• ENTEROVIRUSES ISOLATED FROM PATIENTS WITH ACUTE RESPIRATORY INFECTIONS DURING SEVEN YEARS IN RIO DE JANEIRO (1985-1991) Virology

    PORTES, Silvana A.R.; SILVA, Edson E. DA; SIQUEIRA, Marilda M.; FILIPPIS, Ana Maria B. DE; KRAWCZUK, Murilo M.; NASCIMENTO, Jussara P.

    Abstract in Portuguese:

    Os enterovírus foram investigados em secreções respiratórias coletadas de pacientes com infecção respiratória aguda (IRA), durante um período de sete anos (1985-1991), dentro de um estudo longitudinal da etiologia das IRAs. Neste estudo foram encontrados todos os vírus que são mais comumente associados com IRA. Entre os vírus isolados, os enterovírus foram apenas menos frequentes que vírus respiratório sincicial, adenovírus e influenzavírus. Quarenta e cinco amostras de enterovirus foram isoladas de pacientes com infecção do trato respiratório superior ou inferior. Entre estes enterovírus isolados, trinta e uma amostras foram identificadas como poliovírus (n=18) e enterovírus não polio (n=13) pelo teste de soroneutralização. As amostras de poliovirus isoladas foram classificadas como amostras vacinais do tipo 1 e 2. Dos treze enterovírus não polio, doze foram identificados como echovírus sorotipos 1, 2, 7, 11, 19 e 31 e apenas um foi identificado como coxsackievírus B4.

    Abstract in English:

    Enteroviruses were investigated in respiratory secretions collected from patients with acute respiratory infections (ARI) over a seven year period (1985-1991), as part of a longitudinal study of ARI aetiology. All the viruses that are most commonly associated with ARI were found in this study. Among the virus isolates, enteroviruses were only less frequent than respiratory syncytial viruses, adenoviruses and influenzaviruses. Forty five enterovirus samples were isolated from patients with either upper respiratory tract infections (URTI) or lower respiratory tract infections (LRTI). From these enterovirus isolates, thirty one samples were identified as poliovirus (n=18) and non polio enterovirus (n=13) by serum neutralization. Poliovirus were identified as type 1 and 2 and all of them were vaccinal strains. From thirteen non polio enterovirus, twelve were identified as echovirus serotypes 1, 2, 7, 11, 19 and 31. The remainder was identified as coxsackievirus B4.
  • ANTIGENIC RELATEDNESS OF SELECTED FLAVIVIRUSES: STUDY WITH HOMOLOGOUS AND HETEROLOGOUS IMMUNE MOUSE ASCITIC FLUIDS Virology

    BABA, S.S.; FAGBAMI, A.H.; OLALEYE, O.D.

    Abstract in Portuguese:

    A relação antigênica de 9 Flavivirus, Febre amarela (YF), Wesselsbron (WSL), Uganda S (UGS), Potiskum (POT), West Nile (WN), Banzi (BAN), Zika (ZK), Dengue tipo 1 (DEN-1) e Dengue tipo2 (DEN-2), foi avaliada por reação de inibição da hemaglutinação cruzada (cross-HI) e reação de fixação do complemento cruzada (Cross-CF) entre cada um dos virus e seu fluido ascítico homólogo em camundongos. Médias de títulos foram calculadas usando os títulos heterólogos e homólogos. Reações cruzadas CF revelaram maiores variações antigênicas entre virus do que reações cruzadas HI. Não houve variação antigênica significativa entre virus WSL, POT e YF usando cada um dos métodos. Todavia, diferenças definidas da antigenicidade foram observadas entre eles e os vírus UGS, BAN e ZK. Não existiram diferenças significativas entre UGS, BAN e ZK ou entre DEN-1 e DEN-2. A relação sorológica entre Flavivirus é importante para se estabelecer o diagnóstico e a epidemiologia destas infecções na África.

