Acute and chronic effects of cortisol on milk yield, the expression of key receptors, and apoptosis of mammary epithelial cells in Saanen goats.

Cortisol (CORT) induces mammary development in late gestation and is fundamental to the differentiation of mammary epithelial cells and lactogenesis. The objective of this study was to investigate the relationship between CORT, insulin, prolactin, growth hormone, and insulin-like growth factor-1 in milk as well as the effect of CORT on the expression of receptors of insulin (INSR), prolactin (PRLR), growth hormone (GHR); we also studied the insulin-like growth factor-1 (IGF1R), glucocorticoid (NR3C1), mineralocorticoid (NR3C2), B-cell lymphoma 2 (BCL2), BCL-2-like protein X (BAX) genes, and the apoptosis rate of mammary epithelial cells of lactating Saanen goats in vivo and in vitro. The following experiments were conducted: (1) comparing hormone release in milk and blood after ACTH or a placebo administration; (2) evaluating the effect of acute CORT increases in mammary gland expression and milk yield in vivo; and (3) evaluating the effect of a chronic increase in CORT concentration in epithelial mammary cell apoptosis in vitro. In vivo, ACTH administration significantly increased CORT release but did not affect insulin, prolactin, growth hormone, and insulin-like growth factor-1 release in plasma and milk versus placebo. The results show also that a low CORT release after ACTH administration increased the expression of GHR and PRLR genes in the mammary tissue. Indeed, CORT release significantly increased the milk yield from goats subjected to ACTH versus goats subjected to the placebo. However, a higher amount of CORT added in vitro upregulated the NR3C1, GHR, PRLR, and BAX genes and downregulated the IGF1R and INSR genes, which could negatively modulate the apoptosis of mammary epithelial cells. Finally, the effect of CORT in vivo after ACTH administration demonstrated the increased expression of the PRLR and GHR genes, which may improve epithelial cell responsiveness and be associated with the positive effect of CORT observed on milk yield at mid-end lactation.

Zymosan enhances in vitro phagocyte function and the immune response of mice infected with Paracoccidioides brasiliensis.

Paracoccidioides brasiliensis is the major etiologic agent of Paracoccidioidomycosis (PCM), the most frequent human deep mycosis in Latin America. It is proposed that masking of ß-glucan in P. brasiliensis cell wall is a critical virulence factor that contributes to the development of a chronic disease characterized by a long period of treatment, which is usually toxic. In this context, the search for immunomodulatory agents for therapeutic purposes is highly desirable. One strategy is to use pattern recognition receptors (PRRs) ligands to stimulate the immune response mediated by phagocytes. Here, we sought to evaluate if Zymosan, a ß-glucan-containing ligand of the PRRs Dectin-1/TLR-2, would enhance phagocyte function and the immune response of mice challenged with P. brasiliensis. Dendritic cells (DCs) infected with P. brasiliensis and treated with Zymosan showed improved secretion of several proinflammatory cytokines and expression of maturation markers. In addition, when cocultured with splenic lymphocytes, these cells induced the production of a potential protective type 1 and 17 cytokine patterns. In macrophages, Zymosan ensued a significant fungicidal activity associated with nitric oxide production and phagolysosome acidification. Importantly, we observed a protective effect of Zymosan-primed DCs delivered intranasally in experimental pulmonary PCM. Overall, our findings support the potential use of ß-glucan-containing compounds such as Zymosan as an alternative or complementary antifungal therapy. LAY SUMMARY: We report for the first time that Paracoccidioides brasiliensis-infected phagocytes treated with Zymosan (cell wall extract from bakers' yeast) show enhanced cytokine production, maturation, and fungal killing. Also, Zymosan-primed phagocytes induce a protective immune response in infected mice.

Effect of heat stress in late gestation on subsequent lactation performance and mammary cell gene expression of Saanen goats.

