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Objective: Duchenne muscular dystrophy (DMD) is the most common form of muscular dystrophy in children, and children with DMD die prematurely because of respiratory failure. We sought to determine the efficacy and safety of yoga breathing exercises, as well as the effects of those exercises on respiratory function, in such children., Methods: This was a prospective open-label study of patients with a confirmed diagnosis of DMD, recruited from among those followed at the neurology outpatient clinic of a university hospital in the city of São Paulo, Brazil. Participants were taught how to perform hatha yoga breathing exercises and were instructed to perform the exercises three times a day for 10 months., Results: Of the 76 patients who entered the study, 35 dropped out and 15 were unable to perform the breathing exercises, 26 having therefore completed the study (mean age, 9.5 ± 2.3 years; body mass index, 18.2 ± 3.8 kg/m(2)). The yoga breathing exercises resulted in a significant increase in FVC (% of predicted: 82.3 ± 18.6% at baseline vs. 90.3 ± 22.5% at 10 months later; p = 0.02) and FEV1 (% of predicted: 83.8 ± 16.6% at baseline vs. 90.1 ± 17.4% at 10 months later; p = 0.04)., Conclusions: Yoga breathing exercises can improve pulmonary function in patients with DMD.

The public sector is the main financing agent of hospital admissions and the information generated constitutes the input for the hospital information network of the Unified Health System (SUS). This paper seeks to design a report template to be used for decision-making in both public and university hospitals. The theoretical approach sought inspiration in discussions about the SUS, hospital institutions, hospital information systems and decision-making. The methodological procedures used are characterized as qualitative-descriptive methods and were conducted in a single case study and action research. The primary data analysis was carried out in two stages from January through December 2007 and from January through December 2008. Based on these periods, the findings were described and the elaboration of new reports was presented, with the importance and need for each being duly emphasized. Lastly, a structured report template was created for the case study that includes information discussed in the article. The conclusion reached is that the hospital information system can become a potential support tool, as the necessary adjustments are made and the report is structured to furnish the institution with an objective communication tool for decision-making.

Background: Although hospitalization is recognized as an important cause of reduction in physical activity in daily life (PADL) in COPD, there is only one study evaluating this effect, and it was performed in European COPD patients who have a lower PADL than that of South American COPD patients., Objectives: To investigate the effect of hospitalization due to acute exacerbation of PADL in Brazilian COPD patients and to evaluate the factors that determines the physical activity levels during hospitalization and after discharge., Methods: PADL was quantified using a 3-axis accelerometer on the 3rd day of hospitalization and 1 month after discharge in Brazilian COPD patients who were hospitalized due to disease exacerbation. Six-minute walking distance (6MWD), lower limb strength and pulmonary function were also evaluated., Results: A total of 20 patients completed the study. During hospitalization, patients spent most of the time (87%) lying down or sitting; however, 1 month after they were walking >40 min/day. In addition, patients with prior hospitalization had a lower level of physical activity compared to those without a previous history of hospitalization. The time spent walking during hospitalization was significantly explained by the quadriceps strength (r(2) = 0.29; p < 0.05), while 1 month after, the time spent walking was only significantly explained by the 6MWD (r(2) = 0.51; p = 0.02)., Conclusions: Brazilian COPD patients are inactive during hospitalization but become active 1 month after discharge. Previously hospitalized are more inactive both during and after exacerbation. The quadriceps strength and 6MWD explain the physical activity levels during hospitalization and at home, respectively.

Gene variation and the differentiation of two populations of Partamona seridoensis (Hymenoptera: Apidae: Meliponini) from the Caatinga biome, a semiarid ecosystem unique to Brazil, were estimated through allozymic and microsatellite analyses. These populations exhibited similar low degrees of enzyme gene variation. Observed genotype frequencies at the allozyme and microsatellite loci were in accordance with Hardy-Weinberg equilibrium in the two populations. Both markers demonstrated that the two populations are not genetically homogeneous and must be considered distinct populations. The occurrence of private alleles at the allozyme and microsatellite loci corroborates this differentiation, sustaining the hypothesis of a low level of interpopulation gene flow. The phenotypic segregations clearly demonstrated that the progeny inside each nest were the result of mating between the queen of the colony and only one male.

