Meningoencefalites toxoplásmica e chagásica em pacientes com infecção pelo vírus da imunodeficiência humana: diagnóstico diferencial anatomopatológico e tomográfico

Em 22 pacientes com sorologia positiva para o vírus da imunodeficiência humana, com ou sem síndrome da imunodeficiência adquirida, dos quais 7 com meningoencefalite toxoplásmica e 15 com meningoencefalite chagásica associadas, procuraram-se dados diferenciais, entre as duas encefalopatias, tanto à anatomia patológica quanto à tomografia computadorizada do crânio. Os resultados observados e os dados da literatura nos permitiram concluir que enquanto na meningoencefalite necrosante focal por Toxoplasma gondii o acometimento dos núcleos da base é freqüente, na meningoencefalite necrosante focal causada pelo Trypanosoma cruzi, lesões dessas estruturas parecem não ocorrer ou ser excepcionais. De outro lado, o acometimento da substância branca parece nitidamente maior na meningoencefalite chagásica que na meningoencefalite toxoplásmica, ao passo que o parasitismo e a hemorragia do tecido nervoso, bem como as lesões das bainhas de mielina são mais freqüentes e intensos na meningoencefalite causada pelo Trypanosoma cruzi que naquela por Toxoplasma.

Enfermedad de Chagas-Mazza congenita en Salta

Se estudió la infección por T. cruzi en mujeres embarazadas en la localidad de General Güemes, provincia de Salta. La misma fue del 12,3 %. El 8,8% de los recién nacidos estudiados tuvieron diagnóstico de Enfermedad de Chagas utilizando la técnica directa (microhematocrito). Todos fueron tratados con benznidazol a razón de 5mg/kg/día durante 30 dias. Todos presentaron anemia, que fue interpretada como reacción adversa medicamentosa. Se estima que la técnica directa representa la mejor opción para llevar a cabo el diagnóstico de esta enfermedad en el recién nacido. Se ha propuesto un flujograma para el seguimiento de la infección por T. cruzi en el recién nacido.

Morphometric study of the fibrosis and mast cell count in the circular colon musculature of chronic Chagas patients with and without megacolon

A morphometric study of the circular colon musculature was performed, in which the mast cell count was determined and the connective fibrous tissue in this layer was measured. The objective was to gain better understanding of Chagas megacolon morphology and contribute towards the knowledge of fibrosis pathogenesis in Chagas megas. An evaluation was made of 15 distal sigmoid rings from Chagas patients with megacolon (MCC), 15 without megacolon (CSMC) and 15 non-Chagas patients (NC). The rings were fixed in formol, embedded in paraffin, and 7mm thick sections were cut and stained using Azan-Heidenhain and Giemsa. The mast cell count and fibrosis were greater in the MCC group than in the CSMC and NC groups (p < 0.05; Kruskal-Wallis test) and there was no significant difference between the latter two. The fibrosis and increased mast cell count in the colon musculature of the MCC group possibly indicates that there is a relationship between mastocytosis and fibrosis, as has already been demonstrated in other pathologies.

Papel do óxido nítrico no desenvolvimento de lesões cardíacas na fase aguda da infecção experimental pelo Trypanosoma cruzi

A doença de Chagas é causada pelo Trypanosoma cruzi e o coração é o órgão mais acometido. O óxido nítrico apresenta importante ação anti-Trypanosoma, porém, com pouca evidência de seu papel no mecanismo de lesão tecidual. O objetivo deste estudo foi analisar a contribuição do óxido nítrico no desenvolvimento da inflamação e da fibrose cardíaca na fase aguda da infecção experimental por cepas Y e Colombiana do Trypanosoma cruzi. A inflamação foi significativamente maior nos animais infectados pela cepa Colombiana, comparada com os infectados com a cepa Y, tanto nos animais C57BL/6 (3,98x1,87%; p=0,004) quanto nos animais C57BL/6 deficientes na sintase do óxido nítrico induzível (3,99x2,4%; p=0,013). O parasitismo cardíaco dos animais C57BL/6 deficientes na sintase do óxido nítrico induzível infectados pela cepa Colombiana foi significativamente maior que o destes mesmos animais infectados com a cepa Y (2,78x0,17 ninhos/mm²; p=0,004) assim como, os animais C57BL/6 infectados com a cepa Colombiana (2,78x1,33 ninhos/mm²; p=0,006) ou cepa Y (2,78x0,53 ninhos/mm²; p=0,005). Os dados reforçam o papel do óxido nítrico no controle do parasitismo e sugerem seu papel na proteção tecidual, controlando a inflamação e potencialmente diminuindo lesões cardíacas durante a fase aguda na doença de Chagas experimental.

