The first confirmed case of Diphyllobothrium latum in Brazil

Diphyllobothriasis is an infection of the small intestine by the broad tapeworm Diphyllobothrium sp. The associated symptomatology is nonspecific, but megaloblastic anemia is a well-described complication. Although the infection is common in temperate regions, descriptions in South America have so far been limited to Chile, Peru, and a few cases in Argentina. This paper presents the first confirmed Brazilian case of diphyllobothriasis. A 29-years-old woman living in Salvador (state of Bahia) apparently acquired the infection from eating sushi. The diagnosis was based on fecal examination that revealed a large quantity of operculated eggs. A single dose of praziquantel (600 mg) was sufficient to cure the infection.

Erythrovirus B19 infection in acquired immunodeficiency syndrome: screening by histopathology, immunohistochemistry, and in situ hybridization

Erythrovirus B19 infects erythrocytic progenitors, transiently interrupting erythropoiesis. In AIDS patients it causes chronic anemia amenable to treatment. We looked for evidences of B19 infection in stored bone marrow material from patients with acquired immunodeficiency syndrome. Histological sections were made from stored paraffin blocks from 33 autopsies (39 blocks) and 35 biopsies (45 blocks, 30 patients) performed from 1988 to 2002. They were examined after hematoxylin-eosin (HE) staining, immunohistochemical (IHC), and in situ hybridization. HE revealed intra-nuclear inclusion bodies ("lantern cells") suggesting B19 infection in 19 sections corresponding to 19 of 63 patients examined with this test. Seven of 78 sections subjected to immunohistochemistry were positive, corresponding to 7 of 58 patients examined with this test. Fourteen sections corresponding to 13 of the 20 HE and/or IHC positive patients were subjected to in situ hybridization, with six positives results. Among the 13 patients subjected to the three techniques, only one gave unequivocal positive results in all and was considered a true positive. The frequency of B19 infection (1/63 patients) in the material examined can be deemed low.

Pathoecology and paleodiet in Postclassic: Historic Maya from northern coastal Belize

This paper examines the synergism among diet, disease, and ecology at two related coastal Maya sites in Belize (Marco Gonzalez and San Pedro) for the Postclassic and Historic periods (1350-1650 AD), which immediately follow the Classic period collapse. Stable carbon- and nitrogen-isotope ratios in collagen and stable carbon-isotope ratios in structural carbonate were analysed for bones from 65 humans and a wide variety of faunal species. There are no apparent differences in whole diets or degree of carnivory between individuals with lesions indicative of anemia and those without, but those with lesions appear to have consumed significantly more C4 foods and protein from lower trophic levels. Non-specific infection (periostitis) and vitamin C deficiency (scurvy) are also present in high frequencies and appear to co-occur with lesions indicative of anemia, particularly in childhood. Individuals with scurvy also appear to have consumed significantly more C4 foods than normal individuals. Spondyloarthropathy is common in adults. These findings are discussed in light of: (1) the debate on how anemia versus scurvy are manifest and diagnosed, (2) Spanish ethnohistoric descriptions of the poor state of Maya health at the time of contact, and (3) the Osteological Paradox. We suggest that although this coastal environment exacerbated morbidity because of possible parasitic infection, the inhabitants were probably able to survive physiological stresses better than either their inland contemporaries or their modern counterparts.

Patterns of tuberculosis in the Americas: how can modern biomedicine inform the ancient past?

Tuberculosis (TB) is an infectious disease that continues to take its toll on human lives. Paleopathological research indicates that it has been a significant cause of death among humans for at least five thousand years. Because of the devastating consequences to human health, social systems, and endangered primate species, TB has been the subject of many and varied research efforts throughout the world, efforts that are amassing an enormous amount of data concerning the causative agent Mycobacterium tuberculosis. Despite sequencing of the M. tuberculosis genome and numerous molecular epidemiological studies, many questions remain regarding the origin, evolution, and future co-evolutionary trajectory of M. tuberculosis and humans. Indeed, the origin of pre-Columbian New World TB has been and remains hotly debated, and resolution of this controversy will likely only come with integration of data and theory from multiple disciplines. In this paper, we discuss the pre-Columbian TB controversy, and then use research from biological and biomedical sciences to help inform paleopathological and archaeological studies of this ubiquitous disease that plagued our ancient forbears.