    Abstract in English:

    The antigenic relationship of 9 flaviviruses, Yellow fever (YF) , Wesselsbron (WSL) , Uganda S (UGS) , Potiskum (POT), West Nile (WN) , Banzi (BAN) , Zika (ZK) , Dengue type 1 (DEN-1) and Dengue type 2 (DEN-2), was assessed by cross-haemagglutination-inhibition (Cross-HI) and cross-complement fixation (Cross-CF) reactions between each of the viruses and their homologous immune mouse ascitic fluids. Titre ratios were calculated using the heterologous and homologous titres. Cross-CF reactions revealed wider antigenic variations among viruses than Cross-HI reactions. There was no significant antigenic variation between WSL, POT and YF viruses using either of those methods. However, definite differences in antigenicity were observed between them and UGS, BAN and ZK viruses. There were no significant differences between UGS, BAN and ZK or between DEN-1 and DEN-2. The serological relationship among flaviviruses is important in establishing diagnosis and epidemiology of these infections in Africa.
  • IL-2 AND IFN-g, BUT NOT IL-4 SECRETION BY PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMC) ARE RELATED TO CD4+ T CELLS AND CLINICAL STATUS IN BRAZILIAN HIV-1-INFECTED SUBJECTS Immunology

    HONG, Marisa A.; WAKIM, Valéria L.; SALOMÃO, Simone J.; CAMARGO, Luizete S.; CASSEB, Jorge; DUARTE, Alberto J.S.

    Abstract in English:

    It has been reported that production of IL-2 and IFN-<FONT FACE="Symbol">g</FONT>, known as T-helper type 1 cytokines, by peripheral mononuclear cells (PBMC) decreases with progression of HIV infection. In contrast, IL-4 and IL-10 production, Th2 cytokine profile, increases with HIV disease progression. PBMC were evaluated from 55 HIV-infected subjects from Divisão de Imunologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, to "in vitro" cytokines production after 24 hours of stimulation with PHA. Low levels of IL-4 production in both HIV- infected patients and normal subjects, were detected. The patients with CD4+ T cell counts <200 showed a significant decrease of IL-2 and IFN-<FONT FACE="Symbol">g</FONT> production compared to controls. Patients with higher counts of CD4+ T cells (either between 200-500 or >500 cells/mm3) also showed decreased production of IL-2 that was not statistically significant. There was a correlation between IL-2 and IFN-<FONT FACE="Symbol">g</FONT> release with CD4+ T cells counts. HIV-1-infected individuals with CD4+ T cells >500 cells/mm3 showed increased levels of IL-2 and IFN-<FONT FACE="Symbol">g</FONT>, than individuals with CD4+ T cells <500 cells/mm3. In conclusion, we observed a decline of IL-2 and IFN-<FONT FACE="Symbol">g</FONT> production at advanced HIV disease. IL-4 production was not affected during HIV infection. Taken together, these findings suggest that the cytokine profile might be influenced by the HIV infection rather than the cause of disease progression.
  • INFLUENCE OF DIETARY PROTEIN CONTENT ON Trypanosoma cruzi INFECTION IN GERMFREE AND CONVENTIONAL MICE Trypanosomiasis

    CINTRA, Isa P.; SILVA, Marcelo E.; SILVA, Marcílio E.C.; SILVA, Márcio E.; AFONSO, L.C. C.; NICOLI, Jacques R.; BAMBIRRA, Eduardo A.; VIEIRA, Enio C.

    Abstract in Portuguese:

    Camundongos isentos de germes (GF) e convencionais (CV) foram alimentados com rações contendo 4,4, 13,2 ou 26,4% de proteína (peso/peso). Os camundongos CV alimentados com ração baixa em proteína não ganharam peso durante quatro semanas, enquanto a ração deficiente em proteína não afetou o crescimento dos camundongos GF. Após quatro semanas nessas rações, os camundongos foram inoculados com 5x103 tripomastigotos de Trypanosoma cruzi. A deficiência em proteína afetou menos os camundongos GF do que os CV, segundo os seguintes parâmetros: ganho em peso, hemoglobina, níveis em proteína e albumina no plasma e conteúdos em água e proteína na carcassa. A infecção com T. cruzi produziu um decréscimo significante nos níveis em hemoglobina, na contagem de células vermelhas sanguíneas e nos conteúdos em água e proteína na carcassa. Este descréscimo foi mais acentuado nos camundongos GF. Histopatologicamente, não houve diferença entre os tratamentos nos animais com o mesmo estatuto microbiológico (GF ou CV). Contudo, a doença foi mais grave nos camundongos GF do que nos CV.

