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1.
Parasitol Int ; 101: 102899, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38663799

RESUMO

Herein, innovative biocides are designed for the treatment of Trichinella spiralis muscle larvae (ML) and adult worms. Samarium-doped ZnO nanorods (Sm-doped ZnO) are stabilized onto the laminar structure of cuttlefish bone (CB) matrix and adorned by either Ag NPs or cobalt phthalocyanine (CoPc) species. Physicochemical characteristics of such nanocomposites are scrutinised. Adorning of Sm-doped ZnO/CB with Ag NPs shortens rod-like shaped Sm-doped ZnO nanoparticles and accrues them, developing large-sized detached patches over CB moiety. Meanwhile, adorning of Sm-doped ZnO/CB by CoPc species degenerates CB lamellae forming semi-rounded platelets and encourages invading of Sm-doped ZnO nanorods deeply inside gallery spacings of CB. Both nanocomposites possess advanced parasiticidal activity, displaying quite intoxication for ML and adult worms (≥88% mortality) within an incubation period of <48 h at concentrations around 200 µg/ml. CoPc@Sm-doped ZnO/CB nanocomposite exhibits faster killing efficiency of adult worms than that of Ag@Sm-doped ZnO/CB at a concentration of ∼75 µg/ml showing entire destruction of parasite after 24 h incubation with the former nanocomposite and just 60% worm mortality after 36 h exposure to the later one. Morphological studies of the treated ML and adult worms show that CoPc@Sm-doped ZnO/CB exhibits a destructive impact on the parasite body, creating featureless and sloughed fragments enriched with intensive vacuoles. Hybridization of cuttlefish bone lamellae by CoPc species is considered a springboard for fabrication of futuristic aggressive drugs against various food- and water-borne parasites.


Assuntos
Indóis , Larva , Nanotubos , Compostos Organometálicos , Prata , Trichinella spiralis , Óxido de Zinco , Animais , Óxido de Zinco/farmacologia , Indóis/farmacologia , Trichinella spiralis/efeitos dos fármacos , Nanotubos/química , Prata/farmacologia , Larva/efeitos dos fármacos , Compostos Organometálicos/farmacologia , Compostos Organometálicos/química , Nanopartículas Metálicas , Decapodiformes/parasitologia , Anti-Helmínticos/farmacologia , Nanocompostos , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/parasitologia , Músculos/parasitologia , Músculos/efeitos dos fármacos
2.
J Parasitol ; 107(2): 275-283, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33844838

RESUMO

Parasitism is inherent to life and observed in all species. Extinct animals have been studied to understand what they looked like, where and how they lived, what they fed on, and the reasons they became extinct. Paleoparasitology helps to clarify these questions based on the study of the parasites and microorganisms that infected those animals, using as a source material coprolites, fossils in rock, tissue, bone, mummy, and amber, analyses of ancient DNA, immunodiagnosis, and microscopy.


Assuntos
Extinção Biológica , Fósseis/parasitologia , Sedimentos Geológicos/parasitologia , Paleopatologia , Doenças Parasitárias em Animais/história , Âmbar , Animais , Osso e Ossos/microbiologia , Osso e Ossos/parasitologia , Osso e Ossos/patologia , História Antiga , Múmias/parasitologia
3.
Nat Rev Immunol ; 18(4): 266-278, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29332936

RESUMO

Systemic inflammation mediated by Plasmodium parasites is central to malaria disease and its complications. Plasmodium parasites reside in erythrocytes and can theoretically reach all host tissues via the circulation. However, actual interactions between parasitized erythrocytes and host tissues, along with the consequent damage and pathological changes, are limited locally to specific tissue sites. Such tissue specificity of the parasite can alter the outcome of malaria disease, determining whether acute or chronic complications occur. Here, we give an overview of the recent progress that has been made in understanding tissue-specific immunopathology during Plasmodium infection. As knowledge on tissue-specific host-parasite interactions accumulates, better treatment modalities and targets may emerge for intervention in malaria disease.


