The aetiology of Parkinson's disease (PD) is still unclear. Research findings suggest that both environmental and genetic factors may contribute to its development. The interactions between genes and the environment might exist and play a key role. Cigarette smoking was found to be one of the few factors exhibiting a protective effect. If chemical compounds found in cigarette smoke influence PD risk, the difference in the ability of certain individuals in metabolising these substances might alter their susceptibility to the risk of developing PD. Many metabolic enzyme genes exhibit polymorphic traits with alteration of gene function. These might be associated with an altered susceptibility of individuals to PD. Few studies have examined the hypothesis that metabolic enzyme gene polymorphisms might modulate the effect of smoking on PD risk. However, it is crucial to consider these potential interactions when we try to elucidate the aetiology of PD. Even if each factor only contributes a slight variation and influences a small portion of the whole population, non-linear and unpredictable interactions may account for a high proportion of the aetiological fraction. Previous studies have not been strictly designed to examine the interactions between smoking and metabolic enzyme genetic polymorphisms. These studies have not been able to elucidate the extent of the interaction. Therefore, this PhD project attempted to examine whether genetic factors, operating in the phase one and phase two metabolic pathways, interact with smoking to influence the development of PD. This is the first genetic epidemiological study of PD specifically addressing this issue. The research aids in further understanding the aetiology of PD and may be useful for identifying people at higher risk. A case-only design was chosen for this project for two reasons: first, PD is a relatively rare disease and the case-only design is much more efficient at detecting gene-environment interactions; second, the PD cases for the project were recruited over the past few years and represent a prevalence series, for which an appropriate comparison group for the cases is difficult to identify and recruit. In a case-only study, only cases are used to investigate the multiplicative effects of the exposures and susceptible genotypes of interest, while non-case subjects (traditionally controls) are solely used to test the independence between the exposure and the susceptible genotype. Therefore, this approach avoids the challenges of control selection, a major limitation inherent in the case-control approach. This thesis comprised of three independent studies: the first study investigated the interactions between genetic polymorphisms of GSTM1, P1, T1 and Z1 and smoking in PD; the second study examined the interactions between genetic polymorphisms of CYP2E1 and smoking in PD; and the third study examined the interactions between genetic polymorphisms of CYP2D6 and smoking in PD. The first two studies recruited 400 white Caucasian PD cases from both hospital wards and private neurology clinics (230 men and 170 women). The third study further included 142 white Caucasian PD cases newly recruited from the same sources (542 in total, 321 men, and 221 women). The mean age of cases was 67 years with the average onset age at 60 years. GSTM1, GSTP1, GSTT1, GSTZ1 AND CYP2E1 genotyping processes were performed using protocols previously published with minor modification, whereas CYP2D6 genotyping methods were mainly developed by me with assistance from associate supervisor Dr. George Mellick. Reliability and validity of the PCR and RFLP methods were assessed through re-conducting the genotype assays using at least a 10% sample of our DNA samples. The results for all re-assessments were 100% concordant. Crude bivariate analyses were adjusted for potential confounding effects of the variables, including age at onset, gender, family history of PD and pesticide exposures. Among our unaffected, aged subjects (mean age: 63.9 years, sd: 11.4 years), the genotype frequencies at each locus were similar to those reported in other Caucasian populations. The first study showed that the proportion of carriers of the GSTP1-114Val allele (mutant) increased with increasing smoking dose from 0 to > 30 pack-years. Homozygotes of the 114Ala allele (wild-type) decreased with increasing smoking dose (trend test: p=0.02). This trend existed both in male and female cases. This dose-effect relationship was most significant in the group of cases with late-onset PD (i.e., age at onset > 55 years) with the ORicase-only values of 1.88 (95%CI: 0.65-5.48) and 2.63 (95%CI: 1.07-6.49) for > 0-10 and > 10 pack-years, respectively. No similar trend was found among our unaffected, aged subjects (p=0.42). Haplotype analyses revealed significant differences for GSTP1 haplotypes between smoking and non-smoking PD cases (ORicase-only for *C haplotype=2.00 (95%CI: 1.11-3.60), p=0.03). In this case, smoking-exposed PD cases were more likely to posses the *C haplotype defined by A to G base-pair transition at