ABSTRACT
The genus Microbispora has been considered difficult to define taxonomically. While 16S rRNA gene analysis is required to determine phylogenetic relationships among species in this genus, most 16S rRNA gene-based phylogenetic tree topologies are not reliable. The genus Microbispora currently contains eight species along with six reclassified species (Microbispora chromogenes, Microbispora diastatica, Microbispora parva, Microbispora indica, Microbispora karnatakensis, Microbispora rosea) and Microbispora rosea subsp. aerata, a taxon composed of three further reclassified species (Microbispora aerata, Microbispora thermodiastatica, and Microbispora thermorosea). 16S rRNA, 23S rRNA, gyrB, and rpoB gene sequences were obtained for the type strains of Microbispora species, and eleven endophytic isolates from a Brazilian medicinal plant, Vochysia divergens. Using the concatenated sequence, most Microbispora type strains could be distinguished with high probability support. Based on these analyses, we propose that five of the species reclassified within the subspecies of M. rosea (M. chromogenes, M. karnatakensis, M. parva, M. aerata and M. thermorosea) are distinct from M. rosea and so should be retained as distinct species. The concatenated 16S-gyrB-rpoB gene phylogenic tree had significant probability support and topology. We propose the use of concatenated 16S-gyrB-rpoB gene sequences to determine phylogenetic relationships within the genus Microbispora. We also suggest that strains sharing >98.1 % 16S-gyrB-rpoB gene sequences similarity be defined as a single species, based on results from this analysis. Seven of the strains isolated from V. divergens were not related to any previously described Microbispora species.
Subject(s)
Actinomycetales/classification , Actinomycetales/genetics , DNA Gyrase/genetics , RNA, Ribosomal, 16S/genetics , Actinomycetales/isolation & purification , Bacterial Proteins/genetics , Brazil , DNA, Bacterial/genetics , DNA, Ribosomal/genetics , DNA-Directed RNA Polymerases/genetics , Endophytes , Fatty Acids/analysis , Multilocus Sequence Typing/methods , Phylogeny , Sequence Analysis, DNA , Tracheophyta/microbiologyABSTRACT
Kawasaki disease (KD) is a systemic vasculitis that predominantly affects infants and young children. Asian race has been described as an important factor for the development of this disease. We reported our experience in a cohort of patients with KD. Clinical and laboratory data from initial presentation and follow-up visits were reviewed in 88 patients with KD treated at Children's Hospital of New Orleans between March 1993 and November 2004. Forty-nine (56%) patients were African American, 35 (40%) Caucasian, two (3%) Asian and two (3%) Hispanic. Coronary artery aneurysms (CAAs) were detected in 15 (17%) patients. CAAs were less frequent in African-American patients compared to Caucasians [relative risk (RR)=0.2, 95% CI: 0.04400-0.8405, p=0.0164]. Eighty-three patients responded to one dose of intravenous human immunoglobulin (IVIG), five patients responded to a second infusion of IVIG, and two who were IVIG resistant responded only following methylprednisolone pulse. Hemoglobin (Hb) levels of <10 g/dl and presence of polymorphic rash were significantly correlated with development of CAAs. No deaths were observed.
