RESUMO
Coatis (Nasua nasua) are wild carnivorous well adapted to anthropized environments especially important because they act as reservoirs hosts for many arthropod-borne zoonotic pathogens. Information about filarioids from coatis and associated Wolbachia spp. in Brazil is scant. To investigate the diversity of filarial nematodes, blood samples (n = 100 animals) were obtained from two urban areas in midwestern Brazil and analyzed using blood smears and buffy coats and cPCR assays based on the cox1, 12S rRNA, 18S rRNA, hsp70 and myoHC genes for nematodes and 16S rRNA for Wolbachia. When analyzing coati blood smears and buffy coats, 30% and 80% of the samples presented at least one microfilaria, respectively. Twenty-five cox1 sequences were obtained showing 89% nucleotide identity with Mansonella ozzardi. Phylogenetic analyses clustered cox1 sequences herein obtained within the Mansonella spp. clade. Sequences of both myoHC and two hsp70 genes showed 99.8% nucleotide identity with Mansonella sp. and clustered into a clade within Mansonella sp., previously detected in coatis from Brazil. Two blood samples were positive for Wolbachia, with a 99% nucleotide identity with Wolbachia previously found in Mansonella perstans, Mansonella ozzardi and Mansonella atelensis and in ectoparasites of the genus Pseudolynchia, Melophagus and Cimex. The study showed a high prevalence of Mansonella sp. in the coati population examined, suggesting that this animal species play a role as reservoirs of a novel, yet to be described, species within the Onchocercidae family.
RESUMO
Procyonids are reservoirs of many zoonotic infectious diseases, including tick-borne pathogens. The role of coatis (Nasua nasua) in the epidemiology of piroplasmids and Rickettsia has not been fully addressed in Brazil. To molecularly study these agents in coatis and associated ticks, animals were sampled in two urban areas in Midwestern Brazil. Blood (n = 163) and tick (n = 248) DNA samples were screened by PCR assays targeting the 18S rRNA and gltA genes of piroplasmids and Rickettsia spp., respectively. Positive samples were further molecularly tested targeting cox-1, cox-3, ß-tubulin, cytB, and hsp70 (piroplasmid) and ompA, ompB, and htrA 17-kDa (Rickettsia spp.) genes, sequenced and phylogenetically analyzed. All coatis' blood samples were negative for piroplasmids, whereas five pools of ticks (2%) were positive for two different sequences of Babesia spp.. The first from Amblyomma sculptum nymphs was close (i.e., ≥ 99% nucleotide identity) to a Babesia sp. previously found in capybaras (Hydrochoerus hydrochaeris); the second from Amblyomma dubitatum nymphs and Amblyomma spp. larvae was identical (100% nucleotide identity) to a Babesia sp. detected in opossums (Didelphis albiventris) and associated ticks. Four samples (0.8%) were positive by PCR to two different Rickettsia spp. sequences, being the first from Amblyomma sp. larva identical to Rickettsia belli and the second from A. dubitatum nymph identical to Rickettsia species from Spotted Fever Group (SFG). The detection of piroplasmids and SFG Rickettsia sp. highlights the importance of Amblyomma spp. in the maintenance of tick-borne agents in urban parks where humans and wild and domestic animals are living in sympatry.
Assuntos
Babesia , Ixodidae , Procyonidae , Rickettsia , Carrapatos , Humanos , Animais , Rickettsia/genética , Babesia/genética , Brasil/epidemiologia , Roedores , Gambás , Amblyomma , Ixodidae/microbiologiaRESUMO
Diabetic neuropathy (DN) encompasses a group of clinical or subclinical manifestations involving a dysfunction in the peripheral nervous system. The cause of the dysfunction is the development of microvascular complications related to diabetes, a disease that affects about 381 million people worldwide. Approximately 50% of patients currently diagnosed with diabetes are expected to manifest DN in the next 10 years. The diagnosis can be made clinically by establishing a good patient history and delving into the symptoms to rule out other etiologies. Treatment of DN focuses on glycemic control and the use of medications to reduce pain, including NSAIDs, antidepressants and antiepileptic drugs. The pathogenesis is of multifactorial origin, associated with various metabolic, vascular, inflammatory and neurodegenerative disorders. The three fundamental cellular alterations participating in the development of DN are chronic inflammation, endothelial dysfunction and oxidative stress. Since the combination of all three is capable of giving rise to nerve ischemia and direct axonal injury, these factors play a key role in the development of polyneuropathy. However, neuronal and microvascular changes do not occur in the same way in all patients with DN, some of whom have no detectable blood abnormalities.
