Paracoccidioides brasiliensis: a mycologic and immunochemical study of a sample isolated from an armadillo (Dasipus novencinctus)

A sample of P. brasiliensis isolated from the spleen and the liver of an armadillo (Dasipus novencinctus) has been analysed under a mycological and immunochemical viewpoint. The armadillo was captured in an area of Tucuruí (State of Pará, Brazil), the animal being already established as an enzootic reservoir of P. brasiliensis at that region of the country. This sample maintained in the fungal collection of the Tropical Medicine Institute of São Paulo (Brazil) numbered 135, has got all the characteristics of P. brasiliensis, with a strong antigenic power and low virulence for guinea-pigs and Wistar rats. The specific exoantigen of P. brasiliensis - the glycoprotein with a molecular weight of 43 kDa - was easily demonstrated with double immunodiffusion, immunoelectrophoresis, SDS-PAGE and immunobloting techniques.

Standardization of an enzyme linked immunosorbent assay (ELISA) for detecting circulating toxic venom antigens in patients stung by the scorpion Tityus serrulatus

The sensitivity and specificity of an enzyme-linked immunosorbent assay (ELISA) for the detection of circulating antigens from toxic components of Tityus serrulatus scorpion venom was determined in patients stung by T. serrulatus before antivenom administration. Thirty-seven patients were classified as mild cases and 19 as moderate or severe cases. The control absorbance in the venom assay was provided by serum samples from 100 individuals of same socioeconomic group and geographical area who had never been stung by scorpions or treated with horse antisera. The negative cutoff value (mean + 2 SD) corresponded to a venom concentration of 4.8 ng/ml. Three out of the 100 normal sera were positive, resulting in a specificity of 97%. The sensitivity of the ELISA when all cases of scorpion sting were included was 39.3%. When mild cases were excluded, the sensitivity increased to 94.7%. This study showed that this ELISA can be used for the detection of circulating venom toxic antigens in patients with systemic manifestations following. T. serrulatus sting but cannot be used for clinical studies in mild cases of envenoming since the test does not discriminate mild cases from control patients.

Subcutaneous hyalohyphomycosis caused by Acremonium recifei: case report

We present a case of subcutaneous hyalohyphomycosis due to Acremonium recifei, a species whose habitat is probably the soil, first identified in 1934 by Arêa Leão and Lobo in a case of podal eumycetoma with white-yellowish grains and initially named Cephalosporium recifei. A white immunocompetent female patient from the state of Bahia, Brazil, with a history of traumatic injury to the right hand is reported. The lesion was painless, with edema, inflammation and the presence of fistulae. Seropurulent secretion with the absence of grains was present. Histopathological examination of material stained with hematoxylin-eosin showed hyaline septate hyphae. A culture was positive for Acremonium recifei. Treatment with itraconazole, 200 mg/day, for two months led to a favorable course and cure of the process. We report for the first time in the literature a case of subcutaneous hyalohyphomycosis due to Acremonium recifei in a immunocompetent woman. Treatment with itraconazole 200 mg/day, for two months, resulted in cure.

Longitudinal clinical and serological survey of abdominal angiostrongyliasis in Guaporé, southern Brazil, from 1995 to 1999

Abdominal angiostrongyliasis is a zoonotic infection caused by Angiostrongylus costaricensis, a nematode with an intra-vascular location in the mesentery. Our objective was to address several aspects of the natural history of this parasitosis, in a longitudinal clinical and seroepidemiological study. A total of 179 individuals living in a rural area with active transmission in southern Brazil were followed for five years (1995-1999) resulting in yearly prevalence of 28.2%, 4.2%, 10%, 20.2% and 2.8% and incidences of 0%, 5.9%, 8% and 1.5%, respectively. Both men and woman were affected with higher frequencies at age 30-49 years. In 32 individuals serum samples were collected at all time points and IgG antibody reactivity detected by ELISA was variable and usually persisting not longer than one year. Some individual antibody patterns were suggestive of re-infection. There was no association with occurrence of abdominal pain or of other enteroparasites and there was no individual with a confirmed (histopathologic) diagnosis. Mollusks were found with infective third-stage larvae in some houses with an overall prevalence of 16% and a low parasitic burden. In conclusion, abdominal angiostrongyliasis in southern Brazil may be a frequent infection with low morbidity and a gradually decreasing serological reactivity.