Little is known about the effects of heat stress during the late gestation period on lactation in dairy goats. For this reason, 32 Saanen goats were randomly assigned to 1 of 2 groups, control (CT; n = 16) or heat stress (HS; n = 16), during late gestation. The HS goats were housed in a climatic chamber before parturition and subjected to heat stress for the last 45 d. After parturition, the HS goats were housed in the same conditions as the CT group. Mammary gland biopsies were performed on 7 goats per treatment at -30, -15, 15, and 30 d relative to parturition, so that the expression levels of several genes could be determined. The HS goats produced less milk than the CT goats did during the first half of lactation, but not during the rest of lactation. Before parturition, apoptosis-related transcripts (TP53 and BAX) were higher in the mammary glands of the HS goats than in those of the CT goats. The HS goats also had higher levels of HSPB1 gene expression during gestation and lactation. However, expression of the prolactin receptor gene was lower after parturition in the mammary glands of HS, suggesting downregulation of prolactin signaling. In summary, heat stress during final gestation reduces milk yield in the subsequent lactation. Although the upregulation of apoptosis signaling in the HS goats suggests that heat stress affects mammary cell number, the loss of the effect on milk production is more compatible with an effect on cell activity, which could be due to a downregulation of prolactin signaling.

Effect of acute stressors, adrenocorticotropic hormone administration, and cortisol release on milk yield, the expression of key genes, proliferation, and apoptosis in goat mammary epithelial cells.

Cortisol is essential to milk synthesis; however, different acute stressors and the exogenous administration of adrenocorticotropic hormone (ACTH) decrease milk yield. Therefore, the effect of cortisol on milk yield and its influence on the survival of mammary epithelial cells have not been fully elucidated. In this context, the objective of this study was to evaluate the effect of cortisol on the expression of growth hormone receptor (GHR), insulin-like growth factor type 1 (IGF1), insulin-like growth factor type 1 receptor (IGF1R), insulin-like growth factor-binding protein 3 and 5 (IGFBP3 and IGFBP5), BAX, and BCL2 genes on the proliferation and apoptotic rates of mammary epithelial cells, and on milk yield in Saanen goats. In the present study, 3 experiments were conducted: (1) comparing the in vivo effects of first milking, vaccination, vermifugation, preventive hoof trimming, and the administration of ACTH or a placebo on cortisol release in dairy goats; (2) studying the in vivo effects of immediate increases in cortisol on the mammary gland of lactating goats; and (3) studying the in vitro effects of a prolonged increase in cortisol on mammary epithelial cells obtained from lactating goats. Cortisol release by goats increased significantly after ACTH administration compared with that observed after a placebo, and the cortisol profiles after first milking, vaccination, vermifugation, hoof trimming, and ACTH administration were similar. However, there was no effect of the immediate increase in cortisol in vivo on IGF-1 release, milk yield, milk quality, or the apoptosis and proliferation rates, nor was there any effect on the expression of the target genes. Furthermore, no interaction was observed between IGF-1 and cortisol in either the in vivo or in vitro experiments. However, the addition of cortisol in vitro significantly increased the expression of the GHR and IGF1R genes, which stimulate cell proliferation, and the BAX gene, which causes apoptosis. These contrasting results can explain why cortisol did not change the rates of proliferation or apoptosis in epithelial cells. Indeed, cortisol supplementation in vitro did not change the number or apoptotic rate of epithelial cells over the course of 5 d. Finally, further studies must be performed to understand the effect of cortisol on the expression of the GHR, IGF1R, and BAX genes by epithelial cells and the roles of these genes in milk synthesis during early lactation.

Effects of different supplemental soya bean oil levels on the performance of prepubertal Saanen goats: Oestrogen and progesterone release.

The aim of this study was to investigate the effects of different levels of soya bean oil in the total diet on the growth rate, metabolic changes, and oestrogen and progesterone release in Saanen goats. After dietary adaptation, 21 prepubertal goats (weight of 29.12 ± 0.91 kg, 230 days old) were randomly distributed among three diets of D2: inclusion of 2% soya bean oil in the total diet; D3: basal diet - inclusion of 3% soya bean oil in the total diet; and D4: inclusion of 4% soya bean oil in the total diet. The basal diet (D3) was formulated to promote a daily gain of 0.140 kg. The goats were weighed, and their blood samples were collected weekly. Glucose, cholesterol, triglycerides, total protein, urea, non-esterified fatty acids, beta-hydroxybutyrate, oestrogen and progesterone in the plasma were measured. Prepubertal goats that were fed D4 exhibited a significantly lower dry matter intake, urea and cholesterol levels compared with the goats that were fed D2 and D3. Indeed, goats that were fed D4 displayed a significantly lower final weight than goats that were fed D2 and D3. In contrast, the inclusion of soya bean oil in the diet increased the progesterone and oestrogen concentrations, and goats that were fed D4 released a significantly higher concentration of progesterone than those that were fed D2 and D3. Furthermore, the percentage of goats with a progesterone level greater than 1 ng/ml (functional Corpus luteum) was significantly higher among the goats that were fed D3 and D4 than among those that were fed D2. In this study, although the inclusion of 4% soya bean oil in the diet decreased dry matter intake and growth rate, it increased progesterone concentration and the percentage of goats with a functional Corpus luteum, suggesting that the inclusion of soya bean oil accelerated puberty in prepubertal goats.