Assuntos
Diabetes Mellitus , Neuropatias Diabéticas , Neuropatias Diabéticas/diagnóstico , Neuropatias Diabéticas/tratamento farmacológico , Humanos , Inflamação/complicações , Estresse OxidativoRESUMO
OBJECTIVE: In 2007, the Ministry of Health (MoH) in Mexico implemented a multidisciplinary health-care model (MHC) for patients with type-2 diabetes (T2D), which has proven more effective in controlling this condition than the conventional health-care model (CHC). RESEARCH DESIGN AND METHODS: We compared the cost-effectiveness of the MHC vs. the CHC for patients with T2D using a quasi-experimental, retrospective design. Epidemiologic and cost data were obtained from a randomly selected sample of health-care units, using medical records as well as patient- and facility-level data. We modelled the cost-effectiveness of the MHC at one, 10 and 20 years using a simulation model. RESULTS: The average cumulative costs per patient at 20 years were US$4,225 for the MHC and US$4,399 for the CHC. With a willingness to pay one gross domestic product (GDP) per capita per quality-adjusted life year (QALY) (US$8,910), the incremental net benefits per patient were US$1,450 and US$3,737 at 10 and 20 years, respectively. The MHC was cost-effective from the third year onward; however, increasing coverage to 500 patients per year rendered it cost-effective at year one. CONCLUSIONS: The MHC is cost-effective at 10 and 20 years. Cost-effectiveness can be achieved in the short term by increasing MHC coverage.
Assuntos
Atenção à Saúde/economia , Diabetes Mellitus Tipo 2/epidemiologia , Setor Público , Adulto , Idoso , Análise Custo-Benefício , Diabetes Mellitus Tipo 2/economia , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Modelos Teóricos , Anos de Vida Ajustados por Qualidade de Vida , Estudos RetrospectivosRESUMO
Embryo biopsy for fetal sexing has clinical application, but few reports are available of its use within an active embryo transfer program. We evaluated results on biopsy of 459 embryos over one breeding season. There were no significant differences in pregnancy rate between biopsied and non-biopsied embryos (72% vs 73%) or for biopsied embryos recovered at the centre (73%) compared with those shipped overnight (72%). However, the pregnancy rate decreased significantly in shipped embryos biopsied ≥20h after collection. Overall, 86% of biopsies provided a sex diagnosis. The likelihood of a positive genomic (g) DNA result was significantly higher for biopsies from large blastocysts (96%) than from smaller embryos (70-85%). In total, 38% of biopsies were positive for Y chromosome DNA (Y-DNA) and were diagnosed as male. Subsequently, 95% of Y-DNA-positive embryos were confirmed as male and 78% of Y-DNA-negative embryos were confirmed as female. The accuracy of prediction of female (Y-DNA negative) was significantly higher when the biopsy sample was probed for Y-DNA only compared with probing for both gDNA and Y-DNA. We estimate that by transferring only Y-DNA-negative embryos, 3% of potential female pregnancies may have been lost, and production of male pregnancies was reduced by 72%.