    Abstract in English:

    Germfree (GF) and conventional (CV) mice were fed on diets containing 4.4, 13.2 or 26.4% of protein (weight/weight). CV mice fed on low protein diet did not gain weight during four weeks, whereas the protein deficient diet did not affect the growth of GF mice. After four weeks on these diets, the mice were inoculated with 5x103 trypomastigotes of Trypanosoma cruzi. The protein deficiency affected less the GF than the CV mice, according to the following parameters: weight gain, hemoglobin, plasma protein and albumin levels and water and protein contents of the carcass. Infection with T. cruzi produced a significant decrease in hemoglobin levels, red blood cell count, and water and protein contents in the carcass. This decrease was more pronounced in the GF mice. Histopathologically, there was no difference between the treatments in animals with the same microbiological status (GF or CV). However, the disease was more severe in the GF than in the CV mice.
  • REACTIONAL STATES IN MULTIBACILLARY HANSEN DISEASE PATIENTS DURING MULTIDRUG THERAPY Hanseniasis

    NERY, José A.C.; VIEIRA, Leila M. M.; MATOS, Haroldo J. de; GALLO, Maria E. N.; SARNO, Euzenir N.

    Abstract in Portuguese:

    Reações são ocorrências comuns no curso da hanseníase e são responsáveis pelo agravamento das lesões neurais. Uma coorte de 162 pacientes recém-diagnosticados, baciloscopicamente positivos, em acompanhamento no Ambulatório de Hanseníase da Fundação Oswaldo Cruz (FIOCRUZ) foi selecionada para estudo. Observou-se que 46% dos pacientes multibacilares submetidos a 24 doses fixas de poliquimioterapia (PQT) apresentaram reações durante o tratamento; todos multibacilares eram suscetíveis e cuidados e atenção constantes eram necessários. Quatorze por cento foram classificados como BB, 52% como BL e 33% como LL. Nenhuma das variáveis em estudo, tais como: sexo, idade, forma clínica, tempo de doença, extensão das lesões dermatológicas, índice baciloscópico (IB), ou grau de incapacidade associaram-se a reação entre os pacientes estudados. Reação Reversa (RR) ocorreu em 45% e Eritema Nodoso Hansênico (ENH) em 55% dos casos. Entre os pacientes BB que desenvolveram reação (15 pacientes), 93% apresentaram RR, enquanto entre os pacientes LL que tiveram reação (34 pacientes), 91% apresentaram ENH. Por outro lado, ENH foi mais frequente entre aqueles com lesões difusas, enquanto RR foi mais frequente em pacientes com lesões localizadas. O RR ocorreu principalmente nos primeiros meses de tratamento. A taxa de recorrência do ENL foi significativamente maior que a do RR. Nenhum grau de incapacidade nem IB esteve associado com RR e ENL. Entretanto a taxa de RR foi significativamente maior entre pacientes mostrando IB < 3, enquanto que o ENH predominou entre os pacientes com IB > 3.

