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Revista da Sociedade Brasileira de Medicina Tropical, Volume: 48, Número: 4, Publicado: 2015
  • Chagas disease: still a challenge around the World Editorial

    Dias, João Carlos Pinto
  • Theranostic applications of phage display to control leishmaniasis: selection of biomarkers for serodiagnostics, vaccination, and immunotherapy Review Articles

    Coelho, Eduardo Antonio Ferraz; Chávez-Fumagalli, Miguel Angel; Costa, Lourena Emanuele; Tavares, Carlos Alberto Pereira; Soto, Manuel; Goulart, Luiz Ricardo

    Resumo em Inglês:

    Abstract Phage display is a high-throughput subtractive proteomic technology used for the generation and screening of large peptide and antibody libraries. It is based on the selection of phage-fused surface-exposed peptides that recognize specific ligands and demonstrate desired functionality for diagnostic and therapeutic purposes. Phage display has provided unmatched tools for controlling viral, bacterial, fungal, and parasitic infections, and allowed identification of new therapeutic targets to treat cancer, metabolic diseases, and other chronic conditions. This review presents recent advancements in serodiagnostics and prevention of leishmaniasis -an important tropical parasitic disease- achieved using phage display for the identification of novel antigens with improved sensitivity and specificity. Our focus is on theranostics of visceral leishmaniasis with the aim to develop biomarker candidates exhibiting both diagnostic and therapeutic potential to fight this important, yet neglected, tropical disease.
  • History of insecticide resistance of Triatominae vectors Review Articles

    Pessoa, Grasielle Caldas Dávila; Vinãs, Pedro Albajar; Rosa, Aline Cristine Luiz; Diotaiuti, Liléia

    Resumo em Inglês:

    Abstract In the last 15 years, different types of Triatominae resistance to different insecticides have been reported; thus, resistance may be more widespread than known, requiring better characterization and delimitation, which was the aim of this review. This review was structured on a literature search of all articles from 1970 to 2015 in the PubMed database that contained the keywords Insecticide resistance and Triatominae . Out of 295 articles screened by title, 33 texts were selected for detailed analysis. Insecticide resistance of Triatomines is a complex phenomenon that has been primarily reported in Argentina and Bolivia, and is caused by different factors (associated or isolated). Insecticide resistance of Triatominae is a characteristic inherited in an autosomal and semi-dominant manner, and is polygenic, being present in both domestic and sylvatic populations. The toxicological profile observed in eggs cannot be transposed to different stages of evolution. Different toxicological profiles exist at macro- and microgeographical levels. The insecticide phenotype has both reproductive and developmental costs. Different physiological mechanisms are involved in resistance. Studies of Triatomine resistance to insecticides highlight three deficiencies in interpreting the obtained results: I) the vast diversity of methodologies, despite the existence of a single guiding protocol; II) the lack of information on the actual impact of resistance ratios in the field; and III) the concept of the susceptibility reference lineage. Research on the biological and behavioral characteristics of each Triatominae species that has evolved resistance is required in relation to the environmental conditions of each region.
  • Prevalence of neurocognitive disorders and depression in a Brazilian HIV population Major Articles

    Troncoso, Flávio Trentin; Conterno, Lucieni de Oliveira

    Resumo em Inglês:

    Abstract INTRODUCTION: Combined antiretroviral therapy has enabled human immunodeficiency virus (HIV) carriers to live longer. This increased life expectancy is associated with the occurrence of degenerative diseases, including HIV-associated neurocognitive disorders (HAND), which are diagnosed via a complex neuropsychological assessment. The International HIV Dementia Scale (IHDS) is a screening instrument validated in Brazil for use in the absence of neuropsychological evaluation. HIV patients are frequently diagnosed with depression. We aimed to determine the prevalence of neurocognitive impairment using the IHDS and depressive disorders using the Hamilton Rating Scale for Depression (HAM-D17), compare the IHDS performance with the performances on the Timed Gait Test (TGT), the Digit Symbol Coding Test (DS) and the Brazilian version of the Scale of Instrumental Activities of Daily Living (IADL), and evaluate the association between the IHDS performance and clinical-demographic variables. METHODS: One hundred fourteen patients were evaluated in a cross-sectional study conducted in a public outpatient clinic for infectious diseases in Marília City, State of São Paulo, Brazil. Data were collected following consultation. Statistical analysis was performed in accordance with the nature and distribution of the data and hypotheses. RESULTS: According to the IHDS, 53.2% of the sampled patients were neuropsychologically impaired. According to the HAM-D17, 26.3% had depressive disorders. There were significant associations between the IHDS and the TGT and DS. Multiple regression analysis indicated that female gender, educational level, and cluster of differentiation 4 (CD4) levels were significantly and independently associated with neurocognitive impairment. CONCLUSIONS: The prevalence of neurocognitive impairment according to the IHDS is high and associated with female gender, education level, and low CD4 levels.
  • Trends and factors associated with dengue mortality and fatality in Brazil Major Articles

