Revista do Instituto de Medicina Tropical de São Paulohttps://www.scielo.br/feed/rimtsp/1998.v40n5/2024-01-02T20:27:02.011000ZVol. 40 No. 5 - 1998WerkzeugEXPERIENCE IN THE EVALUATION OF CHILDREN WITH HEPATOSPLENOMEGALY AT A TEACHING AMBULATORY, SÃO PAULO, BRAZIL10.1590/S0036-466519980005000012024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZBRICKS, Lucia F.COCOZZA, Ana MariaRESEGUE, RosaSUCUPIRA, Ana Cecília S.L.RODRIGUES, DalethKOBINGER, Maria Elizabeth B.A.BOURROUL, Maria Lucia M.ZUCCOLOTTO, Sandra M.C.BRESOLIN, Ana Maria B.
<em>Bricks, Lucia F.</em>;
<em>Cocozza, Ana Maria</em>;
<em>Resegue, Rosa</em>;
<em>Sucupira, Ana Cecília S.l.</em>;
<em>Rodrigues, Daleth</em>;
<em>Kobinger, Maria Elizabeth B.a.</em>;
<em>Bourroul, Maria Lucia M.</em>;
<em>Zuccolotto, Sandra M.c.</em>;
<em>Bresolin, Ana Maria B.</em>;
<br/><br/>
Objectives: Describe cases of children with hepatosplenomegaly (HS) attended at the General Pediatric Teaching Ambulatory (AGER) of Instituto da Criança, São Paulo, identifying the main causes, evolution, necessity for hospitalization and/or referral to specialists. Methodology: Retrospective analysis of the records of children presenting HS on admission at AGER from September 1, 1993 to August 31, 1996. Results: Of the 89 children included (age range, 1 to 148 months; median, 24 months), 64 (72%) were referred from other services for HS investigation. Most common presenting complaints were: fever - 39 (44%); pallor - 26 (29%); weight loss - 21 (24%) and jaundice - 14 (16%). Main alterations noticed on physical examination were: pallor - 47 (53%) and short stature - 17 (19%). Anemia was diagnosed in 70 children (79%); 35 children (39%) had infections; 7 (8%) metabolic disorders and 5 (6%) neoplastic disorders. The most frequent infections were of the urinary tract - 9 (10%) and hepatitis A - 6 (7%).Thirty six children (40%) were referred to specialists, 17 of which were already diagnosed. Conclusions: Most of the children with HS present deficiency anemia associated with infections which the general pediatrician is able to diagnose. Persistence of unexplained HS for more than 2 months, especially when there is substantial volume enlargement or alteration in the organs consistency, is an indication for referral to specialists.RE-EVALUATION OF SCHISTOSOMIASIS MANSONI IN MINAS GERAIS, BRAZIL. III. "NOROESTE DE MINAS" MESOREGION10.1590/S0036-466519980005000022024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZCARVALHO, Omar S.MASSARA, Cristiano L.GUERRA, Henrique L.CAMPOS, Yoná R.CALDEIRA, Roberta L.CHAVES, AdelúKATZ, Naftale
<em>Carvalho, Omar S.</em>;
<em>Massara, Cristiano L.</em>;
<em>Guerra, Henrique L.</em>;
<em>Campos, Yoná R.</em>;
<em>Caldeira, Roberta L.</em>;
<em>Chaves, Adelú</em>;
<em>Katz, Naftale</em>;
<br/><br/>
This study was conducted to assess the presence of schistosomiasis mansoni in the "Noroeste de Minas" mesoregion, an area considered non-endemic. A malacologic survey and parasitologic stool examinations were undertaken in 13 municipalities of the mesoregion. A sample of 3,283 primary school students was submitted to fecal examination by the Kato-Katz method. A total of 3,627 planorbids was collected and examined. The molluscs were identified as Biomphalaria straminea in seven municipalities (Unaí, Bonfinópolis de Minas, Paracatu, João Pinheiro, Vazante, Lagamar and Lagoa Grande) and as Biomphalaria peregrina in one (Presidente Olegário). All planorbids were negative for Schistosoma mansoni. Four students were diagnosed with schistosomiasis in the municipalities of Buritis, Formoso, Paracatu and Unaí, but none of these cases was considered autochthonous. The data obtained indicate that the "Noroeste de Minas" mesoregion continues to be non-endemic for schistosomiasis mansoni, although the presence of intermediate hosts associated with parasitized individuals emphasizes the need for epidemiological surveillance of schistosomiasis in this mesoregion.HEPATITIS B VIRUS INFECTION PROFILE IN CENTRAL BRAZILIAN HEMODIALYSIS POPULATION10.1590/S0036-466519980005000032024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZTELES, Sheila A.MARTINS, Regina M. BSILVA, Simonne A.GOMES, Dinalva M. F.CARDOSO, Divina D. P.VANDERBORGHT, Bart O. M.YOSHIDA, Clara F. T.
