Antifungal susceptibilities of clinical and environmental isolates of Cryptococcus neoformans in goiânia city, Goiás, Brasil

We evaluated the antifungal activities of amphotericin B, fluconazole, itraconazole and voriconazole in 70 Cryptococcus neoformans strains obtained from cerebrospinal fluid from AIDS patients and 40 C. neoformans strains isolated from the environment. Four clinical isolates were identified as C. neoformans var. gattii. The susceptibility test was done using a broth microdilution method according to NCCLS M27-A2. Range minimal inhibitory concentrations (MICs) for C. neoformans clinical isolates were 0.06-1.0 µg/mL for amphotericin B, 0.125-8 µg/mL for fluconazole, 0.03-0.5 µg/mL for itraconazole and 0.03-0.25 µg/mL for voriconazole. C. neoformans environmental isolates showed range MICs 0.015-0.125 µg/mL, 0.25-2.0 µg/mL, 0.007-0.125 µg/mL and 0.03-0.25 µg/mL for amphotericin B, fluconazole, itraconazole and voriconazole respectively. The MICs results obtained from clinical and environmental isolates showed similar pattern of susceptibility and no resistance has been found in our isolates.

Ten years experience with Jorge Lobo's disease in the state of Acre, Amazon region, Brazil

Jorge Lobo's disease is a cutaneous and subcutaneous mycosis that affects patients in the Amazon region. The number of patients is relatively small, but the real situation of the disease as public health problem is not known, because Jorge Lobo's disease is not a notifiable disease. This study aims to report the clinical evolution in patients affected and to determine the prevalence and areas of occurrence of the disease. A retrospective study was carried out based on the analysis of the clinical records, which included a collection of photographs of patients in the Department of Sanitary Dermatology, in Rio Branco, and patients seen in the interior of the state. In a decade, in Rio Branco, 249 cases of the disease were reported, 30 were females and 219 males. Of these patients, 153 had localized lesions, 94 of them were on one ear, 55 had multifocal lesions and 41 had disseminated lesions. The average time between the onset of symptoms and diagnosis was 19 years. The average age at the time of diagnosis was 53 years, and ages ranged from 14 to 96 years.

DISTINCT CELLULAR MIGRATION INDUCED BY Leishmania infantum chagasi AND SALIVA FROM Lutzomyia longipalpis IN A HEMORRHAGIC POOL MODEL

Recruitment of a specific cell population after Leishmania infection can influence the outcome of the disease. Cellular migration in response to Leishmania or vector saliva has been reported in air pouch model, however, cellular migration induced by Leishmania associated with host's blood and vector saliva in this model has not been described. Herein we investigated cellular migration into air pouch of hamster after stimulation with combination of L. chagasi and host's blood and Lutzomyia longipalpis saliva. Migration induced by saliva was 3-fold more than those induced by L. chagasi alone. Additionally, L. chagasi associated with blood and saliva induced significantly even more leukocytes into air pouch than Leishmania alone. L. chagasi recruited a diverse cell population; however, most of these cells seem to have not migrated to the inflammatory exudate, remaining in the pouch lining tissue. These results indicate that L. chagasi can reduce leukocyte accumulation to the initial site of infection, and when associated with vector saliva in the presence of blood components, increase the influx of more neutrophils than macrophages, suggesting that the parasite has developed a strategy to minimize the initial inflammatory response, allowing an unlimited progression within the host. This work reinforces the importance of studies on the salivary components of sand fly vectors of leishmaniasis in the transmission process and the establishment of the infection.

HCV INFECTION THROUGH PERFORATING AND CUTTING MATERIAL AMONG CANDIDATES FOR BLOOD DONATION IN BELÉM, BRAZILIAN AMAZON

This study evaluated epidemiological factors for HCV infection associated with sharing perforating and cutting instruments among candidates for blood donation (CBD) in the city of Belém, Pará, Brazilian Amazon. Two definitions of HCV infection cases were used: anti-HCV positivity shown by EIA, and HCV-RNA detection by PCR. Infected and uninfected CBD completed a questionnaire about possible risk factors associated with sharing perforating and cutting instruments. The information was evaluated using simple and multiple logistic regressions. Between May and November 2010, 146 (1.1%) persons with anti-HCV antibodies and 106 (0.8%) with HCV-RNA were detected among 13,772 CBD in Belém. Risk factors associated with HCV infection based on the EIA (model 1) and PCR (model 2) results were: use of needles and syringes sterilized at home; shared use of razors at home, sharing of disposable razors in barbershops, beauty salons etc.; and sharing manicure and pedicure material. The models of HCV infection associated with sharing perforating and cutting instruments should be taken into account by local and regional health authorities and by those of other countries with similar cultural practices, in order to provide useful information to guide political and public strategies to control HCV transmission.