    Paixão, Enny Santos; Costa, Maria da Conceição Nascimento; Rodrigues, Laura Cunha; Rasella, Davide; Cardim, Luciana Lobato; Brasileiro, Alcione Cunha; Teixeira, Maria Gloria Lima Cruz

    Resumo em Inglês:

    Abstract INTRODUCTION: Studies that generate information that may reduce the dengue death risk are essential. This study analyzed time trends and risk factors for dengue mortality and fatality in Brazil from 2001 to 2011. METHODS: Time trends for dengue mortality and fatality rates were analyzed using simple linear regression. Associations between the dengue mortality and the case fatality rates and socioeconomic, demographic, and health care indicators at the municipality level were analyzed using negative binomial regression. RESULTS: The dengue hemorrhagic fever case fatality rate increased in Brazil from 2001 to 2011 (β=0.67; p=0.036), in patients aged 0-14 years (β=0.48; p=0.030) and in those aged ≥15 years (β=1.1; p<0.01). Factors associated with the dengue case fatality rate were the average income per capita (MRR=0.99; p=0.038) and the number of basic health units per population (MRR=0.89; p<0.001). Mortality rates increased from 2001 to 2011 (β=0.350; p=0.002).Factors associated with mortality were inequality (RR=1.02; p=0.001) high income per capita (MRR=0.99; p=0.005), and higher proportions of populations living in urban areas (MRR=1.01; p<0.001). CONCLUSIONS: The increases in the dengue mortality and case fatality rates and the associated socioeconomic and health care factors, suggest the need for structural and intersectoral investments to improve living conditions and to sustainably reduce these outcomes.
  • The absence of the human platelet antigen polymorphism effect on fibrosis progression in human immunodeficiency virus-1/hepatitis C virus coinfected patients Major Articles

    Picelli, Natália; Tanikawa, Aline Aki; Grotto, Rejane Maria Tommasini; Silva, Giovanni Faria; Barbosa, Alexandre Naime; Ferrasi, Adriana Camargo; Silveira, Liciana Vaz de Arruda; Pardini, Maria Inês de Moura Campos

    Resumo em Inglês:

    Abstract INTRODUCTION: Hepatic fibrosis progression in patients with chronic hepatitis C virus infections has been associated with viral and host factors, including genetic polymorphisms. Human platelet antigen polymorphisms are associated with the rapid development of fibrosis in HCV-monoinfected patients. This study aimed to determine whether such an association exists in human immunodeficiency virus-1/hepatitis C virus-coinfected patients. METHODS: Genomic deoxyribonucleic acid from 36 human immunodeficiency virus-1/hepatitis C virus-coinfected patients was genotyped to determine the presence of human platelet antigens-1, -3, or -5 polymorphisms. Fibrosis progression was evaluated using the Metavir scoring system, and the patients were assigned to two groups, namely, G1 that comprised patients with F1, portal fibrosis without septa, or F2, few septa (n = 23) and G2 that comprised patients with F3, numerous septa, or F4, cirrhosis (n = 13). Fisher's exact test was utilized to determine possible associations between the human platelet antigen polymorphisms and fibrosis progression. RESULTS: There were no deviations from the Hardy-Weinberg equilibrium in the human platelet antigen systems evaluated. Statistically significant differences were not observed between G1 and G2 with respect to the distributions of the allelic and genotypic frequencies of the human platelet antigen systems. CONCLUSION: The greater stimulation of hepatic stellate cells by the human immunodeficiency virus and, consequently, the increased expression of transforming growth factor beta can offset the effect of human platelet antigen polymorphism on the progression of fibrosis in patients coinfected with the human immunodeficiency virus-1 and the hepatitis C virus.
  • Detection of immunogenic proteins from Anopheles sundaicussalivary glands in the human serum Major Articles

