Histological and endoscopic features of the stomachs of patients with Chagas disease in the era of Helicobacter pylori

Introduction Most studies that have evaluated the stomachs of patients with Chagas disease were performed before the discovery of Helicobacter pylori and used no control groups. This study compared the gastric features of chagasic and non-chagasic patients and assessed whether gastritis could be associated with Chagas disease. Methods Gastric biopsy samples were taken from patients who underwent endoscopy for histological analysis according to the Updated Sydney System. H. pylori infection was assessed by histology, 16S ribosomal ribonucleic acid (rRNA) polymerase chain reaction (PCR), serology and the 13C-urea breath test. Patients were considered H. pylori-negative when all of these diagnostic tests were negative. Clinical and socio-demographic data were obtained by reviewing medical records and using a questionnaire. Results The prevalence of H. pylori infection (70.3% versus 71.7%) and chronic gastritis (92.2% versus 85%) was similar in the chagasic and non-chagasic groups, respectively; such as peptic ulcer, atrophy and intestinal metaplasia. Gastritis was associated with H. pylori infection independent of Chagas disease in a log-binomial regression model. However, the chagasic H. pylori-negative patients showed a significantly higher grade of mononuclear (in the corpus) and polymorphonuclear (PMN) (in the antrum) cell infiltration. Additionally, the patients with the digestive form of Chagas disease showed a significantly lower prevalence of corpus atrophy than those with other clinical forms. Conclusions The prevalence of H. pylori infection and of gastric histological and endoscopic features was similar among the chagasic and non-chagasic patients. Additionally, this is the first controlled study to demonstrate that H. pylori is the major cause of gastritis in patients with Chagas disease.

Opportunistic infections among individuals with HIV-1/AIDS in the highly active antiretroviral therapy era at a Quaternary Level Care Teaching Hospital

INTRODUCTION : In this study, clinical-laboratory and epidemiological characteristics are described for a group of 700 individuals with HIV (human immunodeficiency virus)/AIDS (acquired immunodeficiency syndrome) in the ART (antiretroviral therapy) era at a teaching hospital that provides a quaternary level of care, with an emphasis on opportunistic infections (OIs), co-infections and immune profile. METHODS : A retrospective cross-sectional study of AIDS cases was conducted from 1998 to 2008 by reviewing medical records from the Base Hospital/FUNFARME (Fundação Faculdade Regional de Medicina), São José do Rio Preto, São Paulo, Brazil. RESULTS: The individuals were 14 to 75 years of age, and 458 were males. Heterosexuals accounted for 31.1% of all patients. Eighty-three percent were on ART, and 33.8% of those presented difficulties with treatment adherence. OIs were analyzed from medical records, and Pneumocystis jiroveci pneumonia was the most prevalent, regardless of the LTCD4+ (TCD4+ Lymphocytes) levels. Individuals whose viral loads were ≥10,000 showed a 90% greater chance of neurotoxoplasmosis. For P. jiroveci pneumonia, neurotoxoplasmosis, esophageal candidiasis, pulmonary tuberculosis and neurocryptococcosis, the chances of infection were higher among patients with LTCD4+ levels below 200 cells/mm3. HIV/hepatitis C virus (HCV) and HIV/hepatitis B virus (HBV) co-infections were significantly associated with death. CONCLUSIONS : OIs remain frequent in the ART era even in populations where the access to medical care is considered satisfactory.

Prevalence and evolution of Mycobacterium tuberculosis infection in tuberculosis case contacts

INTRODUCTION : The tuberculin test is a diagnostic method for detecting latent tuberculosis (TB) infection, especially among disease contact cases. The objective of this study was to analyze the prevalence and evolution of Mycobacterium tuberculosis infection among TB contact cases. METHODS : A retrospective cohort study was performed in a reference center for TB. The study population consisted of 2,425 patients who underwent a tuberculin test from 2003 to 2010 and whose results indicated contact with individuals with TB. The data were collected from the registry book of the tuberculin tests, patient files and the Information System Records of Notification Grievance. To verify the evolution of TB, case records through September 2014 were consulted. Data were analyzed using the Statistical Package for the Social Sciences (SPSS). In all hypothesis tests, a significance level of 0.05 was used. RESULTS : From the studied sample, 435 (17.9%) contacts did not return for reading. Among the 1,990 contacts that completed the test, the prevalence of latent TB infection was 35.4%. Of these positive cases, 50.6% were referred to treatment; the dropout rate was 42.5%. Among all of the contacts, the TB prevalence was 1.8%, from which 13.2% abandoned treatment. CONCLUSIONS : The collected data indicate the need for more effective public policies to improve TB control, including administering tests that do not require a return visit for reading, enhancing contact tracing and encouraging actions that reinforce full treatment adherence.

