Association between Angiotensin-Converting Enzyme Inhibitors and Troponin in Acute Coronary Syndrome

Background:Cardiovascular disease is the leading cause of mortality in the western world and its treatment should be optimized to decrease severe adverse events.Objective:To determine the effect of previous use of angiotensin-converting enzyme inhibitors on cardiac troponin I measurement in patients with acute coronary syndrome without ST-segment elevation and evaluate clinical outcomes at 180 days.Methods:Prospective, observational study, carried out in a tertiary center, in patients with acute coronary syndrome without ST-segment elevation. Clinical, electrocardiographic and laboratory variables were analyzed, with emphasis on previous use of angiotensin-converting enzyme inhibitors and cardiac troponin I. The Pearson chi-square tests (Pereira) or Fisher's exact test (Armitage) were used, as well as the non-parametric Mann-Whitney's test. Variables with significance levels of <10% were submitted to multiple logistic regression model.Results:A total of 457 patients with a mean age of 62.1 years, of whom 63.7% were males, were included. Risk factors such as hypertension (85.3%) and dyslipidemia (75.9%) were the most prevalent, with 35% of diabetics. In the evaluation of events at 180 days, there were 28 deaths (6.2%). The statistical analysis showed that the variables that interfered with troponin elevation (> 0.5 ng / mL) were high blood glucose at admission (p = 0.0034) and ST-segment depression ≥ 0.5 mm in one or more leads (p = 0.0016). The use of angiotensin-converting inhibitors prior to hospitalization was associated with troponin ≤ 0.5 ng / mL (p = 0.0482). The C-statistics for this model was 0.77.Conclusion:This study showed a correlation between prior use of angiotensin-converting enzyme inhibitors and reduction in the myocardial necrosis marker troponin I in patients admitted for acute coronary syndrome without ST-segment elevation. However, there are no data available yet to state that this reduction could lead to fewer severe clinical events such as death and re-infarction at 180 days.

Euglossine bees (Hymenoptera, Apidae) in a remnant of Atlantic Forest in Paraná State, Brazil

Species composition, relative abundance, seasonal changes in the species abundance and scent association of male Euglossini collected in a semi-deciduous forest fragment in the north of the State of Paraná, southern Brazil, were recorded. Euglossine males were collected twice a month, for twelve months, from 8:00 am to 3:00 pm. The scents eucalyptol, eugenol, vanillin, methyl salicylate and benzyl acetate were used as baits. A total of 434 males distributed among 3 genera and 9 species were attracted to the chemical baits. Eufriesea violacea (Blanchard, 1840) (49.8%), Eulaema nigrita Lepeletier, 1841 (23.0%) and Euglossa pleosticta Dressler, 1982 (13.8%) were dominant in number of individuals. Among the non-dominant species, Euglossa fimbriata Rebêlo & Moure, 1995 was more common (9.0%), followed by E. cordata (L., 1758) (1.8%), E. truncata Rebêlo & Moure, 1995 (1.4%), E. melanotricha Moure, 1967 (0.7%), E. townsendi Cockerell, 1904 (0.23%) and Eufriesea auriceps Friese, 1899 (0.23%). In general, bees were more abundant in warm-wet season (September-March). Eufriesea violacea was the most seasonal species, showing activity through the warm-wet season, from October to February. Eucalyptol was the most attractive fragrance, which was responsible for 92.6% of all visits by euglossine bees.

Seasonality, age structure and reproduction of Leptodactylus (Lithodytes) lineatus (Anura, Leptodactylidae) in Rondônia state, southwestern Amazon, Brazil

Leptodactylus(Lithodytes) lineatus (Schneider, 1799) is an Amazonian leaf litter frog considered rare or uncommon in several studies on anuran communities. Despite being a widely distributed frog in Amazonian forests, knowledge of the biology and ecology of this species is relatively scarce. This species has been reported to live in association with leaf-cutter ant nests (Atta spp.) during the breeding period. In this paper we present data on the seasonality of this species and some reproductive information gathered at a locality of Rondônia state, northwestern Brazil. Field work was carried out between April 2001 and March 2002, with the use of pitfall traps with drift fences as a survey method. Leptodactylus (L.) lineatus had a higher capture frequency in this locality compared to that of other studies carried out in other Amazonian localities, possibly because this species has secretive habits, such as calling and breeding from nests of leaf-cutting ants, and are difficult to find during visual encounter surveys. The breeding period occurs between October and March. Calling males and egg-bearing females were found between September and February and juvenile recruitment occurred mainly from the end of the rainy season to the beginning of the dry season (February to June). Males and females show sexual dimorphism in SVL, females being significantly larger than males. The number of ovarian eggs per female varies from 110 to 328 and analyses indicate that there is a significant correlation with SVL.

