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1.
Rev Bras Parasitol Vet ; 29(4): e017820, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33295378

RESUMO

Leishmania infantum infection in cats has been reported in several countries, including Brazil. However, the transmission of visceral leishmaniasis (VL) from cats to another host has not been proven yet. Therefore, the aim of this study was to verify the possibility of L. infantum transmission from cats to dogs. In order to verify the possibility of VL transmission from the cat to the dog, xenodiagnosis was carried out in a VL-positive cat, using 55 female Lutzomyia longipalpis. Five days later, 40 insects were dissected to verify Leishmania infection. The remaining 15 females were fed in a healthy dog. The potential infection of the dog was verified through clinical, serological, parasitological examinations, and PCR, at three, six, and twelve months post-infection. All 55 L. longipalpis females became visibly engorged. Leishmania promastigotes were detected in 27.5% of the dissected insects. Leishmania infection in the dog was confirmed upon first evaluation. DNA sequencing of the parasite isolated from the cat confirmed L. infantum infection and showed 99% similarity with the L. infantum DNA sequences from the dogs. Through this study, it was possible to confirm the L. infantum experimental transmission from a domestic cat to a domestic dog through its biological vector L. longipalpis.

2.
Front Immunol ; 11: 615628, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33224154

RESUMO

[This corrects the article DOI: 10.3389/fimmu.2020.01739.].

3.
Parasite Immunol ; : e12797, 2020 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-32984951

RESUMO

BACKGROUND: Early biomarkers of the response to treatment are lacking and may help to reduce mortality by the vector-borne disease visceral leishmaniasis (VL). METHODS: A prospective cohort study was conducted to investigate plasma cytokines and clinical laboratory data as biomarkers of the early response to specific treatment for VL in 36 patients. RESULTS: The mean interleukin 6 (IL-6) concentration on the 7th day was 2.3% of the pre-treatment concentration, interleukin 10 (IL-10) was 8.0%, and interleukin 8 (IL-8) was 8.2%. On the 7th day, IL-10 was below half of the pre-treatment concentration in 100.0%, IL-8 in 95.5% and IL-6 in 90.9%. The spleen and liver sizes, haemoglobin, interleukin 1 beta (IL-1ß) and tumour necrosis factor alpha (TNF-α) showed a slower recovery. Fever disappeared in 91% on the 7th day, 69.4% had a normal white cell count, and 77.8% had a normal platelet value by this time. CONCLUSIONS: The plasma cytokines IL-6, IL-10 and IL-8 were demonstrated to be excellent markers of the early response to VL treatment and if tested before the 7th day, will likely prove to be better than fever measurement.

5.
Sci Rep ; 10(1): 12321, 2020 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-32704096

RESUMO

Visceral leishmaniasis (VL) is a life-threatening disease caused by the protozoa Leishmania donovani and L. infantum. Likely, L. infantum was introduced in the New World by the Iberic colonizers. Due to recent introduction, the genetic diversity is low. Access to genomic information through the sequencing of Leishmania isolates allows the characterization of populations through the identification and analysis of variations. Population structure information may reveal important data on disease dynamics. Aiming to describe the genetic diversity of L. infantum from the Middle-North, Brazil, next generation sequencing of 30 Leishmania isolates obtained in the city of Teresina, from where the disease dispersed, was performed. The variations were categorized accordingly to the genome region and impact and provided the basis for chromosomal ploidy and population structure analysis. The results showed low diversity between the isolates and the Iberic reference genome JPCM5. Most variations were seen in non-coding regions, with modifying impact. The ploidy number analysis showed aneuploid profile. The population structure analysis revealed the presence of two L. infantum populations identified in Teresina. Further population genetics studies with a larger number of isolates should be performed in order to identify the genetic background associated with virulence and parasite ecology.

