Frequency of Mycoplasma hominis and Ureaplasma urealyticum infections in women with systemic lupus erythematosus

Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) have been detected in the urine of women with systemic lupus erythematosus (SLE). We evaluated the presence of these mycoplasma in the endocervix of women presenting SLE. A total of 40 SLE patients (mean age 40.2 years), and 51 healthy women (mean age 30.9 years), were studied. Endocervical swabs were cultured in specific liquid media for MH or UU, detected by a quantitative color assay, and considered positive at >10�� dilutions. Statistical analysis was performed using the two-tailed Fisher test. UU was detected in 52.5 % of patients and in 11.8% of controls (p= 0.000059). MH was detected in 20% of patients and 2% controls (p=0.003905). Both mycoplasmas were detected in 7.3% patients and 0% controls (p<0.000001). The results reported here corroborate the association of the mycoplasma infection and SLE. Thus, these agents may stimulate the production of autoreactive clones.

Viral etiology of acute respiratory infections among children in Porto Alegre, RS, Brazil

Although acute respiratory infections (ARIs) are a major cause of child morbidity and mortality in Southern Brazil, little information is available on their seasonality and viral etiology. This study was conducted on children under 5 years of age with ARI to assess viral etiology in the State of Rio Grande do Sul, from 1990 to 1992. A total of 862 nasopharyngeal secretion (NPS) samples were tested using indirect immunofluorescence. The results showed that 316 (36.6%) NPS samples were positive: 26.2% for RSV, 6% for adenovirus, 1.7% for influenzaviruses, 1.5% for parainfluenzaviruses, and 1.2% for mixed infection. The mean viral prevalence rates in out-patient services, emergency wards, and in-patient hospital wards were 26.7%, 53% and 42.3%, respectively. Respiratory syncytial virus (RSV) and adenovirus accounted for 91.4 % of the viral diagnoses. RSV was more frequent in children under one year of age at the three levels of health care and was prevalent in infants under six months. Adenovirus was the most prevalent pathogen in hospitalized children, in 1992. Influenza A virus showed an increased prevalence with age among out-patient children. This study shows the annual occurence of viral respiratory infections in the coldest months, with a significant annual variation in the frequency of RSV infection.

Capillaria hepatica-induced hepatic fibrosis in rats: paradoxical effect of repeated infections

Multiple exposures to parasitic agents are considered an important factor in the genesis of the most severe forms of the diseases they cause. Capillaria hepatica-induced septal fibrosis of the liver in rats usually runs without signs of portal hypertension or hepatic failure. After determining the hepatic profile of 15 animals during the course of a single infection, we submitted 20 rats to multiple Capillaria hepatica infections to determine whether repeated exposures would augment fibrosis production, transforming septal hepatic fibrosis into a true cirrhosis. Ten single-infection rats served as controls. A total of 5 exposures, with 45-day intervals, were made. Histological changes were followed by means of surgical liver biopsies, collected prior to infection and to each re-infection. Functional changes were minimal and transient. Although a slight recrudescence of fibrosis was observed after the first two re-infections and when the single-infected control group was re-infected at the end of the experiment, subsequent re-infections failed to increase the amount of fibrosis. On the contrary, there occurred quantitative and qualitative evidence of collagen degradation and suppression of parasite development. These paradoxical results are in keeping with the hypothesis that a complex immunological modulation participates in the mechanism of hepatic fibrosis induced by Capillaria hepatica infection in rats.

The use of qualitative and quantitative polymerase chain reactions for diagnosis of cytomegalovirus infections in bone marrow and kidney transplant recipients

The purpose of this work was to test a cytomegalovirus qualitative PCR and a semi-quantitative PCR on the determination of CMV load in leukocytes of bone marrow and kidney transplanted (RT) patients. Thirty three BMT and 35 RT patients participated of the study. The DNA was subjected to a qualitative PCR using primers that amplify part of CMV gB gene. CMV load of positive samples was determined by a semi-quantitative PCR using quantified plasmids inserted with part of the gB gene of CMV as controls. The sensitivity of the test was determined to be 867 plasmid copies/��g DNA. CMV loads between 2,118 and 72,443 copies/��g DNA were observed in 12.1% BMT recipients and between 1,246 and 58,613 copies/��g DNA in 22.9% RT recipients. Further studies are necessary to confirm the usefulness of this CMV semi-quantitative PCR in transplanted patients.