Paleopathology of the commoners at Tell Amarna, Egypt, Akhenaten's capital city

The Egyptian Pharaoh Akhenaten initiated worship of a single god and established a new capital city (Tell Amarna) that was built and occupied only once from 1350-1330 BCE. This single short occupation offers a unique opportunity to study a short time period. The royal tombs have long been known and studied, but the location of graves for the common inhabitants has been an archaeological puzzle for more than 50 years. Recently four cemeteries have been located and the analysis of commingled bones from the South Tombs cemetery is presented here. The remains yield the following demographic profile: 53 adults with 19 females and 18 males; 14 juveniles between the ages of 5 and 17; and 3 infants. Arthritis and degenerative joint disease of the spine and joints indicates that DJD was not excessive. Only 2 to 8% of the adult population exhibits arthritis. There are 3 healed fractures of the arm (2 to 8% of the adult sample). There is 1 healed compressed fracture of the skull suggesting violence. The adult infection rate is between 2 and 8% with 3 healed and 1 active case of periostitis and no severe infections. Anemia is implicated by 23% of adult frontals exhibiting cribra orbitalia. Life for the common residents of Amarna appears to not have been as good as initially postulated.

Gauging differential health among the sexes at Windover (8Br246) using the Western Hemisphere Health Index

Assessment of intrapopulation human health provides information concerning social structure, division of labor, and lifestyle. Differential health among the sexes can provide clues to social roles, resource acquisition and status within prehistoric populations. Windover (8Br246) is an Archaic mortuary pond located in eastern central Florida. Its occupation spans over 500 years and dates to 7000 years BP. Over 168 well-preserved individuals were excavated, providing a glimpse into life during Florida's Archaic. Through the application of the Western Hemisphere Health Index, we find that males within the group experienced better overall health than females. Males outscore females in quality of life, percent of maximum scores, stature, anemia, dental disease, and infection. Females out-score males in enamel hypoplasia and degenerative joint disease. Causative factors for observed differential health are examined and include activity levels, sexual division of labor, access to resources, and the physiological demands of childbearing.

Experimental infection of dogs with a Brazilian strain of Rickettsia rickettsii: clinical and laboratory findings

The bacterium Rickettsia rickettsii is the etiological agent of an acute, severe disease called Rocky Mountain spotted fever in the United States or Brazilian spotted fever (BSF) in Brazil. In addition to these two countries, the disease has also been reported to affect humans in Mexico, Costa Rica, Panama, Colombia and Argentina. Like humans, dogs are also susceptible to R. rickettsii infection. However, despite the wide distribution of R. rickettsii in the Western Hemisphere, reports of R. rickettsii-induced illness in dogs has been restricted to the United States. The present study evaluated the pathogenicity for dogs of a South American strain of R. rickettsii. Three groups of dogs were evaluated: group 1 (G1) was inoculated ip with R. rickettsii; group 2 (G2) was infested by R. rickettsii-infected ticks; and the control group (G3) was infested by uninfected ticks. During the study, no clinical abnormalities, Rickettsia DNA or R. rickettsii-reactive antibodies were detected in G3. In contrast, all G1 and G2 dogs developed signs of rickettsial infection, i.e., fever, lethargy, anorexia, ocular lesions, thrombocytopenia, anemia and detectable levels of Rickettsia DNA and R. rickettsii-reactive antibodies in their blood. Rickettsemia started 3-8 days after inoculation or tick infestation and lasted for 3-13 days. Our results indicate that a Brazilian strain of R. rickettsii is pathogenic for dogs, suggesting that canine clinical illness due to R. rickettsii has been unreported in Brazil and possibly in the other South American countries where BSF has been reported among humans.

Hemoglobin curves during pregnancy before and after fortification of flours with iron

Objective: To assess the level of hemoglobin-Hb during pregnancy before and after fortification of flours with iron. Method: A cross-sectional study with data from 12,119 pregnant women attended at a public prenatal from five macro regions of Brazil. The sample was divided into two groups: Before-fortification (birth before June/2004) and After-fortification (last menstruation after June/2005). Hb curves were compared with national and international references. Polynomial regression models were built, with a significance level of 5%. Results: Although the higher levels of Hb in all gestational months after-fortification, the polynomial regression did not show the fortification effect (p=0.3). Curves in the two groups were above the references in the first trimester, with following decrease and stabilization at the end of pregnancy. Conclusion: Although the fortification effect was not confirmed, the study presents variation of Hb levels during pregnancy, which is important for assistencial practice and evaluation of public policies.


