Susceptibility to antifungal agents and enzymatic activity of Candida haemulonii and Cutaneotrichosporon dermatis isolated from soft corals on the Brazilian reefs.

Candida is a common fungus with the capacity to cause infections in humans. However, most studies have concentrated on clinical isolates and little is known about the identity, ecology and drug resistance of free living species/strains. Here, we isolate eight strains of Candida haemulonii and four strains of Cutaneotrichosporon dermatis from three marine cnidarian zoanthids species (Palythoa caribaeorum, Palythoa variabilis and Zoanthus sociatus) collected from Brazilian coral reefs. Strains were identified by sequencing of the D1/D2 domain LSU rDNA and ITS region. We tested these environmental isolates for their capacity to grow in media with increasing concentration of NaCl, capacity to grow in different temperatures, enzymatic activity and antifungal susceptibility. For C. haemulonii, all strains strongly produced gelatinase, esterase and albuminase and were either able to express lipase, phospholipase and keratinase, but not express urease and DNase. The strains were able to grow at 37 °C, but not at 39 °C, and except for LMS 40, all of them could grow in a 10 % NaCl medium. All isolates were resistant to all antifungals tested, with exception for ketoconazole and tioconazole (MIC = 2 µg/mL). For C. dermatis, all strains could grow at 39 °C and could not express phospholipase, keratinase or gelatinase. However, all were capable of expressing urease, lipase and esterase. Three out of four strains could grow in a 10 % NaCl medium, but none grew in a 30 % NaCl medium. The strains showed high values of minimal inhibitory concentration. LMPV 90 was resistant to tioconazole, terbinafine, fluconazole and posaconazole, and LMS 38 was resistant to all antifungal agents tested. We discuss the characterization of C. haemulonii and C. dermatis as a possible emerging pathogen due to its animal-related enzymatic arsenal and antifungal resistance.

Children with chronic renal disease undergoing dialysis or conservative treatment--differences in structural and functional echocardiographic parameters.

UNLABELLED: Cardiac disease frequently occurs in children with chronic kidney disease (CKD) undergoing dialysis (DI), but it is not well studied in patients undergoing conservative treatment (CT). The aim of our study was to use echocardiography to analyze and compare the cardiac involvement of children with CKD undergoing DI or CT. METHODS: Seventy-one children with CKD were included; 41 undergoing DI and 30 undergoing CT. There were 33 controls. Measurements of arterial pressure and structural and functional echocardiographic variables were obtained; the children were followed up for 18 months. Tests of comparison and multiple regression were used; significant if P < 0.05. RESULTS: Arterial hypertension (AH) was present in 37 of 71 (52%) children with CKD: 27 (65.8%) in DI and 10 (33.3%) in CT (X2 = 8.7; P = 0.003). An abnormal left ventricular geometric pattern was present in 37/41 (90.3%) undergoing DI, 33 had left ventricular hypertrophy (LVH), and in 14/30 (46.7%) undergoing CT, 5 had LVH. Ejection fraction was normal in all groups; diastolic function alteration (DFA) occurred in 28/41 (68.3%) children on DI and in 10/30 (33.3%) on CT (X2 = 9.2; P = 0.002). For children with CKD, DI (P = 0.002) and hypertension (P = 0.04) were associated with LVH; among those on DI, only AH was associated with LVH (P = 0.02). During the follow-up, 18 (43.9%) children undergoing DI had at least one cardiovascular event. CONCLUSION: Children with CKD undergoing CT had less cardiac involvement than those undergoing DI. LVH was associated with DI and AH in all children with CKD and with AH in those on DI.

Morphobiological aspects of Rhodnius brethesi Matta, 1919 ( Hemiptera:Reduviidae ) from the Upper and Middle Negro River, Amazon region of Brazil: I - scanning electron microscopy

The occurrence of autochthonous cases of Chagas disease in the Amazon region of Brazil over recent decades has motivated an intensification of studies in this area. Different species of triatomines have been identified, and ten of these have be proven to be carriers of the parasite Trypanosoma cruzi or " cruzi-like " parasites. Studies conducted in the municipalities of Santa Isabel do Rio Negro and Barcelos, located on the Upper and Middle of the Negro River, microregion of Negro River, state of Amazonas have confirmed not only that Rhodnius brethesi is present in the palm tree Leopoldinia piassaba, but also that this insect was recognized by palm fiber collectors. A morphological study of eyes, inter-ocular and inter-ocellar regions, antennae, buccula, labrum, rostrum, stridulatory sulcus and feet, including the apex of the tibia, spongy fossette and ctenidium was conducted by scanning electron microscopy. The buccula and the stridulatory sulcus presented notable differences in specimens of different genera and also of different species. These data make it possible to suggest that the details presented in these structures can be included as diagnostic characteristics to be used in new dichotomous keys, thereby contributing towards studies of taxonomy and systematics and furnishing backing for comparative analysis of specimens collected from different localities.