    Armiyanti, Yunita; Nuryady, Mohammad Mirza; Arifianto, Renam Putra; Nurmariana, Elisa; Senjarini, Kartika; Fitri, Loeki Enggar; Sardjono, Teguh Wahju

    Resumo em Inglês:

    Abstract INTRODUCTION: The saliva of mosquitoes has an important role in the transmission of several diseases, including malaria, and contains substances with vasomodulating and immunomodulating effects to counteract the host physiological mechanisms and enhance pathogen transmission. As immunomodulatory components, salivary gland proteins can induce the generation of specific IgG antibodies in the host, which can be used as specific biomarkers of exposure to Anopheles sundaicus . The objective of this study was to identify immunogenic proteins from the salivary glands of Anopheles sundaicus by reaction with sera from individuals living in malaria-endemic areas who are thus exposed to Anopheles mosquitoes. METHODS: IgG antibodies targeting salivary gland proteins in serum samples from individuals living in malaria-endemic areas were measured by enzyme-linked immunosorbent assay (ELISA). Sera from healthy individuals living in non-endemic areas were used as negative controls. Determination of the presence of salivary gland immunogenic proteins was carried out by western blotting. RESULTS: Sixteen bands appeared in sodium dodecyl sulfate polyacrylamide gel electrophoresis, with molecule weights ranging from 22 to 144kDa. Among the exposed individuals, IgG responses to salivary gland proteins were variable. Protein bands with molecular weights of 46, 41, 33, and 31kDa were the most immunogenic. These immunogenic proteins were consistently recognized by pooled serum and individual samples from people living in malaria-endemic areas but not by negative controls. CONCLUSIONS: These results support the potential use of immunogenic proteins from the salivary glands of Anopheles as candidate markers of bite exposure or in malaria vaccines.
  • Variability of susceptibility to deltamethrin in peridomestic Triatoma sordida from Triângulo Mineiro, State of Minas Gerais, Brazil Major Articles

    Pessoa, Grasielle Caldas DÁvila; Santos, Tamara Rodrigues Martins dos; Salazar, Gabriela Chadid; Dias, Letícia Sena; Mello, Bernardino Vaz de; Ferraz, Marcela Lencine; Diotaiuti, Liléia

    Resumo em Inglês:

    Abstract INTRODUCTION: Despite chemical and physical vector control strategies, persistent infestations of Triatoma sordida have been reported in a large part of Minas Gerais, Brazil, and the cause for this is little investigated. We aimed to characterize the deltamethrin toxicological profile in peridomestic T. sordidapopulations from Triângulo Mineiro area of Minas Gerais. METHODS: Susceptibility to deltamethrin was assessed in seventeen peridomestic T. sordida populations. Serial dilutions of deltamethrin in acetone (0.2µL) were topically applied on the first instar nymphs (F1; five days old; fasting weight, 1.2 ± 0.2mg). Dose response results were analyzed using Probit software, and the lethal doses, slope and resistance ratios were determined. Qualitative tests were also performed. RESULTS: The deltamethrin susceptibility profile of T. sordida populations revealed resistance ratios ranging from 0.84 to 2.8. The percentage mortality in response to a diagnostic dose was 100.0% in all populations. CONCLUSIONS: From our results, the lack of resistance to insecticides but persistent T. sordida infestations in the Triângulo Mineiro area may be because of: 1) environmental degradation facilitating dispersion of T. sordida , allowing colonization in artificial ecotopes; 2) operational failures; and 3) complexity of the peridomicile in the study area.These variables are being investigated.
  • Susceptibility of Triatoma sordida Stal, 1859 (Hemiptera: Reduviidae) to alpha-cypermethrin under natural climatic conditions Major Articles

    Pessoa, Grasielle Caldas DÁvila; Rosa, Aline Cristine Luiz; Cavalari, Letícia; Rezende, João Geraldo de; Mello, Bernardino Vaz de; Diotaiuti, Liléia

    Resumo em Inglês:

