• Bites and stings from venomous animals: a neglected Brazilian tropical disease Editorial

    Cupo, Palmira
  • Clinical update on scorpion envenoming Review Article

    Cupo, Palmira

    Abstract in English:

    Abstract: Scorpion stings are currently the leading cause of venom-related injury to humans in Brazil and are a significant public health problem globally. Only scorpions of the Tityus genus are of medical importance in Brazil, and Tityus serrulatus is responsible for the most serious envenomations and deaths. The toxic effects of scorpion envenomation are due to a massive release of sympathetic and parasympathetic neurotransmitters; the severity is related to cardiac and hemodynamic changes, with cardiogenic shock and pulmonary edema contributing to the main causes of death. The pathophysiology of cardiac involvement has been discussed for decades and has been attributed to adrenergic discharge and a possible toxic effect of venom on the myocardium, while acute pulmonary edema may have a cardiogenic and/or non-cardiogenic origin. Currently, the clinical data point to catecholamine excess as the cause for reversible scorpion cardiomyopathy . These data include electrocardiographic changes, profiling of cardiac enzymes and troponin I, echocardiographic data with global or regional left ventricle dysfunction, and myocardial perfusion alterations compatible with spasm in the coronary microcirculation. Furthermore, recent data on cardiac magnetic resonance imaging findings, which are similar to those observed for stress-induced cardiomyopathy, have also been linked to catecholamine excess. The efficiency of antivenom serum treatment is controversial in the literature. Our experience in Brazil is that the management of patients with systemic manifestations of scorpion stings is based on three approaches, all of which are extremely important. These include symptomatic treatment, antivenom serum, and cardiorespiratory support.
  • Venomous and poisonous arthropods: identification, clinical manifestations of envenomation, and treatments used in human injuries Review Article

    Haddad Junior, Vidal; Amorim, Paulo Cezar Haddad de; Haddad Junior, William Teixeira; Cardoso, João Luiz Costa

    Abstract in English:

    Abstract This review presents the main species of venomous and poisonous arthropods, with commentary on the clinical manifestations provoked by the toxins and therapeutic measures used to treat human envenomations. The groups of arthopods discussed include the class Arachnida (spiders and scorpions, which are responsible for many injuries reported worldwide, including Brazil); the subphylum Myriapoda, with the classes Chilopoda and Diplopoda (centipedes and millipedes); and the subphylum Hexapoda, with the class Insecta and the orders Coleoptera (beetles), Hemiptera (stink bugs, giant water bugs, and cicadas), Hymenoptera (ants, wasps, and bees), and Lepidoptera (butterflies and moths).
  • Evaluation of the World Health Organization 2009 classification of dengue severity in autopsied individuals, during the epidemics of 2011 and 2012 in Brazil Major Article

    Cavalcanti, Luciano Pamplona de Góes; Braga, Deborah Nunes de Melo; Pompeu, Margarida Maria de Lima; Lima, Antônio Afonso Bezerra; Silva, Lívia Maria Alexandre da; Aguiar, Marina Gondim; Castiglioni, Mariana; Araújo, Fernanda Montenegro de Carvalho; Malta, Daniele Lima; Queiroz, Anastácio

    Abstract in English:

    Abstract: INTRODUCTION: The dengue classification proposed by the World Health Organization (WHO) in 2009 is considered more sensitive than the classification proposed by the WHO in 1997. However, no study has assessed the ability of the WHO 2009 classification to identify dengue deaths among autopsied individuals suspected of having dengue. In the present study, we evaluated the ability of the WHO 2009 classification to identify dengue deaths among autopsied individuals suspected of having dengue in Northeast Brazil, where the disease is endemic. METHODS: This retrospective study included 121 autopsied individuals suspected of having dengue in Northeast Brazil during the epidemics of 2011 and 2012. All the autopsied individuals included in this study were confirmed to have dengue based on the findings of laboratory examinations. RESULTS: The median age of the autopsied individuals was 34 years (range, 1 month to 93 years), and 54.5% of the individuals were males. According to the WHO 1997 classification, 9.1% (11/121) of the cases were classified as dengue hemorrhagic fever (DHF) and 3.3% (4/121) as dengue shock syndrome. The remaining 87.6% (106/121) of the cases were classified as dengue with complications. According to the 2009 classification, 100% (121/121) of the cases were classified as severe dengue. The absence of plasma leakage (58.5%) and platelet counts <100,000/mm3 (47.2%) were the most frequent reasons for the inability to classify cases as DHF. CONCLUSIONS: The WHO 2009 classification is more sensitive than the WHO 1997 classification for identifying dengue deaths among autopsied individuals suspected of having dengue.
  • Incidence of hepatitis C in Brazil Major Article