Active surveillance of American tegumentary leishmaniasis in endemic areas in rural Bolivia

INTRODUCTION: American tegumentary leishmaniasis (ATL), including mucocutaneous leishmaniasis (MCL) and localized cutaneous leishmaniasis (LCL), is endemic in Bolivia. We describe the results of active surveillance of ATL from 2001 to 2006 and assess demographic data related to ATL epidemiology in the Yungas valleys. METHODS: Community-based active ATL surveillance was performed by the institutions SERVIR, CÁRITAS, and the Health Services Department of La Paz, whose files were reviewed retrospectively. A cross-sectional survey was carried out to assess demographic data in two communities. RESULTS: Two thousand nine hundred nine cases of ATL were detected from 2001 to 2006: 2,488 (85.5%) corresponded to LCL and 421 (14.5%) to MCL. A reduction in the proportion of mucosal cases was observed between 2001 and 2006. The proportion of MCL cases increased with age and was higher among males (15.5% versus 12.1%, p=0.018). The rate of positivity via direct observation of the parasite in dermal scrapings and in parasite cultivation was significantly higher for LCL than for MCL (p<0.001 and p=0.009, respectively). The rate of reactivity in the leishmanin skin test was higher in the group with mucosal lesions (p=0.012). The cross-sectional survey showed that 40% of the families had emigrated from the Altiplano. CONCLUSIONS: It is necessary to undertake continuous case detection of ATL in the area, where the disease presents a high rate of mucosal cases. Increasing incidence seems to be associated with immigration and continuous deforestation to expand the crop-growing areas.

Immune reconstitution inflammatory syndrome in HIV and sporotrichosis coinfection: report of two cases and review of the literature

We report 2 cases of patients with immune reconstitution inflammatory syndrome (IRIS) associated with cutaneous disseminated sporotrichosis and human immunodeficiency virus (HIV) coinfection. The patients received specific treatment for sporotrichosis. However, after 4 and 5 weeks from the beginning of antiretroviral therapy, both patients experienced clinical exacerbation of skin lesions despite increased T CD4+ cells (T cells cluster of differentiation 4 positive) count and decreased viral load. Despite this exacerbation, subsequent mycological examination after systemic corticosteroid administration did not reveal fungal growth. Accordingly, they were diagnosed with IRIS. However, the sudden withdrawal of the corticosteroids resulted in the recurrence of IRIS symptoms. No serious adverse effects could be attributed to prednisone. We recommend corticosteroid treatment for mild-to-moderate cases of IRIS in sporotrichosis and HIV coinfection with close follow-up.

Quality assessment of clinical practice guidelinesfor Chagas disease

INTRODUCTION: The development of clinical practice guidelines (CPGs) has increased; this study aimed to assess the quality of CPGs for the management of Chagas disease. METHODS: Following a systematic search of the scientific literature, two reviewers assessed the eligible guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) II instrument. RESULTS: Five CPGs were included. The AGREE domains of scope/purpose, stakeholder involvement, and clarity of presentation were rated well, and the domains of applicability and editorial independence received poor ratings. CONCLUSIONS: The quality of CPGs for Chagas disease is poor, and significant work is required to develop high-quality guidelines.

Titanium pigment in tissues of drug addicts: report of 5 necropsied cases

The aim of this report is to describe the anatomic-pathologic findings from necropsies of 5 drug addicts with titanium pigment in several organs after chronic intravenous injection of crushed propoxyphene hydrochloride tablets. Samples from liver, spleen, lungs, lymph nodes, and bone marrow were obtained, and after being grossly studied, they were submitted to evaluation using common light and polarized microscopy. In all 5 cases, a pigment with characteristics of titanium dioxide was found within tissue samples of the organs studied. Our findings suggest that research concerning titanium pigment within body tissues should be enhanced, considering the potential contribution of this morphologic data to forensic pathology.

