The use of genetic markers in the molecular epidemiology of histoplasmosis: a systematic review.

Histoplasmosis is a systemic mycosis caused by Histoplasma capsulatum, a dimorphic fungal pathogen that can infect both humans and animals. This disease has worldwide distribution and affects mainly immunocompromised individuals. In the environment, H. capsulatum grows as mold but undergoes a morphologic transition to the yeast morphotype under special conditions. Molecular techniques are important tools to conduct epidemiologic investigations for fungal detection, identification of infection sources, and determination of different fungal genotypes associated to a particular disease symptom. In this study, we performed a systematic review in the PubMed database to improve the understanding about the molecular epidemiology of histoplasmosis. This search was restricted to English and Spanish articles. We included a combination of specific keywords: molecular typing [OR] genetic diversity [OR] polymorphism [AND] H. capsulatum; molecular epidemiology [AND] histoplasmosis; and molecular epidemiology [AND] Histoplasma. In addition, we used the specific terms: histoplasmosis [AND] outbreaks. Non-English or non-Spanish articles, dead links, and duplicate results were excluded from the review. The results reached show that the main methods used for molecular typing of H. capsulatum were: restriction fragment length polymorphism, random amplified polymorphic DNA, microsatellites polymorphism, sequencing of internal transcribed spacers region, and multilocus sequence typing. Different genetic profiles were identified among H. capsulatum isolates, which can be grouped according to their source, geographical origin, and clinical manifestations.

Clinical and epidemiological features of visceral leishmaniasis and HIV co-infection in fifteen patients from Brazil.

Cases of visceral leishmaniasis (VL) in the course of human immunodeficiency virus (HIV) infection have regularly been recorded, mainly in southern Europe. HIV infection can increase the risk of VL development by 10-100 times in endemic areas. We describe the occurrence of this co-infection in 15 patients from Brazil. The mean age of the patients was 38 +/- 8.8 yr, with 86.6% males. The mean time between HIV diagnosis and the onset of visceral leishmaniasis was 44 +/- 39 mo. The main signs and symptoms presented at admission were splenomegaly (73%), weight loss (73%), cough (67%), fever (67%), asthenia (60%), and diarrhea (60%). The mean T CD4+ lymphocyte count was 173.7 +/- 225.6 cells/mm3, and viral load was 51,030 +/- 133,737/mm3. Treatment consisted of pentavalent antimonials (67% of cases). Most (87%) patients recovered from VL infection; death occurred in 1 patient due to septic shock. VL is an important opportunistic infection in HIV patients, which is potentially fatal, even when correct treatment is completed. Treatment should be done with pentavalent antimonials or amphotericin B in the case of relapse. Although there is no consensus, secondary prophylaxis should be considered in severe cases.

On the use of different potential energy functions in rare-gas cluster optimization by genetic algorithms: application to argon clusters.

We study the effect of the potential energy function on the global minimum structures of argon clusters arising in the optimization performed by genetic algorithms (GAs). We propose a robust and efficient GA which allows for the calculation of all of the putative global minima of Ar(N) (N = 3-78) clusters modeled with four different potentials. Both energetic and structural properties of such minima are compared among each other and with those previously obtained for the Lennard-Jones function. In addition, the possibility of obtaining global minima of one potential through local optimization over the corresponding cluster geometry given by other potentials was associated with some structural parameters. The influence of the contribution from the three-body (Axilrod-Teller-Muto) triple-dipole potential (including or not a damping function to describe its correct behavior at smaller interatomic distances) has also been analyzed.

HIV-positive women in northeast Brazil: tubal sterilization, medical recommendation and reproductive rights.

Tubal sterilization is the most common contraceptive method used by Brazilian HIV-positive women. This cross sectional study describes the main reasons why HIV-positive women decide to be sterilized and identifies factors associated with choosing sterilization in HIV-positive women in Ceará, northeast Brazil. Data from 229 non-sterilized women, 80 women sterilized before HIV diagnosis and 48 women sterilized after diagnosis were analysed. Of the women sterilized after HIV diagnosis, 96% had the procedure done in the postpartum, during a caesarean section. No desire for more children was the most common appointed reason to be sterilized (39.6%), followed by medical recommendation because of HIV (31.3%). Seventy-nine women (28.5%) had a child after HIV diagnosis. Of those, 46 (58.2%) were sterilized in the postpartum. Factors associated with sterilization for HIV-positive women were: having a child after diagnosis (AOR: 120.9; 95%CI: 27.8-525.4) and having at least three children (AOR: 2.8; 95%CI: 1.1-7.1). It is recommended that non-coercive counselling should be provided so that HIV-positive women can make informed decisions on their reproductive options.