Morphological characteristics and pulmonary function of naval saboteurs and ground special forces of the armed forces of Montenegro / Características morfológicas y función pulmonar de saboteadores navales y fuerzas especiales terrestres de las fuerzas armadas de Montenegro

SUMMARY: The results of numerous medical and kinesiological studies indicate the existence of differences in pulmonary function in relation to age, body height, and the relationship between certain parameters of body composition. The aim of this study was to determine the state of morphological characteristics and pulmonary function of naval saboteurs and ground Special Forces of the Armed Forces of Montenegro. The sample of participants included 30 naval saboteurs aged 30.3±6 years and 30 members of the ground special forces aged 25.6±5 years. The sample of measuring instruments included 4 indicators each for the evaluation of longitudinal dimensionality, transversal dimensionality, mass and body volume, subcutaneous fat, body composition, and pulmonary function. The central and dispersion parameters of the variables were calculated. The specificities of body composition of the naval saboteurs and members of the ground Special Forces of the AF of Montenegro were determined, while the parameters of lung volume and capacity and the parameters of airway flow indicated an excellent state of their respiratory function. Furthermore, it was determined that the studied members of the armed forces had no individual health risks in the sense of the onset of obesity or obstructive ventilatory defects. The results obtained indicate the need for further studies which would predominantly focus on the impact of individual morphological measurements and parameters of body composition on pulmonary function. This would provide important data both for the armed forces in the sense of improving the training system and the realization of specific tasks, as well as for kinesiology as a science from the aspect of determining certain regularities in the functioning of the human body in specific living and working conditions in the armed forces.

Los resultados de numerosos estudios médicos y kinesiológicos indican la existencia de diferencias en la función pulmonar en relación con la edad, la altura corporal y la relación entre determinados parámetros de la composición corporal. El objetivo de este estudio fue determinar el estado de las características morfológicas y la función pulmonar de los saboteadores navales y de las Fuerzas Especiales terrestres de las Fuerzas Armadas de Montenegro. La muestra de participantes incluyó a 30 saboteadores navales de 30,3±6 años de edad y 30 miembros de las fuerzas especiales terrestres de 25,6±5 años. La muestra de instrumentos de medición incluyó 4 indicadores cada uno para la evaluación de dimensionalidad longitudinal, dimensionalidad transversal, masa y volumen corporal, grasa subcutánea, composición corporal y función pulmonar. Se calcularon los parámetros centrales y de dispersión de las variables. Se determinaron las especificidades de la composición corporal de los saboteadores navales y miembros de las Fuerzas Especiales terrestres de la FA de Montenegro, mientras que los parámetros de volumen y capacidad pulmonar y los parámetros de flujo de las vías respiratorias indicaron un excelente estado de su función respiratoria. Además, se determinó que los miembros de las fuerzas armadas estudiados no tenían riesgos individuales de salud en el sentido de la obesidad o defectos ventilatorios obstructivos. Los resultados obtenidos indican la necesidad de más estudios que se centren predominantemente en el impacto de las medidas morfológicas individuales y los parámetros de composición corporal en la función pulmonar. Esto proporcionaría datos importantes tanto para las fuerzas armadas en el sentido de mejorar el sistema de entrenamiento y la realización de tareas específicas, como para la kinesiología como ciencia desde el aspecto de determinar ciertas regularidades en el funcionamiento del cuerpo humano en situaciones específicas de vida. y condiciones de trabajo en las fuerzas armadas.

Nutritional status of younger primary school children in urban and rural areas of Montenegro in relation to sex and age during COVID-19 pandemic: a national study / Estado nutricional de los niños más pequeños de la escuela primaria en áreas urbanas y rurales de Montenegro en relación con el sexo y la edad durante la pandemia de COVID-19: un estudio nacional

SUMMARY: Prevention and correction of overweight in children and adolescents is also very important for many reasons. According to previous research, the problem tends to vary according to sex, and different ages and the lifestyle in rural and urban areas has changed drastically in recent years and decades. Regarding the above-mentioned, the main goal of this research was to determine the nutritional status of young school children in urban and rural areas of Montenegro in relation to sex and age. The sample in this research has consisted of children aged 6 and 9 (younger school age). The total sample in this research is 800 male and female children who belong to the urban and rural areas of Montenegro. The sample of variables used in this study was: body mass index-percentile values (BMI), and waist circumference and body height ratio (WHtR) which were used as indicators to assess nutritional status. Based on obtained results it could be generally concluded that there are no statistically significant differences in nutritional status between primary school children from urban and rural areas of Montenegro, which is the opposite of what was expected based on previous research, but also which is very important since all subjects in the future can be treated as homogeneous groups when it comes to the impact of environment and lifestyle on the nutrition status of younger school children. On the other hand, it is important to emphasize that the main limitation of this research is that measurements were carried out in the middle of the COVID-19 pandemic, and the recommendation could be that after the end of the pandemic, special "COVID teams" should be formed, which would consist of experts from various fields of physical culture, sports, and medicine, all with the aim of influencing possible problems with nutritional status and physical activity of young school children caused by a pandemic.

