates evolved from 2011 to 2017 according to sex, age and place of residence in the state of São Paulo.

METHODS

A historical series was organized with data from the Notification Disease Information System. The acquired syphilis detection rates (ASDR) per 100,000 inhabitants and the acquired syphilis detection rates including pregnant women with syphilis (PASDR) per 100,000 inhabitants were described. For a trend analysis of the rates in the studied period, the Poisson Jointpoint (inflection point) model was performed, and the annual percentage change (APC) per segment and the average annual percentage change (AAPC) were estimated, with respective 95% confidence intervals (95%CI).

RESULTS

A total of 205,424 cases of acquired syphilis and syphilis in pregnant women in the period were reported. The ASDR per 100,000 inhabitants ranged from 26.0 to 84.6 between 2011 and 2017 and the PASDR per 100,000 inhabitants ranged from 33.7 to 108.9; the trend was increasing in both, and an inflection point was identified dividing the ASDR and PASDR curve into two periods: 2011 to 2013 and 2013 to 2017: the AAPC found for ASDR was 21.0% (95%CI 15.5 ‒ 26.4) and the PASDR was 21.2% (95%CI 16.4 ‒ 26.1), in the age groups up to 24 years old, there was a significant growth in both sexes. A heterogeneity in the evolution of rates by region of the state was observed between 2011 and 2017.

CONCLUSIONS

The increasing trend in acquired syphilis detection rates can be attributed to better adherence to notification and disproportionate involvement of young people.

Work and health issues of the transgender population: factors associated with entering the labor market in the state of São Paulo, Brazil

The transgender population encounters several barriers in entering the labor market, whichfurther impacts their health. In this cross-sectional study, the factors associated with their insertion in the formal job market were analyzed. Participants were recruited in seven municipalities of the state of São Paulo between 2014 and 2015. Logistic regression was used to estimate the odds ratios (OR) of the association between formal insertion and selected characteristics. We included 672 individuals, of which 82.3% were working, 13.1% were not employed, and 4.6% were not in the labor market. Among those working, only 16.7% were in the formal labor market. Factors independently associated with formal employment were: being atrans man, having 12 years or more of education, being under follow-up for gender transition procedures in the healthcare services, having private health insurance, and never having been arrested. Our results highlightpart of the obstacles the transgender population has toovercome to enter the labor market, and point to the need for public policies specifically designed for the transgender population aiming to reduce school dropout and expand access to comprehensive health care, thereby reducing theirvulnerability.

Morphometric and Vascular Analyses and MMP-2 Expression in Bladders of Animals with Bovine Enzootic Haematuria

