Epidemia de nefrite por Streptococcus equi subsp. zooepidemicus: estudo de caso-controle no município de Monte Santo de Minas, Minas Gerais, 2013 / Outbreak of nephritis by Streptococcus equi subspecies zooepidemicus: case-control study in the municipality of Monte Santo de Minas, Minas Gerais, Brazil, 2013 / Epidemia de nefritis por Streptococcus equi subsp. zooepidemicus: estudio de casos y controles en Monte Santo de Minas, Minas Gerais, Brasil, 2013

OBJETIVO: investigar a epidemia de nefrite por Streptococcus zooepidemicus em Monte Santo de Minas, Minas Gerais, Brasil. MÉTODOS: realizou-se estudo de caso-controle e tentativa de isolamento do agente, no período de janeiro a abril de 2013, utilizando-se dados clínicos, laboratoriais, de entrevistas e de inspeções. RESULTADOS: houve 417 casos notificados e 175 (42,0%) confirmados, dos quais 90,9% residiam no município e 67,4% eram do sexo feminino, com idade mediana de 36 anos; 24% dos casos foram hospitalizados; três sorveterias do município utilizavam leite do laticínio A; houve associação significativa entre adoecimento e consumo do leite A (odds ratio [OR]=4,16/IC95%: 1,55;11,18), um dos sorvetes feito com esse leite (OR=3,09/IC95%: 1,39;6,86) e milk shake de leite não industrializado (OR=3,25/IC95%: 1,13;9,36); não se detectou a bactéria em propriedades rurais. CONCLUSÃO: a epidemia de nefrite por Streptococcus zooepidemicus foi associada ao consumo de leite e derivados.

OBJECTIVE: to investigate an outbreak of nephritis by Streptococcus zooepidemicus in Monte Santo de Minas, Minas Gerais State, Brazil. METHODS: a case-control study and attempt to isolate the bacterial agent were carried out from January to April 2013, using clinical and laboratory data, interviews and inspections. RESULTS: 417 suspected cases were reported, of which 175 (42.0%) were confirmed; 90.9% lived in that municipality, of which 67.4% were female, with median age of 36 years; 24% of cases were hospitalized; three ice cream shops in the municipality used type A milk; there was significant association between the illness and the consumption of type A milk (odds ratio [OR]=4.16/95%CI: 1.55;11.18), one of the ice cream made with this milk (OR=3.09/95%CI: 1.39;6.86) and milk shake of non-processed milk (OR=3.25/95%CI: 1.13;9.36); the bacterium was not detected in rural properties. CONCLUSION: the outbreak of nephritis by Streptococcus zooepidemicus was associated with the consumption of milk and dairy products.

OBJETIVO: investigar la epidemia de nefritis por Streptococcus zooepidemicus en Monte Santo de Minas, Minas Gerais, Brasil. MÉTODOS: fue realizado un estudio de casos y controles e intento de aislamiento del agente, entre enero y abril de 2013, con datos clínicos y de laboratorio, entrevistas e inspecciones. RESULTADOS: fueron notificados 417 casos sospechoso, de los cuales, 175 confirmados; 90,9% eran residentes del municipio, 67,4% de sexo femenino, con mediana de edad de 36 años; 24% casos fueron hospitalizados; tres heladerías del municipio utilizaban leche del lacticinio A; encontramos asociación significativa entre la enfermedad y el consumo de leche A (odds ratio [OR]=4,16/IC95%: 1,55;11,18), en helados hechos con leche (OR=3,09/IC95%: 1,39;6,86) y milk shake de leche no industrializada (OR=3,25/IC95%: 1,13;9,36); la bactéria no fue aislada en zonas rurales. CONCLUSIÓN: la epidemia de nefritis por Streptococcus zooepidemicus se asoció con el consumo de leche y derivados.

Causas de Mortalidad urológicas en Jerez de los Caballeros (Badajoz) en el siglo XIX / Nefro-Urological Mortality Causes in Jerez de los Caballeros (Badajoz) in the Nineteenth Century

Las causas de mortalidad por patologías urológicas en Jerez de los Caballeros (Badajoz) durante el siglo XIX serán nuestro objeto de estudio. Para ello hemos analizado los Libros de Defunciones de las parroquias jerezanas. El porcentaje de fallecimientos frente al resto de patologías es del 0,8%, siendo los varones comprendidos en las franjas de edad de los 25 a los 34 y de los 65 a los 75 años de edad, los más afectados. Los meses con mayor mortalidad fueron julio, diciembre y enero. Debido a las carencias a la hora de anotar las defunciones en las primeras décadas de siglo, los resultados hay que tomarlos con precaución

