Antimicrobial resistance of isolated Streptococcus pneumoniae in a hospital of the Brazilian public system

Streptococcus pneumoniae is the predominant bacterial agent that affects the human population with pneumonia. This disease is an important cause of death in the elderly and the children under five years old. In this study, 29 strains of invasive S. pneumoniae were isolated from 29 patients of pneumonia, bacteremia and meningitis in the laboratory of the Municipal Hospital in Paulinia, Brazil, from May 2006 to October 2007. Patients' age ranged from 8 months old to 60 years old. These strains of S. pneumoniae were isolated from blood, pleural fluid and cerebrospinal fluid (CSF) of patients. After typing of encapsulated strains of S. pneumoniae through quellung reaction, their resistance to antimicrobial agents was gauged through Disc Diffusion Technique followed by determination of minimum inhibitory concentration (MIC). Among the 29 strains analyzed, 23 were methicillin-sensitive and six were methicillin-resistant and penicillin intermediate resistant. No strain presented full resistance to penicillin. Serotyping was performed only in two samples, which belonged to serotype 18. Our data may alert ambulatory regarding the incidence of pneumococcal strains resistant to the most common drugs due to inappropriate use of antimicrobials and also collaborate to the elaboration of pneumococcal conjugate vaccines specific to each region.

Lymphocyte transformation assay for C neoformans antigen is not reliable for detecting cellular impairment in patients with Neurocryptococcosis

Background: Cryptococcus neoformans causes meningitis and disseminated infection in healthy individuals, but more commonly in hosts with defective immune responses. Cell-mediated immunity is an important component of the immune response to a great variety of infections, including yeast infections. We aimed to evaluate a specific lymphocyte transformation assay to Cryptococcus neoformans in order to identify immunodeficiency associated to neurocryptococcosis (NCC) as primary cause of the mycosis.Methods: Healthy volunteers, poultry growers, and HIV-seronegative patients with neurocryptococcosis were tested for cellular immune response. Cryptococcal meningitis was diagnosed by India ink staining of cerebrospinal fluid and cryptococcal antigen test (Immunomycol-Inc, SP, Brazil). Isolated peripheral blood mononuclear cells were stimulated with C. neoformans antigen, C. albicans antigen, and pokeweed mitogen. The amount of H-3-thymidine incorporated was assessed, and the results were expressed as stimulation index (SI) and log SI, sensitivity, specificity, and cut-off value (receiver operating characteristics curve). We applied unpaired Student t tests to compare data and considered significant differences for p<0.05.Results: The lymphotoxin alpha showed a low capacity with all the stimuli for classifying patients as responders and non-responders. Lymphotoxin alpha stimulated by heated-killed antigen from patients with neurocryptococcosis was not affected by TCD4+ cell count, and the intensity of response did not correlate with the clinical evolution of neurocryptococcosis.Conclusion: Response to lymphocyte transformation assay should be analyzed based on a normal range and using more than one stimulator. The use of a cut-off value to classify patients with neurocryptococcosis is inadequate. Statistical analysis should be based on the log transformation of SI. A more purified antigen for evaluating specific response to C. neoformans is needed.

Complicações neurológicas determinadas pela anestesia subaracnóidea

JUSTIFICATIVA E OBJETIVOS: Complicações neurológicas da anestesia subaracnóidea, apesar de raras, podem determinar seqüelas importantes. O objetivo deste estudo é apresentar estas complicações com a finalidade de esclarecer os fatores desencadeantes, o que facilita o diagnóstico das lesões. CONTEÚDO: São apresentadas as seguintes complicações: lesão de nervo desencadeada pela agulha e cateter, cefaléia pós-punção, síndrome da artéria espinhal anterior, hematoma espinhal, meningite bacteriana, meningite asséptica, aracnoidite adesiva, síndrome da cauda eqüina e sintomas neurológicos transitórios. CONCLUSÕES: O conhecimento dos fatores desencadeantes de complicações neurológicas determinadas pela anestesia subaracnóidea pode prevenir as lesões, diagnosticar e tratar mais precocemente e, desse modo, mudar o prognóstico das mesmas.