<em>Teles, Sheila A.</em>;
<em>Martins, Regina M. B</em>;
<em>Silva, Simonne A.</em>;
<em>Gomes, Dinalva M. F.</em>;
<em>Cardoso, Divina D. P.</em>;
<em>Vanderborght, Bart O. M.</em>;
<em>Yoshida, Clara F. T.</em>;
<br/><br/>
Hepatitis B has proved to be a major health hazard in hemodialysis patients. In order to investigate the hepatitis B virus (HBV) infection profile in the hemodialysis population of Goiânia city - Central Brazil, all dialysis patients (N=282) were studied. The prevalence of any HBV marker (HBsAg, anti-HBs, and anti-HBc) was 56.7% (95% CI: 51.1-62.7), ranging from 33.3% to 77.7% depending on dialysis unit. HBV-DNA was detected in 67.6% and 88.2% of the HBsAg-positive serum samples, in 91.3% and 100% of the HBsAg/HBeAg-positive samples, and in 18.2% and 63.6% of the HBsAg/anti-HBe-reactive sera by hybridization and PCR, respectively. The length of time on hemodialysis was significantly associated with HBV seropositivity. Only 10% of the patients reported received hepatitis B vaccination. The findings of a high HBV infection prevalence in this population and the increased risk for HBV infection on long-term hemodialysis suggest the environmental transmission, emphasizing the urgent need to evaluate strategies of control and prevention followed in these units.REPRODUCIBILITY OF ALKALINE ANTIGENS OF Leishmania major-LIKE AND Leishmania (V.) braziliensis EVALUATED BY IgG-ELISA. COMPARISON OF ANTIGENS ADDED OF A PROTEIN INHIBITOR (PMSF) OR NOT10.1590/S0036-466519980005000042024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZCeleste, Beatriz JulietaGuimarães, Maria Carolina SoaresSouza, José Maria Pacheco deBergamaschi, Denise P.
<em>Celeste, Beatriz Julieta</em>;
<em>Guimarães, Maria Carolina Soares</em>;
<em>Souza, José Maria Pacheco De</em>;
<em>Bergamaschi, Denise P.</em>;
<br/><br/>
This paper deals with the analysis of 10 batches of L.major-like and L.(V.) braziliensis antigens added or not of a proteases inhibitor evaluated by means of an IgG-ELISA on three consecutive days using positive standard sera from patients with diagnosis of American Leishmaniasis previously tested for the presence of IgG antibodies by means of ELISA. The statistical analysis showed that for L. (V.) braziliensis the PMSF-containing antigen did not show any difference among batches or days of testing; the L.(V.) braziliensis antigen without PMSF showed statistical significance for differences among batches and a two-way ANOVA showed significant differences between antigens. L.major-like antigen prepared with or without PMSF showed differences among batches; all 3 days of testing displayed differences for the PMSF antigen but only for days 1 and 2 for the antigen without inhibitor. A two-way ANOVA showed differences among batches of the antigens but not for antigens with and without the protein inhibitor. According to the statistical analysis the L.major-like antigen added or not of PMSF has shown that it is the choice antigen for mucocutaneous leishmaniasis serology.OBTENTION OF RABIES ANTIGEN THROUGH BHK21 CELLS ADHERED TO MICROCARRIERS10.1590/S0036-466519980005000052024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZFRAZATTI GALLINA, Neuza M.LIMA PAOLI, Rosana deFRANCISCO, Izilda A.CASTRO GARCIA, Gislaine deMOURÃO FUCHES, Regina M.