6.
Artigo em Inglês | MEDLINE | ID: mdl-32491143

RESUMO

In Latin America, the causative agent of kala-azar is the intracellular protozoan Leishmania infantum. Most cases in South America are reported in Brazil. Worldwide, it mainly affects Bangladesh, Ethiopia, India, South Sudan and Sudan. Despite the high morbidity and lethality of kala-azar, most infections are asymptomatic. However, a small portion of patients evolves with recurrence of kala-azar becoming symptomatic even after all available drug treatments. Kala-azar is not a formal indication for splenectomy in adults. Splenectomy is recommended as a saving measure, when kala-azar is associated with symptomatic hypersplenism and for drug-resistant cases. In the study, we report two cases of kala-azar with splenomegaly that presented several hospitalizations due to the recurrence of the kala-azar, in addition to hospitalizations for normalizing the blood count. After splenectomy, kala-azar cases and the effects of hypersplenism are cured. Thus, splenectomy should be seen as a surgical treatment option with a curative purpose in patients with recurrent kala-azar, in whom the possibilities of drug therapy have been exhausted and even so they progressed with hypersplenism and clinical repercussions.


Assuntos
Leishmaniose Visceral/cirurgia , Adulto , Humanos , Masculino , Recidiva , Esplenectomia , Resultado do Tratamento
7.
Biosci. j. (Online) ; 36(3): 956-967, 01-05-2020.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1147179

RESUMO

The visceral establishment of Leishmania infantum in dogs may result in kidney and bladder tissue injury, with L. infantum ending up in urine. This study therefore aimed at investigating the presence of Leishmania sp. in urinary sediments, and correlating the results with those from renal and bladder serum biochemistry and histopathology. Thirty dogs with negative Nested-Polymerase Chain Reaction (PCR) for E. canis were used in the experiment, and were divided into three groups: control group (10 dogs), neither leishmaniasis nor clinical changes; group I (15 dogs), leishmaniasis but no Leishmania sp. in urine; and group II (5 dogs), leishmaniasis, as well as Leishmania sp. in urine. All animals were submitted to clinical, serological, and parasitological diagnosis for leishmaniasis, biochemical exams, and kidney and bladder histopathology. The parasite was also detected in the bladder imprint of one group II dog. Group II dogs presented with very low albumin concentrations, low albumin/globulin ratios, and kidney and bladder lesions. In the kidneys, hydropic degeneration, thickened Bowman's capsule, and thickening of the tubular capsule were detected in all dogs with positive urinary sediment. However, no significant difference in these renal changes was observed between groups. The intensity and distribution of bladder inflammatory infiltrates were significantly (p-value < 0.05, Kruskal-Wallis' and Dunn's tests) higher in group II dogs, compared with those of the other groups. The presence of Leishmania sp.in the urine of infected dogs appeared to be related to low serum albumin concentrations and more severe bladder lesions


O estabelecimento visceral de Leishmania infantum em cães pode resultar em lesões nos tecidos dos rins e da bexiga, favorecendo a chegando do parasito até a urina. Portanto, este estudo teve como objetivo investigar a presença de Leishmania sp. em sedimentos urinários e correlacionar os resultados com os achados de quantificações bioquímicas séricas e histopatologia de rim e bexiga. Trinta cães com Nested-Reação em Cadeia da Polimerase (PCR) negativa para E. canis foram utilizados no experimento e foram divididos em três grupos: grupo controle (10 cães), negativos para leishmaniose e sem alterações clínicas; grupo I (15 cães), com leishmaniose, mas sem Leishmania sp. na urina; e grupo II (5 cães), com leishmaniose e com Leishmaniasp. na urina. Todos os animais foram submetidos a diagnóstico clínico, sorológico e parasitológico para leishmaniose, exames bioquímicos e histopatologia de rim e bexiga. O parasito foi detectado no imprimt de bexiga de um cão do grupo II. Os cães do grupo II apresentaram concentrações muito baixas de albumina, baixa relação albumina/globulina e lesões nos rins e na bexiga. Nos rins, foram detectadas degeneração hidrópica, espessamento da cápsula de Bowman e espessamento da cápsula tubular, em todos os cães com sedimento urinário positivo. No entanto, nenhuma diferença significativa nessas alterações renais foi observada entre os grupos. A intensidade e a distribuição dos infiltrados inflamatórios da bexiga foram significativamente (p-valor < 0,05, testes de Kruskal-Wallis e Dunn) maiores nos cães do grupo II, em comparação com a dos outros grupos. A presença de Leishmania sp. na urina de cães infectados parece estar relacionada a baixa concentração sérica de albumina e a lesões mais graves na bexiga.

