Unusual case of lagochilascariasis with breast involvement: the first case report in pregnancy.

Lagochilascariasis is a neglected neotropical helminthiasis, responsible for human infections through the ingestion of raw or undercooked meat from wild animals infected by larvae encysted in their tissues. It is characterized by a chronic evolution with periods of remission and recurrences, affecting mainly the head and neck regions. It can progress to death by invasion of the central nervous system. It is caused by the Lagochilascaris minor nematode, first described in 1909 and mainly found in the Brazilian Amazon ecosystem, notably in Para State. In May 2010, a 15-year-old female, born in the city of Aveiro, Para State, was hospitalized in the city of Santarem, Para State, presenting with cervical and spinal abscesses and osteolytic lesions at T3-T5 level. During hospitalization, white larvae identified as L. minor were observed in a cervical subcutaneous fistula. After the surgical drainage of abscesses, albendazole 400 mg/day was started, with improvement of symptoms. The patient abandoned the follow-up and in January 2016, during the 20th week of pregnancy, she was readmitted to the Santarem Municipal Hospital with new cervical abscesses in the infra-mammary region, with numerous larvae exiting by subcutaneous left breast fistulas. The antiparasitic treatment was restarted due to possible reactivation of the infection in the spine and dissemination to the central nervous system. Ten weeks after hospital discharge, the patient had resolution of the fistulas and decreased abscesses, without gestational complications. This is the first case report of lagochilascariasis during pregnancy, as well as of involvement of mammary glands.

Parámetros biométricos y consumo de alcohol en pacientes rurales con enfermedad cardiovascular / Biometric parameters and alcohol consumption in rural patients with cardiovascular disease / Parâmetros biométricos e consumo de álcool em pacientes rurais com doença cardiovascular

Resumen El objetivo fue identificar el nivel de consumo de alcohol y los parámetros biométricos en pacientes con enfermedad cardiovascular en la población rural colombiana de Tausa (Cundinamarca). Se realizó una investigación cuantitativa, con un diseño descriptivo y transversal. La población estuvo constituida por 29 pacientes que cursaban con enfermedad cardiovascular y que acudieron entre octubre de 2017 y mayo de 2018 a la consulta del programa de crónicos de una Empresa Social del Estado de primer nivel en el municipio de Tausa. A estos pacientes se les realizó una valoración inicial y posterior, de parámetros biométricos y aplicación del instrumento AUDIT-C. Los resultados muestran que la edad media (DE) de la muestra fue de 70 años. Según los puntajes obtenidos con la aplicación del AUDIT-C, el 75,9% de los participantes se encontraba sin riesgo de consumo de alcohol o alguna de sus complicaciones derivadas. Este estudio constituye un aporte a la caracterización del consumo de alcohol y la valoración de parámetros biométricos en población rural con enfermedad cardiovascular.

Abstract The objective was to identify the level of alcohol consumption and biometric parameters in patients with cardiovascular disease in the rural Colombian population of Tausa (Cundinamarca). Quantitative research was carried out, with a descriptive and cross-cutting design. The population consisted of 29 patients who were in cardiovascular disease and who attended between October 2017 and May 2018 the consultation of the chronic program of a State Social of first level in the municipality of Tausa. These patients were given an initial and subsequent assessment of biometric parameters and application of the AUDIT-C instrument. The results show, the average age (ED) of the sample was 70 years. According to the scores obtained with the application of the AUDIT-C, the 75,9% of the participants were without risk of alcohol consumption or any of its relapse complications. This study constitutes a contribution to the characterization of alcohol consumption and the assessment of biometric parameters in rural population with cardiovascular disease.

Resumo O objetivo foi identificar o nível de consumo de álcool e os parâmetros biométricos em pacientes com doença cardiovascular na população rural colombiana de Tausa (Cundinamarca). Foi realizada uma investigação quantitativa, com delineamento descritivo e transversal. A população foi composta por 29 pacientes atendidos em doenças cardiovasculares e que compareceram entre outubro de 2017 e maio de 2018 à consulta do programa crônico de uma Empresa Social Estadual primeiro nível no município de Tausa. Esses pacientes foram submetidos a uma avaliação inicial e subsequente dos parâmetros biométricos e à aplicação do instrumento AUDIT-C. Os resultados mostram que a média de idade (DP) da amostra foi de 70 anos. De acordo com os escores obtidos com a aplicação do AUDIT-C, 75,9% dos participantes estavam sem risco de consumo de álcool ou de quaisquer complicações. Este estudo constitui uma contribuição para a caracterização do consumo de álcool e a avaliação de parâmetros biométricos na população rural com doença cardiovascular.

Genotypic variation in response to salinity in a new sexual germplasm of Cenchrus ciliaris L.