nucleotide +313 and C to T base-pair transition at nucleotide +341 (at amino acid level, valine at both positions 105 and 114). The second study found no difference in CYP2E1 genotype frequencies between PD cases who ever smoked compared to those who never smoked (odds ratio for interaction (ORi) = 1.00 (95% CI: 0.39-2.51, p=0.99)). No CYP2E1 gene-smoking interactions were detected in relation to age at onset of PD. The third study found that among cases without regular pesticide exposures, CYP2D6 PMs who smoked more than 5 pack-years had a later mean age at disease onset (68.6 years) than those with extensive metaboliser phenotypes (EMs) (61.1 years, p=0.02) and non-smokers (60.5 years, p=0.01). Analysis of aged subjects without PD confirmed that neither smoking status nor CYP2D6 PM status was associated with age itself. Our data suggest: 1. smoking exposure is independent of GSTM1, P1, T1, Z1 and CYP2E1 genotypes; 2. smoking may be, to some extent, associated with CYP2D6 genotypes; 3. there are no multiplicative interactive effects linking smoking and GSTM1, T1, Z1 or CYP2E1 genotypes with the risk for PD; 4. there is a multiplicative interactive effect between smoking and GSTP1 haplotype - particularly for genotypes carrying the 114Val allele; and 5. there is a multiplicative interactive effect between smoking and CYP2D6 PMs - particularly for people who ever smoked cigarettes more than 5 pack-years. In general, this thesis provides a model for exploring the gene-smoking interactions in PD. Further studies need to consider the recruitment of a large number of population-based and randomly-selected samples and to pay more attention to measurement of environmental exposures. Further studies also need to examine simultaneously the impact of smoking, pesticide exposures and other potential risk factors on PD. These studies will build evidence for interactions contributing to this common neurological movement disorder.

Orientador: Rogério Saad Hossne / Resumo: Introdução: As Doenças inflamatórias intestinais (DII), que tem como principais entidades a Retocolite Ulcerativa (RCU) e a Doença de Crohn (DC), tem altas taxas de incidência e prevalência em países desenvolvidos, especialmente da Europa e América do Norte, porém com aumento progressivo de sua frequência em todas os continentes. Este estudo visa estimar as taxas de incidência e prevalência das DII no Estado de São Paulo, Brasil, entre os anos de 2012 e 2015, e correlacionar os resultados com dados nacionais sobre estas doenças. Material e Método: Este é um estudo observacional analítico, do tipo descritivo e transversal. Foram incluídos dados epidemiológicos de 22.638 pacientes que iniciaram seu tratamento para Doença Inflamatória Intestinal através do programa de fornecimento gratuito de medicamentos do Estado de São Paulo, entre os anos de 2012 e 2015. As variáveis analisadas foram a data do início do tratamento, o diagnóstico clínico (DC ou RCU), a idade, gênero, cor/raça/etnia dos pacientes, assim como sua região de residência no Estado de São Paulo. As análises estatísticas incluíram média e desvio padrão para variáveis quantitativas. O nível de significância adotado foi de 1% Resultados: A taxa de incidência de DII no Estado de São Paulo foi, em média, de 13,31 casos novos / 100.000 habitantes / ano, enquanto a prevalência de DII no Estado de São Paulo foi de 52,5 casos / 100.000 habitantes. Os portadores de DC somavam 10.451 (46,16%), e os de RCU somavam 12.187 (53,83... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Inflammatory bowel disease (IBD), which has as its main entities Ulcerative Colitis (UC) and Crohn's Disease (CD), have high rates of incidence and 11 prevalence in developed countries, especially in Europe and North America, but with increasing frequency in all continents. This study aims to verify the incidence and prevalence rates of IBD in São Paulo State, Brazil, between the years 2012 and 2015, and correlate with the national data on these diseases. Casuistic and Methods: This is an observational, descriptive and cross-sectional study. We included data from 22.638 patients who started their treatment for Inflammatory Bowel Disease through the Program of free medication supply of São Paulo State, between the years of 2012 and 2015. The variables analyzed were the date of beginning of treatment with drugs provided by the clinical diagnosis (CD or UC), the age, gender, color/race/ethnicity of the patients, as well as their region of residence in São Paulo State. Statistical analyses included mean and standard deviations for quantitative variables. The level of significance adopted was 1% Results: The incidence rate of IBD in the State of São Paulo was 13.31 new cases / 100.000 inhabitants per year, while the overall prevalence of IBD in the state of São Paulo was 52,5 cases/100.000 inhabitants. The patients with CD were 10,451 (46.16%), and those with UC were 12,187 (53.83%), from 1 to 97 years of age, with a mean of 45.5 years (SD = 16.7), of wich 9,124 (40.30%) were male... (Complete abstract click electronic access below) / Doutor