8.
Vet Parasitol ; 280: 109058, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32200198

RESUMO

The clinical manifestations most frequently observed in cats with leishmaniasis caused by Leishmania infantum are cutaneous alterations, which suggest a high parasitic load in the skin and the possibility of infecting a vector. This study evaluated the infectiousness of to phlebotomine sand flies cats infected with L. infantum. A total of 12 cats with infection by L. infantum from the city of Teresina, Piauí, Brazil, were included in the study. Cats were diagnosed by direct visualization of the parasite. Laboratory-bred insects, free from infection by Leishmania spp. were offered a blood meal for 60 min on cats infected with L. infantum. On the fifth and sixth day after the blood meal, flies were dissected to assess promastigote forms of the parasite in the digestive system. Eight cats (67 %) were able to infect the vectors. The frequency of infected insects per cat ranged 0.0-94.4%. The mean frequency of insects feeding on cats was 95.2 %. Large numbers of the parasite were observed per insect, but were not quantified. The result confirm that cats are able to infect L. longipalpis, indicating that cats are part of the epidemiological chain of VL, acting as reservoir of the disease.


Assuntos
Doenças do Gato/transmissão , Insetos Vetores/parasitologia , Leishmania infantum/fisiologia , Leishmaniose Visceral/veterinária , Psychodidae/parasitologia , Animais , Brasil , Gatos , Feminino , Leishmaniose Visceral/transmissão , Masculino
9.
Rev Soc Bras Med Trop ; 53: e20190446, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130324

RESUMO

INTRODUCTION: Visceral leishmaniasis (VL) represents a public health concern in several areas of the world. In the American continent, VL transmission is typically zoonotic, but humans with active VL caused by Leishmania infantum are able to infect sandflies. Thus, individuals with cutaneous parasitic infections may act as reservoirs and allow interhuman transmission. Additionally, the skin may be responsible for reactivation of the disease after therapy. This study's objective was to evaluate cutaneous parasitism in humans with VL in an American endemic area. METHODS: A cross-sectional hospital-based study was conducted in northeast Brazil from October 2016 to April 2017. Biopsies of healthy skin for histopathology and immunohistochemistry were performed prior to treatment in all study patients. RESULTS: Twenty-two patients between the ages of five months to 78 years were included in the study. Seven patients (31.8%) tested positive for HIV. Only one patient had cutaneous parasitism, as confirmed by immunohistochemistry prior to treatment. Parasitism was not detected after treatment. CONCLUSIONS: Cutaneous parasitism in the healthy skin of humans with visceral leishmaniasis, although unusual, may be a source of infection for phlebotomine sandflies.


Assuntos
Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/parasitologia , Pele/parasitologia , Adolescente , Adulto , Idoso , Biópsia , Criança , Pré-Escolar , Estudos Transversais , Escolaridade , Doenças Endêmicas , Feminino , Humanos , Imuno-Histoquímica , Lactente , Leishmaniose Visceral/patologia , Masculino , Pessoa de Meia-Idade , Pele/patologia , Adulto Jovem
10.
Int J Parasitol ; 50(3): 171-176, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32126240

RESUMO

Prevention of canine Leishmania infantum infection is critical to management of visceral leishmaniasis in people living in endemic areas of Brazil. A bill (PL 1738/11), currently under consideration, proposes to establish a national vaccination policy against canine leishmaniasis in Brazil. However, there is no solid scientific evidence supporting the idea that this could reduce transmission from infected vaccinated dogs to sand flies to a level that would significantly reduce the risk of L. infantum infection or visceral leishmaniasis in humans. Thus, we advocate that insecticide-impregnated collars should the first line protective measure for public health purposes and that vaccines are applied on a case-by-case, optional basis for individual dog protection.