Objective: To determine the prevalence of exercise-induced bronchoconstriction among elite long-distance runners in Brazil and whether there is a difference in the training loads among athletes with and without exercise-induced bronchoconstriction., Methods: This was a cross-sectional study involving elite long-distance runners with neither current asthma symptoms nor a diagnosis of exercise-induced bronchoconstriction. All of the participants underwent eucapnic voluntary hyperpnea challenge and maximal cardiopulmonary exercise tests, as well as completing questionnaires regarding asthma symptoms and physical activity, in order to monitor their weekly training load., Results: Among the 86 male athletes recruited, participation in the study was agreed to by 20, of whom 5 (25%) were subsequently diagnosed with exercise-induced bronchoconstriction. There were no differences between the athletes with and without exercise-induced bronchoconstriction regarding anthropometric characteristics, peak oxygen consumption, baseline pulmonary function values, or reported asthma symptoms. The weekly training load was significantly lower among those with exercise-induced bronchoconstriction than among those without., Conclusions: In this sample of long-distance runners in Brazil, the prevalence of exercise-induced bronchoconstriction was high.

Introduction: Several studies related that different human papillomavirus (HPV) types and intratype variants can present different oncogenic potential. In opposite to HPVs 16 and 18 variants, information about variants of other carcinogenic HPV types is still scarce. The aim of this study was to investigate the genetic variability of HPVs 53, 56, and 66 from Central Brazil isolates., Methods: The long control region (LCR), E6, and L1 genomic regions were amplified and sequenced. We evaluate for nucleotide variations in relation to the reference sequence of each HPV type and also the conservation of physicochemical properties of the deduced amino acid substitutions. In silico analysis was performed to locate binding sites for transcriptional factors within the LCR. Moreover, we performed a phylogenetic analysis with the Central Brazilian and worldwide sequences available at genomic databases., Results: Gathering LCR, E6, and L1 genomic regions, the highest genetic variability was found among HPV-53 isolates with 52 nucleotide variations, followed by HPVs 56 and 66 with 24 and 16 nucleotide substitutions, respectively. The genetic analysis revealed 11 new molecular variants of all HPV types analyzed, totalizing 31 new nucleotide and 3 new amino acid variations. Eight nonconservative amino acid substitutions were detected, which may indicate a biological and pathogenic diversity among HPV types. Furthermore, 8 nucleotide substitutions were localized at putative binding sites for transcription factors in the LCR with a potential implication on viral oncogene expression. The HPVs 53, 56, and 66 phylogenetic analysis confirmed a dichotomic division only described to HPV subtypes and different from the patterns described for HPVs 16 and 18 variants., Conclusions: The high genetic variability observed emphasizes the importance of investigating polymorphisms in types other than HPVs 16 or 18 to better understand the molecular genomic profile of viral infection by different HPV types.

Early promoter activity of HPV-58 molecular variants isolated from high-grade cervical lesions in Brazil was compared. Luciferase reporter assays were conducted in C33 cells transfected with the complete long control region of 3 molecular variants of HPV-58 as well as HPV-58, -18 or -16 prototypes. The HPV-58 prototype and Bsb-329 and Bsb-367 variants showed a promoter activity similar to that of HPV-16, but lower than that of Bsb-295 and HPV-18. The introduction of the Bsb-295 7788 mutation into the HPV-58 prototype resulted in the enhancement of transcription closer to Bsb-295 and HPV-18. These results could impact the expression of E6 and E7 viral oncogenes., (Copyright © 2010 S. Karger AG, Basel.)

