ABSTRACT
Abstract Fascioliasis is a food-borne anthropozoonotic disease caused by Fasciola hepatica that affects multiple hosts, including humans. We herein report the first case of human fascioliasis in the state of Santa Catarina, Brazil. A 57-year-old female patient complaining of abdominal pain was admitted to the hospital for a clinical investigation. The diagnosis of F. hepatica was confirmed by ultrasound and indirect enzyme-linked immunosorbent assay. Authorities of the Northern coast of Santa Catarina were notified to investigate other cases and risk factors for contamination. The disease is also prevalent in cattle, which could pose as a potential route for infection.
Subject(s)
Humans , Animals , Female , Fasciola hepatica/immunology , Fascioliasis/diagnosis , Brazil , Enzyme-Linked Immunosorbent Assay , Magnetic Resonance Imaging , Ultrasonography , Sensitivity and Specificity , Middle AgedABSTRACT
INTRODUÇÃO: O envolvimento da coluna cervical é comum na artrite reumatoide (AR). OBJETIVO: Estudar a prevalência das alterações radiológicas de coluna cervical em pacientes com AR e sua associação com perfil clinico e sorológico da doença. MÉTODOS: Analisaram-se as radiografias de coluna cervical em perfil neutro hiperextensão, hiperflexão e transoral de 80 pacientes com AR para presença de subluxação atlanto-axial (LAA), invaginação basilar (IB) e instabilidade subaxial (ISA). Dados de perfil demográfico, clínico (nódulos, pneumonite intersticial, síndrome Sjögren secundária, uso de medicamentos etc.) e sorológico (FR, anti-CCP e FAN) foram obtidos por revisão de prontuários. RESULTADOS: Havia alguma alteração de eixo de coluna cervical em 26/80 (32,5%); em 12/80 (15%) havia LAA; em 6/80(7,5%) existia IB; em 13/80 (16,2%) existia ISA. Erosões em odontoide foram vistas 16/80 (20,0%). As alterações do eixo cervical estavam associadas com idade de início da doença e duração da mesma (P = 0,03 e 0,02, respectivamente). Não se encontrou associação das alterações em coluna cervical com raça, gênero, nódulos, pneumonite intersticial, Sjögren secundário, FR, FAN ou anti-CCP. Pacientes com alterações do eixo cervical apresentavam mais erosões de odontoide (P = 0,03). CONCLUSÕES: Alterações radiológicas em eixo de coluna cervical são comuns e aparecem mais frequentemente em indivíduos com diagnóstico mais precoce de AR e maior tempo de doença.
INTRODUCTION: The involvement of the cervical spine is a common feature of rheumatoid arthritis (RA). OBJECTIVE: To study the prevalence of radiographic changes of the cervical spine in patients with RA and their association with clinical and serological profiles of the disease. METHODS: We analysed lateral (neutral position, hyperextension, hyperflexion) and transoral views of cervical spine radiographs from 80 individuals with RA to investigate the presence of atlanto-axial subluxation (AAS), basilar invagination (BI), and subaxial instability (SAI). Demographic, clinical (nodules, interstitial pneumonitis, secondary Sjögren's syndrome, medications etc.), and serologic (rheumatoid factor - RF, cyclic citrullinated peptide antibody - anti-CCP, and antinuclear factor - ANF) data were obtained from the clinical records. RESULTS: Cervical spine misalignments were identified in 26/80 (32.5%) participants; AAS occurred in 12/80 (15%) participants, BI in 6/80 (7.5%), and SAI in 13/80 (32.5%). Odontoid erosions were identified in 16/80 (20.0%) participants. Cervical spine misalignment exhibited associations with age at onset and disease duration (P = 0.03 and 0.02, respectively). No associations were identified between the cervical spine changes and the participants' ethnicity or gender, presence of nodules, interstitial pneumonitis, secondary Sjögren's syndrome, RF, ANF, or anti-CCP. The participants with cervical spine misalignment exhibited higher frequencies of odontoid erosion (P = 0.03). CONCLUSIONS: Cervical spine misalignment was a common radiographic finding and occurred more frequently in participants with earlier onset and longer length of RA.