Influence of canine brain decomposition on laboratory diagnosis of rabies

Canine brains infected with rabies virus were submitted to decomposition by being left at room temperature of 25 to 29oC for up to 168h. At 24h intervals, brain fragments were analyzed by immunofluorescence (IF) and by the mouse intracerebral inoculation (MI) test to confirm the diagnosis of rabies and to measure the putrefaction effect on the accuracy of the diagnosis. Forty eight h after the beginning of the experiment, the MI test showed signs of impairment with four negative results, while after 72h, 100% of the results were negative to the MI test and only one result was negative to the IF test, indicating that the threshold period for accurate diagnosis is 24 to 48h before putrefaction. The authors recommend the shipment of suspected cases of rabies to the laboratory for confirmation, but the use of putrid materials for diagnosis is meaningless because of false-negative results.

Simultaneous occurrence of brain tumor and myeloradiculopathy in schistosomiasis mansoni: case report

Simultaneous occurrence of brain tumor and myeloradiculopathy in cases of Manson's schistosomiasis have only rarely been described. We report the case of a 38-year-old man who developed seizures during a trip to Puerto Rico and in whom a brain tumor was diagnosed by magnetic resonance imaging: brain biopsy revealed the diagnosis of schistosomiasis. He was transferred to a hospital in the United States and, during hospitalization, he developed sudden paraplegia. The diagnosis of myeloradiculopathy was confirmed at that time. He was administered praziquantel and steroids. The brain tumor disappeared, but the patient was left with paraplegia and fecal and urinary dysfunction. He has now been followed up in Brazil for one year, and his clinical state, imaging examinations and laboratory tests are presented here.

Soap bubble appearance in brain magnetic resonance imaging: cryptococcal meningoencephalitis

Although cryptococcal infections begin in the lungs, meningoencephalitis is the most frequently encountered manifestation of cryptococcosis among individuals with advanced immunosuppression. As the infection progresses along the Virchow-Robin spaces, these structures may become dilated with mucoid material produced by the capsule of the organism. We report a case of a 24-year-old man with cryptococcal meningoencephalitis in which magnetic resonance imaging showed clusters of gelatinous pseudocysts in the periventricular white matter, basal ganglia, mammillary bodies, midbrain peduncles and nucleus dentatus with a soap bubble appearance.

Brain schistosomiasis in mice experimentally infected with Schistosoma mansoni

Introduction Human neuroschistosomiasis has been reported in the literature, but the possibility of modeling neuroschistosomiasis in mice is controversial. Methods In two research laboratories in Brazil that maintain the Schistosoma mansoni life cycle in rodents, two mice developed signs of brain disease (hemiplegia and spinning), and both were autopsied. Results S. mansoni eggs, both with and without granuloma formation, were observed in the brain and meninges of both mice by optical microscopy. Conclusions This is the first description of eggs in the brains of symptomatic mice that were experimentally infected with S. mansoni. An investigation of experimental neuroschistosomiasis is now feasible.

Puerperal brain cryptococcoma in an HIV-negative woman successfully treated with fluconazole: a case report

Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma.

Chemotherapy versus best supportive care in stage IV non-small cell lung cancer, non metastatic to the brain

Stage IV non-small cell lung cancer is a fatal disease, with a median survival of 14 months. Systemic chemotherapy is the most common approach. However the impact in overall survival and quality of life still a controversy. OBJECTIVES: To determine differences in overall survival and quality of life among patients with stage IV non-small cell lung cancer non-metastatic to the brain treated with best supportive care versus systemic chemotherapy. PATIENTS: From February 1990 through December 1995, 78 eligible patients were admitted with the diagnosis of stage IV non-small cell lung cancer . Patients were divided in 2 groups: Group A (n=31 -- treated with best supportive care ), and Group B (n=47 -- treated with systemic chemotherapy). RESULTS: The median survival time was 23 weeks (range 5 -- 153 weeks) in Group A and 55 weeks (range 7.4 -- 213 weeks) in Group B (p=0.0018). In both groups, the incidence of admission for IV antibiotics and need of blood transfusions were similar. Patients receiving systemic chemotherapy were also stratified into those receiving mytomycin, vinblastin, and cisplatinum, n=25 and those receiving other combination regimens (platinum derivatives associated with other drugs, n=22). Patients receiving mytomycin, vinblastin, and cisplatinum, n=25 had a higher incidence of febrile neutropenia and had their cycles delayed for longer periods of time than the other group. These patients also had a shorter median survival time (51 versus 66 weeks, p=0.005). CONCLUSION: In patients with stage IV non-small cell lung cancer, non-metastatic to the brain, chemotherapy significantly increases survival compared with best supportive care.