Timoma em cão. Relato de caso

Uma cadela, Dachshund, quatro anos, foi encaminhada ao H.V. da FMVZ-UNESP-Botucatu-SP com histórico de prostração, emagrecimento progressivo, anorexia, cansaço e tosse seca. Ao exame clínico observou-se apatia, secreção nasal serosa bilateral e dispnéia intensa. Radiografia torácica demonstrou efusão pleural, edema pulmonar acentuado, desvio dorsal da traquéia e possível massa mediastinal. A ultra-sonografia, após drenagem torácica, confirmou a presença de massa mediastinal, sendo classificada como neoplasia maligna de origem epitelial pela citologia aspirativa por agulha fina. O animal veio a óbito logo após o diagnóstico de neoplasia. À necropsia constatou-se massa mediastinal encapsulada, consistência macia e superfície de corte com coloração branco-acinzentada e áreas necrótico-hemorrágicas, localizada na região ântero-ventral do tórax. O exame histopatológico demonstrou células epiteliais neoplásicas, células linfóides (timócitos) com morfologia normal, vasos sangüíneos de pequeno e médio calibre, formações císticas com conteúdo eosinofílico e corpúsculos de Hassall. A imunohistoquímica apresentou positividade para citoqueratina AE1/AE3 e UCHL, confirmando o diagnóstico de timoma.

Agaricus blazei (Himematsutake) does not alter the development of rat diethylnitrosamine-initiated hepatic preneoplastic foci

The modifying potential of crude extracts of the mushroom Agaricus blazei Murrill (Himematsutake) on the development and growth of glutathione S-transferase placental form (GST-P)-positive liver foci (liver preneoplastic lesion) was investigated in adult male Wistar rats. Six groups of animals were used. Groups 2 to 5 were given a single i.p. injection of 200 mg/kg b.w. of diethylnitrosamine (DEN) and groups 1 and 6 were treated with saline at the beginning of the experiment. After 2 weeks, animals of groups 3 to 6 were orally treated with three dose levels of aqueous extracts of the mushroom A. blazei (1.2, 5.6, 11.5, and 11.5 mg/ml of dry weight of solids) for 6 weeks. All animals were subjected to two-thirds partial hepatectomy at week 3 and sacrificed at week 8. Two hours before sacrifice, ten animals of each group were administered a single i.p injection of 100 mg/kg of bromodeoxyuridine (BrdU). Apoptotic bodies and BrdU-positive hepatocyte nuclei were quantified in liver sections stained for hematoxylin and eosin (H&E) (eosinophilic foci) and simultaneously stained for GST-P expression (GST-P-positive foci), respectively. The 6-week treatment with A. blazei did not alter the development (number and size) of GST-P-positive foci and did not affect the growth kinetics of liver normal parenchyma or foci in DEN-initiated animals. Our results indicate that the treatment with aqueous extracts of the mushroom A. blazei during the post-initiation stage of rat liver carcinogenesis does not exert any protective effect against the development of GST-P-positive foci induced by DEN. (Cancer Sci 2003; 94: 188-192).

Abdominopelvic sarcoma of perivascular epithelioid cells. Report of four cases in young women, one with tuberous sclerosis

The perivascular epithelioid cell has been proposed to be the unifying proliferating cell type in a number of lesions such as angiomyolipoma, lymphangiomyomatosis, clear cell sugar tumor and renal capsuloma. With the exception of rare examples of angiomyolipoma, they are non-metastasizing. We report four examples of a new member of this family of perivascular epithelioid cell neoplasms that occur in abdominopelvic location and show metastatic properties. The patients, all women, were aged 19 to 41 years (mean, 32), and presented with a tumor mass involving the serosa of the ileum, uterus or pelvic cavity. Morphologically, the tumors were composed of sheets of large polygonal cells with glycogen-rich clear or eosinophilic cytoplasm and moderately pleomorphic nuclei, traversed by a delicate vasculature, mimicking clear cell carcinoma. There were areas of coagulative necrosis and occasional mitotic figures. Intracytoplasmic brown pigment was present in two cases. Spindly cells, smooth muscle and fat were absent. Lymphovascular invasion was present in all, lymph node metastasis was documented in two and metastasis to the ovary was present in one case. Two patients developed widespread metastatic disease after 10 and 28 months from diagnosis. One patient showed the clinical signs of tuberous sclerosis. In spite of the epithelial-like appearance, the tumor cells were negative for epithelial markers but were strongly positive with the melanogenesis-related marker HMB45. Another melanogenesis marker (MART-1) was positive in two cases. Other markers including S-100 protein, vimentin, muscle-specific actin, desmin and chromogranin A were negative. Thus, these tumors are not readily classifiable in the existing schema of known entities, and show over-lapping morpho-phenotypic features of clear cell sugar tumor of the lung and epithelioid angiomyolipoma. We consider them as sarcomas composed of a pure population of uncommitted perivascular epithelioid cell, that lack modulation toward smooth muscle or adipose cells.

