Haematological response of curimbas Prochilodus lineatus, naturally infected with Neoechinorhynchus curemai.

This study evaluated the haematological response of curimbas Prochilodus lineatus, naturally infected with Neoechinorhynchus curemai (Acanthocephala: Neoechinorhynchidae). Thirty-seven fish were captured in October 2010 from the Mogi Guaçu River, Porto Ferreira, SP, Brazil. Infected fish presented increased mean corpuscular volume of erythrocytes, and lower thrombocyte and higher monocyte counts than uninfected fish.

Distribution of Taenia saginata metacestodes: a comparison of routine meat inspection and carcase dissection results in experimentally infected calves.

A comparison of techniques for detecting the presence of Cysticercus bovis in bovine carcasses was made by using carcass dissection and routine beef inspection guidelines. In the study, 28 calves were used after they were tested and found to be negative for the presence of anti-C. bovis serum antibodies and were inoculated orally with aliquots containing 6×10(4) Taenia saginata eggs. One hundred and twenty days after inoculation, the animals were slaughtered and a post mortem evaluation was done following Brazilian Federal Beef Inspection guidelines. This routine meat inspection was able to identify 71·42% of the assessed infected carcasses as being parasitized. This result implies that 28·58% of the infected carcasses would have been released as fit for human consumption since they would have been considered as free of C. bovis infection when using this method for carcass assessment. Only 3·07% of the total 2311 metacestodes present in the carcasses were identified by the conventional procedures of sanitary inspection. The assessment of different parts of the carcasses showed high infestation rates in shoulder clod (14·37%), head (11·21%), neck+chuck roll (8·05%), heart (7·75%) and top (inside) round (7·18%) which, together, were responsible for housing 48·51% of all the cysts found in the 24 beef cuts assessed. These numbers contrasted to the low incidence of cysts found in organs such as tongue (3·12%), diaphragm (1·69%) and esophagus (1·60%) which are usually described as predilection sites for the parasite.

Genetic variability among natural populations of Zaprionus indianus (Drosophilidae) in the States of São Paulo and Minas Gerais, Brazil.

Random amplified polymorphic DNA (RAPD) was used to detect polymorphisms among Zaprionus indianus fly populations collected from six municipalities in the States of São Paulo and Minas Gerais, Brazil. This species is an important, recently introduced fruit fly pest of figs and other fruit. Among 21 primers, 16 produced 73 reproducible polymorphic fragments; primer AM-9 produced the greatest number of polymorphic bands (nine), with 52% genetic variability among populations. Genetic divergence analysis of the Z. indianus populations demonstrated two major groups, named Western and Eastern groups. There was greater gene flow within than between groups. The correlation coefficient for genetic and geographic distances (Mantel test) was significant, demonstrating isolation by distance.

Two-step tuberculin skin test and booster phenomenon prevalence among Brazilian medical students.

SETTING: Five medical schools in three cities in Rio de Janeiro State, Brazil, with different tuberculosis (TB) incidence rates. OBJECTIVE: To evaluate the prevalence of the booster phenomenon and its associated factors in a young universally BCG-vaccinated TB-exposed population. DESIGN: A two-step tuberculin skin test (TST) was performed among undergraduate medical students. Boosting was defined as an induration > or =10 mm in the second TST (TST2), with an increase of at least 6 mm over the first TST (TST1). The association of boosting with independent variables was evaluated using multivariate analysis. RESULTS: Of the 764 participants (mean age 21.9 +/- 2.7 years), 672 (87.9%) had a BCG scar. The overall booster phenomenon prevalence was 8.4% (95%CI 6.5-10.6). Boosting was associated with TST1 reactions of 1-9 mm (aOR 2.5, 95%CI 1.04-5.9) and with BCG vaccination, mostly after infancy, i.e., after age two years (aOR 9.1, 95%CI 1.2-70.7). CONCLUSION: The prevalence of the booster phenomenon was high. A two-step TST in young BCG-vaccinated populations, especially in those with TST1 reactions of 1-9 mm, can avoid misdiagnosis as a false conversion and potentially reduce unnecessary treatment for latent TB infection.

[Problematics of subarachnoid hemorrhage in developing countries: The case of Togo]. / Problématique des hémorragies méningées dans les pays en développement : cas du Togo.