Occupational hepatitis C seroconversions in a Brazilian hospital.

BACKGROUND: There are six known cases of occupational human immunodeficiency virus (HIV) seroconversion in Brazil. However, there are neither published cases of occupational hepatitis C virus (HCV) seroconversion nor systematic studies of blood and body fluid exposures (BBFE) that could estimate the risk of HCV or HIV occupational seroconversion in Brazil. AIMS: To describe the outcomes of BBFEs in a Brazilian hospital over 12 years and 2 months. METHODS: Statistical analysis of a computerized database of exposure events recorded on printed forms. Incidence rates (IR) were calculated as the number of BBFE per 100 full-time equivalent worker-years. RESULTS: There were 1457 BBFE, 87% being percutaneous and 561 (38%) recurring in health care workers (HCWs) who reported having previous exposures. The highest IRs occurred in laboratory technicians (9.7), medical students (9.5), cleaning staff (9.5) and nursing aids (9.2). The IR in temporary employees was 13.0. Two HCWs, a nursing aid and a surgeon, seroconverted to hepatitis C after HCV exposures involving 13 G catheter needles. The risk of acquiring a HCV infection was 2 in 38 percutaneous HCV exposures, i.e. 5% (95% CI: 0.89-16.3). There were no seroconversions to HIV despite 80 percutaneous HIV exposures. CONCLUSIONS: HCV has a higher potential for occupational transmission than HIV. Measures to reduce the risks of BBFE and occupational transmission of blood-borne viral infections should be improved in Brazil.

Morphological alterations on the prostate of Calomys callosus submitted to chronic ethanol ingestion.

The objective of the present study was to assess the possible toxic effects of chronic alcohol ingestion on the ultrastructure of the glandular epithelium of the prostate of the rodent Calomys callosus, in order to contribute to the understanding of the consequences of alcohol abuse for the morphology of the male reproductive apparatus. Sixteen adult animals aged three months were divided into two experimental groups. The control group received a solid diet and tap water, and the alcoholic group received the same solid diet and ethanol P.A. diluted 20% in water (v/v). After 120 days of treatment, all animals were anesthetized, weighed and sacrificed. At the end of treatment, mean body weight did not differ between control and alcoholic animals. The prostate epithelial cells of the alcoholic group showed intense atrophy and ultrastructural alterations such as the presence of lipid droplets, altered nuclei, ruptured mitochondrial cristae, and intense dilatation of the cisterns of the granular endoplasmic reticulum. It was concluded that 20% ethanol provokes marked lesions on the epithelium of the prostate probably interfering on the glandular secretion.

The Medicine, Angioplasty or Surgery Study (MASS): a prospective, randomized trial of medical therapy, balloon angioplasty or bypass surgery for single proximal left anterior descending artery stenoses.

OBJECTIVES: This study sought to evaluate, in a prospective and randomized trial, the relative efficacies of three possible therapeutic strategies for patients with a single severe proximal stenosis of the left anterior descending coronary artery and stable angina. BACKGROUND: Although percutaneous transluminal coronary angioplasty and coronary artery bypass surgery are often performed in patients with a single proximal stenosis of the left anterior descending coronary artery, it is unclear whether revascularization offers greater clinical benefit than medical therapy alone. METHODS: At a single center, 214 patients with stable angina, normal ventricular function and a proximal stenosis of the left anterior descending coronary artery > 80% were randomly assigned to undergo mammary bypass surgery (n = 70), balloon angioplasty (n = 72) or medical therapy alone (n = 72). Angioplasty had to be considered technically feasible in every case. The predefined primary study end point was the combined incidence of cardiac death, myocardial infarction or refractory angina requiring revascularization. RESULTS: At an average follow-up period of 3 years, a primary end point had occurred in only 2 patients (3%) assigned to bypass surgery compared with 17 assigned to angioplasty (24%) and 12 assigned to medical therapy (17%) (p = 0.0002, angioplasty vs. bypass surgery; p = 0.006, bypass surgery vs. medical treatment; p = 0.28, angioplasty vs. medical treatment, all by log-rank test). There was no difference in mortality or infarction rates among the groups. However, no patient allocated to bypass surgery needed revascularization, compared with eight and seven patients assigned, respectively, to coronary angioplasty and medical treatment (p = 0.019). Both revascularization techniques resulted in greater symptomatic relief and a lower incidence of ischemia on the treadmill test; however, all three strategies eventually resulted in the abolition of limiting angina. CONCLUSIONS: The more aggressive therapeutic approach with initial bypass surgery for patients with a single severe proximal stenosis of the left anterior descending coronary artery is associated with a lower incidence of medium-term adverse events than coronary angioplasty or medical treatment. However, all three strategies resulted in a similar incidence of death and infarction during an average follow-up period of 3 years. This information should be taken into consideration when physicians and patients make therapeutic choices in this setting.