    Hanus, Juliét Silveira; Ceretta, Luciane Bisognin; Simões, Priscyla Waleska; Tuon, Lisiane

    Abstract in English:

    Abstract INTRODUCTION: Hepatitis C is a public health problem of global dimensions, affecting approximately 200 million people worldwide. The main objective of this study was to estimate the incidence rate of hepatitis C in Brazil during the period between 2001 and 2012. METHODS: An epidemiological, temporal, and descriptive study was performed using data from the Information System for Reportable Diseases. RESULTS: Between 2001 and 2012, a total of 151,056 hepatitis C cases were recorded, accounting for 30.3% of all hepatitis notifications in Brazil. The average gross coefficient for the analysis period was 6.7 new cases per 100,000 inhabitants. The regions with the highest rates were the Southeast region (8.7 new cases/100,000 inhabitants) and the South (13.9 new cases/100,000 inhabitants). There was a predominance of men with respect to the incidence rate (8.0 new cases/100,000 inhabitants) compared to women (5.5 new cases/100,000 inhabitants). Injection drug use was the most common source of infection, and members of the white race, residents of urban areas, and those aged 60 to 64 years had the highest incidences. CONCLUSIONS: Over the last 10 years, the incidence of hepatitis C in Brazil has increased, mainly in the South and Southeast. The adoption of fast, accurate diagnostic methods, together with epidemiological awareness, can facilitate early intervention measures for adequate control of the disease.
  • Epidemiological study of hepatitis B and C in a municipality with rural characteristics: Cássia dos Coqueiros, State of São Paulo, Brazil Major Article

    Melo, Laura Valdiane Luz; Silva, Marcondes Alves Barbosa da; Perdoná, Gleici da Silva Castro; Nascimento, Margarida Maria Passeri; Secaf, Marie; Monteiro, Rosane Aparecida; Martinelli, Ana de Lourdes Candolo; Passos, Afonso Dinis Costa

    Abstract in English:

    Abstract: INTRODUCTION: Hepatitis B and C viral infections remain an important cause of global morbidity and mortality. Studies have been conducted in population groups of large cities, leaving gaps in the knowledge regarding the situation in small municipalities. We aimed to measure the prevalence of hepatitis B and C markers and presence of infection-associated factors. METHODS: All inhabitants of Cássia dos Coqueiros aged ≥18 years who agreed to participate in the research were included. We collected blood as well as information via a questionnaire between March 2011 and December 2013. Univariate and multivariate analyses were conducted. RESULTS: Among the 1,001 participants, 41 (4.1%) participants had a serological profile of hepatitis B viral exposure, and only one (0.1%) participant was considered a virus carrier. The frequency of isolated antibody to hepatitis B virus surface antigen (anti-HBs) markers was 17.8% for the overall population. In the multivariate analysis, hepatitis B virus (HBV) infection was associated with age, birth outside the State of São Paulo, history of hepatitis, ≥2 sexual partners in the last 6 months, and tattoos. Four (0.4%) participants had a serological profile of hepatitis C viral exposure. However, after confirmation using viral ribonucleic acid (RNA) evaluation, only one (0.1%) individual remained positive. CONCLUSIONS: The positivity rates for hepatitis B and C were low, despite greater sexual freedom and the recent emergence of illicit drugs, as observed by the health personnel working in Cássia dos Coqueiros.
  • Can body traits, other than wings, reflect the flight ability of Triatominae bugs? Major Article

    Hernández, María Laura; Dujardin, Jean Pierre; Gorla, David Eladio; Catalá, Silvia Susana

    Abstract in English:

    Abstract: INTRODUCTION : Insects of the subfamily Triatominae are vectors of Trypanosoma cruzi , the Chagas disease parasite, and their flying behavior has epidemiological importance. The flying capacity is strikingly different across and within Triatominae species, as well as between sexes or individuals. Many Triatoma infestans individuals have wings but no flying muscles. In other Triatominae species, no clear relationships were found between wing length and flying behavior. If wing presence or size is not reflective of the flying behavior, which other parts of the body could be considered as reliable markers of this important function? METHODS : The genus Mepraia has exceptional characteristics with invariably wingless females and wingless or winged males. We calculated the porous surface exposed to odorant molecules to estimate the olfactory capacity of Mepraia spinolai . The head shape and thorax size were estimated using the geometric morphometric approach and traditional morphometric techniques, respectively. RESULTS : Alary polymorphism in M. spinolai was significantly associated with consistent modification of the thorax size, head shape, and notable change in the estimated olfactory capacity. The macropterous individuals had a larger olfactory surface and thorax size and significantly different head shape compared to those of the micropterous individuals. CONCLUSIONS: We concluded that these structural changes could be associated with the flying potential of Triatominae. Thus, morphological attributes not found on wings could help determine the likely flying potential of the bugs.
  • Occurrence and sensitivity profile of extended spectrum beta-lactamase-producing Enterobacteriaceae at a tertiary hospital in Southern Brazil Major Article

    Rugini, Cristina Letícia; Sobottka, Andréa Michel; Fuentefria, Daiane Bopp

    Abstract in English:

    Abstract: INTRODUCTION: Nosocomial infections are closely associated with antimicrobial drug resistance. One of the most important mechanisms of resistance to β-lactam antibiotics is the production of extended spectrum β-lactamases (ESBLs). The objective of the present study was to evaluate the prevalence and antimicrobial susceptibility profile of ESBL-producing strains and to assess the evolution of antimicrobial drug resistance between 2007 and 2013 at the Hospital São Vicente de Paulo, Passo Fundo, State of Rio Grande do Sul, Brazil. METHODS: We conducted a descriptive, observational, cross-sectional study. Bacterial culture was performed from January to December 2013. The antimicrobial susceptibility profile of these cultures was determined using the disk diffusion method. Phenotypic screening for ESBL production was performed using the disk approximation method. RESULTS : We analyzed a total of 19,112 cultures, 11.5% of which were positive for Enterobacteriaceae. Of these, 30.3% of the isolates were positive for ESBL production, and the most prevalent species was Klebsiella sp. (37.5%). Over 95% of these isolates showed reduced susceptibility to all cephalosporins, aztreonam, and amoxicillin/clavulanic acid. The isolates also showed high sensitivity to the following antimicrobials: amikacin, meropenem, and piperacillin/tazobactam. Overall, the resistance rates among ESBL-producing Enterobacteriaceae decreased from 2007 to 2013. CONCLUSIONS : In our hospital, the increased sensitivity to certain antimicrobial agents seems to be directly related to the implementation of improvements in the methods to prevent and control nosocomial infections in addition to the natural development of other resistance mechanisms.
  • Antimicrobial resistance profiles and oxacillinase genes in carbapenem-resistant Acinetobacter baumannii isolated from hospitalized patients in Santa Catarina, Brazil Major Article

    Cortivo, Giselle Dall; Gutberlet, Andréia; Ferreira, Jéssica Augustini; Ferreira, Leslie Ecker; Deglmann, Roseneide Campos; Westphal, Glauco Adrieno; França, Paulo Henrique Condeixa de

    Abstract in English:

    Abstract: INTRODUCTION: Carbapenems are the therapy of choice for treating severe infections caused by the Acinetobacter calcoaceticus-Acinetobacter baumannii complex. We aimed to assess the prevalence and antimicrobial susceptibility profiles of producers of distinct oxacillinases among nosocomial isolates of the A. calcoaceticus-A. baumannii complex in a 249-bed general hospital located in Joinville, Southern Brazil. METHODS: Of the 139 A. baumannii clinical isolates with reduced susceptibility to carbapenems between 2010 and 2013, 118 isolates from varying anatomical sites and hospital sectors were selected for genotypic analysis. Five families of genes encoding oxacillinases, namely blaOXA-23-like, blaOXA-24-like, blaOXA-51-like, blaOXA-58-like, and blaOXA-143-like, wereinvestigated by multiplex polymerase chain reaction (PCR). RESULTS: Most (87.3%) isolates simultaneously carried the blaOXA-23-likeand blaOXA-51-likegenes, whereas three (2.5%) isolates harbored only blaOXA-51-likeones. The circulation of carbapenem-resistant isolates increased during the study period: from none in 2010, to 22 in 2011, 64 in 2012, and 53 in 2013. CONCLUSIONS: Isolates carrying the blaOXA-23-likeand blaOXA-51-likegenes were widely distributed in the hospital investigated. Because of the worsening scenario, the implementation of preventive measures and effective barriers is needed.
  • Chagas disease: morbidity profile in an endemic area of Northeastern Brazil Major Article

