Balance of apoptotic and anti-apoptotic marker and perforin granule release in squamous intraepithelial lesions. HIV infection leads to a decrease in perforin degranulation.

Cell-mediated cytotoxicity plays an important role in the regulation to HPV-associated cervical intraepithelial neoplasia. HIV co-infection is related to poorer prognosis and more rapid clinical progression to cancer. We evaluated the presence of cervical inflammatory cells, apoptotic (Bax, Bcl-2, FasL, NOS2, perforin) markers and the degranulating expressing cell marker (CD107a) in low and high squamous intraepithelial lesions (LSIL and HSIL, respectively) from HIV-negative and -positive women. Higher percentage of cervical CD4(+), CD8(+) T cells and macrophage were observed in LSIL and HSIL groups when compared with control, especially in epithelium and basal layer of epithelium. However, progression from LSIL to HSIL did not change the frequency of inflammatory cells. HIV-infection lead to a reduction on cervical CD4(+) T cell infiltration and an increased CD8(+) T cell distribution in LSIL groups. A balance between pro- and anti-apoptotic protein expressions was verified. Bax-expressing cells were present in all groups and were rarely expressed in keratinocytes in the epithelium in LSIL and control groups, but notably decreased in HSIL group. However, its frequency was enhanced in the basal layer of the epithelium meanly in LSIL group. Bcl2-expressing cells in the epithelium and the stroma were enhanced in HSIL group when compared with LSIL group. HIV-infection did not interfere in both expressions NOS2 expression was located on keratinocytes in both LSIL and HSIL groups when compared with control group. There were few FasL cervical expressing cells in all groups. Indeed, perforin was identified in few cervical cells. However, CD107a, a surface marker for cellular degranulation was significantly higher in epithelium, basal layer of epithelium and stroma in LSIL and HSIL, respectively, when compared with control group. These results support that HIV infection may induce reduction on inflammatory cervical cell degranulation corroborating to carcinogenesis process. This is the first description on the role of HIV in downregulation of perforin degranulation in the cervical lesions and it might be related to carcinogenesis.

Primary endemic Cryptococcosis gattii by molecular type VGII in the state of Pará, Brazil

In order to study the infectious agents causing human disseminated cryptococcosis in the state of Pará, North Brazil, 56 isolates of Cryptococcusspp. (54 isolated from cerebral spinal fluid and two from blood cultures) from 43 cases diagnosed between 2003-2007 were analysed. The species were determined through morphological and physiological tests and genotypes were determined by URA5-RFLP and PCR-fingerprinting (wild-type phage M13). The following species and genotypes were identified: Cryptococcus neoformans VNI (28/56, 50 percent), Cryptococcus gattii VGII (25/56, 44.64 percent) and C. gattii VGI (3/56, 5.26 percent). The genotype VNI occurred in 12 out of 14 HIV-positive adults, whereas the genotype VGII occurred in 11 out of 21 HIV-negative adults (p < 0.02, OR = 6.6 IC95 percent 0.98-56.0). All patients less than 12 years old were HIV negative and six cases were caused by the VGII genotype, one by the VGI and one by VNI. Therefore, endemic primary mycosis in HIV-negative individuals, including an unexpectedly high number of children, caused by the VGII genotype deserves further study and suggests the need for surveillance on cryptococcal infection in the state of Pará, Eastern Amazon.

Primary endemic Cryptococcosis gattii by molecular type VGII in the state of Pará, Brazil.

In order to study the infectious agents causing human disseminated cryptococcosis in the state of Pará, North Brazil, 56 isolates of Cryptococcusspp. (54 isolated from cerebral spinal fluid and two from blood cultures) from 43 cases diagnosed between 2003-2007 were analysed. The species were determined through morphological and physiological tests and genotypes were determined by URA5-RFLP and PCR-fingerprinting (wild-type phage M13). The following species and genotypes were identified: Cryptococcus neoformans VNI (28/56, 50%), Cryptococcus gattii VGII (25/56, 44.64%) and C. gattii VGI (3/56, 5.26%). The genotype VNI occurred in 12 out of 14 HIV-positive adults, whereas the genotype VGII occurred in 11 out of 21 HIV-negative adults (p < 0.02, OR = 6.6 IC95% 0.98-56.0). All patients less than 12 years old were HIV negative and six cases were caused by the VGII genotype, one by the VGI and one by VNI. Therefore, endemic primary mycosis in HIV-negative individuals, including an unexpectedly high number of children, caused by the VGII genotype deserves further study and suggests the need for surveillance on cryptococcal infection in the state of Pará, Eastern Amazon.

