Bilateral posterior circulation stroke secondary to a crotalid envenomation: case report

Snake bite envenoming is a disease with potential serious neurological complications. We report a case of an adolescent who was bitten by a rattlesnake and developed bilateral posterior circulation stroke. The rattlesnake was later identified as being Crotalus durissus terrificus. Stroke was probably due to toxic vasculitis or toxin-induced vascular spasm and endothelial damage.

Evaluation of parasitological examination, kDNA polymerase chain reaction and rK39-based immunochromatography for the diagnosis of visceral leishmaniasis in seropositive dogs from the screening-culling program in Brazil

Introduction Dogs play a primary role in the zoonotic cycle of visceral leishmaniasis (VL). Therefore, the accurate diagnosis of infected dogs, primarily asymptomatic dogs, is crucial to the efficiency of VL control programs. Methods We investigated the agreement of four diagnostic tests for canine visceral leishmaniasis (CVL): parasite detection, either after myeloculture or by direct microscopic examination of tissue imprints; kinetoplast-deoxyribonucleic acid-polymerase chain reaction (kDNA-PCR); and an immunochromatographic test (ICT). An enzyme-linked immunosorbent assay (ELISA) and an indirect immunofluorescence test (IFAT), both of which were adopted as part of the screening-culling program in Brazil, were used as reference tests. Our sample set consisted of 44 seropositive dogs, 25 of which were clinically asymptomatic and 19 were symptomatic for CVL according to ELISA-IFAT. Results The highest and lowest test co-positivities were observed for ICT (77.3%) and myeloculture (58.1%), respectively. When analyzed together, the overall percentage of co-positive tests was significantly higher for the symptomatic group compared to the asymptomatic group. However, only ICT was significantly different based on the results of a separate analysis per test for each group of dogs. The majority (93.8%) of animals exhibited at least one positive test result, with an average of 2.66 positive tests per dog. Half of the symptomatic dogs tested positive for all four tests administered. Conclusions The variability between test results reinforces the need for more efficient and reliable methods to accurately diagnose canine VL, particularly in asymptomatic animals.

Evaluation of the reference value for the Montenegro skin test

Abstract:INTRODUCTION:The Montenegro skin test (MST) has good clinical applicability and low cost for the diagnosis of American tegumentary leishmaniasis (ATL). However, no studies have validated the reference value (5mm) typically used to discriminate positive and negative results. We investigated MST results and evaluated its performance using different cut-off points.METHODS:The results of laboratory tests for 4,256 patients with suspected ATL were analyzed, and 1,182 individuals were found to fulfill the established criteria. Two groups were formed. The positive cutaneous leishmaniasis (PCL) group included patients with skin lesions and positive direct search for parasites (DS) results. The negative cutaneous leishmaniasis (NCL) group included patients with skin lesions with evolution up to 2 months, negative DS results, and negative indirect immunofluorescence assay results who were residents of urban areas that were reported to be probable sites of infection at domiciles and peridomiciles.RESULTS:The PCL and NCL groups included 769 and 413 individuals, respectively. The mean ± standard deviation MST in the PCL group was 12.62 ± 5.91mm [95% confidence interval (CI): 12.20-13.04], and that in the NCL group was 1.43 ± 2.17mm (95% CI: 1.23-1.63). Receiver-operating characteristic curve analysis indicated 97.4% sensitivity and 93.9% specificity for a cut-off of 5mm and 95.8% sensitivity and 97.1% specificity for a cut-off of 6mm.CONCLUSIONS:Either 5mm or 6mm could be used as the cut-off value for diagnosing ATL, as both values had high sensitivity and specificity.

First report of hepatic hematoma after presumed Bothrops envenomation

ABSTRACTIn Latin America, Bothrops envenomation is responsible for the majority of accidents caused by venomous snakes. Patients usually present local edema, bleeding and coagulopathy. Visceral hemorrhage is extremely rare and considered a challenge for diagnosis and management. We report the first case of hepatic hematoma owing to the bothropic envenomation in a 66-year-old man who was bitten in the left leg. He presented local edema, coagulopathy, and acute kidney injury. Radiological findings suggested hepatic hematoma, with a volume of almost 3 liters. The hepatic hematoma was gradually absorbed without the need for surgical intervention with complete resolution in 8 months.

Antimicrobial resistance profiles and oxacillinase genes in carbapenem-resistant Acinetobacter baumannii isolated from hospitalized patients in Santa Catarina, Brazil

Abstract: INTRODUCTION: Carbapenems are the therapy of choice for treating severe infections caused by the Acinetobacter calcoaceticus-Acinetobacter baumannii complex. We aimed to assess the prevalence and antimicrobial susceptibility profiles of producers of distinct oxacillinases among nosocomial isolates of the A. calcoaceticus-A. baumannii complex in a 249-bed general hospital located in Joinville, Southern Brazil. METHODS: Of the 139 A. baumannii clinical isolates with reduced susceptibility to carbapenems between 2010 and 2013, 118 isolates from varying anatomical sites and hospital sectors were selected for genotypic analysis. Five families of genes encoding oxacillinases, namely blaOXA-23-like, blaOXA-24-like, blaOXA-51-like, blaOXA-58-like, and blaOXA-143-like, wereinvestigated by multiplex polymerase chain reaction (PCR). RESULTS: Most (87.3%) isolates simultaneously carried the blaOXA-23-likeand blaOXA-51-likegenes, whereas three (2.5%) isolates harbored only blaOXA-51-likeones. The circulation of carbapenem-resistant isolates increased during the study period: from none in 2010, to 22 in 2011, 64 in 2012, and 53 in 2013. CONCLUSIONS: Isolates carrying the blaOXA-23-likeand blaOXA-51-likegenes were widely distributed in the hospital investigated. Because of the worsening scenario, the implementation of preventive measures and effective barriers is needed.