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Bakgrund: Alzheimers är en långsam progressiv sjukdom och är den vanligaste demenssjukdomen. Sjukdomen innebär försämrat närminne och begränsar kommunikationsförmågan. Hur smärta uttrycks i jämförelse med friska personer i samma ålder är oklart. Syfte: Syftet var att belysa hur personer med Alzheimers sjukdom uttrycker sin smärta. Metod: Arbetet var en litteraturöversikt med systematiska sökningar som gjordes i tre databaser. Resultat: Denna litteraturstudie belyste tre olika kategorier: Variation av uttalad smärtintensitet, manifestation av smärta och skattning av smärta. Slutsats: Det som framträdde var att hur personer med Alzheimers sjukdom uttryckte sin smärta inte gick att generalisera, smärta upplevdes olika för varje individ. Observerande skalor var att föredra framför självskattningsskalor vid bedömning av smärta hos personer med Alzheimers sjukdom. / Alzheimer disease is a slow progressive disease that is the most common type of dementia. The disease cause deterioration of cache and limit the ability to communicate. How pain is expressed in comparison to healthy people of the same age is unclear. Aim: The purpose was to highlight how people with Alzheimer's disease expressed their pain. Result: This literature study has highlighted three different categories: The variation of pain intensity, manifestation of pain and estimation of pain. Conclusion: What emerged was how people with Alzheimer's disease expressed their pain could not be generalized, pain was different for each individual. Observing scales was preferable to self-assessment scales for pain assessment in people with Alzheimer's disease.

Adenosine is a ubiquitous metabolite with multiple physiological functions in organisms. In this thesis, I studied the effect of extracellular adenosine on Huntington´s disease (HD) model Drosophila melanogaster. I show that extracellular Adenosine signaling mitigates HD pathology by observing three main types of symptoms of the disease in Drosophila. The results suggest that the mechanism involves Drosophila melanogaster adenosine receptor signaling.

This diploma thesis focuses on the care for persons with AD and the limits of care for these persons in a regular program facility. For several years already, the life expectancy has been increasing. However, this relates to the fact of increasing number of people suffering from diseases connected especially with the end of one's life, AD being no exception. This diploma thesis consists of theoretical and empirical parts. The aim of the theoretical part was to study and then analyse professional literature related to the topic. The theoretical part of the thesis is divided in three chapters. The main aim of the thesis was to find out, whether regular program facilities are capable of taking care of a client with dementia. Partial aims were to discover in which areas the employees of the regular program facility feel the strain while taking care of a person with dementia and how this client is perceived by other clients. While collecting data for the empirical part of the thesis, qualitative survey, inquiry and semi-structured interview were used as the methods of choice. The prepared questions were divided in five groups, making a total of 32. Through the survey I've found the regular program facilities able to take care of clients with AD. Since living together of clients with and without AD is possible, although problematic, it burdens the caring personnel, who see the most common problem in the regular program facility in a lack of time for clients, for taking care of them and communicating with them, and also in a small number of staff compared to the number of clients. According to my survey, the employees of a regular program facility mostly perceive situations connected with changing behaviour of clients with AD as stressful. This includes wandering of clients, their aggressiveness, the need of a different daily regime of a client with AD (sleep, diet) and complains on the behaviour of clients with AD from those without the disease. The employees are also under stress from the communication with clients with AD. I've also learned that clients without AD, according to the caring staff, perceive the clients with AD as problematic, they know that those receive more attention from the personnel and some clients with AD disturb other clients. However, living together of both groups is possible. I suppose that the number of patients with AD plays a part here, while it's not high in a regular program facility, and therefore clients with AD don't disrupt business as usual in the facility. From the empirical part of the thesis, following hypothesis can be made: The regular program facilities will take care of the clients with AD better, when the number of caring staff increases. The suggested hypothesis needs to be verified through a higher number of respondents. I assume that this thesis can serve as a source of information to both lay public and experts in the field of care for persons suffering from AD.