Assuntos
Leishmania infantum/imunologia , Leishmaniose Visceral , Psychodidae/parasitologia , Piretrinas/administração & dosagem , Vacinação/veterinária , Administração Tópica , Animais , Brasil/epidemiologia , Doenças do Cão/prevenção & controle , Doenças do Cão/transmissão , Cães , Humanos , Insetos Vetores/efeitos dos fármacos , Insetos Vetores/parasitologia , Inseticidas/administração & dosagem , Inseticidas/farmacologia , Vacinas contra Leishmaniose , Leishmaniose Visceral/prevenção & controle , Leishmaniose Visceral/transmissão , Leishmaniose Visceral/veterinária , Psychodidae/efeitos dos fármacos , Piretrinas/farmacologia
11.
Rev. Soc. Bras. Med. Trop ; 53: e20190446, 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1092226

RESUMO

Abstract INTRODUCTION: Visceral leishmaniasis (VL) represents a public health concern in several areas of the world. In the American continent, VL transmission is typically zoonotic, but humans with active VL caused by Leishmania infantum are able to infect sandflies. Thus, individuals with cutaneous parasitic infections may act as reservoirs and allow interhuman transmission. Additionally, the skin may be responsible for reactivation of the disease after therapy. This study's objective was to evaluate cutaneous parasitism in humans with VL in an American endemic area. METHODS: A cross-sectional hospital-based study was conducted in northeast Brazil from October 2016 to April 2017. Biopsies of healthy skin for histopathology and immunohistochemistry were performed prior to treatment in all study patients. RESULTS: Twenty-two patients between the ages of five months to 78 years were included in the study. Seven patients (31.8%) tested positive for HIV. Only one patient had cutaneous parasitism, as confirmed by immunohistochemistry prior to treatment. Parasitism was not detected after treatment. CONCLUSIONS: Cutaneous parasitism in the healthy skin of humans with visceral leishmaniasis, although unusual, may be a source of infection for phlebotomine sandflies.

12.
Rev. bras. parasitol. vet ; 29(4): e017820, 2020. graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1144228

RESUMO

Abstract Leishmania infantum infection in cats has been reported in several countries, including Brazil. However, the transmission of visceral leishmaniasis (VL) from cats to another host has not been proven yet. Therefore, the aim of this study was to verify the possibility of L. infantum transmission from cats to dogs. In order to verify the possibility of VL transmission from the cat to the dog, xenodiagnosis was carried out in a VL-positive cat, using 55 female Lutzomyia longipalpis. Five days later, 40 insects were dissected to verify Leishmania infection. The remaining 15 females were fed in a healthy dog. The potential infection of the dog was verified through clinical, serological, parasitological examinations, and PCR, at three, six, and twelve months post-infection. All 55 L. longipalpis females became visibly engorged. Leishmania promastigotes were detected in 27.5% of the dissected insects. Leishmania infection in the dog was confirmed upon first evaluation. DNA sequencing of the parasite isolated from the cat confirmed L. infantum infection and showed 99% similarity with the L. infantum DNA sequences from the dogs. Through this study, it was possible to confirm the L. infantum experimental transmission from a domestic cat to a domestic dog through its biological vector L. longipalpis.