Surgical treatment of endomyocardial fibrosis: a new approach.

Endomyocardial fibrosis has been treated surgically for many years. For complete removal of fibrosis from both ventricles by the classic technique, each atrioventricular (AV) valve was removed and replaced with a prosthesis. Relapse of endomyocardial fibrosis has not been observed after surgical correction. Reoperations have been carried out because of complications of valve prostheses. A new surgical technique for removal of ventricular fibrous tissue with preservation of the mitral and tricuspid valves was used in nine consecutive patients with endomyocardial fibrosis. Initial results show a reduction of pulmonary hypertension, mean right and left atrial pressures and end-diastolic pressures in both ventricles. Tricuspid annuloplasty was performed in seven patients and mitral annuloplasty in five. No valve prosthesis was used. There was no death and New York Heart Association functional class improved from class III or IV in the preoperative period to class I or II in the postoperative period. These data suggest that resection of endocardial fibrous tissue can be indicated early in the clinical course and performed with preservation of the AV valves.

Ultrastructural changes on the hard palatine mucosa of Calomys callosus after 120 days of experimental chronic alcoholism.

The present study analyzed the toxic effects of chronic alcohol ingestion on the ultrastructure of the lining epithelium of the hard palatine mucosa of the rodent Calomys callosus, in order to contribute to the understanding of the consequences of alcohol abuse for the morphology of the digestive system. Twenty-six adult animals aged three months were divided into two experimental groups. The control group received a solid diet and tap water, and the alcoholic group received the same solid diet and ethanol P.A. diluted 20% in water (v/v). After 120 days of treatment, all animals were anaesthetised, weighed and sacrificed. At the end of treatment, mean body weight did not differ between control and alcoholic animals. The epithelial cells of the alcoholic group showed many alterations such as the presence of lipid droplets, nuclei in corneum layer, nuclei with increase peripheral chromatin and greater electron density, altered mitochondria, and intense dilatation of the intercellular spaces. It was concluded that 20% ethanol provokes marked ultrastructural lesions in the hard palatine mucosa.

Tricuspid dura mater bioprostheses: more than 20-year follow-up of 3 patients.

Replacement of the tricuspid valve is sometimes necessary. We report 3 consecutive patients with tricuspid insufficiency who underwent valve replacement with glycerol-preserved, homologous dura mater cardiac bioprostheses between 1971 and 1973. The first 2 patients are well 28 and 27 years later; the last patient was lost to follow-up after 20 years. We conclude that preservation of homologous dura mater bioprostheses in glycerol may reduce rates of thromboembolism, thrombosis, and structural dysfunction during the late postoperative period.

VATS for complete dissection of LIMA in minimally invasive coronary artery bypass grafting.