Assuntos
Malária/imunologia , Malária/patologia , Animais , Vasos Sanguíneos/imunologia , Vasos Sanguíneos/parasitologia , Vasos Sanguíneos/patologia , Osso e Ossos/imunologia , Osso e Ossos/parasitologia , Osso e Ossos/patologia , Encéfalo/imunologia , Encéfalo/parasitologia , Encéfalo/patologia , Sistema Digestório/imunologia , Sistema Digestório/parasitologia , Sistema Digestório/patologia , Eritrócitos/imunologia , Eritrócitos/parasitologia , Eritrócitos/patologia , Interações Hospedeiro-Parasita/imunologia , Humanos , Sistema Linfático/imunologia , Sistema Linfático/parasitologia , Sistema Linfático/patologia , Malária/parasitologia , Malária Cerebral/imunologia , Malária Cerebral/parasitologia , Malária Cerebral/patologia , Modelos Imunológicos , Especificidade de Órgãos , Plasmodium/imunologia , Plasmodium/patogenicidade , Retina/imunologia , Retina/parasitologia , Retina/patologia
4.
J Korean Med Sci ; 33(6): e53, 2018 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-29349942

RESUMO

The parasitic infection patterns of the Joseon period have begun to be revealed in a series of paleoparasitological studies. However, parasitism prevailing during or before the Three Kingdom period is still relatively unexplored. In the present study, we therefore conducted parasitological examinations of soil and organic-material sediments precipitated upon human hipbone and sacrum discovered inside an ancient Mokgwakmyo tomb dating to the Silla Dynasty (57 BCE-660 CE). Within the samples, we discovered ancient Ascaris lumbricoides (eggs per gram [EPG], 46.6-48.3) and Trichuris trichiura (EPG, 32.8-62.1) eggs, the species commonly detected among Korean populations until just prior to the 1970s. These findings show that soil-transmitted parasitic infection among the Silla nobility might not have been uncommon. This is the first-ever report on the presence of ancient parasite eggs in the samples obtained from a Three Kingdom period tomb; and it also presents the earliest positive results for any of the ancient South Korean tombs paleoparasitologically examined to date.


Assuntos
Ascaris lumbricoides/isolamento & purificação , Solo/parasitologia , Trichuris/isolamento & purificação , Animais , Arqueologia , Ascaris lumbricoides/crescimento & desenvolvimento , Osso e Ossos/parasitologia , Óvulo/citologia , Sacro/parasitologia , Trichuris/crescimento & desenvolvimento
5.
Orthopade ; 46(6): 477-483, 2017 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-28444415

RESUMO

BACKGROUND: Benign bone tumors are of special clinical importance because they might be confused with malignant bone tumors. OBJECTIVES: The aim of this article it to present the characteristics of benign bone tumors. The focus is orientated towards conventional x­ray as the essential pillar for primary diagnosis. Consequently, the description of signal intensities of benign bone tumors in magnetic resonance images or less helpful clues like male-female ratios are deliberately omitted. RESULTS: The classification of bone tumors introduced by Lodwick allows the identification of benign growth patterns. Growth patterns will not help, for example, in case of dedifferentiation of benign chondroid tumors towards chondrosarcomas. Therefore, each diagnosis has to incorporate the patient's clinical scenario. Furthermore, benign bone tumors might also cause aggressive growth patterns. Tumors classified as Lodwick Ic or higher should not be automatically regarded as malignant. Naturally, further clarification is mandatory for these tumors. CONCLUSIONS: Differentiation between definitely benign bone tumors and those which need further work up is a critical diagnostic step. In the majority of cases, this is possible based on the appearance in conventional x­ray images. In case of possibly malignant lesions, both the patient's symptoms and the x­ray morphology have to be considered by orthopedic surgeons, pathologists, and radiologists to determine the optimal diagnostic strategy.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/classificação , Neoplasias Ósseas/patologia , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/parasitologia , Transformação Celular Neoplásica/patologia , Condrossarcoma/classificação , Condrossarcoma/diagnóstico por imagem , Condrossarcoma/patologia , Diagnóstico Diferencial , Humanos , Sensibilidade e Especificidade
6.
Exp Parasitol ; 168: 51-5, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27292545