SEASONAL DISTRIBUTION OF MALARIA VECTORS (DIPTERA: CULICIDAE) IN RURAL LOCALITIES OF PORTO VELHO, RONDÔNIA, BRAZILIAN AMAZON

We conducted a survey of the malaria vectors in an area where a power line had been constructed, between the municipalities of Porto Velho and Rio Branco, in the states of Rondônia and Acre, respectively. The present paper relates to the results of the survey of Anopheles fauna conducted in the state of Rondônia. Mosquito field collections were performed in six villages along the federal highway BR 364 in the municipality of Porto Velho, namely Porto Velho, Jaci Paraná, Mutum Paraná, Vila Abunã, Vista Alegre do Abunã, and Extrema. Mosquito captures were performed at three distinct sites in each locality during the months of February, July, and October 2011 using a protected human-landing catch method; outdoor and indoor captures were conducted simultaneously at each site for six hours. In the six sampled areas, we captured 2,185 mosquitoes belonging to seven Anopheles species. Of these specimens, 95.1% consisted of Anopheles darlingi, 1.8% An. triannulatus l.s., 1.7% An. deaneorum, 0.8% An. konderi l.s., 0.4 An. braziliensis, 0.1% An. albitarsis l.s., and 0.1% An. benarrochi. An. darlingi was the only species found in all localities; the remaining species occurred in sites with specific characteristics.

Toxoplasma-SPECIFIC IgG SUBCLASS ANTIBODY RESPONSE IN CEREBROSPINAL FLUID SAMPLES FROM PATIENTS WITH CEREBRAL TOXOPLASMOSIS

SUMMARY Cerebral toxoplasmosis can be highly debilitating and occasionally fatal in persons with immune system deficiencies. In this study, we evaluated the Toxoplasma gondii-specific IgG subclass antibody response in 19 cerebrospinal fluid (CSF) samples from patients with cerebral toxoplasmosis who had a positive IgG anti-T. gondii ELISA standardized with a cyst antigen preparation. There were no significant differences between the rates of positivity and the antibody concentrations (arithmetic means of the ELISA absorbances, MEA) for IgG1 and IgG2, but the rates of positivity and MEA values for these two IgG subclasses were significantly higher than those for IgG3 and IgG4. The marked IgG2 response in CSF from patients with cerebral toxoplasmosis merits further investigation.

HEPATOCELLULAR CARCINOMA IN A NON-CIRRHOTIC PATIENT WITH SUSTAINED VIROLOGICAL RESPONSE AFTER HEPATITIS C TREATMENT

Chronic infection by hepatitis C virus (HCV) is one of the main risk factors for the development of liver cirrhosis and hepatocellular carcinoma. However, the emergence of hepatocellular carcinoma (HCC) in non-cirrhotic HCV patients, especially after sustained virological response (SVR) is an unusual event. Recently, it has been suggested that HCV genotype 3 may have a particular oncogenic mechanism, but the factors involved in these cases as well as the profile of these patients are still not fully understood. Thus, we present the case of a non-cirrhotic fifty-year-old male with HCV infection, genotype 3a, who developed HCC two years after treatment with pegylated-interferon and ribavirin, with SVR, in Brazil.

Incidência da cardiopatia chagásica em 15.000 necrópsias consecutivas e sua associação com os «megas»

Os AA. estudaram, a incidência da cardiopatia chagásica em 15.000 necrópsias consecutivas e sua associação com os megas. Em 875 cardiopatias chagásicas houve 145 casos de megas, ou seja, 16,56%, com predominância do sexo masculino. No branco houve maior incidência (55) de megas do que no mulato (53) e no negro (31) dentre 858 cardiopatias chagásicas. Em 848 cardiopatias chagásicas, 85,78% eram de indivíduos que faleceram entre 21 e 60 anos. O maior número de cardiopatias (120 ou 14,14%) e de "megas'' (21 ou 15,78%) foi encontrado nos indivíduos entre 36 a 40 anos. Os nossos resultados mostram uma incidência diferente da associação cardiopatia-mega, em comparação da observada em outras regiões do País e em outros países da América do Sul.

