RESUMO
The genetic risk of developing type 2 diabetes (T2D) increases in parallel with the proportion of Native American ancestry. Mestizo Mexicans have a 70% Native Amerindian genetic background. The T130I polymorphism in the HNF4A gene has been associated with early-onset T2D in mestizo Mexicans. Thus, the aim of the present study was to evaluate the frequency and relationship of the T130I variant in the HNF4A gene with risk factors for developing T2D in eleven indigenous groups from Mexico. In two groups, all exons of the HNF4A gene were directly sequenced; in the remaining the T130I polymorphism was analyzed by restriction fragment length polymorphism. Ancestry informative markers were assessed to confirm the Amerindian component. An additional analysis of EHH was carried out. Interestingly, HNF4A gene screening revealed only the presence of the T130I polymorphism. The range frequency of the risk allele (T) in the indigenous groups was from 2.7 to 16%. Genotypic frequencies (T130I/I130I) were higher and significantly different from those of all of the populations included in the HapMap Project (P < 0.005). EHH scores suggest a positive selection for T130I polymorphism. Metabolic traits indicate a relationship between the T130I/I130I genotypes with high triglyceride concentrations in the indigenous groups (P < 0.005). These results strongly suggest that the high frequency of the T130I polymorphism and its biological relationship with dysfunction in lipid metabolism in Mexican indigenous groups is a risk factor for the developing of T2D in Mexicans.
Assuntos
Diabetes Mellitus Tipo 2/genética , Predisposição Genética para Doença , Fator 4 Nuclear de Hepatócito/genética , Estudos Transversais , Diabetes Mellitus Tipo 2/etnologia , Etnicidade/genética , Haplótipos , Humanos , México/etnologia , Polimorfismo de Fragmento de Restrição , Polimorfismo de Nucleotídeo ÚnicoRESUMO
Association of type 2 diabetes (T2D) with common variants in HHEX, HNF4α, KCNJ11, PPARγ, CDKN2A/2B, SLC30A8, CDC123/CAMK1D, TCF7L2, ABCA1 and SLC16A11 genes have been reported, mainly in populations of European and Asian ancestry and to a lesser extent in Latin Americans. Thus, we aimed to investigate the contribution of rs1111875 (HHEX), rs1800961 (HNF4α), rs5219 (KCNJ11), rs1801282 (PPARγ), rs10811661 (CDKN2A/2B), rs13266634 (SLC30A8), rs12779790 (CDC123/CAMK1D), rs7903146 (TCF7L2), rs9282541 (ABCA1) and rs13342692 (SLC16A11) polymorphisms in the genetic background of Maya population to associate their susceptibility to develop T2D. This is one of the first studies designed specifically to investigate the inherited component of T2D in the indigenous population of Mexico. SNPs were genotyped by allelic discrimination method in 575 unrelated Maya individuals. Two SNPs rs10811661 and rs928254 were significantly associated with T2D after adjusting for BMI; rs10811661 in a recessive and rs9282541 in a dominant model. Additionally, we found phenotypical alterations associated with genetic variants: HDL to rs9282541 and insulin to rs13342692. In conclusion, these findings support an association of genetic polymorphisms to develop T2D in Maya population.
