Primary cutaneous cryptococcosis in Brazil: report of 11 cases in immunocompetent and immunosuppressed patients

Background Primary cutaneous cryptococcosis is an uncommon infectious disease caused by Cryptococcus neoformans or Cryptococcus gattii affecting immunosuppressed as well as immunocompetent patients. It is often misdiagnosed as it may mimic other cutaneous diseases. Materials and methods We report a series of cases diagnosed from 2005 to 2010 in two general hospitals. The diagnosis in all patients was made on the basis of histopathology and culture. Phenoloxidase and canavanine-glycine-bromothymol blue tests were used in order to identify the Cryptococcus species. Systematic investigation ruled out the systemic involvement in every case. Results Eleven patients, 81.8% male, were diagnosed during this study. The immunosuppression status was identified in 54.5% of patients, and all of them were under corticosteroid therapy due to a variable set of diseases. All patients presented with circumscribed lesions on their upper limbs. Most lesions showed an infiltrative or tumoral aspect with up to 40 cm diameter. Fluconazole, up to 400 mg/daily, was the main therapeutic regimen and proved to be efficient. Conclusions Primary cutaneous cryptococcosis has been diagnosed in both immunosuppressed and immunocompetent patients. Its peculiar clinical aspect could facilitate early diagnosis. Culture and biochemical tests should be performed in order to define the species involved.

Alcohol use and falls among the elderly in Metropolitan São Paulo, Brazil

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

COEVOLUTION BETWEEN ATTINE ANTS and ACTINOMYCETE BACTERIA: A REEVALUATION

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Historical aspects of Belly Dance and its practice in Brazil

Dance is regarded as one of the oldest art forms, which is based on evidence from prehistoric paintings found in caves; man expressed himself through body language prior to the development of spoken and written forms of communication. Dance was then used during important events, common to their era and culture, and often in religious rituals, to ensure good harvests - their economic activity. Belly-dance appeared approximately eight thousand years B. C. E. as a sacred dance firstly practiced by priestesses, and after that, it was popularized amongst women from Mesopotamia. Virtually considered an ancient form of physical exercise, it is still practiced by Bedouin women as a preparation for spontaneous delivery. In Brazil, belly-dance is widely practiced and our corporal culture enables its learning and improvement, resulting in professional dancers.

Drinking patterns between men and women in two distinct Brazilian communities

OBJETIVO: Realizou-se um inquérito para comparar diferenças de gênero nos padrões de consumo de álcool em duas amostras urbanas, estratificadas e representativas de duas comunidades (B e RJr). MÉTODO: O questionário Genacis (Gênero, Álcool e Cultura: Um Estudo Internacional Gender, Alcohol, and Culture: An Internacional Study) foi utilizado. RESULTADOS: Houve várias diferenças significativas em dados sociodemográficos e de padrões de uso de álcool entre essas duas amostras. Uma delas tinha população mais velha, educada, católica, branca e mais mulheres na força de trabalho. Dados da comunidade B mostraram que mulheres e homens tiveram padrões similares de consumo de álcool. RJr teve uso de álcool mais alto entre homens e 22% dos homens abaixo de 49 anos de idade tinham padrão de uso do tipo binge. DISCUSSÃO: O acesso, tabagismo, renda e ter um parceiro com consumo pesado de álcool foram fatores de risco importantes para o consumo das mulheres. CONCLUSÕES: Este estudo mostra que quando os papéis das mulheres se tornam similares aos dos homens, modificam seu padrão de consumo de álcool.

Factors contributing to the differences in peritonitis rates between centers and regions

Despite improvements in connectology, peritoneal dialysis (PD) - associated peritonitis contributes significantly to morbidity and modality failure in patients maintained on PD therapy. A broad spectrum of organisms -gram-positive, gram-negative, fungal, anaerobic - are involved in this complication. In addition, a significant percentage of episodes involve polymicrobial and culture-negative infection. Technological advances are being developed to minimize the incidence of access-related complications such as peritonitis. Many traditional factors such as exit-site infection and poor technique have been already identified. In the present review, we discuss the geographic, patient selection, and clinical issues that can affect peritonitis rates in different areas of the world and in different centers in the same area.

