Clinical and laboratory findings in patients with dengue associated with hepatopathy

INTRODUCTION: Hepatic disorders caused by dengue infection may progress to severe manifestations, including mortality and morbidity. Cytokines are involved in it, such as the migration inhibitory factor of macrophages (MIF), tumor necrosis factor (TNF), natural killer cells (NK), B lymphocytes, and macrophages. METHODS: This study was carried out from January to April 2007 at a public hospital from the Federal University of Mato Grosso do Sul, Campo Grande, Brazil. Sixty-eight patients were studied concerning hepatic alterations, with 56 reported having classic dengue, 6 with hemorrhagic dengue grade I, and 6 with hemorrhagic dengue grade II. RESULTS: Among the 56 with classic dengue, 83.3% had aspartate aminotransferase (AST) alterations, and 69.6% had altered alanine aminotransferase (ALT). For those with hemorrhagic dengue grade I, 100% had AST alterations, and 83.3% had altered ALT. All the patients with hemorrhagic dengue grade II had AST and ALT alterations. AST variations reached 22.0 and 907.0, with an average value of 164.6. For ALT, we found variations between 25.0 and 867.0, with an average value of 166.07. There had been statistical significance between dengue clinical shapes and hepatic function markers. CONCLUSIONS: We conclude that the infection was predominant in adults, females, and in those with low income and education. The liver enzymes were of larger amount in hemorrhagic dengue, but there was weak statistical evidence of the clinical manifestations and transaminases. Major signs and clinical symptoms were fever, headache, myalgia, arthralgia, weakness, severe pain behind the eyes, and rashes.

In-house ELISA method to analyze anti-Trypanosoma cruzi IgG reactivity for differential diagnosis and evaluation of Chagas disease morbidity

INTRODUCTION: The goal was to develop an in-house serological method with high specificity and sensitivity for diagnosis and monitoring of Chagas disease morbidity. METHODS: With this purpose, the reactivities of anti-T. cruzi IgG and subclasses were tested in successive serum dilutions of patients from Berilo municipality, Jequitinhonha Valley, Minas Gerais, Brazil. The performance of the in-house ELISA was also evaluated in samples from other relevant infectious diseases, including HIV, hepatitis C (HCV), syphilis (SYP), visceral leishmaniasis (VL), and American tegumentary leishmaniasis (ATL), and noninfected controls (NI). Further analysis was performed to evaluate the applicability of this in-house methodology for monitoring Chagas disease morbidity into three groups of patients: indeterminate (IND), cardiac (CARD), and digestive/mixed (DIG/Mix), based on their clinical status. RESULTS: The analysis of total IgG reactivity at serum dilution 1:40 was an excellent approach to Chagas disease diagnosis (100% sensitivity and specificity). The analysis of IgG subclasses showed cross-reactivity, mainly with NI, VL, and ATL, at all selected serum dilutions. Based on the data analysis, the IND group displayed higher IgG3 levels and the DIG/Mix group presented higher levels of total IgG as compared with the IND and CARD groups. CONCLUSIONS: These findings demonstrated that methodology presents promising applicability in the analysis of anti-T. cruzi IgG reactivity for the differential diagnosis and evaluation of Chagas disease morbidity.

Testicular schistosomiasis as differential diagnosis for testicular nodules: a case report

AbstractDespite its infrequent occurrence, testicular schistosomiasis forming pseudo-tumors can be considered in the differential diagnosis of testicular tumors, especially in areas where the parasitic disease is endemic. In this report, we present a case of testicular schistosomiasis caused by Schistosoma mansoni and mimicking a testicular neoplasm. We describe the patterns of a testicular nodule on ultrasonography and magnetic resonance images in a 46-year-old man. The nodule was removed after a pre-operative diagnosis of a non-malignant lesion. Histology demonstrated granulomas with epithelioid macrophages and eosinophils around S. mansoni eggs within a fibrous tissue that formed a nodular structure.

Migration and mental health: Japanese Brazilians in Japan and in Brazil

OBJECTIVE: Brazil is the country with the largest community of Japanese descendants in the world, from a migration movement that started in 1908. However, more recently (1988), a movement in the opposite direction began. Many of these descendants went to Japan for work purposes and suffered mental distress. Some of them sought treatment in Japan, while others returned to Brazil to seek treatment. The aim of the present study was to compare the sociodemographic profile and diagnoses of Japanese Brazilian psychiatric outpatients in Japan (remaining group) and in Brazil (returning group). METHOD: All consecutive Japanese Brazilian outpatients who received care from the psychiatric units in Japan and Brazil from April 1997 to April 2000 were compared. The diagnoses were based on ICD-10 and were made by psychiatrists. Sociodemographic data and diagnoses in Brazil and Japan were compared by means of the Chi-Squared Test. RESULTS: The individuals who returned to Brazil were mostly male and unmarried, had lived alone in Japan, had stayed there for short periods and were classified in the schizophrenia group. The individuals who remained in Japan were mostly female and married, were living with family or friends, had stayed there for long periods and were classified in the anxiety group. Logistic regression showed that the most significant factors associated with the returning group were that they had lived alone and stayed for short periods (OR = 0.93 and 40.21, respectively). CONCLUSION: We conclude that living with a family and having a network of friends is very important for mental health in the context evaluated.

Uhl's anomaly. Differential diagnosis and indication for cardiac transplantation in an infant

We report the case of an 8-month-old female infant with Uhl's anomaly, who underwent successful cardiac transplantation. The clinical findings, complementary laboratory tests, anatomic findings, and differential diagnosis of the anomaly are discussed.