Assuntos
Blastocisto/patologia , Embrião de Mamíferos/patologia , Cavalos/embriologia , Reação em Cadeia da Polimerase , Diagnóstico Pré-Implantação , Análise para Determinação do Sexo , Animais , Argentina , Biópsia , Cruzamento/economia , Cruzamento/métodos , Comércio , Transferência Embrionária/economia , Transferência Embrionária/métodos , Transferência Embrionária/veterinária , Feminino , Masculino , Reação em Cadeia da Polimerase/métodos , Reação em Cadeia da Polimerase/veterinária , Gravidez , Diagnóstico Pré-Implantação/métodos , Diagnóstico Pré-Implantação/veterinária , Análise para Determinação do Sexo/métodos , Análise para Determinação do Sexo/veterinária , Medicina Veterinária Esportiva/economia , Medicina Veterinária Esportiva/métodos , Medicina Veterinária Esportiva/organização & administraçãoRESUMO
In Mexico, mosquito vector-borne diseases are of public health concern as a result of their impact on human morbidity and mortality. The use of insecticides against adult mosquitoes is one of the most common ways of controlling mosquito population densities. However, the use of these compounds has resulted in the development of insecticide resistance. The aim of this study was to estimate susceptibility to six pyrethroids, two carbamates and two organophosphates in Mexican populations of Stegomyia aegypti (Linnaeus, 1762) (= Aedes aegypti) (Diptera: Culicidae) mosquitoes. Bottle insecticide susceptibility tests, with 1 h exposure, were performed on adult mosquitoes from 75 localities across 28 states. At 30 min of exposure, the proportion of fallen mosquitoes was recorded. After 60 min of exposure, mosquitoes were recovered in non-treated containers and mortality was determined at 24 h after the set-up of the experiment. In general, the carbamate insecticides represented the most effective group in terms of the proportion of mosquitoes fallen at 30 min (72-100%) and 24-h mortality (97-100%). High and widespread resistance to pyrethroids Types I and II and, to a lesser extent, to organophosphates was observed. Insecticide susceptibility among and within states was highly variable.
Assuntos
Aedes/efeitos dos fármacos , Carbamatos/farmacologia , Resistência a Inseticidas , Inseticidas/farmacologia , Organofosfatos/farmacologia , Piretrinas/farmacologia , Animais , Feminino , MéxicoRESUMO
The chigger mite genus Blankaartia includes 28 known species, of which 10 are distributed in the Nearctic and Neotropical regions. These species preferentially parasitize birds, but occasionally they can also be found on rodents, bats, and reptiles, showing low host selectivity. In the present study, we report the presence of this genus in Brazil for the first time, including the first report of Blankaartia sinnamaryi (Floch and Fauran) and the description of a new species of Blankaartia collected from birds (Order Passeriformes).
Assuntos
Doenças das Aves/parasitologia , Infestações por Ácaros/veterinária , Passeriformes , Trombiculidae/anatomia & histologia , Trombiculidae/classificação , Animais , Brasil , Larva/anatomia & histologia , Larva/classificação , Larva/crescimento & desenvolvimento , Larva/fisiologia , Infestações por Ácaros/parasitologia , Trombiculidae/crescimento & desenvolvimento , Trombiculidae/fisiologiaRESUMO
Stegomyia aegypti (= Aedes aegypti) (Diptera: Culicidae) is a species of mosquito that is currently widespread in Mexico. Historically, the mosquito has been distributed across most tropical and subtropical areas lower than 1700 m a.s.l. Currently, populations that are found at higher altitudes in regions with cold and dry climates suggest that these conditions do not limit the colonization and population growth of S. aegypti. During a survey of mosquitoes in September 2015, larvae of S. aegypti mosquitoes were found in two different localities in Mexico City, which is located at about 2250 m a.s.l. Mexico City is the most populous city in Mexico and has inefficient drainage and water supply systems. These factors may result in the provision of numerous larval breeding sites. Mosquito monitoring and surveillance are now priorities for the city.