RESUMO

Paleoparasitology studies parasite infections by finding the parasites' remains in preserved organic remains such as natural or artificial mummy tissues, skeletons, teeth, and coprolites, among others. However, some currently important infections like toxoplasmosis have not been studied by paleoparasitology. The reasons include this parasite's complex life cycle, the resulting difficulties in locating this protozoan in the intermediate host tissues, and the limitation of coprolite studies to felines, the protozoan's definitive host. The current study thus aimed to produce an experimental model for molecular diagnosis of toxoplasmosis, prioritizing its study in bones and skin, the most abundant materials in archeological collections and sites. The study demonstrated the feasibility of recovering Toxoplasma gondii DNA from desiccated material, including bones and skin, in experimental models both with circulating tachyzoites (RH strain), characteristic of acute infection, and with cysts (ME49 cystogenic strain), characteristic of chronic infection. At present, most individuals with T. gondii infection are in the chronic phase, and the same was probably true in the past. The current study thus expands the odds of finding the parasite in archeological material, enhanced by the nature of the material in which the diagnosis was made. Finding the parasite may help answer questions that are widely debated in the literature on this protozoan's origin (Old World versus New World). In addition, when conditions do not allow ideal storage of samples for molecular tests, the methodology creates the possibility of testing oven-dried samples transported at room temperature.


Assuntos
DNA de Protozoário/isolamento & purificação , Múmias/parasitologia , Toxoplasma/genética , Toxoplasmose/história , Animais , Osso e Ossos/parasitologia , História Antiga , Humanos , Camundongos , Modelos Animais , Pele/parasitologia , Toxoplasma/isolamento & purificação
7.
Acta Orthop Belg ; 81(3): 530-7, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26435250

RESUMO

The objective of this retrospective study was to evaluate clinical outcomes, local recurrence and complication rates of antihelminthic chemotherapy and wide resection in patients with muscle or bone hydatidosis. The authors treated 10 patients (6 females, 4 males) between 2004 and 2012: 8 with muscle and 2 with bone hydatidosis. The mean age at surgery was 42.5 years (range, 11-66 years). All patients were treated with wide resection and pre- and postoperative chemotherapy with albendazole. The mean follow-up was 64 months (range, 28-120 months). All patients achieved satisfactory clinical outcomes. There were no local recurrences. Surgical complications were seen in 3 patients (30%) : one superficial infection, one deep infection, and one hematoma. Two (20%) required additional surgery. An aggressive oncological approach, consisting of antihelminthic chemotherapy and wide resection, can provide favorable clinical outcomes and prevent local recurrence in patients with musculoskeletal hydatidosis. Potential complications of aggressive surgery should be preferred to potential morbidity of local and systemic dissemination.


Assuntos
Albendazol/uso terapêutico , Doenças Ósseas Infecciosas/terapia , Equinococose/terapia , Miosite/terapia , Procedimentos Ortopédicos/métodos , Adolescente , Adulto , Idoso , Animais , Anti-Helmínticos/uso terapêutico , Doenças Ósseas Infecciosas/diagnóstico , Doenças Ósseas Infecciosas/parasitologia , Osso e Ossos/parasitologia , Criança , Diagnóstico Diferencial , Equinococose/diagnóstico , Equinococose/parasitologia , Echinococcus granulosus/isolamento & purificação , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/parasitologia , Miosite/diagnóstico , Miosite/parasitologia , Estudos Retrospectivos , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
8.
BMC Evol Biol ; 12: 189, 2012 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-23006795

