Exposure to Treponema pallidum Infection among Adolescent and Young Adult Women in Roraima, Amazon Region of Brazil.

BACKGROUND: Syphilis is a chronic infectious disease, and its prevalence has been described since the 15th century. Because of the high prevalence of this infection in Brazil, this study aimed to evaluate the prevalence of syphilis and its associated factors among adolescent and young women living in the city of Boa Vista, Roraima, Brazil. METHODS: The present study was cross-sectional, descriptive, analytical and quantitative. It involved 200 young and adolescent women. Laboratory tests were performed to diagnose syphilis, and a sociodemographic and epidemiological questionnaire was employed. RESULTS: In the studied sample, 10 women had a positive result for syphilis, characterizing a prevalence of 5% for infection with Treponema pallidum. There was a statistically significant association between a monthly family income of less than 1 minimum wage and syphilis (p = 0.0449) and between illicit drug use and syphilis (p = 0.0234). CONCLUSIONS: These results indicate the need for public health interventions, action plans, and the implementation of risk reduction strategies focused on this population.

Expression of NLRP3 inflammasome in leprosy indicates immune evasion of Mycobacterium leprae.

BACKGROUND: Leprosy is an infectious-contagious disease caused by Mycobacterium leprae that remain endemic in 105 countries. This neglected disease has a wide range of clinical and histopathological manifestations that are related to the host inflammatory and immune responses. More recently, the inflammasome has assumed a relevant role in the inflammatory response against microbiological agents. However, the involvement of inflammasome in leprosy remains poorly understood. OBJECTIVES: The aim is to associate biomarkers of inflammasome with the different immunopathological forms of leprosy. METHODS: We performed an observational, cross-sectional, and comparative study of the immunophenotypic expression of inflammasome-associated proteins in immunopathological forms of leprosy of 99 skin lesion samples by immunohistochemistry. The intensity and percentage of NLRP3, Caspase-1, Caspases-4/5, interleukin-1ß and interleukin-18 immunoreactivities in the inflammatory infiltrate of skin biopsies were evaluated. FINDINGS: Strong expression of NLRP3 and inflammatory Caspases-4/5 were observed in lepromatous leprosy (lepromatous pole). In addition, were observed low expression of caspase-1, interleukin-1ß, and interleukin-18 in tuberculoid and lepromatous leprosy. The interpolar or borderline form showed immunophenotype predominantly similar to the lepromatous pole. MAIN CONCLUSIONS: Our results demonstrate that the NLRP3 inflammasome is inactive in leprosy, suggesting immune evasion of M. leprae.

A randomized trial of nebulized 3% hypertonic saline with salbutamol in the treatment of acute bronchiolitis in hospitalized infants.

OBJECTIVE: Acute bronchiolitis is a common disorder of infants that often results in hospitalization. Apart from supportive care, no therapy has been shown to influence the course of the disease, except for a possible effect of nebulized hypertonic saline (HS). To determine whether this does have beneficial effects on length of stay in hospital or on severity scores, we undertook a double-blind, randomized, controlled trial in a pediatric department of a Portuguese hospital. METHODS: Previously healthy infants, younger than 12 months, hospitalized with mild-to-moderate acute viral bronchiolitis were randomized to receive either nebulized 3% (hypertonic, HS) or 0.9% (normal, NS) saline during their entire hospital stay. Primary endpoints were: length of hospital stay and severity scores on each day of hospitalization. Need for supplemental oxygen, further add-on medications and adverse effects were also analyzed. RESULTS: Sixty-eight patients completed the study (HS: 33; NS: 35). The median length of hospital stay did not differ between groups: HS: 5.6 ± 2.3 days; NS: 5.4 ± 2.1 days (P = 0.747). We found no difference between groups in severity scores from day 1 to day 4. There were no differences in need for supplemental oxygen or add-on medications. Patients in HS group had significantly more cough (46% vs. 20%, P = 0.025) and rhinorrhoe (58% vs. 31%, P = 0.30). CONCLUSION: This study does not support the use of nebulized HS over NS in therapy of hospitalized children with mild-to-moderate acute viral bronchiolitis.

Tuberculose endobrônquica simulando neoplasia: relato de caso / Endobronchial tuberculosis simulating neoplasm: case report

Tuberculose endobrônquica (TE) é definida como uma inflamação específica da árvore traqueobrônquica causada pelo bacilo da tuberculose (TB) e se desenvolve como complicação dessa doença. Trata-se de entidade patológica de curso clínico variável e com peculiaridades em relação ao seu tratamento e suas complicações. O objetivo deste estudo foi descrever um caso de tuberculose endobrônquica cujas manifestações broncoscópicas assemelhavam-se a neoplasia pulmonar, além de permitir revisão bibliográfica sobre o tema. Paciente do sexo masculino, 65 anos,casado, lavrador, apresentando tosse com expectoração do tipomucosa, dispneia, perda ponderal, astenia e hiporexia, além de quadro mal especificado de disfagia, principalmente para sólidos.Apresentou, em radiografia de tórax, moderado derrame pleural em hemitórax esquerdo e infiltrado pulmonar com padrão acinar bilateralmente. Tabagista em abstinência. Etilismo crônico.À fibrobroncoscopia: lesão vegetante em brônquio principal esquerdo sugerindo câncer de esôfago invasivo e lesão em traqueia.Endoscopia digestiva alta sem alterações. Biópsias de traqueia e brônquio esquerdo mostrando processo inflamatório crônico granulomatoso com necrose de caseificação, sugestivo de bacilo da tuberculose. Foi iniciado esquema padrão para tratamento de bacilo da tuberculose pulmonar, com melhora gradativa dos sintomas.A tuberculose endobrônquica pode ser encontrada relacionada à forma pulmonar do bacilo da tuberculose, e os achados clínicos podem variar de inespecíficos a intensas manifestações de obstrução das vias aéreas secundária a estenose brônquica. É preciso que o profissional de saúde esteja atento à investigação de disfagia e que não se esqueça de colocar a tuberculose endobrônquica como diagnóstico diferencial entre as disfagias associadas a sintomas respiratórios.

Endobronchial tuberculosis (ET) is defined as a specific inflammation of the tracheobronchial tree caused by the tuberculosis bacillus, and develops as a complication of this disease. It is a disease entity with variable clinical course and some peculiarities regarding its treatment and complications. The objective of this study was to describe a case of endobronchial tuberculosis whose bronchoscopic manifestations resembled lung cancer, and to allow a review of the literature on the subject. Male patient, 65 years old, married, farmer, showing cough with mucus, dyspnea, weight loss, asthenia and hyporexia,as well as a poorly specified case of dysphagia, especially for solids. On chest radiograph he showed moderate pleural effusion in the left hemithorax and pulmonary infiltrate with acinar pattern bilaterally. Smoker in abstinence. Chronic alcoholism. In fiberoptic bronchoscopy: a vegetative lesion in the left main bronchus suggesting invasive cancer of the esophagus and lesion on trachea. No alterations at upper endoscopy. Biopsies of the trachea and left bronchus showing chronic granulomatous inflammatory process with caseous necrosis, suggestive of tuberculosis. Standard regimen was initiated for the treatment of pulmonary tuberculosis, with gradual improvement of symptoms. Endobronchial tuberculosis can be found related to the pulmonary form of tuberculosis, and clinical findings can vary from nonspecific to severe manifestations of airway obstruction secondary to bronchial stenosis. It is necessary that health professionals are aware of the investigation of dysphagia and do not forget to put endobronchial tuberculosis as a differential diagnosis among dysphagias associated with respiratory symptoms.