Diagnóstico laboratorial de varíola: II. resultados do segundo ano de atividades, de maio de 1969 a maio de 1970

Os autores relatam os resultados obtidos no diagnóstico laboratorial de varíola, durante o segundo ano de funcionamento de uma unidade montada no Instituto Presidente Castello Branco, da Fundação Instituto Oswaldo Crus, no Rio de Janeiro. O exame de 105 espécimens de crostas e de 76 de líquido vesicular /pustular, forneceu 39 e 34 amostras de vírus da varíola, respectivamente (Tabela 1). A demora em chegar ao laboratório influencia significativamente a taxa de isolamento de vírus (Tabela 2). Foi encontrada estreita relação entre os diagnósticos clínico e laboratorial (Tabela 3), quando possível compará-los. A inoculação em ovos embrionados após 1 a 2 horas do abaixamento da mebrana cório-alantóica, foi considerada como adequada às condições em que são realizados os exames. O laboratório continua a receber regularmente mais especimens para diagnóstico.

Rinosporidiose nasal - estudo de 11 casos

Os A. A. apresentam 11 casos de rinosporidiose nasal, cujos aspectos clínicos, anatomo-patológicos e epidemiológicos são analisados. Os pacientes - um negro, um branco e nove de cor parda, todos rurícolas - tinham de 6 a 33 anos. Nove eram áo sexo masculino. O tempo de evolução da doença variou de três meses a quatro anos e havia um caso com três recidivas. A grande maioria era proveniente do Maranhão.

Epidemiologic studies of chagas' disease in the urban zone of Teresina. State of Piauí, northeastern Brazil

The triatomine species Rhodnius nasutus and Triatoma pseudomaculata were captured on palm trees Orbignya martiana "babaçu ", in the urban zone of Teresina. This kind of palm tree is largely distributed in Piauí State. The predominant species was R. nasutus; the young in stars predominated. The infestation index of palm trees and the infection index of triatomines by flagellates were 96.0 ana 29.1%, respectively. Marsupiais, bats and a rodent were captured in palm trees. The flagellates found in both triatomines ana marsupiais were morphologically and biologically indistinguishable from Trypanosoma cruzi. Forty seven percent (481/1,025) of triatomines were found concentrated in six palm trees where marsupiais circulated. Of the total of 1,025 triatomines 230 (22%) were infected by flagellates and 53.0% (123/230) of these infected triatomines were present in the same six palm trees. No evidence of triatomine domiciliation or human transmission was observed in the houses in the vicinity of palm trees. The results suggest that marsupiais play an important role in the life-cycle of T. cruzi in this region. The natural focus of Chagas' disease, demonstrated in the present study could represent a potential epidemiological threat.

Hemoglobinopatias no Distrito Federal, Brasil

Em uma amostra de 3137 pessoas, residentes no Distrito Federal, foram detectadas as seguintes hemoglobinas: em 3009(95,92%) HbAA; em 91 (2,90%) HbAS; em 20(0,64%) HbAC; em 8 (0,26%) talassemia beta minor; em 5(0,16%) HbAJ alfa; em 3 (0,09%) HbAM e em 1 (0,03%) talassemia major associada com HbAS. A HbAS têm as seguintes freqüências, quanto ao grupo racial: branco - 1,84%; mulato claro 2,55%; mulato médio-3,68%; mulato escuro - 6,80%; negro -10,43% e mestiço de índio -3,85%.

Resultado do uso de um esquema terapêutico para Plasmodium vivax em cinco dias em três municípios da ilha de São Luís, Estado do Maranhão, Brasil

Foram tratados pela Cloroquina, 1500mg (em três dias) e Primaquina, 75mg (adulto 15mgx 5 dias) 1232 pacientes acometidos de malária por Plasmodium vivax, na Ilha de São Luís-MA, no período de janeiro de 1984 a dezembro de 1985. Destes casos, 499 (40,5%) concluíram o tratamento; 164 (13,3%) encontram-se em fase de verificação de cura e 569 (46,2%) que o abandonram. Dentre os pacientes (10%) concluíram 448 (90%) curaram-se, e 51% recaíram. Estes responderam ao curso de tratamento com o mesmo esquema.

Forma hepatosplênica da esquistossomose mansônica, em relação à composição racial e ao nível sócio-econômico, em Catolândia-Bahia

De 1125 indivíduos, residentes em área hiperendêmica de esquistossomose mansônica, estudou-se a apresentação clínica, relacionada aos grupos raciais (mestiço de índio, branco, mulato-claro, mulato-médio, mulato-escuro e negro) e ao nível sócio- econômico, conforme o somatório de 16 variáveis. Em 229 indivíduos brancos havia 24 (10,5%) com a forma hepatosplênica, significantemente superior, em comparação, com 32 (3,6%) dos 896 não-brancos; entre os grupos raciais negroides ocorreram freqüências semelhantes. Os hepatosplênicos apresentaram nível sócío-econômíco mais alto e quando, também, brancos, o risco relativo (2,78) foi marcadamente superior.