O emprego da geoestatística na determinação do tamanho "ótimo" de amostras aleatórias com vistas à obtenção de estimativas dos volumes dos fustes de espécies florestais em Paragominas, estado do Pará

O objetivo do trabalho foi determinar o tamanho adequado de amostra para estimar o volume de fustes de espécies florestais de uma população de árvores a serem cortadas no sistema de manejo florestal da empresa Cikel Brasil Verde Madeiras - Pará. Utilizaram-se as metodologias da amostragem sistemática e do estimador geoestatístico da krigagem ordinária com simulação sequencial, respectivamente para a escolha das amostras e estimação dos volumes dos fustes das árvores. Os resultados mostraram que os métodos podem ser utilizados no cálculo dos volumes de fustes de árvores. Entretanto, o método da krigagem apresenta um efeito de suavização, tendo como conseqüência uma subestimação dos volumes calculados. Neste caso, um fator de correção foi aplicado para minimizar o efeito da suavização. A simulação sequencial indicativa apresentou resultados mais precisos em relação à krigagem, uma vez que tal método apresentou algumas vantagens, tal como a não exigência de amostras com distribuições normais e ausência de efeito de suavização, característico dos métodos de interpolação.

Influence of angiotensin II receptor subtypes of the paraventricular nucleus on the physiological responses induced by angiotensin II injection into the medial septal area

OBJECTIVE: We determined the effects of losartan and PD 123319 (antagonists of the AT1 and AT2 angiotensin receptors, respectively), and [Sar¹, Ala8] ANG II (a relatively peptide antagonist of angiotensin receptors) injected into the paraventricular nucleus (PVN) on water and 3% NaCl intake, and the diuretic, natriuretic, and pressor effects induced by administration of angiotensin II (ANG II) into the medial septal area (MSA) of conscious rats. METHODS: Holtzman rats were used . Animals were anesthetized with tribromoethanol (20 mg) per 100 grams of body weight, ip. A stainless steel guide cannula was implanted into the MSA and PVN. All drugs were injected in 0.5-mul volumes for 10-15 seconds. Seven days after brain surgery, water and 3% NaCl intake, urine and sodium excretion, and arterial blood pressure were measured. RESULTS: Losartan (40 nmol) and [Sar¹, Ala8] ANG II (40 nmol) completely eliminated whereas PD 123319 (40 nmol) partially blocked the increase in water and sodium intake and the increase in arterial blood pressure induced by ANG II (10 nmol) injected into the MSA. The PVN administration of PD 123319 and [Sar¹, Ala8] ANG II blocked whereas losartan attenuated the diuresis and natriuresis induced by MSA administration of ANG II. CONCLUSION: MSA involvement with PVN on water and sodium homeostasis and arterial pressure modulation utilizing ANGII receptors is suggested.

Diferenças relacionadas ao sexo nos volumes ventriculares e na fração de ejeção do ventrículo esquerdo estimados por cintilografia de perfusão miocárdica: comparação entre os programas Quantitative Gated SPECT (QGS) e Segami

OBJETIVO: Analisar as diferenças relacionadas ao sexo nas medidas obtidas pelos programas Segami e Quantitative Gated SPECT (QGS). MÉTODOS: Cento e oitenta e um indivíduos assintomáticos sem evidência de cardiopatia foram submetidos a estudos de perfusão miocárdica. O volume diastólico final (VDF), volume sistólico final (VSF) e a fração de ejeção do ventrículo esquerdo (FEVE) foram quantificados pelos programas QGS and Segami para avaliar a influência do sexo, idade, peso, altura, freqüência cardíaca, pressão arterial sistólica, pressão arterial diastólica, índice de massa corporal e área de superfície corporal. RESULTADOS: As médias obtidas com o método QGS foram VDF (mulheres = 68 ml; homens = 95 ml; p < 0,001) e FEVE (mulheres = 66,24%; homens = 58,7%), e com o Segami, VDF (mulheres = 137 ml; homens = 174 ml) e FEVE (mulheres = 62,67%; homens = 58,52%). Foram observadas diferenças significantes entre homens e mulheres no VDF (p < 0,001) e VSF (p < 0,001), que persistiram após o ajuste em relação à área de superfície corporal. CONCLUSÃO: Os volumes ventriculares foram significantemente menores e a FEVE foi significantemente maior em mulheres, de acordo com os programas QGS e Segami.