OBJECTIVE: To analyze the diagnostic and therapeutic strategies as well as the results of the treatment of spontaneous subarachnoid hemorrhage (SAH) in Togo, before creating a neurosurgery department. METHODS: We conducted a case series of subarachnoid hemorrhage collected from 30 June 2005 to 30 June 2010 in the Universities Hospital of Lomé. It involved patients older than 15 years of age hospitalized for subarachnoid hemorrhage with clinical and/or radiation confirmation. RESULTS: Thirty-five cases of SAH were found and corresponded to 0.20 % of neurological emergencies. The average age was 48 years with a range of 22 to 78 years with a sex-ratio F/H 1.33. The consciousness disorders (48.57 %) and headaches (42.85 %) were the main reasons for admission. Seventeen patients (48.57 %) had hypertension and 14 (40 %) were ethylic. Lumbar puncture performed in 9 patients (25.71 %) and CT scan in 29 patients (82.86 %), respectively, had a sensitivity of 100 % and 93.10 %. Four cases of intracranial aneurysm were diagnosed. The admission average was 3.07±3.69 days. The treatment was mainly symptomatic. Mortality was 22.85 % and severe disability was observed in 8 patients (22.85 %). CONCLUSION: The profile of the SAH in Lomé appeared to differ from the literature. Too low a proportion of aneurysm is diagnosed. The equipment of Hospital and neurosurgeons training would be needed to improve the management of this pathology.

Non-completion of latent tuberculous infection treatment among children in Rio de Janeiro State, Brazil.

BACKGROUND: Children with latent tuberculous infection (LTBI) are particularly vulnerable to progression to active tuberculosis (TB), and are thus a priority target for isoniazid preventive therapy (IPT). However, adherence to IPT is poor. We hypothesised that children from poorer families, with reduced access to health care and lack of understanding about the disease are more likely to default from IPT. METHODS: A questionnaire was administered to close child contacts or their parents at the time of prescribing IPT in three cities in Rio de Janeiro State. The children were followed prospectively. Treatment adherence was defined as taking 80% of prescribed doses. RESULTS: Among 1078 children screened for LTBI, 97 (8.9%) did not return for tuberculin skin test (TST) reading; 332 (30.8%) were TST-positive; 115/332 (34.6%) were prescribed IPT, 6 of whom did not initiate treatment and 11 did not adhere during the first 2 months; 25 additional children did not complete IPT. Overall non-completion was four times more frequent among those with lower income. Health care access and knowledge did not improve treatment completion. CONCLUSIONS: Substantial losses to follow-up occurred before IPT prescription; this should be further investigated. Among the children who started isoniazid, low income, but not difficult access or poor knowledge, increased the risk of treatment non-completion.

Latent tuberculosis infection among undergraduate medical students in Rio de Janeiro State, Brazil.

SETTING: Five medical schools in three cities with different tuberculosis (TB) incidence rates in Rio de Janeiro State, Brazil. OBJECTIVE: To estimate prevalence of and associated factors for latent tuberculosis infection (LTBI) among medical students. DESIGN: A cross-sectional survey was conducted among undergraduate students in pre-clinical, early and late clinical years from schools in cities with low (28/100,000), intermediate (63/100,000) and high (114/100,000) TB incidence rates. Information on socio-demographic profile, previous BCG vaccination, potential TB exposure, co-morbidity and use of respiratory protective masks was obtained. A tuberculin skin test (TST) was performed using the Mantoux technique by an experienced professional. A positive TST, defined as induration > or = 10 mm, was considered LTBI. RESULTS: LTBI prevalence was 6.9% (95%CI 5.4-8.6). In multivariate analysis, male sex (adjusted odds ratio [aOR] 1.8; 95% CI 1.1-3.0), late clinical years (aOR 1.9; 95% CI 1.01-3.5), intermediate TB incidence (aOR 4.3; 95% CI 1.3-14.6) and high TB incidence in the city of medical school (aOR 5.1; 95% CI 1.6-16.8) were significantly associated with LTBI. CONCLUSIONS: The higher prevalence of LTBI in late clinical years suggests that medical students are at increased risk for nosocomial Mycobacterium tuberculosis infection. The implementation of a TB control program may be necessary in medical schools, particularly in cities with higher TB incidence.

Effect of dietary supplementation with vitamin E and stocking density on macrophage recruitment and giant cell formation in the teleost fish, Piaractus mesopotamicus.