Política externa planejada: os planos plurianuais e a ação internacional do Brasil, de Cardoso a Lula (1995-2008)

Analisando as orientações estratégicas dos últimos quatro planos plurianuais - 1996-1999, 2000-2003, 2004-2007 e 2008-2011, no artigo, revela-se como a política externa tem sido incorporada no planejamento federal e qual o papel concedido ao setor externo nas estratégias de desenvolvimento empreendidas pelos governos Cardoso e Lula. Demonstra coerência entre a política externa planejada e a efetivamente empreendida, explicitando as diferenças entre as estratégias adotadas e as linhas de ação externa priorizadas.

A cooperação técnica do Brasil com a África: comparando os governos Fernando Henrique Cardoso (1995-2002) e Lula da Silva (2003-2010)

É consensual entre os analistas da Política Externa Brasileira o reconhecimento da priorização do eixo Sul-Sul nas estratégias de inserção internacional do país durante o governo Lula da Silva, bem como o papel de destaque concedido ao continente africano. Com o intuito de dar lastro empírico às análises sobre a retomada e repriorização das relações entre Brasil e África, este trabalho pretende analisar comparativamente a cooperação técnica provida pelo Brasil para os países africanos durante os governos Fernando Henrique Cardoso (1995-2002) e Lula da Silva (2003-2010). Procura-se identificar e comparar o número e os tipos de acordos firmados, a dispersão geográfica desses acordos e a diversidade temática dos projetos de cooperação técnica horizontal desenvolvidos pelo Brasil naquele continente. A fonte principal dos dados analisados, ainda pouco explorada pela literatura acadêmica brasileira, é o banco de dados do Departamento de Atos Internacionais do Ministério das Relações Exteriores.

Competencia en el sector salud: análisis de la reforma sueca (1992 - 1995)

El artículo revisa los éxitos y fracasos de la reforma sueca de salud, así como las lecciones que dejó en su afán de alcanzar mejores resultados financieros y estándares de calidad.

Participacao crescente de produtos ultraprocessados na dieta brasileira (1987-2009)

OBJETIVO Estimar tendências temporais do consumo domiciliar de itens alimentícios no Brasil, levando em conta a extensão e o propósito do seu processamento industrial. MÉTODOS Os dados analisados são provenientes de Pesquisa de Orçamentos Familiares realizadas no Brasil em 1987-1988, 1995-1996, 2002-2003 e 2008-2009. Foram analisadas amostras probabilísticas dos domicílios das áreas metropolitanas em todos os períodos mencionados e, nas duas amostras mais recentes, a abrangência foi nacional. As unidades de análise foram registros de aquisições de agregados de domicílios. Os itens alimentícios foram divididos segundo extensão e propósito de seu processamento industrial em: alimentos in natura ou minimamente processados, ingredientes culinários processados e produtos alimentícios prontos para consumo, processados ou ultraprocessados. A quantidade adquirida de cada item foi convertida em energia. Estimaram-se a disponibilidade diária total per capita de calorias e a contribuição dos grupos de alimentos em cada pesquisa. Calcularam-se estimativas por quintos de renda para as pesquisas nacionais. Variações temporais foram testadas por teste de diferença de médias e modelos de regressão linear. RESULTADOS Houve aumento significativo da participação de produtos prontos para o consumo (de 23,0% para 27,8% das calorias), graças ao aumento no consumo de produtos ultraprocessados (de 20,8% para 25,4%) entre 2002-2003 e 2008-2009. Houve redução significativa na participação de alimentos e de ingredientes culinários nesse período. O aumento da participação de produtos ultraprocessados ocorreu em todos os estratos de renda. Observou-se aumento uniforme da participação calórica de produtos prontos para o consumo em áreas metropolitanas, novamente à custa de produtos ultraprocessados e acompanhada por reduções na participação de alimentos in natura ou minimamente processados quanto de ingredientes culinários. CONCLUSÕES Produtos ultraprocessados apresentam participação crescente na dieta brasileira, evidenciada desde a década de 1980 nas áreas metropolitanas e confirmada para todo o País na década de 2000.

