Levantamento de leishmaniose visceral em cäes de Santa Maria e municípios próximos, Estado do Rio Grande do Sul / A survey of visceral leishmaniasis in dogs from Santa Maria and neighbouring municipalities, State of Rio Grande do Sul

A partir de relato de diagnóstico de leishmaniose visceral em cinco cäes dos municípios de Santa Maria, Itaara e Júlio de Castilhos, no centro do Estado do Rio Grande do Sul, foi realizado levantamento sorológico através de teste de imunofluorescência indireta em sangue obtido em papel de filtro de 40 cäes de Santa Maria, 20 de Itaara e 11 de Júlio de Castilhos, em geral relacionados aos cinco cäes considerados como positivos. Além destes, foi também examinado o sangue de 44 cäes vadios de Júlio de Castilhos, 68 de Cachoeira do Sul e 20 de Caçapava do Sul. Soros fracamente reagentes com títulos < 1:40 foram avaliados em ensaios de Ensaio Imuno-enzimático. Amostras de fígado, baço, pulmäo e linfonodos de um sexto cäo de Santa Maria, considerado como positivo à necropsia, foram examinadas através de histopatologia e PCR. Todos os resultados dos 204 cäes foram negativos, indicando que, apesar de näo ser impossível a ocorrência de leishmaniose visceral na regiäo, por vários fatores aqui discutidos, ela deve ser pelo menos extremamente rara, sendo necessários estudos mais detalhados do material dos cinco cäes tidos como positivos

Evaluation of the direct agglutination test and the rK39 dipstick test for the sero-diagnosis of visceral leishmaniasis

The direct agglutination test (DAT) based on a freeze-dried antigen and the rK39 dipstick test were evaluated for the sero-diagnosis of visceral leishmaniasis (VL). The sensitivity and specificity of both tests were determined using sera from confirmed VL patients (n = 21), healthy controls (n = 19) and from patients with other confirmed infectious diseases (n = 42). The DAT had a sensitivity and a specificity of 100 percent. The rK39 had a sensitivity of 85.7 percent and a specificity of 82 percent. Both tests were also used to screen blood samples of confirmed VL patients (n = 15) and serum samples of VL suspects (n = 61). The DAT found all blood samples of confirmed VL patients positive and tested 98.4 percent of the serum samples of the VL suspects positive. In contrast, rK39 detected in 9/15 blood samples (60 percent) antibodies against Leishmania chagasi and found 85.3 percent of the serum samples of the suspected patients positive. Although the rK39 dipstick is more rapid and user friendlier than the DAT, the latter has a superior sensitivity and specificity. Furthermore, the reagents used for DAT do not require cold storage, whereas the buffer of the rK39 must be stored at 4ºC. Therefore, the DAT is the most suitable test for the sero-diagnosis of VL under field conditions

Concurrent cutaneous, visceral and ocular leishmaniasis caused by Leishmania (Viannia) braziliensis in a kidney transplant patient

Although cases of leishmaniasis co-infection have been described in acquired immunodeficiency syndrome patients as well as those who have undergone organ transplants, to our knowledge, the present report is the first documented case of simultaneous cutaneous, visceral and ocular leishmaniasis due to Leishmania (Viannia) braziliensis in a transplant patient. The patient had been using immunosuppressive drugs since receiving a transplanted kidney. The first clinical signs of leishmaniasis included fever, thoracic pain, hepatosplenomegaly, leucopenia and anemia. The cutaneous disease was revealed by the presence of amastigotes in the skin biopsy. After three months, the patient presented fever with conjunctive hyperemia, intense ocular pain and low visual acuity. Parasites isolated from iliac crest, aqueous humor and vitreous body were examined using a range of molecular techniques. The same strain of L. (V.) braziliensis was responsible for the different clinical manifestations. The immunosuppressive drugs probably contributed to the dissemination of Leishmania

Visceral leishmaniasis in the Metropolitan Region of Belo Horizonte, State of Minas Gerais, Brazil

