O babaçu (Orbignya phalerata martins) como provável fator de risco de infecção humana pelo agente da cromoblastomicose no Estado do Maranhão, Brasil

Após estudo de 30pacientes portadores de cromoblastomicose, acompanhados no hospital dos servidores do Estado do Maranhão, verificou-se em 2 (6,6%) lesões ná região glútea, diferindo do que geralmente se observa, pois na cromoblastomicose existe sempre história de microtraumatismo sofridos durante o trabalho na lavoura, propiciando o desenvolvimento mais freqüente das lesões nas extremidades, principalmente dos membros inferiores. Ambos pacientes, doentes há 10 anos, apresentavam lesões nodulares e verrugo-confluentes em placas coalescentes na região glútea direita. O diagnóstico etiológico foi firmado através de exame histopatológico e cultura, com isolamento de Fonsecaea pedrosoi. Na investigação epidemiológica do tipo de exposição verificou-se que os mesmos desempenhavam a profissão de quebradores de coco-babaçu, atividade relativamente comum no Estado. Parece evidente a relação entre o tipo de atividade profissional e o desenvolvimento da infecção.

Analysis of Toxoplasma gondii antigens with sera from toxoplasmosis patients

Some proteins of the Toxoplasma gondii are recognized by IgG, IgM and IgA antibodies in patients with acute and chronic toxoplasmosis, depending on the strain and stage of the Toxoplasma. Sixty-nine sera from immunocompetent individuals were studied through the Western-Blot Test: 20 has an acute infection, 29 has a chronic toxoplasmosis infection and 20 were healthy (seronegatives). The protein analysis revealed by IgG and IgM antibodies were performed through the Immunoplot method in order to know their recognition frequency (f) and be valued as infection markers. In the acute phase, the IgM antibodies showed a recognition frequency (f = 0.60) for the 60kDa protein, and in the chronic phase the IgG antibodies showed a recognition frequency (f = 0.68) for the 12kDa protein. Seronegatives revealed no type of band. The protein of 12kDa can be a diagnostic marker of the chronic phase while protein 60kDa of the acute phase of toxoplasmosis.

Reativação da infecção por Trypanosoma cruzi em paciente com síndrome de imunodeficiência adquirida

Uma paciente com síndrome de imunodeficiência adquirida (SIDA) e doença de Chagas, com xenodiagnóstico positivo, estava em uso prolongado de cetoconazol com o objetivo de suprimir a parasitemia e prevenir a reativação da doença de Chagas. O cetoconazol foi suspenso inadvertidamente após 6 meses de uso. Um mês após, a paciente foi internada com febre, cefaléia, vômitos, taquicardia e hepatoesplenomegalia. Tanto o xenodiagnóstico como o exame de sangue a fresco demonstraram a presença de Trypanosoma cruzi. O tratamento com benzonidazol foi instituído, com supressão da parasitemia. A paciente desenvolveu concomitantemente uma provável neurotoxoplasmose, evoluindo para o óbito em septicemia. À necropsia, não foram encontrados parasitas.

Avaliação de parâmetros para o diagnóstico laboratorial de infecção genital feminina pela Chlamydia trachomatis

Foram examinadas prospectivamente189 amostras cervicais de mulheres sintomáticas e assintomáticas. Foram colhidas 2 amostras do canal endocervical, das quais uma foi examinada pela reação de imunofluorescência direta (IFD) com anticorpo monoclonal (MicroTrak), para verificação da adequação das amostras. A segunda amostra foi inoculada em cultura de células McCoy. Uma terceira amostra foi coletada para pesquisa de anticorpos das classes IgG e IgA. A Chlamydia trachomatis foi isolada de 14/166 (8,4%) das mulheres com sintomas e de 3/23 (13%) daquelas sem sintomas. Observamos que as 152 mulheres do grupo sintomático, com cultura negativa, possuiam sintomas equivalentes. Em relação ao número de células epiteliais, verificou-se que 13 das 17 (76,5%) amostras endocervicais positivas pela cultura e pela IFD, todas apresentavam mais de 5 células. Tomando-se como critério de positividade títulos ³ 1:8, foram detectados anticorpos das classes IgG e/ou IgA específicos para C. trachomatis em 11/189 (64,7%) das 17 mulheres com cultura positiva. Conclusões: a) não existe sintoma que seja específico de infecção por clamídia (p > 0,05); b) a quantidade de células epiteliais representariam fator de interferência na positividade da cultura, sendo, portanto, variáveis dependentes (p < 0,001); c) a pesquisa de anticorpos na cérvice não poderia ser utilizada como diagnóstico alternativo, pois a sua detecção depende da fase evolutiva da infecção e da resposta imunitária individual.