Assuntos
Transportador 1 de Cassete de Ligação de ATP/genética , Inibidor de Quinase Dependente de Ciclina p15/genética , Inibidor p16 de Quinase Dependente de Ciclina/genética , Diabetes Mellitus Tipo 2/genética , Indígenas Norte-Americanos/genética , Transportadores de Ácidos Monocarboxílicos/genética , Adulto , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/etnologia , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Indígenas Norte-Americanos/etnologia , Masculino , México/etnologia , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo ÚnicoRESUMO
Aiming to evaluate the microbiological and physico-chemical quality of the toscana sausage commercialized in the city of Mossoró, state of Rio Grande do Norte, Brazil, samples from 6 supermarkets were analyzed, verifying the most likely number (MLN) of thermotolerant coliforms, Salmonella spp. , and psychrotrophic bacteria, humidity, pH and water activity. All the samples were within the current standards which establish a maximum limit of 5 x 10³ MLN/g for thermotolerant coliforms according to ANVISA. On the psychrotrophic bacteria count there was a variation of 1.46 to 4.10 expressed in log10 values. Of the 28 samples analyzed for the presence of Salmonella spp. , in 5 the presence of this microorganism was verified in 25 g. In regard to humidity, all the samples were found to be in accordance with the established legislation (lower than 70% humidity), and for water activity the limits varied between 0.772 and 0.809. The pH values were within normalcy, ranging from 5.7 to 6.2. In spite of the fact that the analyzed samples are in accordance with Brazilian laws, it is necessary to apply good practices, since the contamination by psychrotrophic microorganisms and Salmonella was significant and could harm the public health and reduce the product's shelf life.
Com o objetivo de avaliar a qualidade microbiológica e físico-química da linguiça toscana comercializada no Município de Mossoró, RN, foram analisadas 28 amostras de seis supermercados, verificando-se o Número Mais Provável (NMP) de coliformes termotolerantes, Salmonella spp. e bactérias psicrotróficas, umidade, pH e atividade de água. Todas as amostras estavam dentro do padrão vigente que estabelece um limite máximo de 5 x 10³ NMP/g-1 para coliformes termotole-rantes conforme a ANVISA. Na contagem de bactérias psicrotróficas houve uma variação de 2,9 x 10¹ a 1,31 x 10(4) UFC/g-1. Das 28 amostras pesquisadas quanto a presença de Salmonella spp., em cinco verificou-se a presença deste micro-organismo em 25 g. Para umidade, todas as amostras encontravam-se dentro da legislação estabelecida ( 70%) e para atividade de água os limites variaram de 0,772 a 0,809. Os valores de pH das amostras estavam entre 5,7 e 6,2. Apesar das amostras analisadas estarem dentro do estabelecido pela legislação brasileira, faz necessária a aplicação de boas práticas, visto que a contaminação por micro-organismos psicrotróficos e Salmonella foi significativa, podendo diminuir a vida de prateleira do produto e causar danos a saúde pública.
RESUMO
Com o objetivo de avaliar a qualidade microbiológica e físico-química da linguiça toscana comercializada no Município de Mossoró, RN, foram analisadas 28 amostras de seis supermercados, verificando-se o Número Mais Provável (NMP) de coliformes termotolerantes, Salmonella spp. e bactérias psicrotróficas, umidade, pH e atividade de água. Todas as amostras estavam dentro do padrão vigente que estabelece um limite máximo de 5 x 103 NMP/g-1 para coliformes termotole-rantes conforme a ANVISA. Na contagem de bactérias psicrotróficas houve uma variação de 2,9 x 101 a 1,31 x 104 UFC/g-1. Das 28 amostras pesquisadas quanto a presença de Salmonella spp., em cinco verificou-se a presença deste micro-organismo em 25 g. Para umidade, todas as amostras encontravam-se dentro da legislação estabelecida (< 70%) e para atividade de água os limites variaram de 0,772 a 0,809. Os valores de pH das amostras estavam entre 5,7 e 6,2. Apesar das amostras analisadas estarem dentro do estabelecido pela legislação brasileira, faz necessária a aplicação de boas práticas, visto que a contaminação por micro-organismos psicrotróficos e Salmonella foi significativa, podendo diminuir a vida de prateleira do produto e causar danos a saúde pública.(AU)
