Bancroftian filariasis in two urban areas of Recife, Brasil: the role of individual risk factors

Bancroftian filariasis is spreading in towns of endemic areas as in Recife, northeastern Brazil, where it is a major public health problem. This paper deals with the prevalence of microfilaraemia and filarial disease in two urban areas of Recife, studying their association with individual characteristics and variables related to the exposure to the vectors. The parasitologic survey was performed through a "door-to-door" census and microfilaraemia was examined by the thick-drop technique using 45µl of peripheral blood collected between 20:00 and 24:00 o' clock. 2,863 individuals aged between 5 and 65 years were interviewed and submitted to clinical examination. Males aged between 15 and 44 years old presented the greatest risk of being microfilaraemic. Microfilaraemia was also significantly associated with no use of bednet to sleep. The risk of being microfilaraemic was greater among those who had lived in the studied areas for more than 5 years. The overall disease prevalence was 6.3%. Males presented the greatest risk of developing acute disease. The risk of developing chronic manifestations was also greater among males and increased with age. We found no association between time of residence, bednet use, microfilaraemia and acute and chronic disease. We may conclude that in endemic areas there are subgroups of individuals who has a higher risk of being microfilariae carriers due to different behaviours in relation to vector contact.

Trypanosoma cruzi strains: behavior after passage into authoctonous or foreign species of triatomine (biological and biochemical patterns)

The behavior of T. cruzi strains from S. Felipe - BA (19 SF, 21 SF and 22 SF) classified as Type II Zymodeme 2, was investigated after passage through the authoctonous (P. megistus) and foreign vectors (T. infestans and R. prolixus). For each strain Swiss mice were infected: I - with blood forms (control); II - with metacyclic forms (MF) from P. megistus; III - with MF from T. infestans; IV - with MF from R. prolixus. Inocula: MF from the three species of triatomine, 60 to 120 days after feeding in infected mice, adjusted to 10 4. Biological behavior in mice (parasitemia, morphology, mortality, virulence and pathogenicity) after passage through triatomine was compared with data from the same strain in control mice. Isoenzymic electrophoresis (ASAT, ALAT, PGM, GPI) were also performed after culture into Warren medium. The three strains maintained the isoenzyme profiles (zymodeme 2), in the control groups and after passages through different species of triatomine. Biological characterization disclosed Type II strains patterns for all groups. An increased virulence was observed with the 22 SF strain isolated from P. megistus and T. infestans and higher levels of parasitemia and predominance of slender forms in mice inoculated with the 19 SF and 21 SF from these same species. Results indicate that the passage through the two species T. infestans and P. megistus had a positive influence on the virulence of the regional strains of S. Felipe, regardless of being autocthonous (P. megistus) or foreign to the area (T. infestans).

Traços da medicina na azulejaria de Lisboa

RESUMO: A presente abordagem procura estabelecer uma relação entre a Medicina e a Azulejaria. Um conjunto de composições produzidas entre o século XVII e a década de 90 do século XX, localizado na área de Lisboa e seus arredores, organiza-se em torno de oito vectores que ilustram a presença de alusões à Medicina na Azulejaria da referida área. São estes, aspectos relacionados com a higiene, marcos da história da assistência, ciclos temáticos relacionados com os quatro elementos primordiais e com os cinco sentidos, representações ligadas à ideia de morte, episódios bíblicos, referências hagiográficas e elementos ligados à acção médica, como objectos, patologias, instituições ou acontecimentos, associados à Medicina, que atestam esta relação entre Arte e Ciência, de forma geral, e entre a Azulejaria e a Medicina, de forma particular. À análise destes vectores, antecede uma resenha histórica relativa à ligação entre Arte e Ciência e um apontamento histórico acerca da história da Azulejaria. Pretende-se demonstrar esta conexão interdisciplinar e reforçar a importância da vertente humanista da Medicina, na sua história, na sua aprendizagem e na sua prática.-------------------------------------ABSTRACT: The present approach aims at establishing a relation between Medicine and Tile Art. A group of compositions produced between the 17th century and the 1990s, located in the Lisbon area and its surroundings, is organized around eight vectors that illustrate the presence of allusions to Medicine in the Tile Art in the mentioned areas. These are related with hygiene aspects, landmarks in the history of assistance, thematic cycles related with the four main elements and with the five senses, representations connected to the idea of death, biblical episodes, hagiographic references and elements connected to the medical intervention, such as objects, pathologies, institutions or events related to Medicine that testify this relation between Art and Science in a broad context, and between Tile Art and Medicine in a strict sense. Prior to the analysis of these vectors there is a historic contextualization concerning the relationship between Art and Science and a historical note about the history of Tile Art. The aim is to demonstrate the interdisciplinary relation and reinforce the importance of the humanistic side of Medicine, in its history, its learning and its practice.------------------------------------RÉSUMÉ: Cet étude vise établir une relation entre la Médecine et l’Art de l’ « Azulejaria ». Un ensemble de compositions produites entre le XVII ème siècle et le dernier quart du XX ème siècle, dans la région de Lisbonne, s’organise autour de huit axes qui illustrent des références à la médecine. Nous avons récupéré des motifs allusifs à l’hygiène, à l’histoire de l’assistance, aux cycles thématiques des quatre éléments primordiaux et des cinq sens, à la mort, aux épisodes bibliques ou hagiographiques mais aussi aux motifs qui reproduisent des objets, des pathologies, des institutions ou des évènements médicaux. Tous ces exemples mettent à jour la relation entre l’Art et la Science, en général, et entre l’ « Azulejaria» et la Médecine, en particulier. Avant d’analyser ces huit axes, nous établirons un parcours historique pour expliquer la relation entre Art et Science, ainsi qu’une brève histoire de l’ «azulejaria». Nous prétendons démontrer cette relation interdisciplinaire et renforcer l’importance de la vertu humaniste des Sciences Médicales dans son histoire, son apprentissage et sa pratique.