    Abstract: INTRODUCTION: Despite the recommendations by interpretation of resistance ratios obtained in laboratory bioassays, little is known about the actual impact of these results in the effectiveness of vector control activities in the field. In this context, our objective was to determine the mean value of different resistance ratios obtained by laboratory bioassays performed as part of the chemical control strategies of Triatoma sordida in the field. METHODS: Field bioassays were developed in Monte Azul and Coração de Jesus (Southeast, Brazil). In each location, samples were formed with three domestic units treated with alpha-cypermethrin 20.0% (Alfatek (r) 200 SC). One day after spraying, 10 fifth-instar nymphs remained in contact with the surfaces treated (adobe with plaster, adobe without plaster, or wood) with insecticide in plastic cones for 72h. Three cones were exposed inside the intradomicile and the peridomicile. The insects in the control group were exposed to an insecticide-free piece of cardboard. Mortality was measured 72h after removal of the insects from the treated surfaces. The tests were realized in triplicate. RESULTS: Mortality was 100.0% in all locations, except for Monte Azul; Landinho (96.6%) and Coração de Jesus; Barriguda (96.6%). CONCLUSIONS: Although the resistant populations in laboratory tests proved to be susceptible in the field, this observation is not sufficient to suggest that the cut-off points used to justify the resistance ratio should be changed. In this sense, we recommend that laboratory and field bioassays are carried out with a greater number of Triatominae populations to allow more in-depth consideration of the subject.
  • Preliminary screening of the larvicidal effect of Brevibacillus laterosporus strains against the blowfly Chrysomya megacephala(Fabricius, 1794) (Diptera: Calliphoridae) Major Articles

    Carramaschi, Isabel Nogueira; Pereira, Lorrane de Andrade; Queiroz, Margareth Maria de Carvalho; Zahner, Viviane

    Resumo em Inglês:

    Abstract INTRODUCTION : This study evaluated whether different strains of Brevibacillus laterosporus could be used to control larvae of the blowfly Chrysomya megacephala , a pest that affects both human and animal health. METHODS: Mortality rates were recorded after 1-mL suspensions of sporulated cells of 14 different strains of B. laterosporus were added to 2.5g of premixed diet consisting of rotting ground beef fed to first instar larvae of C. megacephala . All bioassays were performed using 10 larvae per strain, with a minimum of three replicates for each bioassay. Larval mortality was recorded daily up to seven days. RESULTS: Strains Bon 707, IGM 16-92, and Shi 3 showed the highest toxicity toward the larvae producing 70.5%, 64.5%, and 51.6% of larval mortality, respectively, which was significantly higher than that in the control group (p < 0.05). In contrast, strains NRS 1642, NRS 661, NRS 590 BL 856, NRS 342, ATCC 6457, Bon 712, and NRS 1247 showed limited or no pathogenic activity against the target larvae. CONCLUSIONS: Our preliminary data indicated that B. laterosporus could be used to develop bioinsecticides against C. megacephala .
  • Antibacterial, anti-swarming and anti-biofilm formation activities of Chamaemelum nobile against Pseudomonas aeruginosa Major Articles

    Kazemian, Hossein; Ghafourian, Sobhan; Heidari, Hamid; Amiri, Pouya; Yamchi, Jalil Kardan; Shavalipour, Aref; Houri, Hamidreza; Maleki, Abbas; Sadeghifard, Nourkhoda

    Resumo em Inglês:

    Abstract INTRODUCTION: Chamomile ( Chamaemelum nobile ) is widely used throughout the world, and has anti-inflammatory, deodorant, bacteriostatic, antimicrobial, carminative, sedative, antiseptic, anti-catarrhal, and spasmolytic properties. Because of the increasing incidence of drug-resistant bacteria, the development of natural antibacterial sources such as medical herbs for the treatment of infectious diseases is necessary. Extracts from different plant parts such as the leaves, flowers, fruit, and bark of Combretum albiflorum, Laurus nobilis , and Sonchus oleraceus were found to possess anti-quorum sensing (QS) activities. In this study, we evaluated the effect of C. nobile against Pseudomonas aeruginosa biofilm formation METHODS: The P. aeruginosa samples were isolated from patients with different types of infection, including wound infection, septicemia, and urinary tract infection. The flowers of C. nobile were dried and the extract was removed using a rotary device and then dissolved in dimethyl sulfoxide at pH 7.4. The microdilution method was used to evaluate the minimum inhibitory concentration (MIC) of this extract on P. aeruginosa , and biofilm inhibition was assayed. RESULTS: Eighty percent of the isolated samples (16/20) could form a biofilm, and most of these were isolated from wound infections. The biofilm inhibitory concentration of the C. nobile extract was 6.25-25mg/ml, whereas the MIC was 12.5-50mg/ml. CONCLUSIONS: The anti-QS property of C. nobile may play an important role in its antibacterial activity, thus offering an additional strategy in the fight against bacterial infections. However, molecular investigation is required to explore the exact mechanisms of the antibacterial action and functions of this phytocompound.
  • Evaluation of the reference value for the Montenegro skin test Major Articles