Resumo A infecção por Leishmania infantum em gatos tem sido relatada em vários países, incluindo o Brasil. No entanto, a transmissão da leishmaniose visceral (LV) de gatos para outro hospedeiro ainda não foi comprovada. Portanto, o objetivo deste estudo foi verificar a possibilidade de transmissão de L. infantum de gatos para cães. Para verificar a possibilidade de transmissão da LV do gato para o cão, foi realizado xenodiagnóstico em um gato com LV, utilizando-se 55 fêmeas de Lutzomyia longipalpis. Cinco dias depois, 40 insetos foram dissecados para verificar a infecção por Leishmania. As 15 fêmeas restantes foram alimentadas em um cão saudável. A possível infecção no cão foi verificada por meio de exames clínicos, sorológicos, parasitológicos e PCR, três, seis e doze meses após a infecção. Todas as 55 fêmeas de L. longipalpis ficaram visivelmente ingurgitadas. Promastigotas de Leishmania foram detectadas em 27,5% dos insetos dissecados. A infecção por Leishmania no cão foi confirmada na primeira avaliação. O sequenciamento do DNA do parasito isolado do gato confirmou a infecção por L. infantum e apresentou 99% de similaridade com sequências de DNA de L. infantum de cães. Através deste estudo, foi possível confirmar a transmissão experimental de L. infantum de um gato doméstico para um cão doméstico através do seu vetor biológico L. longipalpis.

13.
Am J Trop Med Hyg ; 101(4): 789-794, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31436148

RESUMO

In India, visceral leishmaniasis (VL) caused by Leishmania donovani has been successfully treated with miltefosine with a cure rate of > 90%. To assess the efficacy and safety of oral miltefosine against Brazilian VL, which is caused by Leishmania infantum, a phase II, open-label, dose-escalation study of oral miltefosine was conducted in children (aged 2-12 years) and adolescent-adults (aged 13-60 years). Definitive cure was assessed at a 6-month follow-up visit. The cure rate was only 42% (6 of 14 patients) with a recommended treatment of 28 days and 68% (19 of 28 patients) with an extended treatment of 42 days. The in vitro miltefosine susceptibility profile of intracellular amastigote stages of the pretreatment isolates, from cured and relapsed patients, showed a positive correlation with the clinical outcome. The IC50 mean (SEM) of eventual cures was 5.1 (0.4) µM, whereas that of eventual failures was 12.8 (1.9) µM (P = 0.0002). An IC50 above 8.0 µM predicts failure with 82% sensitivity and 100% specificity. The finding of L. infantum amastigotes resistant to miltefosine in isolates from patients who eventually failed treatment strongly suggests natural resistance to this drug, as miltefosine had never been used in Brazil before this trial was carried out.


Assuntos
Antiprotozoários/administração & dosagem , Leishmania infantum/efeitos dos fármacos , Leishmaniose Visceral/tratamento farmacológico , Fosforilcolina/análogos & derivados , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Imunidade Inata , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/parasitologia , Masculino , Pessoa de Meia-Idade , Fosforilcolina/administração & dosagem , Falha de Tratamento , Adulto Jovem
14.
PLoS Negl Trop Dis ; 13(7): e0007493, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31260440

RESUMO

BACKGROUND: Visceral Leishmaniasis in humans presents with fever, anemia, and splenomegaly and can be lethal if not treated. Nevertheless, the majority of Leishmania infantum-infected individuals does not manifest symptoms and remain so provided they are not immunosuppressed. In this work, the performance of different tests was evaluated to detect asymptomatic individuals who were living in Teresina, Piauí state, Brazil, an endemic area for VL. METHODOLOGY: L. infantum-specific antibodies were detected by ELISA and two different rapid immunochromatographic (IC) diagnostic tests, Kalazar Detect and OnSite, and parasitic loads were detected by real time PCR [qPCR]. Additionally, we measured levels of the biomarkers monokine induced by IFN-γ (MIG) and IFN-γ-induced protein 10 (IP-10) before and after stimulation of whole blood with soluble Leishmania antigen [SLA]. PRINCIPAL FINDINGS: Kalazar Detect and OnSite detected, respectively, 76% and 64% of patients presenting with active Visceral Leishmaniasis; 50% and 57% of patients remained positive in these tests, respectively, after treatment. Of the healthy participants in the study who were living in the endemic area, only 1.7% were positive with both of the IC tests. On the other hand, reactivity in ELISA tests revealed that 13% of these individuals presented asymptomatic infections; among VL patients, 84% presenting with active disease were reactive in ELISA, and after treatment, 55.5% were seropositive. L. infantum DNA was present in the blood of 37.9% of infected individuals living in the endemic area, while IP-10 and MIG biomarkers were detected in 26.7% of them. The greatest concordance of positivity occurred between ELISA and qPCR. CONCLUSION: The association of different techniques can detect asymptomatic infections, however, more research is necessary to develop ideal biomarkers that are simple to use in the clinic and in field studies in areas endemic for Visceral Leishmaniasis.