Evaluation of the phagocytic activity of peripheral blood monocytes of patients with Jorge Lobo's disease

Studies on host-parasite interaction in Jorge Lobo's disease are scarce, with no report in the literature on the phagocytosis of Lacazia loboi by phagocytic mononuclear cells. Thus, the objective of the present study was to assess the phagocytic activity of blood monocytes in the presence of L. loboi in patients with the disease and in healthy subjects (controls) over 3 and 24 hours of incubation. Statistical analyses of the results showed no significant difference in percent phagocytosis of the fungus between patient and control monocytes. With respect to incubation time, however, there was a significant difference, in that percent phagocytosis was higher at 3 hours than at 24 hours (p <0.01). These results suggest that monocytes from patients with the mycosis are able to phagocyte the fungus, as also observed in control individuals.

Características clínicoepidemiológicas dos acidentes ofídicos em Rio Branco, Acre

Com o objetivo de determinar o perfil clínico-epidemiológico dos acidentes ofídicos, em hospital do Estado do Acre, foram estudados prospectivamente 144 pacientes admitidos no período de janeiro a dezembro de 2002. Desses, 113 (78,5%) foram classificados como vítimas de acidente com envenenamento. Os gêneros Bothrops, Lachesis e Micrurus foram responsáveis por, respectivamente, 75,7%, 2,1% e 0,7% dos casos. Os acidentes predominaram em pessoas do sexo masculino (78,5%), trabalhadores rurais (51,4%) e com idades entre 10 e 29 anos (43,8%). Nos acidentes botrópicos, os envenenamentos considerados moderados (48,6%) prevaleceram sobre os leves (31,2%) e graves (20,2%). Dois casos envolvendo o gênero Bothrops não receberam terapia antipeçonha. Entretanto, soro heterólogo foi administrado em 23 vítimas de acidente sem envenenamento. Concluindo, os resultados obtidos neste estudo diferiram dos observados por outros autores quanto à gravidade dos casos e adequação do tratamento, indicando a necessidade de treinamento da equipe.

Risk factors for Leishmania chagasi infection in an urban area of Minas Gerais State

In order to understand the determinants of human infection by Leishmania chagasi in an urban area, a cross-sectional population based study was conducted using molecular and serologic methods to identify infection. Participants were interviewed using a pre-coded questionnaire. Two criteria were tested to identify risk factors: Model 1- including all participants positive in hybridization by Leishmania donovani complex probe; Model 2- including all participants positive for hybridization and at least one serologic test. In Model 1, the variables associated with infection were: ownership of birds, time spent outside house between 6:00-10:00 PM and garbage not collected. In Model 2, the variables associated with infection were: family with knowledge of the vector, garbage not collected, garbage not removed or buried, ownership of birds and eroded areas in the neighborhood. The risk factors identified were associated with household conditions, presence of animals and the likelihood of contact with phlebotomine sandflies.

Diagnosing human asymptomatic visceral leishmaniasis in an urban area of the State of Minas Gerais, using serological and molecular biology techniques

A population-based cross-sectional study was set up in Sabará country, Southeastern Brazil, to identify asymptomatic human visceral leishmaniasis in an urban area of low disease prevalence. Blood was collected on filter paper (n=1,604 inhabitants) and examined by indirect immunofluorescent test, enzyme-linked immunosorbent assay and immunochromatographic strip test. The prevalence rates of infection ranged from 2.4 to 5.6% depending on the test used. One year later, venous blood was collected in a subset of 226 participants (102 seropositive and 124 seronegative). The tests performed were IFAT, ELISA, rk39-ELISA, polymerase chain reaction and hybridization with Leishmania donovani complex probe. No clinical signs or symptoms of leishmaniasis were observed. Using hybridization as a reference test, the sensitivity and specificity of serology were respectively: 24.8 and 71% (ELISA); 26.3 and 76.3% (rk-39); 30.1 and 63.4% (IFAT). Due to disagreements, different criteria were tested to define the infection and hybridization should be considered in epidemiological studies.