Background: Bovine enzootic haematuria is a chronic, non-infectious disease caused by the ingestion of bracken Pteridium aquilinum that contain ptaquiloside, substance responsible for the development of neoplasms in combination with bovine papillomavirus infection. Studies examining metalloproteinases have shown that these enzymes may be useful as prognostic markers and many studies have correlated the intratumoural microvessel density and incidence of metastasis in a variety of cancers, including bladder cancer. This study aimed to evaluate the urothelial morphology and vasculature and quantify the expression of the enzyme metalloproteinase-2 in the bladder lesions of bovine with enzootic haematuria.Materials, Methods & Results: Forty bladders with macroscopic lesions were subjected to routine histological processing. The material was stained using the Hematoxylin-Eosin (HE) and Weigert's resorcin-fuchsin staining methods. The morphometric analysis included the measurement of the total thickness of the urothelium. Microscopically, the lesions were differentiated as neoplastic or non-neoplastic, and the vascular changes were characterised as vascular proliferation, ectasia, dilation and thickening and the material stained using the Weigert's resorcin-fuchsin method was used to evaluate sclerosis and the vascular fibroelastosis. The metalloproteinase expression was evaluated using an anti-metalloproteinase-2 antibody. The main non-neoplastic lesions found in the urothelium included clear cell metaplasia, dysplasia, hyperplasia, haemorrhage, cystitis cystica and Brunn's nests and the neoplastic lesions were haemangioma, myxoma, transitional cell carcinoma, adenocarcinoma, in situ carcinoma and haemangiosarcoma. The urothelium measurements revealed differences between the epithelial thicknesses of bladders with and without neoplasms. The bladder vasculature evaluation revealed the frequent occurrence of different pathological aspects, such as vascular proliferation, dilation, expansion, ectasia and thickening; more severe vascular proliferation, thickening and fibroelastosis were observed in bladders with neoplasms. Metalloproteinase-2 expression was observed in the epithelial cells, fibroblasts, endothelial cells and smooth muscle cells present in the tumour tissue and was a significant increase in the expression of MMP-2 in the neoplasms of mesenchymal origin compared to the neoplasms of epithelial origin.Discussion: The presence of a large variety of non-neoplastic lesions indicates the possibility that there are other factors concomitant to BEH involved. Epithelial hyperplasia and metaplasia, for example, could be the result of damage caused by bovine papillomavirus type 2 or even an altered urine pH. Furthermore, it is believed that the bladder has the capacity to generate various types of neoplasms due to the different histological components of the bladder, thus enabling it to generate both mesenchymal and epithelial lesions. The thickness of the urothelium was greater in all the quadrants with neoplasms compared to the quadrants without neoplasms. These data revealed that it is possible to use less invasive diagnostic imaging methods to characterise bovine enzootic haematuria and to measure tumour progression based on the severity of vascular changes. The vascular proliferation and thickening were significant in bladders with neoplasms, which may be explained by the fact that tumours require an extensive vascular supply. In addition, many tumours release vascular growth factors and promote neovascularisation. The intensity of the immunostaining of metalloproteinase-2 differed among the different types of neoplasms. However, due to the diversity of the tumours, it was not possible to establish a relationship between metalloproteinase-2 expression and tumour progression.

Schistosomal Myeloradiculopathy - A case report

The most common neurological impairments related to schistosomiasis involve the lower portions of the medulla and the cauda equina. A 22-year-old woman, with no history, signs, or symptoms of hepatointestinal schistosomiasis, presented with lumbar pain associated with acute paresthesia and paresis of the right lower limb. Spinal schistosomiasis was suspected based on the disease progression and radiological findings, and the diagnosis was confirmed after cerebrospinal fluid analysis. The authors emphasize this pathology as important as a differential diagnosis in similar clinical scenarios, especially in endemic areas, because both early diagnosis and treatment are essential to avoid permanent sequelae.

Donor characteristics and hematopoietic stem cell transplantation outcome: experience of a single center in Southern Brazil

Background

Hematopoietic stem cell transplantation is a curative treatment for many patients with hematological disorders. Donor-recipient genetic disparity, especially involving the human leukocyte antigen system is a critical factor for transplant outcome.

Objective

To evaluate retrospectively donor characteristics and correlations with the occurrence of acute and chronic graft-versus-host disease, disease-free survival and overall survival in a Brazilian population submitted to allogeneic hematopoietic stem cell transplantation between 1994 and 2012 in a single center.

Results

Three hundred and forty-seven consecutive transplantations were included. Related transplants (81.2%) were significantly more common than unrelated transplants (18.7%); donor and recipient median ages were 34 (range: 1-61) and 33 (range: 3-65) years respectively with donor HLAs being matched for 333 (95.9%) patients. Donor gender, cytomegalovirus status and ABO incompatibility did not influence the five-year overall survival. In univariate analyses, overall survival was negatively influenced by the presence of acute graft-versus-host disease (33% vs. 47%, respectively; p-value = 0.04), unrelated transplant (41.5% vs. 50.9%, respectively; p-value = 0.045) and donors aged over 40 years (41% vs. 52%, respectively; p-value = 0.03). Older donors were associated with a higher rate of acute (52% vs. 65.8%; p-value = 0.03) and chronic graft-versus-host disease (60% vs. 43%, respectively; p-value = 0.015). In multivariate analyses, acute graft-versus-host disease [relative risk (RR): 1.8; 95% confidence interval (CI): 1.1-29; p-value = 0.008] and older donors (RR: 1.6; 95% CI 1.11-2.24; p-value = 0.013) were associated with higher transplant-related mortality.