Made available in DSpace on 2014-06-11T19:32:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-01-10Bitstream added on 2014-06-13T19:43:39Z : No. of bitstreams: 1 oliveira_lg_dr_jabo.pdf: 2434476 bytes, checksum: 7f35c972fe80e9df46284df3347b98ab (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A doença de Aujeszky (DA) é uma enfermidade conhecida na suinocultura pelo seu grande impacto produtivo e econômico. O Estado de São Paulo (SP) não é considerado área livre para DA, pois há evidências de circulação do vírus. Por isso, este trabalho teve como objetivo a identificação, o diagnóstico da situação epidemiológica e a avaliação de estratégias para a erradicação de focos de DA em sistema de produção de suínos no Estado de SP. Foram identificados dois focos da enfermidade no Município de Cerqueira César, um apresentou somente animais sororreagentes (Foco 1), e outro, casos clínicos da enfermidade (Foco 2). Para a erradicação da DA foram tomadas ações de defesa sanitária animal, sendo avaliadas duas estratégias: (A) eliminação de animais sororreagentes e (B) despovoamento gradual, com acompanhamento durante 12 meses. A erradicação por eliminação dos sororreagentes foi aplicada no Foco 1 e compreendeu: identificação por teste sorológico, isolamento e abate dos sororreagentes; vacinação dos negativos, reposição no plantel com animais livre de DA e avaliação dos índices produtivos. No início do estudo, 68% do plantel eram sororreagentes e, no final, 51%. No Foco 2 utilizou-se o despovoamento gradual; todos os animais foram enviados gradativamente ao abate sanitário, até que fosse estabelecido o vazio sanitário das instalações e, somente depois repovoado com animais livres da DA. Como essa última estratégia, apresentou maior eficácia, pois erradicou a DA no Foco 2, a mesma também foi aplicada no Foco 1, tendo em vista o insucesso da estratégia A inicialmente aplicada. Ao final, após monitoramentos sorológicos, concluiu-se que a DA foi erradicada em todos os focos identificados / Aujeszky´s disease (AD) is an important viral affection within the swine production, once it plays a significant role in economic losses. São Paulo state is not considered free of the disease, once evidences show that there is circulation of the virus. This study aimed to identify the epidemiologic situation and evaluation strategies for the eradication of outbreaks of AD in system of swine production in the state of Sao Paulo. Two outbreaks were identified in the Cerqueira César county, one of them only seroreagents were observed (Outbreak 1), and in the other, clinical signs were seen (Outbreak 2). In order to eradicate the disease, two sanitary strategies were tested: (A) eradication by means of positive serology and; (B) gradual depopulation, with a follow up of 12 months. The eradication by means of serology was used in the Outbreak 1, and included the identification, isolation and sacrifice of positives animals; vaccination of negative subjects, replacement with naive subjects, and assessment of production indices. At the beginning, 68% of animals were positive, and at the end 51% were positive. In Outbreak 2, gradual depopulation was employed, and all animals were sent to sanitary slaughter, until facilities were completely empty. Afterwards, animals free of the disease were used to repopulation. At the end of the study, it was observed that the last strategy was more effective, being, therefore, used in the outbreak 1. Finally, after serological monitoring, it was concluded that the AD was eradicated in all outbreaks identified