First encounter of subclinical human Leishmania (Viannia) infection in State of Rio Grande do Sul, Brazil

The objective of the present study was to evaluate the specificity of the Montenegro skin test (MST) in an area in Brazil, state of Grande do Sul State (RS), which was considered to be non-endemic for leishmaniasis. Sixty subjects presented a positive MST and were reevaluated by clinical examination, serology and polymerase chain reaction (PCR) of peripheral blood for the detection of subclinical Leishmania infection. None of the subjects presented clinical signs or symptoms of current leishmaniasis or a history of the disease.Leishmania (Viannia) DNA was detected in blood by PCR and hybridization in one subject. The PCR skin test-positive individual remained asymptomatic throughout the study. Clinical examination showed no scars suggestive of past cutaneous leishmaniasis. Human subclinical infection with Leishmania (Viannia) in RS was confirmed by PCR. This is the first report of subclinical infection with this parasite in the human population of this area.

First encounter of subclinical human Leishmania (Viannia) infection in State of Rio Grande do Sul, Brazil.

The objective of the present study was to evaluate the specificity of the Montenegro skin test (MST) in an area in Brazil, state of Grande do Sul State (RS), which was considered to be non-endemic for leishmaniasis. Sixty subjects presented a positive MST and were reevaluated by clinical examination, serology and polymerase chain reaction (PCR) of peripheral blood for the detection of subclinical Leishmania infection. None of the subjects presented clinical signs or symptoms of current leishmaniasis or a history of the disease. Leishmania (Viannia) DNA was detected in blood by PCR and hybridization in one subject. The PCR skin test-positive individual remained asymptomatic throughout the study. Clinical examination showed no scars suggestive of past cutaneous leishmaniasis. Human subclinical infection with Leishmania (Viannia) in RS was confirmed by PCR. This is the first report of subclinical infection with this parasite in the human population of this area.

Evaluation of an epidemic of sporotrichosis in cats: 347 cases (1998-2001).

OBJECTIVE: To evaluate characteristics of a large epidemic of sporotrichosis in cats. DESIGN: Retrospective study. ANIMALS: 347 cats with naturally acquired infection with Sporothrix schenckii. PROCEDURE: Medical records were reviewed for data regarding clinical, mycologic, histopathologic, and routine hematologic and serum biochemical findings; assays for FIV-specific antibodies and FeLV antigen; antifungal treatment; and follow-up. RESULTS: Lesions varied from small papules to extensive zones of necrosis. Ten cats had no skin lesions, 114 had skin lesions at a single site, 86 had skin lesions in 2 sites, and 137 had skin lesions in 3 or more sites. Respiratory tract signs were observed in 154 cats and were the most frequent extracutaneous sign. Anemia, leukocytosis with neutrophilia, hypoalbuminemia, and hyperglobulinemia were the main blood abnormalities. Antibodies against FIV were detected in 28 cats, FeLV antigen was detected in 2 cats, and both were detected in 1 cat among 142 cats tested. During the study, 118 cats were lost to follow-up and 124 died. Of 266 cats that were treated, 68 were cured. Complete healing of the lesions was observed regardless of the presence of extracutaneous signs, general condition, treatment schedule, or coinfection with FIV. CONCLUSIONS AND CLINICAL RELEVANCE: Feline sporotrichosis was evident in subclinical to severe forms; however, cats can respond well to regular and prolonged antifungal treatment.

Serotyping of 467 Cryptococcus neoformans isolates from clinical and environmental sources in Brazil: analysis of host and regional patterns.

Cryptococcus neoformans is an important zoopathogen, and it is one of the most prevalent lethal mycotic agents. Its polysaccharide capsule, synthesized in vivo and in vitro, is a virulence factor, contains predominantly glucuronoxylomannan, and is responsible for the antigenic differentiation of serotypes A, B, C, D, and AD. A total of 467 isolates of C. neoformans obtained from clinical and environmental sources from Brazilian regions were studied serologically by using the Crypto Check Iatron RM 304-K kit. Serotyping of the clinical isolates showed the following prevalences of the serotypes: A (77.95%), followed by B (18.2%), AD (1.3%), D (0.4%), C (0.2%), and untypeable (1.93%). The epidemiology of serotype A in the Brazilian southern and southeastern regions reproduces the picture observed worldwide. In contrast, serotype B was the most frequent agent of cryptococcosis in the northeastern region, occurring nearly equally in male and female healthy hosts. Among the isolates from environmental sources, serotypes A and B were found to occur in the hollows of tropical trees of the genera Cassia, Ficus, and MOQUILLEA: The few isolates from Eucalyptus camaldulensis debris were serotypes A and B and untypeable. Overall, no association with a specific host tree was identified for these serotypes, denoting a distinct ecoepidemiological regional pattern. The one serotype C isolate was recovered from a human immunodeficiency virus-negative host. Serotype AD predominated over serotype D among both clinical and environmental isolates.