<em>Frazatti Gallina, Neuza M.</em>;
<em>Lima Paoli, Rosana De</em>;
<em>Francisco, Izilda A.</em>;
<em>Castro Garcia, Gislaine De</em>;
<em>Mourão Fuches, Regina M.</em>;
<br/><br/>
Four rabies antigen batches were produced from virus suspensions resulting from BHK21 cells adhered to microcarriers (Cytodex 1), inoculated and cultured in a bioreactor. In parallel the methodology of production of rabies virus through cultures of BHK21 cells in monolayers in bottles was used. The results obtained showed that infecting titles were 106.69 DL50/mL and 107.28 DL50/mL for suspensions cultured in bottles and in the bioreactor, respectively. The viral suspension volumes collected were on average 11,900 per batch from the bioreactor and 800mL per bottle. Ten horses were immunized with the antigen produced in the bioreactor. The means of antirabies antibody titers found were 240 and 212 IU/mL after the initial and the first booster doses, respectively. Rabies antigen with satisfactory infecting titers can be obtained on a large scale by culturing in a bioreactor inoculated BHK21 cells adhered to microcarriers.ADVERSE EFFECT VERSUS QUALITY CONTROL OF THE FUENZALIDA-PALACIOS ANTIRABIES VACCINE10.1590/S0036-466519980005000062024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZNOGUEIRA, Yeda L.
<em>Nogueira, Yeda L.</em>;
<br/><br/>
We evaluated the components of the Fuenzalida-Palacios antirabies vaccine, which is till used in most developing countries in human immunization for treatment and prophylaxis. This vaccine is prepared from newborn mouse brains at 1% concentration. Even though the vaccine is considered to have a low myelin content, it is not fully free of myelin or of other undesirable components that might trigger adverse effects after vaccination. The most severe effect is a post-vaccination neuroparalytic accident associated with Guillain-Barré syndrome. In the present study we demonstrate how the vaccines produced and distributed by different laboratories show different component patterns with different degrees of impurity and with varying protein concentrations, indicating that production processes can vary from one laboratory to another. These differences, which could be resolved using a better quality control process, may affect and impair immunization, with consequent risks and adverse effects after vaccination. We used crossed immunoelectrophoresis to evaluate and demonstrate the possibility of quality control in vaccine production, reducing the risk factors possibly involved in these immunizing products.HEART ANEURYSM IN CHAGAS' DISEASE10.1590/S0036-466519980005000072024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZOLIVEIRA, José Alberto Mello de
<em>Oliveira, José Alberto Mello De</em>;
<br/><br/>
This prospective study on 41 autopsy collected human hearts concerns the "apical" lesion in Chagas' disease. Previous report did not show a correlation between lesion frequency and heart weight then discarding a vascular factor in its pathogenesis. The present paper involves other variables besides the heart weight to evaluate the relative coronary insufficiency. Distinct colored gel (green and red) injected through the capillary beds of both coronary arteries defined the extent of both vessels before separating the atria and removing the sub-epicardium fat. The Right Ventricle (RV) and Left Ventricle (LV) free walls furnished the RV/LV mass ratio. The myocardium mass colored green (right coronary artery - RC) and the whole Ventricular Weight (VW) determined the RC/VW mass ratio. The heart weight plus these mass ratios, graded and added, composed a score inversely proportional to the myocardium irrigation condition. It intended to be a more sensitive morphologic evaluation of the relative ischaemia to correlate to the apical lesion. This study showed a right deviation for the relative accumulated frequency of lesions plotted as a score function and a significant difference for higher scores in hearts with aneurysm. It suggests a ischaemic factor intervening in the apical lesion pathogenesis in Chagas' cardiopathy.STANDARDIZATION OF PROCEDURES OF Plasmodium falciparum ANTIGEN PREPARATION FOR SEROLOGIC TESTS10.1590/S0036-466519980005000082024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZAVILA, Sandra L.M.TOZETTO-MENDOZA, Tania R.ARRUK, Viviana G.FERREIRA, Antonio Walter
<em>Avila, Sandra L.m.</em>;
<em>Tozetto-Mendoza, Tania R.</em>;
<em>Arruk, Viviana G.</em>;
<em>Ferreira, Antonio Walter</em>;
<br/><br/>
The objective of the present study is to standardize the technical variables for preparation and storage of Plasmodium falciparum and of antigen components extracted with the amphoteric detergent Zwittergent. P. falciparum obtained from in vitro culture was stored at different temperatures and for different periods of time. For each variable, antigen components of the parasite were extracted in the presence or absence of protease inhibitors and submitted or not to later dialysis. Products were stored for 15, 30 and 60 days at different temperatures and immunological activity of each extract was determined by SDS-PAGE and ELISA using positive or negative standard sera for the presence of IgG directed to blood stage antigens of P. falciparum. Antigen extracts obtained from parasites stored at -20oC up to 10 days or at -70oC for 2 months presented the best results, showing well-defined bands on SDS-PAGE and Western blots and presenting absorbance values in ELISA that permitted safe differentiation between positive and negative sera.PCR-BASED DIAGNOSIS OF A CASE OF HERPETIC WHITLOW IN AN AIDS PATIENT10.1590/S0036-466519980005000092024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZNOGUEIRA, Maurício L.OLIVEIRA, Adriana F.ARAUJO, Janaína G.GALLO, Márcio A.FONSECA, João G. M.BONJARDIM, Claudio A.FERREIRA, Paulo C.P.KROON, Erna G.
