ABSTRACT
Genital infection by Schistosoma mansoni is usually misdiagnosed in individuals who reside in, or travel to endemic areas. We describe two cases of genital tumor associated with S. mansoni infection manifested by methrorragy. Surgical specimens revealed leiomyomas in both cases associated with S. mansoni. In one of them, granulomas were found in the ovary and in the other they were found in the uterine tube. Although none presented intestinal/hepatic disease, fecal egg excretion was detected in one. Both had elevated pretreatment antibody reactivity to S. mansoni antigen, but follow-up showed different outcomes. Schistosomiasis should be considered as a diagnosis in individuals with methrorragy residing in or having traveled to endemic areas. Since diagnosis follows genital amputation, and cure control is troublesome, improvement of diagnostic tools and follow-up markers are important priorities to decrease schistosomiasis morbidity.
Subject(s)
Adult , Animals , Female , Humans , Ovarian Diseases/diagnosis , Schistosoma mansoni/isolation & purification , Schistosomiasis mansoni/diagnosis , Feces/parasitology , Ovarian Diseases/parasitology , Ovarian Diseases/therapy , Parasite Egg Count , Schistosomiasis mansoni/therapy , Schistosomicides/therapeutic useABSTRACT
Counseling for human immunodeficiency virus infected travelers is becoming increasingly specialized. Previous studies have reported the experience of HIV-infected travelers from temperate-climate countries but little is known about HIV-infected travelers from tropical countries. A retrospective study was conducted on HIV-infected travelers presenting at a travel health clinic in Rio de Janeiro. Eleven journeys by ten people were recorded. Brazil (Amazon region and Northeast) was the destination for six journeys. Other destinations were Peru, Angola, Europe and Asia. Nine attendees were undergoing antiretroviral therapy. Few HIV-infected people from Rio de Janeiro consulted a travel medicine specialist before traveling. Since they travel to destinations in Brazil and abroad where there are endemic diseases not encountered in Rio de Janeiro, careful pre-travel planning needs to be undertaken. Strategies for increasing the frequency of pre-travel consultations need to be developed, such as closer collaboration between HIV clinics and travel health clinics.
O aconselhamento para os viajantes infectados pelo vírus da imunodeficiência humana está se especializando cada vez mais. Estudos prévios relatam a experiência dos viajantes infectados pelo vírus da imunodeficiência humana dos países de clima temperado, mas pouco se sabe sobre os viajantes infectados pelo vírus da imunodeficiência humana dos países tropicais. Foi realizado um estudo retrospectivo dos viajantes infectados pelo vírus da imunodeficiência humana que consultaram um serviço de medicina de viagem no Rio de Janeiro. Dez viajantes realizaram onze viagens. O Brasil (Amazônia e Nordeste) foi o destino de seis viagens. Outros destinos foram Peru, Angola, Europa e Ásia. Nove pacientes estavam sob terapia anti-retroviral. No Rio de Janeiro, poucas pessoas infectadas pelo vírus da imunodeficiência humana consultaram um especialista em medicina de viagem antes de viajar. Como elas viajam para destinos no Brasil e no exterior aonde existem doenças endêmicas não encontradas no Rio de Janeiro, deve-se realizar um planejamento cuidadoso antes da viagem. Devem ser desenvolvidas estratégias para aumentar a freqüência das consultas pré-viagem, como, por exemplo, uma colaboração mais próxima entre as clínicas de vírus da imunodeficiência humana e de medicina de viagem.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Directive Counseling/statistics & numerical data , Health Knowledge, Attitudes, Practice , HIV Infections , Travel/statistics & numerical data , Brazil , Environment , Retrospective Studies , Vaccines/administration & dosageABSTRACT
Most patients with acute suppurative meningitis are otherwise healthy individuals with regard to immune mechanisms against invasive bacterial disease. This medical emergency is among the most dramatic and potentially ravaging diseases that affect humans, particularly young children. The illness often strikes suddenly, and can either result in death or leave the survivors with significant neurological dysfunctions. The demonstration of a bacterial aetiology is necessary for decisions regarding treatment and prophylaxis. Conventional bacteriological methods frequently fail to identify an agent, as a result of administration of antibiotics or delayed lumbar punctures. We investigated the major aetiologic sources of unspecified bacterial meningitis cases (G00.9, ISCD-10) by polymerase chain reaction (PCR)-based identification of Neisseria meningitidis (crgA), Streptococcus pneumoniae (ply) and Haemophilus influenzae (bexA) in cerebrospinal fluid samples. The multiplex PCR detected N. meningitidis in 92 percent, S. pneumoniae in 4 percent and H. influenzae in 1 percent of the 192 clinical samples assayed; 3 percent were negative for all three DNA targets. Bacterial DNA detection was found to be a valuable adjunct to enhance bacterial meningitis surveillance when the yield of specimens by culture is reduced. The implementation of PCR assays as a diagnostic procedure in Public Health Laboratories is perceived to be a significant advance in the investigation of bacterial meningitis.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , DNA, Bacterial/analysis , Haemophilus influenzae/genetics , Meningitis, Bacterial/microbiology , Neisseria meningitidis/genetics , Polymerase Chain Reaction , Streptococcus pneumoniae/genetics , Haemophilus influenzae/isolation & purification , Meningitis, Bacterial/cerebrospinal fluid , Meningitis, Bacterial/diagnosis , Meningitis, Haemophilus/diagnosis , Meningitis, Meningococcal/diagnosis , Meningitis, Pneumococcal/diagnosis , Neisseria meningitidis/isolation & purification , Reproducibility of Results , Retrospective Studies , Streptococcus pneumoniae/isolation & purificationABSTRACT
Os autores revisam os principais distúrbios endócrinos e metabólicos associados à síndrome da imunodeficiência adquirida (Sida/Aids).
