Anxiety, Depression, and General Psychological Distress in Patients with Coronary Slow Flow

AbstractBackground:The relationship between psychiatric illness and heart disease has been frequently discussed in the literature. The aim of the present study was to investigate the relationship between anxiety, depression and overall psychological distress, and coronary slow flow (CSF).Methods:In total, 44 patients with CSF and a control group of 50 patients with normal coronary arteries (NCA) were prospectively recruited. Clinical data, admission laboratory parameters, and echocardiographic and angiographic characteristics were recorded. Symptom Checklist 90 Revised (SCL-90-R), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) scales were administered to each patient.Results:The groups were comparable with respect to age, sex, and atherosclerotic risk factors. In the CSF group, BAI score, BDI score, and general symptom index were significantly higher than controls (13 [18.7] vs. 7.5 [7], p = 0.01; 11 [14.7] vs. 6.5 [7], p = 0.01; 1.76 [0.81] vs. 1.1[0.24], p = 0.01; respectively). Patients with CSF in more than one vessel had the highest test scores. In univariate correlation analysis, mean thrombolysis in myocardial infarction (TIMI) frame counts were positively correlated with BAI (r = 0.56, p = 0.01), BDI (r = 0.47, p = 0.01), and general symptom index (r = 0.65, p = 0.01). The psychiatric tests were not correlated with risk factors for atherosclerosis.Conclusion:Our study revealed higher rates of depression, anxiety, and overall psychological distress in patients with CSF. This conclusion warrants further studies.

Contribuição ao conhecimento do Cruá (Sicana odorifera Naud.)

Um experimento foi conduzido na E.S.A. "Luiz de Queiroz" em Piracicaba, SP., com a finalidade de incrementar o conhecimento sobre o Cruá (Sicana odorifera Naud.) de apreciadas qualidades, bem como aquilatar alguns aspectos relacionados com a morfologia na fase de plântula. As sementes utilizadas neste trabalho, foram obtidas de frutos em perfeitas condições e semeadas na casa de vegetação do Departamento de Botânica da ESALQ, em Piracicaba. As sementes foram colocadas em duas posições no momento da semeadura, posição horizontal e posição vertical. O substrato utilizado foi uma mistura de terriço peneirado e areia de rio lavada. Os resultados obtidos permitiram concluir que as posições das sementes na germinação em nada influíram, mas para os caracteres morfológicos estudados mostraram significâncias. O comprimento da futura raiz (CR) e o comprimento do pecíolo (CP) mostraram significâncias ao nível de 5%, enquanto que a distância das folhas cotiledonares, a inserção das folhas definitivas (DFCIFD), o comprimento do limbo foliar (CL) e a largura do limbo (LL), mostraram significância ao nível de 1%. Já a distância do colo à inserção das folhas cotiledonares (DCIFC) não foi significativo. Todas essas significâncias se referem às sementes colocadas na posição horizontal quando foram semeadas, consequentemente sendo a melhor posição.

Dermatite verrucosa leprotica (Estudo de 3 casos)

The writer has discovered in Curupaity (National Leprosarium, Rio de Janeiro), three cases of verrucous dermatitis in C 3 type lepers. He suspected it to be an association of leprosy with Dermatilis verrucosa blastomycetica (Chromoblastocycosis) but various attempts to cultivate the fungus (Acrotheca or Hormodendrum Pedrosoi) responsible for the disease gave negative results and also the histopathologic aspect of the verrucous tissue proved it to be a leprotic granuloma without mycotic association. The writer's conclusion, based upon the cultural and histopathological studies, is that the verrucous dermatitis observed is due to leprosy alone, considering it as a new syndrome of the disease and not a new clinical form. He has called it « Dermatitis verrucosa leprotica » and made suggestions to all doctors of leprosaria to look for new cases and to study their etiology and pathogeny. Electrocoagulation improved the lesions.

