IgG, IgM and IgA antibody response for the diagnosis and follow-up of paracoccidioidomycosis: Comparison of counterimmunoelectrophoresis and complement fixation

IgG, IgM and IgA antibodies to GP43 (glycoprotein fraction of Paracoccidioides brasiliensis) were measured by ELISA in 63 samples from 23 patients with paracoccidioidomycosis before and twice after chemotherapy was started. Antibodies against P. brasiliensis were detected by indirect immunofluorescence (IF) (IgG, IgM and IgA isotypes), counterimmunoelectrophoresis (CIE) and complement fixation. Two control groups composed of 19 healthy individuals and 12 patients with other diseases (six with histoplasmosis, three with tuberculosis and three with other mycoses). The highest efficiency percentages were found with IgG and IgA- ELISA (100%), IgG-IF (96.2%), CIE (94.4%) and the lowest with CF (75.9%). Highest positive and negative predictive values (100%) were observed for IgG and IgA ELISA. IgG and IgM-ELISA antibodies are more often found in patients with acute than chronic disease (P = 0.01). Four to six months after treatment follow-up showed decreased levels of IgG and IgM-ELISA for acute cases and decreased titres of CIE for chronic cases in relation to pretreatment levels. This study suggests that IgG-ELISA anti-GP43 represents a good marker to monitor clinical response to therapy.

Penfigo foliaceo no Hospital das Clinicas da Faculdade de Medicina de Botucatu, SP

BACKGROUND - Pemphigus foliaceus is an autoimmune bullous disease that is endemic in Brazil and in other South American countries such as Paraguay, Bolivia, Peru and Colombia. OBJECTIVES - To compare the observed clinical and epidemiological data with those referred in the literature. METHOD - Retrospective study in patients with pemphigus foliaceus admitted to and treated at University Hospital of the School of Medicine of Botucatu, SP, Brazil, from 1976 to 1993, analyzing the following variables: age, sex, race, origin and onset of disease. RESULTS - From 1976 to 1993, 63 patients were treated, with an average of 3.7 cases/year. Patients within the age range of 20 to 60 years old were the most affected. Most of the patients were white, females being slightly more affected than males. The majority of male patients were rural workers. Some towns presented higher incidence of cases. Most of the patients from rural areas became sick mainly in summer and in autumn. Occurrence of similar cases was observed in blood-related family members and neighbors. CONCLUSIONS - Clinical and epidemiological data were similar to those referred in the literature.

Crystallization and X-ray diffraction data analysis of oxyhemoglobin-I from the catfish Liposarcus anisitsi (pisces)

Hemoglobin remains, despite the enormous amount of research involving this molecule, as a prototype for allosteric models and new conformations. Functional studies carried out on Hemoglobin-I from the South-American Catfish Liposarcus anisitsi [1] suggest the existence of conformational states beyond those already described for human hemoglobin, which could be confirmed crystallographically. The present work represents the initial steps towards that goal.

Detection of circulating Paracoccidioides brasiliensis antigen in urine of paracoccidioidomycosis patients before and during treatment

For the diagnosis and follow-up of paracoccidioidomycosis patients undergoing therapy, we evaluated two methods (immunoblotting and competition enzyme immunoassay) for the detection of circulating antigen in urine samples. A complex pattern of reactivity was observed in the immunoblot test. Bands of 70 and 43 kDa were detected more often in urine samples from patients before treatment. The immunoblot method detected gp43 and gp70 separately or concurrently in 11 (91.7%) of 12 patients, whereas the competition enzyme immunoassay detected antigenuria in 9 (75%) of 12 patients. Both tests appeared to be highly specific (100%), considering that neither fraction detectable by immunoblotting was present in urine samples from the control group. gp43 remained present in the urine samples collected during the treatment period, with a significant decrease in reactivity in samples collected during clinical recovery and increased reactivity in samples collected during relapses. Reactivity of some bands was also detected in urine specimens from patients with 'apparent cure.' The detection of Paracoccidioides brasiliensis antigens in urine appears to be a promising method for diagnosing infection, for evaluating the efficacy of treatment, and for detecting relapse.