Made available in DSpace on 2016-06-02T19:48:19Z (GMT). No. of bitstreams: 1 4177.pdf: 5761817 bytes, checksum: cb8d207716a1afe86708253767f3f7ee (MD5) Previous issue date: 2012-02-24 / Financiadora de Estudos e Projetos / Alzheimer's disease (AD) is the most common cause of dementia in people over 65 years. Platelet studies with ADAM10 have shown to decrease its expression in AD patients. The association between cognitive testing and molecular biomarkers such as levels of platelet ADAM10 protein can be important tools for the accurate and early diagnosis of AD. The aim of this research was to investigate the relationship between the Mini-Mental State Examination - MMSE and the Clinical Dementia Rating - CDR with the ADAM10 expression in two groups of elderly. 30 subjects with AD were compared with 25 matched controls by sex, age and education. All ethical considerations were observed. Individual evaluations were carried out and applied the CDR and MMSE, and then performed the collection of biological material of the elderly. The techniques SDS-PAGE and Western blotting were used to quantify the ADAM10 content in platelets. After collecting the data, they were analyzed using statistical methods of comparison, correlation, association, logistic regression and diagnostic accuracy. The results show that the ratio ADAM10/_-actin was reduced in elderly patients with AD and that this reduction is intensified with the progression of the disease. MMSE and CDR have significant correlations with the values of ratio ADAM10/_-actin, this being the only statistically significant variable (p = 0.01) to increase the probability of occurrence of AD. The cutoff value < 0.4212 in ROC curve captures 70% sensitivity and specificity of 80.77% for the presence of AD according to the ratio ADAM10/_-actin. Therefore, the ratio ADAM10/_-actin seems to be a relevant biomarker for AD. The results bring important contributions to an accurate diagnosis of Alzheimer's disease from the perspective of ADAM10 as a biomarker for this disease. The results are preliminary but encouraging. / A doença de Alzheimer (DA) é a causa mais comum de demência em pessoas com mais de 65 anos de idade. Estudos plaquetários com a ADAM10 têm demonstrado diminuição na sua expressão em pacientes com DA. A associação entre testes de avaliação cognitiva e biomarcadores moleculares, tais como os níveis plaquetários da proteína ADAM10 podem contribuir para o diagnóstico preciso e precoce da DA. O objetivo desta pesquisa foi verificar a relação entre o Mini-Exame do Estado Mental MEEM e o Clinical Dementia Rating CDR com a expressão da ADAM10 em dois grupos de idosos. 30 sujeitos com DA foram comparados com 25 controles, pareados segundo sexo, idade e escolaridade. Todos os cuidados éticos foram observados. Foram realizadas avaliações individuais e aplicados o CDR e MEEM e em seguida realizada a coleta do material biológico dos idosos. As técnicas SDSPAGE e Western Blotting foram utilizadas para detecção da ADAM10. Após a coleta dos dados, estes foram analisados por meio de métodos estatísticos de comparação, correlação, associação, regressão logística e acurácia diagnóstica. Os resultados mostram que a razão ADAM10/_-actina apresenta-se diminuída em idosos com DA e que esta redução se intensifica com o avanço da doença. O MEEM e o CDR apresentam correlações significativas com os valores da razão ADAM10/_-actina, sendo esta a única variável estatisticamente significativa (p = 0,01) para o aumento da probabilidade de ocorrência da DA. O ponto de corte < 0,4212 da curva ROC capta sensibilidade de 70% e especificidade de 80,77%, para a presença de DA segundo a razão ADAM10/_-actina. Portanto, a razão ADAM10/_-actina parece ser um relevante biomarcador para DA. Os resultados trazem contribuições importantes para um diagnóstico preciso da doença de Alzheimer na perspectiva da ADAM10 como um biomarcador para esta doença. Os resultados são preliminares, porém animadores.