    Andrade, Cléber de Mesquita; Câmara, Antônia Cláudia Jácome da; Nunes, Daniela Ferreira; Guedes, Paulo Marcos da Matta; Pereira, Wogelsanger Oliveira; Chiari, Egler; Diniz, Rosiane Viana Zuza; Galvão, Lúcia Maria da Cunha

    Abstract in English:

    Abstract: INTRODUCTION : This study evaluated the clinical forms and manifestation severities of Chagas disease among serologically reactive individuals from Western Rio Grande do Norte (Northeastern Brazil). METHODS : This cross-sectional study included 186 adults who were evaluated using electrocardiography, echocardiography, chest radiography, and contrast radiography of the esophagus and colon. A clinical-epidemiological questionnaire was also used. RESULTS : The indeterminate, cardiac, digestive, and cardiodigestive clinical forms of Chagas disease were diagnosed in 51.6% (96/186), 32.2% (60/186), 8.1% (15/186) and 8.1% (15/186) of the participants, respectively. Heart failure (functional classes I-IV) was detected in 7.5% (14/186) of the participants, and 36.4% (24/66), 30.3% (20/66), 15.2% (10/66), 13.6% (9/66), and 4.5% (3/66) of the patients were at stage A, B1, B2, C, and D, respectively. Dilated cardiomyopathy and electrocardiographic changes were detected in 10.2% (19/186) and 48.1% (91/186) of the participants, respectively. Apical aneurysm was diagnosed in 10.8% (20/186) of the participants, and other changes in the segmental myocardial contractility of the left ventricle were diagnosed in 33.9% (63/186) of the participants. Megaesophagus (groups I-IV) was observed in 7% (13/186) of the participants, megacolon (grades 1-3) was detected in12.9% (24/186) of the participants, and both organs were affected in 29.2% (7/24) of the megacolon cases. CONCLUSIONS : We detected various clinical forms of Chagas disease (including the digestive form). Our findings indicate that clinical symptoms alone may not be sufficient to exclude or confirm cardiac and/or digestive damage, and the number of patients with symptomatic clinical forms may be underestimated.
  • Spatial and spatiotemporal occurrence of human visceral leishmaniasis in Adamantina, State of São Paulo, Brazil Major Article

    Cardim, Marisa Furtado Mozini; Vieira, Carolina Portugal; Chiaravalloti-Neto, Francisco

    Abstract in English:

    Abstract: INTRODUCTION : Several municipalities of the Western region of the State of São Paulo have been affected by human visceral leishmaniasis (HVL), including the City of Adamantina, where the first autochthonous cases occurred in 2004. Therefore, this study aimed to describe the spatial and spatiotemporal occurrence of HVL in Adamantina. METHODS : Secondary data regarding the occurrence of HVL in Adamantina between 2004 and 2011 were used. Incidence, mortality, and case fatality rates were calculated. We used local empirical Bayesian incidence rates to represent the occurrence of the disease in the census sector of the city. The existence of spatial and spatiotemporal clusters of cases was evaluated using scan statistics. In situ observation was performed to assess the socioeconomic and environmental characteristics of the areas with medium and high incidences. RESULTS : Adamantina reported cases in 70% of its census sectors. No differences were observed between sexes. The group aged 0-4 years presented the highest incidence and mortality rates, and the group aged 40-59 years presented the highest fatality rate. We detected a spatiotemporal cluster, which coincided with the commencement of the endemic in the city. CONCLUSIONS : The individuals most affected by the disease were children. The disease was present in areas with better and worse socioeconomic conditions. The use of spatial analysis techniques was important to achieve the study objectives.
  • Diagnosis of latent Mycobacterium tuberculosis infection: tuberculin test versus interferon-gamma release Major Article

    Ferreira, Thaís Furtado; Matsuoka, Pollyanna da Fonseca Silva; Santos, Alcione Miranda dos; Caldas, Arlene de Jesus Mendes

    Abstract in English:

    Abstract: INTRODUCTION: The treatment of individuals with active tuberculosis (TB) and the identification and treatment of latent tuberculosis infection (LTBI) contacts are the two most important strategies for the control of TB. The objective of this study was compare the performance of tuberculin skin testing (TST) with QuantiFERON-TB Gold In TUBE(r) in the diagnosis of LTBI in contacts of patients with active TB. METHODS: Cross-sectional analytical study with 60 contacts of patients with active pulmonary TB. A blood sample of each contact was taken for interferon-gamma release assay (IGRA) and subsequently performed the TST. A receiver operating characteristic curve was generated to assess the cutoff points and the sensitivity, predictive values, and accuracy were calculated. The agreement between IGRA and TST results was evaluated by Kappa coefficient. RESULTS: Here, 67.9% sensitivity, 84.4% specificity, 79.1% PPV, 75% NPV, and 76.7% accuracy were observed for the 5mm cutoff point. The prevalence of LTBI determined by TST and IGRA was 40% and 46.7%, respectively. CONCLUSIONS: Both QuantiFERON-TB Gold In TUBE(r) and TST showed good performance in LTBI diagnosis. The creation of specific diagnostic methods is necessary for the diagnosis of LTBI with higher sensitivity and specificity, preferably with low cost and not require a return visit for reading because with early treatment of latent forms can prevent active TB.
  • Single-tube nested PCR assay with in-house DNA extraction for Mycobacterium tuberculosis detection in blood and urine Major Article

    Lima, Juliana Figueirêdo da Costa; Guedes, Gabriela de Moraes Rêgo; Lima, Juliana Falcão de Araújo; Lira, Laís Ariane de Siqueira; Santos, Fabiana Cristina Fulco; Arruda, Mercia Eliane de; Montenegro, Lílian Maria Lapa; Schindler, Haiana Charifker

    Abstract in English:

    Abstract: INTRODUCTION : Molecular analyses are auxiliary tools for detecting Koch's bacilli in clinical specimens from patients with suspected tuberculosis (TB). However, there are still no efficient diagnostic tests that combine high sensitivity and specificity and yield rapid results in the detection of TB. This study evaluated single-tube nested polymerase chain reaction (STNPCR) as a molecular diagnostic test with low risk of cross contamination for detecting Mycobacterium tuberculosis in clinical samples. METHODS: Mycobacterium tuberculosis deoxyribonucleic acid (DNA) was detected in blood and urine samples by STNPCR followed by agarose gel electrophoresis. In this system, reaction tubes were not opened between the two stages of PCR (simple and nested). RESULTS: STNPCR demonstrated good accuracy in clinical samples with no cross contamination between microtubes. Sensitivity in blood and urine, analyzed in parallel, was 35%-62% for pulmonary and 41%-72% for extrapulmonary TB. The specificity of STNPCR was 100% in most analyses, depending on the type of clinical sample (blood or urine) and clinical form of disease (pulmonary or extrapulmonary). CONCLUSIONS: STNPCR was effective in detecting TB, especially the extrapulmonary form for which sensitivity was higher, and had the advantage of less invasive sample collection from patients for whom a spontaneous sputum sample was unavailable. With low risk of cross contamination, the STNPCR can be used as an adjunct to conventional methods for diagnosing TB.
  • Risk-benefit assessment of Bacillus Calmette-Guérin vaccination, anti-phenolic glycolipid I serology, and Mitsuda test response: 10-year follow-up of household contacts of leprosy patients Major Article

    Araujo, Sergio; Rezende, Marina Monteiro Figueiredo; Sousa, Diogo Carrijo Rodrigues de; Rosa, Maraísa Resende; Santos, Danielle Cristina dos; Goulart, Luiz Ricardo; Goulart, Isabela Maria Bernardes

    Abstract in English:

    Abstract: INTRODUCTION: Despite multidrug therapy, leprosy remains a public health issue. The intradermal Bacillus Calmette-Guérin (BCG) vaccine, Mitsuda test (lepromin skin test), and anti-phenolic glycolipid I (PGL-I) serology are widely used in leprosy studies and have shown great epidemiological value. METHODS: This longitudinal study evaluated the relative risks and benefits of these three tools by comparing results observed in household contacts (HHCs) of leprosy patients who developed leprosy with those of HHCs who did not in a population of 2,992 individuals monitored during a 10-year period. RESULTS : Seventy-five (2.5%) new leprosy cases were diagnosed, including 28 (0.9%) co-prevalent cases. Therefore, for the risk-benefit assessment, 47 (1.6%) HHCs were considered as truly diagnosed during follow-up. The comparison between healthy and affected contacts demonstrated that not only did BCG vaccination increase protection, but boosters also increased to 95% relative risk (RR) reduction when results for having two or more scars were compared with having no scars [RR, 0.0459; 95% confidence interval (CI), 0.006-0.338]. Similarly, Mitsuda reactions >7mm in induration presented 7-fold greater protection against disease development compared to reactions of 0-3mm (RR, 0.1446; 95% CI, 0.0566-0.3696). In contrast, anti-PGL-I ELISA seropositivity indicated a 5-fold RR increase for disease outcome (RR, 5.688; 95% CI, 3.2412-9.9824). The combined effect of no BCG scars, Mitsuda reaction of <7mm, and seropositivity to anti-PGL-I increased the risk for leprosy onset 8-fold (RR, 8.109; 95% CI, 5.1167-12.8511). CONCLUSIONS: The adoption of these combined assays may impose measures for leprosy control strategies.
  • Chemical composition and antifungal activity of essential oil from Eucalyptus smithii against dermatophytes Major Article