Assuntos
Aedes/fisiologia , Distribuição Animal , Insetos Vetores/fisiologia , Aedes/crescimento & desenvolvimento , Animais , Insetos Vetores/crescimento & desenvolvimento , Larva/crescimento & desenvolvimento , Larva/fisiologia , MéxicoRESUMO
PURPOSE: To assess the clinical results in terms of local control, toxicity, failure pattern and toxicity of SBRT in oligometastatic patients with inoperable lung metastases. METHODS: Forty-four patients were treated (53 metastases). Dose regimen: 5 × 12 Gy (66 %), 8 × 7.5 Gy (20.8 %) and 10 × 5 Gy (13.2 %). Response was assessed using PET/CT at 6 months after SBRT. RESULTS: Local control at 1 and 2 years was 86.7 %. Seventy-five percent of local failures had received a BED <105 Gy. After a median follow-up of 13.3 months, 25 % experienced distant progression. Overall survival at 1 and 2 years was 86.7 and 60.4 %, and cancer-specific survival was 95.3 and 75.2 %, respectively. Grade 2 toxicity was 6.8 %. There was no grade 3-4 toxicity. CONCLUSION: SBRT is effective and safe. The main failure pattern is distant progression. The selection of patients with a high probability of remaining oligometastatic is crucial for the efficiency of SBRT, both clinically and in terms of resources.
Assuntos
Adenocarcinoma/radioterapia , Carcinoma de Células Escamosas/radioterapia , Neoplasias Pulmonares/radioterapia , Neoplasias/radioterapia , Radiocirurgia/mortalidade , Adenocarcinoma/mortalidade , Adenocarcinoma/secundário , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/secundário , Fracionamento da Dose de Radiação , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias/mortalidade , Neoplasias/patologia , Prognóstico , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
No Abstract available.
Assuntos
Cateterismo de Swan-Ganz/instrumentação , Artéria Pulmonar , Idoso , Falha de Equipamento , Feminino , HumanosAssuntos
Sífilis , Feminino , Heterossexualidade , Humanos , Masculino , Sífilis/diagnóstico , Adulto JovemAssuntos
Feminino , Humanos , Masculino , Adulto Jovem , Sífilis , Heterossexualidade , Sífilis/diagnósticoRESUMO
We have previously developed and validated a self-administered questionnaire, modelled after the Systemic Lupus International Collaborating Clinics Damage Index (SDI), the Lupus Damage Index Questionnaire (LDIQ), which may allow the ascertainment of this construct in systemic lupus erythematosus (SLE) patients followed in the community and thus expand observations made about damage. We have now translated, back-translated and adapted the LDIQ to Spanish, Portuguese and French and applied it to patients followed at academic and non-academic centres in North and South America, Portugal and Spain while their physicians scored the SDI. A total of 887 patients (659 Spanish-speaking, 140 Portuguese-speaking and 80 French-speaking patients) and 40 physicians participated. Overall, patients scored all LDIQ versions higher than their physicians (total score and all domains). Infrequent manifestations had less optimal clinimetric properties but overall agreement was more than 95% for the majority of items. Higher correlations were observed among the Spanish-speaking patients than the Portuguese-speaking and French-speaking patients; further adjustments may be needed before the Portuguese and French versions of the LDIQ are applied in community-based studies. The relationship between the LDIQ and other outcome parameters is currently being investigated in a different patient sample.
Assuntos
Idioma , Lúpus Eritematoso Sistêmico , Inquéritos e Questionários , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Lúpus Eritematoso Sistêmico/patologia , Lúpus Eritematoso Sistêmico/fisiopatologia , América do Norte , Portugal , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , América do Sul , Espanha , Inquéritos e Questionários/normasRESUMO
Forty-seven plant extracts of 10 species of the genus Euphorbia (Euphorbiaceae) used by Colombian traditional healers for the treatment of ulcers, cancers, tumors, warts, and other diseases, were tested in vitro for their potential antitumour (antiproliferative and cytotoxic) and antiherpetic activity. To evaluate the capacity of the extracts to inhibit the lytic activity of herpes simplex virus type 2 (HSV-2) and the reduction of viability of infected or uninfected cell cultures, the end-point titration technique (EPTT) and the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] colorimetric assay were used, respectively. The therapeutic index of the positive extracts for the antiviral activity was determined by calculating the ratio CC50 (50% cytotoxic concentration) over IC50 (50% inhibitory concentration of the viral effect). Five of the 47 extracts (11%) representing 3 out of 10 Euphorbia species (30%) exhibited antiherpetic action; the highest activity was found in the leaf/stem water-methanol extracts from E. cotinifolia and E. tirucalli. The therapeutic indexes of these two plant species were > 7.1; these extracts exhibited no cytotoxicity. Six extracts (13%) representing 4 plant species (40%) showed cytotoxic activity. The highest cytotoxicity was found in the dichloromethane extract obtained from E. cotinifolia leaves and the CC50 values for the most susceptible cell lines, HEp-2 and CHO, were 35.1 and 18.1 microgram/ml, respectively.