Aiming to evaluate the microbiological and physico-chemical quality of the toscana sausage commercialized in the city of Mossoró, state of Rio Grande do Norte, Brazil, samples from 6 supermarkets were analyzed, verifying the most likely number (MLN) of thermotolerant coliforms, Salmonella spp., and psychrotrophic bacteria, humidity, pH and water activity. All the samples were within the current standards which establish a maximum limit of 5 x 103 MLN/g for thermotolerant coliforms according to ANVISA. On the psychrotrophic bacteria count there was a variation of 1.46 to 4.10 expressed in log10 values. Of the 28 samples analyzed for the presence of Salmonella spp., in 5 the presence of this microorganism was verified in 25 g. In regard to humidity, all the samples were found to be in accordance with the established legislation (lower than 70% humidity), and for water activity the limits varied between 0.772 and 0.809. The pH values were within normalcy, ranging from 5.7 to 6.2. In spite of the fact that the analyzed samples are in accordance with Brazilian laws, it is necessary to apply good practices, since the contamination by psychrotrophic microorganisms and Salmonella was significant and could harm the public health and reduce the products shelf life.(AU)
Assuntos
Qualidade dos Alimentos , Microbiologia/tendências , Coliformes/análise , Bacteriologia/tendências , Salmonella/patogenicidade , Saúde Pública/normasRESUMO
Com o objetivo de avaliar a qualidade microbiológica e físico-química da linguiça toscana comercializada no Município de Mossoró, RN, foram analisadas 28 amostras de seis supermercados, verificando-se o Número Mais Provável (NMP) de coliformes termotolerantes, Salmonella spp. e bactérias psicrotróficas, umidade, pH e atividade de água. Todas as amostras estavam dentro do padrão vigente que estabelece um limite máximo de 5 x 103 NMP/g-1 para coliformes termotole-rantes conforme a ANVISA. Na contagem de bactérias psicrotróficas houve uma variação de 2,9 x 101 a 1,31 x 104 UFC/g-1. Das 28 amostras pesquisadas quanto a presença de Salmonella spp., em cinco verificou-se a presença deste micro-organismo em 25 g. Para umidade, todas as amostras encontravam-se dentro da legislação estabelecida (< 70%) e para atividade de água os limites variaram de 0,772 a 0,809. Os valores de pH das amostras estavam entre 5,7 e 6,2. Apesar das amostras analisadas estarem dentro do estabelecido pela legislação brasileira, faz necessária a aplicação de boas práticas, visto que a contaminação por micro-organismos psicrotróficos e Salmonella foi significativa, podendo diminuir a vida de prateleira do produto e causar danos a saúde pública.
Aiming to evaluate the microbiological and physico-chemical quality of the toscana sausage commercialized in the city of Mossoró, state of Rio Grande do Norte, Brazil, samples from 6 supermarkets were analyzed, verifying the most likely number (MLN) of thermotolerant coliforms, Salmonella spp., and psychrotrophic bacteria, humidity, pH and water activity. All the samples were within the current standards which establish a maximum limit of 5 x 103 MLN/g for thermotolerant coliforms according to ANVISA. On the psychrotrophic bacteria count there was a variation of 1.46 to 4.10 expressed in log10 values. Of the 28 samples analyzed for the presence of Salmonella spp., in 5 the presence of this microorganism was verified in 25 g. In regard to humidity, all the samples were found to be in accordance with the established legislation (lower than 70% humidity), and for water activity the limits varied between 0.772 and 0.809. The pH values were within normalcy, ranging from 5.7 to 6.2. In spite of the fact that the analyzed samples are in accordance with Brazilian laws, it is necessary to apply good practices, since the contamination by psychrotrophic microorganisms and Salmonella was significant and could harm the public health and reduce the products shelf life.
