Human cysticercosis in Portugal: long gone or still contemporary?

Cysticercosis, a leading cause of acquired epilepsy in developing countries, has been controlled or eradicated in industrialized countries. This paradigm has recently been challenged, with human neurocysticercosis (NCC) being increasingly diagnosed in these countries. In order to assess the NCC burden in Portugal, a retrospective study on NCC hospitalizations (2006-2013) was conducted based on the national database on hospital morbidity: 357 hospitalized cases were detected. NCC was most frequent in the following age groups: 20-64 years (n = 197, 55·2%) >64 years (n = 111, 31·1%), and <20 years (n = 49, 13·7%). In the Norte and Centro regions cases tended to be older than in the Lisboa and Vale do Tejo Region. The results raise concerns for imported and autochthonous disease, suggesting the Lisboa and Vale do Tejo Region, due to its higher frequency of cases at younger ages, as a priority for research and intervention, and further suggest that NCC should be under surveillance (notifiable). The National Observatory of Cysticercosis and Taeniasis has been established and will define NCC cases as well as monitoring and surveillance.

Seroprevalence of human cysticercosis in Maputo, Mozambique.

We carried out a serosurvey for cysticercosis among people visiting the Central Hospital of Maputo, the capital of Mozambique, between January and June 1993. A standardized questionnaire was designed to obtain information on demographic, socioeconomic, environmental, and behavioral characteristics related to the transmission of the infection. Four hundred eighty-nine individuals were tested for anti-cysticercosis antibodies: 222 blood donors and patients from the Department of Orthopedics, 148 patients from the Department of Neurology, and 119 patients from the Department of Psychiatry. The overall positivity rate was 12.1% (59 of 489). Anti-cysticercus antibodies was detected in 14.9% of the blood donors and patients from the Department of Orthopedics, 11.5% of the patients from the Department of Neurology, and 7.6% of the patients from the Department of Psychiatry. Living in poor sanitary conditions seems to be an important factor related to human cysticercosis in Maputo, Mozambique.

[Genotype of C. trachomatis strains isolated in a region of Guinea-Bissau: Farim]. / Génotypage de souches de C. trachomatis isolées dans une région de Guinée-Bissau: farim.

In order to diagnose the trachoma we observed the eyes of 506 students aged between 6 and 14 years. 14,03% of these children presented follicular or intense trachomatous inflammation of the eye. The use of molecular biology methods (PCR + RFLP) over the conjonctival samples we had collected, led us to the identification of 21 C. trachomatis strains: 11 of the A genotype and 10 of the B genotype.

[Deaths due to smallpox vaccination in France 1968-1977 (author's transl)]. / Etude des décès imputés à la vaccination antivariolique en France, de 1968 à 1977.

Between 1968 and 1977 there were 4 113 109 primary smallpox vaccinations in France. There were 30 deaths but no deaths occurred after re-vaccination. The mortality can be analysed as follows: -- proven or probable cases: 1.5 death/million vaccinations; -- proven, probable or possible cases 2.9/million vaccinations; -- proven, probable, possible or doubtful 7.3 cases/million vaccinations. The risk of death is 3 to 4 times greater under the age of one year and an overall death rate of 6/million vaccinations in reasonably accurate.

Ultrastructural alterations of mycobacterium leprae in skin biopsies of untreated and treated lepromatous patients.

1. -- Mycobacterium leprae cells under a process of progressive disaggregation are present in the skin of both treated and untreated patients. 2. -- The ultrastructural alterations observed during the degenerative process seem to be qualitatively similar in treated and untreated patients. 3. -- The proportion of altered M. leprae cells increases during the treatment, mainly with rifampicin and rifampicin + clofazimine + diaminodiphenyl sulfone. 4. -- The cell wall of M. leprae is the last bacterial structure to disappear during the degenerative process.

[Results of a comparative therapeutic trial of single-dose treatment of non-complicated acute male gonorrhea]. / Résultats d'un essai thérapeutique comparatif pour le traitement en une prise de la gonococcie masculine aiguë non compliquée.

A single dose treatment trial with: spectinomycine 2 g, ampicilline + probenecide 3.5 g + 1 g, thiamphenicol 2.5 g, minocycline 300 mg was undertaken. Three teams were involved, epidemiologists clinicians, microbiologists, 636 patients were included, 483 resumed for control. A negative culture on the third day was considered a success. Failure rates were: spectinomycine 4%, ampicilline-probenecide 3%, thiamphenicol 4%, minocycline 3%. No significant difference was noted between the four rates. The delay of clinical cure was 1.98 days for spectinomycin, 1.87 days for ampicilline - probenecide, 2.16 days for thiamphenicol and 2.12 for minocycline without significant difference. When side effects were analysed, 10% of the patients reported asthenia without difference between the four treatments. Thiamphenicol is responsible for diarrhea 28%, P less than 0,01 minocycline more significantly responsible for guidiness 13%, P less than 0,001, and 18% treated by spectinomycine complained of pain at the time of injection. The antibiotics MIC's are studied. After the analysis of the results, the cost, and the resistances, one treatment was selected.

[Present sensitivity of Neisseria gonorrhoeae in the Paris area. Results of a comparative therapeutic trial]. / La sensibilité actuelle de Neisseria gonorrhoeae en région parisienne. Résultats d'un thérapeutique comparé.

From September 1978 to September 1979, the Authors determined the M. I. C. of 16 antibiotics against 420 Neisseria gonorrhoeae strains collected in Paris area, with standard gel dilution technic. These strains remain susceptible to the greatest proportion of antibiotics tested, except streptomycin. It has been noted, however, that sensibility of a certain percentage of strains, has decreased for penicillins, cyclins, macrolides. Some strains producing beta-lactamase has been identified. Authors compared results given by the gel dilution method to those given by the diffusion or so-called "disc" method. This shows no correlation between radius of inhibition and M. I. G., with no reliable criteria to estimate the area of inhibition. Also, four protocols for therapy were followed: spectinomycin, ampicillin-probenocid, thiamphenicol, minocyclin. The patients were surveyed by physical examination and bacteriological tests. No statistically significant differences could be noted between these four protocols. However, considering the size of the samples, it is not possible to conclude. The authors reassess the necessity to survey the drug-sensitivity of Neisseria gonorrhoeae strains, in each geographical area, following an internationally agreed method. They also conclude to the necessity to compare in vitro sensitivity tests with therapeutic schemes suggested by usual sensitivity to main antibiotics.