    Abstract in English:

    It is well known that reactions are commonplace occurrences during the course of leprosy disease. Stigmatization may even be attributable to reactions which are also responsible for the worsening of neural lesions. A cohort of 162 newly-diagnosed baciloscopically positive patients from the Leprosy Care Outpatient Clinic of the Oswaldo Cruz Foundation (FIOCRUZ) was selected for this study. While 46% of the multibacillary (MB) patients submitted to the 24 fixed-dose multidrug therapy (MDT) regimen suffered reactions during treatment, it was found that all MBs were susceptible and that constant attention and care were required at all times. Fourteen per cent were classified as BB, 52% as BL, and 33% as LL. None of the variables under study, such as, sex, age, clinical form, length of illness, length of dermatological lesions, baciloscopic index (BI), or degree of disability proved to be associate with reaction among the patients studied. Reversal Reaction (RR) occurred in 45%, and Erythema Nodosum Leprosum (ENL) occurred in 55%. Among BB patients who developed reactions (15 patients), 93% presented RR; while among the LL patients who developed reactions (34 patients), 91% presented ENL. Likewise, ENL was very frequent among those with disseminate lesions, while RR was most often observed in patients with segmentary lesions. RR was also most likely to occur during the initial months of treatment. It was demonstrated that the recurrence rate of ENL was significantly higher than that of RR. Neither grade of disability nor BI was shown to be associated with RR and ENL reaction. However, the RR rate was significantly higher among patients showing BI < 3, while ENL predominated among those patients with BI > 3.
  • PALEOPARASITOLOGY: PERSPECTIVES WITH NEW TECHNIQUES Invited review

    ARAÚJO, Adauto; Reinhard, Karl; Bastos, Otílio M.; Costa, Ligia C.; Pirmez, Claude; Iñiguez, Alena; Vicente, Ana Carolina; Morel, Carlos M.; Ferreira, Luiz Fernando

    Abstract in Portuguese:

    Paleoparasitologia é o estudo de parasitos encontrados em material arqueológico. O desenvolvimento deste campo da pesquisa teve início com a identificação de ovos de helmintos em tecidos mumificados, análise de coprólitos e, recentemente, através da biologia molecular. Neste artigo faz-se uma breve revisão da história da paleoparasitologia com referência especial aos estudos de ADN antigo (ancient DNA) em material arqueológico

    Abstract in English:

    Paleoparasitology is the study of parasites found in archaeological material. The development of this field of research began with histological identification of helminth eggs in mummy tissues, analysis of coprolites, and recently through molecular biology. An approach to the history of paleoparasitology is reviewed in this paper, with special reference to the studies of ancient DNA identified in archaeological material.
  • PARACOCCIDIOIDOMYCOSIS AND AIDS: REPORT OF THE FIRST TWO COLOMBIAN CASES Case report

    TOBON, Angela M.; OROZCO, Beatriz; ESTRADA, Santiago; JARAMILLO, Edilma; BEDOUT, Catalina de; ARANGO, Myrtha; RESTREPO, Angela

    Abstract in Portuguese:

    Relato dos dois primeiros casos de pacientes colombianos com AIDS e paracoccidioidomicose. Os pacientes, ambos masculinos, não tinham conhecimento do fator de risco por HIV, embora tivessem no passado trabalhado no campo onde poderíam ter sido infectados por fungos. Eles tiveram o tipo juvenil da doença em vários orgãos com sintomas de curta duração. Eles estavam profundamente imunodeprimidos, com menos de 100 CD4 T linfócitos por mL; todavia, os testes sorológicos revelaram anticorpos circulantes anti-Paracoccidioides brasiliensis em um dos pacientes e os primeiros indícios diagnósticos vieram destes testes. Em um caso, a micose precedeu o diagnóstico da AIDS enquanto que no outro, ambas patologias foram descobertas simultaneamente. A terapia antimicótica com itraconazole, foi dada por 10 meses, começando com 200mg/dia e seguida por 100 mg/dia: foi notada pronunciada melhora nos sintomas e sinais da micose, sem recorrência. A melhora dos pacientes provavelmente também foi devido à combinação do tratamento retro-viral que foi ministrado. Embora rara a associação de AIDS com paracoccidioidomicose, médicos que atuam em áreas endêmicas devem considerar a presença de micoses em pacientes imunodeprimidos como diagnóstico imediato e instaurar o tratamento combinado antimicótico/antiretroviral,que resultaria em melhora e sobrevivência dos pacientes. Parece que é possível que o tempo de sobrevida longo visto nestes pacientes com AIDS dará tempo para o fungo quiescente ressurgir, multiplicar e produzir a doença de forma expressiva.