The effect of dietary supplementation with 0, 100 and 450 mg of vitamin E (DL-alpha tocopheryl acetate)/kg of a dry diet on the kinetics of macrophage recruitment and giant cell formation in the pacu, maintained at different stocking densities (5 kg/m(3) and 20 kg/m(3)), was investigated by insertion of round glass coverslips into the subcutaneous connective tissue. After a feeding period of 18 weeks, the coverslips were implanted and later removed for examination at 2, 7 and 15 days post-implantation. Fish fed diets supplemented with 450 mg of vitamin E showed an increase (P<0.05) in the accumulation of macrophages, foreign body giant cells and Langhans type cells. The kinetics of macrophage recruitment and giant cell formation on the glass coverslips appeared to be strongly influenced by vitamin E supplementation, since fish fed a basal diet and held at high stocking densities showed low numbers of adhering cells on the coverslips, and high concentrations of plasma corticosteroids. On the other hand, fish given a diet supplemented with 450 mg of vitamin E did not show a similar difference in plasma cortisol concentrations related to stocking density. The effect of cortisol concentrations on carbohydrate metabolism, analysed by assessment of plasma glycaemia, was not clear. Blood glucose concentrations did not vary substantially with the different treatments examined. These results suggest that vitamin E may contribute to the efficiency of the fish's inflammatory response by increasing macrophage recruitment and giant cell formation in the foreign body granulomatous reaction. Vitamin E appeared to act on the stress response of pacus by preventing a stress-related immunosuppression.

[Neurological manifestations of Gougerot and Sjögren disease: a Black African case]. / Les manifestations neurologiques du syndrome de Gougerot et Sjögren: à propos d'un cas en Afrique noire.

Primitive Gougerot-Sjögren syndrome (PGSS) is a systemic autoimmune exocrinopathy in which twenty percent of affected patients develop neurological manifestations. It has been little described in the Black African literature. We report a case of PGSS in a 64-year-old Black woman as revealed by neurological manifestations in an inflammatory context. Central neuropathy was present and the patient fulfilled at least four of the six Vitali American-European diagnostic criteria. There were abnormal aspects on the sylvian artery and hyperintense lesions of periventricular predominance. PGSS is a serious disease which we must consider when we encounter any unexplained neurological manifestations especially those associated with vasculitic lesions.

[Vascular age and cardiovascular risk in patients suffering from stroke]. / Âge vasculaire et risque cardiovasculaire chez les patients victimes d'accident vasculaire cérébral.

AIMS: To determine the vascular age of patients suffering from stroke and their cardiovascular risk at 10 years and to compare their vascular age to their real age. MATERIAL AND METHODS: It was about a descriptive and retrospective study carried up from 1st January 2012 to 31st December 2013 at the neurologic clinic of the University teaching hospital Sylvanus Olympio of Lome from patients' files with a confirmed diagnostic of stroke according to the clinical examination and the scanner data. RESULTS: One hundred and ninety-four patients were related to our study. They were shared-out into 101 men and 93 women equal to a sex-ratio (man/woman) of 1.08. The average real age was of 57.6 ± 13.7 years. High blood pressure was the main risk factor with a prevailing rate of 86.6%, followed by the total hypercholesterolemia (54.3%), the hypocholesterolemia HDL (22.7%), diabetes (10.8%) and nicotinism addiction (4.1%). The average vascular age for all patients was of 68.23 years. The average difference between the real age and the vascular age was of 10 years. The average cardiovascular risk at 10 years in our study was of 13.2%. CONCLUSION: The vascular age of patients suffering from stroke at the University teaching hospital Sylvanus Olympio of Lome is 10 years higher than their real age. This condition considerably increases their risk of cardiovascular diseases. The screening and the early care about vascular risk factors appear therefore of utmost importance.

Antibody-dependent cellular cytotoxicity against HIV-1 in sera of immunized chimpanzees.

After immunization of chimpanzees against HIV antigens, antibodies that mediate antibody-dependent cellular cytotoxicity (ADCC) were evaluated and compared with anti-HIV-antibody levels detected by enzyme-linked immunosorbent assay (ELISA) and neutralizing antibody titers. Adult chimpanzees were immunized with different HIV-1 (LAV-BRU) antigen preparations: recombinant vaccinia virus (rVV) expressing gp160, p25 or p27nef; formalin- and beta-propiolactone-inactivated whole virus (inHIV); soluble recombinant gp160 either associated or not associated with other HIV proteins; a 25-mer peptide from the V3 region of gp120 coupled with KLH (V3-KLH). Immunization with the various rVV mixtures induced no or borderline ADCC increase above preimmune serum levels. Stronger and more sustained reactivity was elicited by inHIV. Purified HIV antigens elicited ADCC activity when the chimpanzees were naive; ADCC increased or remained at the same level when the animals had been preimmunized with rVV and/or inHIV. This type of reactivity apparently did not depend on whether gp160 alone or mixed with other proteins was used for immunization. The injection of V3-KLH resulted in only little, if any, recall ADCC response. ELISA antibody titers significantly correlated with ADCC and neutralizing antibody titers, but serum ADCC was independent of neutralizing antibody titers, an indication that the two latter serum activities are mediated by independent antibodies. Therefore, ADCC is elicited in the same manner as other antibody activities by the immunization of chimpanzees with inHIV or with purified recombinant HIV antigen preparations. The results obtained from the three chimpanzees of this series, which were subsequently challenged with infectious virus through the intravenous route, suggest that serum ADCC may be considered for vaccination purposes.