Assuntos
Bacteriologia/tendências , Coliformes/análise , Microbiologia/tendências , Qualidade dos Alimentos , Salmonella/patogenicidade , Saúde Pública/normasRESUMO
Aiming to evaluate the microbiological and physico-chemical quality of the toscana sausage commercialized in the city of Mossoró, state of Rio Grande do Norte, Brazil, samples from 6 supermarkets were analyzed, verifying the most likely number (MLN) of thermotolerant coliforms, Salmonella spp. , and psychrotrophic bacteria, humidity, pH and water activity. All the samples were within the current standards which establish a maximum limit of 5 x 10³ MLN/g for thermotolerant coliforms according to ANVISA. On the psychrotrophic bacteria count there was a variation of 1.46 to 4.10 expressed in log10 values. Of the 28 samples analyzed for the presence of Salmonella spp. , in 5 the presence of this microorganism was verified in 25 g. In regard to humidity, all the samples were found to be in accordance with the established legislation (lower than 70% humidity), and for water activity the limits varied between 0.772 and 0.809. The pH values were within normalcy, ranging from 5.7 to 6.2. In spite of the fact that the analyzed samples are in accordance with Brazilian laws, it is necessary to apply good practices, since the contamination by psychrotrophic microorganisms and Salmonella was significant and could harm the public health and reduce the product's shelf life.
Com o objetivo de avaliar a qualidade microbiológica e físico-química da linguiça toscana comercializada no Município de Mossoró, RN, foram analisadas 28 amostras de seis supermercados, verificando-se o Número Mais Provável (NMP) de coliformes termotolerantes, Salmonella spp. e bactérias psicrotróficas, umidade, pH e atividade de água. Todas as amostras estavam dentro do padrão vigente que estabelece um limite máximo de 5 x 10³ NMP/g-1 para coliformes termotole-rantes conforme a ANVISA. Na contagem de bactérias psicrotróficas houve uma variação de 2,9 x 10¹ a 1,31 x 10(4) UFC/g-1. Das 28 amostras pesquisadas quanto a presença de Salmonella spp., em cinco verificou-se a presença deste micro-organismo em 25 g. Para umidade, todas as amostras encontravam-se dentro da legislação estabelecida ( 70%) e para atividade de água os limites variaram de 0,772 a 0,809. Os valores de pH das amostras estavam entre 5,7 e 6,2. Apesar das amostras analisadas estarem dentro do estabelecido pela legislação brasileira, faz necessária a aplicação de boas práticas, visto que a contaminação por micro-organismos psicrotróficos e Salmonella foi significativa, podendo diminuir a vida de prateleira do produto e causar danos a saúde pública.
RESUMO
The aim of this study was to evaluate the potential of dehydroleucodine (DhL), a new drug isolated from a medicinal herb used in Argentina, for activation of bovine oocyte. Several DhL concentrations and exposure times after ionomycin (Io) treatment were tested. The optimal DhL treatment, found for parthenogenetic development, was employed to produce bovine embryos by intracytoplasmic sperm injection (ICSI) and somatic cell nuclear transfer (SCNT). The best parthenogenic embryo developments were observed with 5 µM Io for 4 min followed by 5 µM DhL concentration and after 3-h exposure time (52.3% cleavage; 17.4% morulae; 7.3% blastocyst; n = 109). This treatment generated no significant differences with standard Io plus 6-dimethylaminopurine (DMAP) treatment in preimplantation embryo development. In our conditions, the embryo development reached after ICSI and SCNT assisted by the DhL treatment did not differ in terms of cleavage and blastocyst development from activation with standard Io plus DMAP treatment (p > 0.05). In conclusion, DhL utilization to activate oocytes and induce development of parthenogenotes, ICSI-embryos or SCNT-embryos is reported here for first time.