More than 100 HPV types have been described, 13 of which are classified as high-risk due to their association with the development of cervical cancer. The intratype genomic diversity of HPV-16 and -18 has been studied extensively, while little data have been generated for other less common high-risk types. The present study explores the nucleotide variability and phylogeny of the high-risk HPV-31, -33, -35, -52, and -58, in samples from Central Brazil. For this purpose, the LCR and the E6 and L1 genes were sequenced. Several variants of these HPV types were detected, some of which have been detected in other parts of the world. Furthermore, new variants of all types examined were characterized in a total of 13 new variants. Based on the E6 and L1 sequences, variants were described comprising conservative and non-conservative amino acid changes. For phylogenetic tree construction, samples characterized in this study were compared to others described and submitted to GenBank previously. The phylogenetic analysis of HPV-31, -33, -35, and -58 isolates did not reveal ethnic or geographical clustering as observed previously for HPV-16 and -18. HPV-35 analysis showed a dichotomic branching characteristic of viral subtypes. Interestingly, four clusters relative to the analysis of HPV-52 isolates were identified, two of which could be classified as Asian and European branches. The genomic characterization of HPV variants is crucial for understanding the intrinsic geographical relatedness and biological differences of these viruses and contributes further to studies on their infectivity and pathogenicity., ((c) 2009 Wiley-Liss, Inc.)

Background: The Walking Impairment Questionnaire (WIQ) has been used to evaluate walking impairment in subjects with intermittent claudication (IC). However, this questionnaire has yet to be translated to Brazilian Portuguese, which limits its use in Brazilian subjects., Objective: To translate and analyze the validity and reliability of WIQ in Brazilian subjects with IC., Methods: Forty-two patients with IC, determined by the ankle-brachial index < 0.90, participated in the study. After translation and re-translation, carried out by two independent translators, the construct validity of the WIQ was analyzed by correlating the WIQ scores with the Medical Outcome Study Questionnaire Short Form 36 (SF-36) scores and the physical fitness performance (treadmill and strength tests). The reliability was analyzed with a 7-day interval between two questionnaire applications., Results: Significant correlations between the WIQ domains and the SF-36 (functional capacity, physical aspects, bodily pain and emotional aspects) and physical fitness performance (treadmill and strength tests) were observed. Moreover, the intraclass coefficient correlation ranged from 0.72 to 0.81, and there were no differences in WIQ scores between the two questionnaire applications., Conclusion: The Brazilian Portuguese version of the WIQ is valid and reliable to be used in Brazilian subjects with IC.

HPV-18 is the second most prevalent human papillomavirus genotype found in cervical cancer. Nucleotide variations in HPV-18 sequence can interfere with the viral oncogenic potential. However, the knowledge about HPV-18 variants in Brazil is still limited. The present study aims to determine the LCR, E6, and L1 genetic variability of HPV-18 variants found in women co-infected with HIV-1 in Central Brazil. Four HPV-18 samples were identified and had the LCR, E6, and L1 genomic regions sequenced. It was possible to characterize three European variants and one African variant of HPV-18. All of them are new variants, showing nucleotide substitutions not previously reported. Nucleotide variations in binding sites for transcriptional factors were observed. Phylogenetic analysis was also performed, evidencing the three clusters related to the Asian-American, African, and European variants. The characterization of HPV genetic variability is of pivotal importance to the understanding of the viral pathogenicity.

HPV-16 is the most prevalent human papillomavirus genotype found in cervical intraepithelial neoplasias. The regulatory region of the HPV genome, LCR, has several binding sites for cellular and viral transcription factors, and nucleotide substitutions in this genomic region can interfere with the viral oncogenic expression. The present study aims to determine the LCR variability of European and non-European HPV-16 variants found in Brazil. Through automated sequencing, it was possible to characterize the LCR of ten non-European (eight Asian-American, one African 1, one African 2) and twelve European isolates. Among the 22 isolates analyzed, nine may be new variants of HPV-16, with different combinations of previously reported nucleotide substitutions, and three showed new substitutions not previously reported. Two new nucleotide substitutions, the insertion of T at position 7621 and the substitution of A to G at position 7836, were found in a single isolate, Bsb-14, a putative new African 1 variant. The characterization of the LCR of human papillomaviruses can be of pivotal importance to the understanding of the viral replication and pathogenicity.