Clinical and laboratorial evidence of Rickettsia felis infections in Latin America

After the discovery and initial characterization of Rickettsia felis in 1992 by Azad and cols, and the subsequent first description of a human case of infection in 1994, there have been two communications of human rickettsiosis cases caused by Rickettsia felis in Latin America. The first one was published in 2000 by Zavala-Velazquez and cols in Mexico. In 2001 Raoult and cols described the occurrence of two human cases of Rickettsia felis rickettsiosis in Brazil. In the present discussion these two articles were compared and after the description of the principal signs and symptoms, it was concluded that more studies are needed with descriptions of a greater number of patients to establish the true frequency of the clinical signs and symptoms present in Rickettsia felis rickettsiosis.

Comparison of the thick smear and Kato-Katz techniques for diagnosis of intestinal helminth infections

This study compared the efficiency of Kato-Katz thick smear and thick smear techniques for the diagnosis of intestinal helminths. The sensitivity of the thick smear technique was higher than that of the Kato-Katz method for the diagnosis of all helminths except Schistosoma mansoni.

Prolonged survival and immune reconstitution after chagasic meningoencephalitis in a patient with acquired immunodeficiency syndrome

We report a case of cerebral meningoencephalitis due to Trypanosoma cruzi in a patient with acquired immunodeficiency syndrome. The patient presented with seizures and focal neurological signs. Definitive diagnosis of chagasic meningoencephalitis was made by demonstration of free trypomastigote forms in the cerebrospinal fluid. Benznidazol was prescribed with clinical and neurological improvement. Antiretroviral drugs improved cellular immunity and three years later the patient presents a good clinical condition with immune reconstitution and undetectable viral load. Chagasic meningoencephalitis has a poor prognosis when specific treatment is not initiated or is delayed. A high index of diagnosis is necessary for early diagnosis and treatment, especially in endemic areas for Trypanosoma cruzi infection.

Schistosomiasis mansoni and severe gastrointestinal cytomegalovirus disease in a patient with acquired immunodeficiency syndrome

The behavior of the Schistosoma mansoni infection in patients with AIDS has not been explored. The case of a young woman with schistosomiasis mansoni, AIDS, and cytomegalovirus disease is reported. The authors suggest that the helminth was not a bystander in this case, or rather, by interfering with the host's immune response, it set the stage for the development and/or aggravation of the viral infection.

Barreiras e facilitadores �� implementa����o de um modelo de gest��o de cuidados em Sa��de Mental