Assuntos
Bovinos/embriologia , Embrião de Mamíferos/efeitos dos fármacos , Ionomicina/farmacologia , Lactonas/farmacologia , Óvulo/efeitos dos fármacos , Sesquiterpenos/farmacologia , Animais , Clonagem de Organismos , Desenvolvimento Embrionário/efeitos dos fármacos , Lactonas/química , Estrutura Molecular , Técnicas de Transferência Nuclear/veterinária , Partenogênese , Sesquiterpenos/química , Injeções de Esperma Intracitoplásmicas/veterináriaRESUMO
Previous studies have sought to associate the Pro12Ala variant of the peroxisome proliferator-activated receptor gamma2 (PPARG2) gene with type 2 diabetes, insulin resistance, and obesity, with controversial results. We have determined the Pro12Ala variant frequency in 370 nondiabetic Mexican Mestizo subjects and in five Mexican Amerindian groups and have investigated its possible association with lipid metabolism, insulin serum levels, and obesity in three of these populations. Two independent case-control studies were conducted in 239 nondiabetic individuals: 135 case subjects (BMI > or = 25 kg/m2) and 104 control subjects (BMI < 25 kg/m2). The PPARG2 Ala12 allele frequency was higher in most Amerindian populations (0.17 in Yaquis, 0.16 in Mazahuas, 0.16 in Mayans, and 0.20 in Triquis) than in Asians, African Americans, and Caucasians. The Pro12Ala and Ala12Ala (X12Ala) genotypes were significantly associated with greater BMI in Mexican Mestizos and in two Amerindian groups. X12Ala individuals had a higher risk of overweight or obesity than noncarriers in Mestizos (OR = 3.67; 95% CI, 1.42-9.48; p = 0.007) and in Yaquis plus Mazahuas (OR = 3.21; 95% CI, 1.27-8.11; p = 0.013). Our results provide further support of the association between the PPARG2 Ala12 allele and risk of overweight or obesity in Mestizos and two Amerindian populations from Mexico.
Assuntos
Variação Genética/genética , Genética Populacional/métodos , Genótipo , Indígenas Norte-Americanos/genética , PPAR gama/genética , Adulto , Índice de Massa Corporal , Humanos , México , Pessoa de Meia-Idade , Obesidade/genéticaRESUMO
The effect of the incorporation of globin (10%), plasma (10%) and both combined (5% each) as fat replacers on the quality of ham paté was investigated. The chemical composition, the sensorial analysis (color, flavor and consistency) and the instrumental analysis of the texture (hardness, adhesiveness, elasticity, cohesiveness and tackiness) were evaluated. The results showed an increase of moisture and protein contents after the fat replacement, while the fat reduction of 25-35% led to the preparation of light products. No change was observed for the aroma, taste and the consistency of fat replacing products, but an intensification of the cohesivity and a reduction of color, hardness and tackiness were detected in some samples.
RESUMO
BACKGROUND: Patients with vitiligo show specific losses of integumentary melanocytes, probably due to autoimmunity against melanocytes. We attempted to determine the presence of antibodies against pigment cell antigens in the sera of vitiligo patients. METHODS: Detergent-solubilized human melanoma cells were submitted to electrophoretic separation and immunoblotted against serum samples obtained from 19 patients with vitiligo and from 20 age- and sex-matched healthy individuals. RESULTS: Eighty-nine per cent of patients with vitiligo had antibodies to one or more pigment cell antigens. Similar antibodies were detected in 20% of healthy individuals. Antigens of 165, 90, and 68 kDa were recognized by the antibodies present in sera from 11%, 26%, and 37% of vitiligo patients, respectively, and in none of the normal sera. All patients with familial vitiligo also had antibodies to these three proteins. CONCLUSIONS: Proteins of 165, 90, and 68 kDa are specifically recognized by antibodies present in the sera of vitiligo patients and in all patients with genetic vitiligo. Whether or not these proteins might be implicated in the destruction of melanocytes by the immune system in vitiligo remains to be evaluated.