As part of a breeding program for new salt-tolerant sexual genotypes of Cenchrus ciliaris L., here we evaluated the salt-stress response of two new sexual hybrids, obtained by controlled crosses, at seedling and germination stages. A seedling hydroponic experiment with 300 mM NaCl was performed and physiological variables and growth components were evaluated. While salt-treated sexual material did not show a decrease in productivity with respect to control plants, a differential response in some physiological characteristics was observed. Sexual hybrid 1-9-1 did not suffer oxidative damage and its proline content did not differ from that of control treatment. By contrast, sexual hybrid 1-7-11 suffered oxidative damage and accumulated proline, maintaining its growth under saline stress. At the germination stage, sexual hybrid 1-9-1 presented the highest Germination Rate Index at the maximum NaCl concentration assayed, suggesting an ecological advantage in this genotype. These new sexual resources are promising maternal parental with differential response to salt and could be incorporated in a breeding program of C. ciliaris in the search of new genotypes tolerant to salinity.

Assessment of genetic and epigenetic changes in virus-free garlic (Allium sativum L.) plants obtained by meristem culture followed by in vitro propagation.

KEY MESSAGE: This is the first report assessing epigenetic variation in garlic. High genetic and epigenetic polymorphism during in vitro culture was detected.Sequencing of MSAP fragments revealed homology with ESTs. Garlic (Allium sativum) is a worldwide crop of economic importance susceptible to viral infections that can cause significant yield losses. Meristem tissue culture is the most employed method to sanitize elite cultivars.Often the virus-free garlic plants obtained are multiplied in vitro (micro propagation). However, it was reported that micro-propagation frequently produces somaclonal variation at the phenotypic level, which is an undesirable trait when breeders are seeking to maintain varietal stability. We employed amplification fragment length polymorphism and methylation sensitive amplified polymorphism (MSAP) methodologies to assess genetic and epigenetic modifications in two culture systems: virus-free plants obtained by meristem culture followed by in vitro multiplication and field culture. Our results suggest that garlic exhibits genetic and epigenetic polymorphism under field growing conditions. However, during in vitro culture system both kinds of polymorphisms intensify indicating that this system induces somaclonal variation. Furthermore, while genetic changes accumulated along the time of in vitro culture, epigenetic polymorphism reached the major variation at 6 months and then stabilize, being demethylation and CG methylation the principal conversions.Cloning and sequencing differentially methylated MSAP fragments allowed us to identify coding and unknown sequences of A. sativum, including sequences belonging to LTR Gypsy retrotransposons. Together, our results highlight that main changes occur in the initial 6 months of micro propagation. For the best of our knowledge, this is the first report on epigenetic assessment in garlic.

Tetanus after envenomations caused by freshwater stingrays.

Injuries caused by freshwater stingray are common in several regions of South America, although they are underreported. The riverside inhabitants are the main victims in the Amazonian and Midwest regions of South America. The fishermen are injured mainly in the new focus of colonization of the rivers by freshwater stingrays. With the increasing population in these regions, where freshwater stingrays are found, there has been a significant increase in injuries within the general population. The highest increase occurred among tourists from other regions, where these animals are not known, when visiting these areas. The envenomations from the stingray causes prolonged and intense pain, both local and regionally. Generally these are associated with other local inflammatory manifestations, such as swelling and erythema. The injury often progresses to necrosis and it is considered potentially tetanogenic. A secondary infection is also a frequent local complication and most frequently is caused by Aeromonas species, usually Aeromonas hydrophila. Herein we report the first 2 cases of tetanus after freshwater stingray injuries: a 51-year-old men who had tetanus and recovered without sequel and the second a 67-year-old men who had severe tetanus and a deep, necrotizing soft-tissue infection with sepsis, septic shock and evolution to death.

Acute cerebellar dysfunction with neuromuscular manifestations after scorpionism presumably caused by Tityus obscurus in Santarém, Pará / Brazil.

Scorpionism is a public health problem in many tropical countries, especially in North Africa, South India, Latin America and the Middle East. In Brazil, patients with severe scorpion envenoming have mainly cardiovascular events, including acute heart failure, acute respiratory distress syndrome and shock, death is rare. We described 58 accidents presumably caused by Tityus obscurus in Brazilian Amazonia. Patients reported a sensation of "electric shocks" which could last hours. The vast majority of patients presented a clinical picture compatible with acute cerebellar dysfunction, beginning minutes and lasting up to 2 days after the accident. They presented cerebellar ataxia, dysdiadochokinesia, dysmetry, dysarthria, dyslalia, nausea and vomiting. Besides, some patients presented myoclonus and fasciculation which can also be attributed to cerebellar dysfunction or maybe the result of direct action on skeletal muscle. Two patients had evidence of intense rhabdomyolysis and acute kidney injury. The clinical picture in this scorpion envenoming is mainly characterized by an acute dysfunction of cerebellar activities and abnormal neuromuscular manifestations and in some cases muscle injury which are not described in any other region of the world. This work presents clinical, epidemiologic, laboratory and treatment aspects of this unmatched scorpion envenoming in the state of Pará, northern Brazil.