Efeito da vitamina C no ganho de peso e em parâmetros hematológicos de tambaqui

O objetivo deste trabalho foi avaliar o efeito da suplementação dietária com ácido L-ascórbico (vitamina C) no ganho de peso e em parâmetros hematológicos de juvenis de tambaqui, Colossoma macropomum. Após dez semanas, em que foram alimentados com dietas contendo 0, 100 e 500 mg de ácido L-ascórbico por kg de ração, os peixes foram capturados e imediatamente anestesiados para a coleta de sangue da veia caudal e determinação dos parâmetros hematológicos. Animais alimentados com maiores níveis de ascorbato mostraram pesos corpóreos maiores, melhores taxas de conversão alimentar e sobrevivência. A asência de ácido L-ascórbico na ração, além de causar redução nos valores de hematócrito e no número de eritrócitos, que caracteriza anemia, provocou aumento no volume corpuscular médio, na hemoglobina corpuscular média e na concentração de hemoglobina corpuscular média. Esses resultados revelam a importância do ácido L-ascórbico na dieta dos juvenis de tambaqui. O nível de 100 mg de ácido L-ascórbico/kg de ração é adequado, garantindo bom ganho de peso e manutenção da homeostase do organismo.

Desempenho produtivo e respostas fisiopatológicas de tambaquis alimentados com ração suplementada com β-glucano

O objetivo deste trabalho foi avaliar o efeito do imunoestimulante β-glucano na dieta do tambaqui (Colossoma macropomum) sobre o desempenho produtivo, as respostas fisiológicas e imunológicas, e a resistência ao desafio com Aeromonas hydrophila. O experimento foi conduzido em delineamento inteiramente casualizado, em arranjo fatorial 5x2, com cinco níveis de β-glucano na dieta (0, 0,1, 0,2, 0,4 e 0,8%) e dois tempos de amostragem (antes e após o desafio com A. hydrophila), com três repetições. Os peixes (28,65±0,49 g; 12,14±0,07 cm) foram alimentados, por 60 dias, com dieta (28% de proteína bruta) suplementada com preparação comercial de β-glucano. Após o período de alimentação, avaliou-se o desempenho produtivo, e os peixes foram desafiados com A. hydrophila. Os parâmetros hematológicos e imunológicos (concentração e atividade de lisozima) foram avaliados antes e após o desafio bacteriano. Após o desafio bacteriano, observouse a ocorrência de anemia normocítica-normocrômica. A suplementação com β-glucano não alterou a concentração nem a atividade da lisozima; porém, a menor concentração de β-glucano (0,1%) favoreceu maior sobrevivência para a espécie quando desafiada com Aeromonas hydrophila. A suplementação de β-glucano não exerce influência sobre o desempenho produtivo e nem sobre os parâmetros hematológicos do tambaqui.

Leiomiossarcoma do intestino grosso: relato de um caso

Os autores relatam um caso de leiomiossarcoma de cólon ascendente acometendo um paciente do sexo masculino, de 49 anos de idade. O paciente iniciou o quadro com anemia e massa abdominal, e a evolução dos sintomas até o diagnóstico final foi de nove meses. Na radiografia simples do abdome havia presença de coleção aérea localizada no hipocôndrio direito, fora da topografia de alças; no clister opaco com duplo contraste foi demonstrado deslocamento inferior da flexura hepática e divertículos. A ultra-sonografia abdominal mostrou lesão expansiva heterogênea, com gás no seu interior, de localização sub-hepática. A tomografia computadorizada do abdome revelou massa escavada com nível líquido, sub-hepática, que não se impregnou pelo meio de contraste. Foi realizada hemicolectomia direita com ileocoloanastomose, e o diagnóstico histopatológico foi de leiomiossarcoma de cólon ascendente.

Hematopoiese extramedular intratorácica: relato de um caso

Os autores relatam o caso de um paciente do sexo masculino, de 40 anos de idade, portador de anemia falciforme, que desenvolveu a forma intratorácica de hematopoiese extramedular, apresentando lesões expansivas com densidade de partes moles, localizadas posteriormente, nas goteiras paravertebrais, na radiologia convencional. A tomografia computadorizada do tórax demonstrou massas bem delimitadas, de contornos lobulados, com densidade heterogênea à custa de áreas de tecido gorduroso e de densidade de partes moles, localizadas no terço inferior das goteiras paravertebrais. Os pulmões tinham coeficientes de atenuação preservados. A tomografia computadorizada de abdome revelou importante aumento da densidade e do volume do fígado, atribuídos à hemossiderose, e baço atrófico e calcificado devido a infartos esplênicos de repetição.