RESUMO: Enquadramento te��rico - Os estudos epidemiol��gicos demonstram que apesar de todo o progresso cient��fico, muitas pessoas continuam sem acesso aos Servi��os de Sa��de Mental (SSM) e que, em muitos casos, os cuidados n��o t��m a qualidade suficiente. A experi��ncia de v��rios pa��ses mostra que os processos de implementa����o de modelos de interven����o terap��utica, como �� o da Gest��o de Cuidados, s��o lentos e complexos, n��o dependendo somente do grau de efectividade ou da complexidade das pr��ticas a implementar. O Modelo de Gest��o de Cuidados (MGC), �� definido como uma pr��tica baseada na evid��ncia, utilizada para ajudar os doentes nos seus processos de recupera����o. As estrat��gias para implementar pr��ticas baseadas na evid��ncia s��o cr��ticas para a melhoria dos servi��os. Existem, apesar de toda a evid��ncia, muitas barreiras �� implementa����o. Ao constatarmos que as pr��ticas validadas pela ci��ncia est��o longe de estar claramente disseminadas nos servi��os de sa��de mental, fundamentamos a necessidade de utilizar metodologia de implementa����o que, al��m da efectividade das pr��ticas, permita uma efectividade da implementa����o. Para responder ��s necessidades de forma����o e no ��mbito da implementa����o do Plano Nacional de Sa��de Mental, foram formados, em Portugal, 170 profissionais de sa��de mental provenientes de servi��os p��blicos e do sector social, de todas as regi��es de Portugal Continental. Considerando que estes profissionais adquiriram compet��ncias espec��ficas no MGC, atrav��s de um programa de forma����o nacional id��ntico para todos os servi��os de sa��de mental, investig��mos o grau de implementa����o deste modelo, bem como os facilitadores e as barreiras �� sua correcta implementa����o. Existem v��rios estudos internacionais sobre as barreiras e os facilitadores �� implementa����o de pr��ticas baseadas na evid��ncia, embora a maior parte desses estudos seja baseado em entrevistas semi-estruturadas a profissionais. Por outro lado, n��o existem, em Portugal, estudos sobre as barreiras e os facilitadores �� implementa����o de pr��ticas de sa��de mental. Objectivos 1. Estimar o grau da implementa����o do MGC nos servi��os de sa��de mental portugueses 2. Caracterizar as regi��es onde a implementa����o do MGC tenha ocorrido em maior grau. 3. Identificar os factores facilitadores e as barreiras �� implementa����o do MGC, entre as regi��esde sa��de do pa��s. 4. Explorar as rela����es entre a fidelidade da implementa����o, as barreiras e os facilitadores da implementa����o, a cultura organizacional e as caracter��sticas dos servi��os de sa��de mental. Metodologia Estudo observacional, transversal e descritivo, com caracter��sticas explorat��rias. Popula����o: profissionais dos servi��os de sa��de mental p��blicos e do sector social que frequentaram o Programa Nacional de Forma����o em Sa��de Mental Comunit��ria no curso ���Cuidados Integrados e Recupera����o���, da Coordena����o Nacional para a Sa��de Mental / Minist��rio da Sa��de, entre Outubro de 2008 e Dezembro de 2009, (n=71). Avalia����o Fidelidade de implementa����o do Modelo de Gest��o de Cuidados - IMR-S (Illness Management and Recovery Scale); Qualidade das guidelines utilizadas na implementa����o do Modelo de Gest��o de Cuidados - AGREE II-PT (Appraisal of Guidelines, for Research and Evaluation); Avalia����o das Barreiras e Facilitadores �� implementa����o do MGC - BaFAI (Barriers and Facilitators Assessment Instrument); Avalia����o da Cultura Organizacional dos servi��os de sa��de mental - CVF-I (Competing Values Framework Instrument). An��lise Estat��stica Para a descri����o dos dados foram aplicados m��todos de estat��stica descritiva. Para a compara����o de subgrupos foram utilizados os testes de Mann Whitney e Kruskall-Wallis. Para a investiga����o de associa����es foram utilizados os m��todos de correla����o de Spearman e a Regress��o M��ltipla. O tratamento e an��lise dos dados foram realizados utilizando o programa estat��stico IBM SPSS Statistics�� para Mac/Apple�� nas vers��es 19 e 20. Resultados Servi��os: A articula����o com os cuidados de sa��de prim��rios existe na maioria dos servi��os (56.34%) e 77.46% dos servi��os t��m autonomia para definir os cuidados a prestar. A maioria dos servi��os (63.38%) realiza duas ou mais reuni��es cl��nicas por m��s e a quase totalidade (95.77%) recebe estagi��rios e/ou internos. A ��rea da investiga����o tem n��veis considerados baixos, quando comparados com outros pa��ses da Europa, tanto para a globalidade das ��reas de investiga����o (25.35%), como para as ��reas psicossociais (22.54%). Considerando componentes fundamentais para a implementa����o de modelos de gest��o de cuidados, os resultados nacionais indicam que 66.20% dos servi��os fazem registos em processo cl��nico ��nico. As percentagens de utiliza����o de planos individuais de cuidados s��o globalmente baixas (46.48%). Por seu turno, a utiliza����o de guidelines, nos servi��os do pa��s, tem uma percentagem m��dia nacional de 57.75%. Profissionais: S��o, na sua maioria, do sexo feminino (69.01%), com idades entre os 25 e os 56 anos (m��dia 38.9, �� 7.41). Pertencem, maioritariamente, aos grupos profissionais da enfermagem (23.94%) e da psicologia (49.30%). A forma����o dos profissionais �� de n��vel superior em todos os grupos, com uma percentagem total de licenciados de 80.3%, tendo os restantes uma forma����o ao n��vel do mestrado. Apesar dos valores baixos (17%) de forma����o pr��via em modelos de gest��o de cuidados, 39% dos profissionais indicou utilizar algumas vertentes destes modelos na sua pr��tica. Apesar de 97,18% dos profissionais ter participado em dois ou mais encontros cient��ficos, num per��odo de dois anos, apenas 38.03% apresentou alguma comunica����o cient��fica no mesmo intervalo. Guideline: Os resultados da avalia����o da guideline do MGC indicaram percentagens mais altas, quanto �� qualidade do seu desenvolvimento, nos Dom��nios 1 (Objectivo e finalidade, com 72.2%) e 4 (Clareza de Apresenta����o, 77.7%). O Dom��nio 5 (Aplicabilidade) foi pontuado no limite inferior do desenvolvimento com qualidade suficiente (54.1%), ao passo que a guideline obteve uma pontua����o negativa nos Dom��nios 2 (Envolvimento das partes interessadas, com 41.6%) e 3 (Rigor do Desenvolvimento, com 28.1%). Adicionalmente n��o foi poss��vel ��s avaliadoras cotar o Dom��nio 6 (Independ��ncia editorial), por aus��ncia de refer��ncias neste contexto. A guideline teve uma avalia����o global positiva (66%), com recomenda����o de aceita����o com modifica����es. Cultura Organizacional: O perfil de lideran��a com maior frequ��ncia nos servi��os de sa��de mental portugueses foi o de Mentor (45.61%). As percentagens mais baixas pertenceram aos perfis Monitor e Inovador (3.51%). Na perspectiva da cultura organizacional dos servi��os, apontua����o mais alta foi a da Cultura das Rela����es Humanas (74.07%). A estrat��gia de lideran��a, com predom��nio em todas as regi��es, foi a estrat��gia de Flexibilidade (66.10%). Os resultados mostram que a ��nica associa����o positivamente significativa com o grau da implementa����o do MGC �� a do perfil Produtor, com um peso espec��fico de 14.55% na preval��ncia dos perfis de lideran��a nos servi��os de sa��de mental portugueses. Barreiras: As barreiras �� implementa����o da pr��tica do MGC, identificadas pelos profissionais dos servi��os de sa��de mental, com percentagens mais altas nos totais do pa��s, foram: o tempo (57.7%), o conhecimento sobre o modelo e a motiva����o (40.8%), a colabora����o dos outros profissionais (33.7%), o n��mero de contactos reduzidos com os doentes (35.2%), as insufici��ncias do ponto de vista dos espa��os (70.4%) e dos instrumentos dispon��veis (69%) para implementar o MGC. Existiu uma varia����o entre as regi��es de sa��de do pa��s. Os resultados mostram que houve uma correla����o negativa, de forma significativa, entre a implementa����o do MGC e as barreiras: da resist��ncia �� utiliza����o de protocolos, do formato da pr��tica, da necessidade de mais treino e da n��o coopera����o dos profissionais. Foram encontradas diferen��as estatisticamente significativas entre as barreiras �� implementa����o e as caracter��sticas dos servi��os, dos profissionais e da cultura organizacional. Implementa����o: A m��dia nacional da fidelidade de implementa����o do MGC (41.48) teve valores aproximados aos de estudos similares. Na pontua����o por regi��es, a implementa����o com maior fidelidade ocorreu no Alentejo. Se considerarmos a implementa����o com fidelidade esta ocorreu em 57.75% dos servi��os e uma boa implementa����o em 15.49%. Os m��todos de regress��o permitiram confirmar a capacidade preditiva das barreiras e da cultura organizacional quanto �� fidelidade da implementa����o do MGC. Discuss��o: No universo das hip��teses inicialmente colocadas foi