The causes of mortality from nefro-urologic diseases in Jerez de los Caballeros (Badajoz) during the nineteenth century will be our object of study. We have analyzed the death registry books of the parishes in Jerez. The percentage of deaths from nefro-urologic diseases compared to other pathologies is 0.8%, being most affected males in age ranges from 25-34 and 65-75 years of age. The months with the highest mortality were July, December and January. Due to the deficient death registrations in the first decades of the century, the results should be taken with caution

Profile of glomerular diseases in a public hospital of Federal District, Brazil / Perfil das doenças glomerulares em um hospital público do Distrito Federal

INTRODUÇÃO: As doenças glomerulares são uma causa frequente de doença renal crônica, sobretudo nos países em desenvolvimento. OBJETIVO: O objetivo deste estudo foi determinar o perfil destas glomerulopatias em um hospital público da cidade de Brasília, Distrito Federal. MÉTODOS: Foram realizadas 121 biopsias renais pela equipe de nefrologia do Hospital Regional da Asa Norte (HRAN) entre agosto de 2005 e maio de 2009. Foram excluídas oito biopsias realizadas em pacientes transplantados renais e analisados os prontuários dos 113 pacientes restantes. Dados analisados: sexo, idade, exames laboratoriais, síndrome glomerular, diagnóstico clínico, grau de fibrose intersticial, uso de imunossupressores, necessidade de diálise e desfecho clínico. RESULTADOS: A média de idade foi 34,9 ± 16,2 anos, com predomínio masculino (51,3 por cento). As principais síndromes glomerulares foram: síndrome nefrótica (41,6 por cento) e glomerulonefrite rapidamente progressiva (35,4 por cento). Entre as glomerulopatias primárias, houve predomínio da glomeruloesclerose segmentar e focal (26,9 por cento) e da nefropatia por IgA (25 por cento) e entre as secundárias a nefrite lúpica (50 por cento) e a glomerulonefrite proliferativa exsudativa difusa (34,2 por cento). A maioria dos pacientes fez uso de imunossupressores (68,1 por cento) e quase um terço deles (29,2 por cento) necessitou de diálise durante a internação. Evoluíram para terapia dialítica crônica 13,3 por cento dos pacientes e 10,6 por cento evoluíram a óbito. CONCLUSÃO: Este estudo poderá contribuir para melhor entendimento epidemiológico das doenças glomerulares no Distrito Federal, orientando na adoção de políticas públicas visando permitir rápido diagnóstico e manejo clínico das mesmas.

INTRODUCTION: Glomerular diseases are a frequent etiology of chronic kidney disease, especially in the developing countries. OBJECTIVE: To determine the profile of such glomerulopathies in a public hospital located in the city of Brasilia, Federal District. METHODS: 121 renal biopsies in different patients were performed by the Renal Division of Hospital Regional da Asa Norte (HRAN) between August 2005 and May 2009. Eight renal biopsies in renal-transplant patients were excluded and the medical records of 113 remaining patients were analyzed. Analyzed data: sex, age, laboratory exams, glomerular syndrome, clinical diagnosis, degree of interstitial fibrosis, immunosuppressants use, need for dialysis and clinical outcome. RESULTS: The age average was 34.9 ± 16.2 years-old, a predominance of male patients (51.3 percent). Major glomerular syndromes were: nephrotic syndrome (41.6 percent) and the rapidly- progressive glomerulonephritis (35.4 percent). Among primary glomerulopathies focal glomerulosclerosis (26.8 percent) followed by IgA nephropathy (25 percent) were predominant; and among the most prevalent secondary glomerulopathies we had lupus nephritis (50 percent) and diffuse exudative proliferative glomerulonephritis (34.2 percent).The majority of the patients used immunosuppressants (68.1 percent) and almost one third of them (29.2 percent) needed dialysis during their hospitalization. Progressed to chronic dialysis therapy 13.3 percent of the patients and 10.6 percent died. CONCLUSION: This study may contribute to better epidemiological understanding of glomerular diseases in the Federal District, guiding the adoption of public policies aiming the quick clinical treatment of such diseases.

Estudio epidemiológico de un brote de nefritis aguda posestreptocócica / Epideiologic study of an outbreak of poststreptococcal acute nephritis

Se realiza un estudio bacteriano y sérico a toda la población de una comunidad rural. Se informa que se habían presentado 12 niños con cuadros clínicos compatibles con la nefritis aguda, durante un período de 4 meses. Se señala que es el primer estudio realizado en nuestro país, donde se analiza un brote de nefritis de manera multidisciplinaria. Se indica que se aislaron estreptococos hemolíticos grupo A, del 143 de los individuos estudiados. Los serotipos predominates fueron los M 49 y los M 12; también se aislaron estreptococos grupo A, del 25 de los niños que padecieron nefritis; del 13,1 de los convivientes, y del 13 de la población general. Se expresa que los títulos medios geométricos de antiestreptolisina O, resultaron elevados y similares en todos los grupos estudiados (portadores de estreptococos o no y nefríticos, convivientes y población general)