Xylella fastidiosa é uma bactéria fitopatogênica transmitida por insetos vetores conhecidos como cigarrinhas (Hemiptera: Cicadellidae, Subfamília Cicadellinae). Uma estirpe desta bactéria causa o Mal de Pierce em videira nos EUA e México. No Brasil, esta bactéria ainda não foi detectada colonizando videira, embora esta cultura tenha importância em algumas regiões Nesta pesquisa foi feito um levantamento faunístico de cigarrinhas da família Cicadellinae por meio de armadilhas adesivas amarelas em vinhedos dos Estados do Rio Grande do Sul e Pernambuco, com o objetivo de identificar potenciais vetoras de X. fastidiosa e sua flutuação populacional. Para a obtenção das cigarrinhas foram realizadas coletas com cartões adesivos amarelos em quatro parreirais comerciais de Vitis vinifera para cada Estado. Em cada parreiral foram instalados 20 cartões, distribuídos em 10 pontos espaçados de 40 x 40 m, com duas alturas de amostragem (45 cm do solo e 45 cm acima da lâmina foliar de videira). Os cartões adesivos foram trocados quinzenalmente no período de setembro/2004-setembro/2006 e junho/2005-junho/2007 no Rio Grande do Sul e Pernambuco, respectivamente. Baseando-se em análise faunística, determinaram-se as espécies de cigarrinhas mais abundantes, constantes, freqüentes e dominantes, as quais foram avaliadas quanto à flutuação populacional. No Rio Grande do Sul, 34 espécies de cicadelíneos e 6 de cercopídeos foram encontradas. Porém, a maioria (98,4%) dos 3,893 espécimes coletados foram cicadelídeos, distribuídos nas subfamílias Cicadellinae (n = 2.344; 23 espécies), Gyponinae (n = 1.327; 9 espécies), Deltocephalinae (n = 147; 1 espécie) e Coelidinae (n = 13; 1 espécie). Os insetos da subfamília Cicadellinae foram divididos nas tribos Cicadellini (n = 1.606; 12 espécies) e Proconiini (n = 738; 11 espécies). Dentre os cicadelíneos, 5 espécies de Cicadellini (Bucephalogonia xanthophis, Dilobopterus dispar, Macugonalia cavifrons e a morfo-espécie Cicadellini sp. 1) e 5 de Proconiini (Molomea consolida, Oncometopia facialis, Oncometopia fusca e Tapajosa rubromarginata) prevalecem nos vinhedos do Rio Grande do Sul, de acordo com as análises faunísticas. Nos vinhedos de Pernambuco, verificou-se uma menor diversidade de espécies de cigarrinhas em relação aos do Rio Grande do Sul. Um total de 4.106 cicadelídeos foram coletados, pertencentes a duas subfamílias: Cicadellinae (n = 4.094; 4 espécies) e Gyponinae (n = 12; 2 espécies). A espécie mais abundante foi a H. spottii com 3.965 indivíduos encontrados. Esta espécie utiliza a videira como hospedeiro de oviposição e desenvolvimento. Os períodos de maior ocorrência de cigarrinhas nos vinhedos são de outubro a agosto na Serra Gaúcha, e de janeiro a junho em Pernambuco. Neste estudo também foi testada a possibilidade de transmissão por cigarrinhas de uma estirpe de X. fastidiosa de citros, causadora da Clorose variegada dos citros (CVC), para videira e ameixeira. Não houve transmissão para videira, indicando que a estirpe de X. fastidiosa de citros pode não ser capaz de estabelecer infecção sistêmica em videira, após a inoculação por inseto vetor. No entanto, a diversidade e abundância de cigarrinhas potenciais vetoras nos Estados de Pernambuco e Rio Grande do Sul indicam um grande risco para disseminação do Mal de Pierce em