Assuntos
Antineoplásicos Fitogênicos/farmacologia , Antivirais/farmacologia , Euphorbia/química , Herpesvirus Humano 2/efeitos dos fármacos , Animais , Antineoplásicos Fitogênicos/toxicidade , Antivirais/toxicidade , Células CHO/efeitos dos fármacos , Células Cultivadas/efeitos dos fármacos , Colômbia , Colorimetria , Cricetinae , Ensaios de Seleção de Medicamentos Antitumorais , Determinação de Ponto Final , Feminino , Células HeLa/efeitos dos fármacos , Humanos , Extratos Vegetais/farmacologia , Extratos Vegetais/toxicidadeRESUMO
Forty-seven plant extracts of 10 species of the genus Euphorbia (Euphorbiaceae) used by Colombian traditional healers for the treatment of ulcers, cancers, tumors, warts, and other diseases, were tested in vitro for their potential antitumour (antiproliferative and cytotoxic) and antiherpetic activity. To evaluate the capacity of the extracts to inhibit the lytic activity of herpes simplex virus type 2 (HSV-2) and the reduction of viability of infected or uninfected cell cultures, the end-point titration technique (EPTT) and the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] colorimetric assay were used, respectively. The therapeutic index of the positive extracts for the antiviral activity was determined by calculating the ratio CC50 (50 percent cytotoxic concentration) over IC50 (50 percent inhibitory concentration of the viral effect). Five of the 47 extracts (11 percent) representing 3 out of 10 Euphorbia species (30 percent) exhibited antiherpetic action; the highest activity was found in the leaf/stem water-methanol extracts from E. cotinifolia and E. tirucalli. The therapeutic indexes of these two plant species were > 7.1; these extracts exhibited no cytotoxicity. Six extracts (13 percent) representing 4 plant species (40 percent) showed cytotoxic activity. The highest cytotoxicity was found in the dichloromethane extract obtained from E. cotinifolia leaves and the CC50 values for the most susceptible cell lines, HEp-2 and CHO, were 35.1 and 18.1 æg/ml, respectively
Assuntos
Humanos , Animais , Feminino , Cricetinae , Antivirais , Euphorbia/química , Herpesvirus Humano 2 , Extratos Vegetais , Antivirais , Células Cultivadas , Colômbia , Colorimetria , Determinação de Ponto Final , Extratos VegetaisRESUMO
Due to the high frequency of oral mucosal lesions observed in paracoccidioidomycosis patients, it was advocated that the infection was acquired by the traumatic implantation of the etiologic agent Paracoccidioides brasiliensis. Although at present this theory is considered invalid, it has not yet been excluded in experimental studies. In order to determine if intra-oral inoculation could explain the pathogenesis of paracoccidioidomycosis, 64 BALB/c mice were inoculated intra-orally with 850.000 viable P. brasiliensis conidia into the mandibular body. Animals were sacrificed at various time intervals up to 20 weeks and cultures were made from gingiva, lungs, spleen, and liver. Additionally, histopathological studies of the mandibular body were also performed. P. brasiliensis was isolated from all gingival tissues during the interval 24-72 h, indicating that the infection was active. During the 5-10 week period, the infection appeared to have been controlled at the inoculation site as cultures showed a significant reduction in colony forming units (CFU); however, at the 15-20 week period such control was lost and the fungus was recovered once more. Dissemination to other body sites was rare; thus, the lungs were involved in just one animal (2%), the liver in two (3%) and the spleen in seven (11%). The infection became established as proven by positive organ cultures, but the dissemination pattern did not correspond to the one observed in humans. Based on these findings, the intra-oral traumatic route does not appear to mimic the natural history of paracoccidioidomycosis.
