O olhar da cardiologia: Francisco Laranja e as pesquisas sobre a doença de Chagas / The cardiological perspective: Francisco Laranja and research on Chagas' disease

Francisco Laranja aproximou-se da cardiologia quando esta era aindauma especialidade incipiente na medicina brasileira. Perito emeletrocardiografia, ele é reconhecido no panorama científico nacional einternacional pelas pesquisas que resultaram na caracterização clínicado quadro cardíaco dos casos crônicos de doença de Chagas, realizadasem Bambuí ao longo da década de 1940. Em seu depoimento, concedido à Casa de Oswaldo Cruz em 1986, Laranja discorre sobre a constituição do campo da cardiologia e da eletrocardiografia no Brasil, seu trabalho no Instituto de Aposentadoria e Pensões dos Industriários, sobre as pesquisas realizadas em Bambuí e sua gestão como diretor do Instituto Oswaldo Cruz.

Francisco Laranja began working in cardiology when this was yet a fledglingspecialty in Brazilian medicine. An expert in electrocardiography, he has gained national and international renown for his research conducted in Bambuí in the 1940s, which led to the clinical characterization of the cardiac profile of chronic cases of Chagas’ disease. In this interview, Laranja talks about the development of the field of cardiology and electrocardiography in Brazil, his work at the Institute of Retirement and Pensions for Industrial Workers, his research in Bambuí, and his term as director of the Oswaldo Cruz Institute.

Experimental chagas' disease in rhesus monkeys. I. Clinical parasitological, hematological and anatomo-pathological studies in the acute and indeterminate phase of the disease

Rhesus monkeys (macaca mulatta) were infected subcutaneously with 1.0 x 10**4 to 1.5 x 10**4 metacyclic trypomastigotes of Trypanosoma cruzi (Colombian strain). Parasitological and immunological parameters were evaluated in these animals for periods of 1 month to over 3 years. a chagona was observed between the 3 rd and the 13th day after infection (a.i) and patent parasitaemia between the 13th and 59th day a.i.. Thereafter, parasites were demonstrated only by haemoculture and/or xenodiagnosis. Circulating specifc IgM and IgC antibodies were observed as early as in the 2nd week a. i. IgG levels persisted until the end of the expriment, but IgM antibodies were detectable nine months a. i. Haematological alterations comprised leucocytosis and lymphocytosis. Eletrocardiographic alterations were minor and transient, similar to those observe in non-lethal human acute Chagas' myocarditis. Myocarditis and myositis, characterized by multiple foci of lympho-histiocyte inflammatory infiltrate, were present in monkeys sacrificed on the 41 th, 70th and 76 th day but not in the animal sacrificed 3 years and 3 months a. i.. The results suggest that Chagas' disease in rhesus monkeys reproduces the acute and indeterminate phases of human Chagas' disease

Historia natural del bloqueo auriculoventricular de tercer grado en la miocarditis chagásica crónica / Natural history of the auriculoventricular block of third grade in the chronic chagasic myocarditis

Presenta un estudio basado en la revisión de 380 electrocardiogramas de 103 enfermos con miocarditis chagásica crónica y bloqueo auriculaventricular de tercer grado, 93 de los cuales fallecieron por insuficiencia cardíaca, arritmias graves y paro cardíaco. Se busca una posible explicación para la larga supervivencia observada, agrupándose a los enfermos fallecidos, en tres grupos, según hayan tenido una sobrevida de entre 3 meses a 5 años, de 5 a 20 años, y, de 20 a 30 o más; observándose en los enfermos restantes una sobrevida de entre 8 meses y 16 años, con 5 meses de evolución. Se observaron tres fases en el tiempo de sobrevida de los enfermos: una, inicial, que puede corresponder a las primeras semanas o meses de asistencia médica; una segun da, media, en que se presentan síntomas variables y algunas limitaciones en la actividad de los enfermos, y, la final, en que se apresentan síntomas importantes y se requiere hospitalización. Analiza ejemplos de alteraciones electrocardiográficas en las distintas fases de evolución y los possibles mecanismos idioventriculares de comandos y de escapas en cada una de las combinaciones de morfología de bloqueos