Avaliação da atividade terapêutica do albendazol sobre infecções experimental e humana pela Hymenolepis nana

Com o intuito de demarcar convenientemente o espectro de atividade do albendazol, no que diz respeito às helmintíases intestinais, foram efetuadas observações referentes à himenolepíase causada por Hymenolepis nana. Nesse contexto, duas ordens de investigações tiveram lugar: a) tratamento de camundongos, renovado depois de transcorridos dez dias, por meio de doses únicas de 25 mg/kg ou 50 mg/kg, sendo que 25 mg/kg de praziquantel e animais que não receberam os antiparasitários, serviram como controles; b) tratamento de crianças e adultos mediante uso de 400 mg cotidianamente, em três oportunidades consecutivas, com repetição após intervalo com duração de dez dias. O estudo concernente aos animais revelou ineficácia do albendazol, pois sistematicamente houve verificação da persistência de vermes vivos no intestino. Por seu turno, só 10% dos indivíduos medicados puderam ser considerados curados. Portanto, pelo menos de acordo com a maneira como procedemos, o albendazol não se afigurou capaz de debelar satisfatoriamente a himenolepíase.

Relationship between the prevalence of antibodies to hepatitis B core antigen and arbovirus in fishermen from the Ribeira Valley, Brazil

Sera from 299 fishermen 16 to 80 years old, residents in Cananeia and Iguape counties, southern cost of São Paulo State, Brazil, were studied in order to identify a possible association between the prevalence of specific antibodies to the hepatitis B virus (HBV) and exposure to haematophagus mosquitoes evaluated by the prevalence of arbovirus antibodies. This professional group presented the highest prevalence of arbovirus antibodies (54.1%) in past investigations carried out in this heavily forested region. Detection of antibody to hepatitis B core antigen (anti-HBc) in the sera was done by enzyme immunoassay (Roche). Prevalence of anti-HBc antibodies in this group was 31.4% (94/299) which is very high compared with 7.2% to 15.0% for different groups of healthy adults in State of São Paulo. No significant difference is observed between the prevalences of HBV antibodies in Iguape and Cananeia. Prevalence of anti-HBc and anti-arbovirus antibodies increases with age. There is a concordance in the distribution according to age groups of the frequency of anti-HBc and anti-arbovirus positive sera. Ag HBs was detected in 4% of the studied sera. These results support the hypothesis that the transmission of the hepatitis B virus and the arboviruses may be due to the same factor, one of the possibilities would be by anthropophilic mosquitoes.

Observações sobre a viabilidade do Trypanosoma cruzi no caldo da cana

Em Catolé do Rocha (Estado da Paraíba, Brasil) várias pessoas foram concomitantemente acometidas de doença de Chagas, em fase aguda. A propósito desse evento, houve cogitação de que o Trypanosoma cruzi foi veiculado pela via digestiva, através de ingestão de caldo de cana acidentalmente contaminado. Com o presente estudo, verificamos que o parasita permaneceu viável, durante quatro horas, no líquido em questão mantido em temperatura ambiente. Ao mesmo tempo, comprovamos que após uma hora ele pôde promover infecção em camundongo ao ser administrado por meio de sonda gástrica, renovando o interesse já demonstrado quanto a esse mecanismo alternativo de transmissão.

Comparison of indirect immunofluorescence test for measles antibodies with haemagglutination inhibition and plaque neutralization tests

Indirect Immunofluorescence (IFA), Plaque Reduction Neutralization (PRN) and Haemagglutination Inhibition (HI) tests for measles antibodies were carried out in 197 sera obtained from umbilical cord and vaccinated children. The IFA was also applied to blood samples collected with filter paper. IFA results demonstrated that the test is relatively simple to perform, with good reproducibility for different antigen lots. Good correlation was obtained between IFA, PRN and HI antibody titers. Better correlation was demonstrated with IFA and PRN than with HI and PRN tests. Sensitivity of IFA in detecting antibody was less effective than PRN, however more effective than HI using rhesus monkey red blood cells. PRN antibody titers over 100 were detected by IFA but not by HI (9.7% with negative results). IFA may be of considerable practical use and able to substitute HI in Seroepidemiological surveys and to evaluate vaccine efficacy. It also can be simplified by employing filter paper collected samples.