Formigas (Hymenoptera: Formicidae) como vetores de bactérias em dois hospitais do município de Divinópolis, Estado de Minas Gerais

A presença de formigas (Hymenoptera: Formicidae) em ambientes hospitalares pode constituir um problema de saúde pública, especialmente por serem vetores mecânicos de organismos patogênicos. O trabalho teve como objetivo realizar o levantamento de formigas e analisar a presença de bactérias a elas associadas em dois hospitais regionais de médio porte da cidade de Divinópolis, MG. As coletas foram realizadas mensalmente, durante um período de seis meses. Foram coletadas formigas Pheidole sp1 e sp2, Linepithema humile, Wasmannia auropunctata, Camponotus sp1 e sp2, Odontomachus sp, Solenopsis sp, Acromyrmex sp e Tapinoma melenocephalum. Observou-se que estas transportavam mecanicamente Pseudomonas aeruginosa, Enterococcus, Streptococcus, Staphylococcus patogênico e não patogênico e Escherichia coli. Tais resultados evidenciam a propensão à ocorrência de infecções hospitalares nesses locais pela transmissão mecânica de agentes patogênicos por formigas.

Reemergence of yellow fever: detection of transmission in the State of São Paulo, Brazil, 2008

INTRODUCTION: Following yellow fever virus (YFV) isolation in monkeys from the São José do Rio Preto region and two fatal human autochthonous cases from the Ribeirão Preto region, State of São Paulo, Brazil, two expeditions for entomological research and eco-epidemiological evaluation were conducted. METHODS: A total of 577 samples from humans, 108 from monkeys and 3,049 mosquitoes were analyzed by one or more methods: virus isolation, ELISA-IgM, RT-PCR, histopathology and immunohistochemical. RESULTS: Of the 577 human samples, 531 were tested by ELISA-IgM, with 3 positives, and 235 were inoculated into mice and 199 in cell culture, resulting in one virus isolation. One sample was positive by histopathology and immunohistochemical. Using RT-PCR, 25 samples were processed with 4 positive reactions. A total of 108 specimens of monkeys were examined, 108 were inoculated into mice and 45 in cell culture. Four virus strains were isolated from Alouattacaraya. A total of 931 mosquitoes were captured in Sao Jose do Rio Preto and 2,118 in Ribeirão Preto and separated into batches. A single isolation of YFV was derived from a batch of 9 mosquitoes Psorophoraferox, collected in Urupês, Ribeirão Preto region. A serological survey was conducted with 128 samples from the municipalities of São Carlos, Rincão and Ribeirão Preto and 10 samples from contacts of patients from Ribeirão Preto. All samples were negative by ELISA-IgM for YFV. CONCLUSIONS: The results confirm the circulation of yellow fever, even though sporadic, in the Sao Paulo State and reinforce the importance of vaccination against yellow fever in areas considered at risk.

Comportamento de formas imaturas de Aedes aegypti, no litoral do Estado de São Paulo

INTRODUÇÃO: Em região de alta incidência de dengue, no litoral do Estado de São Paulo, selecionaram-se 9 áreas, com objetivo de avaliar o comportamento de formas imaturas de Aedes aegypti. MÉTODOS: As 9 áreas foram agrupadas em 4 estratos, diferenciados pelo uso e ocupação do solo. Foram coletadas larvas e pupas numa amostra de cerca de 500 imóveis em cada área. RESULTADOS: Apesar do pneu e lona apresentarem as maiores taxas de positividade para Aedes aegypti, o ralo, juntamente com outros recipientes fixos nas edificações foram altamente predominantes entre os recipientes positivos (32 a 76% dos recipientes positivos). As áreas coletivas de prédios e os imóveis não residenciais de grande porte apresentaram as maiores taxas de positividade para Aedes aegypti enquanto os apartamentos, as menores. Os níveis de infestação foram maiores na área residencial com predominância de prédios de apartamentos, onde 76% dos criadouros detectados foram recipientes fixos nas edificações. CONCLUSÕES: Esses conhecimentos são importantes subsídios para a estratégia de controle, pois reforçam a necessidade de atenção especial para determinados tipos de imóveis, bem como da adequação da norma técnica de ralo de água pluvial e da melhoria de manutenção das edificações. Além disso, são necessárias observações sistemáticas que permitam acompanhar a dinâmica de ocupação de diferentes imóveis e recipientes por Aedes aegypti e a incorporação desses conhecimentos nas ações de controle do vetor na região.