RESUMEN: La prevención y corrección del sobrepeso en niños y adolescentes es muy importante por muchas razones. Según investigaciones previas, el problema tiende a variar según el sexo, las diferentes edades y el estilo de vida en las zonas rurales y urbanas ha cambiado drásticamente en los últimos años y décadas. Con respecto a lo mencionado anteriormente, el objetivo principal de esta investigación fue determinar el estado nutricional de los niños pequeños en edad escolar en áreas urbanas y rurales de Montenegro en relación con el sexo y la edad. La muestra en esta investigación ha estado compuesta por niños de 6 y 9 años (menor edad escolar). La muestra total en esta investigación fue de 800 niños y niñas que pertenecían a las zonas urbanas y rurales de Montenegro. La muestra de variables utilizadas en este estudio fue: índice de masa corporal-valores percentiles (IMC), circunferencia de la cintura y relación talla corporal (RCCE), los cuales se utilizaron como indicadores para evaluar el estado nutricional. Sobre la base de los resultados obtenidos, se pudo concluir en general que no existen diferencias estadísticamente significativas en el estado nutricional entre los niños de primaria de las zonas urbanas y rurales de Montenegro, que es lo contrario de lo que se esperaba en base a investigaciones anteriores, pero que también es muy importante, ya que todos los temas en el futuro pueden ser tratados como grupos homogéneos en lo que respecta al impacto del medio ambiente y el estilo de vida en el estado nutricional de los niños en edad escolar más pequeños. Por otro lado, es importante recalcar que la principal limitación de esta investigación fue que las mediciones se realizaron en plena pandemia de COVID-19, y la recomendación podría ser que luego de finalizada la pandemia, equipos especiales "COVID", que estaría integrado por expertos de diversas áreas de la cultura física, el deporte y la medicina, todo ello con el objetivo de incidir en los posibles problemas del estado nutricional y de actividad física de los jóvenes escolares provocados por una pandemia.

Body mass index and measures of body fat for defining obesity and underweight: a cross-sectional study of various specialties in Montenegrin police force / Índice de masa corporal y medidas de la grasa corporal para definir la obesidad y el bajo peso: un estudio transversal de diversas especialidades en la policía de Montenegro

SUMMARY: The Police force personnel cover an exceptionally wide range of different activities, so it is logical that this heterochronic group has different abilities and characteristics, including daily needs, while changes in body composition and decrease in physical abilities represent a modern issue that has not bypassed this population either. Therefore, the aim of this study is to determine the indicators of the body composition of the Police force personnel, as well as possible differences that might occur in relation to different specialized police units. The subjects of this Cross Sectional study included 115 active-duty male members of the Police force (31.54 ± 10.5 year-old), divided into four groups, belonging to different specialized units. The sample of variables included five anthropometric measures (body height, body weight, abdominal skinfold, pectoral skinfold and front thigh skinfold) by which two body composition indicators - body mass index (BMI) and body fat percentage (FAT %) were calculated. The variables were analysed by using the one-way ANOVA and LSD Post Hoc test. It has been determined that there are differences in body composition indicators between the members of different specialized units of the Police force, while overweight was noted among the members of the two subpopulations. This fact indicates that members of certain specialized units of the Montenegrin Police force have adverse nutritional status and the situation may be described as alarming, which may lead to decrease in their physical fitness and effectiveness in service.