Investigação sobre a passagem transplacentária de microfilárias de Wuchereria bancrofti em recém-nascidos de mães microfilarêmicas

A ocorrência de microfilárias circulantes de Wuchereria bancrofti foi pesquisada em 304 gestantes da Unidade Mista Prof. Barros Lima e do Hospital das Clínicas da Universidade Federal de Pernambuco pelo Centro de Pesquisas Aggeu Magalhães. A microfilaremia materna foi investigada pela filtração de sangue venoso, sendo encontrados 13 casos positivos (4,2%). A pesquisa de microfilárias no sangue do cordão umbilical de suas crianças foi negativa (6/13), assim como no sangue periférico destas até 72 horas pós-parto e com 6 meses de vida. As amostras de leite coletadas destas mães também não apresentaram microfilárias. Os autores sugerem que a ocorrência de lesões placentárias seja um possível fator envolvido na passagem transplacentária de microfilárias, e que a exposição in utero a microfilárias e/ou antígeno filarial possam influenciar a resposta a uma infecção filarial adquirida posteriormente, sendo importante o acompanhamento clínico e laboratorial de crianças expostas previamente a antígenos filariais em períodos precoces do desenvolvimento humano.

Infecção perinatal pelo citomegalovírus em hospital público de São Paulo: estudo prospectivo

Com o objetivo de se avaliar a magnitude da infecção perinatal pelo citomegalovírus em hospital público do município de São Paulo, os autores acompanharam prospectivamente 98 recém-nascidos até o quarto mês de vida. Amostras de urina foram coletadas ao nascimento e posteriormente a cada mês, para inoculação em tubos contendo fibroblastos humanos. Amostras de sangue foram coletadas ao nascimento, no segundo e quarto mês de vida para pesquisa de anticorpos IgM específicos para o CMV, pelo método de imunofluorescência indireta. Dos 37 recém-nascidos que foram acompanhados até o quarto mês de vida, 9 se infectaram neste período, com diagnóstico feito pelo isolamento do CMV. O risco de aquisição da infecção pelo citomegalovírus no período perinatal estimado pela tábua de sobrevivência foi de 30,9%. A pesquisa de anticorpos IgM por imunofluorescência indireta só permitiu tal diagnóstico em 2 casos (8,1%). A diferença observada entre os dois métodos foi estatisticamente significante (p = 0,015). O estudo da prevalência de anticorpos IgG pelo ensaio imunoenzimático nas mães das crianças mostrou taxas de 92,7%. Não se isolou CMV nas amostras de leite materno, coletadas mensalmente até o terceiro mês de lactação. O acompanhamento clínico evidenciou que as crianças infectadas apresentaram-se de forma assintomática e com desenvolvimento neurop-sicomotor normal até o quarto mês.

Infecção pelo citomegalovírus em pacientes com síndrome da imunodeficiência adquirida (AIDS): relações clínico-virológicas e anatomopatológicas

Com o objetivo de determinar a prevalência da infecção pelo Citomegalovírus (CMV) em pacientes com AIDS, bem como relacionar os achados clínico-virológicos decorrentes desta infecção com as repercussões anatomopatológicas, estudamos 50 pacientes adultos atendidos entre abril de 1986 a junho de 1987, em dois hospitais públicos de São Paulo (HSP e HSPE). Estes pacientes foram acompanhados clínica e laboratorialmente, por período médio de 2 meses com coletas seriadas de sangue, urina e saliva. Foram realizados isolamento do CMV em monocamadas de fibroblastos humanos e testes sorológicos de Imunofluorescência Indireta (IFI-IgG/IgM) e Reação Imunoenzimática (ELISA-IgG). No momento da admissão no estudo 20% (10/50) dos pacientes apresentavam anticorpos IgM CMV específicos e 100% (50/50) deles anticorpos IgG (IFI). Durante o acompanhamento, 5 pacientes inicialmente IgM negativos tornaram-se IgM positivos, sugerindo reativação ou reinfecção pelo CMV. O CMV foi isolado de sangue periférico em 12,5%, da urina em 23,2%, da saliva em 21,9% dos pacientes. Exames anatomopatológicos foram realizados em 24 pacientes, correspondendo a 60% dos pacientes que evoluiram para óbito durante o período de estudo. Corpúsculos de inclusão citomegálica característicos foram observados em 50% das necrópsias, sendo o aparelho digestivo, pulmões e supra-renais os sítios mais acometidos. Não se observou uma relação estatisticamente significante entre os achados clínicos e os achados virológicos e anatomopatológicos.