Cultura cromogênica dum bacilo ácido-álcool resistente isolado de pus de lesão fechada de lepra humana

Last October 2nd the Author smeared nine tubes of Loewenstein medium with material obtained from closed pustulae of a seven years old boy, L2 case of leprosy. This material was very rich in Hansen bacilli in its different forms, inclusive globus, as is seen in the figures 2 and 3 of Plate 1. Part of this material obtained from pustulae opened by galvanocautery, was inoculated, at the same day, into white rats and guinea-pigs. November 26th a new biopsy gave more rich material, which was smeared again into Loewenstein fresh medium. December 15th three of the first and two of the second series of tubes of cultures showed germination of a yellow, dry and rough culture, covering almost the total surface of the medium. Microscopic examination of the culture showed that it was a pure culture of an acid-fast organism. Passages into glycerinated potatoes germinated well covering the surface of the same with a clear yellow granulated culture remaining the fluid (glycerinated water) quite limpid. The germination in glycerinated broth produced a yellow velum in the surface of the medium, as is seen in fig. 3 of Plate 2, without becoming turbid. The microorganism isolated twice from the same source of material was cocciforme (as Mycobacterium pulviforme of Marchoux), in the original culture, becoming more bacilliforme, always acid-fast, after passage into glycerinated media. The A. sent his culture to foreigner colleagues to study it and will inoculate it soon into laboratory animals.

Poderá o carrapato transmitir a lepra?: isolamento e cultura dum bacilo acido-álcool resistente de sedimento de "Amblyomma cajennense" capturado em leproso: 2ª nota

In this 2nd note upon the possibility of transmission of human leprosy by ticks, the A. relates his stepps to obtain the collaboration of his colleagues working in leprosaria in various States of Brazil, Argentina and Paraguay in such studies. Firstly the A. describes the positive results of examination of sediment of ticks, the cattle tick Boophilus microplus (Canestrini, 1888), received from Paraná (Leprosário São Roque) , which were put on active lepers, two of them sucking during 9 days and one during 7 days. Two out of three were killed for examination and were very strongly positive for acid-fast bacilli. A series of tubes of Loewenstein medium was smeared with the sediment of such ticks. Secondly the A. relates his personnal experiment, carried out in Rio de Janeiro, trying to infect normal ticks in lepers. The experiment with Boophilus microplus was negative and was twicely positive the experiment with Amblyomma cajennense Fabricius, 1794. The experiment is being in progress and will be continued in other places of Brazil. Finally, after being given the general characteristics of Boophilus microplus, the A. describes the non-chromogenic culture of a acid-fast bacillus isolated by him from sediment of ticks (Amblyomma cajennense) captured in lepers from Colônia Santa Isabel (Minas gerais), which parasitism was spontaneous. The first isolation was obtained in Loewenstein medium after 62 days incubation at 37°C. The culture is pure and the bacillus is permanent acid-fast. The plate1, in full color, represents this culture in its four generations. The colonies are pearl-white in color, dry, elevated and rough, developing slowly and beginning as white pinhead points scattered upon the surface of the medium. The culture is not yet rich enough to be inoculated into laboratory animals, which will be done when possible.

Poderá o carrapato transmitir a lepra?: mais quatro amostras de culturas de bacilos acido-alcool resistentes obtidas de carrapatos (2 de "Amblyomma cajennense"e 2 de "Boophilus microplus") infectados em leprosos do Paraná: 3ª nota

The AA. carried out experiments in the leprosarium São Roque, State of Paraná, South Brazil, to verify if the cattle tick Boophilus microplus could be experimentally infected in lepers, which was true. The AA. Tried also to be ascertained if Boophilus microplus and Amblyomma cajennense could change of hosts during their feedings which was true, both ticks continue feeding, the last species for many days, after being transferred from one to another leper. The junior A. describes in full their experiments and also a dermatites caused by tick bites. The senior A. brought to Rio de Janeiro most of the infected ticks for examination, which revealed a very high positivity. He smeared the sediments of lots of both species of ticks in Loewenstein medium and after a variable periode of incubation at 37° C. he obtained four new samples of cultures of acid-fast organisms, two from Amblyomma cajennense and two from Boophilus microplus. These cultures are being studied and will be inoculated into laboratory animals. The senior A. inoculated new batches of white rats with sediments of many ticks infected in lepers. Various hypotheses of both previous notes upon the subject now are verified facts. The A. is accumulating facts to draw the conclusions in the future. He also suggested the leprosy workers in the interior of the country to cooperate with him in such important studies, specially in the habitat of lepers in the rural zones of various States.