RESUMEN: El personal de la fuerza policial cubre una amplia gama de actividades diferentes, por lo que es lógico que este grupo heterocrónico tenga diferentes habilidades y características, incluyendo las necesidades diarias, mientras que los cambios en la composición corporal y la disminución de las capacidades físicas representan un tema de actualidad que también es evidente en esta población. Por tanto, el objetivo de este estudio fue determinar los indicadores de la composición corporal del personal policial, así como las posibles diferencias que pudieran presentarse en relación a las distintas unidades policiales especializadas. Los sujetos de este es- tudio transversal incluyeron a 115 hombres en servicio activo de la policía (31,54 ± 10,5 años), divididos en cuatro grupos, pertenecientes a diferentes unidades especializadas. La muestra de variables incluyó cinco medidas antropométricas (altura corporal, peso corporal, pliegue cutáneo abdominal, pliegue cutáneo pectoral y pliegue cutáneo frontal del muslo) mediante las cuales se calcularon dos indicadores de composición corporal: índice de masa corporal (IMC) y porcentaje de grasa corporal (% FAT). Las variables se analizaron mediante ANOVA de una vía y la prueba LSD Post Hoc. Se determinó que existen diferencias en los indicadores de composición corporal entre los integrantes de las distintas unidades especializadas de la Policía, mientras que se observó sobrepeso entre los integrantes de las dos subpoblaciones. Este hecho indica que los miembros de determinadas unidades especializadas de la Policía de Montenegro tienen un estado nutricional adverso y la situación puede calificarse de alarmante, lo que puede llevar a una disminución de su aptitud física y eficacia en el servicio.

Trends in body height, body weight, BMI, and nutrition status from 1979 to 1987: a measurement-based analysis of 10, 954 male adolescents from the municipality of Bijelo Polje / Tendencias en la altura corporal, el peso corporal, el IMC y el estado nutricional de 1979 a 1987: un análisis basado en mediciones de 10. 954 adolescentes varones del municipio de Bijelo Polje

SUMMARY: This study aimed to consolidate data regarding body height, body weight, body mass index, and nutrition status of the entire young male population from the Municipality of Bijelo Polje in order to estimate trends from 1979 to 1987. The sample of respondents includes 10,954 young males divided into nine groups. The measurement sample includes body height, body weight, and body mass index based on two previous measures. The descriptive statistics were expressed as a mean and standard deviation for each variable, while the analysis of nutrition status was done based on body mass index (underweight, normal weight, pre-obese, obese). The results showed that a secular trend in the observed study period is not visible regarding body height, body weight, and body mass index. The contribution of this study is reflected in the fact that there were no previously published data for this period and this municipality; the data can significantly aid in monitoring the secular trends throughout Montenegro.

RESUMEN: Este estudio tuvo como objetivo consolidar los datos sobre la altura corporal, el peso corporal, índice de masa corporal y el estado nutricional de toda la población masculina joven del Municipio de Bijelo Polje con el fin de estimar las tendencias de 1979 a 1987. La muestra de encuestados incluyó 10.954 hombres jóvenes divididos en nueve grupos. Las mediciones incluyeron la altura corporal, el peso corporal y el índice de masa corporal basado en dos medidas anteriores. Las estadísticas descriptivas se expresaron como media y desviación estándar para cada variable, mientras que el análisis del estado nutricional se realizó con base en el índice de masa corporal (bajo peso, peso normal, pre-obesidad, obesidad). Los resultados mostraron que una tendencia secular en el período de estudio observado no es visible con respecto a la altura corporal, el peso corporal y el índice de masa corporal. La contribución de este estudio está basada en que no existían datos publicados previamente para este período y en este municipio; los datos pueden ayudar significativamente a monitorear las tendencias seculares en todo Montenegro.

Morphological characteristics and body composition of elite soccer players in Montenegro / Características morfológicas y composición corporal de futbolistas de élite en Montenegro

SUMMARY: The aim of this research was to determine the differences among the soccer players of three the most successful clubs in Montenegro, FC Buducnost, FC Mladost and FC Sutjeska in a terms of morphological characteristics and body composition. A sample of 70 subjects was divided into three sub-samples. The first sub-sample of the subjects consisted of 30 players of FC Buducnost of the average age 22.73±4.33, the champions of Montenegro in the season 2016/17, the other sub-sample consisted of 17 players of FC Mladost of the average age of 24.59±4.66, the vice champions of the Montenegrin Championship in the season 2016/17, and the last subsample of the examinees consisted of 23 players of FC Sutjeska of the average age 21.69±4.30, the champions of the Cup of Montenegro in the season 2016/17. Soccer players were tested immediately after the end of the competition season 2016/17. Morphological characteristics in the body composition were evaluated by a battery of 11 variables: body height, body weight, body mass index, fat percentage, muscle mass, bone mass, waist circumference, triceps skinfold, biceps skinfold, skinfold of the back and abdominal skinfold. Data were analyzed using SPSS and the descriptive statistics were expressed as a mean (SD) for each variable. The significance of the differences between the players of the three the most successful soccer clubs in the morphological characteristics and variables for assessing body composition were determined by ANOVA and LSD Post Hoc test. ANOVA test found that the soccer players of the three mentioned clubs have statistically significant differences by the two variables that estimate the fat percentage and skinfold of the back. LSD Post Hoc test found that the soccer players of FC Sutjeska are significantly better in these variables than other players.