Síndrome de apnea obstructiva del sueño en niños (SAOS) / Obstructive sleep apnea syndrome in children (OSAS)

El síndrome de la apnea obstructiva del sueño (SAOS) es ocasionado por una obstrucción de las vías aéreas superiores, resultado de un desequilibrio entre la fuerza de succión respiratoria y la compensación de los músculos dilatadores faríngeos. El diagnóstico positivo es establecido por el registro polisomnográfico nocturno durante el sueño que define las características y la severidad de esta enfermedad. El objetivo del siguiente artículo es difundir los diversos aspectos clínicos y diagnósticos de una enfermedad recientemente descripta de alta prevalencia y que cruza las fronteras de múltiples especialistas (pediatras, neurólogos, neumólogos, otorrinolaringólogos, psiquiatras, psicólogos, odontoestomatólogos, ortodoncistas), así contribuiremos a su diagnóstico precoz a partir de los niños que roncan, evitando las importantes secuelas del SAOS infantil...

Clinical aspects of envenomation caused by Tityus obscurus (Gervais, 1843) in two distinct regions of Pará state, Brazilian Amazon basin: a prospective case series.

BACKGROUND: Scorpion envenomations are a major public health problem in Brazil, whose most dangerous cases are attributable to the genus Tityus. This study was designed to compare the clinical and demographic features of envenomations by Tityus obscurus in two areas of the state of Pará located in the Amazon basin.Were compared demographic findings, local and systemic signs and symptoms of human envenomations caused by T. obscurus that occurred in western and eastern areas of the state. RESULTS: Forty-eight patients with confirmed envenomation by T. obscurus were evaluated from January 2008 to July 2011. Most of them came from the eastern region, where male and female patients were present in similar numbers, while males predominated in the west. Median age groups were also similar in both areas. Most scorpion stings took place during the day and occurred significantly more frequently on the upper limbs. The time between the sting and admission to the health center was less than three hours in both areas. Most eastern patients had local manifestations while in the west, systemic manifestations predominated. Local symptoms were similar in both areas, but systemic signs and symptoms were more common in the west. Symptoms frequently observed at the sting site were local and radiating pain, paresthesia, edema, erythema, sweating, piloerection and burning. The systemic manifestations were significantly higher in patients from the west. Futhermore, neurological symptoms such as general paresthesia, ataxia, dysarthria, myoclonus, dysmetria, and electric shock-like sensations throughout the body were reported only by patients from the west. CONCLUSION: The present study shows that two regions of Para state differ in the clinical manifestations and severity of confirmed envenomation by T. obscurus which suggests a toxicity variation resulting from the diversity of T. obscurus venom in different areas of the Brazilian Amazon basin, and that T. serrulatus antivenom can be successfully used against T. obscurus.

Clinical aspects of envenomation caused by Tityus obscurus (Gervais, 1843) in two distinct regions of Pará state, Brazilian Amazon basin: a prospective case series

Scorpion envenomations are a major public health problem in Brazil, whose most dangerous cases are attributable to the genus Tityus. This study was designed to compare the clinical and demographic features of envenomations by 77tyus obscurus in two areas of the state of Pará located in the Amazon basin. Were compared demographic findings, local and systemic signs and symptoms of human envenomations caused by T. obscurus that occurred in western and eastern areas of the state.

Clinical aspects of envenomation caused by Tityus obscurus (Gervais, 1843) in two distinct regions of Pará state, Brazilian Amazon basin: a prospective case series

Scorpion envenomations are a major public health problem in Brazil, whose most dangerous cases are attributable to the genus Tityus. This study was designed to compare the clinical and demographic features of envenomations by 77tyus obscurus in two areas of the state of Pará located in the Amazon basin. Were compared demographic findings, local and systemic signs and symptoms of human envenomations caused by T. obscurus that occurred in western and eastern areas of the state.

Osteogénesis imperfecta: caso clínico / Osteogenesis imperfecta: report of a clinical case

Las displasias esqueléticas son un grupo de enfermedades de los huesos, de origen genético, tipo generalizado. Son enfermedades poco frecuentes. Se han descrito aproximadamente 350 tipos de displasias óseas diferentes. Dentro de éstas, se encuentra la osteogénesis imperfecta, en la que hay una alteración del colágeno tipo 1. Este colágeno se encuentra también en la conjuntiva, en los ligamentos y en los dientes; de allí que las manifestaciones pueden observarse también en áreas extraóseas. En el caso clínico, se describe la situación de una paciente pediátrica con diagnóstico de osteogéensis imperfecta tipo 1, la problemática de la enfermedad y las posibilidades de tratamiento odontológico.