videira caso uma estirpe de X. fastidiosa patogênica a esta cultura seja introduzida ou evolua a partir de estirpes existentes no Brasil. / Xylella fastidiosa is plant-pathogenic bacterium transmitted by leafhoppers (Hemiptera: Cicadellidae) in the subfamily Cicadellinae, commonly known as sharpshooters. In the United States and Mexico, a particular strain of this bacterium causes Pierce\'s disease (PD) in grapevines. PD has not been reported in Brazil, although grape is a major crop in some regions of this country. In this study, a 2-year survey of Cicadellidae leafhoppers was carried out by yellow sticky traps in vineyards of the States of Rio Grande do Sul and Pernambuco, in order to identify potential vectors of X. fastidiosa as well as their seasonal patterns of occurrence in the crop. The survey was conducted in four commercial plantings of Vitis vinifera L. per State, by using 20 traps distributed in 10 sampling points and 2 heights (45 cm above soil and 45 cm above the crop canopy) per vineyard. The cards were changed fortnightly during the periods of September/2004-September/2006 and June/2005-June/2007 in the States of Rio Grande do Sul and Pernambuco, respectively. Faunistic analyses of the trapping data from each vineyard were run to determine the most abundant, constant, frequent and dominant sharpshooter species, for which the population fluctuation was studied. In Rio Grande do Sul, 34 leafhopper and 6 spittlebugs (Hemiptera: Cercopidae) species were trapped, but most (98.4%) of the 3,893 specimens collected were leafhoppers, which were distributed in the subfamilies Cicadellinae (n = 2,344; 23 species), Gyponinae (n = 1,327; 9 species), Deltocephalinae (n = 147; 1 species) and Coelidinae (n = 13; 1 species). The sharpshooter (Cicadellinae) specimens were divided in the tribes Cicadellini (n = 1,606; 12 species) and Proconiini (n = 738; 11 species). Among the sharpshooters, 5 species of Cicadellini (Bucephalogonia xanthophis, Dilobopterus dispar, Macugonalia cavifrons and the morpho-species Cicadellini sp. 1) and 5 of Proconiini (Molomea consolida, Oncometopia facialis, Oncometopia fusca and Tapajosa rubromarginata) are prevalent in vineyards of Rio Grande do Sul based on the faunistic indices. In the vineyards of Pernambuco State, a different species composition and a lower diversity of sharpshooters were found. A total of 4,106 leafhopper specimens were trapped, distributed in two subfamilies: Cicadellinae (n = 4,106; 4 species) and Gyponinae (n = 12; 2 species). H. spottii was the most abundant sharpshooter, with 3,965 specimens. The periods of higher sharpshooter populations in the vineyards are from October to August in Rio Grande do Sul, and from January to June in Pernambuco. The possibility of transmission of a Citrus variegated chlorosis (CVC) strain of X. fastidiosa from citrus to grape was tested by using the sharpshooter B. xanthophis as a vector. No transmission to the test plants was recorded, suggesting that the CVC strain may not establish systemic infections in grape after vector inoculation. However, the diversity and abundance of native sharpshooters found in Rio Grande do Sul and Pernambuco indicate a high risk of PD spread in vineyards if a pathogenic strain of X. fastidiosa to grapes evolves or is introduced in Brazil.

CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior / IntroduÃÃo. A leptospirose à uma doenÃa endÃmica no Nordeste, sendo caracterizada por complicaÃÃes potencialmente fatais como a lesÃo renal aguda (LRA). O objetivo deste estudo foi avaliar as manifestaÃÃes clÃnicas, a classificaÃÃo da LRA e os fatores de risco para Ãbito em pacientes com a forma grave de leptospirose. MÃtodos. Foi realizado estudo retrospectivo em pacientes com a forma grave de leptospirose internados em hospitais terciÃrios na cidade de Fortaleza, nordeste do Brasil. Foram avaliadas as manifestaÃÃes clÃnicas, os exames laboratoriais na admissÃo e durante a internaÃÃo e o tratamento instituÃdo. LRA foi definida de acordo com as classificaÃÃes RIFLE e AKIN, sendo comparados os pacientes nas diferentes classes. Foram comparados os pacientes que usaram com aqueles que nÃo usaram penicilina, assim como os pacientes que sobreviveram com os que foram a Ãbito. AnÃlises univariada e multivariada foram usadas para a investigaÃÃo dos fatores de risco para Ãbito. A anÃlise estatÃstica foi feita pelo programa SPSS versÃo 10.0. Resultados. Foram incluÃdos 287 pacientes, com mÃdia de idade de 36,8Â15,6 anos, sendo 80,8% do sexo masculino. Os principais sinais e sintomas apresentados foram febre (96,2%), mialgia (90,6%), icterÃcia (85,7%), cefaleia (74,2%), vÃmitos (70,7%), desidrataÃÃo (54%) e calafrios (53,7%). LRA foi observada em 237 pacientes (82%) pelo critÃrio RIFLE e 242 (84%) pelo AKIN. A mortalidade geral foi de 13%. A mortalidade foi semelhante nos pacientes que usaram e que nÃo usaram penicilina (11,6% vs. 13,7%, p=0,60). Aumento da mortalidade foi observado de acordo com as piores classificaÃÃes: RIFLE-R (2%), RIFLE-I (8%) e RIFLE-F (23%), assim como AKIN 1 (2%), AKIN 2 (8%) e AKIN 3 (23%), p < 0,0001. Os pacientes com oligÃria tiveram maior mortalidade (20%), em comparaÃÃo com os pacientes sem oligÃria (5%), p=0,02. Os fatores de risco independentes para Ãbito foram: RIFLE-F (OR=10,5, IC 95%=1,3-80,8, p<0,001), AKIN 3 (OR=7,5, IC 95%=2,2-25,2 p<0,001) e necessidade de diÃlise (OR=3,5, IC 95%=1,1-11,01, p=0,01). ConclusÃes. A LRA à uma complicaÃÃo frequente na leptospirose, com mortalidade significativa. Houve associaÃÃo entre as classificaÃÃes RIFLE e AKIN com a mortalidade na leptospirose. Os fatores de risco independentes para Ãbito sÃo classificaÃÃo RIFLE-F, AKIN 3 e necessidade de diÃlise. / Introduction. Leptospirosis is en endemic disease in Northeast of Brazil, which is characterized by potential fatal complications such as acute kidney injury (AKI). The aim of this study was to evaluate the clinical manifestations, the AKI classification and the risk factors for death in patients with the severe form of leptospirosis. Methods. A retrospective study was conducted in patients with severe form of leptospirosis admitted to tertiary hospitals in Fortaleza city, Northeast of Brazil. The clinical manifestations, laboratory tests at admission and during hospital stay, as well as treatment, were evaluated. AKI was defined according to the RIFLE and AKIN classifications, and the patients in each category were compared. Patients who used and who did not use penicillin, as well as survivors and non-survivors, were compared. Univariate and multivariate analysis were performed to investigate the risk factors for death. Statistical analysis was done with SPSS program version 10.0. Results. A total of 287 patients were included, with a mean age of 36.8Â15.6 years, and 80.8% were male. The main signs and symptoms at admission were fever (96.2%), myalgia (90.6%), jaundice (85.7%), headache (74.2%), vomiting (70.7%), dehydration (54%) and chills (53.7%). AKI was observed in 237 patients (82%) according to the RIFLE criteria and 242 (84%) according to AKIN. General mortality was 13%. Mortality was similar in patients who used and who did not use penicillin (11.6% vs. 13.7%, p=0.60). An increase in mortality was observed according to the worst classifications of RIFLE and AKIN: RIFLE-R (2%), RIFLE-I (8%) e RIFLE-F (23%), AKIN 1 (2%), AKIN 2 (8%) e AKIN 3 (23%), p<0.0001. Patients with oliguria had a higher mortality (20%), when compared to those without oliguria (5%), p=0.02. Independent risk factors for death were: RIFLE-F (OR=10.5, 95% CI=1.3-80.8, p<0.001), AKIN 3 (OR=7.5, 95% CI=2.2-25.2 p<0.001) and need of dialysis (OR=3.5, 95% CI=1.1-11.01, p=0.01). Conclusions. AKI is a frequent complication in leptospirosis, with significant mortality. There was association between RIFLE and AKIN classifications with mortality. Independent risk factors for death were RIFLE-F, AKIN 3 and need of dialysis.