Clinical and histopathological aspects of the insect bite hypersensitivity in horses

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Expression of odontogenic ameloblast-associated protein, amelotin, ameloblastin, and amelogenin in odontogenic tumors: immunohistochemical analysis and pathogenetic considerations

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

SPERMATOGENESIS, SPERMATOPHORE, and SEMINAL FLUID PRODUCTION IN THE ADULT BLUE CRAB CALLINESTES DANAE (PORTUNIDAE)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Dynamics and cytochemistry of oogenesis in Astyanax fasciatus (Cuvier) (Teleostei, Characiformes, Characidae) from Rio Sapucaí, Minas Gerais State, Brazil

Oogenesis involves a set of transformations which are undergone by female germ cells These cells change into oogonias and then into mature oocytes. Sexually mature female fish were collected monthly, during one year, from the Sapucaí River, a tributary of the Rio Grande, which is part of the Furnas Reservoir in the state of Minas Gerais. During the several stages of maturation, we observed small round oogonias with a large nucleus, a single nucleolus, and weakly stained cytoplasm with eosinophilic granules. The primary oocytes showed a large basophilic nucleus, with a developed peripheral nucleolus and a reduced cytoplasm. The previtellogenic oocytes presented voluminous cytoplasm and nucleus with several small peripheral nucleoli. The oocytes underwent vitellogenesis with the development of the zona radiata and the follicle cells. Their cytochemical reactions indicated that the two layers of the zona radiata of A. fasciatus contained proteins and polysaccharides. The initially squamous follicle cells, became cuboidal. In mature oocytes, the nucleus moved toward the periphery, next to the micropyle, and the yolk granules formed by proteins, fulfilled the cytoplasm. The clear unstained vesicles are likely to be the cortical alveoli in the perivitelline region.

Dynamics and cytochemistry of oogenesis in Leporinus striatus Kner (Teleostei, Characiformes, Anostomidae) from the Rio Sapucaí, Minas Gerais State, Brazil

Oogenesis involves a sequense of transformations which are undergone by female germ cells. These cells change into oogonias and then into mature oocytes. Sexually mature females were collected monthly, during one year, from the Rio Sapucaí, tributary of the Rio Grande, which is part of the Furnas Reservoir system in the state of Minas Gerais. The observed material showed that oogonias were small spherical cells, had a big spherical nucleus, with a single nucleolus, and weakly stained cytoplasm with eosinophilic granules (FG stained), which indicate their protein content. The primary oocytes showed a big basophilic nucleus, with a large peripheral nucleolus, and several smaller nucleoli. They show a reduced cytoplasmic content. The previtellogenic oocytes presented voluminous cytoplasm and nucleus with several small peripheral nucleoli. The oocytes underwent vitellogenesis with the development of the zona radiata and the follicle cells. The zona radiata had two layers, the outer and the inner, which showed its protein content when stained with CM and FG techniques. TB pH 2.5 and pH 4.0 staining showed that oocytes undergoing vitellogenesis presented weakly stained cytoplasm and peripheral cytoplasmic vesicles. The follicle cells that were squamous became cuboidal. In mature oocytes, the yolk granules that filled the cytoplasm became green and blue when stained with FG and CM techniques, indicating their protein content. The perivitclline region showed rosy stained vesicles (TB pH 2.5 and pH 4.0) spread among the weakly stained peripheral vesicles, which seemed to be the cortical alveoli. The zona radiata cells, CM and FG stained, still showed two layers like the oocytes from the previous stage, but thicker.

Histopathological and ultrastructural characteristics of myeloid leukosis in broiler chicken

Caracterizaram-se a linhagem e o grau de diferenciação das células neoplásicas no estudo histopatológico e ultraestrutural da leucose mielóide. Histologicamente as células neoplásicas apresentaram pleomorfismo, núcleos ovais, nucléolos proeminentes, cromatina distribuída de maneira irregular, figuras de mitose atípicas e moderada quantidade de citoplasma contendo granulações eosinofílicas esféricas. Essas características indicam a linhagem mielóide. Ultraestruturalmente evidenciaram-se células com núcleo oval, volumoso, eletrodenso, com predomínio de eucromatina e citoplasma com numerosos grânulos esféricos, eletrodensos e homogêneos, indicando mielócitos com diferenciação para eosinófilos. Constatou-se também a presença de partículas virais tipo-C no espaço intercelular dos túbulos renais, no interior de vesículas intracitoplasmáticas dos mielócitos imaturos presentes na medula óssea e ovário, e PCR positivo para ALV-J.