Assuntos
Anticorpos Antiprotozoários/sangue , Infecções Assintomáticas , Leishmaniose Visceral/sangue , Leishmaniose Visceral/diagnóstico , Adulto , Biomarcadores/sangue , Brasil , Quimiocina CXCL10/sangue , DNA de Protozoário/genética , Doenças Endêmicas , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoensaio , Interferon gama/sangue , Leishmania infantum , Masculino , Pessoa de Meia-Idade , Carga Parasitária
15.
Sci Rep ; 9(1): 9932, 2019 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-31289323

RESUMO

Visceral leishmaniasis (VL) is one of the leading infectious diseases affecting developing countries. Colloidal gold-based diagnostic tests are rapid tools to detect blood/serum antibodies for VL diagnosis. Lack of uniformity in the performance of these tests in different endemic regions is a hurdle in early disease diagnosis. This study is designed to validate a serum-based dipstick test in eight centres of six countries, India, Nepal, Sri Lanka, Brazil, Ethiopia and Spain with archived and fresh sera from 1003 subjects. The dipstick detects antibodies against Leishmania donovani membrane antigens (LAg). The overall sensitivity and specificity of the test with 95% confidence intervals were found to be 97.10% and 93.44%, respectively. The test showed good sensitivity and specificity in the Indian subcontinent (>95%). In Brazil, Ethiopia, and Spain the sensitivity and specificity of the dipstick test (83.78-100% and 79.06-100%) were better as compared to the earlier reports of the performance of rK39 rapid test in these regions. Interestingly, less cross-reactivity was found with the cutaneous form of the disease in Spain, Brazil, and Sri Lanka demonstrating 91.58% specificity. This dipstick test can therefore be a useful tool for diagnosing VL from other symptomatically similar diseases and against cutaneous form of leishmaniasis.


Assuntos
Anticorpos Antiprotozoários/imunologia , Antígenos de Protozoários/imunologia , Leishmania donovani/imunologia , Leishmaniose Visceral/sangue , Leishmaniose Visceral/diagnóstico , Proteínas de Protozoários/imunologia , Testes Sorológicos/métodos , Brasil/epidemiologia , Estudos de Casos e Controles , Etiópia/epidemiologia , Humanos , Índia/epidemiologia , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/parasitologia , Nepal/epidemiologia , Espanha/epidemiologia , Sri Lanka/epidemiologia
16.
Mem Inst Oswaldo Cruz ; 113(11): e170538, 2018 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-30379197

RESUMO

This study showed that laboratory markers of recent infection by dengue, Zika or chikungunya arboviruses were detected in the biological samples of approximately one-third of patients with encephalitis, myelitis, encephalomyelitis or Guillain-Barré syndrome, in a surveillance programme in Piauí state, Brazil, between 2015-2016. Fever and myalgia had been associated with these cases. Since in non-tropical countries most infections or parainfectious diseases associated with the nervous system are attributed to herpesviruses, enteroviruses, and Campylobacter jejuni, the present findings indicate that in tropical countries, arboviruses may now play a more important role and reinforce the need for their surveillance and systematic investigation in the tropics.