BACKGROUND: The aim of this work is to report our initial experience with minimally invasive coronary artery bypass grafting, using video-assisted thoracic surgery (VATS) to facilitate the operation and provide complete dissection of the left internal mammary artery (LIMA). METHODS: Of 44 scheduled patients, 43 patients, 30 (69.8%) male, ranging in age from 31 to 83 years (60.8 +/- 12.0 years), with a severe lesion in the anterior descending artery, were operated upon. An 8-cm left anterior minithoracotomy was performed at the fourth intercostal space. Through this incision the optical device for video-assisted thoracic surgery as well as the surgical instruments were placed to provide complete LIMA dissection. This permits dissection until the subclavian region, allowing for anastomosis without tension or distortion. Bypass circulation was not used, and the cardiac rate was decreased with the use of intravenous beta-blockers. For LIMA-to-anterior descending artery anastomosis, proximal and distal tourniquets were used and 1.5 mg/kg of heparin was administered intravenously. RESULTS: Video-assisted thoracic surgery provided a complete dissection of LIMA. The 43 patients presented satisfactory postoperative progress, being released from the hospital between 2 and 12 days after their operation, with a mean of 4 days. The patients have remained asymptomatic during a period that ranged from 1 to 13 months (6.3 +/- 3.5 months). During the follow-up, there was one death as a result of stroke and pneumonia 2 months after the release from the hospital. CONCLUSIONS: The use of video-assisted thoracic surgery through thoracotomy allows the LIMA dissection without the necessity of other incisions. The procedure also permitted more ample dissection of LIMA when compared with minithoracotomy without video-assisted thoracic surgery.

Surgical treatment of the congenital fistulae of coronary arteries.

Six cases of coronary artery fistulae surgically treated are presented. All patient but one was male; the ages varied from 4 to 44 years. The fistulae originated from the left coronary artery in three cases from the right in two cases and from both arteries in one case. The draining heart chambers were the right atrium in three, the right ventricle in two and the pulmonary artery in one case. Associated lesions were present in three cases. One patient died on the early postoperative period and the evolution was satisfactory in five cases.

A prospective comparison of Doppler echocardiography and postoperative angiography in the assessment of left internal thoracic artery graft in 72 patients submitted to minimally invasive direct coronary artery bypass.

BACKGROUND: Concerns have been raised regarding the accuracy of the left internal thoracic artery (LITA) anastomosis performed during minimally invasive direct coronary artery bypass (MIDCAB). In a prospective study, we tested the hypothesis that transthoracic Doppler echocardiography is an adequate technique to determine LITA patency when compared to "gold standard" postoperative angiography. METHODS: Seventy-two consecutive patients with single left anterior descending (LAD) coronary artery stenosis were submitted to MIDCAB performed on a beating heart using the LITA. All patients underwent transthoracic Doppler Echocardiography and angiography before discharge. LITA was considered patent when diastolic fraction (DF) of time-velocity integral was equal or greater than 0.5. FitzGibbon grading system was used to evaluate LITA patency by angiography (A=excellent; B=stenosis reducing caliber of anastomosis or trunk to < 50% of grafted coronary artery; O=occlusion). RESULTS: Angiography showed that LITA was patent in 70 (97.2%) patients, 69 of them been graded A. Adequate image and flow signal of the LITA was achieved in 65 (90.3%) patients, been considered patent in 61 (93.8%) of them. Comparison between echocardiography and angiography in these 65 patients showed a specificity of 96.8% and a sensitivity of 50%. In 7 (9.7%) patients in whom no adequate echocardiography signal was obtained, the LITA graft was normal in six and occluded in one. CONCLUSIONS: For patients whose LITA graft can be imaged, transthoracic Doppler echocardiography is highly specific and is a valuable method for noninvasive evaluation of LITA graft patency after MIDCAB.

Two family members with a syndrome of headache and rash caused by human parvovirus B19.

Human parvovirus B19 infection can cause erythema infectiosum (EI) and several other clinical presentations. Central nervous system (CNS) involvement is rare, and only a few reports of encephalitis and aseptic meningitis have been published. Here, we describe 2 cases of B19 infection in a family presenting different clinical features. A 30 year old female with a 7-day history of headache, malaise, myalgias, joint pains, and rash was seen. Physical examination revealed a maculopapular rash on the patient's body, and arthritis of the hands. She completely recovered in 1 week. Two days before, her 6 year old son had been admitted to a clinic with a 1-day history of fever, headache, abdominal pain and vomiting. On admission, he was alert, and physical examination revealed neck stiffness, Kerning and Brudzinski signs, and a petechial rash on his trunk and extremities. Cerebrospinal fluid analysis was normal. He completely recovered in 5 days. Acute and convalescent sera of both patients were positive for specific IgM antibody to B19. Human parvovirus B19 should be considered in the differential diagnosis of aseptic meningitis, particularly during outbreaks of erythema infectiosum. The disease may mimic meningococcemia and bacterial meningitis.

Influence of immunopreventable diseases and AIDS on the demand of an infectious diseases department in Rio de Janeiro State, Brazil, in the course of thirty years (1965-1994).