poss��vel verificar a varia����o da implementa����o do MGC entre as regi��es do pa��s. O estudo permitiu, adicionalmente, concluir pela exist��ncia de denominadores comuns de maior sucesso da implementa����o do MGC. Foi ainda poss��vel verificar uma rela����o significativa, existente entre o grau de implementa����o e as dimens��es das barreiras, a cultura organizacional e os recursos dos SSM (aqui definidos pelas caracter��sticas dos servi��os e dos profissionais). De uma forma mais conclusiva podemos afirmar que existem outros factores, que n��o est��o relacionados com a avalia����o restrita dos recursos financeiros ou humanos, associados �� qualidade da implementa����o de pr��ticas baseadas na evid��ncia, como o MGC. Exemplo disso s��o os achados referentes �� regi��o de sa��de do Alentejo, onde a dist��ncia dos grandes centros urbanos e as conhecidas dificuldades de acessibilidade, combinadas com os problemas conhecidos da falta de recursos, n��o impediram que fosse a regi��o com os valores mais altos da fidelidade de implementa����o. Conclus��es: Foram encontradas in��meras barreiras �� implementa����o do MGC. Existem barreiras diferentes entre regi��es, que resultam das caracter��sticas dos servi��os, dos profissionais e da cultura organizacional. Para existir implementa����o �� necess��ria a considera����o de metodologias pr��prias que v��o para al��m dos tradicionais programas de forma����o. As pr��ticas baseadas na evid��ncia, amplamente defendidas, exigem implementa����es baseadas na evid��ncia.-------------ABSTRACT: Introduction - Several epidemiological studies show that, despite all scientific progress, many people still continue to have no access to mental health services and in many situations the quality of care is poor. The experiences of several countries show that progress towards case management implementation is slow and complex, depending not only from the degree of effectiveness or the complexity of the practice. Case management is defined as an evidence-based practice used to help patients in the recovery process. Strategies to implement evidence-based practices are critical to services improvement. There are many barriers to their implementation, despite all available evidence. Realising that practices of proved scientific value are far from being clearly implemented, justifies the need to use implementation methodologies that, beyond practice effectiveness, allow implementation effectiveness. To answer training needs and in the framework of the National Mental Health Plan implementation, 170 mental health (MH) professionals from portuguese public and private sectors were trained. Considering that case management skills were acquired, as a result of this training programme, we decided to study the degree of implementation in the services.Barriers and facilitators to the implementation were studied as well. There are several studies related with barriers and facilitators to the implementation of evidence-based practices, but most of them use semi-structured interviews with professionals. Additionally, there are no studies in Portugal related with barriers and facilitators to the implementation of mental health practices. Objectives1. Estimate the degree of case management implementation in Portuguese MH Services. 2.Describe regions where implementation occurred with higher fidelity degree. 3. Identify barriers and facilitators to case management implementation across country regions. 4. Explore the relationships between implementation, barriers and facilitators, organisational culture and services characteristics. Methodology - Cross sectional, descriptive study. Assessments - Implementation fidelity - IMR-S (Illness Management and Recovery Scale); Guideline quality - AGREE II-PT (Appraisal of Guidelines, for Research and Evaluation); Barriers and facilitators assessment - BaFAI (Barriers and Facilitators Assessment Instrument); Organisational culture assessment - CVF-I (Competing Values Framework Instrument). Statistical analysis - Descriptives and cross-tabs. Subgroups comparison: Mann-Witney and Kruskall-Wallis. Associations between variables were calculated using Spearman correlation's and Multiple Regression. Results - Services: Liaison with primary care is done in most services (56.34%) and 77.46% have autonomy to determine care. Most services have regular clinical meetings and almost all give internship training (95.77%). Research activity is low compared with other European countries, for both general and psychosocial research. Considering key components for the case management implementation, 66.20% of all services use single clinical records. The use of individual care plans is globally low (46.48%) and there is a use of guidelines in 57.75% of services. Human Resources: most are women (69.01%), with age ranging from 25-56 (average 39.9, SD 7.41). The majority are psychologists (49.30%) and nurses (23.94%). All have a university degree, 19.7% have a masters degree and 83% didn���t have any case management training before the above mentioned national training. Despite the low levels of preceding case management training, 39% have used model components in day-to-day practice and although 97.18% of the workforce have attended scientific meetings in the last 2 years, only 38.03% presented communications in the same period. Guideline: Results show that higher scores were obtained in Domain 1. Scope and Purpose (72.2.%),and Domain 4. Clarity of presentation (77.7%). Domain 5. pplicability scored near low boundary (54.1%) and negative scores were found in Domain 2. Stakeholder Involvement (41.6%) and Domain 3. Rigour of Development (28.1%). Global score was 66% and the guideline was recommended with modifications. Organisational Culture: The most frequent leadership profile was the Mentor profile (45.61%). Lower scores belonged to Innovator and Monitor profiles (3.51%). On the organisational culture overall, higher scores were found in the Human Relations culture (74.07%). The higher leadership strategy was the strategy of flexibility (66.10%). The results additionally showed that the only leadership profile associated with case management implementation was the Producer profile, representing 14.55% of all leadership profiles in the country.Barriers: The barriers identified by MH professionals, with high percentages, were: lack of time (57.7%), knowledge and motivation (40.8%), other colleagues cooperation (33.7%), low number of contacts with patients (35.2%), lack of facilities (70.4%) and lack of instruments (69%) to implement case management, varying across regions. Results show that there was a negative correlation between implementation and the following barriers: using protocols, practice format, need for more training and lack of cooperation from colleagues. Additionally, statistical differences were found between barriers to implementation and: services characteristics, workforce characteristics, organisational culture. Implementation: The national average results of case management implementation fidelity was (41.48), close to values found in similar studies. In the regional scores South Region Alentejo had the highest implementation score. If we look at minimum scores to assume implementation fidelity, these occurred in 57.75% of services and a good implementation occurred in 15.49% of these. Regression methods allowed to confirm that implementation score prediction was possible using the combination of barriers and organisational culture scores. Discussion - Considering the initial study hypotheses, it was possible to confirm the variation of case management implementation across country regions. Additionally, we could conclude that common denominators exist when successful implementation occurred. It was possible to observe a significant relationship between implementation degree and the dimensions of barriers, organisational culture and services resources (defined as professionals and services characteristics). In a more conclusive way, we can say that there are factors, other than financial and human resources, that are associated with evidence based practices implementation like case management. An example is the Alentejo region, were the distance from urban centres, and the known difficulties associated with accessibility, plus the lack of financial and human resources, have not impeded the regional higher score on implementation. Conclusions: Case management implementation had several barriers to implementation. There are different barriers across country regions, resulting from organisational culture, services and professionals characteristics. To reach implementation it is necessary to consider specific methodologies that go beyond traditional training programs and evident practices, widely promoted. Evidence-based practices require evidence-based implementations.