Isolation and characterization of Wharton's jelly-derived multipotent mesenchymal stromal cells obtained from bovine umbilical cord and maintained in a defined serum-free three-dimensional system

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

Efficacy, safety and tolerability of terbinafine for Tinea capitis in children: Brazilian multicentric study with daily oral tablets for 1, 2 and 4 weeks

Background: Tinea capitis is a common skin disease seen predominantly in children. The standard therapies for this disease are griseofulvin and ketoconazole. Nevertheless, these drugs have drawbacks in that they are only fungistatic and require treatment for at least 6 weeks. Previous studies with oral terbinafine for the treatment of Tinea capitis have shown that this agent is effective when given for 4 weeks, comparable to an 8-week regimen with griseofulvin. To date there is no data on the use of oral terbinafine in Brazilian children. Objectives: To assess the efficacy, safety and tolerability of oral terbinafine in short-term treatments (1-, 2- and 4-week treatment) of Tinea capitis in children. Patients and methods: One hundred and thirty-two children aged 1-14 years were enrolled in this study, but only 107 were considered for the final efficacy analysis. Diagnosis included clinical assessment and examination by Wood's light. Confirmation was obtained by direct microscopy and culture for fungus. Terbinafine dosage (125 or 250 mg/day) was adjusted according to patient weight. Efficacy was evaluated both by clinical and mycological assessment. Safety and tolerability variables included data on adverse reaction and clinical laboratory evaluations. Results: Mycological evaluation in the follow-up visit at week 12 showed negative direct microscopy and culture results in 48.6, 60.5 and 69.7% patients in groups 1-, 2- and 4-week, respectively (n.s.). At week 12, 84.8% patients in group 4-week achieved clinical cure with a significant difference compared to groups 1- and 2-week, 54.3 and 60.5%, respectively (P < 0.01). Adverse reactions were present in 4.8, 6.8 and 10.9% of patients in groups 1-, 2- and 4-week, respectively. Terbinafine was not associated with clinically relevant increases in liver function tests. Conclusions: Terbinafine is an effective, well tolerated and safe antifungal agent for the treatment of Tinea capitis m children. The shorter duration of treatment resulted in lower cure rates. However, it is important to note that depending on the severity of the disease, a 1-week-only treatment can also be effective in this indication.

In vitro evaluation of antimicrobial activity of sealers and pastes used in endodontics

The antimicrobial activity of four root canal sealers (AH Plus, Sealapex, Ketac Endo, and Fill Canal), two calcium hydroxide pastes (Calen and Calasept), and a zinc oxide paste was evaluated. Seven bacterial strains were used, six of them standard; Micrococcus luteus ATCC 9341, Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853, Staphylococcus epidermidis ATCC 12228, Escherichia coli ATCC 25922, and Enterococcus faecalis ATCC 10541. There was a wild strain of Streptococcus mutans isolated from saliva obtained in an adult dental clinic. Activity was evaluated using the agar diffusion method with Brain Heart Infusion agar and Müller Hinton medium seeded by pour plate. Calcium hydroxide-based sealers and pastes were either placed directly into 4.0 × 4.0 mm wells or by using absorbent paper points. The plates were kept at room temperature for 2 hr for diffusion. After incubation at 37°C for 24 hr, the medium was optimized with 0.05 g% TTC gel and inhibition haloes were measured. All bacterial strains were inhibited by all materials using the well method. However, when the materials were applied with absorbent paper points, Enterococcus faecalis was not inhibited by zinc oxide, and Pseudomonas aeruginosa was not inhibited by AH Plus, Fill Canal, and the zinc oxide-based paste. We conclude that sealers and pastes presented antimicrobial activity in vitro and culture medium optimization with 0.05 g% TTC gel facilitated observation of the inhibition haloes. Copyright © 2000 by The American Association of Endodontists.

