Multicenter, International Study of MIC/MEC Distributions for Definition of Epidemiological Cutoff Values for Sporothrix Species Identified by Molecular Methods.

Clinical and Laboratory Standards Institute (CLSI) conditions for testing the susceptibilities of pathogenic Sporothrix species to antifungal agents are based on a collaborative study that evaluated five clinically relevant isolates of Sporothrixschenckii sensu lato and some antifungal agents. With the advent of molecular identification, there are two basic needs: to confirm the suitability of these testing conditions for all agents and Sporothrix species and to establish species-specific epidemiologic cutoff values (ECVs) or breakpoints (BPs) for the species. We collected available CLSI MICs/minimal effective concentrations (MECs) of amphotericin B, five triazoles, terbinafine, flucytosine, and caspofungin for 301 Sporothrix schenckii sensu stricto, 486 S. brasiliensis, 75 S. globosa, and 13 S. mexicana molecularly identified isolates. Data were obtained in 17 independent laboratories (Australia, Europe, India, South Africa, and South and North America) using conidial inoculum suspensions and 48 to 72 h of incubation at 35°C. Sufficient and suitable data (modal MICs within 2-fold concentrations) allowed the proposal of the following ECVs for S. schenckii and S. brasiliensis, respectively: amphotericin B, 4 and 4 µg/ml; itraconazole, 2 and 2 µg/ml; posaconazole, 2 and 2 µg/ml; and voriconazole, 64 and 32 µg/ml. Ketoconazole and terbinafine ECVs for S. brasiliensis were 2 and 0.12 µg/ml, respectively. Insufficient or unsuitable data precluded the calculation of ketoconazole and terbinafine (or any other antifungal agent) ECVs for S. schenckii, as well as ECVs for S. globosa and S. mexicana These ECVs could aid the clinician in identifying potentially resistant isolates (non-wild type) less likely to respond to therapy.

Crystallinity, thermal and pasting properties of starches from different potato cultivars grown in Brazil.

Starches from different potato cultivars were characterized as amylose and phosphorus content, crystallinity, thermal and paste properties. Statistical analysis of amylose content showed difference between starches samples and the cultivars Asterix and BRS Clara showed higher contents than others. Phosphorus content ranged from 633 to 966.7 mg kg(-1). The X-ray diffraction analysis showed that the crystallization of potato starches can be classified as B-type X-ray pattern, presenting crystallinity index ranging from 20.02% to 21.59%. Regarding thermal properties, the onset temperature did not show statistical difference between starch samples, in gelatinization and retrogradation analysis. As expected there was a significant decrease in peak temperature and enthalpy after the retrogradation of starches. For the pasting properties results showed significant difference in all cultivars. Pearson correlation coefficients showed that amylose content was negatively correlated to the onset, peak and final temperature of gelatinization, final temperature of retrogradation and pasting temperature. Phosphorus content was positively correlated to crystallinity index, peak viscosity and breakdown. Starches extracted from potato varieties showed different characteristics which can be useful to food and related industries that make use of potato starch, allowing wide options of use in various sectors of industrial application in Brazil.

Host-Parasite Relationship of Ticks (Acari: Ixodidae and Argasidae) and Feral Pigs (Sus scrofa) in the Nhecolândia Region of the Pantanal Wetlands in Mato Grosso do Sul.

Feral pigs (S. scrofa) were introduced to the Pantanal region around 200 years ago and the population appears to be in expansion. Its eradication is considered to be impossible. The population of feral pigs in the Pantanal wetlands is currently estimated at one million. Two scientific excursions were organized. The first was conducted during the dry season, when 21 feral pigs were captured and the second was during the wet season, when 23 feral pigs were captured. Ticks were collected and the oviposition and hatching process were studied to confirm the biological success of each tick species. Three tick species were found to be feeding on feral pigs: Amblyomma cajennense, A. parvum, and Ornithodoros rostratus. During the dry season, 178 adult A. cajennense were collected, contrasting with 127 A. cajennense specimens in the wet season. This suggests that the seasonality of these ticks in the Brazilian Pantanal wetlands could be different from other regions. The results indicate that A. parvum and A. cajennense are biologically successful parasites in relation to feral pigs. A. cajennense appears to have adapted to this tick-host relationship, as well as the areas where feral pigs are abundant, and could play a role in the amplification of this tick population.