<em>Nogueira, Maurício L.</em>;
<em>Oliveira, Adriana F.</em>;
<em>Araujo, Janaína G.</em>;
<em>Gallo, Márcio A.</em>;
<em>Fonseca, João G. M.</em>;
<em>Bonjardim, Claudio A.</em>;
<em>Ferreira, Paulo C.p.</em>;
<em>Kroon, Erna G.</em>;
<br/><br/>
Herpetic infections are common complications in AIDS patients. The clinical features could be uncommon and antiviral chemotherapy is imperative. A rapid diagnosis could prevent incorrect approaches and treatment. The polymerase chain reaction is a rapid, specific and sensible method for DNA amplification and diagnosis of infectious diseases, especially viral diseases. This approach has some advantages compared with conventional diagnostic procedures. Recently we have reported a new PCR protocol to rapid diagnosis of herpetic infections with suppression of the DNA extraction step. In this paper we present a case of herpetic whitlow with rapid diagnosis by HSV-1 specific polymerase chain reaction using the referred protocol.Scedosporium apiospermum SINUSITIS AFTER BONE MARROW TRANSPLANTATION: REPORT OF A CASE10.1590/S0036-466519980005000102024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZMACHADO, Clarisse M.MARTINS, Marilena A.HEINS-VACCARI, Elizabeth MariaLACAZ, Carlos da SilvaMACEDO, Maria Cristina A.CASTELLI, Jussara B.MEDEIROS, Rosaura S.SILVA, Roberto L.DULLEY, Frederico L.
<em>Machado, Clarisse M.</em>;
<em>Martins, Marilena A.</em>;
<em>Heins-Vaccari, Elizabeth Maria</em>;
<em>Lacaz, Carlos Da Silva</em>;
<em>Macedo, Maria Cristina A.</em>;
<em>Castelli, Jussara B.</em>;
<em>Medeiros, Rosaura S.</em>;
<em>Silva, Roberto L.</em>;
<em>Dulley, Frederico L.</em>;
<br/><br/>
A forty-year-old man underwent an allogeneic BMT from his HLA identical sister. GvHD prophylaxis was done with cyclosporine (CyA), methotrexate and prednisone (PDN). On day +90 extensive GvHD was noted and higher doses of immunosuppressive drugs alternating CyA with PDN were initiated. Patient's follow-up was complicated by intermittent episodes of leukopenia and monthly episodes of sinusitis or pneumonia. One year after BMT, the patient developed hoarseness and nasal voice. No etiologic agent could be identified on a biopsy sample of the vocal chord. Upon tapering the doses of immunosuppressive drugs, the patient had worsening of chronic GvHD and was reintroduced on high doses of cyclosporine alternating with prednisone on day +550. Three months later, GvHD remained out of control and the patient was started on azathioprine. On day +700, hoarseness and nasal voice recurred. Another biopsy of the left vocal chord failed to demonstrate infection. Episodes of sinusitis became more frequent and azathioprine was withheld 3 months after it was started. One month later, the patient had bloody nasal discharge and surgical drainage of maxillary sinuses was performed. Histopathology showed hyphae and cultures grew Scedosporium apiospermum. ltraconazole 800 mg/day was initiated. The patient developed progressive respiratory failure and died 15 days later.ANTI-Trypanosoma cruzi ANTIBODIES IN THE INHABITANTS OF URBAN AND RURAL AREAS OF ABADIA DOS DOURADOS, STATE OF MINAS GERAIS, BRAZIL10.1590/S0036-466519980005000112024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZMACHADO, Eleuza RodriguesCOSTA-CRUZ, Julia MariaGOMES, Sandra B. P.