    Skraba, Cissiara Manetti; Mello, Tatiane França Perles de; Pedroso, Raíssa Bocchi; Ferreira, Érika Cristina; Demarchi, Izabel Galhardo; Aristides, Sandra Mara Alessi; Lonardoni, Maria Valdrinez Campana; Silveira, Thaís Gomes Verzignassi

    Resumo em Inglês:

    Abstract: INTRODUCTION: The Montenegro skin test (MST) has good clinical applicability and low cost for the diagnosis of American tegumentary leishmaniasis (ATL). However, no studies have validated the reference value (5mm) typically used to discriminate positive and negative results. We investigated MST results and evaluated its performance using different cut-off points. METHODS: The results of laboratory tests for 4,256 patients with suspected ATL were analyzed, and 1,182 individuals were found to fulfill the established criteria. Two groups were formed. The positive cutaneous leishmaniasis (PCL) group included patients with skin lesions and positive direct search for parasites (DS) results. The negative cutaneous leishmaniasis (NCL) group included patients with skin lesions with evolution up to 2 months, negative DS results, and negative indirect immunofluorescence assay results who were residents of urban areas that were reported to be probable sites of infection at domiciles and peridomiciles. RESULTS: The PCL and NCL groups included 769 and 413 individuals, respectively. The mean ± standard deviation MST in the PCL group was 12.62 ± 5.91mm [95% confidence interval (CI): 12.20-13.04], and that in the NCL group was 1.43 ± 2.17mm (95% CI: 1.23-1.63). Receiver-operating characteristic curve analysis indicated 97.4% sensitivity and 93.9% specificity for a cut-off of 5mm and 95.8% sensitivity and 97.1% specificity for a cut-off of 6mm. CONCLUSIONS: Either 5mm or 6mm could be used as the cut-off value for diagnosing ATL, as both values had high sensitivity and specificity.
  • Efficacy and tolerability of two single-day regimens of triclabendazole for fascioliasis in Peruvian children Major Articles

    Maco, Vicente; Marcos, Luis; Delgado, Jaime; Herrera, Julio; Nestares, José; Terashima, Angelica; Samalvides, Frine; Gotuzzo, Eduardo

    Resumo em Inglês:

    Abstract: INTRODUCTION: The therapeutic scheme of triclabendazole (TCBZ), the recommended anthelmintic against Fasciola hepatica , involves 10mg/kg of body weight administered in a single dose; however, clinical trials in children are scarce. We evaluated the efficacy and tolerability of 2 schemes of TCBZ. METHODS : Eighty-four Peruvian children with F. hepatica eggs in their stools were allocated into 2 groups: 44 received 2 dosages of 7.5mg/kg each with a 12-h interval (Group I), and 40 received a single 10-mg/kg dose (Group II). Evaluation of efficacy was based on the presence of eggs in stools, and tolerability was based on the presence of symptoms and signs post-treatment. RESULTS : A parasitological cure was obtained in 100% of individuals from Group I and 95% of individuals from Group II. The most common adverse event was biliary colic. CONCLUSIONS : The tested scheme was efficacious and tolerable, and it might be an optimal scheme in the region. To the best of our knowledge, this represents the largest series of children treated with TCBZ in a non-hospital setting.
  • Molecular identification and antifungal susceptibility profiles of Candida parapsilosis complex species isolated from culture collection of clinical samples Major Articles

    Ataides, Fábio Silvestre; Costa, Carolina Rodrigues; Souza, Lúcia Kioko Hasimoto e; Fernandes, Orionalda deFátima Lisboa; Jesuino, Rosália Santos Amorim; Silva, Maria do Rosário Rodrigues

    Resumo em Inglês:

    Abstract INTRODUCTION: Candida parapsilosis is a common yeast species found in cases of onychomycosis and candidemia associated with infected intravascular devices. In this study, we differentiated Candida parapsilosis sensu stricto, Candida orthopsilosis , and Candida metapsilosis from a culture collection containing blood and subungual scraping samples. Furthermore, we assessed the in vitro antifungal susceptibility of these species to fluconazole, itraconazole, voriconazole, posaconazole, amphotericin B, and caspofungin. METHODS: Differentiation of C. parapsilosis complex species was performed by amplification of the secondary alcohol dehydrogenase (SADH) gene and digestion by the restriction enzyme Ban I. All isolates were evaluated for the determination of minimal inhibitory concentrations using Etest, a method for antifungal susceptibility testing. RESULTS: Among the 87 isolates, 78 (89.7%) were identified as C. parapsilosis sensu stricto , five (5.7%) were identified as C. orthopsilosis , and four (4.6%) were identified as C. metapsilosis . Analysis of antifungal susceptibility showed that C. parapsilosis sensu strictoisolates were less susceptible to amphotericin B and itraconazole. One C. parapsilosis sensu stricto isolate was resistant to amphotericin B and itraconazole. Moreover, 10.2% of C. parapsilosis sensu stricto isolates were resistant to caspofungin. Two C. parapsilosis sensu strictoisolates and one C. metapsilosis isolate were susceptible to fluconazole in a dose-dependent manner. CONCLUSIONS: We reported the first molecular identification of C. parapsilosiscomplex species in State of Goiás, Brazil. Additionally, we showed that although the three species exhibited differences in antifungal susceptibility profiles, the primary susceptibility of this species was to caspofungin.
  • Injuries caused by aquatic animals in Brazil: an analysis of the data present in the information system for notifiable diseases Major Articles

    Reckziegel, Guilherme Carneiro; Dourado, Flávio Santos; Garrone Neto, Domingos; Haddad Junior, Vidal

    Resumo em Inglês:

    Abstract INTRODUCTION: We present a review of injuries in humans caused by aquatic animals in Brazil using the Information System for Notifiable Diseases [ Sistema de Informação de Agravos de Notificação (SINAN)] database. METHODS: A descriptive and retrospective epidemiological study was conducted from 2007 to 2013. RESULTS: A total of 4,118 accidents were recorded. Of these accidents, 88.7% (3,651) were caused by venomous species, and 11.3% (467) were caused by poisonous, traumatic or unidentified aquatic animals. Most of the events were injuries by stingrays (69%) and jellyfish (13.1%). The North region was responsible for the majority of reports (66.2%), with a significant emphasis on accidents caused by freshwater stingrays (92.2% or 2,317 cases). In the South region, the region with the second highest number of records (15.7%), jellyfish caused the majority of accidents (83.7% or 452 cases). The Northeastern region, with 12.5% of the records, was notable because almost all accidents were caused by toadfish (95.6% or 174 cases). CONCLUSIONS: Although a comparison of different databases has not been performed, the data presented in this study, compared to local and regional surveys, raises the hypothesis of underreporting of accidents. As the SINAN is the official system for the notification of accidents by venomous animals in Brazil, it is imperative that its operation be reviewed and improved, given that effective measures to prevent accidents by venomous animals depend on a reliable database and the ability to accurately report the true conditions.
  • Hepatitis E virus infection in Brazil: results of laboratory-based surveillance from 1998 to 2013 Short Communications

    Passos-Castilho, Ana Maria; Sena, Anne de; Reinaldo, Mônica Renata; Granato, Celso Francisco Hernandes

    Resumo em Inglês:

    INTRODUCTION: Data on hepatitis E virus (HEV) in Brazil are limited. We analyzed 15 years of HEV surveillance data in a major clinical laboratory in São Paulo, Brazil. METHODS: The seroprevalence of HEV of 2,271 patients subjected to anti-HEV tests from 1998 to 2013 were analyzed. RESULTS: HEV seroprevalence was 2.1%, and the anti-HEV IgM positivity rate was 4.9%. Six hepatitis E patients were identified. CONCLUSIONS: HEV seroprevalence and detection rates appear to have increased in recent years. Hepatitis E should be investigated further and included in the differential diagnosis of hepatitis in Brazil.
  • First report of Rhodnius montenegrensis (Hemiptera, Reduviidae, Triatominae) in the State of Acre, Brazil Short Communications

