Although low- and middle-income countries still bear the burden of major infectious diseases, chronic noncommunicable diseases are becoming increasingly common due to rapid demographic, epidemiologic, and nutritional transitions. However, information is generally scant in these countries regarding chronic disease incidence, social determinants, and risk factors. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) aims to contribute relevant information with respect to the development and progression of clinical and subclinical chronic diseases, particularly cardiovascular diseases and diabetes. In this report, the authors delineate the study's objectives, principal methodological features, and timeline. At baseline, ELSA-Brasil enrolled 15,105 civil servants from 5 universities and 1 research institute. The baseline examination (2008-2010) included detailed interviews, clinical and anthropometric examinations, an oral glucose tolerance test, overnight urine collection, a 12-lead resting electrocardiogram, measurement of carotid intima-media thickness, echocardiography, measurement of pulse wave velocity, hepatic ultrasonography, retinal fundus photography, and an analysis of heart rate variability. Long-term biologic sample storage will allow investigation of biomarkers that may predict cardiovascular diseases and diabetes. Annual telephone surveillance, initiated in 2009, will continue for the duration of the study. A follow-up examination is scheduled for 2012-2013.

Seeking the identification ofA. cantonensis has already been found in Southeast Asia, South Pacific, Africa, India, Caribbean, Australia, North America (Pien & Pien 1999), Jamaica (Lindo et al. 2002) and Haiti (Raccurt et al. 2003).Eosinophilic meningitis is a rare clinical entity that is defined by the presence of 10 or more eosinophils/ ml in the cerebrospinal fluid (CSF) or a CSF eosinophilia of at least 10% of the total CSF leukocyte count (Kuberski 1979). The most common cause is invasion of the central nervous system by helminthic parasites, inciting an inflammatory response that eventually kills the parasites. Clinical manifestations, which develop in humans at two to 35 days after larvae ingestion, may include headache, nuchal rigidity and visual disturbances (Koo et al. 1988). Cerebral angiostrongyliasis usually has an incubation period of about two weeks, although it may vary from 12 to 28 days (Dooley & Neafie 1976). Paresthesias of the extremities, trunk or face, are the most distinctive neurological findings and can persist for weeks to months after the other symptoms are resolved. Occasionally, infective larvae can migrate to the eye, causing retinal detachment or intraocular hemorrhage, but most patients recover completely (Alicata 1962, Sawanyawisuth et al. 2007. In Brazil, a clinical case of eosinophilic meningoencephalitis that resulted in death ten days after ingestion of three Achatina fulica snails was reported in a regional meeting in 2006 (AVS Moll, G Zanini and C Graeff-Teixeira, unpublished observations).In January 2007, two male individuals aged 21 and 39 years were admitted to the local hospital of Cariacica, state of Espírito Santo (ES), Brazil, with eosinophilic meningitis and history of ingestion of raw terrestrial slugs. By that time, a male child aged one year and eight months from the city of Vila Velha, ES, had also been admitted to the hospital with similar symptoms.A number of 270 mollusc specimens and feces from Rattus norvergicus were collected with a grasping tool, in peridomiciliary areas of the patients' houses by health agents of the Central Laboratory of the ES (LACEN-ES). The materials were sent to the Laboratory of Intestinal Helminthiasis of Instituto René Rachou-Fiocruz for mollusc morphological identification and molecular characterization of nematode larvae. The gastropods were identified as: Sarasinula marginata (Semper, 1885) (Veronicellidae), 45 specimens, Subulina octona (Bruguière, 1792) (Subulinidae), 157 specimens, A. fulica (Bowdich, 1822) (Achatinidae), 45 specimens, and Bradybaena similaris (Férussac, 1821) (Bradybaenidae), 23 specimens.