Aspectos da esfingofauna (lepidoptera, sphingidae), em área de terra-firme, no estado do Amazonas, Brasil

Abundância, riqueza, horário de vôo, razão sexual de Sphingidae são estudadas no Município de Itacoatiara, Estado do Amazonas, em área perturbada de terra-firme na Amazônia brasileira, durante treze meses consecutivos (40 noites), entre julho/1990 - julho/1991. Obteve-se 61 espécies, incluindo todo material coletado, com a predominância de Dilophonotini (29 espécies), seguida por Sphingini (14), Philampelini (7), Smerinthini (6) e Macroglossini (5). A comunidade de Sphingidae é comparada com dados de outras localidades da região Neotropical (Américas do Sul e Central).

Leaf micronutrient concentrations and potential photosynthesis in Ochroma pyramidale established in a degraded land

In the Brazilian Amazon, large areas of abandoned lands may revert to secondary forest. In the process, pioneer tree species have an important role to restore productivity in old fields and improve environmental conditions. To determine potential photosynthesis (Apot), stomatal conductance (g), transpiration (E), and leaf micronutrient concentrations in Ochroma pyramidale (Cav. ex Lam.) Urban a study was carried out in the Brazilian Amazon (01o 51' S; 60o 04' W). Photosynthetic parameters were measured at increasing [CO2], saturating light intensity (1 mmol (photons) m-2 s-1), and ambient temperature. The rate of electron-transport (J), Apot,and water-use efficiency (WUE) increased consistently at increasing internal CO2 concentration (Ci). Conversely, increasing [CO2] decreased gs, E, and photorespiration (Pr). At the CO2-saturated region of the CO2 response curve (1.1 mmol (CO2) mol-1(air), J was 120 μmol (e-) m-2s-1 and Apot reached up to 24 μmol (CO2) m-2s-1. Likewise, at saturating C1 g and E were 30 and 1.4 mmol (H2O) m-2s-1, respectively, and P 2 r about 1.5 μmol (CO2) m-2s-1. Foliar nutrients were 185, 134, 50, and 10 μmol (element) m-2 (leaf area) for Fe, Mn, Zn, and Cu, respectively. It was concluded that [CO ] probably limits light saturated photosynthesis in this site. Furthermore, from a nutritional point of view, the low Fe to Cu ratio (15:1) may reflect nutritional imbalance in O. pyramidale at this site.

Nutritional status and specific leaf area of mahogany and tonka bean under two light environments

Studies on nutritional status and leaf traits were carried out in two tropical tree species Swietenia macrophylla King (mahogany) and Dipetryx odorata Aubl. Willd. (tonka bean) planted under contrasting light environments in Presidente Figueiredo-AM, Brazil. Leaves of S. macrophylla and D. odorata were collected in three year-old trees grown under full sunlight (about 2000 µmol m-2 s-1) and natural shade under a closed canopy of Balsa-wood plantation (Ochroma pyramidale Cav. Ex. Lam.Urb) about 260 µmol m-2 s-1. The parameters analysed were leaf area (LA), leaf dry mass (LDM), specific leaf area (SLA) and leaf nutrient contents. It was observed that, S. macrophylla leaves grown under full sunlight showed LA 35% lower than those grown under shade. In D. odorata leaves these differences in LA were not observed. In addition, it was observed that S. macrophylla shade leaves, for LDM, were 50% smaller than sun leaves, while in D. odorata, there differences were not observed. SLA in S. macrophylla presented that sun leaves were three times smaller than those grown under shade. In D. odorata, no differences were observed. Nutrient contents in S. macrophylla, regardless of their light environments, showed higher contents for P and Ca than those found in D. odorata. The N, K, Fe and Mn contents in S. macrophylla leaves decreased under shade. Finally, we suggest that the decreasing in leaf nutrient contents may have a negative influence on leaf growth. The results demonstrated that the tested hypothesis is true for leaf traits, which D. odorata, late-successional species, showed lower plasticity for leaf traits than Swietenia macrophylla, mid-successional species.

La agricultura en la Amazonia ribereña del río Ucayali: ¿una zona productiva pero poco rentable?