Assuntos
Anticorpos/imunologia , Antígenos de Neoplasias/imunologia , Melanoma/imunologia , Vitiligo/sangue , Anticorpos/sangue , Western Blotting , Células Cultivadas , Humanos , Melanoma/patologia , Células Tumorais CultivadasRESUMO
Reactive oxygen species are involved in gentamicin (GM) nephrotoxicity, and garlic is effective in preventing or ameliorating oxidative stress. Therefore, the effect of garlic on GM nephrotoxicity was investigated in this work. Four groups of rats were studied: (i) fed normal diet (CT), (ii) treated with GM (GM), (iii) fed 2% garlic diet (GA), and (iv) treated with GM and 2% garlic diet (GM + GA). Rats were placed in metabolic cages and GM nephrotoxicity was induced by injections of GM (75 mg/kg every 12 h) for 6 d. Lipoperoxidation and enzyme determinations were made in renal cortex on day 7. GM nephrotoxicity was made evident on day 7 by (i) tubular histological damage, (ii) enhanced BUN and urinary excretion of N-acetyl-beta-D-glucosaminidase, and (iii) decreased creatinine clearance. These alterations were prevented or ameliorated in GM + GA group. The rise in lipoperoxidation and the decrease in Mn-SOD and glutathione peroxidase (GPx) activities observed in the GM group, were prevented in the GM + GA group. Cu, Zn-SOD activity and Mn-SOD and Cu,Zn-SOD content did not change. CAT activity and content decreased in the GM, GA, and GM + GA groups. CAT mRNA levels decreased in the GM group. The protective effect of garlic is associated with the prevention of the decrease of Mn-SOD and GPx activities and with the rise of lipoperoxidation in renal cortex.
Assuntos
Catalase/metabolismo , Alho , Gentamicinas/toxicidade , Glutationa Peroxidase/metabolismo , Rim/efeitos dos fármacos , Rim/enzimologia , Peroxidação de Lipídeos/efeitos dos fármacos , Plantas Medicinais , Superóxido Dismutase/genética , Acetilglucosaminidase/urina , Animais , Nitrogênio da Ureia Sanguínea , Catalase/genética , Dieta , Regulação Enzimológica da Expressão Gênica/efeitos dos fármacos , Rim/patologia , Córtex Renal/efeitos dos fármacos , Córtex Renal/patologia , Masculino , Estresse Oxidativo , Proteinúria , Ratos , Ratos Wistar , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Superóxido Dismutase/metabolismoRESUMO
Artrite como manifestação isolada de paracoccidioidomicose, tem sido raramente descrita na literatura médica. O presente relato, descreve mulher de 46 anos de idade, com monoartrite crônica do joelho em tratamento com anti-inflamatórios não hormonais durante 4 anos, cujo diagnóstico definitivo foi obtido apenas por biópsia da membrana sinovial, que revelou uma inflamação crônica granulomatosa de tipo tuberculóide, com abundantes elementos leveduriformes do Paracoccidioides brasiliensis. A terapêutica específica (iniciada com ketoconazol e seguida por cotrimoxazol) levou à completa recuperação funcional da articulação acometida. Não se detectou a presença de outros sítios acometidos pela doença, apesar da utilização de vários métodos propedêuticos, incluindo tomografia axial computadorizada do tórax e abdome. Os autores chamam a atenção para a raridade do caso e discutem os possíveis fenômenos fisiopatológicos responsáveis por esta monoartrite fúngica.