Infecção experimental de carrapatos (Amblyomma cajennense) em ratos com lepra Stefansky

The A. succeeded, after various experiments, to infect ticks (Amblyoma cajennense) with STEFANSKY bacillus, upon feeding them in rats suffering from murine leprosy, in advanced stages. The A. thinks that will be ease to transfer the sickness from rat to rat by means of inoculation of triturate of infected ticks, as did MARCHOUX with Laelaps echdninus.

A lepra tuberculoide, ou melhor, a lesão tuberculoide na lepra, representa uma fase de transição desta dermatose e não uma forma clínica autônoma: novos achados bacterioscópicos na linfa subcutânea de leprosos

The A., after an intorductory history of his experience in leprosy, discusses the more convinient routine method of classification of leprosy cases, basing it in the facte that every case is mixt, i. e. when the skin shows any lesion the nerves of that region are also affected by the bacilli. Studying by a new thecnics, which he baptised before as "Lleras' method", the scarching of the agent of leprosy in tuberculoid cases, by examination of sub-corium lymph obtained from the lesion, he discovered new forms of the Hansen bacillus, which describes briefly, arriving at the following conclusions: 1. The A., after discussing about the evolution and clinical classification of leprosy, describes new forms of the HANSIN bacillus, discoverd in the lymph extracted from subcutis of leprosy lesion. 2. In 100 % of tuberculoid cases (total studied 29) the A. found, in the subcutis lymph, bacilli, granules, clubs or other forms of HANSEN bacillus. 3. Such bacteriological findigs and the proved mutation of tuberculoid leprosy into lepromatous type, demolished the basis of the so-called "polar" classification of leprosy. 4. Considering the proved facts already referred to, the A. arrived at the conclusion that 50 % of all papers published about tuberculoid leprosy, within the last ten years, are fanciful. 5. The presence, in the subcutis of lepers, of metamorphosic forms of HANSEN bacillus, is the cause of common relapses of negativated cases by treatment, which fact suggests a new therapeutics method to destroy such elements in loco, and exiges more strict examination before release of interned patients.

Verificação, em condiçoes naturais, da infecção de mais três hematófagos (Anophelineos, Flebótomos e Simulídeos) em leprosos

The A. went last August to the State of Minas Gerais to continue his studies on transmission of leprosy by insects. He selected ten lepers (all L3 cases) for his experiments. It happened in the middle of August, a few day after freezing temperature. Practically there were no day mosquitoes, even near a river where in March there were very many. Bringing the patients to a wood, near the Peixe River (Fish River), at the dawn they were attacked by very many Anopheles, some flebotomus, a few Simulium and very rare Culex scapularis. All these insects became infected, in different degrees, by biting such patients. CONCLUSIONS. 1. Two species of Anopheles (A. albitarsis and A. tarsimaculatus) became strongly infected by Hansen bacilli. 2. By dissection done by Dr. Oliveira Castro were found lepra bacilli in various points of the proboscis of two Flebotomus (F. intermedius) and in their stomachs. 3. By smearing were found lepra bacilli in two specimens of Simulium sp. (probably pertinax). 4. It was confirmed also the verification done last March, at the same Leper Colony, that Phthirius pubis can be also a carrier of lepra bacillus. 5. There was confirmed also natural infection of nymphs of Amblyomma cajennense in lepers. Dr. Oliveira Castro is dissecting the Anopheles to locate the bacilli in their organisms and he started, with the cooperation of the Director of Colonia Santa Fé, Dr. José Mariano, attenpts to re-infect a group of negative-nerve cases of leprosy with infected mosquitoes.