    Meneguetti, Dionatas Ulises de Oliveira; Tojal, Simone Delgado; Miranda, Pedro Raimundo Mathias de; Rosa, João Aristeu da; Camargo, Luis Marcelo Aranha

    Resumo em Inglês:

    INTRODUCTION: This paper reports, for the first time, the presence of Rhodnius montenegrensis in the State of Acre, Brazil. METHODS: Two female R. montenegrensis were collected in a dwelling in the rural area of Rio Branco, Acre, Brazil. RESULTS: The occurrence of this species was confirmed, and the number of Triatominae species in the State of Acre increased from four to five. CONCLUSIONS: Further studies should be performed to reach a clearer understanding of the ecology of this arthropod, its possible role in transmitting Chagas' disease and rangeliosis, and its current geographical distribution in the region.
  • Impact of livestock on a mosquito community (Diptera: Culicidae) in a Brazilian tropical dry forest Short Communications

    Santos, Cleandson Ferreira; Borges, Magno

    Resumo em Inglês:

    Abstract INTRODUCTION : This study evaluated the effects of cattle removal on the Culicidae mosquito community structure in a tropical dry forest in Brazil. METHODS : Culicidae were collected during dry and wet seasons in cattle presence and absence between August 2008 and October 2010 and assessed using multivariate statistical models. RESULTS: Cattle removal did not significantly alter Culicidae species richness and abundance. However, alterations were noted in Culicidae community composition. CONCLUSIONS: This is the first study to evaluate the impact of cattle removal on Culicidae community structure in Brazil and demonstrates the importance of assessing ecological parameters such as community species composition.
  • Phenotypic and molecular characterization of CTX-M extended-spectrum beta-lactamase-producing Escherichia coli isolates in Shiraz, Iran Short Communications

    Zamani, Khosrow; Emami, Amir; Bazargani, Abdollah; Moattari, Afagh

    Resumo em Inglês:

    Abstract INTRODUCTION The aim of this study was to detect the prevalence of the extended-spectrum beta-lactamase (ESBL)-encoding CTX-M gene in Escherichia coliisolates. METHODS: Phenotypic screening of 376 E. coli isolates for ESBL was conducted using disk diffusion. ESBL-producing isolates were tested using PCR and specific primers. The bla CTX-M cluster was identified using the RFLP method, and its genotype was sequenced. RESULTS: From 202 ESBL-producing E. coli , 185 (91.5%) possessed CTX-M genes. CTX-M-1 subtypes were found in 98% of the isolates. The bla CTX-M gene was identical to CTX-M-15. CONCLUSIONS: A high prevalence of CTX-M-1-producing E. coli apparently exists in Shiraz, Iran.
  • Induction and nosocomial dissemination of carbapenem and polymyxin-resistant Klebsiella pneumoniae Short Communications

    Gaspar, Gilberto Gambero; Bellissimo-Rodrigues, Fernando; Andrade, Leonardo Neves de; Darini, Ana Lúcia; Martinez, Roberto

    Resumo em Inglês:

    INTRODUCTION: Polymyxins are antimicrobial agents capable of controlling carbapenemase-producing Klebsiella pneumoniae infection. METHODS: We report a cluster of four patients colonized or infected by polymyxin-resistant and Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae. RESULTS: Three patients were hospitalized in adjacent wards, and two were admitted to the intensive care unit. The index case maintained prolonged intestinal colonization by KPC-producing K. pneumoniae. Three patients received polymyxin B before the isolation of polymyxin-resistant K. pneumoniae. CONCLUSIONS: Colonization by KPC-producing K. pneumoniae and previous use of polymyxin B may be causally related to the development of polymyxin-resistant microorganisms.
  • New strategies for active finding of leprosy cases in the Amazonian region Short Communications

    Campos, Dony Cristioney Castilho de; Dutra, Ana Paula Barzan; Suares, Vagner Lucas; Carvalho, Paulo Abner Cardoso de; Camargo, Luís Marcelo Aranha

    Resumo em Inglês:

    Abstract INTRODUCTION : The use of the Self-Image Form (SIF) expands the identification of active leprosy cases to neighbors of index cases. METHODS : The SIF was used to screen two groups: case (neighbors of index cases of leprosy) and control (individuals residing next to houses without leprosy) group. A specialist investigated suspected leprosy cases for disease confirmation. RESULTS : New cases of leprosy were diagnosed in the case group (n = 7, 8.6%), but not the control group. CONCLUSIONS : The new surveillance strategy is inexpensive, efficient, and feasible within a primary health strategy. Future studies can help improve the use of the SIF.
  • Prevalence of zoonotic visceral leishmaniasis in dogs in an endemic area of Brazil Short Communications