Fração de ejeção e volumes do ventrículo esquerdo medidos com eco 3D e com tomografia ultra-rápida

FUNDAMENTO: O ecocardiograma tridimensional em tempo real (ECO 3D) e a tomografia computadorizada ultra-rápida (CT) são dois novos métodos de análise da fração de ejeção e dos volumes do VE. OBJETIVO: Comparar as medidas da FEVE e dos volumes do VE aferidos pelo ECO 3D e pela CT ultra-rápida. MÉTODOS: Foram estudados pelo ECO 3D e pela CT ultra-rápida de 64 cortes, 39 pacientes consecutivos (27 homens, média etária de 57±12 anos). Foram analisados: FEVE e volumes do VE. Análise estatística: coeficiente de correlação (r: Pearson), teste de Bland & Altman, teste de regressão linear, 95 % IC, p<0,05. RESULTADOS: Medidas do ECO 3D: a FEVE variou de 56,1 a 78,6 (65,5±5,58)%; volume diastólico final variou de 49,6 a 178,2 (87±27,8)ml; volume sistólico final variou de 11,4 a 78 (33,1±13,6)ml. Medidas da CT: a FEVE variou de 53 a 86 (67,8±7,78)%; volume diastólico final variou de 51 a 186 (106,5±30,3) ml; volume sistólico final variou de 7 a 72 (35,5±13,4)ml. As correlações entre ECO 3D e CT foram: FEVE (r: 0,7888, p<0,0001, 95% IC 0,6301 a 0,8843); volume diastólico final (r: 0,7695, p<0,0001, 95% IC 0,5995 a 0,8730); volume sistólico final (r: 0,8119, p<0,0001, 95% IC 0,6673 a 0,8975). CONCLUSÃO: Nesta série, foi observada boa correlação entre as medidas da FEVE e entre os volumes ventriculares aferidos pelo ECO3D e pela CT ultra-rápida de 64 cortes.

Brain cell karyotype of the phlebotomine sand fly Lutzomyia shannoni (Dyar) (Diptera: Psychodidae)

The brain cell karyotype of New World sand fly Lutzomyia shannoni was described. This species has four pairs of chromosomes, 2N=8, with one pair of heteromorphic chromosomes.

Brain natriuretic peptide and left ventricular dysfunction in chagasic cardiomyopathy

Global left ventricular (LV) systolic dysfunction is the strongest predictor of morbidity and mortality in Chagas disease. Echocardiography is considered the gold standard for the detection of LV dysfunction, but not always available in endemic areas where chagasic cardiomyopathy is most common. Brain natriuretic peptide (BNP) is a neurohormone that has been recently described as a simple and inexpensive diagnostic and prognostic marker for patients with congestive heart failure. Chagasic patients (n = 63) and non-infected healthy individuals (n = 18) were recruited prospectively and underwent complete clinical examination, echocardiography and 24-h Holter monitoring. BNP was measured from thawed plasma samples using the Triage BNP test. We observed high levels of BNP in association with depression of LV ejection fraction, with increase of LV end-diastolic diameter and with LV premature complexes. An elevated concentration of BNP, defined as a concentration of 60 pg/ml or more, had a sensitivity of 91.7%, specificity of 82.8%, positive predictive value of 52.4%, and negative predictive value of 98% for detecting LV dysfunction (LV ejection fraction < 40%).BNP measurement using a simple, relatively inexpensive and rapid test has a promising role in identifying LV dysfunction associated with chagasic cardiomyopathy. Equally important, patients with Trypanosoma cruzi infection who have low levels of BNP level in plasma have a very low likelihood of severe cardiac involvement, and echocardiography is probably not necessary.