A Leishmaniose visceral em Portugal Continental : 1999-2009

RESUMO - As alterações climáticas alteraram a incidência e distribuição mundial de zoonoses, ao modificarem o perfil epidemiológico dos seus vectores. A leishmaniose visceral é reemergente na bacia mediterrânica, sendo o seu impacto real subestimado. Em Portugal, é endémica em três regiões, de declaração obrigatória desde 1948 e o reservatório é o canídeo. O aumento da incidência da doença no cão e a escassez de informação epidemiológica tornou pertinente investigar a realidade nacional. A partir das bases de dados das notificações e dos grupos de diagnósticos homogéneos hospitalares, foram identificados todos os casos e, consultados todos os processos clínicos dos doentes com episódios de internamento nos hospitais do continente entre 1999-2009. Ocorreram 730 internamentos para 375 indivíduos na maioria: homens, eurocaucasianos, com em média, 27 anos e, residência em Lisboa e Vale do Tejo. A sintomatologia e comorbilidades dos doentes vão de encontro ao descrito internacionalmente. A doença foi subnotificada, com uma demora média de 19 dias. A letalidade foi de 5%. A taxa de incidência média do continente foi de 0,294/100000 habitantes, sem padrão de sazonalidade. O corredor endémico de Bortman construído apresentou picos com amplitudes de 2-3 anos. O mapeamento dos doentes evidenciou casos em regiões não endémicas acompanhando a distribuição da leishmaniose canina. Seria pertinente que futuras investigações construíssem uma modelação matemática que confirmasse a tendência do corredor endémico (pico em 2011?) para accionar um sistema de alerta nos Serviços de Saúde. Seria também útil a avaliação das condições geoclimáticas das localidades com casos para evidenciar possíveis similitudes no território. -------ABSTRACT - Climate changed the incidence and worldwide distribution of zoonosis while the epidemiological profile of their vectors was changing. Visceral leishmaniasis is reemerging in the Mediterranean basin and its real impact underestimated. In Portugal, it’s endemic in three regions; the notification occurs since 1948 and dog is the reservoir. The increased incidence of the canines’ disease and the scarcity of epidemiological information relevant investigate the national reality. From Notifications and Homogeneous’ Diagnostics Groups system databases, all cases were identified and also analyze all clinical processes of inpatients’ hospitals in 1999- 2009 in Portugal. 730 admissions occurred for 375 patients. In most they were men, Caucasians, with an average of 27 years and residency in Lisboa e Vale do Tejo. The symptoms and comorbilidades patient go against described internationally. The disease was under notified, with an average delay of 19 days. Lethality was 5%. The incidence rate was 0,294/100000 inhabitants, without seasonality. The endemic’s Bortman corridor presents peak amplitudes of 2-3 years. Mapping patient’s residency shows that cases’ distribution is similar to endemic canine leishmaniasis. It would be appropriate a research to build a mathematical modeling up to confirm the trend of corridor endemic (peak in 2011?), to trigger an alert system for health services. It would also be useful to evaluate the geo-climatics conditions of localities with cases to highlight possible similarities in the territory.