RESUMEN: El objetivo de esta investigación fue determinar las diferencias entre los futbolistas de los tres clubes más exitosos de Montenegro, FC Buducnost, FC Mladost y FC Sutjeska en términos de sus características morfológicas y de su composición corporal. Una muestra de 70 sujetos fue dividida en tres submuestras. La primera sub-muestra consistió en 30 jugadores del FC Buducnost con edades promedio de 22,73 ± 4,33 años, campeones de Montenegro en la temporada 2016/17. La otra sub-muestra consistió en 17 jugadores del FC Mladost con edad promedio de 24,59 ± 4,66 años, vice campeones del Campeonato de Montenegro en la temporada 2016/17. La última sub-muestra consistió en 23 jugadores del FC Sutjeska con edad promedio 21,69 ± 4,30 años, campeones de la Copa de Montenegro. Los jugadores de fútbol se pusieron a prueba inmediatamente después de la final de temporada de competición 2016/17. Las características morfológicas en la composición corporal se evaluaron mediante una batería de 11 variables: altura corporal, peso corporal, índice de masa corporal, porcentaje de grasa, masa muscular, masa ósea, circunferencia de la cintura, pliegue cutáneo tríceps, pliegue cutáneo bíceps, pliegue cutáneo de la espalda y pliegue cutáneo abdominal . Los datos se analizaron mediante SPSS y las estadísticas descriptivas se expresaron como una media (DE) para cada variable. La importancia de las diferencias entre los jugadores de los tres clubes de fútbol más exitosos en cuanto a las características morfológicas y las variables para evaluar la composición corporal se determinó mediante la prueba ANOVA y LSD Post Hoc. La prueba ANOVA encontró que los jugadores de fútbol de los tres clubes mencionados tienen diferencias estadísticamente significativas para las dos variables que estiman el porcentaje de grasa y el pliegue cutáneo de la espalda. La prueba LSD Post Hoc encontró que los jugadores de fútbol del FC Sutjeska son significativamente mejores en estas variables que otros jugadores.

Morphological, Chemical and Molecular Characterization of 'Old olive' (Olea europaea L.) from Montenegro

ABSTRACT Thousands of years of tradition of olive cultivation in Montenegro is witnessed with the 'Old olive' estimated to be more than 2000 years old. 'Old olive' draws attention to its genetic potential and the relation to the closest grown olive cultivars. Therefore, the aim of this paper was to give the basic description of 'Old olive' (through 20 morphological and 37 chemical properties) as well as to determine its DNA profile and to examine the closeness with major olive cultivar grown, cv. 'Žutica'. The obtained data showed the differences between examined samples. 'Old olive' started flowering (27. May) more than 10 days later than cv. 'Žutica' (14. May), and began ripening 15 days later (20th October and 5th October, respectively). From 21 morphological parameters analysed all traits of fruit (weight 2.11g in 'Old olive' and 3.55g in cv. 'Žutica'), and inflorescence density (6.39 versus 5.55) showed very significant and significant differences, respectively. The chemical properties also showed very significant differences in olive oil content in the fresh (11.28 versus 19.68%) and dry matter (27.97 versus 47.78%), and significant differences in the content of linolenic acid (0.76 versus 0.54g/100 of FA and of campesterol (3.4 versus 3.1%). Three out of eleven SSR markers (DCA05, DCA09, DCA16) distinguished obtained DNA fragments, and showed as important tool in differentiation of two samples. Further study of the 'Old olive' as a living memory of olive cultivation in Montenegro, should be to examine its relation with other ancient olive trees and local varieties.

New strategy to improve quality control of Montenegro skin test at the production level

Abstract INTRODUCTION: The production of the Montenegro antigen for skin test poses difficulties regarding quality control. Here, we propose that certain animal models reproducing a similar immune response to humans may be used in the quality control of Montenegro antigen production. METHODS: Fifteen Cavia porcellus (guinea pigs) were immunized with Leishmania amazonensis or Leishmania braziliensis , and, after 30 days, they were skin tested with standard Montenegro antigen. To validate C. porcellus as an animal model for skin tests, eighteen Mesocricetus auratus (hamsters) were infected with L. amazonensis or L. braziliensis , and, after 45 days, they were skin tested with standard Montenegro antigen. RESULTS: Cavia porcellus immunized with L. amazonensis or L. braziliensis , and hamsters infected with the same species presented induration reactions when skin tested with standard Montenegro antigen 48-72h after the test. CONCLUSIONS: The comparison between immunization methods and immune response from the two animal species validated C. porcellus as a good model for Montenegro skin test, and the model showed strong potential as an in vivo model in the quality control of the production of Montenegro antigen.