Conclusions

In transplant patients, to have a donor older than 40 years of age seems to significantly increase the incidence of acute and chronic graft-versus-host disease and transplant-related mortality with no impact on disease-free survival and overall survival. In spite of the rather small cohort of patients, these findings are similar to what is described in the literature suggesting that a younger donor should be chosen whenever possible.

Fractionating Executive Functions of Adults With ADHD

OBJECTIVE

To evaluate the performance of adults with ADHD considering the fractionation of executive functions into six different domains.

METHOD

Participants were adult ADHD patients who were not under the acute effects of medication ( n = 48). Their performance was compared with that of a healthy control group ( n = 20) of comparable age, education, and nonverbal intelligence quotient. The cognitive domains assessed were executive shifting, updating, inhibition of prepotent responses, dual-task performance, planning, and access to long-term memory. We also assessed the symptoms of inattention, hyperactivity/impulsivity, anxiety, and depression by validated questionnaires.

RESULTS

Compared with controls, patients reported more symptoms related to ADHD, anxiety and depression symptoms and were impaired in the shifting cost measure and phonemic fluency (measure of access to long-term memory).

CONCLUSION

ADHD in adults selectively impaired executive shifting and access to long-term memory, domains that may alter performance in a wide range of daily tasks.

Molluscicidal potential of Heterorhabditis baujardi (Rhabditida: Heterorhabditidae), strain LPP7, on Lymnaea columella (Gastropoda: Pulmonata): An alternative for biological control of fasciolosis

This study elucidated for the first time, under laboratory conditions, the susceptibility of Lymnaea columella to infective juveniles of Heterorhabditis baujardi LPP7. Exposure to the nematodes induced an average mortality rate of 66.66% in the population of L. columella, with the highest values attained from the second week after exposure onward. In addition, all the reproductive parameters analyzed (total number of eggs, number of egg masses, number of eggs laid/snail, embryo hatching rate and content of galactogen stored in the albumen gland) changed as a result of the infection. The results indicate the occurrence of the phenomenon of parasitic castration in L. columella infected by H. baujardi LPP7, probably through depletion of energy reserves such as galactogen, necessary to meet the intense metabolic demands of the nematode's larval stages. Finally, histopathological analysis demonstrated an intense process of cell disorganization, characterized by the occurrence of granulomatous inflammatory reactions in tissues of exposed snails, induced by the spoliative action of the bacteria/nematode. The results suggest the use of H. baujardi LPP7 as an alternative for biological control of the population of this intermediate host, and thus of the diseases in whose epidemiological chain it participates, especially fasciolosis, in line with the recommendations of the World Health Organization (WHO).

High IQ May "Mask" the Diagnosis of ADHD by Compensating for Deficits in Executive Functions in Treatment-Naïve Adults With ADHD

OBJECTIVE

To evaluate and compare the performance of adults with ADHD with high and standard IQ in executive functions (EF) tasks.

METHOD

We investigated the neuropsychological performance of 51 adults with ADHD, compared with 33 healthy controls (HC) while performing a wide battery of neuropsychological tests that measure executive functioning. Adults with clinical diagnosis of ADHD were divided into two groups according to their IQ level (IQ ≥ 110-ADHD group with more elevated IQ, and IQ < 110-ADHD group with standard IQ).