Osteoarthritis in paracoccidioidomycosis has been rarely reported. The present case describes a 36-[quot ]year[quot ]-old woman, with chronic monoarthritis in the knee lasting 4 years. The diagnosis was achieved only after synovial biopsy, by anatomopathological examination showing granulomatous reaction with a large number of the characteristic [quot ]pilot wheel[quot ]Paracoccidioides brasiliensis yeast cells. Specific therapy, initially with ketoconazole and followed by cotrimoxazole led to complete functional recovery of the compromised joint. No other affected site was detected by various propaedeutic methods, including computed axial tomography of the thorax and abdomen. The authors emphasize the rarity of the case and discuss its possible pathophysiology.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Artrite Infecciosa/diagnóstico , Articulação do Joelho , Paracoccidioidomicose/diagnóstico , Anti-Infecciosos , Antifúngicos/administração & dosagem , Articulação do Joelho/microbiologia , Artrite Infecciosa/tratamento farmacológico , Artrite Infecciosa/microbiologia , Doença Crônica , Combinação Trimetoprima e Sulfametoxazol/administração & dosagem , Cetoconazol/administração & dosagem , Membrana Sinovial/microbiologia , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/tratamento farmacológico , Paracoccidioidomicose/microbiologiaRESUMO
Acquired immunodeficiency syndrome (AIDS) is one of the main causes of death in adults worldwide. More commonly than in the general population, in patients with AIDS there is substantial disagreement between causes of death which are clinically suspected and those established by postmortem examination. The findings of 52 postmortem examinations were compared to the premortem (clinical) diagnoses, and there was 46% agreement between them. Fifty two percent of the patients had more than one postmortem diagnosis, and 48% had at least one AIDS-related disease not suspected clinically. Cytomegalovirus infection was the commonest (30.7%) autopsy finding, but not a single case had been suspected premortem. Bacterial infection, tuberculosis, and histoplasmosis were also common, sometimes not previously suspected, postmortem findings. This study shows that multiple infections occur simultaneously in AIDS patients, and that many among them are never suspected before the postmortem examination. These findings suggest that an aggressive investigation of infections and cancers should be done in patients with AIDS, particularly in those who do not respond to therapy of an already recognized condition.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Síndrome da Imunodeficiência Adquirida/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adolescente , Autopsia , Brasil , Causas de Morte , Feminino , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/epidemiologia , PrevalênciaRESUMO
The diagnosis of histoplasmosis was made by isolation of Histoplasma capsulatum from cerebrospinal fluid (CSF), blood and bone marrow or by histopathologic (biopsy or post mortem) examination. The mean age of the patients was 35.8 years; 13 patients were male (72.2%). The disease was disseminated, with the following distribution:skin (38.8%), bone marrow (27.7%), nasopharyngeal mucosa (22.2%), lungs (22.2%), colon (11.1%), central nervous system (5.5%) and esophagus (5.5%). Adenomegaly (50%), hepatomegaly (77.7%) and splenomegaly (61.1%) were frequently seen. The most common hematologic abnormality was pancytopenia (33.3%) of the patients. Eleven patients were treated, 9 with amphotericin B and 2 with itraconazole. Eight had good clinical improvement and all of them were given amphotericin B or a triazolic as maintenance therapy. This study emphasize the importance of this mycosis in immunodepressed patients, specially AIDS patients, in whom the infection tends to invade the macrophagic-lymphoid system and preferentially the cutaneous tegument.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/complicações , Histoplasmose/complicações , Hospedeiro Imunocomprometido , Cirrose Hepática Alcoólica/complicações , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Adulto , Feminino , Histoplasmose/imunologia , Humanos , Cirrose Hepática Alcoólica/imunologia , Masculino , Pessoa de Meia-IdadeRESUMO
Osteoarthritis in paracoccidioidomycosis has been rarely reported. The present case describes a 36-"year"-old woman, with chronic monoarthritis in the knee lasting 4 years. The diagnosis was achieved only after synovial biopsy, by anatomopathological examination showing granulomatous reaction with a large number of the characteristic "pilot wheel"Paracoccidioides brasiliensis yeast cells. Specific therapy, initially with ketoconazole and followed by cotrimoxazole led to complete functional recovery of the compromised joint. No other affected site was detected by various propaedeutic methods, including computed axial tomography of the thorax and abdomen. The authors emphasize the rarity of the case and discuss its possible pathophysiology.