Assuntos
Vírus Chikungunya , Vírus da Dengue , Doenças do Sistema Nervoso/virologia , Zika virus , Doença Aguda , Vírus Chikungunya/genética , Vírus Chikungunya/imunologia , Vírus da Dengue/genética , Vírus da Dengue/imunologia , Encefalite/diagnóstico , Encefalite/virologia , Encefalomielite Aguda Disseminada/diagnóstico , Encefalomielite Aguda Disseminada/virologia , ELISPOT , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/virologia , Humanos , Mielite Transversa/diagnóstico , Mielite Transversa/virologia , Doenças do Sistema Nervoso/diagnóstico , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Zika virus/genética , Zika virus/imunologia
17.
Epidemiol Serv Saude ; 27(3): e2017329, 2018 10 22.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30365697

RESUMO

OBJECTIVE: to describe a simplified protocol to diagnose suspected cases of meningitis. METHODS: this is an experience report on the approach to diagnosing meningitis at the Tropical Diseases Reference Service in the state of Piauí, Brazil, between 2007 and 2016; information was extracted from the Notifiable Diseases Information System (SINAN) and the laboratory record book; the chi-square test was used to compare epidemiological surveillance indicators based on final meningitis case classification; the Phi coefficient was used to verify the correlation between presumed diagnosis and laboratory-confirmed diagnosis. RESULTS: considering the 4,096 cases of meningitis investigated, there was a reduction in the generic classification of meningitis cases from 72% to 47% (p<0.001); indicated laboratory investigation profile showed agreement with final meningitis case diagnosis. (rf=0.66; p<0.001). CONCLUSION: a greater proportion of specific etiologic diagnosis of meningitis was achieved while the protocol was in use.


Assuntos
Sistemas de Informação , Meningite/diagnóstico , Vigilância da População , Brasil/epidemiologia , Técnicas de Laboratório Clínico , Humanos , Meningite/classificação , Meningite/epidemiologia
18.
An Bras Dermatol ; 93(3): 347-355, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29924242

RESUMO

BACKGROUND: Pentavalent antimonials remain as the standard drugs in the treatment of cutaneous leishmaniosis. The high cost, difficult administration, long treatment time, toxicity and increasing morbidity are factors that limit the use of these drugs. OBJECTIVES: To describe the response to radiofrequency thermotherapy in the treatment of localized cutaneous leishmaniasis in Brazil, and to evaluate its safety and tolerability. METHODS: We conducted a non-comparative open trial with a total of 15 patients confirmed to have cutaneous leishmaniasis on parasitological examination. A single radiofrequency thermotherapy session at 50ºC for 30 seconds was applied to the lesion and its edges. In patients with more than one lesion, only the largest one was treated initially. If after 30 days there was no evidence of healing, the smaller lesion was also treated with thermotherapy. Clinical cure was defined as visible healing for three months after treatment. The patients were followed-up for six months and there was no follow-up loss. RESULTS: Of all 23 lesions, only two evolved to complete healing without the need of treatment. Of 21 lesions, 18 (85.7%) achieved full healing. The main observed side effects were itching, burning sensation, pain and blisters. STUDY LIMITATIONS: Sample with a small number of patients and short follow-up. CONCLUSION: Thermotherapy can be considered a therapeutic alternative in localized cutaneous leishmaniasis, especially in cases of single cutaneous lesions and with formal contraindications to conventional treatment with pentavalent antimonials.


