Fernando Portela Câmara

Clima e epidemias de dengue no Estado do Rio de Janeiro

Temperatures in the city of Rio de Janeiro in the first quarter of the year over the period 1986-2003, especially the minimum, were significantly higher in the years in which dengue epidemics started in the city. There was no significant relationship with total rainfall for the same quarter of the year, but epidemics were more frequent in the years in which the volume of rain during the summer was small (less than 200 mm).

Antioxidant pathways are up-regulated during biological nitrogen fixation to prevent ROS-induced nitrogenase inhibition in Gluconacetobacter diazotrophicus

Gluconacetobacter diazotrophicus, an endophyte isolated from sugarcane, is a strict aerobe that fixates N2. This process is catalyzed by nitrogenase and requires copious amounts of ATP. Nitrogenase activity is extremely sensitive to inhibition by oxygen and reactive oxygen species (ROS). However, the elevated oxidative metabolic rates required to sustain biological nitrogen fixation (BNF) may favor an increased production of ROS. Here, we explored this paradox and observed that ROS levels are, in fact, decreased in nitrogen-fixing cells due to the up-regulation of transcript levels of six ROS-detoxifying genes. A cluster analyses based on common expression patterns revealed the existence of a stable cluster with 99.8% similarity made up of the genes encoding the α-subunit of nitrogenase Mo–Fe protein (nifD), superoxide dismutase (sodA) and catalase type E (katE). Finally, nitrogenase activity was inhibited in a dose-dependent manner by paraquat, a redox cycler that increases cellular ROS levels. Our data revealed that ROS can strongly inhibit nitrogenase activity, and G. diazotrophicus alters its redox metabolism during BNF by increasing antioxidant transcript levels resulting in a lower ROS generation. We suggest that careful controlled ROS production during this critical phase is an adaptive mechanism to allow nitrogen fixation.

Shedding of Polyomavirus in the Saliva of Immunocompetent Individuals

The aim of this study was to investigate and compare the frequency of BKV, JCV, WUV, and KIV in the saliva of healthy individuals. Samples were analyzed for the presence of polyomaviruses (BKV, JCV, WUV, and KIV) DNA by real‐time PCR. Of the 291 samples tested, 71 (24.3%) were positive for at least one of the screened polyomaviruses. Specifically, 12.7% (37/291) were positive for WUV, 7.2% (21/291) positive for BKV, 2.4% (7/291) positive for KIV, and 0.3% (1/291) positive for JCV. BKV and WUV co‐infections were detected in 1.7% (5/291) of individuals. No other co‐infection combinations were found. The mean number of DNA copies was high, particularly for WUV and BKV, indicating active replication of these viruses. Polyomavirus detection was higher among individuals 15–19 years of age (46.0%; 23/50) and ≥50 years of age (33.3%; 9/27). However, the detection rate in the first group was almost 1.7× greater than the latter. WUV infections were more frequent in individuals between the ages of 15 and 19 years and the incidence decreased with age. By contrast, BKV excretion peaked and persisted during the third decade of life and KIV infections were detected more commonly in subjects ≥50 years old. These findings reinforced the previous hypotheses that saliva may be a route for BKV transmission, and that the oral cavity could be a site of virus replication. These data also demonstrated that JCV, WUV, and KIV may be transmitted in a similar fashion. J. Med. Virol. 85:144–148, 2012.

Dynamic behavior of sylvatic yellow fever in Brazil (1954-2008)

INTRODUCTION Sylvatic yellow fever (SYF) is enzootic in Brazil, causing periodic outbreaks in humans living near forest borders or in rural areas. In this study, the cycling patterns of this arbovirosis were analyzed. METHODS Spectral Fourier analysis was used to capture the periodicity patterns of SYF in time series. RESULTS SYF outbreaks have not increased in frequency, only in the number of cases. There are two dominant cycles in SYF outbreaks, a seven year cycle for the central-western region and a 14 year cycle for the northern region. Most of the variance was concentrated in the central-western region and dominated the entire endemic region. CONCLUSIONS The seven year cycle is predominant in the endemic region of the disease due the greater contribution of variance in the central-western region; however, it was possible identify a 14 cycle that governs SYF outbreaks in the northern region. No periodicities were identified for the remaining geographical regions.

International guidelines for the management of personality disorders.