[Neuropsychology of primary progressive multiple sclerosis]. / Neuropsicología de la esclerosis múltiple primaria progresiva.

INTRODUCTION: Cognitive impairment is a symptom of multiple sclerosis (MS); however, in the primary progressive form of the disease (PPMS), data on the prevalence and type of cognitive impairment are controversial. AIM: To evaluate the frequency of cognitive impairment, according to the diagnostic criteria defined by Thompson, in Brazilian patients with PPMS attending a referral center for the treatment of MS in Rio de Janeiro, Brazil. SUBJECTS AND METHODS: A battery of neuropsychological tests was used to evaluate the following cognitive functions: screening for dementia, attention/concentration, speed of information processing, verbal fluency, memory and abstract/conceptual thought. The Beck scale was used to evaluate mood disorders. Twenty-six patients with PPMS and 26 controls paired for gender, age and education level were evaluated. Statistical analysis was based on the study performed by Rao. RESULTS: The frequency of cognitive impairment in the PPMS patients in the present study was 50%. The cognitive functions most affected were: recent memory (60%), verbal fluency (40%) and speed of information processing (40%). Depression was more common in the PPMS patients compared to the control group; however, no association was found between cognitive impairment and depression. CONCLUSION: These results confirm the presence of cognitive impairment in PPMS and emphasize the need for further studies with larger sample sizes.

Occurrence of Antibodies to Paracoccidioides brasiliensis in dairy cattle from Mato Grosso do Sul, Brazil.

The aim of this study was to evaluate the humoral immune response in cattle immunized with Paracoccidioides brasiliensis and perform a seroepidemiological study of paracoccidioidomycosis in dairy cattle from Mato Grosso do Sul. Two animals (one steer and one heifer) were inoculated with a suspension of P. brasiliensis in Freund incomplete adjuvant. Blood samples were collected periodically to evaluate humoral immune response by immunodiffusion and ELISA, using exoantigen and gp43 as antigens, respectively. The antibody production was detected by immunodiffusion and ELISA, in both animals, 14 days after immunization. The soroepidemiologic study was carried out in 400 cattle of Mato Grosso do Sul from four municipalities: Corumbá, Dourados, Nova Andradina, and São Gabriel d'Oeste. The municipalities of Corumbá (30%) and Nova Andradina (28%) showed higher positivity than Dourados (8%) and São Gabriel d'Oeste (4%). In this study we concluded that cattle immunized with P. brasiliensis develop humoral immune response for gp43, remaining with high titers of antibodies, and that this animal species could be an epidemiologic marker of paracoccidioidomycosis.

The fabella: a forgotten source of knee pain?

We present a case of chondromalacia of the fabella, describe a provocative diagnostic test and review the literature on this unusual cause of knee pain.

Survival and Histopathological Study of Animals Bearing Ehrlich Tumor Treated With a Rhodium(II) Amidate.

The survival of 90% of a tumor-bearing population treated with the complex Rh(2) (CF(3)CONH)(4) was examined and the pharmacological parameter Surv(90) determined. Histopathological alterations raised for this drug in several tissues were studied in Balb-c mice. A Surv(90) dose of 3.8x 10(-5) mol/kg was found.

Association of Epstein-Barr virus with pediatric Hodgkin's disease.