    Abstract in English:

    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.
  • VISCERAL LARVA MIGRANS AND TROPICAL PYOMYOSITIS: A CASE REPORT Case report

    LAMBERTUCCI, Roberto; RAYES, Abdunnabi; SERUFO, José Carlos; TEIXEIRA, Daniela Moura; GERSPACHER-LARA, Rogério; NASCIMENTO, Evaldo; BRASILEIRO-FILHO, Geraldo; SILVA, Ana Cristina

    Abstract in English:

    We report a case of tropical pyomyositis in a boy who presented with a severe febrile illness associated with diffuse erythema, and swelling in many areas of the body which revealed on operation extensive necrotic areas of various muscles that required repeated débridement. The patient gave a history of contact with dogs, and an ELISA test for Toxocara canis was positive. He also presented eosinophilia and high serum IgE levels. Staphylococcus aureus was the sole bacteria isolated from the muscles affected. We suggest that tropical pyomyositis may be caused by the presence of migrating larvae of this or other parasites in the muscles. The immunologic and structural alterations caused by the larvae, in the presence of concomitant bacteremia, would favour seeding of the bacteria and the development of pyomyositis.
  • Lagochilascaris minor IN A PATIENT FROM THE COLOMBIAN AMAZON: A CASE REPORT Case report

    MONCADA, Ligia I.; ALVAREZ, Carlos A.; CASTELLANOS, Carlos; CACERES, Elvia; NICHOLLS, Santiago; CORREDOR, Augusto

    Abstract in Portuguese:

    Infecção crônica (10 anos) por Lagochilascaris minor é descrita em mulher da região amazônica colombiana. Este é o terceiro caso de infecção por este parasita que é descrito até agora na Colombia, e o único em pessoa proveniente da região amazônica colombiana.

    Abstract in English:

    A chronic infection (10 years) by Lagochilascaris minor is described in a woman from the amazon region of Colombia. This is the third case of infection by this parasite that has been described so far in Colombia, and only the first one in a person coming from the Colombian Amazon region.
  • HUMAN CYCLOSPORIASIS DIAGNOSIS: REPORT OF A CASE IN SÃO PAULO, SP, BRAZIL Case report

    Fernandes, Andréia Otaviani Di Pietro; Carollo, Maria Cristina Casaqui; Braz, Lúcia Maria Almeida; Amato Neto, Vicente; Villela, Maria Silvia Hadler

    Abstract in Portuguese:

    É relatado o diagnóstico de ciclosporíase humana em São Paulo, SP, Brasil. Cyclospora cayetanensis foi encontrada nas fezes de um indivíduo através de exame pelo método de coloração de Kinyoun modificado, com posterior esporulação em dicromato de potássio a 2,5%. Esta verificação deve estimular a necessidade de considerar a ciclosporíase como eventual causa de distúrbios gastrointestinais no país, podendo ela ser reconhecida até mesmo por meio de técnica razoavelmente simples. Foi ainda lembrado que esta parasitose vem adquirindo expressividade sobretudo pelo fato de não raramente acometer imunodeprimidos, agora cada vez mais numerosos em especial como decorrência da infecção pelo vírus da imunodeficiência humana (HIV), que causa a síndrome da imunodeficiência adquirida (AIDS).

    Abstract in English:

    Diagnosis of the human cyclosporiasis is reported in São Paulo, SP, Brasil. Cyclospora cayetanensis has been identified in the feces of a patient by a modified Kinyoun staining method, with later sporulation in a solution of 2.5% potassium dichromate. The probability that this parasite is the eventual cause of gastrointestinal disturbances in the country was stimulated by this finding, which was arrived at by a simple technique. It had been kept in mind that the disease was expressing itself mainly among immunocompromised patients, whose number is increasing; especially in those with acquired immunodeficiency syndrome (AIDS), which is caused by the human immunodeficiency virus (HIV).
  • Untitled document Summaries of thesis

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