In the last few years the number of human cases of American visceral leishmaniasis in the Metropolitan Region of Belo Horizonte (MRBH), Minas Gerais, Brazil has increased, indicating an elevation in the transmission rate of the disease. The total number of notified human cases in the MRBH since 1994, when the first case was identified, up to 1999 was 345 of which 223 (65 percent) were from the city itself, indicating an urbanization of the disease in this region of Minas Gerais. The age distribution of visceral leishmaniasis cases in the MRBH shows a higher prevalence in children from 0-4 years old, responsible for 28.9 percent of the notifications. Clinical and immunological findings from dogs infected with Leishmania chagasi are described. The majority of these animals showed no sign of the disease. Sera from all infected dogs showed detectable Leishmania-induced high titles of antibodies based on the results of an indirect fluorescent antibody test. Samples of isolated Leishmania from human and dogs were characterized as L. (L.) chagasi by biochemical and molecular techniques

Papel da membrana da fossa oval no desencadeamento de arrtmias cardíacas fetais / Role of the fossa ovalis membrane in the development of fetal cardiac arrhythmias

Já foi sugerido que a redundância aneurismática do septum poderia estar envolvida com a presença de arritmias fetais, especialmente flutter atrial e taquicardia paroxística. Entretanto, nao existem na literatura dados objetivos a respeito de qual o grau de excursao da membrana da fossa oval dentro do átrio esquerdo necessário para desencadear um distúrbio do ritmo em um feto sem outras anormalidades. Este estudo transversal controlado foi delineado para testar a hipótese de que a redundância do forame oval é mais pronunciada em fetos com extra-sístoles atriais do que em fetos normais. Vinte e cinco fetos consecutivos com extra-sístoles atriais detectadas à ecocardiografia pré-natal como única alteraçao, com idade gestacional média de 34 ñ 3 semanas, constituíram o grupo de estudo. O grupo-controle foi formado por 50 fetos consecutivos sem arritmias e com ecocardiograma pré-natal normal, examinados com uma idade gestacional média de 34 ñ 3 semanas. Um índice de redundância (IR) foi obtido pela razao entre a máxima excursao do septum primum e o máximo diâmetro atrial esquerdo, na projeçao de 4-câmaras. A análise estatística utilizou o teste "t" de Student-Fisher. O IR no grupo de estudo variou de O,50 a 1,00 (média = O,76 ñ O,13) e no grupo-controle de O,29 a O,67 (média = O,45 ñ O,O8). Estas diferenças foram estatisticamente significantes para p

Estudo ecocardiográfico pré-natal da redundância do septum primum e sua relação com a gênese de extra-sístoles atriais no feto / Prenatal echocardiographic study of septum primum redundancy and its relationship to the genesis of atrial extrasystole in the fetus

PURPOSE--To test the hypothesis that the redundancy of the septum primum is more pronounced in fetuses with atrial premature beats than in normal fetuses. METHODS--Twenty-five consecutive fetuses with atrial premature beats detected by prenatal echocardiography as the sole alteration at a mean gestational age of 34 +/- 3.3 (26 to 38) weeks and a mean maternal age of 27 +/- 6.5 (18 to 39) years made up the study group. The control group was formed by 50 consecutive fetuses without rhythm disturbances and normal prenatal echocardiography, examined at a mean gestational age of 33.9 +/- 3 (26 to 39) weeks and a mean maternal age of 31 +/- 5.8 (18 to 43) years. A redundancy index (RI) was obtained as a ratio between the maximal septum primum excursion and the maximal left atrium diameter during atrial diastole, at the 4-chamber projection. Statistical analysis utilized the unpaired Student-Fisher's "t" test. RESULTS--The RI in the study group varied from 0.50 to 1.00 (mean = 0.758 +/- 0.127) and in the control group in ranged from 0.29 to 0.67 (mean = 0.449 +/- 0.080). These differences were statistically significant for p < 0.0001. CONCLUSION--Septum primum is more redundant in fetuses with atrial premature beats than in those with normal regular rhythm. Although it is still speculative that this feature may have a cause-effect relationship, the measurement of the RI during routine fetal echocardiography may allow detection of a potential risk factor FOR developing atrial arrhythmias.