La riqueza de los suelos aluviales a lo largo de los ríos amazónicos permite altos rendimientos en los cultivos. En el Perú, esta característica ha sido sustento de propuestas que sugieren concentrar la agricultura amazónica en sus riberas. Sin embargo, la viabilidad económica de la agricultura ribereña sigue siendo desconocida. Este artículo usa un modelo agroeconómico y analiza la rentabilidad de la agricultura ribereña del río Ucayali en las cercanías de Pucallpa. Se da énfasis a la importancia de las distintas condiciones agronómicas y del mercadeo propias de la zona. Los resultados muestran que la rentabilidad de los sistemas agrícolas ribereños difiere con el tipo de tierra utilizado y con el carácter temporal o permanente de la actividad que realizan los agricultores. Además, la rentabilidad está condicionada a las variaciones propias de la agricultura ribereña, particularmente las inundaciones tempranas. Así los buenos rendimientos de sus suelos aluviales no garantizan la rentabilidad en todos sus cultivos y sistemas.

Utilização de dados MODIS para a detecção de queimadas na Amazônia

O objetivo do presente artigo foi o de avaliar o produto MOD14 quanto à sua performance para detectar áreas queimadas na Amazônia, mais específicamente no norte do Estado do Mato Grosso, considerando o período entre 21/06/2004 e 07/07/2004, comparando os resultados fornecidos pelo MOD14 e interpretações visuais de áreas queimadas obtidas de imagens TM/Landsat-5. O produto MOD14 detectou 51,58% do total de áreas queimadas, cujo tamanho médio foi de 83,14 ha; os restantes 48,42% não detectados tinham tamanho médio de 38,74 ha. O produto MOD14 superestima a quantidade de áreas queimadas ao classificar solos expostos, florestas e outros tipos de coberturas da terra como pixels "hot spots"; além disso, este produto não detecta áreas queimadas de dimensões pequenas (< 100 ha), proporcionando erros de classificação em grandes áreas de solos expostos.

First record of the bushy-tailed opossum, Glironia venusta, Thomas, 1912, (Didelphimorphia) from Manaus, Amazonas, Brazil

A new record of a very rarely observed mammal, the bushy-tailed opossum, Glironia venusta (Didelphimorphia), was obtained for the Adolpho Ducke Forest Reserve, Manaus, Amazonas state, Brazil. Only 17 other records existed of this species, most from the 1980s. There were only three previous records of the species from Brazil (in the states of Pará, Amazonas and Rondônia). This new record supports the notion that G. venusta is a locally rare species throughout its range, but widely distributed in Brazilian Amazonia.

Variación florística de especies arbóreas a escala local en un bosque de tierra firme en la Amazonia colombiana

El presente estudio se llevó a cabo en cinco hectáreas de una parcela permanente establecida en el Parque Nacional Amacayacu, Amazonia colombiana. En éste, se evaluó el efecto de la variación ambiental y la configuración espacial sobre los patrones florísticos de las especies arbóreas (DAP>10 cm) a escala local en un bosque de tierra firme. Se estudió la variación florística y ambiental en cuadrantes de 20x20 m. Adicionalmente, se consideraron diferentes categorías de abundancia (total, alta, media y baja). Se utilizó el Análisis de Correspondencia Linealizado y el Análisis de Correspondencia Canónica, seguido de una partición de la variación, para cuantificar la magnitud a la cual el ambiente y la limitación en dispersión determinan la variación florística. La fracción espacial, representando procesos de autocorrelación como la limitación en dispersión, se analizó mediante dos métodos: Asumiendo un polinomio de tercer grado y por el método de Coordenadas Principales de Matrices Vecinas (PCNM). La diversidad beta de la parcela fue baja. El PCNM aparece como el método de análisis más apropiado para estudios a esta escala. Las diferencias florísticas explicadas a lo largo de la parcela de 5-ha fueron principalmente asociadas con procesos biológicos como la limitación en dispersión. La mayor parte de la variación florística, no obstante, no fue explicada por las variables ambientales o espaciales consideradas. En conclusión, estos resultados sugieren que procesos aleatorios son determinantes esenciales de la variación espacial de las especies arbóreas a escala local en tierra firme en los bosques en el Parque Nacional Amacayacu.