RESULTS

The ADHD group with standard IQ presented a worse executive functioning compared with the HC group in the following measures: Stroop 2 ( p = .000) and 3 ( p = .000), Trail Making Test (TMT) B ( p = .005), Wisconsin Card-Sorting Test (WCST)-perseverative errors ( p = .022) and failures to maintain set ( p = .020), Continuous Performance Test (CPT)-omission errors ( p = .005) and commission errors ( p = .000), and Frontal Assessment Battery (FAB)-conceptualization ( p = .016). The ADHD group with more elevated IQ presented only impairments in the CPT-commission errors ( p = .019) when compared with the control group.

CONCLUSION

Adults with ADHD and more elevated IQ show less evidence of executive functioning deficits compared with those with ADHD and standard IQ, suggesting that a higher degree of intellectual efficiency may compensate deficits in executive functions, leading to problems in establishing a precise clinical diagnosis.

Pathologies of the digestive system caused by marine debris in Chelonia mydas

The growth of human population and deficient pollution control measures pose significant challenge to the environment. Despite conservation efforts, all sea turtle species are at some risk of extinction. The present study investigated the effect of marine debris on the gastrointestinal tract of green turtles in southeastern Brazil. Of the 777 animals evaluated, 290 showed marine debris in one segment of the gastrointestinal tract. The presence of these materials in the gastrointestinal tract may be harmful, independent of the segment involved, and increases the risk of impaction. Marine debris has become a significant hazard to Chelonia mydas in the region surveyed, causing perforation, rupture, or fecal impaction that, when not treated, is potentially fatal, exposing the intestine to bacterial infection.

Ego Defense Mechanisms and Types of Object Relations in Adults With ADHD

OBJECTIVE

This research evaluates the personality structure of adults with ADHD from a psychodynamic perspective. The hypothesis was that possible structural characteristics in personality could be correlated with this syndrome.

METHOD

Assessment tools for ego functions (Bell Object Relations and Reality Testing Inventory [BORRTI-Form O], Defense Style Questionnaire ( DSQ-40)) were applied to a sample of 90 adults with ADHD, recruited in a specialized clinic.

RESULTS

Among the ADHD sample, 84.4% of the participants were identified as having object relations pathologies. Pathological elevations were observed mainly in the Alienation, Egocentricity, and Insecure Attachment subscales. Statistically, significant differences were found especially in the use of immature and neurotic defense mechanisms, compared with normative data.

CONCLUSION

The findings indicate that adults with ADHD make more use of immature and neurotic defense mechanisms, and presented pathological internalized object relations that are typical of an archaic and poorly structured egoic structure.

Influence of emotional stimulus valence on inhibitory control in adults with and without ADHD

Human behavior is influenced both by approach and avoidance automatic reactions to positive and negative stimulus, respectively, but these reactions have not been well studied in attention-deficit/hyperactivity disorder (ADHD) patients. Moreover, studies employing spatial stimulus-response compatibility tasks in ADHD and healthy control (HC) subjects are scarce and inconclusive. The present study investigated inhibitory control and emotional processing in ADHD adults with a modified stimulus-response compatibility task in which spatial and emotional features of affective stimuli had to be processed together to select the correct response. Manual responses to figures of Favorite and Rival soccer team players were measured, and compatible or incompatible responses were chosen according to the soccer team figure. Eighteen HC participants and sixteen ADHD adults performed the task. We found an ordinary spatial compatibility effect for the Favorite soccer team and a reversed one for the Rival team in the ADHD group but not in the HC group. The effects may be due to stronger approach and withdrawal reactions toward the Favorite soccer team and away from the Rival one, respectively, indicating poor inhibitory control for the ADHD group. These results show that differences between ADHD and HC subjects become prominent when response selection involves both emotional and spatial features of the stimulus.