RESUMO

BACKGROUND: Osedax worms use a proliferative root system to extract nutrients from the bones of sunken vertebrate carcasses. The roots contain bacterial endosymbionts that contribute to the nutrition of these mouthless and gutless worms. The worms acquire these essential endosymbionts locally from the environment in which their larvae settle. Here we report on the temporal dynamics of endosymbiont diversity hosted by nine Osedax species sampled during a three-year investigation of an experimental whale fall at 1820-m depth in the Monterey Bay, California. The host species were identified by their unique mitochondrial COI haplotypes. The endosymbionts were identified by ribotyping with PCR primers specifically designed to target Oceanospirillales. RESULTS: Thirty-two endosymbiont ribotypes associated with these worms clustered into two distinct bacterial ribospecies that together comprise a monophyletic group, mostly restricted to deep waters (>1000 m). Statistical analyses confirmed significant changes in the relative abundances of host species and the two dominant endosymbiont ribospecies during the three-year sampling period. Bone type (whale vs. cow) also had a significant effect on host species, but not on the two dominant symbiont ribospecies. No statistically significant association existed between the host species and endosymbiont ribospecies. CONCLUSIONS: Standard PCR and direct sequencing proved to be an efficient method for ribotyping the numerically dominant endosymbiont strains infecting a large sample of host individuals; however, this method did not adequately represent the frequency of mixed infections, which appears to be the rule rather than an exception for Osedax individuals. Through cloning and the use of experimental dilution series, we determined that minority ribotypes constituting less than 30% of a mixture would not likely be detected, leading to underestimates of the frequency of multiple infections in host individuals.


Assuntos
Gammaproteobacteria/genética , Variação Genética , Poliquetos/genética , Simbiose/genética , Animais , Teorema de Bayes , Osso e Ossos/parasitologia , Bovinos , Complexo IV da Cadeia de Transporte de Elétrons/genética , Gammaproteobacteria/classificação , Gammaproteobacteria/fisiologia , Frequência do Gene , Haplótipos , Especificidade de Hospedeiro/genética , Interações Hospedeiro-Parasita , Dados de Sequência Molecular , Filogenia , Poliquetos/microbiologia , Poliquetos/fisiologia , RNA Ribossômico 16S/genética , Ribotipagem , Estações do Ano , Análise de Sequência de DNA , Especificidade da Espécie , Fatores de Tempo , Baleias
9.
Dis Aquat Organ ; 98(2): 133-41, 2012 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-22436461

RESUMO

A specimen of Greenland halibut Reinhardtius hippoglossoides (Walbaum, 1792) caught on the west coast of Greenland (Qasigiannguit) was found to possess serious pathological changes in the body musculature. A series of cartilaginous cylindrical structures organized symmetrically at the position of the proximal pterygiophores had changed the musculature and produced irreversible distortions (cavities and holes) in the fillet of the processed fish, leaving it with no value for the industry. Histopathological investigation showed that these structures consisted of hypertrophic cartilage containing numerous myxospore-producing plasmodia. Morphometric and molecular analyses of the parasites showed that both spore morphology and rDNA sequences complied with characteristics of the genus Myxobolus, but no full affiliation with a known species could be found. The parasite is a previously undescribed species, and the name Myxobolus groenlandicus n. sp. is assigned to this new myxobolid.


Assuntos
Doenças dos Peixes/parasitologia , Linguados/parasitologia , Myxobolus/fisiologia , Doenças Parasitárias em Animais/parasitologia , Animais , Osso e Ossos/parasitologia , Osso e Ossos/patologia , DNA Ribossômico/genética , Doenças dos Peixes/patologia , Músculo Esquelético/parasitologia , Músculo Esquelético/patologia , Myxobolus/classificação , Myxobolus/genética , Doenças Parasitárias em Animais/patologia , Filogenia , Esporos de Protozoários
11.
Virchows Arch ; 459(3): 247-54, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21779895

RESUMO

Human skeletal paleopathology provides important insight regarding the antiquity of some diseases and their distribution in past human groups. The history of human skeletal paleopathology extends back more than 150 years. Rudolf Virchow published reports on the subject, and research on paleopathology has provided critical data on important topics such as the origin of syphilis. With the development of powerful new research tools, human paleopathology will continue to be a source of data on the development of disease and its effect on human biological and cultural development.


