Ana Beatriz Monteiro Fonseca

Prevalence and risk factors for Toxoplasma gondii infection among pregnant and postpartum women attended at public healthcare facilities in the City of Niterói, State of Rio de Janeiro, Brazil.

INTRODUCTION To determine the prevalence of immunoglobulin G (IgG) and immunoglobulin M (IgM) anti-Toxoplasma gondii antibodies among pregnant and postpartum women attended within the public healthcare system in Niterói, State of Rio de Janeiro,and to detect possible exposure factors associated with T. gondii infection in this population. METHODS IgM and IgG anti- T. gondii antibodies were investigated in 276 pregnant and 124 postpartum women by using the indirect immunofluorescence (IFAT) and immunoenzymatic assay (ELISA) techniques. The participants were selected by convenience sampling. All these 400 patients filled out a free and informed consent statement, answered an epidemiological questionnaire and were informed about the disease. RESULTS Among the 400 samples analyzed, 234 (58.5%) were reactive to IgG anti-T. gondii antibodies, according to the IFAT and/or ELISA assay. One pregnant woman was found to be reactive to IgM anti- T. gondii antibodies, with an intermediate IgG avidity test. Risk factor analysis showed that seropositivity was significantly associated (p<0.05) with age, contact with cats and presence of rodents at home. Through a logistic regression model, these associations were confirmed for age and contact with cats, while education at least of the high school level was found to be a protective factor. CONCLUSIONS The prevalence rate of IgG anti-T. gondii antibodies in the city of Niterói was high and the risk factors for infection detected after multivariate analysis were: age over 30 years, contact with cats and education levels lower than university graduate level.

Clinical, cytological and histopathological evaluation of mammary masses in cats from Rio de Janeiro, Brazil

The vast majority of mammary tumors in cats are malignant with high metastatic and mortality rates. This study evaluated clinical, cytological and histopathological aspects of 20 cases of cat mammary masses deriving from the city of Rio de Janeiro. Data on history, macroscopic description, evidence of regional lymph node and distant metastases, clinical examination and treatment were collected. The cats were treated with unilateral mastectomy, unilateral mastectomy plus chemotherapy or chemotherapy alone. Tissues were submitted for cytological and histological evaluation. Histopathological analysis described one case of mammary hyperplasia and 19 cases of adenocarcinoma. Inadequate surgical margins were obtained in two cats while six showed evidence of microscopic invasion in other mammary glands. Multiple mammary involvement and greater tumor size (diameter over 7.05 cm) were correlated with increased chance of local metastases. Ulceration of tumors and metastases were common. These facts support the highly malignant nature of this neoplasia and emphasize the risks associated with delay in diagnosis and treatment of feline patients. In conclusion, mammary palpation should be performed routinely in the clinical practice.

Immunohistochemical identification of Toxoplasma gondii in tissues from Modified Agglutination Test positive sheep

Toxoplasma gondii is a zoonotic agent of great importance in veterinary and public health. The aim of this study was to identify T. gondii by IHC (immunohistochemistry) in different sheep tissues and to determine if an association exists between the results obtained by this method and those obtained by the Modified Agglutination Test (MAT). Tissue specimens of twenty-six sheep seroreactive for T. gondii were selected for histopathological evaluation. The presence of T. gondii was investigated in brain, liver and heart samples by IHC and a possible anti-T. gondii antibody cross reactions with other parasites. McNemars, Chi-square and Fishers Exact Tests were applied for the statistical analysis of the results. The analysed tissues showed at least one of the following histopathological changes: mild-to-moderate congestion, focal polymorphonuclear inflammatory infiltrate and multifocal or focal mononuclear inflammatory infiltrate. Sarcocystis spp. were identified in the histological sections from both the heart and diaphragm tissues of 88.5% (23/26) of the animals. A total of 46.2% (12/26) of the T. gondii seroreactive sheep was also positive for T. gondii by IHC in at least one organ (brain, liver or heart). The liver IHC-positivity for T. gondii was statistically equivalent to the global individual IHC-positivity, according to McNemars test. In addition, IHC allowed the detection of T. gondii in infected animals regardless of the titration observed in the MAT. The statistical difference observed between the three organs when comparing the low titration group, suggested that the heart might be the most suitable organ to detect T. gondii infection by IHC. The IHC results in this study revealed that almost half of MAT positive animals could serve as potential sources of infection for humans because bradyzoites were identified in different tissues, regardless of the MAT titration.