The effect of plant diversity on fungus garden development and foraging behavior of leaf-cutting ants (Hymenoptera: Formicidae)

The leaf-cutting ants forage a wide variety of plant species, used for symbiotic fungus cultivation. To better understand this tripartite complex interaction, 24 colonies of Acromyrmex subterraneus brunneus were conditioned for 4 months to 6 different plants (Citrus spp., Ligustrum spp., Acalypha spp., Eucalyptus spp., Alchornea triplinervia, Melia spp.), to verify the influence of conditioning on foraging behavior of workers. The effect of plants on symbiotic fungus development was studied separately, through macerated plants in Agar and culture medium A as the control. During foraging, workers presented polyphagic foraging behavior, refusing the plants to which they were conditioned. The selection of plants is not correlated with the plant substrate that promotes good development of symbiotic fungus. Such results demonstrate the importance of plant diversity for fungus garden maintenance.

Evaluation of serum- and animal protein-free media for the production of infectious bronchitis virus (M41) strain in a continuous cell line

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Antimicrobial activity of coffee-based solutions and their effects on Streptococcus mutans adherence

The aim of this study was to evaluate the antimicrobial activity of different coffee solutions and their effects on the adherence of Streptococcus mutans to glass surface. Coffee solutions were prepared with three commercial products (Pilao, Mellita and Café do Ponto) by two different methods (simple and boiled) (n=15). A control group was also included in the study. For antimicrobial activity testing, tubes containing coffee solution and culture medium were inoculated with a suspension of S. mutans ATCC 35688 and incubated for 1 min 1h, 2h and 4h. Serial dilutions and plating on BHI agar were performed. S, mutans adherence to glass in presence of different coffee solutions was also tested. The number of adhered bacteria (CFU/mL) was determined by plating method. The results were statistically analyzed by ANOVA and Turkey's test. The tested coffee solutions did not reduce the number of colony forming units of S. mutans in relation to the control at all evaluation periods. All the solutions reduced significantly the adherence of S. mutans to the glass surface in relation to control. The tested coffee solutions did not present any antimicrobial effect on Streptococcus mutans, however, all the coffee solutions reduced significantly the adherence of S mutans to the glass surface.

Detection of enterotoxin and toxic shock syndrome toxin 1 genes in Staphylococcus, with emphasis on coagulase-negative staphylococci

The detection of staphylococcal enterotoxins is decisive for the confirmation of an outbreak and for the determination of the enterotoxigenicity of strains. Since the recognition of their antigenicity, a large number of serological methods for the detection of enterotoxins in food and culture media have been proposed. Since immunological methods require detectable amounts of toxin, molecular biology techniques represent important tools in the microbiology laboratory. In the present study, polymerase chain reaction (PCR) was used to identify genes responsible for the production of enterotoxins and toxic shock syndrome toxin 1 (TSST-1) in S. aureus and coagulase-negative staphylococci (CNS) isolated from patients and the results were compared with those obtained by the reverse passive latex agglutination (RPLA) assay. PCR detection of toxin genes revealed a higher percentage of toxigenic S. aureus strains (46.7%) than the RPLA method (38.3%). Analysis of the toxigenic profile of CNS strains showed that 26.7% of the isolates produced some type of toxin, and one or more toxin-specific genes were detected in 40% of the isolates. These results suggests the need for further studies in order to better characterize the pathogenic potential of CNS and indicate that attention should be paid to the toxigenic capacity of this group of microorganisms.

Effects of Coffea arabica on Streptococcus mutans adherence to dental enamel and dentine

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

Reality and language in The Voyage Out, by Virginia Woolf

This article discusses one of Virginia Woolf's greatest literary concerns: the difficulty of expressing human experience through language. The focus is on The Voyage Out, her first novel, published in 1915, particularly the conflicts and contrasts present not only in the trajectory of Rachel Vinrace, the main character, but also in the structure of the novel itself, which establish a constant tension between reality and language.