Paracoccidioidomycosis: Survey and clinical aspects from the Department of Dermatology of the School of Medicine of Botucatu (Sao Paulo - Brazil)

Background - Paracoccidioidomycosis is the most frequent among the systemic mycoses in Brazil. Objective: To study the cases of paracoccidioidomycosis diagnosed from 1976 to 1996 at the Department of Dermatology of the School of Medicine of Botucatu. Methods - Descriptive study obtained from specific protocols comprising anamnesis, clinical- dermatological-laboratorial examination, treatment and follow-up of the patients. Results - Paracoccidioidomycosis was diagnosed in 1.04% of the dermatologic outpatients assisted from 1976 to 1996. In 315 cases, 89.8% were male, 61.9% were over forty and 53.7% were rural workers. The complaints were related more to oropharyngolaryngeal (53.6%) or cutaneous (23.8%) lesions or adenopathy (10.2%). Seventy patients had already been treated in other health services. The chronic multifocal clinical from was the most common: 80.6% of the cases, followed by the acute-subacute (juvenile type) 15.5%. The disease was pulmonary in 80.0%, oropharyngolaryngeal in 69.2% and cutaneous in 45.7%. Th treatment: Amphotericin B in 146 patients, Ketoconazole - 88, Itraconazole - 56, Sulfonamide derivatives - 146 and Terbinafine in 3. The lethality index resulting from the disease or its treatment was 2.0%. Conclusions - The high number of cases, showing the regional relevance of the disease and the high percentage of tegumentary complaints and the high number of relapsing are remarkable.

Paracoccidioidomicose

The aspects related to the epidemiology, pathogenesis, clinical classification, clinical manifestations and treatment of Paracoccidioidomycosis, are presented. The disease is caused by Paracoccidioides brasiliensis and is the most frequent and the most important systemic mycosis in the South America, specifically in Brazil, Argentina, Colombia and Venezuela. Because of the high frequency of cutaneous-mucosal lesions presented by the patients, the potential severity of the disease and the socio-economic consequences to the patient, it is very important for a drematologist to be qualified to precisely diagnose the disease and render proper care.

Energetic cost of predation: Aerobic metabolism during prey ingestion by juvenile rattlesnakes, Crotalus durissus

We investigated the cost of prey ingestion in the South American rattlesnake, Crotalus durissus, to see if the capacity to generate energy aerobically could be a constraint on the size of the prey that can be ingested. To accomplish this goal, we measured time and aerobic metabolism (inferred from oxygen consumption) of juvenile C. durissus ingesting prey ranging from 10 to 50% of their own body mass. Time needed for prey ingestion increased with prey size, with prey representing 10 and 20% of snake size being ingested with the same effort. Whole animal rates of oxygen consumption increased linearly with prey size, but at a slower pace for snakes ingesting prey larger than 30% of their body mass. Aerobic factorial power input necessary for prey ingestion increased with prey size, and for snakes ingesting prey representing 50% of their body mass it equaled the aerobic factorial scope for exercise. For the maximum prey size tested, the aerobic derived energy necessary for prey ingestion represented 0.02% of the total energy content of the prey. Within the prey size range we studied, the cost of ingestion did not constitute any constraint on the size of the prey that can be ingested. These constraints are set by morphological (gape size), ecological (predation risk), and, probably, by physiological parameters, as suggested by the tendency of V̇O2 during ingestion to increase at a slower pace at relative larger prey sizes.

Re-evaluation of antibiotic and mercury resistance in Escherichia coli populations isolated in 1978 from Amazonian rubber tree tappers and Indians

A study was carried out to assess the stability of antimicrobial susceptibility of wild isolates upon long-term storage using fifty-three Escherichia coli strains isolated in 1978 from feces of healthy children from the Amazon region in Brazil, exposed to low levels of antimicrobial agents, and examined for resistance to mercury and four antibiotics. All of the strains were kept in Lignieres medium at room temperature and were transferred to fresh media four times during this period. Thirty-five out of the 53 strains analyzed in 1978 were viable. Upon recovery, antibiotic and mercury resistance was estimated. All of the 35 strains maintained their original phenotype in a stable fashion, except for one multiresistant strain which became susceptible to kanamycin. Fifty-four percent of the strains exhibited a resistance phenotype, among which 47% had conjugative plasmids.