<em>Machado, Eleuza Rodrigues</em>;
<em>Costa-Cruz, Julia Maria</em>;
<em>Gomes, Sandra B. P.</em>;
<br/><br/>
DERMATOMYCOSIS OF THE TOE WEB CAUSED BY Curvularia lunata10.1590/S0036-466519980005000122024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZLOPES, Jorge O .JOBIM, Neicy M.
<em>Lopes, Jorge O .</em>;
<em>Jobim, Neicy M.</em>;
<br/><br/>
SEROEPIDEMIOLOGICAL STUDY OF HUMAN STRONGYLOIDIASIS WITH BLOOD SAMPLES COLLECTED ON FILTER PAPER, IN ABADIA DOS DOURADOS (MINAS GERAIS, BRAZIL)10.1590/S0036-466519980005000132024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZCOSTA-CRUZ, Julia MariaMACHADO, Eleuza R.CAMPOS, Dulcinéa Maria B.
<em>Costa-Cruz, Julia Maria</em>;
<em>Machado, Eleuza R.</em>;
<em>Campos, Dulcinéa Maria B.</em>;
<br/><br/>
SIMPLIFIED DIAGNOSIS OF MALARIA INFECTION: GFM/PCR/ELISA A SIMPLIFIED NUCLEIC ACID AMPLIFICATION TECHNIQUE BY PCR/ELISA10.1590/S0036-466519980005000142024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZMACHADO, Ricardo Luiz DantasGARRET, Denise OliveiraADAGU, Ipemida SullaymanWARHURST, David CharlesPÓVOA, Marinete Marins
<em>Machado, Ricardo Luiz Dantas</em>;
<em>Garret, Denise Oliveira</em>;
<em>Adagu, Ipemida Sullayman</em>;
<em>Warhurst, David Charles</em>;
<em>Póvoa, Marinete Marins</em>;
<br/><br/>
We report an adaptation of a technique for the blood sample collection (GFM) as well as for the extraction and amplification of Plasmodium DNA for the diagnosis of malaria infection by the PCR/ELISA. The method of blood sample collection requires less expertise and saves both time and money, thus reducing the cost by more than half. The material is also suitable for genetic analysis in either fresh or stored specimens prepared by this method.TRANFUSION-TRANSMITED VIRUS (TTV) IN BRAZIL. PRELIMINARY REPORT10.1590/S0036-466519980005000152024-01-02T20:27:02.011000Z2020-08-09T06:49:20.912000ZPINHO, João R. R.TAKAHASHI, Daniela A.FAVA, Adriano L. B.GONÇALES, Neiva S. L.CARRILHO, Flair J.STUCCHI, Raquel S. BGONÇALES Jr., Fernando L.DA SILVA, Luiz C.SOARES, Manoel C. P.BENSABATH, GilbertaBUCK, Gregory A.MEYERS, Gregory A.BERNARDINI, A. Plínio
<em>Pinho, João R. R.</em>;
<em>Takahashi, Daniela A.</em>;
<em>Fava, Adriano L. B.</em>;
<em>Gonçales, Neiva S. L.</em>;
<em>Carrilho, Flair J.</em>;
<em>Stucchi, Raquel S. B</em>;
<em>Gonçales Jr., Fernando L.</em>;
<em>Da Silva, Luiz C.</em>;
<em>Soares, Manoel C. P.</em>;
<em>Bensabath, Gilberta</em>;
<em>Buck, Gregory A.</em>;
<em>Meyers, Gregory A.</em>;
<em>Bernardini, A. Plínio</em>;
<br/><br/>
TTV is a recently discovered DNA virus, isolated from a patient with post-transfusion hepatitis of unknown etiology by Japanese researchers. In the present study, we evaluated the presence of TTV among chronic liver diseases patients in São Paulo and Pará states, representing two geographically distinct Brazilian regions. TTV DNA was found in 21/105 (20%) and 9/20 (45%) cases from São Paulo and Pará States, respectively. DNA sequence data confirmed the presence of TTV genotypes 1a and 2a, as well as other genotypes not yet described. In conclusion, TTV is present in chronic liver diseases cases from Southeast and North Brazil. However, further studies involving healthy populations are necessary before establishing any causal relationship among TTV and human hepatitis.