Expression of antibodies and retroviralVectors from defined chromosomal sites: strategies towards reliable production systems

Dissertation presented to obtain a Ph.D. degree in Sciences of Engineering and Technology, Cell Technology, at the Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa

COLONIZATION AND LABORATORY MAINTENANCE OFAnopheles albimanus WIEDEMANN IN VENEZUELA

Anopheles albimanus is one of the main vectors of malaria in Central America and the Caribbean, based on its importance, there are previous reports of the successful colonization of this species in Latin America countries. Mosquitoes were collected in the Aragua State of Venezuela colonized in the laboratory, using a simple and efficient maintenance method. Based on life table calculations under well established laboratory conditions, the Survival Rate Probability was constant and always close to 1 in immature stages, the Reproductive Net Rate (Ro) was 3.83, the generation time (Tc) was 24.5 days and the Intrinsic Growth Rate (rm) was 0.0558. This is the first report of the colonization of A. albimanus in Venezuela.

PARACOCCIDIOIDOMYCOSIS AND AIDS: REPORT OF THE FIRST TWO COLOMBIAN CASES

The records of the first two Colombian patients with AIDS and paracoccidioidomycosis are presented. Both patients were males and had no known risk factors for HIV although in the past they had worked in the field where they could have been infected with the fungus. They exhibited the juvenile type of disease with multiple organ system involvement and symptoms of short duration. They were deeply immunodepressed as indicated by less than 100 CD4 T lymphocytes per mL; however, serologic tests revealed circulating anti-Paracoccidioides brasiliensis antibodies and in one patient the first diagnostic clue came from such tests. In one case, the mycosis preceded the AIDS diagnosis while in the other, both pathologies were discovered simultaneously. Antimycotic therapy with itraconazole was administered for over 10 months, with an initial dose of 200 mg/day followed by 100 mg/day; marked improvement of the mycotic signs and symptoms was soon noticed an there have been no signs of relapse. The patients´ improvement was also due to the combined retroviral treatment that was instituted. In spite of the rarity of the AIDS-paracoccidioidomycosis association, physicians practicing in endemic areas should consider the presence of the mycosis in immunosuppressed patients, since a prompt diagnosis and institution of combined antimycotic-anti-retroviral treatments would result in patient improvement and survival. It appears possible that the longer survival time of today's AIDS patients would give the quiescent fungus the opportunity to revive, multiply and cause overt disease.

Cavin 1 and cavin 2 roles on adipocyte cell function

Dissertação para obtenção do Grau de Mestre em Genética Molecular e Biomedicina

Oral transmission of Chagas disease: importance of Trypanosoma cruzi biodeme in the intragastric experimental infection

Oral transmission of Trypanosoma cruzi has been suspected when epidemic episodes of acute infection were observed in areas devoid of domiciled insect vectors. Considering that the distribution of T. cruzi biodemes differs in sylvatic and domestic cycles, results of studies on biodemes can be of interest regarding oral transmission. The infectivity of T. cruzi strains of different biodemes was tested in mice subjected to infection by the digestive route (gavage). Swiss mice were infected either with the Peruvian strain (Biodeme Type I, Z2b) or the Colombian strain (Biodeme Type III, Z1, or T. cruzi I); for control, intraperitoneal inoculation was performed in a group of mice. The Colombian strain revealed a similar high infectivity and pathogenicity when either route of infection was used. However, the Peruvian strain showed contrasting levels of infectivity and pathogenicity, being high by intraperitoneal inoculation and low when the gastric route was used. The higher infectivity of the Colombian strain (Biodeme Type III) by gastric inoculation is in keeping with its role in the epidemic episodes of acute Chagas disease registered in the literature, since strains belonging to Biodeme III are most often found in sylvatic hosts.

Evidence of spotted fever group rickettsiae in state of Rio de Janeiro, Brazil

Ticks were obtained from dogs from February to September of 1999 at weekly intervals, in the County of Piraí, State of Rio de Janeiro. Four hundred seventy four ixodids were taxonomically identified, 103 Amblyomma cajennense, seven Amblyomma ovale, 209 Rhipicephalus sanguineus, and 155 Amblyomma sp. An hemolymph test associated with Giemsa's stain revealed two specimens in 163 ticks tested (R. sanguineus and Amblyomma sp), containing rickettsia-like organisms. Direct immunofluorescence verified the presence of spotted fever group rickettsia in one specimen of R. sanguineus. Considering the limited information on rickettsiosis in Brazil, principally in relation to the vectors involved in perpetuating it in foci, these preliminary results give us an idea on the importance of infection in ticks, allowing to expand our knowledge on this zoonosis.