Assuntos
Doenças Ósseas/história , Osso e Ossos , Paleopatologia/história , Doenças Ósseas/microbiologia , Doenças Ósseas/parasitologia , Doenças Ósseas/patologia , Osso e Ossos/microbiologia , Osso e Ossos/parasitologia , Osso e Ossos/patologia , Equinococose/história , História do Século XIX , Humanos , Hanseníase/história , Infecções por Mycobacterium/história , Sífilis/história , Infecções por Treponema/história , Tuberculose Osteoarticular/história
12.
Trans R Soc Trop Med Hyg ; 104(9): 583-7, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20673935

RESUMO

Medical accounts and ancient autopsy reports imply that tertian malarial fevers caused the death of four members of the Medici family of Florence: Eleonora of Toledo (1522-1562), Cardinal Giovanni (1543-1562), don Garzia (1547-1562) and Grand Duke Francesco I (1531-1587). All members of the Medici family hunted in the endemic malarial areas of Tuscany, such as the marshy areas surrounding their villas and along the swampy Maremma and were, therefore, highly exposed to the risk of being infected by Falciparum malaria. To determine if the original death certificates issued by the court physicians were correct, we carried out immunological investigations and then compared the biological results to the historical sources. Bone samples were examined for the presence of Plasmodium falciparum histidine-rich- protein-2 (PfHRP2) and P. falciparum lactate dehydrogenase (PfLDH) using two different qualitative double-antibody immunoassays. Our findings provide the first modern laboratory evidence of the presence of P. falciparum ancient proteins in the skeletal remains of four members of the Medici family. We confirm the clinical diagnosis of the court physicians, using modern methods. Finally, this study demonstrates that immunodetection can be successfully applied not only to mummified tissues but also to skeletal remains, thus opening new paths of investigation for large archaeological series.


Assuntos
Osso e Ossos/parasitologia , Malária Falciparum/história , Plasmodium falciparum/química , Antígenos de Protozoários/análise , Arqueologia , Osso e Ossos/química , Causas de Morte , Cerâmica , Feminino , História do Século XVI , Humanos , Itália , L-Lactato Desidrogenase/análise , Malária Falciparum/diagnóstico , Masculino , Plasmodium falciparum/isolamento & purificação , Proteínas de Protozoários/análise
13.
Proc Natl Acad Sci U S A ; 107(19): 8656-9, 2010 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-20424110

RESUMO

Osedax is a recently discovered group of siboglinid annelids that consume bones on the seafloor and whose evolutionary origins have been linked with Cretaceous marine reptiles or to the post-Cretaceous rise of whales. Here we present whale bones from early Oligocene bathyal sediments exposed in Washington State, which show traces similar to those made by Osedax today. The geologic age of these trace fossils ( approximately 30 million years) coincides with the first major radiation of whales, consistent with the hypothesis of an evolutionary link between Osedax and its main food source, although older fossils should certainly be studied. Osedax has been destroying bones for most of the evolutionary history of whales and the possible significance of this "Osedax effect" in relation to the quality and quantity of their fossils is only now recognized.


Assuntos
Osso e Ossos/parasitologia , Comportamento Alimentar/fisiologia , Fósseis , Helmintos/fisiologia , Baleias/parasitologia , Animais , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/patologia , História Antiga , Tamanho do Órgão , Fatores de Tempo , Tomografia Computadorizada por Raios X , Washington
14.
J Clin Microbiol ; 47(10): 3191-6, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19656973

RESUMO

Two cases of alveolar echinococcosis (AE) with multiple-organ involvement (the liver, lungs, and bone) were monitored by imaging and serology for 20 years. Resection of the bone lesion was complete in one case but incomplete in the other case. Albendazole treatment was markedly to moderately effective against hepatic and pulmonary AE lesions in both cases, whereas it had almost no effect against the bone lesion in one case. The results of the serological tests with recombinant Em18 antigen coincided with the clinical findings in each case. An enzyme-linked immunosorbent assay for the detection of immunoglobulin G (IgG) responses, especially IgG4 responses, is expected to be a real-time indicator of the dynamics of active AE.