New auxiliary indicators for the differential diagnosis of functional cardiorespiratory limitation in patients with chronic obstructive pulmonary disease and congestive heart failure

OBJECTIVE: To differentiate the nature of functional cardiorespiratory limitations during exercise in individuals with chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF) and to determine indicators that may help their classifications. METHODS: The study comprised 40 patients: 23 with COPD and 17 with CHF. All individuals underwent maximal cardiopulmonary exercise testing on a treadmill. RESULTS: The values of peak gas exchange ratio (R peak), peak carbon dioxide production (VCO2 peak), and peak oxygen ventilatory equivalent (V E O2 peak) were higher in the patients with CHF than in those with COPD, and, therefore, those were the variables that characterized the differences between the groups. For group classification, the differentiating functions with the R peak, VCO2 peak (L/min), and V E O2 peak variables were used as follows: group COPD: - 44.886 + 78.832 x R peak + 5.442 x VCO2 peak + 0.336 x V E O2 peak; group CHF: - 69.251 + 89.740 x R peak + 8.461 x VCO2 peak + 0.574 x V E O2 peak. The differentiating function, whose result is greater, correctly classifies the patient's group as 90%. CONCLUSION: The R peak, VCO2 peak, and V E O2 peak values may be used to identify the cause of the functional cardiorespiratory limitations in patients with COPD and CHF.

Drosophilidae (Diptera) associated to fungi: differential use of resources in anthropic and Atlantic Rain Forest areas

This study investigates the Drosophilidae species associated to fruiting bodies of fungi in forested and anthropized environments of the Atlantic Rain Forest Biome, in south and southeastern Brazil. We collected samples of imagoes flying over and emerging from fruiting bodies of species of five fungi families, in six collection sites. We obtained 18 samples, from which emerged 910 drosophilids of 31 species from the genera Drosophila Fallen, 1823, Hirtodrosophila Duda, 1923, Leucophenga Mik, 1886, Mycodrosophila Oldenberg, 1914, Scaptomyza Hardy, 1849, Zaprionus Coquillett, 1901 and Zygothrica Wiedemann, 1830. The Drosophila species collected on fungi, as well as Zaprionus indianus Gupta, 1970, had previously been recorded colonizing fruits, demonstrating their versatility in resource use. Most of these species belong to the immigrans-tripunctata radiation of Drosophila. Our records expands the mycophagous habit (feeding or breeding on fungi) to almost all species groups of this radiation in the Neotropical region, even those supposed to be exclusively frugivorous. Assemblages associated to fungi of forested areas were more heterogeneous in terms of species composition, while those associated to fungi of anthropized areas were more homogeneous. The drosophilids from anthropized areas were also more versatile in resource use.

Diel vertical migration of predators (planktivorous fish larvae) and prey (zooplankton) in a tropical lagoon

ABSTRACT Based on the hypothesis that diel vertical migration (DVM) is a mechanism of predator avoidance, the objective of the present study was to test for the occurrence of DVM in planktivorous fish larvae of Hypophthalmus edentatus (Spix, 1829) (Siluriformes, Pimelodidae) and Plagioscion squamosissimus (Heckel, 1840) (Perciformes, Sciaenidae), and zooplankton (rotifers, cladocerans and copepods) in an isolated tropical lagoon in the floodplain of the Upper Paraná River, Brazil (region of Parque Nacional de Ilha Grande). We investigated spatial overlap between predators (planktivorous fish larvae) and prey (zooplankton), and tested which physical and chemical variables of the water are related to the DVM of the studied communities. We performed nocturnal (8:00 pm and 4:00 am) and diurnal sampling (8:00 am and 4:00 pm) in the limnetic region of the lagoon for six consecutive months, from October 2010 to March 2011, which comprises the reproductive period of the fish species analyzed. During the day the larvae tried to remain aggregated in the bottom of the lagoon, whereas at night they tried to disperse in the water column. Especially for cladocerans, the diel vertical migration is an important behavior to avoid predation larvae of H. edentatus and P. squamosissimus once decreased spatial overlap between secured and its potential predators, which corroborates the hypothesis that DVM is a mechanism of predator avoidance. Although significant correlations were observed between the abiotic factors and WMD of microcrustaceans at certain times of day, the effect of predation of fish larvae on zooplankton showed more important in this environment, because the small depth and isolation not allow great variation of abiotic factors seasonally and between strata the lagoon.

Dysproteinaemia in the differential diagnosis of kala-azar

Serum protein abnormalities were examined in six kala-azar (KA) patients, six controls with positive immunofluorescence tests with Leishmania donovani antigens, and six seronegative controls. KA patients were clearly distinguishable from controls by several parameters, including A/G ratio, albumin and globulin levels, IgM and IgG titers, and positive rheumatoid factor (RF) tests. A positive relationship was noted between RF titers and serum levels of IgM. The diagnostic value and possibel pathologic significance of serum abnormalities in KA is discussed.

Differential effect of culture epimastigotes and blood-form Trypamastigotes on normal mouse splenocyte responsiveness to mitogens

Blood form trypomastigotes of the Y strain of T. cruzi, produced a strong inhibition of the blastogenic response to T and B cell mitogens, of the C3H/He, C57BLand BALB/cJ strains of mice, while culture epimastigotes of the Y strain kept in a medium that allows parasite growth at 26°. 30° and 37°C produced a strong stimulatory effect that was even higher than the effect of the mitogens alone. Both the inhibitory or the stimulatory effects were dose-dependent. The stimulatory effect of epimastigotes was also temperature-dependent producing increasedstimulation indexes as the temperature of parasite cultures was raised. Metabolically active,living parasites seemed to be necessary for an improved lymphocyte stimulation suggesting a potential role of secreted metabolites as polyclonal activators of mouse lymphocytes.