    Pimentel, Danillo de Souza; Ramos, Rafael Antonio Nascimento; Santana, Marília de Andrade; Maia, Carina Scanoni; Carvalho, Gílcia Aparecida de; Silva, Hernande Pereira da; Alves, Leucio Câmara

    Resumo em Inglês:

    INTRODUCTION: The northeast region of Brazil is endemic for zoonotic visceral leishmaniasis (ZVL). The aim of this study was to determine the prevalence of infection in dogs in Petrolina. METHODS: Blood samples were collected from dogs (n = 600), and bone-marrow biopsy was performed in animals with positive serological test results that presented clinical signs of ZVL. The serological analyses were performed using an enzyme-linked immunosorbent assay (ELISA) (S7(r)Biogene). RESULTS: Of the 600 dogs tested, 19% (115/600) presented anti-L. infantum chagasi antibodies. CONCLUSIONS: Our data are important because canine infection is an important risk factor for the human disease.
  • Description of continuous data using bar graphs: a misleading approach Short Communications

    Martinez, Edson Zangiacomi

    Resumo em Inglês:

    INTRODUCTION: With the ease provided by current computational programs, medical and scientific journals use bar graphs to describe continuous data. METHODS: This manuscript discusses the inadequacy of bars graphs to present continuous data. RESULTS: Simulated data show that box plots and dot plots are more-feasible tools to describe continuous data. CONCLUSIONS: These plots are preferred to represent continuous variables since they effectively describe the range, shape, and variability of observations and clearly identify outliers. By contrast, bar graphs address only measures of central tendency. Bar graphs should be used only to describe qualitative data.
  • Acute disseminated encephalomyelitis following inactivated influenza vaccination in the Brazilian Amazon: a case report Cases Reports

    Andrade, Solange Dourado de; Andrade, Maria Graciede Filha Santarém; Santos, Pablo José; Galvão, Maria de Lourdes; Barros, Mariana Martins de; Ramasawmy, Rajendranath; Safe, Izabella Picinin; Monteiro, Wuelton Marcelo; Sabidó, Meritxell; Alecrim, Maria das Graças Costa

    Resumo em Inglês:

    Abstract Here, we describe a case of acute disseminated encephalomyelitis (ADEM) that occurred during a plausible risk interval following inactivated influenza vaccination in a previously healthy 27-year-old man from Manaus, Brazil. He was treated with intravenous methylprednisolone and immunoglobulin. One-month follow-up revealed resolution of the brain lesions, but not of the spinal cord lesions. No recurrence or progression of the main neurological symptoms was observed. After two years of monitoring, the patient continues to experience weak lower limbs and urinary retention. Thus, we recommend that ADEM should be considered in a patient presenting with neurological symptoms after influenza vaccination.
  • Testicular schistosomiasis as differential diagnosis for testicular nodules: a case report Case Reports

    Ferreira, Tiago Neves; Higa, Hana Caroline Morais; Rondina, Ronaldo Garcia; Miranda, Márcio Maia Lamy; Kaddoun, Marcos Lyra; Santos, Maria Carmen Ferreira Lopes Silva; Souza, Rodrigo Stênio Moll de

    Resumo em Inglês:

    Abstract Despite its infrequent occurrence, testicular schistosomiasis forming pseudo-tumors can be considered in the differential diagnosis of testicular tumors, especially in areas where the parasitic disease is endemic. In this report, we present a case of testicular schistosomiasis caused by Schistosoma mansoni and mimicking a testicular neoplasm. We describe the patterns of a testicular nodule on ultrasonography and magnetic resonance images in a 46-year-old man. The nodule was removed after a pre-operative diagnosis of a non-malignant lesion. Histology demonstrated granulomas with epithelioid macrophages and eosinophils around S. mansoni eggs within a fibrous tissue that formed a nodular structure.
  • Hypersensitivity reaction to Sporothrix schenckii: erythema nodosum associated with sporotrichosis Images In Infectious Diseases

    Papaiordanou, Francine; Silveira, Bruno Rebelo Lages da; Abulafia, Luna Azulay
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