Alterações ultra-sonográficas na gravidez Rh negativo sensibilizada avaliada pela espectrofotometria do líquido amniótico e pela dopplervelocimetria da artéria cerebral média

OBJETIVO: Avaliar e confrontar a presença de alterações ultra-sonográficas nas gestações Rh negativo sensibilizadas, quando a anemia fetal foi determinada ou pela espectrofotometria do líquido amniótico, ou pela dopplervelocimetria da artéria cerebral média. MATERIAIS E MÉTODOS: Observacional descritivo com grupo de comparação. Nosso grupo de estudo foi constituído por 99 pacientes, avaliadas no período de janeiro de 1995 a janeiro de 2004. Foram analisados e comparados dois grupos: 74 gestantes sensibilizadas pelo fator Rh cuja anemia fetal foi acompanhada pela espectrofotometria (grupo SE) e 25 gestantes sensibilizadas pelo fator Rh cuja anemia fetal foi acompanhada pela dopplervelocimetria (grupo SD). Avaliamos a presença ou não de alterações ultra-sonográficas no acompanhamento pré-natal e confrontamos os dois grupos de estudo. RESULTADOS: No grupo cuja anemia fetal foi acompanhada através da espectrofotometria (grupo SE), apuramos modificações placentárias, principalmente o aumento da espessura e sua alteração textural, mais assiduamente que as encontradiças no grupo de gestantes sensibilizadas, em que a anemia foi determinada através da dopplervelocimetria (grupo SD) (64% X 32%, p = 6,294). CONCLUSÃO: As alterações ultra-sonográficas foram detectadas em dobro quando a anemia foi avaliada pela espectrofotometria em comparação com o grupo seguido pela dopplervelocimetria.

Sistema antioxidante envolvendo o ciclo metabólico da glutationa associado a métodos eletroanalíticos na avaliação do estresse oxidativo

The most relevant advances on the analytical applications of glutathione determination based on glutathione redox cycle and the antioxidant system are given. The main enzymes that participate of the glutathione metabolism are the glutathione peroxidase and glutathione reductase. The glutathione peroxidase has a major role in the removal of hydrogen peroxide and lipid peroxides from the cells. These enzymes, operating in tandem with catalase and superoxide dismutase promote a scavenging of oxyradical products in tissues minimizing damages caused by these species. Reduced glutathione is the major intracellular thiol found in mammals and changes in the glutathione concentration in biological fluids or tissues may provide a useful marker in certain disorders like hemolytic anemia, myocardial oxidative stress and in the investigation of some kinds of cancers. Particular attention is devoted to the main advantages supplied by biosensors in which there is an incorporation of bioactive materials for the glutathione determination. The correlation between stability and sensitivity of some reduced glutathione electrochemical sensors is discussed.

Spectrophotometric study of iron oxidation in the iron(II)/thiocyanate/acetone system and some analytical applications

The possibility of using thiocyanate to determine iron(II) and/or iron(III) in water-acetone mixture has been re-examined as part of a systematic and comparative study involving metallic complexes of pseudohalide ligands. Some parameters that affect the complete oxidation of the ferrous cations, their subsequent complexation and the system stability have been studied to optimize the experimental conditions. Our results show the viability and potentiality of this simply methodology as an alternative analytical procedure to determine iron cations with high sensitivity, precision and accuracy. Studies on the calibration, stability, precision, and effect of various different ions have been carried out by using absorbance values measured at 480 nm. The analytical curve for the total iron determination obeys Beer's law (r = 0.9993), showing a higher sensitivity (molar absorptivity of 2.10x10(4) L cm-1 mol-1) when compared with other traditional systems (ligands) or even with the "similar" azide ion [1.53x10(4) L cm-1 mol-1, for iron-III/azide complexes, in 70% (v/v) tetrahydrofuran/water, at 396 nm]. Under such optimized experimental conditions, it is possible to determine iron in the concentration range from 0.5 to 2 ppm (15-65% T for older equipments, quartz cells of 1.00 cm). Analytical applications have been tested for some different materials (iron ores), also including pharmaceutical products for anemia, and results were compared with atomic absorption determinations. Very good agreement was obtained with these two different techniques, showing the potential of the present experimental conditions for the total iron spectrophotometric determinations (errors < 5%). The possibility of iron speciation was made evident by using another specific and auxiliary method for iron(II) or (III).