    Baptista, Edilene Bolutari; Zimmermann-Franco, Danielle Cristina; Lataliza, Alexandre Augusto Barros; Raposo, Nádia Rezende Barbosa

    Abstract in English:

    ABSTRACT INTRODUCTION: In this study, we evaluated the chemical composition of a commercial sample of essential oil from Eucalyptus smithii R.T. Baker and its antifungal activity against Microsporum canis ATCC 32903, Microsporum gypseum ATCC 14683, Trichophyton mentagrophytes ATCC 9533, T. mentagrophytes ATCC 11480, T. mentagrophytes ATCC 11481, and Trichophyton rubrum CCT 5507. METHODS: Morphological changes in these fungi after treatment with the oil were determined by scanning electron microscopy (SEM). The antifungal activity of the oil was determined on the basis of minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) values. RESULTS: The compound 1,8-cineole was found to be the predominant component (72.2%) of the essential oil. The MIC values of the oil ranged from 62.5μg·mL−1 to >1,000μg·mL−1, and the MFC values of the oil ranged from 125μg·mL−1 to >1,000μg·mL−1. SEM analysis showed physical damage and morphological alterations in the fungi exposed to this oil. CONCLUSIONS: We demonstrated the potential of Eucalyptus smithii essential oil as a natural therapeutic agent for the treatment of dermatophytosis.
  • Emergent and re-emergent parasites in HIV-infected children: immunological and socio-environmental conditions that are involved in the transmission of Giardia spp. and Cryptosporidium spp. Short Communication

    Fregonesi, Brisa Maria; Suzuki, Meire Nikaido; Machado, Carolina Sampaio; Tonani, Karina Aparecida de Abreu; Fernandes, Ana Paula Morais; Monroe, Aline Aparecida; Cervi, Maria Célia; Segura-Muñoz, Susana

    Abstract in English:

    ABSTRACT INTRODUCTION: Emergent and re-emergent waterborne protozoans have become a worldwide public health problem, especially among vulnerable groups. METHODS: This cross-sectional study evaluated 17 HIV-infected children and their families. RESULTS: A high (76.5%) percentage of parasite-infected children was observed, even among children with CD4+ T-cell counts of >200 cells/mm3. Giardia spp., Cryptosporidium spp. and Cyclospora spp. were observed in 41.2% of these children Low income, poor hygiene practices, and co-infection in domestic, peridomestic and scholastic environments were significant sources of these intestinal infections. CONCLUSIONS: Early diagnosis, timely treatment, and socio-educational interventions may improve the health conditions of this vulnerable population.
  • Are lipid disorders involved in the predominance of human T-lymphotropic virus-1 infections in women? Short Communication

    Carvalho, Luciana Debortoli de; Gadelha, Sandra Rocha; Marin, Lauro Juliano; Brito-Melo, Gustavo Eustaquio Alvim; Martins, Camila Pacheco Silveira; Fonseca, Flavio Guimarães da; Barbosa-Stancioli, Edel Figueiredo

    Abstract in English:

    Abstract INTRODUCTION : The human T-lymphotropic virus-1 (HTLV-1) is associated with chronic inflammatory diseases such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a chronic inflammatory disease. Disturbances in lipid metabolism are involved in inflammatory and demyelinating diseases. METHODS : Plasma levels of triglycerides, total cholesterol, and fractions of HTLV-1-infected individuals of both sexes with different clinical progressions were determined. RESULTS : Elevated levels of triglyceride and very low-density lipoproteins (VLDL) were exclusively detected in HTLV-1-infected women from asymptomatic and HAM/TSP groups compared with uninfected individuals (p = 0.02). CONCLUSIONS : Elevated triglyceride and VLDL levels in HTLV-1-infected women may be related to the predominance of HAM/TSP in women.
  • Performance of direct immunofluorescence assay for the detection of human metapneumovirus under clinical laboratory settings Short Communication