Estudo dos níveis de exposiçäo e efeitos à saúde por mercúrio metálico em uma populaçäo urbana de Paconé, Mato Grosso, Brasil / Study of exposure to and health effects of atmospheric metallic mercury pollution in an urban population of Poconé, Mato Grosso, Brazil

Foram avaliados os níveis de exposiçäo e dos efeitos causados por emissöes na atmosfera de mercúrio metálico proveniente de casas compradoras de ouro na populaçäo do município de Paconé, estado de Mato Grosso. O projeto foi desenvolvido através da comparaçäo da morbidade referida, dos exames clínicos e da análise dos teores de mercúrio na urina de três grupos populacionais. As análises dos teores de mercúrio na urina mostraram diferenças altamente significativas entre os grupos centro e periferia em comparaçäo ao grupo-controle. Entrevistas com as pessoas que apresentavam teores elevados evidenciaram que a exposiçäo no centro da cidade poderia ser proveniente das casas compradoras de ouro e, no caso da periferia, poderia ter ocorrido exposiçäo através da queima de amálgamas no interior das residências. Os dados de morbidade referida apresentaram proporçöes maiores de queixas entre os moradores do centro em comparaçäo aos outros grupos e também maior número de alteraçöes no exame clínico. Conclui-se que há maiores exposiçäo e efeitos à saúde devido ao mercúrio metálico entre pessoas pertencentes aos primeiros dois grupos.

Complicaçöes neurológicas da síndrome de imunodeficiência adquirida: experiência do HUSFF-UFRJ / Neurological complications in adquired immunodeficiency syndrome: experience of the Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro

A frequência de manifestaçöes neurológicas foi analisada em 653 pacientes soropositivos para o HIV, internados em um hospital universitário na cidade do Rio de Janeiro, entre 1985 e 1989. Do total de pacientes, 172 (26%) apresentavam sintomas referentes ao sistema nervoso. Nesta populacäo, foram estudados os diferentes fatores de risco e distribuiçäo etária. Dentre as complicaçöes observadas predominaram: toxoplasmose cerebral (80), neurocriptococose (57), encefalite subaguda (17) e meningite tuberosa (8). Fez-se correlaçäo entre os aspectos clínicos e tomográficos. A maioria dos casos (60%) evoluiu para o óbito no período estudado e 89%) destes tiveram inferior a 6 meses

Estudo comparativo dos efeitos da utilizaçao de mercúrio por dentistas / Comparative study on the effects of mercury utilization by dentists

Foi realizado um estudo comparativo dos efeitos do mercúrio entre dentistas e médicos que trabalhamna Universidade Federal do Rio de Janeiro. Os resultados obtidos mostraram que os dentistas apresentavam um número estatisticamente maior de morbidade referida por rins e aparelho digestivo e sinais e sintomas de alteraçoes de sistema nervoso. Outrossim, nao houve diferenças significativas entre os dois grupos em relaçao aos teores de mercúrio no cabelo, o que pode ser explicado por alteraçoes recentes no processo de trabalho dos dentistas

Teores de mercúrio no cabelo: um estudo comparativo em trabalhadores da lavoura de cana-de-açucar com exposiçäo pregressa aos fungicidas organo-mercuriais no município de Campos - RJ / Levels of mercury in the hair: a comparative study in agricultural workers of sugar caane platations previons exposureto the organo-mercurial fungicidas in the municpality of Campos - RJ

Como parte de uma tese de doutoramento, foi realizado um estudo comparativo dos teores de mercúrio no cabelo de un grupo de trabalhadores que tinham deixado de manipular os fungicidas organo-mercuriais há pelo menos dois anos com outro semelhante, porém sem a história de manipulaçäo prévia destes fungicidas. Embora näo tenham sido encontradas diferenças estatisticamente significantes entre os grupos, os dados apresentados sugerem que pode ter havido contaminaçäo ambiental por mercúrio em trabalhadores, pelo menos dois anos depois da proibiçäo do uso dos fungicidas organo-mercuriais no Brasil