Preparo de antígenos (Leprolinas Souza-Araujo) de culturas de bacilos ácido-álcool resistentes isolados de leprosos: seu emprêgo intradérmico, comparativamente com o da Lepromina, e subcutâneo ou intravenoso como tentativa terapêutica

The A. prepared five antigens from his leprosy cultures which by analogy with ROST's product he called Leprolins. The methods of its preparation and use are given. After a few tests to prove its innocuity for man the A. in cooperation with Dr. JOSÉ MARIANO, injected all five antigens intracutaneously in 120 patients. Now the products are being tested in 17 Leper Colonies of Brazil, in Argentina by Dr. SALOMON SCHUJMAN and in two leprosaria of Colombia. As antigen for skin tests the first results obtained are more or less identical with the results with Lepromin. Its use in serology for leprosy diagnosis will be made by Dr. T. PINTO of Rio, and Prof. LUIZ PRADO BARRIENTOS, of La Paz, Bolivia. As curative means the Leprolins are being injected into resistent lesions of leprosy and also by intraven injections, whose results Dr. José Mariano will publish soon. The Leprolins Souza-Araujo are put at disposal of all leprologists interested in its use.

Culturas de bacilos ácido-álcool resistentes isolados de hematófagos infectados em leprosos: evidências de se tratar do bacilo de Hansen

The A. summarises the history of his first culture of acidfast bacillus isolated directly from leprosy lesions (Sample José) and refers about two samples recovered from guinea pig and white rat inoculated with said culture. Then the A. completes his previous descriptions of four cultures of acidfast bacilli isolated by him from ticks (Amblyomma cajaennense and Boophilus microplus, two cultures from each species) infected experimentally in lepers. The A. having found specimens of two species of Triatomidae (Triatoma infestans and Panstrongylus megistus) naturally infected with HANSEN bacillus in huts habited by lepers in the State of Minas Gerais (Dec. 1942), started a series of experiments, using larvae and nymphs of T. infestans bred in laboratory at the Instituto Oswaldo Cruz, to infect in active cases of leprosy, in the city of Rio de Janeiro, could obtain two new samples of cultures of acid-fast bacilli (Ns. 6 and 7 of his set). In this papaer the A. studies the biological properties of said cultures, proving that Penicilin has not effect upon them, like other substances. The sulphuric and acetic acids were used to purify some of the cultures, with good results, the cultures becoming more rich and growing faster. Potassium hydroxide Sodium (10% solution) was also used with success to isolate and to purify the cultures, but it seems that it affects the bacilli in some way. In flud glycerinated media the majority of such cultures produce velum suitable for the preparation of antigens for skin tests and for therapeutical use. At last the A. says that he is becoming convinced that the HANSEN bacillus is in cause, especially after thee evidences of culturing the bacillus from one patient, in different opportunities.

Verificação da infecção de moscas da família Tachinidae pela Empusa Cohn, 1855: essas moscas, sugando ulceras lepróticas, se infestaram com o bacilo de Hansen

The A. refers that, in his last study, in his last studying trip to Colonia Santa Fé, Minas Gerais State, last month of March (autumn), had captured many wild flies (all from Tachinidae family, according to various entomologists of the Instituto Oswaldo Cruz), on a leprotic ulceration of the left leg of a lepromatous case of leprosy. The microscopical examination of the abdominal material from sch flies proved the presence, in rather great number, of HANSEN bacilli and a fungus of the genus Empusa COHN 1855. The A. intends to continue, next summer, such interesting research.