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One difficulty in studying dengue virus (DENV) is the lack of an experimental model that reproduces the human disease. In a previous work, we have shown that BALB/c mice intraperitoneally inoculated with a DENV-2 isolate presented viremia and mild focal areas of liver injuries. In this study, mice were inoculated by the intravenous route and presented extensive damage areas in the liver tissue, which were evaluated by histopathological and ultrastructural analysis. Hepatic injury was noted mainly around the central vein and portal tracts. Damages consist of hepatocyte injury, including steatosis, swelling and necrosis. Further, erythrophagocytosis, intercellular edema and vascular damages were evident, including hemorrhage, which is characteristic of the dengue-induced hepatitis in human liver. Hepatic lesions were already noted 2 days post infection (p.i.), although effects were more extensive after the seventh day p.i. An increase in alanine aminotransferase and aspartate aminotransferase serum levels was detected 7 and 14 days p.i., respectively, and had correlation to hepatic lesions. Alterations caused by the DENV infection were self-limiting, with a remarkable reduction of all liver damages 49 days p.i. Virus antigens were detected in hepatocytes, Kupffer cells and vascular endothelium, suggesting virus replication in these cells. In situ hybridization, using a probe that anneals in the virus negative RNA strand, showed positive reaction in hepatocytes and vascular endothelium cells of infected mice, thus confirming virus replication in such cells. In general, results revealed that this mouse model reproduces some histopathological effects observed in humans and supports previous findings indicating virus replication in the hepatic tissue.

OBJETIVOS: analisar as tendências das principais causas de internações hospitalares entre aquelas sensíveis à atenção primária (ICSAP) no Brasil, por faixa etária e região, no período de 1999 a 2006. MÉTODOS: trata-se de um estudo ecológico misto das tendências das três principais causas de ICSAP em menores de vinte anos. Os dados secundários foram provenientes do Sistema de Informação Hospitalar (SIH-SUS) e do censo demográfico do ano de 2001 e projeções populacionais do Instituto Brasileiro de Geografia e Estatística (IBGE). RESULTADOS: as três principais causas de ICSAP, em menores de 20 anos, foram as gastroenterites, asma e as pneumonias bacterianas. Houve redução das taxas de internação por gastroenterites (-12,0%) e asma (-31,8%) e, incremento de 142,5% nas taxas de internações por pneumonias bacterianas, tendências que ocorreram de forma distinta por faixa etária e região. CONCLUSÕES: a descrição das tendências temporais revelou mudanças positivas na evolução das taxas de internações por asma e gastroenterites infecciosas e negativas nas internações por pneumonia. Uma vez que estes problemas de saúde constituem objeto de intervenção prioritária na atenção primária, tais achados evidenciam a necessidade de se aprofundar a análise e reflexão sobre os determinantes do perfil das internações hospitalares no país.

This paper centers on some whole-istic organizational and functional aspects of hepatic

The fact that the Schistosoma mansoni egg has two ATP diphosphohydrolase (EC 3.6.1.5) isoforms with different net charges and an identical molecular weight of 63,000, identified by non-denaturing polyacrylamide gel electrophoresis and immunological cross-reactivity with potato apyrase antibodies, is shown. In soluble egg antigen (SEA), only the isoform with the lower net negative charge was detected and seemed to be the predominant species in this preparation. By confocal fluorescence microscopy, using anti-potato apyrase antibodies, the S. mansoni egg ATP diphosphohydrolase was detected on the external surface of miracidium and in von Lichtenberg's envelope. Intense fluorescence was also seen in the outer side of the egg-shell, entrapped by the surface microspines, suggesting that a soluble isoform is secreted. ATP diphosphohydrolase antigenicity was tested using the vegetable protein as antigen. The purified potato apyrase was recognized in Western blots by antibodies present in sera from experimentally S. mansoni-infected mice. In addition, high levels of IgG anti-ATP diphosphohydrolase antibodies were detected by ELISA in the same sera. This work represents the first demonstration of antigenic properties of S. mansoni ATP diphosphohydrolase and immunological cross-reactivity between potato apyrase and sera from infected individuals.

The traditional concept of health information systems (HIS) poses numerous problems when attempting to support local management orientated to the reduction of health inequalities. How does one design a local HIS, and what would its characteristics be? We view HIS as open and complex systems of which we ourselves are a part. The hypothesis is that a HIS that provides support to local management must be conceived as a set of processes including data, information, knowledge, communication, and action (DIKCA). Data constitute a complex structure with five components. Information is a set of processed data; meanwhile knowledge output involves a subject's understanding and grasp of the phenomenon. Communication links the previous concepts to action. Strategic and communicative actions should be priorities in local management. This proposal aims at management support by the HIS to eliminate health inequalities and build an inclusive society.