[Endothelial function of normotensive adolescents with no risk factors for arterial hypertension]. / Função endotelial de adolescentes normotensos sem fatores de risco para hipertensão arterial.

OBJECTIVE: To define standards for normal endothelial function in adolescents by high-resolution ultrasound measurement of endothelium-dependent vascular dilatation. METHODS: This was a cross-sectional, descriptive, observational study and part of the thematic project "Clinical Study of Growth, Behavior, Arterial Hypertension, Obesity and Oral Health" (ECCCHOS) that was developed by the Discipline of Nutrition at the Universidade Federal de São Paulo. Thirty-one adolescents, eight male and twenty-three female, with no risk factors for systemic arterial hypertension were selected from 1,420 secondary school students. The students were daytime pupils at a school in the southeastern district of the city of São Paulo, the capital of São Paulo state, located in the Southeast region of Brazil. All results are presented in the form of means with standard deviations and percentiles. RESULTS: For male students, endothelium-dependant dilation 90 seconds after the cuff was released was 20.9+/-6.7% [mean +/-1 standard deviation] with a 10th percentile of 12.5 and for females these figures were 18.8+/-12.9% with a 10th percentile of 6.6%. Values for the whole group of subjects were 19.3+/-11.7% and 6.7%, respectively. CONCLUSION: Endothelium-dependant vascular dilation of 6.7%, after 90 seconds, which corresponds to the 10th percentile, can be considered the lower limit of normality for this age group. Knowledge of this limit is important for the diagnosis of endothelium dysfunction that appears before cardiovascular disease.

Função endotelial de adolescentes normotensos sem fatores de risco para hipertensão arterial / Endothelial function of normotensive adolescents with no risk factors for arterial hypertension

OBJETIVO: Definir padrões de normalidade da função endotelial de adolescentes através de avaliação ultra-sonográfica da dilatação vascular dependente do endotélio. MÉTODOS: Estudo descritivo observacional de corte transversal, parte do projeto temático "Estudos Clínicos de Crescimento, Comportamento, Hipertensão Arterial, Obesidade e Saúde Bucal", de sigla ECCCHOS, desenvolvido na Disciplina de Nutrologia da Universidade Federal de São Paulo - Escola Paulista de Medicina. Foram selecionados 31 adolescentes, sendo oito do sexo masculino e 23 do feminino, sem fatores de risco conhecidos para hipertensão arterial sistêmica, entre 1.420 alunos de uma escola de ensino médio da cidade de São Paulo, capital do estado de São Paulo, situado no Sudeste do Brasil. Para apresentação de todos os resultados, utilizaram-se as médias, desvios padrão e percentis. RESULTADOS: A dilatação vascular dependente do endotélio 90 segundos pós-liberação do manguito foi de 20,9±6,7 por cento [média mais ou menos 1 desvio padrão (DP)] e o 10° percentil ficou em 12,5 por cento no sexo masculino e de 18,8±12,9 por cento DP e o 10° percentil em 6,6 por cento no sexo feminino. Os valores no grupo todo foram de 19,3±11,7 por cento e 6,7 por cento, respectivamente. CONCLUSÃO: O 10° percentil (6,7 por cento) da curva de distribuição dos valores de dilatação vascular dependente do endotélio, em adolescentes do presente estudo, pode ser considerado como limite inferior da normalidade. O conhecimento desse limite é importante para o diagnóstico de disfunções endoteliais que aparecem antes das doenças cardiovasculares.

Morphobiological aspects of Rhodnius brethesi Matta, 1919 (Hemiptera:Reduviidae) from the Upper and Middle Negro River, Amazon region of Brazil: I - scanning electron microscopy.

The occurrence of autochthonous cases of Chagas disease in the Amazon region of Brazil over recent decades has motivated an intensification of studies in this area. Different species of triatomines have been identified, and ten of these have be proven to be carriers of the parasite Trypanosoma cruzi or " cruzi-like " parasites. Studies conducted in the municipalities of Santa Isabel do Rio Negro and Barcelos, located on the Upper and Middle of the Negro River, microregion of Negro River, state of Amazonas have confirmed not only that Rhodnius brethesi is present in the palm tree Leopoldinia piassaba, but also that this insect was recognized by palm fiber collectors. A morphological study of eyes, inter-ocular and inter-ocellar regions, antennae, buccula, labrum, rostrum, stridulatory sulcus and feet, including the apex of the tibia, spongy fossette and ctenidium was conducted by scanning electron microscopy. The buccula and the stridulatory sulcus presented notable differences in specimens of different genera and also of different species. These data make it possible to suggest that the details presented in these structures can be included as diagnostic characteristics to be used in new dichotomous keys, thereby contributing towards studies of taxonomy and systematics and furnishing backing for comparative analysis of specimens collected from different localities.

