CALIBRATION AND USE OF AN IN-HOUSE ANTI-MEASLES IgG STANDARD SERUM

For the purpose of research a large quantity of anti-measles IgG working reference serum was needed. A pool of sera from five teenagers was prepared and named Alexandre Herculano (AH). In order to calibrate the AH serum, 18 EIA assays were performed testing in parallel AH and the 2nd International Standard 1990, Anti-Measles Antibody, 66/202 (IS) in a range of dilutions (from 1/50 to 1/25600). A method which compared parallel lines resulting from the graphic representation of the results of laboratory tests was used to estimate the power of AH relative to IS. A computer programme written by one of the authors was used to analyze the data and make potency estimates. Another method of analysis was used, comparing logistic curves relating serum concentrations with optical density by EIA. For that purpose an existing computer programme (WRANL) was used. The potency of AH relative to IS, by either method, was estimated to be 2.4. As IS has 5000 milli international units (mIU) of anti-measles IgG per millilitre (ml), we concluded that AH has 12000 mIU/ml.

Schistosoma mansoni: inflammatory foci around larvae in the peritoneal cavity of naive mice is radiosensitive

Innate attack to Schistosoma mansoni cercariae was evaluated in irradiated mice. It was observed that 70% of the larvae from mice sacrificed one day after whole body irradiation with 400 or 800 rads were surrounded by cluster reactivities, without difference from controls. Differences were apparent on day 5 after irradiation with sub lethal (400 rads) or lethal doses (800 rads) suggesting that innate defence to infection take at least 5 days to be affected by low dose whole-body radiation.

Low efficacy of azithromycin to treat cutaneous leishmaniasis in Manaus, AM, Brazil

An open trial to evaluate the azithromycin efficacy in cutaneous leishmaniasis patients was carried out in Manaus (AM), where Leishmania (Viannia) guyanensis is the main etiologic agent. Forty-one patients with skin lesions of less than 12 weeks duration, without specific treatment for the last three months and a positive imprint to Leishmania sp. were included. From these, 31 (75.6%) were male with median age of 30.2. All of them received a daily-single oral dose of 500 mg of azithromycin for ten days. At 25th day, 16 (39%) presented therapeutic failure and received intramuscular pentavalent antimonial, four were considered lost, 21, that had improved or were inaltered received another ten-day series of azithromycin and were monthly followed, but nine (21.9%) of them presented a poor clinical response and switched to intramuscular pentavalent antimonial on day 55. Of the 12 remaining cases evaluated on day 55, despite of clinical improvement, three asked for antimony therapy and 9 (21.9%) continued the follow-up but, only three were cured on 55th, 85th and 115th days, and six did not come back for final evaluation. The intention-treatment overall response rate was 22% and whole cure was seen in three (7.3%) of cases. Thus, azithromycin showed a low efficacy to treat cutaneous leishmaniasis in Manaus.

Failure of both azithromycin and antimony to treat cutaneous leishmaniasis in Manaus, AM, Brazil

A non-randomized controlled clinical trial was carried outin order to evaluate both azithromycin and antimony efficacy in cutaneous leishmaniasis in Manaus, AM, Brazil. Forty nine patients from both genders, aged 14 to 70, with cutaneous ulcers for less than three months and a positive imprint for Leishmania spp. amastigotes were recruited into two groups. Group I (26 patients) received a daily-single oral dose of 500 mg of azithromycin for 20 days and Group II (23 patients) received a daily-single intramuscular dose of 20 mg/kg of meglumine antimony, also for 20 days. Azithromycin cured three of 24 (12.5%) patients on days 60, 90 and 120 respectively whereas therapeutic failure was considered in 21 of 24 (87.5%) cases. In group II, antimony cured eight of 19 (42.1%) cases as follows: three on day 30, one each on day 60 and day 90, and three on day 120. Therapeutic failure occurred in 11 of 19 (57.9%) individuals. The efficacy of antimony for leishmaniasis was better than azithromycin but analysis for the intention-to-treat response rate did not show statistical difference between them. Although azithromycin was better tolerated, it showed a very low efficacy to treat cutaneous leishmaniasis in Manaus.

Melanoides tuberculata (Mollusca: Thiaridae) as an intermediate host of Centrocestus formosanus (Trematoda: Heterophyidae) in Brazil

Pleurolophocercous cercariae emerged from naturally infected Melanoides tuberculata from Minas Gerais State, Brazil, were used to perform experimental infection of laboratory-reared Poecilia reticulata. Mature metacercariae were obtained from the gills of fishes and force-fed to Mus musculus. The adult parasites which recovered from small intestines of mice were identified as Centrocestus formosanus. This is the first report of M. tuberculata as intermediate host of this heterophyid in Brazil.

