RESUMO
Identifying morphologically similar triatomine species is key to Chagas' disease vector control and surveillance, but remains challenging when only qualitative phenotypic data are available. We investigated whether morphometric and ecological variation can provide additional criteria for species delimitation by combining geometric morphometrics and ecological niche modelling to characterize two near-sibling triatomine species, Triatoma sordida and Triatoma garciabesi (Reduviidae: Triatominae). We analysed size and shape variation in 231 wings and 123 heads from one T. garciabesi and three T. sordida populations. Predicted distribution maps (21 climatic variables, 324 vector occurrence points) were produced using the Maxent method. Multivariate analyses summarized morphological and ecological variation. Wings and heads of T. sordida were significantly larger and more elongated than those of T. garciabesi. Discriminant analyses separated the species, with a partial overlap between Argentinean populations. The predicted distribution of T. garciabesi included northwest Argentina (mainly arid Chaco), whereas that of T. sordida included northeast Argentina (humid Chaco) and the Brazilian Cerrado and Caatinga ecoregions. Clear ecological niche differences were observed, with T. garciabesi occupying colder and drier areas than T. sordida. Our results show how morphometric variation and niche divergence can be used to enhance operational criteria for the delimitation of phenotypically similar triatomine species.
Assuntos
Modelos Biológicos , Triatoma/anatomia & histologia , Triatoma/classificação , Animais , Argentina , Brasil , Doença de Chagas/transmissão , Ecossistema , Insetos Vetores/anatomia & histologia , Insetos Vetores/classificação , Insetos Vetores/fisiologia , Triatoma/fisiologiaRESUMO
A total of 70 blood-donor volunteers were studied to determine the utility of the echocardiogram and Doppler in the diagnosis of cardiopathies in asymptomatic patients with Chagas disease. These patients came from endemic areas and had humoral positive reactions for South American Trypanosomiasis. They were checked against a control group of blood-donors with no environmental antecedents and with negative reactions. Both groups were similar in age and sex. The chagasic group showed an abnormal electrocardiogram in twelve cases (17.4%), being left anterior hemiblock the most frequent alteration found (nine cases, 62.5%). In the control group no alterations were found (p = 0.0005). The echocardiogram and Doppler were abnormal in 29 cases of the chagasic group (38.8%): alterations in ventricular relaxation were found in 8 cases (27.6%), enlargement of cavities in 9 (31%), both phenomena in 9 (31%) and alteration of parietal motility in 3 (10.3%). In the control group, 1 case presented alteration in ventricular relaxation (p = 0.000008). These results confirmed that the abnormal discoveries were related to Chagas disease. Out of 70 chagasic patients, 31 (44.29%) showed some alteration in the tests: 12 had an abnormal electrocardiogram, and of these only 2 had normal echocardiogram and Doppler, the rest showed abnormal echocardiogram and Doppler. Other 29 (of these 70 patients) showed some alteration in the echocardiogram and Doppler, and 20 of them presented a normal electrocardiogram. It can be concluded that the echocardiogram and Doppler are more accurate to detect cardiac involvement in asymptomatic chagasic patients than the electrocardiogram, showing abnormality in many cases where there are no electrocardiographic alterations. On the other hand, patients with abnormal electrocardiogram and Doppler are less frequent. Therefore, to define the undetermined period of Chagas disease echocardiogram and Doppler should be incorporated as a routine resource of diagnosis considering the high percentage of cases in which cardiac participation is detected when there is no clinic, radiologic and electrocardiographic disturbance.