Injuries caused by aquatic animals in Brazil: an analysis of the data present in the information system for notifiable diseases

AbstractINTRODUCTION:We present a review of injuries in humans caused by aquatic animals in Brazil using the Information System for Notifiable Diseases [ Sistema de Informação de Agravos de Notificação (SINAN)] database.METHODS:A descriptive and retrospective epidemiological study was conducted from 2007 to 2013.RESULTS:A total of 4,118 accidents were recorded. Of these accidents, 88.7% (3,651) were caused by venomous species, and 11.3% (467) were caused by poisonous, traumatic or unidentified aquatic animals. Most of the events were injuries by stingrays (69%) and jellyfish (13.1%). The North region was responsible for the majority of reports (66.2%), with a significant emphasis on accidents caused by freshwater stingrays (92.2% or 2,317 cases). In the South region, the region with the second highest number of records (15.7%), jellyfish caused the majority of accidents (83.7% or 452 cases). The Northeastern region, with 12.5% of the records, was notable because almost all accidents were caused by toadfish (95.6% or 174 cases).CONCLUSIONS:Although a comparison of different databases has not been performed, the data presented in this study, compared to local and regional surveys, raises the hypothesis of underreporting of accidents. As the SINAN is the official system for the notification of accidents by venomous animals in Brazil, it is imperative that its operation be reviewed and improved, given that effective measures to prevent accidents by venomous animals depend on a reliable database and the ability to accurately report the true conditions.

Prognostic factors in locally advanced colon cancer treated by extended resection

The impact of clinical, pathologic, and surgical variables on the postoperative morbidity, mortality, and survival of patients undergoing extended resections of colon carcinoma were evaluated. METHODS: The medical records of 95 patients who underwent extended resections for colon carcinoma between 1953 and 1996 were reviewed. In all cases, in addition to colectomy, 1 or more organs and/or structures were resected en bloc due to a macroscopically based suspicion of tumor invasion. The clinical, pathologic, and surgical parameters were analyzed. Overall survival rates were analyzed according to the method of Kaplan and Meier. Multivariate analysis was performed using the Cox proportional hazards model. RESULTS: Eighty-six patients were treated by curative surgeries and the remaining by palliative resections. Invasion of the organs and/or adjacent structures and regional lymph nodes was found microscopically in 48 and 31 patients, respectively. The median follow-up without postoperative mortality was 47.7 months. The 5-year overall survival rates was 52.6%. The 5-year overall survival rates for patients undergoing curative and palliative surgeries was 58.3% and 0%, respectively. The mean survival time in the palliative surgery group was 3.1 months. Multivariate analysis showed that Karnofsky performance status was strongly related to the risk of postoperative complications (P = .01), and postoperative deaths were associated with the type of surgery and Karnofsky performance status at the time of admission (P = .001). CONCLUSIONS: Some patients with locally advanced colon adenocarcinomas undergoing extended resections have a 5-year overall survival rates of 58.3%. Patients could benefit from palliative-intent procedures, but these measures should cautiously be indicated and avoided in patients with low Karnofsky performance status due to high rates of postoperative mortality and poor survival.

New pteridophyte records for the territory of Amapá, Brazil.

Eighteen Pteridophyte taxa in 15 genera are reported as new for the Territory of Amapá, Brazil. The collections area a result of a recent Projeto Flora Amazônica/Programa Flora expedition to that region, and update previous lists of taxa for Amapá.In 1975, Tryon and Conant publised a checklist of the ferns of the Brazilian Amazônia reporting 84 taxa for the Territory of Amapá. The paucity of records for Amapá reflects, at least in part, the amount of botanical exploration. The most complete list of taxa occurring in the Territory is an unpublished list of collection compiled by J. M. Pires. This compilation reports 118 taxas for the Territory of Amapá. The following list is intended to update both the Pires compilation an the Tryon and Conant checklist for the Territor. These records are the result of a Projeto Flora Amazônica/Programa Flora expedition to the region in the latter part of 1979. Species were included in this list is not reportes in the compilation of colections for Amapá, or listed as specifically occurrin in Amapá in the monographs and revisions consulted for listed as specifically occurring in Amapá in the monograohs and revisions consulted for identification (Evans, 1969; Kramer, 1957, 1978; de la Sota, 1960; Lellinger, 1972; Maxon & Morton, 1938; Scamman, 1960, Smith, 1971; Tryon, 1941, 1964).This list reports 18 taxa in 15 genera, increasing the number of taxa in Amapá from the 118 listed by Pires to 136. Most of the taxa reported here might have been predicted to occur in Amapá on the basis of their distribution records for surrounding regions.Each species is followed by a collection number. The collection number is that of D. F. Austin, C. E. Nauman, R. S. Secco, C. Rosario, and M. R. Santos except for four collections in which R. S. Secco was absent and B. V. Rabelo was present, and these are indicated after the collection number. Specimens are deposited in the herbaria of the Museu Paraense Emílio Goeldi, Belém, Brazil and the United States. The family system is essentially that used by Tyron and Conant.