Subject(s)
Mucocutaneous Lymph Node Syndrome/diagnosis , Racial Groups , Child, Preschool , Cohort Studies , Coronary Aneurysm/diagnosis , Coronary Aneurysm/etiology , Female , Hemoglobins/analysis , Humans , Immunoglobulins, Intravenous/therapeutic use , Male , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/drug therapyABSTRACT
BACKGROUND: Bidirectional cavopulmonary anastomosis (BCPA) has been used as an intermediate stage in the treatment of patients with single-ventricle physiology. Leaving additional antegrade pulmonary blood flow has been shown to improve postoperative arterial blood oxygen saturations; however, controversy continues over whether the potential increase in systemic venous pressure is detrimental. We studied the effects of controlled antegrade pulmonary blood flow on cardiac function in patients after BCPA. METHODS: From January 1993 to July 2000, 128 patients underwent BCPA. Mean age at operation was 6.2 +/- 4 months (range 2 to 36 months). In group 1 (n = 72), restricted antegrade pulmonary blood flow was maintained through a native narrowed pulmonary valve or by adjustment of previously placed pulmonary artery band with the goal of maintaining the mean pulmonary artery pressure less than 16 mm Hg. In group 2 (n = 56), BCPA was the only source of pulmonary blood flow. RESULTS: One hospital death (0.8%) occurred. The mean pulmonary artery pressure at the end of the operation was 13 +/- 2 mm Hg in group 1 compared with 12 +/- 2 mm Hg in group 2, a difference that was not significant. Patients in group 1 had higher arterial oxygen saturations (84% +/- 3% compared with 74% +/- 3% in group 2, p < 0.05), and shorter mean hospital stay (9 +/- 3 days compared with 15 +/- 2 days, p < 0.05). Persistent pleural effusion (> 10 days) or late chylothorax occurred in 4 patients from group 1 and 3 from group 2, a difference that was not significant. During a mean follow-up of 36 +/- 10 months no late deaths occurred. The mean oxygen saturation remained higher in group 1, 80% +/- 3% compared with 74% +/- 4% in group 2, and the hematocrit was lower, at 38% +/- 3% compared with 46% +/- 4% (p < 0.05 for both comparisons). Cardiac catheterizations were performed in 68 patients before completion Fontan. Total pulmonary artery (Nakata) index was 263 +/- 34 mm(2)/m(2) in group 1 (n = 40) and 188 +/- 13 mm(2)/m(2) in group 2 (n = 28) (p < 0.05). The mean pulmonary artery pressure and mean ventricular end-diastolic pressure were similar. CONCLUSIONS: Controlled antegrade pulmonary blood flow may have favorable effects on cardiac function for a selected group of patients and does not appear to have adverse effects on subsequent suitability for completion Fontan.
Subject(s)
Heart Bypass, Right , Heart/physiopathology , Pulmonary Circulation , Blood Pressure , Child, Preschool , Heart Defects, Congenital/physiopathology , Heart Defects, Congenital/therapy , Heart Ventricles/abnormalities , Humans , Infant , Oxygen/blood , Pulmonary Artery/physiology , Reoperation , Retrospective Studies , Venous Pressure , Ventricular PressureABSTRACT
A group of experts on schistosomiasis and ultrasonography discussed the experiences and results obtained with the Niamey-Belo Horizonte Protocol on Ultrasonography in Schistosomiasis. A series of recomendations about qualitative and quantitative data obtained by ultrasound in studies performed in Africa and Brazil are presented. Imunological, genetic and epidemiological studies must rely on ultrasound for the identification of patients with periportal thickening/fibrosis
Subject(s)
Humans , Schistosomiasis , Africa , Brazil , Clinical Protocols , Fibrosis , Hypertension, Portal , LiverABSTRACT
Objetivo: Comprovar na regiäo endêmica de Agua Comprida (MG) a maior incidência de anisocoria e menor pressäo intra-ocular (Po) em chagásicos anteriormente observados em outra regiäo endêmica da doença de Chagas (Mambaí, GO). Material e métodos: Em estudo prospectivo, mascarado e pareado quanto a idade, sexo e cor, foram analisados 190 pacientes (95 pares de chagásicos e näo-chagásicos). Em 84 pares, realizou-se estudo fotográfico da pupila para a determinaçäo do diâmetro pupilar e frequências de anisocoria (diferença>0,3 mm). Em 95 pares, foi estudada a pressäo intra-ocular entre chagásicos e näo-chagásicos. Resultados: No grupo chagásicos foram observados 25 casos de anisocoria (29,8 por cento) e nos näo-chagásicos, 10 ocorrências (11,9 por cento), diferença essa estatisticamente significante (p = 0,007). Näo houve diferenças estatisticamente significantes para o diâmetro pupilar entre os grupos tanto para OD quanto para OE. Os chagásicos mostraram uma Po média de 11,3 + ou - 2,5 mmHg em OD e de 11,3 + ou - 2,4 mmHg em OE e os näo chagásicos uma Po de 13,1 + ou - 2,6 e 13,1 + ou - 2,5 mmHg respectivamente, diferenças essas estatisticamente significantes entre chagásicos e näo-chagásicos tanto para OD quanto para OE (pOD=pOE<0,0001). Tais diferenças mantiveram-se quando a Po foi comparada quanto ao sexo (feminino p=0,002, masculino p=0,003). Conclusäo: Os resultados comprovam a maior frequência de anisocoria e menores valores de pressäo intra-ocular em pacientes portadores da forma crônica da doença de Chagas.