Modelos volumétricos para a Floresta Nacional do Tapirapé-Aquirí, Serra dos Carajás (PA)

Medidas precisas de volume de madeira são ferramentas importantes no planejamento do uso do recurso florestal. Neste estudo, foram investigados modelos volumétricos para a Floresta Nacional do Tapirapé-Aquirí, na Serra dos Carajás (PA), baseados numa cubagem rigorosa de 55 árvores para obter o diâmetro, altura comercial do fuste e volume sólido. Um total de 8 modelos de dupla entrada e 4 de simples entrada foram testados para o diâmetro mínimo de 14 cm. Para seleção do melhor modelo foram usadas as estatísticas do coeficiente de determinação, erro padrão da estimativa e distribuição dos resíduos. Entre os modelos de simples entrada o modelo logarítmico de Husch se ajustou melhor aos dados (R² = 0,9105) e entre os de dupla entrada o logarítmico de Schumacher & Hall se ajustou melhor (R² = 0,9942). O uso do modelo da Flona de Tapajós ou o uso do modelo de volume cilíndrico com fator de forma 0,7 subestimam a volumetria na Flona do Tapirapé. Isso enfatiza a importância de modelos volumétricos locais para melhorar a precisão da estimativa de madeira.

Efeito da fertilidade de terra preta de índio da Amazônia Central no estado nutricional e na produtividade do mamão hawaí (Carica papaya L.)

Com o objetivo de avaliar o efeito da fertilidade de solos antropogênicos no estado nutricional e na produtividade do mamão Havaí (Carica papaya L.), conduziu-se o presente estudo em um plantio, localizado na Costa do Açutuba, Iranduba, AM, em Latossolo Amarelo antrópico em plantas com oito meses de idade e no início da produção de frutos, no período de agosto a outubro de 2003. O delineamento experimental foi inteiramente casualizado, com quatro tratamentos e nove repetições, constituídos de uma amostra composta por três plantas e trinta e seis unidades experimentais, sendo os tratamentos Tpn = plantio em terra preta não adubada; Tpa = plantio em terra preta adubada; Tm1 = plantio em terra mulata não adubada; Tm2 = plantio em terra mulata com um ano de pousio. O tratamento que apresentou maior produção foi o Tpa, com média de 61,10 frutos/planta, e o que apresentou menor produção foi o Tpn, com média de 18,18 frutos/planta. A acidez potencial em todos os tratamentos apresentou-se em níveis médios, mesmo com o manejo da fertilidade praticado nos últimos anos. Observou-se um desbalanço nutricional provocado pelos altos teores de P, Ca, Mg e baixo teor de K; todos os tratamentos apresentaram teores de Zn e Mn considerados tóxicos, enquanto que o Fe apresentou níveis adequados.

Análise faciológica e estratigráfica da planície costeira de Soure (margem leste da ilha de Marajó-PA), no trecho compreendido entre o canal do Cajuúna e o estuário Paracauari

A planície costeira de Soure, na margem leste da ilha de Marajó (Pará), é constituída por áreas de acumulação lamosa e arenosa, de baixo gradiente, sujeitas a processos gerados por marés e ondas. Suas feições morfológicas são caracterizadas por planícies de maré, estuários, canais de maré e praias-barreiras. A análise faciológica e estratigráfica de seis testemunhos a vibração, com profundidade média de 4 m, e de afloramentos de campo permitiu a caracterização dos ambientes deposicionais, sua sucessão temporal e sua correlação lateral, a elaboração de seções estratigráficas e a definição de uma coluna estratigráfica. Foram identificadas cinco associações de facies: (1) facies de planície de maré, (2) facies de manguezal, (3) facies de barra de canal de maré, (4) facies de praia e (5) facies de duna. A história sedimentar da planície costeira de Soure é representada por duas sucessões estratigráficas: (1) a sucessão progradacional, constituída pelas associações de facies de planície de maré, manguezal e barra de canal de maré; e (2) a sucessão retrogradacional, formada pelas associações de facies de praia e de duna. Essas sucessões retratam uma fase de expansão das planícies de maré e manguezais, com progradação da linha de costa (Holoceno médio a superior), e uma posterior fase de retrogradação, com migração dos ambientes de praias e dunas sobre depósitos lamosos de manguezal e planície de maré, no Holoceno atual. A história deposicional da planície costeira de Soure é condizente com o modelo de evolução holocênica das planícies costeiras do nordeste paraense.