Brazil's nosologic profile has been sustaining profound modifications. Some occurred because of massive immunization campaigns and socioeconomic and demographic trends. Some yet were pure nosologic transitions, such as the emergence of AIDS. In this demand study it is described how these changes reflected on the 8,630 admission of an Infectious Diseases Department in Niterói, along a thirty year period. Brazilian rural endemic diseases were infrequent (3.45%). Men predominated (62%) all the time, in all age strata and in nearly all diseases. Children under fifteen predominated until 1983. There was, in the case of tetanus, a striking rise in age strata. Institutional mortality dropped from 31% in 1965 to 10% in 1984, but rose since then to 15% in 1994. However, if AIDS patients had not been computed, mortality would have kept descending till 8% at the end of the study period. The crescent unimportance of immunopreventable diseases paralleled with the growing prominence of AIDS. In less than a decade, AIDS ranked fifth among the most frequent diseases in the whole period of thirty years. As opposed to the immunopreventable diseases, neither meningitides nor pneumonia appear to be in decline. AIDS, by its exponential incidence, by its chronic character, and by the uncountable opportunistic infections it determines, imposes itself as a challenge for the coming years.

Antimeasles antibodies in children submitted to different vaccination schedules.

In order to study the measles antibody behavior of three vaccination schedules, 684 children were divided into 4 Groups: Group A (341 vaccinated children under the age of one); Group B (101 children at the age of one); Group C (74 children under the age of one and one at the age of one); Group D (163 unvaccinated children with a history of measles in the past-Group control). Children of Group A presented lower rates and 25.9% of the age group under two did not show any measles antibodies. In Group B, all the children presented antibodies. In Group C only 4.0% did not. In all age groups, the geometric mean HI antibody titers of Group A were lower than the values found in the other groups. The age at vaccination was the factor of greater influence on the results of this study.

Diagnosis of rubella infection by detecting specific immunoglobulin M antibodies in saliva samples: a clinic-based study in Niterói, RJ, Brazil.

This study was designed to investigate whether saliva could be a feasible alternative to serum for the diagnosis of recent rubella infection in a clinic setting. Forty-five paired blood and saliva samples collected 1 to 29 days after onset of illness were tested for specific immunoglobulin (Ig) M by antibody-capture radioimmunoassay (MACRIA). Rubella IgM was detected in all serum samples and in 38 (84.4%) saliva specimens. Forty-six serum and saliva samples from other patients with rash diseases were tested by MACRIA for control purposes and two saliva specimens were reactive. The saliva test had specificity of 96%. These results indicate that salivary IgM detection may be a convenient non-invasive alternative to serum for investigation of recent rubella cases, especially for disease surveillance and control programmes.

Clinical and epidemiological findings during a measles outbreak occurring in a population with a high vaccination coverage.

From March 1991 to April 1992, 250 measles suspected cases were studied in the Municipality of Niterói, State of Rio de Janeiro. The median age found was 11 years and 76.0% of the cases were in school age children. Exposure histories were present in 149 patients and schools were the most frequent sites of transmission (45.0%). Vaccination status was known for 127 studied cases and 76.4% of them had received measles vaccine before their first birthday. One or more complications were reported for 68 cases and in 8.9% of the studied cases hospitalization was required. Frequency of complications varied according to each age group studied and were more commonly encountered among children < 1 year of age (55.6%). The history of previous vaccination did not diminish the number of complications of the cases studied. The results of this work show changes in age distribution of measles leading to sizeable outbreaks among teenagers and young adults.

[The joint manifestations of exanthematous viroses]. / Manifestações articulares nas viroses exantemáticas.

The frequency of arthropathy was evaluated in 251 patients with clinical and serological diagnosis (specific IgM detection by enzyme immunoassay) of exanthematous disease. Arthropathy (arthralgia and/or arthritis) was more frequent in dengue fever (49%) and rubella (38.2%) cases than in human parvovirus (30%) and measles (28.1%) cases. Except for measles cases, joint complaints prevailed in adults (> or = 15 years of age) and this difference was significant. The higher frequency of arthropathy in adults was more evident in human parvovirus (75%), rubella (65%) and dengue fever (57.7%) cases than in measles cases (31%). Arthropathy was also more frequent in females for all rash diseases studied. The results of this study showed the high occurrence of joint complaints in the disease described here and the importance of laboratory confirmation for their differential diagnosis.