Assuntos
Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos , Equinococose/imunologia , Equinococose/patologia , Echinococcus/imunologia , Adulto , Albendazol/uso terapêutico , Animais , Anti-Helmínticos/uso terapêutico , Osso e Ossos/parasitologia , Osso e Ossos/patologia , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Humanos , Imunoglobulina G/sangue , Fígado/parasitologia , Fígado/patologia , Pulmão/parasitologia , Pulmão/patologia , Resultado do Tratamento
15.
Intern Med ; 47(16): 1495-7, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18703862

RESUMO

Alveolar echinococcosis, which is caused by Echinococcus multilocularis, is a very aggressive and potentially fatal infestation which always affects the liver primarily and metastasizes to any part of the body. Imaging studies are usually highly suspicious of carcinoma or sarcoma, and biopsy may provide the first indication of infection. We report a case of disseminated alveolar echinococcosis with liver, lung, and bone involvement mimicking a metastatic malignancy.


Assuntos
Neoplasias Ósseas/diagnóstico , Equinococose Pulmonar/diagnóstico , Echinococcus multilocularis/patogenicidade , Neoplasias Hepáticas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Alvéolos Pulmonares/parasitologia , Adulto , Animais , Osso e Ossos/parasitologia , Diagnóstico Diferencial , Feminino , Humanos , Fígado/parasitologia
18.
J Parasitol ; 90(5): 1186-8, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15562628

RESUMO

The leech Placobdella ornata was observed feeding from the blood sinuses of the plastron and carapace bones of Chelydra serpentina and Chrysemys picta. Evidence of successful feeding included blood upwelling from the point of attachment and gastric ceca of the leeches freshly filled with blood after removal. There was an apparent preference for the sulci between scales of the shell.


Assuntos
Osso e Ossos/parasitologia , Sanguessugas/fisiologia , Tartarugas/parasitologia , Animais , Osso e Ossos/irrigação sanguínea , Comportamento Alimentar/fisiologia , Feminino , Interações Hospedeiro-Parasita , Sanguessugas/enzimologia , Especificidade da Espécie
20.
Can J Anaesth ; 51(1): 84-7, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14709468

RESUMO

PURPOSE: Recurrent cytomegalovirus (CMV) disease is a frequent complication of liver transplantation. Visceral leishmaniosis in a transplant recipient is, on the other hand, extremely rare and only two cases of kala-azar have been described after liver transplantation. Immunosuppressed patients are known to be at risk of Legionella infection and the relationship between infection with this organism and hospital water supplies has been well described. These three diseases carry a high mortality rate. Our report examines the potential relationship between these complications. CLINICAL FEATURES: We describe the case of a liver transplant recipient who presented the three complications successively and survived. After reviewing the literature, we explore hypotheses linking these infections and discuss treatment strategies. CONCLUSIONS: In the patient described, infection with leishmania probably occurred months prior to the clinical presentation, a delay that matches the incubation period of kala-azar. The simultaneous onset of leishmaniosis and of a high CMV viremia may have been a coincidence. However, CMV infection has been shown to be an independent predictor of invasive fungal infection in liver transplant recipients. CMV does indeed have a suppressive effect on the humoral and cellular immune response in vitro as well as in vivo. The clinical manifestations of leishmaniosis may, therefore, have been precipitated in this patient by the additive immunosuppressive effect of antirejection drugs and CMV.


Assuntos
Infecções por Citomegalovirus/complicações , Doença dos Legionários/complicações , Leishmaniose Visceral/complicações , Transplante de Fígado , Complicações Pós-Operatórias/etiologia , Antibacterianos/uso terapêutico , Gluconato de Antimônio e Sódio/uso terapêutico , Antivirais/uso terapêutico , Osso e Ossos/parasitologia , Osso e Ossos/patologia , Claritromicina/uso terapêutico , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/terapia , Infecções por Citomegalovirus/tratamento farmacológico , Infecções por Citomegalovirus/virologia , Foscarnet/uso terapêutico , Ganciclovir/uso terapêutico , Humanos , Doença dos Legionários/tratamento farmacológico , Doença dos Legionários/terapia , Leishmaniose Visceral/tratamento farmacológico , Leishmaniose Visceral/parasitologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/terapia , Esquistossomicidas/uso terapêutico , Carga Viral
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