Assuntos
Paracoccidioides/fisiologia , Paracoccidioides/patogenicidade , Paracoccidioidomicose/microbiologia , Paracoccidioidomicose/fisiopatologia , Administração Oral , Animais , Contagem de Colônia Microbiana , Feminino , Gengiva/microbiologia , Gengiva/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Paracoccidioidomicose/patologiaRESUMO
This is a report of a woman in the fifth decade of life with primary antiphospholipid syndrome and involvement of a heart valve. Diagnosis was reached with echocardiography and serological studies.
Assuntos
Síndrome Antifosfolipídica/diagnóstico por imagem , Ecocardiografia Tridimensional , Ecocardiografia , Cardiopatia Reumática/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
In order to determine the effect of right atrial dysfunction on clinical outcome, six patients with inferior myocardial infarction with extension to right ventricle and right atrium involving only obstructions of the right coronary artery were examined with transesophageal echocardiography (TEE) at the time of the event. Five of the patients were reexamined 15 to 55 months later. Two patients underwent thrombolysis and maintained ratios of right-to-left ventricular diameters of less than 1, as well as normal convexity of the interatrial septum. One patient had spontaneous reperfusion of the right coronary artery, reduction in right ventricular diameter, and normalization of interatrial septum. Another patient underwent delayed angioplasty and manifested a diminished wall movement score (WMS) in the follow-up echocardiogram. One patient died during his first hospitalization with significant right ventricular dilatation, inverted convexity of the interatrial septum, and right atrial thrombosis. The last patient died during follow-up with right ventricular dilatation, increased WMS, right atrial akinesis, and inverted interatrial convexity. Serial TEE examination of patients with infarction of the left ventricular inferior wall is a safe technique for determining the degree of the extension of the ischemic process to the right chambers.
Assuntos
Fibrilação Atrial/diagnóstico por imagem , Flutter Atrial/diagnóstico por imagem , Ecocardiografia Transesofagiana/métodos , Infarto do Miocárdio/diagnóstico por imagem , Disfunção Ventricular Direita/diagnóstico por imagem , Adulto , Idoso , Fibrilação Atrial/complicações , Fibrilação Atrial/mortalidade , Flutter Atrial/complicações , Flutter Atrial/mortalidade , Angiografia Coronária , Feminino , Seguimentos , Átrios do Coração/diagnóstico por imagem , Testes de Função Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/mortalidade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Taxa de Sobrevida , Fatores de Tempo , Disfunção Ventricular Direita/complicações , Disfunção Ventricular Direita/mortalidadeRESUMO
El tejido epitelial gastrointestinal normal presenta estructuras glicoesfingolipídicas que son propias de los antígenos ABH, las cuales confieren propiedades biológicas esenciales, dirigen el recambio y el tráfico transcelular y tienen gran importancia para la interacción entre células durante el desarrollo, crecimiento y diferenciación. Está descripto que la glicosilación aberrante es un atributo común del crecimiento neoplásico y uno de los principales determinantes del fenómeno relacionado con el cáncer, como es el crecimiento invasivo de la metástasis. El objetivo de este trabajo fue estudiar la expresión de los antígenos ABH en células epiteliales de neoplasias gastrointestinales. Se trabajó con catorce muestras de tumores gastrointestinales en tacos de parafina aplicando la técnica SRCA (Specific Red Cell Adherence). Se demostró que en 13 de las 14 muestras hubo pérdida total o parcial, o cambio de la expresión antigénica (AU)