    Wolf, Jonas Michel; Gregianini, Tatiana Schäffer; Seadi, Claudete Maria Farina; Tumioto, Gabriela Luchiari; Dambrós, Bibiana Paula; Lehmann, Fernanda Kieling Moreira; Carli, Silvia De; Ikuta, Nilo; Lunge, Vagner Ricardo

    Abstract in English:

    ABSTRACT INTRODUCTION: Human metapneumovirus (hMPV) is an emergent human respiratory pathogen. This study aimed to evaluate the performance of direct immunofluorescence (DIF) to detect hMPV in a clinical laboratory setting. METHODS: Nasopharyngeal aspirate samples (448) of children and adults with respiratory illness were used to detect hMPV by using DIF and real time quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assays. RESULTS: In all, 36 (8%) samples were positive by DIF and 94 (21%) were positive by qRT-PCR. Direct immunofluorescence specificity was 99% and sensitivity was 38%. CONCLUSIONS: DIF is not very sensitive under clinical laboratory settings.
  • Anopheles darlingi and Anopheles marajoara (Diptera: Culicidae) susceptibility to pyrethroids in an endemic area of the Brazilian Amazon Short Communication

    Galardo, Allan Kardec Ribeiro; Póvoa, Marinete Marins; Sucupira, Izis Monica Carvalho; Galardo, Clícia Denis; Santos, Roseli La Corte dos

    Abstract in English:

    Abstract: INTRODUCTION: This study aimed to evaluate the susceptibility of Anopheles darlingi Root (1926) and Anopheles marajoara Galvão & Damasceno (1942) to pyrethroids used by the National Malaria Control Program in Brazil. METHODS: Mosquitoes from Amapá, Brazilian Amazon, were assessed for resistance to cypermethrin, deltamethrin, and alpha-cypermethrin. Insecticide-impregnated bottles were used as suggested by the CDC/Atlanta. RESULTS: Diagnostic dose for Anopheles darlingi was 12.5µg/bottle during 30 min of exposure. Concentrations for Anopheles marajoara were 20µg/bottle of cypermethrin and deltamethrin and 12.5µg/bottle of alpha-cypermethrin. CONCLUSIONS : No resistance was recorded for Anopheles darlingi , but Anopheles marajoara requires attention.
  • Aedes aegypti eggs oviposited on water surface collected from field ovitraps in Nova Iguaçu City, Brazil Short Communication

    Wermelinger, Eduardo Dias; Ferreira, Aldo Pacheco; Carvalho, Raimundo Wilson de; Silva, Adriano Anselmo da; Benigno, Ciro Villanova

    Abstract in English:

    ABSTRACT INTRODUCTION: Aedes aegypti eggs can be collected from the water surface. METHODS: Aedes aegypti oviposition from 97 field ovitraps was studied. RESULTS: Of the 16,016 eggs collected, 11,439 were obtained from paddles in ovitraps and 4,577 from water. Further, 89 (91.8%) traps contained eggs on water and 22 (22.7%) traps contained eggs only on water. CONCLUSIONS: In field traps, Aedes aegypti females usually oviposit some eggs on water surface suggesting that they might also oviposit on water of some natural breeding, and this possibility needs to be investigated. Eggs oviposited on water need to be considered for collecting trap data.
  • Risk factors for Toxoplasma gondii infection among pregnant women from the State of Tocantins, Northern Brazil Short Communication

    Rocha, Élvio Machado da; Lopes, Carlos Wilson Gomes; Ramos, Rafael Antonio Nascimento; Alves, Leucio Câmara

    Abstract in English:

    ABSTRACT INTRODUCTION: The prevalence of infection by Toxoplasma gondii and associated risk factors in pregnant women in Tocantins, Northern Brazil were assessed. METHODS: Serological analysis was performed in 338 serum samples and an oral questionnaire was utilized to identify potential risk factors. RESULTS: Anti-IgG antibodies against T. gondii were detected in 71% (240/338) of the pregnant women. Prior contact with cats and meat handling were found to be associated with T. gondii infection. CONCLUSIONS: A considerable percentage (29%) of women living in the Tocantins area remain susceptible to infection by the T. gondii protozoon, representing a serious public health risk.
  • Molecular detection of Trypanosoma sp. and Blastocrithidia sp. (Trypanosomatidae) in phlebotomine sand flies (Psychodidae) in the Federal District of Brazil Short Communication