Low prevalence of hepatitis B virus, hepatitis D virus and hepatitis C virus among patients with human immunodeficiency virus or acquired immunodeficiency syndrome in the Brazilian Amazon basin

Comorbidities in human immunodeficiency virus infection are of great interest due to their association with unfavorable outcomes and failure of antiretroviral therapy. This study evaluated the prevalence of coinfection by human immunodeficiency virus and viral hepatitis in an endemic area for hepatitis B in the Western Amazon basin. Serological markers for hepatitis B virus, hepatitis C virus and hepatitis D virus were tested in a consecutive sample of all patients referred for treatment of human immunodeficiency virus or acquired immunodeficiency syndrome. The variables sex, age, origin and exposure category were obtained from medical records and from the sexually transmitted diseases and acquired immunodeficiency syndrome surveillance database. Among 704 subjects, the prevalence of chronic hepatitis B carriage was 6.4% and past infection 40.2%. The presence of hepatitis B was associated with birth in hyperendemic areas of the Amazon basin, male sex and illegal drug use. The overall prevalence of hepatitis C was 5% and was associated with illegal drug use. The prevalence of hepatitis B and C among human immunodeficiency virus or acquired immunodeficiency syndrome patients in the Western Amazon basin was lower than seen elsewhere and is probably associated with the local epidemiology of these viruses and the degree of overlap of their shared risk factors. An opportunity presents itself to evaluate the prevention of hepatitis C through harm reduction policies and hepatitis B through vaccination programs among human immunodeficiency virus or acquired immunodeficiency syndrome patients.