Human papillomavirus detection in cervical dysplasias or neoplasias and in condylomata acuminaata by in situ hybridization with biotinylated DNA probes

Specimens from cervical dysplasias or carcinomas and genital condylomata acuminata were retrospectively analysed by in situ hybridization (ISH) with bioti-nylated DNA probes for human papillomavirus (HPV) types 6, 11, 16 and 18. In the control group no case was positive for HPV DNA. In mild/moderate dysplasias, 4 cases (14%) were positive for HPV 6 or 11 and 2 cases (7%), for HPV 16. In the severe dysplasia/in situ carcinoma group, 9 cases (31%) showed presence of DNA of HPV types 16 or 18. Six invasive carcinomas (20%) were positive for HPV type 16 or 18. Among condylomata acuminata, 22 cases (73%) were positive for HPV types 6 or 11. In all ISH-positive cases only one viral type was detected. No correlation between HPV DNA positivity and histological findings of HPV infection was observed. Although less sensitive than some other molecular biology techniques, in situ hybridization with biotinylated DNA probes proved to be simple and useful for detecting and typing HPV in samples routinely received for histopathological analysis.

Non-venomous snake bite and snake bite without envenoming in a brazilian teaching hospital: analysis of 91 cases

A retrospective survey of 473 cases of snake bite admitted to a Brazilian teaching hospital from 1984 to 1990 revealed 91 cases of bite without envenoming and/or caused by non-venomous snakes. In 17 of these cases the snake was identified, and one patient was bitten by a snake-like reptile (Amphisbaena mertensii). In 43 cases diagnosis was made on clinical grounds (fang marks in the absence of signs of envenoming). The other 30 cases were of patients who complained of being bitten but who did not show any sign of envenoming or fang mark. Most cases occurred in men (66;73%), in the 10-19 years age group (26;29%), in the lower limbs (51/74;69%), between 6 A. M. and 2 P.M. (49;61%) and in the month of April (16; 18%). One patient bitten by Philodryas olfersii developed severe local pain, swelling and redness at the site of the bite, with normal clotting time. The patient bitten by Drymarcon corais was misdiagnosed as being bitten by a snake of the genus Bothrops, was given the specific antivenom, and developed anaphylaxis. One patient bitten by Sibynomorphus mikanii presented prolonged clotting time, and was also given antivenom as a case of Bothrops bite. Correct identification of venomous snakes by physicians is necessary to provide correct treatment to victims of snake bite, avoiding unnecessary distress to the patient, and overprescription of antivenom, which may eventually cause severe untoward effects.

Lance-headed viper (Bothrops moojeni) bite wounding the eye

A 5-year-old girl was bitten in her left eye by a lance-headed viper identified as Bothrops moojeni, measuring 115 cm of length. There was severe facial swelling and left exophthalmus, and enucleation of the eye was necessary. The patient apparently had mild systemic envenoming, but local inflammatory signs and histological evidence of necrosis suggest that both the mechanical trauma and the local action of the venom had a role in the genesis of the eye lesion. It is arguable if the loss of the eye could be prevented even if the antivenom was administered earlier.