Melanoides tuberculata as intermediate host of Philophthalmus gralli in Brazil

Melanoides tuberculata that naturally harbored trematode larvae were collected at the Pampulha dam, Belo Horizonte (Minas Gerais, Brazil), during malacological surveys conducted from 2006 to 2010. From 7,164 specimens of M. tuberculata collected, 25 (0.35%) were infected by cercariae, which have been morphologically characterized as belonging to the Megalurous group, genus Philophthalmus. Excysted metacercariae were used for successful experimental infection of Gallus gallus domesticus, and adult parasites recovered from the nictitating membranes of chickens were identified as Philophthalmus gralli. This is the first report of P. gralli in M. tuberculata in Brazil.

EXPERIMENTAL INFECTION OF SWISS AND AKR/J MICE WITH Centrocestus formosanus (TREMATODA: HETEROPHYIDAE)

In order to better understand the biology of Centrocestus formosanus in a definitive host model, mice of Swiss and AKR/J strains were experimentally infected with 100 metacercariae of the parasite. Fourteen days post-infection, the rodents were killed and adult trematodes were recovered from the small intestine. The percentage of parasite recovery from AKR/J mice (11.4%) was significantly higher than that from Swiss mice (5.3%). Moreover, trematodes recovered from the AKR/J strain were more developed and had greater fecundity. Peculiarities concerning the mice’s immune system could explain the difference in susceptibility and in worm development seen in the present study. The data obtained confirm that mice are susceptible to infection with C. formosanus and indicate that the AKR/J strain provides a more favorable environment for parasite development.

Histopatologia da esquistossomose mansoni em fígado de Mus musculus infectado por amostras humanas de fase aguda e crônica da periferia de Belo Horizonte, Minas Gerais

Exemplares de Biomphalaria glabrataforam infectados com miracídios obtidos de ovos de Schistosoma mansoni, encontrados em fezes de indivíduos de 7 a 18 anos, da região de Lagoa da Pampulha, Belo Horizonte, MG. Os pacientes de fase aguda se infectaram em uma primeira visita ao foco. Os da fase crônica eram moradores próximos aos focos. Para cada caso clínico, isolou-se a respectiva amostra do parasita. Foram infectados pela cauda 55 camundongos fêmeas com 70 ± 10 cercárias. Cortes histológicos de fígados, corados por HE, tricrômico de Gomori, impregnação metálica pela prata, e PAS foram observados à microscopia óptica. Não houve diferenças estatísticas em relação às médias das mensurações dos diâmetros dos granulomas referentes às amostras e datas de sacrifícios. Os granulomas apresentaram fase exsudativa do tipo Ha (reação de inflamação mista) e IIIa (granuloma com células epitelióides). Com amostras de pacientes em fase aguda o padrão predominante foi a Ha na 7ª semana. Na 10.ª semana predominaram granulomas do tipo IIIa. Nas amostras de pacientes em fase crônica, verificou-se uma mescla de granulomas do tipo Ha e IIIa na 7ª semana. Na 10ª semana predominou o tipo IIIa. Alguns aspectos histopatológicos de fígados foram descritos e comparados com aqueles existentes na literatura.

Efficacy of sulfadoxine-pyrimethamine and mefloquine for the treatment of uncomplicated Plasmodium falciparum malaria in the Amazon basin of Peru

In vivo antimalarial drug efficacy studies of uncomplicated Plasmodium falciparum malaria at an isolated site in the Amazon basin of Peru bordering Brazil and Colombia showed >50% RII/RIII resistance to sulfadoxine-pyrimethamine but no evidence of resistance to mefloquine.

Destruição de larvas infectantes de Strongyloides venezuelensis pelos fungos Duddingtonia flagrans, Arthrobotrys robusta e Monacrosporium sinense

INTRODUÇÃO: Strongyloides venezuelensis tem sido utilizado como um modelo para estudo da estrongiloidose humana. MÉTODOS: O objetivo deste trabalho foi comparar a capacidade predatória dos fungos nematófagos Duddingtonia flagrans (AC001), Arthrobotrys robusta (I-31) e Monacrosporium sinense (SF53) sobre larvas infectantes (L3) de Strongyloides venezuelensis em condições laboratoriais no meio ágar-água 2%. RESULTADOS: Ao final do experimento, os percentuais de redução de L3 de Strongyloides venezuelensis observados foram de: 93% (AC001); 77,2% (I-31) e 65,2% (SF53). CONCLUSÕES: Os fungos nematófagos foram capazes de capturar e destruir in vitro as L3, podendo ser utilizados como controladores biológicos de Strongyloides venezuelensis.