Transmission of human herpesvirus type 8 infection within families in american indigenous populations from the Brazilian Amazon.

BACKGROUND: The intrafamilial dynamics of endemic infection with human herpesvirus type 8 (HHV-8) in Amerindian populations is unknown. METHODS: Serum samples were obtained from 517 Amerindians and tested for HHV-8 anti-latent nuclear antigen (anti-LANA) and antilytic antibodies by immunofluorescence assays. Logistic regression and mixed logistic models were used to estimate the odds of being HHV-8 seropositive among intrafamilial pairs. RESULTS: HHV-8 seroprevalence by either assay was 75.4% (95% confidence interval [CI]: 71.5%-79.1%), and it was age-dependent (P(trend) < .001). Familial dependence in HHV-8 seroprevalence by either assay was found between mother-offspring (odds ratio [OR], 5.44; 95% CI: 1.62-18.28) and siblings aged ≥10 years (OR 4.42, 95% CI: 1.70-11.45) or siblings in close age range (<5 years difference) (OR 3.37, 95% CI: 1.21-9.40), or in families with large (>4) number of siblings (OR, 3.20, 95% CI: 1.33-7.67). In separate analyses by serological assay, there was strong dependence in mother-offspring (OR 8.94, 95% CI: 2.94-27.23) and sibling pairs aged ≥10 years (OR, 11.91, 95% CI: 2.23-63.64) measured by LANA but not lytic antibodies. CONCLUSIONS: This pattern of familial dependence suggests that, in this endemic population, HHV-8 transmission mainly occurs from mother to offspring and between close siblings during early childhood, probably via saliva. The mother to offspring dependence was derived chiefly from anti-LANA antibodies.

Immunohistochemistry and polymerase chain reaction on paraffin-embedded material improve the diagnosis of cutaneous leishmaniasis in the Amazon region.

BACKGROUND: Recently, there has been an increase in the incidence of cutaneous leishmaniasis (CL), which represents an important health problem. This increase may be related to the epidemiologic expansion of the infective agent and the increase in tourism in tropical areas. The difficulty in clinical diagnosis, mainly in areas in which CL is not the first consideration of local physicians, has intensified efforts to describe diagnostic tests, which should be specific, sensitive, and practical. Amongst the new tests described are those including nucleic acid amplification (polymerase chain reaction, PCR) and immunohistochemistry (IHC). METHODS: In this study, we evaluated the sensitivity of a PCR based on small subunit (SSU) ribosomal DNA, in comparison with IHC using Leishmania spp. antibodies, in biopsies embedded in paraffin. RESULT: The results indicated a total sensitivity of 96% (90.9% with PCR and 68.8% with IHC), showing the possibility of using paraffin-embedded biopsies to diagnose CL. CONCLUSION: We propose the use of the two tests together as a routine protocol for diagnosis. This would require the provision of local medical services to perform molecular biology techniques and adequate Leishmania antibodies.

First report of an accident with the speckled forest pit viper (Bothriopsis taeniata) in Brazil.

The first reported case of an accident with Bothriopsis taeniata in Brazil is described. The victim, a 43-year-old man, was bitten just above his right heel and presented a clinical condition compatible with mild Bothrops poisoning: local edema with hemorrhage at the bite site and pain, although without coagulopathy.

First report of an accident with the speckled forest pit viper (Bothriopsis taeniata) in Brazil / Primeiro registro de acidente pela jararaca estrela (Bothriopsis taeniata) no Brasil

The first reported case of an accident with Bothriopsis taeniata in Brazil is described. The victim, a 43-year-old man, was bitten just above his right heel and presented a clinical condition compatible with mild Bothrops poisoning: local edema with hemorrhage at the bite site and pain, although without coagulopathy.

Relatamos o primeiro caso de acidente por Bothriopsis taeniata no Brasil. A vítima, trabalhador rural com 43 anos de idade, foi picada pouco acima do calcanhar direito, apresentando quadro clínico compatível por envenenamento botrópico leve: discreto edema com hemorragia no local da picada e dor, embora com ausência de coagulopatia.

Seroprevalence of Kaposi sarcoma-associated herpesvirus and other serologic markers in the Brazilian Amazon.

To determine the presence of Kaposi sarcoma-associated herpesvirus (KSHV) and other serologic markers, we tested serum specimens of 339 Amerindians, 181 rural non-Amerindians, and 1,133 urban blood donors (13 Amerindians) in the Brazilian Amazon. High KSHV seroprevalence in children and inverse association with herpes simplex virus type 2 indicates predominant nonsexual transmission among Amerindians.