Paracoccidioides cerebriformis Moore, 1935. MYCOLOGIC AND IMMUNOCHEMICAL STUDY

The present study concern on mycologic and immunochemical data obtained from two samples of a fungus considered as belonging to the species Paracoccidioides cerebriformis described by Moore in 1935, and maintained since then on Sabouraud’s agar in the mycology collection of the Instituto de Medicina Tropical de São Paulo. After 60 years, the samples exhibited the same characteristics described by Moore (1935). However, experimental lesions did not resulted in guinea-pigs inoculated intratesticularly. The dominant antigen in Paracoccidioides brasiliensis, 43 kDa glicoprotein (gp43), could not be demonstrated by SDS PAGE and Western blotting. Immunoelectrophoresis did not demonstrated the E arch of cathodic migration using a policlonal anti gp43 serum. According to these findings, it is concluded that the fungus described by Moore (1935) as P. cerebriformis does not belong to the genus Paracoccidioides. Paracoccidioidomycosis should therefore be considered as resulting from infection by a single species, Paracoccidioides brasiliensis (Splendore, 1912) as asserted by Almeida (1930). Further studies, through molecular biology methods, could identify the mentioned fungus

Hepatocellular carcinoma in Brazil: report of a national survey (Florianópolis, SC, 1995)

In order to investigate epidemiological aspects of hepatocellular carcinoma (HCC) in Brazil, basic informations about cases diagnosed from January 1992 to December 1994 were requested to several medical centers of different Brazilian States. A simple questionnaire included age, sex, alcohol abuse (over 80g/day), associated liver cirrhosis, persistent HBV infection (HBsAg), HCV infection (anti-HCV) and serum levels of alpha fetoprotein. 287 cases, over 16 years old, from 19 medical centers of 8 States (Pará, Bahia, Minas Gerais, Espirito Santo, Rio de Janeiro, São Paulo, Paraná and Rio Grande do Sul) were analysed. The results showed: (a) Mean age was 56.3 ± 14.4 for men and 54.7 ± 16.8 yr for women and the male/female ratio was 3.4:1. (b) 69.6% were caucasians, 21.8% mullatoes, 4.8% orientals and 3.7% blacks. (c) HBsAg (+) in 77/236 cases (41.6%) without differences between males and females. (d) Anti-HCV (+) in 52/193 cases (26.9%). (e) 7/180 cases were positive both for HBsAg and anti-HCV (3.8%). (f) There was chronic alcoholism in 88/235 cases (37%). (g) HCC was found in cirrhotic livers in 71.2% of 202 cases in which the presence or absence of cirrhosis was reported. (h) Alpha-fetoprotein above 20 ng/ml was found in 124/172 cases (72%) and above 500 ng/ml only in 40 cases (23.2%). These results showed that the HCC in Brazil has an intermediate epidemiological pattern as compared to those from areas of low and high incidence of the tumor. In spite of the high frequency of the association of HCC with the HBV and/or HCV infections, 42% of 180 cases were negative both for HBsAg and anti-HCV, indicating the possible role of other etiological factors. The comparison of data from different States showed some regional differences: higher frequency of associated HBsAg in Pará, Bahia, Minas Gerais and Espírito Santo, higher frequency of associated HCV infection in Rio de Janeiro, São Paulo and States of the Southern region and low frequency of associated liver cirrhosis in Salvador and Rio de Janeiro (55.5 and 50% respectively). Further investigation will be necessary to study the presence of other possible etiological factors as aflatoxins, suggested by the favourable climatic conditions for food contamination by fungi in the majority Brazilian regions

Variabilidade diária da precipitação em regiões de floresta e pastagem na Amazônia