    Ferreira, Tauana de Sousa; Minuzzi-Souza, Thaís Tâmara Castro; Andrade, Andrey José de; Coelho, Thais Oliveira; Rocha, Douglas de Almeida; Obara, Marcos Takashi; Hecht, Mariana; Nitz, Nadjar; Gurgel-Gonçalves, Rodrigo

    Abstract in English:

    Abstract: INTRODUCTION : This study describes the occurrence of trypanosomatids in phlebotomines in Brasília, Brazil. METHODS : Two hundred and ten females of 13 sand fly species were analyzed by polymerase chain reaction (PCR) using different molecular markers (D7 24Sα rRNA, kDNA, and ITS1) and sequencing. RESULTS : PCR revealed trypanosomatid-positive samples from Nyssomyia whitmani and Evandromyia evandroi, which were negative by kDNA and ITS1 Leishmania-specific PCRs. DNA sequence analysis of D7 24Sα rRNA amplicons indicated the occurrence of Blastocrithidia sp. and Trypanosoma sp. in Nyssomyia whitmani and Evandromyia evandroi, respectively. CONCLUSIONS : Two trypanosomatid species other than Leishmania sp. were found to circulate in sand flies in Central Brazil.
  • First report of schistosomiasis on Serrambi beach, Ipojuca, State of Pernambuco Short Communication

    Barbosa, Verônica Santos; Guimarães, Ricardo José de Paula Souza e; Loyo, Rodrigo Moraes; Marcelino, Silas; Barbosa, Constança Simões

    Abstract in English:

    Abstract: INTRODUCTION : The expansion of schistosomiasis to previously unaffected areas is being monitored by identifying new cases and georeferencing outbreaks of vector snails. METHODS : In 2014, the Laboratório de Esquistossomose began an epidemiological survey in Serrambi and registered 2,574 people living there. RESULTS : Of these subjects, 1,414 (54.9%) underwent feces examination and 63 (4.5%) were diagnosed with Schistosoma mansoni infection. At this locality, seven breeding sites each were identified for Biomphalaria straminea and Biomphalaria glabrata. At two sites, B. glabrata were shedding cercariae. CONCLUSIONS : Implementing preventive measures is necessary to avoid the establishment of schistosomiasis in yet another tourist locality, Pernambuco.
  • Severe dengue in the early postoperative period after kidney transplantation: two case reports from Hospital Geral de Fortaleza Case Report

    Maia, Samuelson Hugo Félix; Brasil, Ivelise Regina Canito; Esmeraldo, Ronaldo De Matos; Ponte, Carlos Nelton Da; Costa, Rebeca Carvalho Souza; Lira, Roberta Alves

    Abstract in English:

    Abstract: Dengue is an arbovirosis that ranges from an asymptomatic presentation to a more severe disease, which is characterized by a vascular leakage syndrome where abdominal pain is a major symptom. Transplant recipients are immunosuppressed and are less likely to develop a severe form of the disease because of a reduction in immune-mediated responses that trigger plasma extravasation events. Herein, we report two cases of severe dengue in the early postoperative period of two kidney transplant recipients. Considering the severity of the cases, we emphasize the importance of dengue screening immediately before transplantation in areas endemic for the disease.
  • Dermatitis caused by the tropical fowl mite Ornithonyssus bursa (Berlese) (Acari: Macronyssidae): a case report in humans Case Report

    Mentz, Márcia Bohrer; Silva, Guilherme Liberato da; Silva, Carlos Eugênio

    Abstract in English:

    Abstract: We herein report human dermatitis caused by the tropical fowl mite Ornithonyssus bursa (Berlese). The cases occurred in an apartment in a residential district of Porto Alegre City, State of Rio Grande do Sul, Brazil, where three members of the same family presented with pruritic lesions on the arms and legs. On inspecting the bathroom, several mites measuring approximately 1.0mm in length were observed coming from a nest of Rufous Hornero, Furnarius rufus (Gmelin). This is the first report of O. bursa in the urban area of Porto Alegre City, from a nest of F. rufus that bites humans.
  • Concomitant pulmonary and central nervous system paracoccidioidomycosis with cerebellar abscess Images in Infectious Diseases

    Abud, Lucas Giansante; Queiroz, Rodolfo Mendes; Abud, Thiago Giansante
Sociedade Brasileira de Medicina Tropical - SBMT Caixa Postal 118, 38001-970 Uberaba MG Brazil, Tel.: +55 34 3318-5255 / +55 34 3318-5636/ +55 34 3318-5287, http://rsbmt.org.br/ - Uberaba - MG - Brazil
E-mail: rsbmt@uftm.edu.br