American cutaneous leishmaniasis caused by Leishmania (Viannia) braziliensis resistant to meglumine antimoniate, but with good response to pentamidine: a case report

This is a case report of a Brazilian soldier with cutaneous leishmaniasis. The lesion relapsed following two systemic treatments with meglumine antimoniate. The patient was treated with amphotericin B, which was interrupted due to poor tolerance. Following isolation of Leishmania sp., six intralesional infiltrations of meglumine antimoniate resulted in no response. Leishmania sp promastigotes were again isolated. The patient was submitted to intramuscular 4mg/kg pentamidine. Parasites from the first and second biopsies were identified as Leishmania (Viannia) braziliensis; those isolated from the first biopsy were more sensitive to meglumine antimoniate in vitro than those isolated from the second biopsy. No relapse was observed.

Evaluation of laboratory markers of progression of HIV disease to death

INTRODUCTION: One of the important current problems in HIV/AIDS infection is the establishment of epidemiological and laboratorial prognostic parameters during patient follow-up. This study aimed at analyzing the evolution of laboratory tests: CD4 lymphocyte count, viral load, hemoglobin (Hb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the epidemiological variables sex and age as prognostic factors for survival in progression to death among AIDS patients. METHODS: A retrospective study was conducted using analysis of medical records, and prospective 24-month follow-up of patients with HIV/ AIDS attended at the President Vargas Hospital Outpatient Clinic, a reference center in HIV/ AIDS attendance in the State of Maranhão, Brazil. The study analyzed patients aged 10 to 60 years old, who manifested AIDS and who were not using antiretroviral therapy or had used it for less than 5 years. The Chi-square test was used for statistical analysis. RESULTS: The sample included 100 patients - 57 were current outpatients, and 43 had died. The variables viral load (p=0.726), ALT (p=0.314), sex (p=0.687), and age (p=0.742) were analyzed, and no evidence of association between them and worst prognosis was observed. CONCLUSIONS: A significant relation was verified between low Hb levels (p=0.000) and CD4 (p=0.000) and shorter survival.

Relationship between rainfall and temperature: observations on the cases of visceral leishmaniasis in São Luis Island, State of Maranhão, Brazil

INTRODUCTION: Visceral leishmaniasis is a serious public health problem that requires global control strategies, especially with respect to factors that may intervene in reducing the incidence of endemicity. In this work, rainfall density and temperature were correlated with the incidence of human cases in an area endemic for leishmaniasis in São Luis do Maranhão, Northeastern Brazil. METHODS: Notification of human cases by the National Health Foundation/Regional Coordination of Maranhão (FUNASA/COREMA) from 2002 to 2010 was used. Ecological data (mean temperature and rainfall density) were provided by the Meteorological Office of State. RESULTS: A significant association was verified between the number of VL cases and rainfall rate but not in the analysis concerning mean temperatures. CONCLUSIONS: These data suggest that the control actions in visceral leishmaniasis should be performed during rainy season in the State of Maranhão, which is in the first half of the year.

Comparison among three polymerase chain reaction assays on detection of DNA from Leishmania in biological samples from patients with american cutaneous leishmaniasis

INTRODUCTION: The study analyzed positivity of polymerase chain reaction (PCR) on detection of DNA from Leishmania in patients' samples. METHODS: Extracted DNA was submitted to L150/L152, 13Y/13Z, and seminested PCR (snPCR). RESULTS: Results were evidenced by bands of approximately 120, 720, and 670 bp for L150/L152, 13Y/13Z, and snPCR, respectively. L150/L152, 13Y/13Z, and snPCR positivity indexes were 76.9, 56.4, and 9.2 (p>0.05), respectively, for suspected and 93.7, 68.7, and 84.4 (p<0.05), respectively, for confirmed. CONCLUSIONS: Preliminary results showed that these assays, mainly L150/L152 and snPCR, can detect Leishmania DNA and carry potential on laboratory diagnosis of leishmaniasis.

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.

First report of Rhodnius montenegrensis (Hemiptera, Reduviidae, Triatominae) in the State of Acre, Brazil

INTRODUCTION: This paper reports, for the first time, the presence of Rhodnius montenegrensis in the State of Acre, Brazil.METHODS: Two female R. montenegrensis were collected in a dwelling in the rural area of Rio Branco, Acre, Brazil.RESULTS: The occurrence of this species was confirmed, and the number of Triatominae species in the State of Acre increased from four to five.CONCLUSIONS: Further studies should be performed to reach a clearer understanding of the ecology of this arthropod, its possible role in transmitting Chagas' disease and rangeliosis, and its current geographical distribution in the region.