Abuso sexual, transtornos mentais e doencas fisicas

Objective: to review and describe the different organic and psychic consequences of sexual abuse. Methodology: 71 papers were sorted in a ten-year literature search (1987-1997) in MedLine and Lilacs (South American Literature Index), besides 14 books in the subject. Results: sexual abuse is much less frequent (or less reported) in Brazil: 7% of the population, while in the USA the prevalence is 12.9% to 28% of women and 2% to 9% of men. Results showed women being more frequently sexually abused but less differences in physical abuse were found between genders. There was a significant association between sexual abuse and the following: eating disorders, depression, irritable bowel, chronic pain (mainly pelvic), neurological, rheumatic and venereal disorders. This association was not observed in chronic constipation, Chron disease and dissociative disorders. Conclusions: although it is important to think of sexual/physical abuse as a predisposing factor to several illnesses, caution is necessary specially in cultures with different moral and ethical values. Research in this subject in Brazil should be conducted with patients in treatment, using control groups, in order to take advantage of the existing rapport. It would be also quite important to separate acute and chronic abuse effects, as well as getting to know the meaning of the experienced abuse to each person.

Tectonics and paleogeography along the Amazon river

The main structural and geomorphological features along the Amazon River are closely associated with Mesozoic and Cenozoic tectonic events. The Mesozoic tectonic setting is characterised by the Amazonas and Marajó Basins, two distinct extensional segments. The Amazonas Basin is formed by NNE-SSW normal faults, which control the emplacement of dolerite dykes and deposition of the sedimentary pile. In the more intense tectonic phase (mid-Late Cretaceous), the depocentres were filled with fluvial sequences associated with axial drainage systems, which diverge from the Lower Tapajós Arch. During the next subsidence phase, probably in the Early Tertiary, and under low rate extension, much of the drainage systems reversed, directing the paleo-Amazon River to flow eastwards. The Marajó Basin encompasses NW-SE normal faults and NE-SW strike-slip faults, with the latter running almost parallel to the extensional axes. The normal faults controlled the deposition of thick rift and post-rift sequences and the emplacement of dolerite dykes. During the evolution of the basin, the shoulder (Gurupá Arch) became distinct, having been modelled by drainage systems strongly controlled by the trend of the strike-slip faults. The Arari Lineament, which marks the northwest boundary of the Marajó Basin, has been working as a linkage corridor between the paleo and modern Amazon River with the Atlantic Ocean. The neotectonic evolution since the Miocene comprises two sets of structural and geomorphological features. The older set (Miocene-Pliocene) encompasses two NE-trending transpressive domains and one NW-trending transtensive domain, which are linked to E-W and NE-SW right-lateral strike-slip systems. The transpressive domains display aligned hills controlled by reverse faults and folds, and are separated by large plains associated with pull-apart basins along clockwise strike-slip systems (e.g. Tupinambarana Lineament). Many changes were introduced in the landscape by the transpressive and transtensive structures, such as the blockage of major rivers, which evolved to river-lakes, transgression of the sea over a large area in the Marajó region, and uplift of long and narrow blocks that are oblique to the trend of the main channel. The younger set (Pliocene-Holocene) refers to two triple-arm systems of rift/rift/strike-slip and strike-slip/strike-slip/rift types, and two large transtensive segments, which have controlled the orientation of the modern drainage patterns. © 2001 Elsevier Science Ltd. All rights reserved.

Morphology and histoenzymology of eosinophilic granulocytes in the circulating blood of the turtle (Chrysemys dorbignih)

The studies on the characterization of eosinophils and neutrophils/ heterophils of turtles are contradictory. Some authors have pointed out the existence of two distinct cell types: eosinophils and heterophils. Other authors have proposed that eosinophils and heterophils may be the same cells in different stages of maturation. These interpretations are based only on a morphological analysis. In the blood of the turtle (Chrysemys dorbignih), a South American freshwater species, there are two types of granulocytes with eosinophilic staining pattern: the first with round cytoplasmic granules and the second with ellipsoidal cytoplasmic granules. In the present study by using histoenzymological methods for the analyses of enzymological cellular content, we found that the cells with round cytoplasmic granules were positive for nonspecific esterase and the cells with ellipsoidal granules were positives for acid phosphatase, alkaline phosphatase, nonspecific esterase and peroxidase. The results show that these cells are distinct cells and that the cells with ellipsoidal cytoplasmic granules have the same histoenzymological characteristics as the neutrophils/heterophils of mammalians and other vertebrates.