New species and records of Psocoptera (Insecta) from Roraima State, Brazil.

Psocoptera. from Ilha de Marcica and Pacaraima, Roraima State, Brazil, representing 103 species are recorded. Sixty-two are new to science. and are described and figured, representing genera Echmepteryx(2), Tapinella(3), Musapsocus, (1), Seopsocus(3),Isth-mopsocis(3), Dolabellopsocus(6), Epipsocus(5), Neurostigma.(1), Nctiopscus(1), Cae-cilius (6) , Enderluinella (1), Xanthocarcilius(1) , Polypsocus(3) , Scytopsocus(1), ar-chipsocus(1), Lachesilla(4), Notolachesilla(1) , Perispsocus(4), Dactylopsocus (1) , Metylophorus(3), Blaste.(4), Lichenomiae(3), Myopsocus (3). Genus Notarchispsu. gen. is erected for Archipsocus macrurusNew and a new species. Genus MonocladellusEu-derlein in placed in synonymy of, PolypsocusHagen. South American species assigned to genus LophopterygllaEnderlein by New (1979) are. reassigned to Myopscus and represent a parallel development in the latter genus.

New records of Fredius denticulatus (H. Milne-Edwards, 1853) and F. reflexifrons (Ortmann, 1897), and the eastern limits of the distribution of pseudothelphusid crabs (Crustacea: Decapoda) in Brazil

The occurence of Fredius reflexifrons (Ortmann, 1897), a pseudothelphusid crab widely distributed in the Amazon region and the Atlantic Guianas, is recorded from the state of Ceará, northeastern Brazil. Other records of this species and Fredius denticulatus (H. Milne-Edwards, 1853) from the Amazon region are also presented. A discussion is made on the eastern limits of the distribution of the family Pseudothelphusidae in Brazil.

Libellulidae (Insecta: Odonata) from Itapiracó reserve, Maranhão, Brazil: new records and species distribution information

In this work, I apply a simple protocol to species occurrence inventory of Odonata in a region of Maranhão state which has very few distributional records. Some relations between species occurrence and environmental characteristics are discussed, mainly in relation to the high occurrence of Erythemis. Eighteen new records are presented discussing the role of this approach to generate useful information for conservation purposes.

Myxomycetes collection preserved in the herbarium of the Federal University of Roraima (Brazil)

First records of myxomycetes in the North region of Brazil go back to the 19th century. Nevertheless, the myxobiota of this region is still largely unexplored, with only 42 species recorded, distributed in 20 genera and seven families. The objectives of this paper were to characterize the Myxomycetes collection of the Herbarium of the Federal University of Roraima (UFRR) and to add new records for the myxobiota of this State. The collection holds specimens collected in fragments of Open Ombrophilous Forest, Seasonal Semi-deciduous Forest, Riparian Forest, deforested areas and urban home gardens in the state of Roraima. The 157 exsiccates were analyzed and identified or redetermined based on identification keys, descriptions and illustrations. The collection is in good conditions of preservation and includes all subclasses of Myxomycetes, 83% of its orders, 50% of its families, and 20 species. Trichiales, with one family, three genera and six species, represents 62% of all exsiccates. Cribraria aff. splendens, Metatrichia vesparia, Physarella oblonga, Stemonaria longa and Stemonitis splendens are new records for Roraima and Arcyria obvelata, Comatricha pulchella, Stemonitis pallida and Stemonitopsis aequalis are referred for the first time in the Northern Region, enlarging the knowledge of the Brazilian geographic distribution of these species.

Bat survey of the lower Juruena River and five new records for the state of Mato Grosso, Brazil

ABSTRACT The northern Brazilian state of Mato Grosso is considered an important biogeographical region, but has many sampling gaps. Apart from the well-documented non volant mammal community in the region, the bat fauna still poorly recorded. The aim of this study was to record the bat species of Juruena National Park, northern Mato Grosso, Brazil. Nineteen sites were sampled using mist-nets placed at ground level and near potential bat roosts. We collected 115 individuals belonging to 35 species and five families, which increased the number of species known for Mato Grosso´s Amazon from 86 to 91. The five new records were: Peropteryx kappleri, Peropteryx leucoptera, Lonchorhina inusitata, Tonatia saurophila, and Artibeus concolor. Our results pointed out the necessity of more studies in order to better estimate the bat diversity in northern Mato Grosso.