Assessment of PCR in the detection of Leishmania spp in experimentally infected individual phlebotomine sandflies (Diptera: Psychodidae: Phlebotominae)

DNA amplification by the polymerase chain reaction (PCR) was applied in the investigation of the presence of Leishmania (Kinetoplastida: Trypanosomatidae) parasites in single phlebotomine sandflies. Three phlebotomine/parasite pairs were used: Lutzomyia longipalpis/Leishmania chagasi, Lutzomyia migonei/Leishmania amazonensis and Lutzomyia migonei/Leishmania braziliensis, all of them incriminated in the transmission of visceral or cutaneous leishmaniasis. DNA extraction was performed with whole insects, with no need of previous digestive tract dissection or pooling specimens. The presence of either mouse blood in the digestive tract of the sandflies or the digestive tract itself did not interfere in the PCR. Infection by as few as 10 Leishmania sp. per individual were sufficient for DNA amplification with genus-specific primers. Using primers for L. braziliensis and L. mexicana complexes, respectively, it was possible to discriminate between L. braziliensis and L. amazonensis in experimentally infected vectors (L. migonei).

Opportunistic infections in patients with aids admitted to an university hospital of the Southeast of Brazil

Opportunistic diseases in HIV-infected patients have changed since the introduction of highly active anti-retroviral therapy (HAART). This study aims at evaluating the frequency of associated diseases in patients with AIDS admitted to an university hospital of Brazil, before and after HAART. The medical records of 342 HIV-infected patients were reviewed and divided into two groups: group 1 comprised 247 patients before HAART and, group 2, 95 patients after HAART. The male-to-female rate dropped from 5:1 to 2:1for HIV infection. There was an increase in the prevalence of tuberculosis and toxoplasmosis, with a decrease in Kaposi's sarcoma, histoplasmosis and cryptococcosis. A reduction of in-hospital mortality (42.0% vs. 16.9%; p = 0.00002) has also occurred. An agreement between the main clinical diagnoses and autopsy findings was observed in 10 out of 20 cases (50%). Two patients with disseminated schistosomiasis and 2 with paracoccidioidomycosis are reported. Overall, except for cerebral toxoplasmosis, it has been noticed a smaller proportion of opportunistic conditions related to severe immunosuppression in the post HAART group. There was also a significant reduction in the in-hospital mortality, possibly reflecting improvement in the treatment of the HIV infection.

Analysis of genetic relatedness between populations of Aedes aegypti from different geographic regions of São Paulo state, Brazil

RAPD markers have been used for the analysis of genetic differentiation of Aedes aegypti, because they allow the study of genetic relationships among populations. The aim of this study was to identify populations in different geographic regions of the São Paulo State in order to understand the infestation pattern of A. aegypti. The dendrogram constructed with the combined data set of the RAPD patterns showed that the mosquitoes were segregated into two major clusters. Mosquitoes from the Western region of the São Paulo State constituted one cluster and the other was composed of mosquitoes from a laboratory strain and from a coastal city, where the largest Latin American port is located. These data are in agreement with the report on the infestation in the São Paulo State. The genetic proximity was greater between mosquitoes whose geographic origin was closer. However, mosquitoes from the coastal city were genetically closer to laboratory-reared mosquitoes than to field-collected mosquitoes from the São Paulo State. The origin of the infestation in this place remains unclear, but certainly it is related to mosquitoes of origins different from those that infested the West and North region of the State in the 80's.

Risco Cardiovascular em Doentes com Infecção por Vírus da Imunodeficiência Humana

O aumento do risco cardiovascular é considerada uma importante complicação da infecção Infecção por Vírus da Imunodeficiência Humana (VIH) e da terapêutica anti-retroviral (TARV). À disfunção endotelial característica do processo inflamatório crónico desencadeado pela infecção retroviral, associa-se a disfunção metabólica induzida pela terapêutica, predispondo, em conjunto, para a aterogénese precoce. O reconhecimento deste aumento de risco cardiovascular permite-nos elaborar estratégias de prevenção e optimização terapêutica que passam pelo uso criterioso de hipolipemiantes e modificação da TARV, consoante a avaliação do risco cardiovascular global de cada doente.

Studies on entomological monitoring: mosquito species frequency in riverine habitats of the Igarapava Dam, Southern Region, Brazil

Diversity of mosquito species was evaluated in different habitats before and after the Igarapava reservoir flooding in the Grande River, Southern Cerrado of Brazil. We aimed at verifying changes in these mosquito populations in consequence of the lake formation. Four habitats were selected as sampling stations: peridomiciliary habitat, pasture, "veredas" and gallery forest patch. Bimonthly collections were made with the Shannon trap and human bait, including diurnal, crepuscular and nocturnal period of mosquito activity. The Shannon Index results from the potential vectors were compared using Student t-test. Aedes scapularis, Anopheles darlingi and An. albitarsis senso latu seasonal abundance were described with moving average and compared using chi2 test. There were changes in the mosquito frequency in the habitats, except for the "veredas" that was 13 km away from the catchment area. The altering in mosquito species seasonal abundance suggests breeding places expansion. Diversity indexes can be used to monitor changes in mosquito vector population in environments where abrupt disturbance can alter disease transmission cycles.