Jejunal biopsy in HIV-infected patients.

Forty-nine HIV-infected patients were submitted to peroral jejunal biopsy in order to evaluate the presence of microorganisms and the histomorphometric aspects of the enteric mucosa with subsequent correlation of these findings to the appropriate clinical stage of the disease. Thirty-seven patients fulfilled the CDC criteria for AIDS, of whom 23 presented with diarrhea. Of the 12 patients who had not yet been given an AIDS diagnosis. 3 had persistent generalized lymphadenopathy and 9 were asymptomatic carriers. Flat mucosa was observed in two patients (8.7%) with diarrhea and coccidea. Subtotal villous atrophy and severe lamina propria (LP) mononuclear infiltrate (13%) were found only in patients with diarrhea. Moderate to severe histologic changes were more frequently observed in this group, not always related to the presence of microorganisms. Crypt hyperregeneration was a constant finding. Intraepithelial lymphocyte (IEL) count was decreased in patients with diarrhea. Specific infectious agents were unexpectedly rare for the tropical developing country population studied. The organism most commonly associated with diarrhea was Cryptosporidium sp. (21.7%). The etiology of diarrhea in a significant number of patients remains unclear.

Pleural tuberculosis and human immunodeficiency virus co-infection.

SETTING: Department of internal medicine in a general hospital in Rio de Janeiro, Brazil, which provides secondary care to the poor population. OBJECTIVE: The aim of this study was to evaluate the prevalence of human immunodeficiency virus (HIV) infection in patients with pleural tuberculosis (TB) and to compare its manifestations in HIV-negative and HIV-infected patients. DESIGN: Cross-sectional study. METHODS: Forty-three patients with a final diagnosis of pleural TB were submitted to HIV testing (ELISA), chest X-ray, and thoracentesis for biochemical, cytological and bacteriological analysis. Pleural tissue was obtained in 36 patients for histopathological examination. PPD testing was performed in 29 patients. Whenever productive cough was present, sputum acid-fast smears and culture for Mycobacterium tuberculosis were performed. RESULTS: The HIV prevalence was high (30%). TB symptoms were similar in both groups. Atypical radiological aspects were observed in HIV-infected patients with concurrent pulmonary TB (P = 0.03). Pleural fluid, tissue aspects and PPD testing were comparable in both groups. CONCLUSION: Only atypical radiographic patterns in patients with concurrent pulmonary TB were indicative of HIV infection. Therefore, a high index of suspicion is necessary for the early recognition of HIV/TB co-infection. We suggest that all patients presenting with pleural TB should be screened for anti-HIV antibodies.

The study of tuberculosis-attributed deaths as a tool for disease control planning in Rio de Janeiro, Brazil.

SETTING: Two tuberculosis (TB) reference hospitals and three general hospitals in Rio de Janeiro (RJ). OBJECTIVE: To analyze TB-attributed deaths as a tool for evaluating the TB control program in RJ. DESIGN: Retrospective study based on 302 medical records selected from the 1998 death database. RESULTS: Of 1146 registered adult (>14 years) TB-attributed deaths in RJ, 328 occurred in five hospitals, and 302 records were analyzed. Median age was 47.5 (17-89) years; 237 (78.5%) were male. Median time elapsed from onset of symptoms until diagnosis was 60 (7-730) days; median hospitalization was 60 (0-517) days. Acid-fast bacilli sputum smears were performed in 200 (69%) of 290 cases of pulmonary disease. Among 32 (36%) smear-negative patients, culture was done in only one. The recommended regimen (RHZ) was used in 175 (58%). Among 125 re-treatment patients, 55 (44%) were on RHZ instead of RHZE. Notification to health authorities was recorded in 131 (43.4%) cases. CONCLUSION: In RJ, young people die from TB. Major issues identified in the public health system were poor detection and notification and a high default rate, perpetuating the spread of TB. Treating professionals do not follow guidelines, and political commitment is needed to ensure TB control in the state and in the country.

