Living invisible: HTLV-1-infected persons and the lack of care in public health

Introduction

Human T-cell lymphotropic virus type 1 (HTLV-1) infection is intractable and endemic in many countries. Although a few individuals have severe symptoms, most patients remain asymptomatic throughout their lives and their infections may be unknown to many health professionals. HTLV-1 can be considered a neglected public health problem and there are not many studies specifically on patients'' needs and emotional experiences.

Objective

To better understand how women and men living with HTLV-1 experience the disease and what issues exist in their healthcare processes.

Methods

A qualitative study using participant observation and life story interview methods was conducted with 13 symptomatic and asymptomatic patients, at the outpatient clinic of the Emilio Ribas Infectious Diseases Institute, in Sao Paulo, Brazil.

Results and Discussion

The interviewees stated that HTLV-1 is a largely unknown infection to society and health professionals. Counseling is rare, but when it occurs, focuses on the low probability of developing HTLV-1 related diseases without adequately addressing the risk of infection transmission or reproductive decisions. The diagnosis of HTLV-1 can remain a stigmatized secret as patients deny their situations. As a consequence, the disease remains invisible and there are potentially negative implications for patient self-care and the identification of infected relatives. This perception seems to be shared by some health professionals who do not appear to understand the importance of preventing new infections.

Conclusions

Patients and medical staff referred that the main focus was the illness risk, but not the identification of infected relatives to prevent new infections. This biomedical model of care makes prevention difficult, contributes to the lack of care in public health for HTLV-1, and further perpetuates the infection among populations. Thus, HTLV-1 patients experience an “invisibility” of their complex demands and feel that their rights as citizens are ignored.     

Methyl- and methylthio-phenanthrenes from Micrandropsis scleroxylon

The trunk wood of Micrandropsis scleroxylon W. Rodr. (Euphorbiaceae) contains besides sitosterol, stigmasterol and ferulic acid, three novel compou     

Sugar metabolism and developmental stages of rubber tree (Hevea brasiliensis L.) seeds

Changes in the concentration of sugars and sucrose metabolism enzymes can characterize the developmental stages of a seed. In recalcitrant species such as Hevea brasiliensis L., little is known about these changes. We aimed to evaluate the three main stages of development of rubber tree seeds – histodifferentiation, cell elongation and accumulation of reserves. The activities of acid and neutral invertases (E.C. 3.2.1.26) and sucrose synthase (EC 2.4.1.13), and the concentrations of reducing sugars (RS), total soluble sugars (TSS) and sucrose (Suc) were determined concomitantly with the histochemical and anatomical evaluation of seed structure. Histodifferentiation in rubber tree seeds occurs up to 75 days after anthesis (DAA). The concentration of RS is high and of Suc is low during seed histodifferentiation, which occurs along with a visible increase in the number of cell divisions. After that period, there is an increase in the concentration of Suc (mg g^?1) and in the number and size of starch granules, and a decrease in the concentration of RS (mg g^?1). At that point, cell elongation occurs. At 135 DAA, there is an inversion in the concentration of these two sugars and an increase in reserve accumulation. Thus, in seeds of the evaluated clone, the period up to 75 DAA is characterized as the histodifferentiation stage, while from that time up to 120 DAA the cell elongation stage takes place. The final stage of seed maturation and reserve accumulation begins at 135 DAA, and the seed, including the embryo, is completely formed at 175 DAA.     

Phylogenetic Analysis of Heterothallic Neurospora Species

We examined the phylogenetic relationships among five heterothallic species of Neurospora using restriction fragment polymorphisms derived from cosmid probes and sequence data from the upstream regions of two genes, al-1 and frq. Distance, maximum likelihood, and parsimony trees derived from the data support the hypothesis that strains assigned to N. sitophila, N. discreta, and N. tetrasperma form respective monophyletic groups. Strains assigned to N. intermedia and N. crassa, however, did not form two respective monophyletic groups, consistent with a previous suggestion based on analysis of mitochondrial DNAs that N. crassa and N. intermedia may be incompletely resolved sister taxa. Trees derived from restriction fragments and the al-1 sequence position N. tetrasperma as the sister species of N. sitophila. None of the trees produced by our data supported a previous analysis of sequences in the region of the mating type idiomorph that grouped N. crassa and N. sitophila as sister taxa, as well as N. intermedia and N. tetrasperma as sister taxa. Moreover, sequences from al-1, frq, and the mating-type region produced different trees when analyzed separately. The lack of consensus obtained with different sequences could result from the sorting of ancestral polymorphism during speciation or gene flow across species boundaries, or both.     

Effect of low density lipoprotein on the quality of cryopreserved dog semen

Egg yolk is included in extenders for semen cryopreservation due to its protective effect against cold shock, which is attributed to the presence of low density lipoprotein (LDL). This study evaluates how semen quality is affected by using LDL as a replacement for egg yolk in extenders for cooled and frozen dog semen. In Experiment 1, semen was extended in TRIS–glucose at 5 °C, in four treatments: 20% egg yolk (T1); 6% (T2); 8% (T3); and 10% LDL (T4). Sperm motility and membrane integrity after 24, 48, 72 and 96 h and the 50% conservation rate of motile spermatozoa (50 M) were evaluated. The 50 M was less for T1 than for the other treatments (P < 0.01), but T2–T4 did not differ (P > 0.05). In Experiment 2, glycerol at 10% was included in the freezing extender, in treatments similar to those from Experiment 1. Sperm motility and membrane integrity did not differ for T2, T3 and T4 at any period in Experiment 1 and after thawing in Experiment 2 (P > 0.05), but were greater for all LDL treatments than for T1 (P < 0.01), in both experiments. Thus, LDL can replace egg yolk in the composition of the TRIS–glucose extender for cooled or frozen dog semen.     

Cytological evidence of natural hybridization in Brachiaria brizantha Stapf (Gramineae)

Two accessions of Brachiaria brizantha under cytological analysis showed 2 n  = 5x = 45 chromosomes. Pentaploidy probably resulted from natural hybridization between two species that were not closely related: an apomictic tetraploid male (2 n  = 4x = 36), and a sexual diploid female (2 n  = 2x = 18). The lack of affinity between genomes was clearly indicated by asynchrony during meiosis. The haploid genome ( n  = 9) showed unique behaviour, remaining univalent during prophase I and metaphase I, and undergoing sister-chromatid segregation and lagging at anaphase I. The laggard genome did not always reach the poles in time to be included in the telophase nucleus. However, when the inclusion was effective, this genome was distributed peripherally, changing the otherwise spherical nucleus shape. In the second division, the haploid genome behaved similarly, but as there was sister-chromatid segregation during the first division, the chromatids were slow to reach the poles, forming several micronuclei at telophase II. The two accessions were characterized as allo-autopentaploids, with the tetraploid genome (2 n  = 4x = 36) designated as B (from B. brizantha ) and the haploid genome as X, representing a species with a distinct genome having little affinity with the B genome. Thus, the hybrids' genome composition is represented by BBBBX. By comparing their meiotic behaviour with that observed in synthetic hybrids between B. brizantha and B. ruziziensis analysed previously, B. ruziziensis is the putative diploid sexual parent species in these pentaploid accessions.  © 2006 The Linnean Society of London , Botanical Journal of the Linnean Society , 2006, 150 , 441–446.