Arboviral diseases in the Western Brazilian Amazon: a perspective and analysis from a tertiary health & research center in Manaus, State of Amazonas

The Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), located in Manaus, the capital of the State of Amazonas (Western Brazilian Amazon), is a pioneering institution in this region regarding the syndromic surveillance of acute febrile illness, including arboviral infections. Based on the data from patients at the FMT-HVD, we have detected recurrent outbreaks in Manaus by the four dengue serotypes in the past 15 years, with increasing severity of the disease. This endemicity has culminated in the simultaneous circulation of all four serotypes in 2011, the first time this has been reported in Brazil. Between 1996 and 2009, 42 cases of yellow fever (YF) were registered in the State of Amazonas, and 71.4% (30/42) were fatal. Since 2010, no cases have been reported. Because the introduction of the yellow fever virus into a large city such as Manaus, which is widely infested by Aedes mosquitoes, may pose a real risk of a yellow fever outbreak, efforts to maintain an appropriate immunization policy for the populace are critical. Manaus has also suffered silent outbreaks of Mayaro and Oropouche fevers lately, most of which were misdiagnosed as dengue fever. The tropical conditions of the State of Amazonas favor the existence of other arboviruses capable of producing human disease. Under this real threat, represented by at least 4 arboviruses producing human infections in Manaus and in other neighboring countries, it is important to develop an efficient public health surveillance strategy, including laboratories that are able to make proper diagnoses of arboviruses.

Falciform ligament abscess: report of a case

Falciform ligament abscess is rare. We report a case of a 65-year-old man who presented with right upper quadrant abdominal pain, postprandial fullness, and fever. Computed tomography disclosed a cylindrical mass in the anterior abdomen that aroused suspicion of a hepatic abscess. At laparoscopic surgery, an abscess of the falciform ligament was found and drained. Two months later, the patient developed recurrence of the abscess secondary to acute calculous cholecystitis. Abscess drainage and cholecystectomy were performed. The presence of right uppper quadrant abdominal pain, epigastric tenderness, fever, leukocytosis, and a mass in the anterior abdomen should arouse suspicion of falciform ligament abscess. Its treatment consists of abscess drainage.

Transformações químicas de lignanas isoladas de Virola sebifera em análogos de podofilotoxina

0 fracionamento do extrato clorofórmico das folhas de Virola sebifera levou ao isolamento da lignanas (2R, 3R) -2, 3-Di- (3', 4'-dimetoxibenzil) -butirolactona (1), (2R, 3R) -2, 3-Di (3'', 4'' -dimetoxibenzil) -butirolactona(3). Tentativa de transformações da lignana(1) em ánalogo de Podofilotoxina (4) foram realizadas com resultados parciais negativos. Um dos produtos obtidos nas transformações propostas foi (2R, 3R) -2, 3Di- (5'-bromo-3', 4' -Dimetoxibenzil) -butirolactona (5).

Efeitos de um evento de friagem nas condições meteorológicas na Amazônia: um estudo de caso

A influência do fenômeno da friagem nas variáveis meteorológicas e nos fluxos de energia e CO2 , foi realizada numa área de floresta próxima à região de Ji-Paraná, Rondônia, durante o mês de junho de 2001. A friagem ocasionou uma diminuição de 35% no valor da temperatura do ar. Notou-se uma redução de 75 W.m-2, na radiação solar incidente, associada à nebulosidade presente em decorrência da penetração da massa de ar fria. Conseqüentemente, tanto o fluxo de calor sensível (H) quanto o de calor latente (LE), apresentaram uma diminuição no seu valor médio diário, apresentando uma diferença em relação aos dias normais de 8 e 34%, respectivamente. A concentração de CO2 permaneceu constante, sem apresentar o aumento comum durante a noite, devido à condição de vento forte típica da friagem. Em situação normal o fluxo médio durante o dia de CO2 (-2,44 mmol m-2 s-1) foi menor que durante os dias de friagem (-5,78 mmol m-2 s-1); enquanto que os fluxos médios noturnos foram +1,77mmol m-2 s-1 e +2,83mmol m-2 s-1 durante situações de dias normais e de friagem, respectivamente.