Subject(s)
Humans , Male , Female , Middle Aged , Anisocoria/epidemiology , Chagas Disease/physiopathology , Intraocular Pressure/physiology , Brazil/epidemiology , Chronic Disease , Chagas Disease/epidemiology , Endemic Diseases , Incidence , Prospective StudiesABSTRACT
El Proyecto Mambaí fue creado en 1980 con la finalidad de estudiar longitudinalmente los rasgos clínicos y epidemiológicos de la enfermedad de Chagas y de adoptarlo como programa piloto del Ministerio de Salud del Brasil. Inicialmente, se efectuó un censo, se evaluaron las viviendas y a los habitantes se les hicieron una exploración clínica y análisis de laboratorio. Después de la fase de ataque masivo con insecticidas, se organizaron las tareas de vigilancia epidemiológica continua para detectar focos triatomínicos residuales en todas las casas del municipio. Esta campaña incluyó un programa de educación sanitaria y contó con la participación de la comunidad. Toda casa infestada fue fumigada selectivamente. En 1988 se llevaron a cabo un nuevo censo y una encuesta serológica en niños nacidos después del inicio del control. En este artículo se describen los resultados de la vigilancia epidemiológica durante los primeros 13 años del programa. La prevalencia de Triatoma infestans en los domicilios disminuyó hasta niveles que sugieren el bloqueo de la transmisión vectorial de la enfermedad en Mambaí. Sin embargo, el riesgo de reinfestación a partir de zonas vecinas no controladas y el riesgo de colonización de vectores secundarios tipo T. sordida constituyen factores que deberán monitorizarse cuidadosamente
Subject(s)
Chagas Disease/prevention & control , Epidemiological Monitoring , Community Participation , Health Education , Brazil/epidemiologyABSTRACT
El Proyecto Mambaí fue creado en 1980 con la finalidad de estudiar longitudinalmente los rasgos clínicos y epidemiológicos de la enfermedad de Chagas y de adoptarlo como programa piloto del Ministerio de Salud del Brasil. Inicialmente, se efectuó un censo, se evaluaron las viviendas y a los habitantes se les hicieron una exploración clínica y análisis de laboratorio. Después de la fase de ataque masivo con insecticidas, se organizaron las tareas de vigilancia epidemiológica continua para detectar focos triatomínicos residuales en todas las casas del municipio. Esta campaña incluyó un programa de educación sanitaria y contó con la participación de la comunidad. Toda casa infestada fue fumigada selectivamente. En 1988 se llevaron a cabo un nuevo censo y una encuesta serológica en niños nacidos después del inicio del control. En este artículo se describen los resultados de la vigilancia epidemiológica durante los primeros 13 años del programa. La prevalencia de Triatoma infestans en los domicilios disminuyó hasta niveles que sugieren el bloqueo de la transmisión vectorial de la enfermedad en Mambaí. Sin embargo, el riesgo de reinfestación a partir de zonas vecinas no controladas y el riesgo de colonización de vectores secundarios tipo T. sordida constituyen factores que deberán monitorizarse cuidadosamente
Este artículo complementa el titulado "Enfermedad de Chagas: control y vigilancia con insecticidas y participación comunitaria en Mambaí, Brasil" de este mismo número