Assuntos
Antiprotozoários/uso terapêutico , Hipertermia Induzida/métodos , Leishmaniose Cutânea/terapia , Adolescente , Adulto , Idoso , Antiprotozoários/efeitos adversos , Brasil , Intervalos de Confiança , Estudos Controlados Antes e Depois , Resistência a Medicamentos , Feminino , Humanos , Hipertermia Induzida/efeitos adversos , Hipertermia Induzida/normas , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/patologia , Masculino , Pessoa de Meia-Idade , Ondas de Rádio , Resultado do Tratamento , Adulto Jovem
19.
An. bras. dermatol ; 93(3): 347-355, May-June 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-949892

RESUMO

Abstract: BACKGROUND: Pentavalent antimonials remain as the standard drugs in the treatment of cutaneous leishmaniosis. The high cost, difficult administration, long treatment time, toxicity and increasing morbidity are factors that limit the use of these drugs. OBJECTIVES: To describe the response to radiofrequency thermotherapy in the treatment of localized cutaneous leishmaniasis in Brazil, and to evaluate its safety and tolerability. METHODS: We conducted a non-comparative open trial with a total of 15 patients confirmed to have cutaneous leishmaniasis on parasitological examination. A single radiofrequency thermotherapy session at 50ºC for 30 seconds was applied to the lesion and its edges. In patients with more than one lesion, only the largest one was treated initially. If after 30 days there was no evidence of healing, the smaller lesion was also treated with thermotherapy. Clinical cure was defined as visible healing for three months after treatment. The patients were followed-up for six months and there was no follow-up loss. RESULTS: Of all 23 lesions, only two evolved to complete healing without the need of treatment. Of 21 lesions, 18 (85.7%) achieved full healing. The main observed side effects were itching, burning sensation, pain and blisters. STUDY LIMITATIONS: Sample with a small number of patients and short follow-up. CONCLUSION: Thermotherapy can be considered a therapeutic alternative in localized cutaneous leishmaniasis, especially in cases of single cutaneous lesions and with formal contraindications to conventional treatment with pentavalent antimonials.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Leishmaniose Cutânea/terapia , Hipertermia Induzida/métodos , Antiprotozoários/uso terapêutico , Ondas de Rádio , Brasil , Resistência a Medicamentos , Intervalos de Confiança , Resultado do Tratamento , Leishmaniose Cutânea/patologia , Leishmaniose Cutânea/tratamento farmacológico , Estudos Controlados Antes e Depois , Hipertermia Induzida/efeitos adversos , Hipertermia Induzida/normas , Antiprotozoários/efeitos adversos
20.
Recent Pat Biotechnol ; 12(3): 221-228, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29564989

RESUMO

BACKGROUND: Interleukin-6 (IL-6) is a multifunctional cytokine that plays a crucial role not only in the immune system but also in numerous biological processes. Elevated IL-6 levels have been observed in many types of cancer and inflammatory diseases. Among the techniques that have been used to quantify IL-6, a Lateral Flow Assay (LFA) is one of the most promising. OBJECTIVE: The objective of this study was to perform a technological and scientific exploration of the development of an LFA for IL-6. METHOD: The Instituto Nacional de Propriedade Industrial-INPI (Brazil), European Patent Office - Espacenet, and United States Patent and Trademark Office-USPTO were used for the technological prospection to consider all the patents regarding an LFA for IL-6 detection. For the scientific investigation, the following periodic databases were used: Web of Science, Science Direct, PubMed, and Scielo, and were monitored from 2007 to May 2017. RESULTS: We found no patents based on the searched keywords, and a limited number of scientific articles were found. Therefore, the development of an LFA sensor for the detection of IL-6 appears to be innovative with significant biotechnological importance, creating a technology transfer to promote economic and industrial growth. CONCLUSION: The development of lateral flow immunosensors for IL-6 is innovative, as we could not find patents describing such a biosensor. Scientific prospection reported two lateral flow immunosensors. However, the test for IL-6 cannot be completed without using some kind of equipment for detection, such as the one we propose in future developments.


Assuntos
Técnicas Biossensoriais/métodos , Biotecnologia/estatística & dados numéricos , Imunoensaio/métodos , Interleucina-6/análise , Técnicas Biossensoriais/instrumentação , Bases de Dados Factuais , Humanos , Patentes como Assunto , Inquéritos e Questionários
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