Histopathology of tick-bite lesions in naturally infested capybaras (Hydrochoerus hydrochaeris) in Brazil

In the present work features of tick-bite lesions were evaluated in capybaras naturally infested with Amblyomma cajennense and Amblyomma dubitatum ticks. Gross appearance of tick bite site was characterized by a mild swelling and erythema. Microscopic examination revealed the cement cone, a tube-like homogenous eosinophilic mass penetrating deep into the dermis. This structure was surrounded in the dermis by a cellular infiltrate and free eosinophilic granules and was associated to edema of variable intensity. Necrosis was a common feature deep in the dermis particularly at the far end of the eosinophilic tube. Hyperplasia, cellular edema and occasionally necrosis of keratinocytes could be seen at both sides of the ruptured epidermis. Cellular infiltrate was constituted overwhelmingly by polymorphonuclear leukocytes with eosinophilic granules. In capybaras cells with such features can be either eosinophils or heterophils (pseudoeosinophils), the latter being the equivalent of neutrophils of other mammals. Ultrastructural analysis of the cellular infiltrate revealed the predominance of heterophils over eosinophils. Mononuclear cells and mast cells and, in lesser numbers, basophils were also seen at skin attachment sites. The presence of heterophils in the reaction of capybaras against Amblyomma ticks is an outstanding feature but its role in the reaction to the tick is not known. It is however speculated that capybara heterophils might be associated with a more permissive environment for tick feeding and pathogen transmission as already shown for the equivalent cell type, the neutrophil, in the reaction of the dog against the Rhipicephalus sanguineus tick.

Modulation of eosinophil generation and migration by Mangifera indica L. extract (Vimang (R))

The effects of Vimang((R)), an aqueous extract of the stem bark of Mangifera indica L. (Anacardiaccae), on cell migration in an experimental model of asthma was investigated. In vivo treatment of Toxocara canis-infected BALB/c mice for 18 days with 50 mg/kg Vimang((R)) reduced eosinophil migration into the bronchoalveolar space and peritoneal cavity. Also, eosinophil generation in bone marrow and blood eosinophilia were inhibited in infected mice treated with Vimang((R)). This reduction was associated with inhibition of IL-5 production in serum and eotaxin in lung homogenates. In all these cases the effects of Vimang((R)) were more selective than those observed with dexamethasone. Moreover, Virnang((R)) treatment is not toxic for the animals, as demonstrated by the normal body weight increase during infection. These data confirm the potent anti-inflammatory effect of Vimang R and support its potential use as an alternative therapeutic drug to the treatment of eosinophilic disorders including those caused by nematodes and allergic diseases. (c) 2006 Elsevier B.V. All rights reserved.

ALTERED FOCI OF HEPATOCYTES IN RATS INITIATED WITH DIETHYLNITROSAMINE AFTER PROLONGED FASTING

The influence of fasting on the potential of diethylnitrosamine (DEN) to initiate liver cucinogenesis was tested in a medium-term assay using the development of putative preneoplastic altered foci of hepatocytes (AFH) as the endpoint. Male Wistar rats fasted for 48 hr were given a single ip injection of DEN (200 mg/kg body weight). Partial hepatectomies were carried out at wk 3 and the rats were killed at wk 8. Fasted rats exhibited a small increase in the numbers of AFH with glutathione S-transferase in the placental form and eosinophilic AFH when compared with non-fasted animals. However, after a 6-wk exposure to 0.05% sodium phenobarbital in the diet, there were no differences in the numbers of AFH between fasted and non-fasted animals. Fasting also increased DEN-dependent centrilobular cell necrosis and specifically drug metabolism as indicated in vivo by a decreased time of paralysis of the lower limbs induced by zoxazolamine (40 mg/kg body weight, ip) and by an unaltered sleeping time induced by sodium pentobarbital (40 mg/kg body weight, ip). The results indicate that although fasting during the initiation stage of carcinogenesis increases DEN hepatotoxicity, it does not interfere quantitatively with the development of liver preneoplastic lesions.