Vitamin C effects in mice experimentally infected with Trypanosoma cruzi QM2 strain

INTRODUCTION: To evaluate the efficacy of vitamin C in reducing the consequences generated by the production of free radicals in the acute and chronic phases of Chagas disease, two different doses of ascorbic acid were administered orally to 60 mice infected by Trypanosoma cruzi QM2 strain. METHODS: The animals were divided into six groups: G1, G2, and G3 for the acute phase study, and G'1, G'2, and G'3 for the chronic stage. The groups G1 and G'1 received 8.6x10-4mg/g of vitamin C daily, whereas G2 and G'2 received 7.14x10-3mg/g daily. The other groups, G3 and G'3, were considered placebos and received 10µL of mineral water. RESULTS: The study of the acute phase showed statistically significant differences between G1 and the other groups at various count days of the parasitemia evolution. The multiplying parasite was slower in G1 until the 11th day, but on the 22nd day it had greater parasitemia than in G2 and G3, and from the 36th day on, parasitemia stabilized at higher levels. However, when the histopathology of acute and chronic phases is considered, one does not note significant differences. CONCLUSIONS: The administration of two different doses of vitamin C was not able to protect mice and to contain the oxidative stress caused by free radicals formed by the metabolism of oxygen (reactive oxygen species) and nitrogen (reactive nitrogen species).

Hepatitis B virus infection in a population exposed to occupational hazards: firefighters of a metropolitan region in central Brazil

INTRODUCTION: By the nature of their activities, firefighters are exposed to a high risk of contracting hepatitis B virus (HBV) as most of the Fire Brigade occurrences in Campo Grande, State of Mato Grosso do Sul (MS), Brazil, are related to the rescue of victims of traffic accidents and the transportation of clinical and psychiatric emergencies. The aim of this study was to investigate the seroepidemiological profile of HBV infection in firefighters from the City of Campo Grande, central Brazil. METHODS: The research involved 308 firefighters. After giving written consent, they were interviewed and blood was collected for the detection of HBsAg, anti-HBs and total anti-HBc of enzyme-linked immunosorbent assays (ELISA). RESULTS: The participants had an average of 36.4 years of age (SD ± 6.5), being 89.9% male. Blood tests revealed 6.5% of seropositivity for hepatitis B (HB) infection (n=20), and 1% for HbsAg. Isolated anti-HBs markers, indicative of vaccine immunity, were found in 66.9% of the participants and 28.2% were susceptible to infection. With regard to risk factors for HB infection, multivariate regression analysis showed a statistically significant association with length of service; and prevalence was higher in individuals with over 20 years of service. CONCLUSIONS: The prevalence of HB found among the firefighters was low and length of time in the profession was found to be a risk factor. Non-occupational risk factors did not influence the occurrence of HB infection in the population studied.

Snakebite cases in the municipalities of the State of Paraiba, Brazil

Introduction This study investigated the epidemiological and clinical profile of snakebite cases reported from 2007 to 2012 in the municipalities of the Curimataú region, State of Paraíba, in northeastern Brazil. Methods Data were collected from the Health Department of the State of Paraíba using the Injury Notification Information System data banks of the Health Ministry. Results A total of 304 snakebite cases were studied. The cases occurred most frequently from April to June. The genera Bothrops, Crotalus, and Micrurus were responsible for 74.6%, 6.2%, and 1.3% of cases, respectively. Snakebite cases predominated in males living in rural areas and between 10 and 19 years old. The highest incidence of bites occurred on the feet. The majority of the victims received medical assistance within 1 to 3h after being bitten. With regard to severity, 48% of the cases were classified as mild, 26% as moderate, and 2.6% as severe. Successful cures predominated, and no deaths were reported. The average antivenom ampoule dose used for the treatment in some snakebite cases was lower than that recommended by the Health Ministry. Conclusions Although our results show that Paraíba has a good level of medical care, there are serious deficiencies in recording snakebite information. These data indicate the need to improve the recording process for snakebite cases. Further training for health professionals seems to be necessary to optimize their skills in treating snakebite victims.