SÍNDROME PIOGRANULOMATOSA ESTÉRIL IDIOPÁTICA EM GATO DOMÉSTICO (Felis catus): RELATO DE CASO

O piogranuloma estéril caracteriza-se por lesões dermatológicas de aspecto granulomatosopiogranulomatoso principalmente na região da cabeça, região periocular, ponte nasal, pavilhão auricular e região plantar das patas. A patogenia de tal afecção ainda não foi elucidada, mas acredita-se tratar-se de uma síndrome imunomediada. Raramente descrita na espécie felina, e pouco frequente na espécie canina, as lesões são comumente em forma de placas, nódulos ou pápulas, e sua diversidade de apresentações dificulta a diferenciação com as neoplasias cutâneas. Objetivou-se com este estudo relatar o caso de um felino doméstico (Felis catus) fêmea, sem raça definida com quatro anos de idade, que apresentou a síndrome piogranulomatosa estéril idiopática. O animal foi atendido no Hospital Veterinário da Faculdade Multivix – Castelo, e ao exame físico constatou-se lesões na narina esquerda com alopecia e eritema, além de região central ulcerada, de aproximadamente três centímetros de diâmetro, rodeada por outras pequenas lesões de menor diâmetro também ulceradas e indolores, foi coletado material para análise histopatológica e processado de acordo com a técnica de rotina para coloração em hematoxilina-eosina e em ácido periódico de Schiff para avaliar possível infecção fúngica.

Multimodal magnetic resonance imaging study of treatment-naïve adults with attention-deficit/hyperactivity disorder

Background

Attention-Deficit/Hiperactivity Disorder (ADHD) is a prevalent disorder, but its neuroanatomical circuitry is still relatively understudied, especially in the adult population. The few morphometric magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) studies available to date have found heterogeneous results. This may be at least partly attributable to some well-known technical limitations of the conventional voxel-based methods usually employed to analyze such neuroimaging data. Moreover, there is a great paucity of imaging studies of adult ADHD to date that have excluded patients with history of use of stimulant medication.

Methods

A newly validated method named optimally-discriminative voxel-based analysis (ODVBA) was applied to multimodal (structural and DTI) MRI data acquired from 22 treatment-naïve ADHD adults and 19 age- and gender-matched healthy controls (HC).

Results

Regarding DTI data, we found higher fractional anisotropy in ADHD relative to HC encompassing the white matter (WM) of the bilateral superior frontal gyrus, right middle frontal left gyrus, left postcentral gyrus, bilateral cingulate gyrus, bilateral middle temporal gyrus and right superior temporal gyrus; reductions in trace (a measure of diffusivity) in ADHD relative to HC were also found in fronto-striatal-parieto-occipital circuits, including the right superior frontal gyrus and bilateral middle frontal gyrus, right precentral gyrus, left middle occipital gyrus and bilateral cingulate gyrus, as well as the left body and right splenium of the corpus callosum, right superior corona radiata, and right superior longitudinal and fronto-occipital fasciculi. Volumetric abnormalities in ADHD subjects were found only at a trend level of significance, including reduced gray matter (GM) in the right angular gyrus, and increased GM in the right supplementary motor area and superior frontal gyrus.

Conclusions

Our results suggest that adult ADHD is associated with neuroanatomical abnormalities mainly affecting the WM microstructure in fronto-parieto-temporal circuits that have been implicated in cognitive, emotional and visuomotor processes.

Câncer do Colo do Útero no Estado de Mato Grosso do Sul: Detecção Precoce, Incidência e Mortalidade