Rumors of Aedes aegypti (L.) resistance to temephos in diferent Brazilian states justified this research, whose objective was to verify and characterize the resistance to temephos in A. aegypti populations from Paraíba State. The temephos resistance was evaluated and characterized through a diagnostic dose of 0.012 mg/l and concentration-mortality curves. The mortality data of multiple concentrations were submitted to Probit analysis, and the resistance ratios (RR) were figured out from the CL50s of the survived population and CL50 a laboratory susceptible population. All the A. aegypti populations showed resistance to temephos. The Sítio Piabas population with RR = 4.0, showed lower resistance, the Campina Grande with RR = 6.0, Lagoa do Mato with RR = 9.3 and Capim de Cheiro with RR = 9.0, showed a moderate resistance, and Boqueirão with RR = 11.0, Brejo dos Santos with RR = 16.6 and Itaporanga with RR= 15.6, showed intermediate levels of resistance to temephos. These results confirm the need of a continuous monitoring and managing program of A. aegypti resistance in Paraíba State.

The present work aimed at estimating the thermal requirements for the development and the number of generations per year of Aedes aegypti (L.) under natural conditions. The life cycle of A. aegypti populations was studied at constant temperatures of 18, 22, 26, 30 and 34 degrees C, and 12 h photophase. The development period, egg viability and larval and pupal survival were evaluated daily as well as adult longevity and fecundity. The low threshold temperature of development (Tb) and the thermal constant (K) were determined. The number of generations per year in laboratory and field were also estimated. The favorable temperature to A. aegypti development is between 21 degrees C and 29 degrees C, and to longevity and fecundity is between 22 degrees C and 30 degrees C. The egg to adult basal temperature, thermal constant and the number of generations in field were, in order, 9.5, 8.5, 3.4, 7.1, 13.5 degrees C; 244.5, 273.9, 298.5, 280.9 and 161.8 degree-days; and 21.9, 23.8, 24.2, 21.1 and 22.1 generations in populations from Boqueirão, Brejo dos Santos, Campina Grande, Itaporanga and Remígio.

The objectives of this study were to analyze the morbidity and mortality profile in elderly patients hospitalized in two teaching and two non-teaching hospitals in Rio de Janeiro, Brazil (Municipal Planning Area 2.2) in 1999, and to compare in-hospital mortality rates adjusted for differences in profile. Data were obtained from the National Hospital Database of the Unified National Health System (SIH/SUS). The logistic model included the variables age and primary diagnosis to calculate risk-adjusted in-hospital mortality rates. Hospital admissions of elderly patients (n = 7,584) represented 29.3% of a total of 25,928 hospitalizations that took place in these units. Senile cataract (7.8%) was the most frequent cause of hospitalization, followed by prostate hyperplasia (4.7%), congestive heart failure (2.9%), and complete atrioventricular block (2.8%). Non-teaching hospitals presented in-hospital mortality rates higher than teaching hospitals even after adjusting for case profile differences with regard to age and primary diagnosis. The use of SIH/SUS databases and the risk adjustment methodology represent an alternative for exploratory analysis of healthcare outcomes.

The present study on molecular characterization of human papillomaviruses occurring in Central Brazil, describes two variants each of HPV-53 and HPV-58 and one variant of HPV-66 detected in samples from smears of women showing cervical intraepithelial neoplasia grade II (CIN II). Samples were assayed by PCR using MY09/ MY11 consensus primers, followed by restriction fragment length polymorphism typing. The five isolates showed atypical restriction fragment length profile and MY09/MY11 L1 PCR products were subsequently sequenced. Isolate Bsb-02 and Bsb-08 showed, respectively, 99% similarity to HPV-58 IS404 and 100% to HPV-58 IS417 previously described in the African Continent. Isolates Bsb-61 and Bsb-63 showed 98% similarity to HPV-53, and isolate Bsb-68, 97% similarity to HPV-66. Amino acid substitutions were found in two samples: one in Bsb-02 (T to N) at position 375 and the other in Bsb-61 (S to C) at position 343. Although all the substitutions in Bsb-68 proved to be silent, this sample showed the highest value of pairwise evolutionary distance (2.05%). In countries such as Brazil, where the virus prevalence is high and ethnicity, as well as socio-demographic characteristics, vary according to different regions, HPV variability must be wider and not yet clearly defined.