Purpose of review Individuals with personality disorders have difficulties in finding specific institutions or services that are designated to bind this kind of problem. These are people who are required to go through many diagnoses and consult many professionals before someone produces the correct diagnosis for their condition. This article reviews the new evidence in the management of personality disorders and incorporates reliable data to determine global clinical recommendations for treatment. Recent findings This review suggests that, although pharmacotherapy forms the cornerstone of the management, utilization of adjunctive psychosocial treatments and incorporation of a model that involves a healthcare team are required to provide optimal management for patients with personality disorders. Summary The authors related the experience obtained in the Personality Disorder Ambulatory of the Department of Psychiatry of Sao Paulo University Medical School in the handling of the people with personality disorders and proposed the use of gabapentin as a coactuator in the treatment of persons with these conditions.

Demographic profile of sylvatic yellow fever in Brazil from 1973 to 2008.

BACKGROUND Yellow fever is an acute, frequently fatal, febrile arbovirosis that in Brazil occurs only in the sylvatic form. Sylvatic yellow fever (SYF) appears in sporadic outbreaks over a large area of Brazil. In this paper, we analyze the demographic profile of 831 SYF cases that occurred between 1973 and 2008, to determine which segments of the exposed population are at greater risk. METHODS Data were statistically analyzed and were also geo-referenced in order to observe their spatial pattern. The basic reproductive number of infections, R0, was estimated by the ratio between average life expectancy and the average age of the cases. RESULTS SYF cases showed a modal profile of young male adults, approximately 30 years of age, living in rural areas of the states of Pará, Goiás, Maranhão and Minas Gerais, who were unvaccinated or whose vaccination was out of date. The disease showed a high mortality rate (51%, 421/831) among the notified cases, with death occurring on around the seventh day of illness for most patients. The R0 for SYF was estimated at approximately 2.4. CONCLUSION The results of this study suggest that lack of vaccination coverage is a major risk factor for SYF, and that the groups most at risk are migrant laborers, farm workers and tourists.

Epidemiological aspects of acquired immunodeficiency syndrome in older Brazilians: a comparative approach

OBJECTIVES To compare epidemiological aspects of young (15 to 49 years old) and older (more than 50 years old) AIDS patients. METHODS We analyzed 511,633 AIDS cases notified to the Brazilian Ministry of Health in the period of 1980-2008 looking at sex, age ranges, educational level and exposure category. Patients were divided into three age groups: under 15, from 15 to 49 and over 50 years old. Using a comparative approach, we analyzed data with regard to category of exposure, education (expressed in years of schooling), and sex ratio among younger (15-49) and older adults (over 50 years old). Time series data were log-transformed and normalized, and the temporal trend was evaluated. RESULTS AIDS incidence is increasing among people over 50 years old in Brazil, with those older than 50 being responsible for 9.64 % of AIDS cases. There was no significant difference between educational level and gender (p = 0.468), but there was a significant difference in exposure category with a lower proportion of injecting drug users amongst the older group. CONCLUSION Based on this analysis over the last 10 years, the percentage of AIDS cases has increased almost three times among people over 50 years old when compared with the 15-49 year-old group. Our findings suggest that public campaigns have to be specially targeted to the older segment of the population, aiming at heterosexual transmission.

Mortalidade por transtornos mentais e comportamentais e a reforma psiquiátrica no Brasil contemporâneo - II: elementos para um debate

O aumento da mortalidade na categoria dos transtornos mentais e comportamentais - face a reducao progressiva das internacoes hospitalares promovida pela reforma psiquiatrica em curso - tem aquecido o debate entre os proponentes da reforma e parte da comunidade psiquiatrica brasileira. Neste artigo, analisa-se os argumentos dos reformistas.

Mortalidade por transtornos mentais e comportamentais e a reforma psiquiátrica no Brasil contemporâneo

A mortalidade por transtornos mentais e comportamentais tem aumentado no Brasil com a reducao progressiva das internacoes hospitalares. A reforma psiquiatrica do governo aparentemente esta contribuindo para este cenario preocupante, com sua politica de desospitalizacao.

A construção do diagnóstico psiquiátrico

Neste texto abordo a formacao do diagnostico psiquiatrico moderno como uma instância cientifica, oriunda do pensamento hipotetico-dedutivo que inaugurou a linguagem cientifica no seculo XIX e a medicina moderna.