Remineralizing potential of CPP-ACP creams with and without fluoride in artificial enamel lesions

BACKGROUND This study evaluated the effect of pastes containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) with and without fluoride on enamel demineralization. METHODS Human enamel blocks were used and after incipient caries-like lesions were formed, they were assigned to four groups: G1 - saliva; G2 - MI Paste (RecaldentTM ); G3 - MI Paste Plus (RecaldentTM 900 ppm as NaF); and G4 - Crest™ (1.100 ppm as NaF). The specimens were soaked in demineralizing solution for 6 hours and remineralized in artificial saliva for 18 hours alternatively for 10 days. The dentifrice was prepared with deionized water in a 1:3 proportion (w/w) or applied undiluted in the case of the CPP-ACP formula. Demineralized enamel changes were analysed by surface microhardness (SMH), 3D-profilometry and SEM. Data were analysed by non-parametric Kruskal-Wallis and Mann-Whitney test comparisons and one-way ANOVA and Tukeys HSD post hoc test (α = 0.05). RESULTS The SMH values observed in the G2 (47.8 ± 28.5) and G3 (53.6 ± 27.6) groups were different from that of G4 (90.2 ± 17.1), which were significantly higher than that found in G1 (39.4 ± 14.2). The %SMH was significantly lower in G4 when compared to G1 (p < 0.001) and G3 (p < 0.05). CONCLUSIONS MI Paste Plus demonstrated a greater protective effect against demineralization than MI Paste and showed smoother surfaces.

Characterization of the zoonotic potential of Toxoplasma gondii in horses from Rio de Janeiro State

The aim of this study was to perform a survey on the prevalence of anti-Toxoplasma gondii antibodies in horses from Rio de Janeiro State, Brazil. From 2012 to 2013, a total of 624 blood samples were collected from horses from the eight regions comprising Rio de Janeiro State (Baixadas Litorâneas, Serrana, Norte Fluminense, Noroeste Fluminense, Centro-Sul, Metropolitana, Médio Paraíba, and Costa Verde). All sera samples were tested for anti-T. gondii antibodies by performing the modified agglutination test with a cut-off of 1:25. Positive serology for T. gondii was detected in 22.8% (142/624) of the horses studied. Seropositivity was detected in all regions sampled; furthermore, statistical significance was observed when all locations were compared at once. The Médio Paraíba region had the highest number of positive animals 54.76% (23/42) in the Bonferroni correction among Costa Verde, Centro Sul, Metropolitana, and Serrana (p<0.001). Seropositivity was 39.58% (38/96) in Norte Fluminense, which was the second most prevalent region. The results indicated that the T. gondii parasite is widely distributed in horses in Rio de Janeiro State and represents a risk to public and animal health. These findings emphasize the need to increase control and prevention of this disease in horses.

Balantidium coli and other gastrointestinal parasites in captives non-human primates of the Rio de Janeiro, Brazil

Parasites are agents of diarrhea in captive non‐human primates (NHP). To broaden information about those etiological agents in captive animals in Brazil, gastrointestinal parasites in captive NHP were researched in nurturing Centers of Rio de Janeiro State.

Atenção em Saúde Bucal no Brasil: uma análise a partir da Avaliação Externa do PMAQ-AB

Este estudo tem como objetivos identificar as caracteristicas da oferta de servicos de odontologia acessados pelos usuarios e analisar a organizacao da atencao a saude bucal das equipes participantes do Programa Nacional do Acesso e da Qualidade da Atencao Basica quanto aos atributos do acesso de primeiro contato e da integralidade. Utilizaram-se dados secundarios da Avaliacao Externa relativos aos modulos usuario e profissional. Os resultados indicam que 45,1% dos usuarios conseguem marcar consulta com o dentista. A garantia de continuidade de tratamento e menor nas regioes Norte e Nordeste. O acesso e o tempo de espera nas especialidades ainda se constituem em problema da rede de atencao.ABSTRACT: This study aims to identify the characteristics of dental service supply accessed by users and to analyze the organization of Oral teams participating in the National Program for Access and Quality Improvement in Primary Care, as for access and first contact comprehensive-ness. Secondary data concerning to External Evaluation were applied in their user and professio-nal component modules. The results indicate that 45.1% of users succeed in making an appoint-ment with the dentist. The ensuring continuity of treatment is lower in the North and Northeast regions. Access and waiting times for specialty still constitute a problem of the care network. KEYWORDS: Primary Health Care; Evaluation of health services; Health services accessibility; Oral health; Integrality in health. Atencao em Saude Bucal no Brasil: uma analise a partir da Avaliacao Externa do PMAQ-AB Dental care in Brazil: an analysis based on PMAQ-AB External Evaluation Elisete Casotti 1 , Priscilla Caran Contarato