Comorbidities of mental and behavioral disorders in chemically dependent patients in different periods of abstinence

OBJECTIVE: To assess the frequency of comorbidities of mental and behavioral disorders (CMBD) in psychoactive substance (PAS)-dependent patients with different periods of abstinence cared for at Alcohol and Other Drug Psychosocial Care Centers (CAPS-ad). METHOD: All patients under treatment in the two CAPS-ad of the city of Uberlândia-MG, between April and September 2010, were consecutively assessed. The ICD-10 symptom checklist was used to diagnose CMBD; additional information was obtained from interviews and medical records. The patients were divided according to duration of abstinence: < 1 week (Group 1); 1-4 weeks (Group 2); and > 4 weeks (Group 3). RESULTS: Of all patients assessed, 62.8% were diagnosed with CMBD, which were more frequent (p < 0.05) in Group 1 (72%) than Group 3 (54.2%), and both groups were similar to Group 2 (61%). Depressive and anxiety disorders were more frequent among patients of Group 1. Mood disorders were more frequent (p < 0.05) in women [22/34 (65%) vs. 54/154 (35.1%)], whereas psychotic disorders were more frequent (p = 0.05) in men [16/154 (10.4%) vs. 0]. The presence of CMBD was associated with more severe clinical conditions. CONCLUSIONS: The higher frequency of diagnosis of CMBD in patients of Group 1 may have resulted from the difficulties in distinguishing mental disorders that are due to PAS intoxication or withdrawal from those that are not. However, to make the diagnosis of CMBD, even during detoxification, can increase the likelihood of better response to treatment.

Mortality by Heart Failure and Ischemic Heart Disease in Brazil from 1996 to 2011

Background:Circulatory system diseases are the first cause of death in Brazil.Objective:To analyze the evolution of mortality caused by heart failure, by ischemic heart diseases and by ill-defined causes, as well as their possible relations, in Brazil and in the geoeconomic regions of the country (North, Northeast, Center-West, South and Southeast), from 1996 to 2011.Methods:Data were obtained from DATASUS and death declaration records with codes I20 and I24 for acute ischemic diseases, I25 for chronic ischemic diseases, and I50 for heart failure, and codes in chapter XIII for ill-defined causes, according to geoeconomic regions of Brazil, from 1996 to 2011.Results:Mortality rates due to heart failure declined in Brazil and its regions, except for the North and the Northeast. Mortality rates due to acute ischemic heart diseases increased in the North and Northeast regions, especially from 2005 on; they remained stable in the Center-West region; and decreased in the South and in the Southeast. Mortality due to chronic ischemic heart diseases decreased in Brazil and in the Center-West, South and Southeast regions, and had little variation in the North and in the Northeast. The highest mortality rates due to ill-defined causes occurred in the Northeast until 2005.Conclusions:Mortality due to heart failure is decreasing in Brazil and in all of its geoeconomic regions. The temporal evolution of mortality caused by ischemic heart diseases was similar to that of heart failure. The decreasing number of deaths due to ill-defined causes may represent the improvement in the quality of information about mortality in Brazil. The evolution of acute ischemic heart diseases ranged according to regions, being possibly confused with the differential evolution of ill-defined causes.

Level of Physical Activity and In-Hospital Course of Patients with Acute Coronary Syndrome

Abstract Background: Acute coronary syndrome (ACS) is one of the main causes of morbidity and mortality in the modern world. A sedentary lifestyle, present in 85% of the Brazilian population, is considered a risk factor for the development of coronary artery disease. However, the correlation of a sedentary lifestyle with cardiovascular events (CVE) during hospitalization for ACS is not well established. Objective: To evaluate the association between physical activity level, assessed with the International Physical Activity Questionnaire (IPAQ), with in-hospital prognosis in patients with ACS. Methods: Observational, cross-sectional, and analytical study with 215 subjects with a diagnosis of ACS consecutively admitted to a referral hospital for cardiac patients between July 2009 and February 2011. All volunteers answered the short version of the IPAQ and were observed for the occurrence of CVE during hospitalization with a standardized assessment conducted by the researcher and corroborated by data from medical records. Results: The patients were admitted with diagnoses of unstable angina (34.4%), acute myocardial infarction (AMI) without ST elevation (41.4%), and AMI with ST elevation (24.2%). According to the level of physical activity, the patients were classified as non-active (56.3%) and active (43.7%). A CVE occurred in 35.3% of the cohort. The occurrence of in-hospital complications was associated with the length of hospital stay (odds ratio [OR] = 1.15) and physical inactivity (OR = 2.54), and was independent of age, systolic blood pressure, and prior congestive heart failure. Conclusion: A physically active lifestyle reduces the risk of CVE during hospitalization in patients with ACS.