Presença de ovos de Toxocara spp em praças públicas da cidade de Uberlândia, Minas Gerais, Brasil

O objetivo deste trabalho foi verificar a presença de ovos de Toxocara spp nos solos de praças públicas da cidade de Uberlândia, região do Triângulo Mineiro, no período de outubro de 1991 a janeiro de 1992. A cidade possui 89 praças distribuídas em 39 bairros. Para que se tivesse um perfil da ocorrência do parasita, foram colhidas amostras de terra e areia (quando existente) de uma praça, determinada por sorteio, por bairro. As amostras de solo homogeneizadas de 5 pontos distintos das 39 praças foram colhidas em frascos plásticos e analisadas empregando-se os métodos de flutuação em solução saturada de cloreto de sódio e de solução saturada de sulfato de magnésio contendo 5% de iodeto de potássio. Para cada amostra foram realizados os dois métodos em duplicata. Os resultados mostraram estarem contaminados os solos de 9 praças (23,07%), das quais 6 localizavam-se próximas ao centro da cidade. A realização de mais de um método laboratorial permitiu a identificação do agente em maior porcentagem de locais.

Philodryas patagoniensis bite and local envenoming

A 5-year-old boy bitten by a specimen of Philodryas patagoniensis, a colubrid snake currently classified as nonvenomous, developed signs of local envenoming characterized by swelling and warmth on the bitten limb. This is the first time that local envenoming following Philodryas patagoniensis bite is recognized. Based on the clinical findings and misidentification of the snake, the patient was treated as a victim of Bothrops bite, having received unnecessarily the specific antivenom. Educational efforts to make doctors and health workers capable to identify correctly venomous snakes are necessary, to avoid inappropriate indication of antivenom and decrease the risk of its potentially harmful untoward effects. Examination of the bite site can be useful to the differential diagnosis between pit viper and colubrid bites.

Pulmonary manifestations in the initial phase of schistosomiasis mansoni

The clinical and radiological pulmonary manifestations in the initial phase of schistosomiasis mansoni were studied in thirty previously healthy individuals who were simultaneously infected. The findings were compared with those concerning a control group and related to possible pathogenetic factors. The respiratory manifestations were of light or of moderate intensity, the dry cough being the most common symptom. The significant radiological alterations were: thickening of bronchial walls and beaded micronodulation, predominantly localized in the lower pulmonary fields. It was observed significant association between wheezing and IgE levels, estimated by the area of immediate intradermal reaction, as well as between the number of blood eosinophils and the occurrence of radiological changes. Moreover, there was correlation between the worm burden and the presence of wheezing, thoracic pain and beaded micronodulation. Thus, the clinical and radiological pulmonary manifestations described are significant part of the initial phase of schistosomiasis mansoni and present the worm burden, eosinophilia and levels of IgE as probable pathogenetic factors.

Enzyme linked immunosorbent assay for rubella antibodies: a simple method of antigen production. A preliminary report

A simple method of rubella antigen production by treatment with sodium desoxycholate for use in enzyme immunoassay (IMT-ELISA) is presented. When this assay was compared with a commercial test (Enzygnost-Rubella, Behring), in the study of 108 sera and 118 filter paper blood samples, 96.9% (219/226) overall agreement and correlation coefficient of 0.90 between absorbances were observed. Seven samples showed discordant results, negative by the commercial kit and positive by our test. Four of those 7 samples were available, being 3 positive by HI.

Candidin: comparison of two antigens for cutaneous delayed hypersensitivity testing

A candidin, which is a suspension of killed yeast cells, is commonly used for intradermal tests of delayed hypersensitivity, to evaluate the immunological cellular competence of the patient, when the test is applied along with other similar tests. When working with a cellular antigen, the histopathology of positive skin tests reveals a cellular infiltrate which not only presents a characteristic hypersensitivity reaction but also a neutrophilic abscess in the central part. This research presents the results of a comparison between the yeast cell suspension and the polysaccharide antigens, both obtained from the same strains of Candida albicans. The results obtained by skin tests in one hundred individuals were 61.0% with the polysaccharide antigen and 69.0% with the yeast cell suspension antigen. Concordant results concerning the two antigens were observed in 82.0% of the individuals. The discussion section presents an assumption to explain the differences of positivity obtained with the two antigens. We conclude that the polysaccharide antigen can be utilized in the intradermal test of delayed hypersensitivity to Candida albicans.