Observations on the dipteran fauna in a focus of dermal leishmaniasis in the State of Minas Gerais: II. The distribution of families in relation to their medical, veterinary and economic importance

Miniature light traps used to collect Phlebotominae in a focus of dermal leishmaniasis in the eastern part of the State of Minas Gerais, Brazil. Over a period of seven months, the other Diptera captured in 179 light trap samples were identified to family level. The traps were placed in eight localities which constituted three different biotopes: three woodland aresas, cultivated land, and a peridomestic site. A comparison is made between the totals of Dipeterans collected in each biotope, the total numbers of families collected in each biotope and the estimated indices of diversity. Dendograms representing the degrees of association between families of Diptera in different biotopes are presented. Some families of Diptera are uniformly distributed throughout the study area; a few families seem to have become adapted to areas where human activity has induced the greatest ecological changes. The impact between Dipterans and human well-being is discussed. The availabel evidence indicates that transmission of dermal leishmaniasis does not occur in areas where sand flies can be captured in greatest densities.

Blastocystis hominis: occurrence in children and staff members of municipal day-care centers from Botucatu, São Paulo State, Brazil

To study the frequency of Blastocystis hominis among healthy individuals, feces were collected from 153 children and 20 staff members of some municipal day-care centers. Three separate stool specimens of each individual were processed by Lutz and Faust methods. From 173 studied individuals, 60 (34.7%) showed B. hominis, frequently in association with other intestinal parasites and/or commensals. B. hominis was found mainly in adults and children between 36 and 72 months old. All positive cases were detected only by Lutz method and the use of three stool specimens increased the positivity of the parasitological diagnostic.

Intestinal Helminthiasis and Anaemia in Youngsters from Matriz da Luz, District of São Lourenço da Mata, State of Pernambuco, Brazil

A group of youngsters (4-18 years old) in northeast Brazil was studied to establish the prevalence of anaemia and intestinal parasitism, as well as to analyze the correlation between them. Two criteria were used to determine the state of anaemia, the level of haemoglobin and the mean of corpuscular volume. The first was considered a single criterion and the second an associated criteria, used in an attempt to correlate anaemia with iron deficiency. The prevalence of intestinal parasitism was 93%, while the prevalence of anaemia was 43.1% and 16.1% according to the criteria employed (single or associated respectively). Anaemia was significantly associated with both sex and age. No significant statistical difference was observed when the association was made between each parasite and anaemia even with those more related to anaemia.

Density of Sand Flies (Diptera: Psychodidae) in Domestic and Wild Animal Shelters in an Area of Visceral Leishmaniasis in the State of Rio Grande do Norte, Brazil

The objective of the present study was to determine the association of sand flies with the presence of domestic and wild animals in the peridomiciliary area. The sand flies were collected using direct aspiration and CDC light traps placed in animal shelters. The results suggest that different sand flies species have different behavioral characteristics in an apparent preference for animal baits and that Lutzomyia longipalpis and Lu. evandroi were the most eclectic species regarding their biotope choice. Lu. longipalpis showed a distinct preference for horses and Lu. evandroi for armadillos.

Frequency of human toxocariasis in Jos, Plateau State, Nigeria

The enzyme-linked immunosorbent assay (Elisa) was used to examine sera of 104 children and adults in Jos, Plateau State, Nigeria for anti-toxocaral antibodies, out of which 31 (29.8%) were reactive. The seropositive rates were 30.4% for adults, 29.6% for children, 34% for females and 25.9% for males. However, the differences were not significant by age and sex. A highly significant association (p < 0.001) was observed between seropositivity and geophagia but none between seropositivity and dog ownership (p > 0.05).