Introdução: O câncer do colo do útero apresenta taxas de incidência e mortalidade elevadas no Brasil. Objetivo: Descrever a cobertura das ações de detecção precoce do câncer do colo do útero, sua incidência e mortalidade no Estado de Mato Grosso do Sul. Método: Estudo descritivo e exploratório. Foram analisados dados provenientes do Departamento de Informática do SUS , Instituto Brasileiro de Geografia e Estatística, Instituto Nacional de Câncer José Alencar Gomes da Silva. Foi realizada análise descritiva das informações. Resultados: O percentual de mulheres de 25 a 59 anos que realizou o exame de Papanicolaou nos últimos três anos se manteve estável entre 2003 e 2008: 82,0% e 82,9%, respectivamente; entretanto, houve uma queda no contingente daquelas que nunca fizeram o exame na vida: de 11,1% para 8,7%, respectivamente. A razão entre o número exames citopatológicos cervicovaginais realizados em mulheres de 25 a 59 anos e a população feminina nessa faixa etária ultrapassou a meta (≥0,90) do triênio 2008 a 2010 em 25 municípios do Estado, porém, as taxas estimadas de incidência do câncer do colo do útero sofreram aumento de 139% nos últimos 12 anos, enquanto na série de dados de mortalidade observou-se um incremento de 33,8% em 30 anos. Conclusão: Esses resultados apontam para a necessidade de se fortalecer as parcerias visando a implementar ações de atenção integral a saúde da mulher, especialmente voltadas para as mulheres indígenas, que representam um importante contingente de mulheres excluídas nessas áreas.  

[Physical activity level and anthropometric data regarding hypertensive and/or diabetic people in a Brazilian city]

OBJECTIVE

This study was aimed at assessing the level of physical activity (PA) and the anthropometric profile of hypertensive and/or diabetic people involved in the Hiperdia programme in the city of Inhumas/Goias, Brazil.

METHODS

This exploratory descriptive study was conducted with 80 individuals from four areas in the aforementioned city. After participants had been invited to participate and their inclusion in the study, a brief medical history was complied and they answered the International Physical Activity Questionnaire (IPAQ-short) and their anthropometric measurements were taken regarding weight and height; body mass index (BMI), waist, hip circumference and waist-hip ratio (WHR) were calculated. The Kolgomorov Smirnov test was used for data analysis; the mean, standard deviation, absolute frequency and percentages were used.

RESULTS

BMI analysis classified 65 % of the subjects as being overweight or obese; only one individual was classified as being at low risk and all others were moderate to very high risk regarding WHR. Regarding PA, 11.25 % were classified as being sedentary and 63.75 % as active or very active.

CONCLUSION

More attention is required regarding anthropometric indices since such data can provide warnings regarding individuals' possible health hazards. Although PA level overall was good, strategies for promoting PA and healthy nutrition must be be implemented since they would contribute directly to improving the anthropometric indices found in this study.

Lack of association between a 3'UTR VNTR polymorphism of dopamine transporter gene (SLC6A3) and ADHD in a Brazilian sample of adult patients

OBJECTIVE

To investigate a possible association between a 3'UTR VNTR polymorphism of the dopamine transporter gene (SLC6A3) and ADHD in a Brazilian sample of adult patients.

METHOD

Study Case-control with 102 ADHD adult outpatients ( DSM-IV criteria) and 479 healthy controls. The primers' sequence used were: 3'UTR-Forward: 5' TGT GGT GAT GGG AAC GGC CTG AG 3' and 3'UTR-Reverse: 5' CTT CCT GGA GGT CAC GGC TCA AGG 3'. Alleles of the 3'UTR were coded according to their number of repeats: 6- repeat 320 bp (allele 6), 8- repeat 400 bp (allele 8), 9- repeat 440 bp (allele 9), 10- repeat 480 bp (allele 10), and 11- repeat 520 bp (allele 11).

RESULTS

There were no allelic (χ(2) = 2.67, 5df, p = .75) and genotypic (χ(2) = 7.20, 1 df, p = .61) association between adult ADHD and VNTR 3'UTR polymorphism of SLC6A3.

CONCLUSION

Our findings do not support SLC6A3 as marker genetic susceptibility factor in adult ADHD. More comprehensive polymorphism coverage within the SLC6A3 region should be conducted in larger samples, including comparisons in clinical subgroups, and in samples with different ethnic backgrounds.

[Cross-sectional study on toxoplasmosis among female students on a university course in the Presidente Prudente region, State of São Paulo]

INTRODUCTION

Toxoplasmosis is a parasitic disease caused by the protozoan Toxoplasma gondii, which affects humans and other animals. The most severe form is congenital toxoplasmosis. Thus, it is important to establish the serological profile of women before pregnancy. This study aimed to analyze the serology of toxoplasmosis among female students on the nursing course at Unoeste (Universidade do Oeste Paulista), in Presidente Prudente, SP.