Estudio epidemiológico de un brote de nefritis aguda posestreptocócica / Epidemiologic study of an outbreak of poststreptococcal acute nephritis

Se realiza un estudio bacteriano y sérico a toda la población de una comunidad rural. Se informa que se habían presentado 12 niños con cuadros clínicos compatibles con la nefritis aguda, durante un período de 4 meses. Se señala que es el primer estudio realizado en nuestro país, donde se analiza un brote de nefritis de manera multidisciplinaria. Se indica que se aislaron estreptococos hemolíticos grupo A, del 143 de los individuos estudiados. Los serotipos predominates fueron los M 49 y los M 12; también se aislaron estreptococos grupo A, del 25 de los niños que padecieron nefritis; del 13,1 de los convivientes, y del 13 de la población general. Se expresa que los títulos medios geométricos de antiestreptolisina O, resultaron elevados y similares en todos los grupos estudiados (portadores de estreptococos o no y nefríticos, convivientes y población general)

Observations on acute rheumatic fever in Trinidad during an outbreak of scabies and acute nephritis - abstract

We have been looking for differentiating aspects of the streptococcal infections associated with acute rheumatic fever (ARF) and acute alonerulonephritis (AGN) in Trinidad since November 1969. At this meeting last year, we reported our first 10 months' observation which were made during a period when AGN was endemic. Since then an outbreak of scabies accompanied by a major epidemic of AGN has occurred which afforded an excellent opportunity to study and compare the related streptococcal infections. Observations to be reported presently include the following: (1) While the number of cases of AGN increased nearly 10-fold to over 150 in both August and September, ARF increased only to less than 20 cases a month during the height of the epidemic of AGN. (2) The scabies epidemic was associated with AGN while skin lesions continued to be relatively rare in patients with ARF. (3) The streptococcal strains isolated from patients with AGN and ARF were not the same, the epidemic M-type 55 being associated with AGN but not ARF while M-type 11 strains were found in many patients with ARF and in none with AGN, (4) Antibody titres were similar in the two groups of patients as reflected by ASO and AH titres; the former continued to be low, while the latter continued to be increased. Thus, we conclude that although the antibody responses of patients with ARF and AGN are similar in Trinidad, skin infections are associated with AGN but not with ARF and the nephritogenic and rheumatogenic streptococcal strains are different (AU)

Epidemic acute nephritis in South Trinidad

Two hundred and ninety-seven patients were admitted to the San Fernando General Hospital with acute glomerulonephritis from September 1964 to February 1965. Only a small number of the patients gave a history of sore throat and many patients had septic skin lesions one to four weeks before the onset of oedema, the presenting symptom in all the cases. Children between the ages of 3 and 9 years were most commonly affected. There were 46 children under the age of 3 years. 57 percent of the patients were male. The concentration of cases occurred in the rural areas within a radius of 10 miles from San Fernando, and 76 percent of the patients were Indians. Group A beta Haemolytic streptococci were isolated from the skin and throat of a representative sample of nephritic patients. A pilot streptococcal survey was also conducted among normal school-children in both "nephritic" and "non-nephritic" districts. 66 percent of 50 normal children selected at random from the three schools in Dede (nephritic district) had Group A beta haemolytic streptococci either in the throat or skin. 44 percent of 50 normal school-children from the two school in Tortuga (non-nephritic) had Group A beta haemolytic streptococci. The epidemic is on the wane. The present epidemic was compared with the 1958-1959 epidemic of acute nephritis in South Trinidad (AU)

Epidemic nephritis in South Trinidad

Over a period of 6 months a remarkable increase was seen in the incidence of acute nephritis among children in South Trinidad, and 263 cases were admitted to a general hospital. The patients were found to differ in their age, sex, and geographic distribution. The disease was associated with respiratory infection rather than skin infection, the form usually seen here, and the appearance of desquamation in many of the children suggested that the underlying organism was one capable of producing scarlet fever. The disease was mild. Only five children (1.9 percent) died, all from cardiac failure. Recovery appears so far to be complete in all but one of the survivors. (Summary)

Epidemic nephritis and streptococcal infections in South Trinidad - a twenty year study

The present study began in 1965 when South Trinidad experienced the third major epidemic of acute nephritis and extends over a twenty year period (AU)

Epidemic and endemic pattern of childhood nephritis: pathogenesis, epidemiology and clinical course of outbreaks in Trinidad

More than 800 children with acute glomerulonephritis were admitted to one hospital in Trinidad during three and one-half years. In the first 15 months the disease was epidemic. The illness affected chiefly the children of the rural poor, with the most cases attributable to streptococcal infection of the skin rather than of the respiratory tract. In signs, symptoms and clinical course, the disease in Trinidad resembles closely the acute glomerulonephritis which follows streptoccocal pharyngitis in temperate climates. (AU)