A bimodal age incidence curve has been shown for Hodgkin's disease (HD). In developing countries, the first age incidence peak occurs in childhood; however, this peak is delayed until young adulthood in developed countries. This difference may reflect differences in the age of exposure to infectious agents involved in the development of HD or may suggest different etiological agents. Epstein-Barr virus (EBV) has been implicated in the pathogenesis of a proportion of HD cases. In this study, EBV association was investigated in a series of 55 pediatric HD cases from three geographical locations (United Kingdom, Brazil, and Saudi Arabia) and the relationship between country, age, sex, histological subtype, and EBV positivity was evaluated. EBV was detected in 38 cases using RNA in situ hybridization, Southern blot, or immunohistochemical analysis. No significant difference in EBV positivity by country, age, or sex was observed; however, children under 10 years of age were particularly likely to be EBV-associated. The difference in EBV association in the pediatric group compared with that observed previously for young adult HD was highly statistically significant (P < 0.0001). These results are consistent with the hypothesis that pediatric and young adult HD have different etiologies and suggest that EBV is likely to be involved in the pathogenesis of pediatric HD.

[Paracoccidioides brasiliensis (Lutz, 1908) isolated by hemoculture in a patient with the acquired immunodeficiency syndrome (AIDS)]. / Paracoccidiodes brasiliensis (Lutz, 1908) isolado por meio de hemocultura em um paciente portador de síndrome de imunodeficiência adquirida (SIDA).

A case of an AIDS patient with positive blood culture for Paracoccidiodes brasiliensis is reported. The patient was a 29-years-old male born in Nova Londrina (Paraná State, Brazil) who presented splenomegaly and fever of unknown origin. Three blood cultures were performed, each one of them for aerobic bacteria, mycobacteria and fungi. Cultures for aerobic bacteria and mycobacteria were negative. However, the yeast phase P. brasiliensis was isolated from two cultures in BHI agar, 20 days after inoculation in Negroni medium. The patient was classified in group V according to the Centers for Disease Control (CDC) criteria for AIDS, due to a Pneumocystis carinii pneumonia. Treatment was discontinued due to an individual decision of the patient on the second dose of amphotericin B. This antibiotic was replaced by ketoconazole in the daily dose of 800 mg. The patient died one year after the isolation of P. brasiliensis on blood culture.

Histopathology of lymphoid organs in experimental leishmaniasis.

Hamsters (Mesocricetus auratus) were inoculated with L. (L.) chagasi and killed on days 7, 15, 30, 45 and 60 after infection. The lymphoid organs developed initial proliferation of the B lymphocyte zone with recovery by the 60th day group when pyroninophilic cells were prominent. The T lymphocyte area showed a progressive selective decrease of lymphocytes and cellular density with cellular pleomorphism including macrophages, plasma cells and reticular cells. The mean volume of the white pulp increased with the lymphoid follicle hyperplasia but returned to its initial level by day 60. The main red pulp change was marked hyperplasia of the phagocytic mononuclear cells containing parasites from the 30th day of infection onward. These changes are compatible with the humoral and cellular immunoresponse found in patients with visceral leishmaniasis (VL).

Familial osteochondritis dissecans.

Two examples of familial osteochondritis dissecans are described, one affecting a mother and daughter and the other a father and son. The mother and daughter both have genu valgum and are short statured. This combination of features has not been reported previously. Radiographs of lesions affecting knee, elbow, hip and ankle joints demonstrate the wide spectrum of radiological abnormality that can occur in this condition.

The management of intussusception.

A scheme of management to achieve maximum success in hydrostatic reduction of intussusception is presented. This takes into account patient selection, radiological technique and the follow-up clinical assessment. By standardizing the management we have increased our success rate and avoided laparotomy in 64% of our patients. Most of the patients in whom the technique failed had infarcted bowel which required resection.

Unilateral pulmonary blood flow loss in a young patient.

A case of total unilateral loss of pulmonary perfusion with almost normal ventilation, in a 21-year-old male patient is described, and the problem of interpretation in an asymptomatic patient is illustrated.

[Dermatitis herpetiformis and systemic lupus erythematosus]. / Dermatite herpetiforme e lupus eritematoso sistêmico.

A case of Dühring-Brocq with high titres of ANA is reported. It was not possible to demonstrate a SLE. The associations DH-SLE, blistering diseases-SLE, ANA-DH are reviewed.