The thrombocyte aggregation process in the turtle Phrynopys hilarii (Chelonia). An ultrastructural study

This study investigates the thrombocyte aggregation process in the South American fresh water turtle (Phrynopys hilarii) using electron microscopy. Blood was taken from surgically exposed lateral neck vessels often turtles Phrynopys hilarii during the spring and summer seasons, when the mean temperature is 37°C. Blood samples were fixed with Karnovsky solution for processing by transmission electron microscopy. The turtle thrombocytes were spindle-shaped with lobulated nuclei. Prominent vesicles and canaliculi were found throughout the cytoplasm. The cytoplasm organelles showed an agranular endoplasmatic reticulum, Golgi complex near the centrioles and scattered free ribosomes. These cells are similar to bird thrombocytes but distinct from fish and frog thrombocytes. Blood clotting time was 5 min ± 30 sec measured by the Lee and White method. Structural alterations resulting from the aggregation process occurred after activation. Thrombocytes developed numerous filopodial projections, an increased number of vacuoles and changed from spindle to spherical shape. P. hilarii thrombocytes have different morphologic characteristics compared to other non-mammalian vertebrate cells. These cells can participate in the aggregation process, as observed in birds.

IL-12 and neutralization of endogenous IL-10 revert the in vitro antigen-specific cellular immunosuppression of paracoccidioidomycosis patients

Treatment of patients with paracoccidioidomycosis is still a challenge. Patients present defective lymphoproliferation and IFN-γ responses to the main Paracoccidioides brasiliensis antigen (gp43), which correlates with disease severity. Here, we demonstrated that the patients show also a defective synthesis of interleukin (IL)-12. Therefore, we attempted to revert this immune disfunction by adding IL-12 and neutralizing anti-IL-10 antibody to gp-43-stimulated peripheral blood mononuclear cell cultures. Both treatments increased IFN-γ secretion to levels observed with healthy sensitized individuals, but affected proliferation only modestly. When combined, the treatments further increased IFN-γ synthesis and cell proliferation. The addition of suboptimal concentrations of IL-2 also further increased the IL-12-mediated secretion of IFN-γ. Interestingly, the immune modulation was mostly antigen-specific, since the responses to Candida albicans' antigen were not affected. These results suggest that appropriate immune intervention with cytokines and/or anti-cytokines may help in the treatment of PCM. © 2002 Elsevier Science Ltd. All rights reserved.

Genetic diversity in Colletotrichum gloeosporioides from Stylosanthes spp. at Centers of origin and utilization

Using molecular markers, this work compares the genetic diversity in Colletotrichum gloeosporioides infecting species of the tropical forage legume Stylosanthes at the center of origin in Brazil and Colombia with that of Australia, China, and India, where Srylosanthes spp. have been introduced for commercial use. There was extensive diversity in the pathogen population from Brazil, Colombia, China, and India. The Australian pathogen population was least diverse probably due to its geographical isolation and effective quarantine. The extensive diversity in China and India means that threats from exotic pathogen races to Stylosanthes pastures can potentially come from countries outside the South American center of origin. In Brazil and India, both with native Stylosanthes populations, a high level of genetic differentiation in the pathogen population was associated with sites where native or naturalized host population was widely distributed. There was limited genetic diversity at germplasm evaluation sites, with a large proportion of isolates having identical haplotypes. This contrasts recent pathogenicity results for 78 of the Brazilian isolates that show hot spots of complex races are more common around research stations where host germplasm are tested, but few are found at sites containing wild host populations. For a pathogen in which the same races arise convergently from different genetic backgrounds, this study highlights the importance of using both virulence and selectively neutral markers to understand pathogen population structure.