In the present paper the endocrine compromising in acquired immunodificiency syndrome (Aids) is reviewed.
Subject(s)
Humans , Male , Female , Anti-Retroviral Agents , Nutrition Disorders , Acquired Immunodeficiency Syndrome/complications , Endocrine System , Endocrine System/pathology , Acidosis , Adrenal Insufficiency , Diabetes Mellitus , Dyslipidemias , Gonadal Disorders , Thyroid Gland/pathology , HIV Wasting Syndrome , Lipodystrophy , Water-Electrolyte ImbalanceABSTRACT
São descritos dois casos de fasciolíase em áreas rurais do Rio de Janeiro, endêmicas para esquistossomose, sendo ambos surpreendidos durante inquéritos coprológicos. O paciente de Paracambi queixava-se de tonteira. A paciente de Sumidouro queixava-se de tonteira, cansaço e tosse, tendo sido tratada com praziquantel; seus exames de controle foram negativos.
Subject(s)
Humans , Animals , Male , Female , Adult , Middle Aged , Fascioliasis/diagnosis , Anthelmintics/therapeutic use , Brazil , Fascioliasis/drug therapy , Praziquantel/therapeutic use , Rural PopulationSubject(s)
Humans , Medicine/trends , Travel , Tropical Medicine , Health Promotion , Physician's Role , Preventive Medicine , Societies, Medical , Medicine/classificationABSTRACT
Neste artigo são revisados os aspectos mais importantes das infecções por Echinococcus spp., com ênfase nos aspectos epidemiológicos, etiológicos, imunopatogênicos, clínicos e terapêuticos, como forma de delinear a situação atual.
Subject(s)
Humans , Echinococcosis , Echinococcus , Parasitic Diseases/epidemiology , Parasitic Diseases/physiopathology , Parasitic Diseases/therapyABSTRACT
Este artigo tem como objetivo discutir as principais características da síndrome hemorrágica de Altamira, enfocando aspectos etiopatogênicos, epidemiológicos, manifestações clínicas, diagnóstico laboratorial, tratamento e prevenção
Subject(s)
Humans , Insect Bites and Stings , Simuliidae , Hemorrhagic Disorders/etiologyABSTRACT
Os autores discutem a profilaxia das infecções oportunistas nos pacientes com síndrome de imunodeficiência adquirida (Sida/Aids), enfatizando os principais fármacos, seus esquemas posológicos e os efeitos adversos mais freqüentes
Subject(s)
Humans , AIDS-Related Opportunistic Infections/complications , AIDS-Related Opportunistic Infections/prevention & control , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/prevention & controlABSTRACT
O Mycobacterium kansasii é causa rara de doença pulmonar em pacientes com SIDA. Ocorre em somente 0,2 por cento dos casos da sindrome. Os autores apresentam um caso de doença pulmonar causada pelo M. Kansasii, com apresentaçao radiológica nao-habitual, em paciente hemofílico com Sida.
Subject(s)
Humans , Male , Adult , AIDS-Related Opportunistic Infections/complications , Mycobacterium Infections, Nontuberculous/microbiology , Nontuberculous Mycobacteria/isolation & purification , Tuberculosis, Pulmonary/microbiology , Fatal Outcome , Mycobacterium Infections, Nontuberculous/etiologyABSTRACT
Säo apresentadas informaçöes epidemiológicas da malária no Estado de Säo Paulo referentes aos anos de 1985 e 1986. Selecionou-se, através das fichas de investigaçäo epidemiológica, um indicador pra a avaliaçäo do tempo decorrido entre o início dos primeiros sintomas/data da coleta da lâmina e início do tratamento, que foi agrupado segundo categorias denominadas tipo de procura. Foram consideradas nesta avaliaçäo as seguintes variáveis: a espécie de plasmódio diagnosticada, a existência de passado malárico e a utilizaçäo de serviços de saúde anteriores a confirmaçäo do diagnóstico pela SUCEN. Os autores concluem que entre as variáveis estudadas a existência de malária anterior se constitui no principal fator explicativo para os diferentes tempos decorridos entre os primeiros sintomas e comprovaçäo diagnóstica