As estações automáticas do Projeto ABRACOS instaladas na Amazônia Ocidental forneceram os dados horários de precipitação em áreas de pastagem e floresta, durante o trimestre mais chuvoso (j/f/m) no período de 1992 a 1995. A variabilidade diária de precipitação maior que 1 mm h1 mostrou uma frequência relativa de 6,7% dos casos às 14 horas local (hl) na pastagem e 5,7% às 16 hl na floresta. O período da tarde (13-18 hl) registra acima de 30% dos eventos de precipitação em ambos os sítios. Há uma boa regularidade na distribuição horária dos eventos, principalmente na floresta. Para as precipitações maiores que 10 mm h1, existe uma concentração dos casos no final da tarde. Na pastagem 12,3%, e na floresta 11,5% dos eventos ocorrem às 18 hl. O intervalo entre 7-18 hl detém 64,9% dos casos na pastagem, e 57,7% na floresta. Do total de eventos de precipitação, 14% são maiores que 10 mm h1, tanto na floresta como na pastagem. Comparando-se o total de chuva ocorrido nas áreas de floresta e pastagem, o volume precipitado na floresta é cerca de 28% em média superior ao da pastagem.

Jornal Brasileiro de Psiquiatria: um estudo bibliométrico dos artigos publicados de 1995 a 2004

OBJETIVO: O Jornal Brasileiro de Psiquiatria (JBP) é um periódico especializado em psiquiatria editado desde 1938 e que publica boa parte da produção científica brasileira nesta área. O objetivo deste artigo é fazer uma análise bibliométrica dos artigos publicados no JBP entre 1995 e 2004. MÉTODOS: Os artigos publicados no JBP neste período foram classificados quanto ao ano de publicação, à origem geográfica (de acordo com a afiliação do primeiro autor) e ao tipo de artigo (artigos de revisão, pesquisas originais, relatos de caso, metanálises e artigos opinativos). Foram analisados os números absolutos e proporcionais de artigos publicados por cada estado brasileiro e as contribuições internacionais e os tipos de artigos, considerando-se toda a década estudada e também cada qüinqüênio. RESULTADOS: Foram publicados 619 artigos no período estudado, sendo 91,4% destes de autores brasileiros. Os estados com maior número de publicações foram: Rio de Janeiro, São Paulo, Minas Gerais, Rio Grande do Sul e Pernambuco. Os artigos de pesquisa e de revisão predominaram no período estudado (37,3% e 35,9%, respectivamente). CONCLUSÃO: Houve uma mudança no perfil dos artigos publicados no JBP ao longo do período estudado, com maior diversidade de origem de artigos no segundo qüinqüênio. Isto pode refletir uma maior visibilidade do JBP.

Surgical revascularization of posterior coronary arteries without cardiopulomonary bypass

OBJECTIVE: To assess the results observed during the early postoperative period in patients who had the posterior coronary arteries revascularized without cardiopulmonary bypass (CPB), in regard to the following parameters: age, sex,bypass grafts types, morbidity and mortality. METHODS: From January 1995 to June 1998, 673 patients underwent myocardial revascularization (MR). Of this total, 607 (90.20%) MR procedures were performed without CPB. The posterior coronary arteries (PCA) were revascularized in 298 (44.27%) patients, 280 (93.95%) without CPB. The age of the patients ranged from 37 to 88 years (mean, 61 years). The male gender predominated, with 198 men (70.7%). The revascularization of the posterior coronary arteries had the following distribution: diagonalis artery (31 patients, 10%); marginal branches of the circumflex artery (243 patients, 78.7%); posterior ventricular artery (4 patients, 1.3%); and posterior descending artery (31 patients, 10%). RESULTS: Procedure-related complications without death occurred in 7 cases, giving a morbidity of 2.5%. There were 11 deaths in the early postoperative period (mortality of 3.9%). CONCLUSION: Similarly to the anterior coronary arteries, the posterior coronary arteries may benefit from myocardial revascularization without CPB.

Carlos Chagas Discoveries as a Drop Back to Scientific Construction of Chronic Chagas Heart Disease

Abstract The scientific construction of chronic Chagas heart disease (CCHD) started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922. In 1928, Chagas detected fibrosis of the conductive system, and pointed out the presence of marked cardiomegaly at the chest X-Ray associated with minimal symptomatology. The use of serological reaction to diagnose CCHD was put into clinical practice in 1936, after Chagas' death, which along with the 12-lead ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long period between initial infection and appearance of CCHD was established, whereas the annual incidence of CCHD from patients with the indeterminate form of the disease was established in 1956. The use of heart catheterization in 1965, exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of CCHD as described by Carlos Chagas.