Assuntos
Artrite Infecciosa/diagnóstico , Articulação do Joelho , Paracoccidioidomicose/diagnóstico , Anti-Infecciosos/administração & dosagem , Antifúngicos/administração & dosagem , Artrite Infecciosa/tratamento farmacológico , Artrite Infecciosa/microbiologia , Doença Crônica , Feminino , Humanos , Cetoconazol/administração & dosagem , Articulação do Joelho/microbiologia , Pessoa de Meia-Idade , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/tratamento farmacológico , Paracoccidioidomicose/microbiologia , Membrana Sinovial/microbiologia , Combinação Trimetoprima e Sulfametoxazol/administração & dosagemRESUMO
Three new cases of reactivation of Chagas' disease in patients with AIDS, with central nervous system and/or cardiac involvement, are reported. One patient had histological evidence of acute esophageal and gastric Trypanosoma cruzi myositis, a previously unrecognized finding in patients with reactivated Chagas' disease. The patients had a low CD4 lymphocyte count and had other AIDS-defining opportunistic infections. One patient's condition improved with benznidazole therapy. Analysis of these three cases and review of the 13 others published in the literature revealed that the central nervous system is the most commonly involved site (75%), followed by the heart (44%). Early diagnosis and treatment with benznidazole or nifurtimox probably improve the survival rate. Long-term secondary prophylaxis should be recommended for patients who respond to therapy, although it is uncertain which drug to use for this purpose. T. cruzi should be included in the list of opportunistic pathogens causing infection in severely immunocompromised patients with AIDS.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Doença de Chagas/parasitologia , Trypanosoma cruzi/isolamento & purificação , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Adulto , Animais , Doença de Chagas/tratamento farmacológico , Evolução Fatal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nitroimidazóis/uso terapêutico , Recidiva , Tripanossomicidas/uso terapêuticoRESUMO
OBJECTIVE: To compare the effects of continuous versus intermittent feedings on physical growth, gastrointestinal tolerance, and macronutrient retention in very low birth weight infants ( < 1500 gm). STUDY DESIGN: Very low birth weight neonates stratified by birth weight were randomly assigned to either continuous (24-hour) or intermittent (every 3 hours) nasogastric feedings. Feedings with half-strength Similac Special Care formula were initiated between day 2 and 3 and were advanced isoenergetically to goal. Daily weights, volume/caloric intakes, weekly anthropometric and dynamic skin-fold thickness measurements, and data on feeding milestones and clinical complications were collected. Nitrogen, carbohydrate, and fat balance studies were performed on a subset of male subjects. RESULTS: Eighty-two neonates with birth weights between 750 and 1500 gm who were born between 27 and 34 weeks of gestation were randomly assigned to continuous (n = 42) and intermittent (n = 40) feeding groups. There were no significant differences in baseline demographics and severity of respiratory distress between groups. There were no significant differences in days to regain birth weight, days to full enteral feedings, days to discharge, and discharge anthropometric measurements between continuously fed and intermittently fed infants, both when evaluated together and according to 250 gm weight intervals. Retention rates of nitrogen, fat, total carbohydrate, and lactose were comparable in the continuously fed (n = 17) and intermittently fed (n = 13) male neonates. Very low birth weight neonates who were fed continuously did not have feeding-related complications. CONCLUSION: Very low birth weight infants achieve similar growth and macronutrient retention rates and have comparable lengths of hospital stay whether they are fed with continuous or intermittent feedings.
Assuntos
Nutrição Enteral/métodos , Alimentos Infantis , Recém-Nascido de muito Baixo Peso , Peso Corporal/fisiologia , Ingestão de Energia/fisiologia , Humanos , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , MasculinoRESUMO
Non-Hodgkin lymphoma is frequently seen in AIDS patients usually affecting the central nervous system (CNS), especially the leptomeninges and the cerebral hemispheres. The epidural involvement is rarely described, ranging from 3.5% to 8.3% among the CNS sites. The authors present a case of disseminated non Hodgkin lymphoma associated to vacuolar myelopathy in a 27 years-old male patient with AIDS emphasizing the importance of this differential diagnosis in the myelopathies of AIDS.