Modelagem Sísmica via métodos das diferenças finitas: caso da bacia do Amazonas

Este trabalho tem por objetivo apresentar os resultados da modelagem sísmica em meios com fortes descontinuidades de propriedades físicas, com ênfase na existência de difrações e múltiplas reflexões, tendo a Bacia do Amazonas como referência à modelagem. As condições de estabilidade e de fronteiras utilizadas no cálculo do campo de ondas sísmicas foram analisadas numericamente pelo método das diferenças finitas, visando melhor compreensão e controle da interpretação de dados sísmicos. A geologia da Bacia do Amazonas é constituída por rochas sedimentares depositadas desde o Ordoviciano até o Recente que atingem espessuras da ordem de 5 km. Os corpos de diabásio, presentes entre os sedimentos paleozóicos, estão dispostos na forma de soleiras, alcançam espessuras de centenas de metros e perfazem um volume total de aproximadamente 90000 Km³. A ocorrência de tais estruturas é responsável pela existência de reflexões múltiplas durante a propagação da onda sísmica o que impossibilita melhor interpretação dos horizontes refletores que se encontram abaixo destas soleiras. Para representar situações geológicas desse tipo foram usados um modelo (sintético) acústico de velocidades e um código computacional elaborado via método das diferenças finitas com aproximação de quarta ordem no espaço e no tempo da equação da onda. A aplicação dos métodos de diferenças finitas para o estudo de propagação de ondas sísmicas melhorou a compreensão sobre a propagação em meios onde existem heterogeneidades significativas, tendo como resultado boa resolução na interpretação dos eventos de reflexão sísmica em áreas de interesse. Como resultado dos experimentos numéricos realizados em meio de geologia complexa, foi observada a influência significativa das reflexões múltiplas devido à camada de alta velocidade, isto provocou maior perda de energia e dificultou a interpretação dos alvos. Por esta razão recomenda-se a integração de dados de superfície com os de poço, com o objetivo de obter melhor imagem dos alvos abaixo das soleiras de diabásio.

A ocorrência de malária em quatro municípios do estado do Pará, de 1988 a 2005, e sua relação com o desmatamento

O objetivo deste trabalho foi estudar a ocorrência de malária em quatro diferentes regiões representativas do estado do Pará, buscando suas possíveis relações com as taxas de desmatamento. Foi realizado um estudo retrospectivo, com dados secundários, no período de 1988 a 2005, através de casos de malária registrados em quatro municípios do Estado (Anajás, Itaituba, Santana do Araguaia e Viseu), como também das taxas de desmatamento fornecidas pelo PRODES-INPE. Aplicou-se a técnica dos Quantis para se estabelecer cinco categorias ou classes de incidência da malária para cada município, sendo gerado posteriormente um IPA representativo para o Estado. De 1988 até 1994, as curvas de incidência de malária acompanham os números de desmatamento. A partir de 1995, evidenciaram-se anos consecutivos com altos índices de ocorrência da doença logo após os períodos de altas taxas de desmatamento, como registrado nos anos de 1995, 2000 e 2004. Percebeu-se que após a época de intenso desmatamento, os casos de malária variaram entre alto e muito alto no seu padrão de incidência, apontando que o desmatamento pode ser um fator de incremento na frequência e aumento no número de pessoas infectadas no estado do Pará.

First record of Trichodina heterodentata (Ciliophora: Trichodinidae) from Arapaima gigas cultivated in Peru

This study characterized morphologically Trichodina heterodentata Duncan, 1977 from cultivated fingerlings of "pirarucu" Arapaima gigas in Peru. Body and gill smears were air-dried at room temperature, impregnated with silver nitrate and/or stained with gomori trichromic. Prevalence was 100%. Trichodina heterodentata was considered a medium-sized trichodinid with mean body diameter of 56.0+ 5.25 (47.3-76.0) μm, denticulate ring 28.21± 2.71 (20-34.7) μm, adhesive disc 45.7±3.8 (37.1-57.3) μm diameter and number of denticles of 20.7± 2.6 (12-24). The present study reports not only the first occurrence of T. heterodentata in Peru but also the first record of this trichodinid infesting A. gigas. Camparative tables of all reports of T. heterodentata are also presented.

Identification of duplicates of cassava accessions sampled on the North Region of Brazil using microsatellite markers

Duplicates are common in germplasm banks and their identification is needed to facilitate germplasm bank management and to reduce maintenance costs. The aim of this work was to identify duplicates of cassava from a germplasm bank in Eastern Amazon, which had been previously characterized both morphological and agronomically. In order to be genotyped with 15 microsatellite loci, 36 accessions were selected. These accessions were classified into 13 groups of similar morpho-agronomical characteristics. All loci were polymorphic, and 75 alleles were identified, with an average of five alleles per loci and H E = 0.66. There were determined 34 pairs of genotypes with identical multiloci profiles and the probability of genetic identity was 1.1x10-12 with probability of exclusion of 99.9999%. Among these duplicates, there are accessions sampled on different years and places, but with different names and accessions with the same name sampled in different places and years. The study identified genotypes that are grown in different places and that have been maintained over the years by local farmers.