O polimorfismo AGT*M235T na disfunção cardíaca de etiologia isquêmica aguda: projeto gisca

FUNDAMENTO: O polimorfismo AGT*M235T tem sido associado a elevados niveis sericos de angiotensinogenio (AGT), hipertensao arterial sistemica e disfuncao cardiaca (DC). OBJETIVO: Testar a hipotese de haver associacao entre polimorfismo AGT*M235T e o risco de desenvolver disfuncao cardiaca (insuficiencia cardiaca ou disfuncao sistolica ventricular esquerda assintomatica) pos-sindrome coronariana aguda (SCA), durante o periodo de internacao hospitalar. METODOS: Foram estudados 363 pacientes (idade media 62 ± 12 anos), sendo 233 (64%) homens e 130 (36%) mulheres, todos da mesma coorte, internados por SCA. Compararam-se dados clinicos e geneticos dos 117 (32,2%) que evoluiram com disfuncao cardiaca (grupo caso) com os dos 246 (67,8%), que nao desenvolveram tal condicao (grupo controle). O polimorfismo AGT*M235T foi determinado por analise de sequenciamento e estava em equilibrio de Hardy-Weinberg. RESULTADOS: Houve diferenca significativa na distribuicao dos genotipos nas mulheres, com predominio do genotipo *235MM no grupo controle (p = 0,001) e do alelo *235T no grupo caso. Em ambos os sexos, nos modelos de regressao logistica, o diagnostico de infarto de parede anterior na admissao foi fator de incremento no risco de DC, enquanto angina instavel na admissao, ausencia do alelo *235T, glicemia 60 e < 90 bpm e tabagismo atual foram fatores de reducao do risco de DC. CONCLUSAO: Este estudo sugere que a ausencia do alelo *235T do AGT contribui para a reducao do risco de disfuncao cardiaca pos-sindrome coronariana aguda.

Hydroxymethylbilane synthase gene mutations and polymorphisms in Brazilian families with acute intermittent porphyria.

Acute intermittent porphyria (AIP), an autosomal dominant disorder, is caused by a deficiency of hydroxymethylbilane synthase (HMBS). In the present study, we sought to establish a correlation between HMBS activity with the presence of mutations and polymorphisms. Enzyme activity was measured in red blood cells of four Brazilian unrelated AIP families (n = 124) and in blood donors (n = 80). The HMBS mutations in AIP family members were studied by PCR‐SSCP followed by direct sequencing. Six intragenic SNPs (1345 G>A, 1500 T>C, 2377 C>A, 2478 A>G, 3581 A>G, and 7064 C>A) were determined by PCR‐RFLP. Abnormal SSCP patterns in exons 7, 9, 12, and 15 were observed. DNA sequencing analysis revealed one nonsense mutation, R149X, two missense mutations, G111R and L338P, and one deletion, CT 730–731. All mutation carriers had lower enzyme activity. All polymorphisms, except 2377 C>A and 7064 C>A, showed no significant differences compared with previous reports. Mutation screening allowed the detection of the missense mutation, L338P, and the 730_731delCT deletion, two as yet unreported mutations in Brazilian AIP patients. Our findings also showed a high frequency of 2478 A>G and 3581 A>G polymorphism combinations suggesting that these polymorphisms contributed to enzymatic activity reduction in our study population.

TOXOPLASMOSIS-RELATED KNOWLEDGE AMONG PREGNANT AND POSTPARTUM WOMEN ATTENDED IN PUBLIC HEALTH UNITS IN NITERÓI, RIO DE JANEIRO, BRAZIL

The present study conducted a toxoplasmosis-related knowledge level survey with 400 pregnant and puerperal women attended in public health units in the municipality of Niterói, Rio de Janeiro. Only 111 (27.8%) women claimed to know about the disease. Most of them (n = 289; 72.2%) had never heard about toxoplasmosis nor knew how to prevent the infection by Toxoplasma gondii. A significant difference (p = 0.013) regarding the presence of anti-T. gondii IgG was observed between women who claimed to know about the disease and those who had never heard about it. These results highlight the importance of a systematic serological screening process for toxoplasmosis, as well as the importance of primary prevention by accurate information during prenatal care, an important Public Health action to be implemented.