Avidity of IgG antibodies against excreted/secreted antigens of Toxoplasma gondii: immunological marker for acute recent toxoplasmosis

Detection of anti-toxoplasma IgM antibodies has frequently been used as a serological marker for diagnosing recently acquired toxoplasmosis. However, the persistence of these antibodies in some patients has complicated the interpretation of serological results when toxoplasmosis is suspected. The purpose of the present study was to evaluate the avidity of IgG antibodies against excreted/secreted antigens of Toxoplasma gondii by means of immunoblot, to establish a profile for acute recent infection in a single serum sample and confirm the presence of residual IgM antibodies obtained in automated assays. When we evaluated the avidity of IgG antibodies against excreted/secreted antigens of Toxoplasma gondii by means of immunoblot, we observed phase-specific reactivity, i.e. cases of acute recent toxoplasmosis presented low avidity and cases of non-acute recent toxoplasmosis presented high avidity towards the 30kDa protein fraction, which probably corresponds to the SAG-1 surface antigen. Our results suggest that the avidity of IgG antibodies against excreted/secreted antigens of Toxoplasma gondii is an important immunological marker for distinguishing between recent infections and for determining the presence of residual IgM antibodies obtained from automated assays.

Acquired non-Chagas megacolon associated with the use of psychiatric medication: case report and differential diagnosis with Chagas megacolon

A case of acquired megacolon in a 62-year-old man with acute abdomen due to sigmoid volvulus is reported. The case was associated with the use of psychiatric medications. The aim in this report was to emphasize the differential diagnosis with Chagas megacolon. Anatomopathological examination did not show any evidence of denervation, ganglionitis and/or myositis, and the serological test for Chagas disease was negative.