Função endotelial e fatores de risco para hipertensão arterial sistêmica em adolescentes / Endothelial function and risk factors for systemic hypertension in adolescents

Objetivos: Definir, em adolescentes eutróficos e normotensos, padrão de normalidade da dilatação vascular dependente do endotélio mediada por fluxo. Identificar, em adolescentes obesos normotensos alterações dessa função endotelial associadas a fatores de risco para hipertensão arterial sistêmica. Metodologia: Ultra-sonografia de alta resolução de modo B. Desenho e casuística: Estudo descritivo observacional de corte transversal para determinação do padrão de normalidade da função endotelial de adolescentes e estudo tipo caso--controle entre grupos obeso e eutrófico para determinar associações entre fatores de risco para hipertensão arterial sistêmica e disfunção endotelial em adolescentes obesos normotensos. Os participantes do estudo foram adolescentes de escola de 2ºgrau do sudeste da cidade de São Paulo. Para determinação da normalidade da função endotelial foram selecionados 31 adolescentes sendo 8 do sexo masculino e 23 do feminino, sem fatores de risco para hipertensão arterial sistêmica. Para apresentação de todos os resultados utilizaram-se médias, desvios padrão e percentis. Para o estudo caso controle foram selecionados 67 adolescentes obesos e 67 adolescentes eutróficos pareados por grupo. Resultados: Nos adolescentes sem fatores de risco para hipertensão arterial sistêmica a dilatação vascular dependente do endotélio apresentou média ± 1 desvio padrão de 19,3 por cento ± 11,7 e o 10ºpercentil ficou 6,7 por cento. No estudo caso controle, a dilatação vascular dependente do endotélio foi menor nos obesos, mas a diferença não mostrou significância estatística. Conclusões: O 10º percentil (6,7 por cento) da curva de distribuição dos valores de dilatação vascular dependente do endotélio, dos adolescentes do presente estudo, pode ser considerado como limite inferior da normalidade dessa função endotelial. O conhecimento deste limite é importante para o diagnóstico de disfunções endoteliais que aparecem antes das doenças cardiovasculares. A obesidade associou-se a tendência de menor dilatação vascular dependente do endotélio. Usou-se a afirmação de tendência por que a diferença não foi estatisticamente significante.

Immunohistochemical and in situ detection of cytomegalovirus in lung autopsies of children immunocompromised by secondary interstitial pneumonia.

Secondary interstitial pneumonia (SIP), a disease affecting patients immunocompromised by primary underlying diseases during their treatment in hospital, is frequently associated with cytomegalovirus (CMV) infection, a potentially treatable condition. However, in many cases, no infectious agent can be determined, and this clinical disease rapidly progresses to death. Theoretically, SIP could be caused by CMV, which may be present in such small amounts or such configuration that routine histopathological analysis or viral culture techniques cannot detect the virus. To test the hypothesis that immunohistochemistry (IH) and in situ detection by hybridization (ISH) provides more accurate results than the mere histological demonstration of CMV inclusions, these methods were applied to 37 autopsied lung sections obtained from children immunocompromised by primary underlying diseases and who died of SIP. As a result, the cases were subdivided into three groups: (1) children with SIP CMV inclusions (Diffuse alveolar damage-DAD-related) (n = 7); (2) children with SIP without classical viral inclusions (CMV-DAD-related) (n = 3); (3) children with SIP exhibiting nuclear cytopathic effect (not CMV-NSIP-related) (n = 27). In the first group, all three techniques yielded clearly positive results, whereas IH and ISH indicated that three of the children of the second group had CMV-related DAD without histological demonstration of CMV inclusions. In the third group, there were no positive CMV signals. These data indicate that DAD-related CMV infection is an important cause of SIP and of death in children immunosuppressed by primary underlying diseases, and that IH and in situ detection were more sensitive than the histological demonstration of CMV inclusions. A direct involvement of CMV in SIP exhibiting DAD is likely, but not in the non-specific interstitial pneumonia (NSIP) pattern. We conclude that all children with primary underlying diseases should be investigated for CMV SIP using sensitive IH and in situ tests in conjunction with histological routine procedures.