Quantitative and qualitative changes in intestinal immunoglobulin-bearing plasma cells in jejunal mucosa of 52 HIV-infected patients.

1. The purpose of the present study was to evaluate the intestinal secretory immunity of HIV-infected patients. Jejunal biopsies were obtained with a Watson capsule from 52 HIV-infected patients and compared to a control group consisting of 12 healthy subjects, matched for age and sex. IgA- and IgM-containing plasma cells were studied by immunofluorescence by two independent observers who had no knowledge of the history of the slides. 2. The IgA and IgM plasma cell density was significantly decreased in HIV-infected patients when compared to the controls (31/52 for IgA and 42/52 for IgM in the HIV group and normal density in all controls). The depletion of intestinal plasma cells was an early feature of HIV disease and did not correlate with diarrhea, enteropathogens or mucosal atrophy. Although IgA plasma cell depletion has been described in HIV infection, this is the first report of IgM cell density reduction. 3. A peripheral fluorescence pattern was observed in the intestinal cells of HIV-infected patients, contrasting with the normal cytoplasmic fluorescence pattern seen in controls. The cells presenting a rim of peripheral fluorescence in HIV disease might correspond to immature B lymphocytes. 4. The intestinal plasma cell depletion may result in hampered mucosal defense in HIV disease, and is likely to be a direct consequence of T lymphocyte function impairment. 5. The data indicate that the intestinal secretory immune system is altered in AIDS and also in the early stages of HIV disease.

Evidence of hemispheric specialization in marmosets (Callithrix penicillata) using tympanic membrane thermometry.

Recent studies have employed tympanic thermometry to assess lateralization of cognitive and emotional functions in primates. However, no studies using this technique have investigated the possibility of hemispheric specialization in New World monkeys. Therefore, the aim of the present study was to investigate tympanic membrane (TM) temperature asymmetries and their possible correlation with stress responses in marmosets (Callithrix penicillata). Infrared TM thermometry was completed bilaterally in 24 animals (14 males and 10 females) during a stressful situation of capture and restraint. There were no significant differences between gender. A significant negative correlation was observed between TM temperature of the right ear and the number of captures (r = -0.633; P<0.001). Subjects with a more frequent previous history of captures (5 to 9 captures; N = 11) showed lower TM temperature when compared to those with fewer previous captures (1 to 4 captures; N = 13). No differences were observed for the left TM temperature. These results suggest that under intense emotional challenge (capture and restraint) there is a stronger activation of the neural structures situated in the right brain hemisphere. Taken together, the data reveal for the first time evidence of hemispheric specialization in emotional physiological processing in a New World monkey.

[Cerebral venous thrombosis presenting as subarachnoid hemorrhage]. / Thrombophlébite cérébrale révélée par une hémorragie sous-arachnoïdienne.

Headache of subacute onset, associated with other signs of increased intracranial pressure, represents the most frequent symptom of cerebral thrombophlebitis. We report a case of subarachnoid hemorrhage as a rare presentation of cerebral thrombophlebitis. Unfractionated intravenous heparin treatment resulted in resolution of subarachnoid hemorrhage on control brain CT scan and quick clinical recovery.

[Pseudo-dementia as presentation of a dural arteriovenous fistula]. / Syndrome pseudo-démentiel révélateur d'une fistule artério-veineuse durale.

We describe a case of a 70-Year-old man who presented subacute pseudo-dementia due to a dural fistula. Neurological assessment and the reversibility of the symptoms after embolization support the originality of this observation.

[Cysticercosis and neurocysticercosis: epidemiological survey in North Togo]. / Cysticercose et neurocysticercose: enquête épidémiologique dans le nord du Togo.

An epidemiologic survey was carried out by a team of medical doctors working in the Kozah district of North Togo during April 1987. It was designed to evaluate the incidence of epilepsy and cysticercosis, taking a sample population of 5,264 subjects aged over 15 years old. 81.7% of the population feed on pigs which are allowed to roam freely in the vicinity of people's habitations. Cysticercosis (123 cases; incidence 23.3 cases per thousand) was diagnosed when one of the following three tests gave a positive result:--serum sample greater than or equal to 0.400 OD with ELISA test (101 cas),--identification of a cysticercosis cyst on anatomopathological examination of subcutaneous cysts (12 cases),--presence of typical calcification patterns revealed by cranial or muscle X-rays (21 cases in 18 patients). General epilepsy or partial motor fits were entirely clinically diagnosed (88 cases; 16 per thousand of population). Cysticercosis proved to be the cause of 29.5% epileptic sufferers, onset occurring after the age of 50 in 66% of these patients.