Community ecology of the metazoan parasites of white croaker, Micropogonias furnieri (Osteichthyes: Sciaenidae), from the coastal zone of the State of Rio de Janeiro, Brazil

One hundred specimens of white croakers, Micropogonias furnieri (Desmarest 1823) (Osteichthyes: Sciaenidae) collected from Pedra de Guaratiba (23°01'S, 43°38'W), State of Rio de Janeiro, Brazil, from September 1997 to August 1999, were necropsied to study their parasites. The majority of the fish (95%) were parasitized by metazoan. Twenty-eight species of parasites were collected. The nematodes were the 40.5% of the total number of parasites specimens collected. Dichelyne elongatus was the most dominant species. Lobatostoma ringens, Pterinotrematoides mexicanum, Corynosoma australe, D. elongatus, and Caligus haemulonis showed a positive correlation between the host's total length and parasite prevalence and abundance. The monogenean P. mexicanum had differences in the prevalence and abundance in relation to sex of the host. The mean diversity in the infracommunities of M. furnieri was H=0.499±0.411, with correlation with the host's total length and without differences in relation to sex of the host. One pair of ectoparasites showed positive covariation, and two pairs of endoparasites showed positive association and covariation between their prevalences and abundances, respectively. Negative association or covariations were not found. The dominance of endoparasites in the croakers parasite infracommunities reinforced the differences found in sciaenids from the South American Pacific Ocean, in which the ectoparasites are dominant.

Schistosomiasis mansoni is asssociated with pyogenic liver abscesses in the state of Minas Gerais, Brazil

The association between pyogenic liver abscesses and schistosomiasis has been confirmed by clinical and experimental studies. In this retrospective study of 78 patients with pyogenic liver abscesses the association with schistosomiasis has been investigated. Pyodermitis, a known focus of bacteremia, was observed in 19 patients (24%). Blood eosinophilia was observed in 30 patients (39%). Staphylococcus aureus was cultured from abscesses in 17 out of 38 patients (45%). Forty-one out of 57 patients (53%) had stool examination. Schistosoma mansoni was the main parasite identified. Eggs of S. mansoni were also identified in liver biopsies in 7 out of 19 patients who did the exam. The large number of young patients with liver abscesses described here is different from what has been observed in developed countries. This clinical study provide support for the concept that granulomas of S. mansoni in the liver are foci for colonization with S. aureus, which in presence of staphylococcal bacteremia can form liver abscesses.

Community ecology of the metazoan parasites of pink cusk-eel, Genypterus brasiliensis (Osteichthyes: Ophidiidae), from the coastal zone of the State of Rio de Janeiro, Brazil

Fifty-five specimens of pink cusk-eel, Genypterus brasiliensis Regan, 1903 (Osteichthyes: Ophidiidae) collected from the coastal zone of the State of Rio de Janeiro, Brazil (approx. 21-23°S, 41-45°W), from September 2000 to January 2001, were necropsied to study their parasites. All fish were parasitized by one or more metazoan. Fourteen species of parasites were collected. G. brasiliensis is a new host record for nine parasite species. The larval stages of cestodes and the nematodes were the majority of the parasite specimens collected, with 38.4% and 36.5%, respectively. Cucullanus genypteri was the dominant species with highest prevalence and/or abundance. The parasites of G. brasiliensis showed the typical overdispersed pattern of distribution. Six parasite species showed correlation between the host's total body length and prevalence and abundance. Host sex did not influence prevalence and parasite abundance of any parasite species. The mean diversity in the infracommunities of G. brasiliensis was H= 0.364 ± 0.103, with correlation with the host's total length and without differences in relation to sex of the host. One pair of adult endoparasites (C. genypteri and A. brasiliensis) showed positive covariations between their abundances. Negative association or covariation was not found. Differences between the qualitative and quantitative aspects of the parasite community of G. brasiliensis from Rio de Janeiro and Argentina suggest the existence of two population stocks of pink cusk-eel in the South America Atlantic Ocean.

Parasitic arthropods of some wild rodents from Juréia-Itatins Ecological Station, State of São Paulo, Brazil

A study of the associations between three species of rodents in the Atlantic forest and their parasitic arthropods was undertaken at the Juréia-Itatins Ecological Station, located in the State of São Paulo, Southeastern Brazil, from March 1989 to February 1990. Individuals of three species, Oryzomys russatus, Proechimys iheringi and Nectomys squamipes were captured and examined for ectoparasites. Eleven species of parasitic arthropods were found, including four species of insects and seven of Acari. Parasitism intensity, phenology, and rainfall were positively correlated with the abundance of the ectoparasites and their hosts. The most abundant host was O. russatus (Muridae: Sigmodontinae), and the most common parasite on it was the laelapid mite Gigantolaelaps oudemansi. The cuterebrid Metacuterebra apicalis caused myiasis in O. russatus. A mutualistic association between the staphylinid beetle Amblyopinus sp. and its host P. iheringi (Echimyidae) was observed. The few N. squamipes captured had small numbers of ectoparasites.