METHODS

Blood samples were collected from 80 female students aged 18 to 35 years after they had signed the consent statement. Occurrences of anti-Toxoplasma gondii IgM and IgG antibodies were determined using the ELISA method. This study was approved by the institution's ethics committee and was conducted in the Immunology Laboratory at Unoeste.

RESULTS

Among the 80 blood samples analyzed, 27 female students were positive for IgG, whereas none of them were positive for IgM antibodies.

CONCLUSIONS

Among the 80 female students, 53 (66.2%) would be susceptible to toxoplasmosis in a possible pregnancy. Twenty-seven of the female students (33.8%) were considered seropositive.

Attention deficit hyperactivity disorder (ADHD) in adults: social-demographic profile from a university hospital ADHD outpatient unit in São Paulo, Brazil

PURPOSE: To describe the social-demographic variables, including interpersonal, academic, and professional performance in adult individuals with the diagnoses of attention deficit hyperactivity disorder (ADHD). There are no reports of this kind in the Brazilian population with ADHD. The ADHD is a common disorder, which can reach up to 3% of the general population. METHOD: Descriptive study of adults with ADHD, according to the DSM-IV criteria (American Psychiatric Association). The sample was selected from a specialized outpatient service in São Paulo city. The social-demographic data was obtained by personal interviews. RESULTS: There was a predominance of males in the sample (61.2%) and a high education level (90.2% had at least a high school degree) and 52% of the 102 patients had repeated their class at a least once during their school lives. In addition, 22.5% of the population sample were unemployed at the time of the interview. CONCLUSION: The distribution of the socio-demographic variables in adult ADHD is similar to other ADHD samples reported in other countries, despite the high education level met in our sample. Similarities between child and adult ADHD could also be traced.

Parathyroid hormone protects against periodontitis-associated bone loss

Parathyroid hormone (PTH) functions as a major mediator of bone remodeling and as an essential regulator of calcium homeostasis. In addition to the well-established catabolic effects (activation of bone resorption) of PTH, it is now recognized that intermittent PTH administration has anabolic effects (promotion of bone formation). The aim of this study was to investigate whether intermittent administration of PTH in rodents would block the alveolar bone loss observed in rats when a ligature model of periodontitis is used. Morphometric analysis showed that intermittent PTH administration (40 microg/kg) was able to protect the tooth site from periodontitis-induced bone resorption. In addition, there was a significant reduction in the number of inflammatory cells at the marginal gingival area in sections obtained from animals receiving PTH compared with control animals. These findings demonstrated that intermittent PTH administration was able to protect against periodontitis-associated bone loss in a rodent model.

[Isolation of potencially pathogenic free-living amoebas in hospital dust]

OBJECTIVE

To evaluate the occurrence of free-living amoebas of the genera Acanthamoeba and Naegleria is dust samples colleted in two hospitals.

METHODS

One-hundred and thirty-two dust samples were collected in two hospitals in Brazil. Hospital collection sites were the following: intensive care unit, operation rooms, nursery, kitchen, emergency and infectious diseases isolation room. The isolation of the amoebas was performed in three culture media: non-nutrient agar inoculated with Escherichia coli, soy agar, and microculture in Giazzi-modified Pavlova's medium. The amoebas were identified according to morphological criteria.

RESULTS

Amoebas of the genera Acanthamoeba and Naegleria were found in 45.5% of the samples, of which 41.6% were collected in the university hospital and 50% in the state hospital. Of all, 45.5% were positive for the genera Acanthamoeba and 3.8% for genera Naegleria.

CONCLUSIONS

Potentially pathogenic free-living amoebas were seen in all sites of the two hospitals and Acanthamoeba was the most frequently isolated genera.