Tentativas de transmissão da lepra ao homem, por meio de Triatomídeos infectados em doentes lepromatosos: (nota prévia)

The A.A. started a new series of experiments upon the transmission of Leprosy to man by means of one of the more widespread hematophagi of the hinterland of Brazil, the Triatomidae. Two species of these insects were found naturally infected with Hansen's bacillus in huts of lepers in the interior of the State of Minas Gerais and one of the writers (S.A.) upon feeding the same insects on lepromatous cases could obtain two strains of acid-fast bacilli cultures smearing Lowenstein medium with the intestinal contains of the same. The first phase of the experiments lasted five months and the results, partially positive, are here describe. More than one hundred Triatomidae (Triatoma infestans and Panstrongylus megistus) bred in the Institute Oswaldo Cruz and fed in normal pigeons until convenient growth were put on lepromatous lesions, which they sucked many times, and them after one or more days they were put to be fed on selected regions of the skin of four negativated cases of leprosy. The arguments in favour and against the possibility of obtaining new lesions of leprosy in such burnet out patients were discussed. The A.A. are not authorized to draw any definite conclusions, but the few facts registered are worth of divulgation, in orther that other workers send their suggestions. Three out of the four volunteers showed moderate local reactions between 1 to 4 days after being sucked by the infected insectes. After five months experiments subcutanous lymph were obtained from the points where the insects have bitten. A very few acid-fast bacilli were found in such material. The patients, being kept in separation from infectious cases, will be followed up during months or a year in order to be detected any suspicious experimental lesions of leprosy.

As Leprolinas "Souza-Araujo" e a sua rápida acção terapêutica nos males perfurantes plantares lepróticos

The A. remembers the history of his lepra-culture and the method he uses to prepare with it the antigen called Leprolin Souza-Araujo, giving photographic illustrations upon the subject. The A. says that the results published about the general action of his Leprolin in leprosy must be revised or rectificated. But he says that the rapid action of his antigen upon perforant ulcers in lepers is consecrated by a large experience. He cured, in relatively short time, perforant ulcers in five lepers. Dr. CASSIANO, from Baurú leper Colony (S. Paulo) treated 21 such cases. The median time of treatment was 23 days and the median dosage of Leprolin injected in each patient was 7.7 cm3. All lesions were cured. After 18 months observation three cases relapsed and 18 (or 85.7%) remained cured. Dr. CALDEIRA, Director of padre DAMIEN Leper Colony (Ubá, Minas Gerais) treated regularly with Leprolin 50 cases of severe perforant ulcers and obtained cure in 46 (or 92%). ina special meeting held in Minas Gerais nineteen leprologists examined the cases of Dr. CALDEIRA and considered the results he have obtained as "magnifico", in the sense as "unic". This experiment is being continued in various brazilian leper colonies and the Author offers, graciously, his antigen to be tried also in foreing countries.

Estudo bacteriológico de escarros de leprosos-tuberculosos em tratamento com a Estreptomicina

Fourteen samples of sputum from fourteen lepers with pulmonary tuberculosis, were treated by PETROFF method and its sediments were smeared on LOEWENSTEIN medium and incubated at 37°C. These fourteen patients are under treatment by Streptomycin. They are advanced cases of active leprosy associated with pulmonary tuberculosis, according to X ray diagnosis. Between 15 to 45 days thirteen out of fourteen (92,85%) sputa gave cultures of acid-fast bacilli with all characteristics of KOCH'S bacillus, eugonic type. Nine out of thirteen positive cases produced eugonic colonies in all ten tubes smeared with each sample. These facts proved that Streptomycin did not affect the pulmonary flora. Three out of fourteen patients died within two months after positive cultures of KOCH'S bacillus. New fact - Three out of those thirteen positive patients gave non-chromogenic cultures, eugonic type, associated with chromogenic ones, quite similar to cultures of acid-fast bacilli isolated previously by the author from leprous material. One of the three patients who died showed in smear of fresh sputum only characteristics globies (globies of MARCHOUX not globi of NEISSER) of HANSEN'S Bacillus. Probably he died from leprous-pneumonia. The eugonic type cultures are being inoculated in guinea-pigs and the choromogenic ones, similar to leprosy-culture, will be inoculated in white rats and mice.