Assuntos
Cardiomiopatia Chagásica/fisiopatologia , Ecocardiografia , Eletrocardiografia , Adulto , Estudos de Casos e Controles , Ecocardiografia Doppler , Feminino , Humanos , Masculino , Estudos ProspectivosRESUMO
A total of 70 blood-donor volunteers were studied to determine the utility of the echocardiogram and Doppler in the diagnosis of cardiopathies in asymptomatic patients with Chagas disease. These patients came from endemic areas and had humoral positive reactions for South American Trypanosomiasis. They were checked against a control group of blood-donors with no environmental antecedents and with negative reactions. Both groups were similar in age and sex. The chagasic group showed an abnormal electrocardiogram in twelve cases (17.4
), being left anterior hemiblock the most frequent alteration found (nine cases, 62.5
). In the control group no alterations were found (p = 0.0005). The echocardiogram and Doppler were abnormal in 29 cases of the chagasic group (38.8
): alterations in ventricular relaxation were found in 8 cases (27.6
), enlargement of cavities in 9 (31
), both phenomena in 9 (31
) and alteration of parietal motility in 3 (10.3
). In the control group, 1 case presented alteration in ventricular relaxation (p = 0.000008). These results confirmed that the abnormal discoveries were related to Chagas disease. Out of 70 chagasic patients, 31 (44.29
) showed some alteration in the tests: 12 had an abnormal electrocardiogram, and of these only 2 had normal echocardiogram and Doppler, the rest showed abnormal echocardiogram and Doppler. Other 29 (of these 70 patients) showed some alteration in the echocardiogram and Doppler, and 20 of them presented a normal electrocardiogram. It can be concluded that the echocardiogram and Doppler are more accurate to detect cardiac involvement in asymptomatic chagasic patients than the electrocardiogram, showing abnormality in many cases where there are no electrocardiographic alterations. On the other hand, patients with abnormal electrocardiogram and Doppler are less frequent. Therefore, to define the undetermined period of Chagas disease echocardiogram and Doppler should be incorporated as a routine resource of diagnosis considering the high percentage of cases in which cardiac participation is detected when there is no clinic, radiologic and electrocardiographic disturbance.
RESUMO
Malignant mesothelioma is a tumor which occurs in one out of every 4,000 patients autopsied for malignant neoplasia. Pericardial location is the least frequently encountered, accounting for less than 2% of the total cardiac tumors. We are presenting here a patient in whom the tumor resulted in a syndrome of cardiac tamponade. It could not be diagnosed in the living patient in spite of having performed a subxiphoideal pericardic biopsy. The patient died suddenly, and the tumor was found during autopsy, infiltrating the right atrium and protruding into the cavity, involving the right coronary artery. This latter situation could have been responsible for the patient's death. Clinical and pathological findings are compared with those of 30 cases found in recent literature.
Assuntos
Neoplasias Cardíacas/patologia , Mesotelioma/patologia , Pericárdio/patologia , Evolução Fatal , Feminino , Humanos , Neoplasias Pulmonares/secundário , Pessoa de Meia-Idade , Invasividade Neoplásica , Neoplasias Pleurais/patologiaRESUMO
Malignant mesothelioma is a tumor which occurs in one out of every 4,000 patients autopsied for malignant neoplasia. Pericardial location is the least frequently encountered, accounting for less than 2
of the total cardiac tumors. We are presenting here a patient in whom the tumor resulted in a syndrome of cardiac tamponade. It could not be diagnosed in the living patient in spite of having performed a subxiphoideal pericardic biopsy. The patient died suddenly, and the tumor was found during autopsy, infiltrating the right atrium and protruding into the cavity, involving the right coronary artery. This latter situation could have been responsible for the patients death. Clinical and pathological findings are compared with those of 30 cases found in recent literature.
RESUMO
El mesotelioma maligno es un tumor que se presenta en relación 1: 4000 pacientes autopsiados por neoplasias malignas. La localización pericárdica es la menos frecuente, constituyendo menos del 2 por ciento del total de tumores cardíacos. Se presenta un caso en el que el tumor produjo un síndrome de taponamiento cardíaco, sin ser diagnosticado en vida a pesar de efectuarse una biopsia pericárdica subxifoidea. El paciente murió bruscamente, halládose en la autopsia dicho tumor infiltrando la aurícula derecha y haciendo protusión en la cavidad, englobando la arteria coronaria derecha. Esto último podría ser responsable de la muerte. Se comparan los hallazgos clínicos y patológicos con 30 casos extraídos de la literatura reciente (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Mesotelioma/patologia , Pericárdio/patologia , Neoplasias Cardíacas/patologia , Neoplasias Pulmonares/secundário , Neoplasias Pleurais/patologia , Invasividade Neoplásica , Evolução FatalRESUMO
El mesotelioma maligno es un tumor que se presenta en relación 1: 4000 pacientes autopsiados por neoplasias malignas. La localización pericárdica es la menos frecuente, constituyendo menos del 2 por ciento del total de tumores cardíacos. Se presenta un caso en el que el tumor produjo un síndrome de taponamiento cardíaco, sin ser diagnosticado en vida a pesar de efectuarse una biopsia pericárdica subxifoidea. El paciente murió bruscamente, halládose en la autopsia dicho tumor infiltrando la aurícula derecha y haciendo protusión en la cavidad, englobando la arteria coronaria derecha. Esto último podría ser responsable de la muerte. Se comparan los hallazgos clínicos y patológicos con 30 casos extraídos de la literatura reciente