Suscetibilidade de larvas de Culex quinquefasciatus a diferentes inseticidas

INTRODUÇÃO: O presente estudo teve como objetivo avaliar a suscetibilidade de larvas de Culex quinquefasciatus a dois piretróides (Cipermetrina e Deltametrina), dois derivados da Avermectina (ivermectina e abamectina) e a um organofosforado (Temefós). MÉTODOS: Larvas de 3º e 4º instares de C. quinquefasciatus foram expostas a diferentes concentrações destes (onze repetições) seguindo o protocolo da Organização Mundial de Saúde. Uma hora após a exposição, as larvas foram lavadas em água desclorada, transferidas para recipientes plásticos contendo água sem cloro, alimentadas e observadas por períodos de 24h, até se transformarem em adultos. Para a determinação das concentrações letais, os valores foram submetidos à análise de regressão usando o modelo probit pelo programa Minitab 15. RESULTADOS: Diferenças entre as estimativas da CL50 e CL90 justificaram que a população de mosquitos testada apresenta heterogeneidade em resposta aos inseticidas, sendo a maior concentração utilizada para a CL50, a partir da análise de probit para o Temefós. Todos os inseticidas avaliados causaram mortalidade mais acentuada nas primeiras 24h exceto quando expostas à ivermectina. CONCLUSÕES: As larvas são suscetíveis a todos os inseticidas testados e há uma necessidade de um monitoramento dos inseticidas utilizados.

The Pampulha reservoir remains a potential urban focus of schistosomiasis mansoni in Brazil: changes in the occurrence patterns of Biomphalaria species and a new record of the parasite

Introduction The Pampulha reservoir has long been a focus of schistosomiasis transmission in Belo Horizonte, State of Minas Gerais, Brazil. The last malacological study conducted in this urban reservoir was more than two decades ago, and thus, an update on the distribution of the species of Biomphalaria as well as new data on the presence of Schistosoma mansoni in this water body are required. Methods The current distribution of Biomphalaria spp. in the Pampulha reservoir and their infection with S. mansoni was evaluated during 55 malacological surveys conducted between 2009 and 2012. Results Biomphalaria straminea displayed a high population density and distribution, and 13.7% (2,233/16,235) of the specimens collected were infected with larval trematodes other than Schistosoma mansoni. Biomphalaria tenagophila and Biomphalaria glabrata, species currently presenting a restricted distribution and small populations, displayed trematode infection rates of 15.2% (98/644) and 13% (83/640), respectively. Thirteen (2%) specimens of B. glabrata were found to be infected with S. mansoni. In addition, a historical review based on previous and new data on the occurrence patterns of Biomphalaria species in this reservoir is presented. Conclusions The results indicate that the Pampulha reservoir remains a potential focus of urban schistosomiasis in Brazil, and significant changes in the occurrence patterns of Biomphalaria species were verified.

Evaluation and treatment of the overactive bladder

The overactive bladder is characterized by symptoms of frequency, urgency, and urge incontinence, substantially affecting the quality of life of millions of people throughout the world. The symptoms are associated with significant social, psychological, occupational, domestic, physical, and sexual problems. Despite the considerable impact of this condition on quality of life, sufferers are often unwilling to discuss their problem with family members or health care professionals. This situation is unfortunate, for much can be done to alleviate the symptoms of this distressing condition. It is therefore of utmost importance that medical education about symptoms of the overactive bladder and other related problems be improved to help health care professionals identify and treat patients who will benefit from therapy. This article reviews current thinking regarding definition, epidemiology, quality of life effects, evaluation, and management of the overactive bladder.

New migraine preventive options: an update with pathophysiological considerations

BACKGROUND: The pharmacological treatment of migraine may be acute or preventive. Frequent, severe and long-lasting migraine attacks require prophylaxis. Multiple threads of research over the last 15 years have led to the concept that migraine is generated from a hyperexcitable brain. A variety of causes for hyperexcitability of the brain in migraine have been suggested. These causes include low cerebral magnesium levels, mitochondrial abnormalities, dysfunctions related to increased nitric oxide or the existence of a P/Q type calcium channelopathy. The better knowledge about migraine pathophisiology led us to discuss new treatment options. OBJECTIVES: The aim of the present study is to present an evidence-based review of some new drugs or some agents that even though available for a long time, are not frequently used. METHODS/RESULTS: We present a review of anticonvulsants with various mechanisms of action such as lamotrigine, gabapentin, topiramate, tiagabine, levetiracetam and zonisamide. We also review natural products, like riboflavin and magnesium, botulinum toxin A, a specific CGRP antagonist and the anti-asthma medication montelukast, with pathophysiological discussion. CONCLUSIONS: We aimed to present an update of newer or less frequently used preventive migraine therapies, drugs that might reduce the burden and the costs of a disease that should be considered as a public health problem all around the world.

Aquatic and semiaquatic Heteroptera (Insecta) from Pitinga, Amazonas, Brazil

A list of aquatic and semiaquatic Heteroptera from a collecting trip to Pitinga, a village in a mining area in the County of Presidente Figueiredo in the Central Amazon is presented. Identified were fifty five species of Heteroptera, distributed in 13 families. Among the insects collected, some are new records for this Amazonian region and in addition 3 apparently undescribed species of Microvelia and one of Paravelia remain for further study.