Clinicopathologic features and outcome of mycophenolate-induced colitis in renal transplant recipients

Reports on the clinical course of mycophenolic acid (MPA)-related colitis in kidney transplant recipients are scarce. This study aimed at assessing MPA-related colitis incidence, risk factors, and progression after kidney transplantation. All kidney transplant patients taking MPA who had colonic biopsies for persistent chronic diarrhea, between 2000 and 2012, at the Kidney Transplantation Unit of Botucatu Medical School Hospital, Brazil, were included. Cytomegalovirus (CMV) immunohistochemistry was performed in all biopsy specimens. Data on presenting symptoms, medications, immunosuppressive drugs, colonoscopic findings, and follow-up were obtained. Of 580 kidney transplant patients on MPA, 34 underwent colonoscopy. Colonoscopic findings were associated with MPA usage in 16 patients. The most frequent histologic patterns were non-specific colitis (31.3%), inflammatory bowel disease (IBD)-like colitis (25%), normal/near normal (18.8%), graft-versus-host disease-like (18.8%), and ischemia-like colitis (12.5%). All patients had persistent acute diarrhea and weight loss. Six of the 16 MPA-related diarrhea patients (37.5%) showed acute dehydration requiring hospitalization. Diarrhea resolved when MPA was switched to sirolimus (50%), discontinued (18.75%), switched to azathioprine (12.5%), or reduced by 50% (18.75%). No graft loss occurred. Four patients died during the study period. Late-onset MPA was more frequent, and no correlation with MPA dose or formulation was found.

Molecular typing and antifungal susceptibility of clinical sequential isolates of Cryptococcus neoformans from São Paulo State, Brazil

The antifungal susceptibility profiles and the genetic variability of 83 sequential clinical isolates of Cryptococcus neoformans, including four Cryptococcus gattii isolates, obtained from 38 São Paulo AIDS patients with cryptococcal meningitis were assessed by electrophoretic karyotyping and random amplified polymorphic DNA (RAPD) analysis. The majority of the Cryptococcus neoformans isolates were highly susceptible to amphotericin B and fluconazole. Twenty percent of the minimum inhibitory concentration values for amphotericin B varied from 0.5 to 1 mu g mL(-1). For fluconazole, 22% occurred in the range 8-16 mu g mL(-1). Sequential isolates from nine patients showed a trend towards lower susceptibility to fluconazole, flucytosine, itraconazole and amphotericin B. The results of molecular typing by electrophoretic karyotyping and RAPD analysis showed the presence of 22 electrophoretic karyotypes (EK) and 15 RAPD profiles that were highly correlated. Our results provided evidence for the occurrence of genetic changes in some strains associated with microevolution during the course of infection. We also observed both microevolution and simultaneous coinfection with two distinct Cryptococcus neoformans strains in one patient. In some patients, we found changed EK- and RAPD patterns in association with increased MIC values.

Chlamydial infection in a high risk population: association with vaginal flora patterns

This study aimed to determine the frequency of Chlamydia trachomatis (CT) infection among high risk Brazilian women and evaluate its association with vaginal flora patterns.This was a cross-sectional study, performed in an outpatient clinic of Bauru State Hospital, So Paulo, Brazil. A total of 142 women were included from 2006 to 2008. Inclusion criteria was dyspareunia, pain during bimanual exam, presence of excessive cervical mucus, cervical ectopy or with three or more episodes of abnormal vaginal flora (AVF) in the previous year before enrollment. Endocervical CT testing was performed by PCR. Vaginal swabs were collected for microscopic assessment of the microbial flora pattern. Gram-stained smears were classified in normal, intermediate or bacterial vaginosis (BV), and recognition of Candida sp. morphotypes. Wet mount smears were used for detection of Trichomonas vaginalis and aerobic vaginitis (AV).Thirty-four of 142 women (23.9%) tested positive for CT. AVF was found in 50 (35.2%) cases. The most frequent type of AVF was BV (17.6%). CT was strongly associated with the presence of AV (n = 7, 4.9%, P = 0.018), but not BV (n = 25, 17.6%, P = 0.80) or intermediate flora (n = 18, 12.7%, P = 0.28).A high rate of chlamydial infection was found in this population. Chlamydia infection is associated with aerobic vaginitis.

Association of two new Coryphasia species (Araneae, Salticidae) with tank-bromeliads in southeastern Brazil: Habitats and patterns of host plant use

Two allopatric species of Coryphasia (Araneae: Salticidae), both described for the first time in this study, have been found associated with Bromeliaceae in distinct phytophysiognomies (e.g., inselbergs, highland forests and restingas) from southeastern Brazil. In this study, we investigated whether these salticids were associated specifically with bromeliads, and whether they used bromeliads of different species and sizes in distinct geographic regions. The Coryphasia species were rarely found outside bromeliads, occupied larger bromeliad species among those available, and were generally more frequent on bromeliads in open areas, such as inselbergs on mountain tops. The two Coophasia species were observed submerging in phytotelmata, possibly as an anti-predatory behavior. The patterns of spatial and microspatial distribution and the submergence behavior of these species were similar to those of other bromeliad-dwelling salticids, which suggests a convergence among spiders that live on bromeliads.

Staphylococcus aureus: Resistance patterns to antimicrobials and Penicillinase among strains isolated from apparently healthy lactating cows

Ninety-two strains of Staphylococcus aureus isolated from the nasal fossa and udder skin of apparently healthy lactating cows were analyzed for resistance to antibiotics and production of penicillinase.The results showed a greater frequency of resistance patterns to penicillin and ampicillin.All strains were sensitive to oxacyllin and gentamicin.The most frequent Barber and Burston model was SSSS (60.90%), followed by RSSS (18.50%).With respect to the production of penicillinase although the Lucas method indicated a larger number of positive samples, we suggest the use of the Haight and Finland method due to a greater consistency of data obtained with it.

Fungus-growing ants (Hymenoptera: Formicidae) on Santa Catarina Island, Brazil: patterns of occurrence

A taxonomic survey on fungus-growing ants (Attini) was made at 14 beaches on Santa Catarina Island (SC), Brazil. The samplings were manual, in soil or litterfall, in the following habitats: sandy beach, herbaceous vegetation and shrubby vegetation. From 12 species of Attini (ten of Acromyrmex Mayr and two of Cyphomyrmex Mayr), the most frequent were Cyphomyrmex morschi Emery and Acromyrmex crassispinus Forel, collected, respectively, on eight and ten of the monitored beaches. Altogether, Sorensen's similarity coefficients were high (range: 0.59-0.80), in spite of the lower numbers of ant species on sandy beaches.

Structure, diversity, and spatial patterns in a permanent plot of a high Restinga forest in Southeastern Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)