Association of human leukocyte antigen DQ1 and dengue fever in a white Southern Brazilian population

Dengue is an infectious disease of viral etiology transmitted by the mosquitoes Aedes aegypti, A. albopictus, and A. scutellaris. It can develop either as a benign form or as a severe hemorrhagic form. Previous work showed an association of the hemorrhagic form with human leukocyte antigens (HLA), suggesting a role of genetic factors in disease susceptibility. Nevertheless, data on HLA association with the classical form of the disease is scarce in literature. Sixty-four patients and 667 normal individuals, living in the state of Paraná, Southern Brazil, were used as test and control group, respectively. The patients developed the disease during a virus 1 dengue outbreak either in Maringá city in 1995 (47) or in Paranavaí city in 1999 (17). The diagnostic was confirmed through serology and/or viral culture. HLA class I and II typing was performed by the classical microlynfocitotoxicity test using monoclonal antisera and fluorobeads. Qui-square statistical analysis confirmed a positive association with HLA-DQ1 (76.6% vs 57.7%; p = 0.005243; pc = 0.026215). HLA-DR1 also presented an increased frequency in the test group, not statistically significant after p correction though (32.8% vs 15.9%; p = 0.005729; pc = 0.080206). In conclusion, genetic factors may play a role on the susceptibility to the classical dengue, virus 1, in the Brazilian population. Further independent studies should be performed in the Brazilian population to confirm these preliminary data.

Serological survey of Babesia bovis, Babesia bigemina, and Anaplasma marginale antibodies in cattle from the semi-arid region of the state of Bahia, Brazil, by enzyme-linked immunosorbent assays

The objectives of this work were to determine the prevalence of Babesia bovis, Babesia bigemina, and Anaplasma marginale detecting antibodies in cattle raised in the semi-arid region of the state of Bahia, Brazil, through indirect enzyme linked immunosorbent assays (ELISA) and to compare the performances of indirect enzyme-linked immunosorbent assays with crude (I-ELISA-CrAnaAg) and recombinant major surface protein-5 (I-ELISA-MSP-5Ag), as antigens to detect antibodies against A. marginale. An stable enzootic area was found in Senhor do Bonfim and Euclides da Cunha for B. bovis that showed 86 and 95.5% of prevalence, respectively, and for B. bigemina with 90.8 and 91.3%. On the other hand, Uauá and Juazeiro, were characterized as enzootically unstable areas, since prevalences were: B. bovis - 63.7 and 56.4% and B. bigemina - 53 and 54.8%, respectively. The prevalence of A. marginale in the four municipalities was above 97% with I-ELISA-CrAnaAg and 94.8% with I-ELISA-MSP-5Ag which is an indication of stable enzootic condition for the rickettsia. The I-ELISA-CrAnaAg and I-ELISA-MSP-5Ag showed a highly significant association (r = 0.977), which means that both ELISA tests are suitable for epidemiological studies of A. marginale.

Distribution of dengue vectors in neighborhoods with different urbanization types of Manaus, state of Amazonas, Brazil

Aedes aegypti and Ae. albopictus are vectors of dengue viruses, which cause endemic disease in the city of Manaus, capital of the state of Amazonas, Brazil. More than 53 thousand cases have been registered in this city since the first epidemic in 1998. We evaluated the hypothesis that different ecological conditions result in different patterns of vector infestation in Manaus, by measuring the infestation level in four neighborhoods with different urbanization patterns, during the rainy (April), dry (August), and transitional (November) seasons. Ae. aegypti predominated throughout the study areas and sampling periods, representing 86% of all specimens collected in oviposition traps. High frequencies of houses positive for both species were observed in all studied sites, with Ae. aegypti present in more than 84% of the houses in all seasons. Ae. albopictus, on the other hand, showed more spatial and temporal variation in abundance. We found no association between infestation level and house traits. This study highlights the homogeneity of dengue vector distribution in Manaus.