Evaluation of the reference value for the Montenegro skin test

The Montenegro skin test (MST) has good clinical applicability and low cost for the diagnosis of American tegumentary leishmaniasis (ATL). However, no studies have validated the reference value (5mm) typically used to discriminate positive and negative results. We investigated MST results and evaluated its performance using different cut-off points.

Estudo clínico, epidemiológico e imunológico para leishmaniose tegumentar americana em centro de referência em dermatologia / Clinical, epidemiological and immunological study to american tegumentary leishmaniasis in a dermatology reference center

Leishmaniose Tegumentar Americana (LTA) é uma doença infecciosa, causada por protozoários do gênero Leishmania. É uma das doenças infectoparasitárias mais incidentes no mundo. No presente trabalho realizou-se um estudo transversal retrospectivo das características clínicas, epidemiológicas e imunológicas de portadores de Leishmaniose Tegumentar Americana.Foram utilizados prontuários de 34 pacientes com diagnóstico de LTA. A análise estatística foi realizada pelo Teste de Spearman. O sexo masculino foi acometido em 68% e o feminino 32%. A idade variou de 1 a 92 anos. A forma cutânea localizada ocorreu em 79,5%,sendo as úlceras a forma clínica mais comum (56%).Principal área acometida foi face (44%). O tempo para o diagnóstico foi menor que 10 meses em 68% dos indivíduos.Intradermorreação de Montenegro (IDRM) foi realizada em 29 pacientes, com positividade em 89,6% e a imunofluorescência indireta (IFI) em apenas 16 pacientes, sendo positiva em 13. A idade e o tempode evolução da doença apresentaram associação significativa com IDRM. Entretanto não foi observada associação da IFI com a idade do paciente e o tempo de doença, pelo teste de Spearman. O tratamento foi realizado na maioria dos casos com glucantime (71%),seguido de pentamidina (17%). Os resultados evidenciam que os exames sorológicos constituem uma ferramenta auxiliar e a correlação com achados clínicos e histopatológicos são imprescindíveis.

Introduction: American cutaneous leishmaniasis (ACL) is an infectious disease caused by protozoa of the genus Leishmania. World  leishmaniasis  is an important endemic disease and public health problem in developing countries. Methods: We conducted a retrospective, descriptive and analytical cross-sectional study of 34 patients diagnosed with ACL. Statistical analysis was performed using the nonparametric Spearman’s test. Results: The gender involved was male (68%) and female(32%); the age range of 1 to 92 years old. The most common clinical manifestations were localized cutaneous form (79.5%) and the ulcers (56%).The face was main affected area (44%) and the minor time from onset of symptoms to consultation was 10 months (68%) of patients. Montenegro skin test (MST) was performed in 29 patients, being positive in (89.6%) and the indirect immunofluorescence (IIF) in only 16 patients, being positive in 13. The age and the duration of the disease were significantly associated with MST. Conclusions: It was not observed the IFI association with the patient’s age and disease duration. The treatment was in most cases, meglumine antimoniate (71%), followed Pentamidine (17%). The results demonstrated thatthe serological tests constitute an auxiliary tool andthe correlations with clinical and histopathological findings are essential.

Aspectos clínico-imunológicos da Leishmania recidiva cútis (LRC) causada por Leishmania Viannia Braziliensis / Clinical and immunological aspects of Leishmania relapse skin (LRC) caused by Leishmania Viannia Braziliensis

Introdução: As leishmanioses representam um grande problema de saúde pública sendo consideradas como doença emergente e sem controle - doença de categoria 1 - e que o foco das pesquisas deve ser a aquisição de novos conhecimentos e medidas eficazes de controle. Sob o ponto de vista clínico, a leishmaniose tegumentar (LT) nas Américas apresenta as seguintes modalidades: infecção inaparente, ganglionar, cutânea localizada (LCL), cutânea disseminada (LD), cutânea difusa (LCD), recidiva cútis (LRC) e mucosa. A primeira descrição sobre LRC ocorreu na leishmaniose no Oriente com o nome “chronic lúpus-like”, definidas como lesões de aparecimento tardio e refratariedade aos tratamentos ou como uma reação peculiar do sistema imune do hospedeiro ao parasito. A LRC é uma variante da LT convencional, uma forma de cicatrização, sendo importante entender aspectos relacionados à resposta imune do hospedeiro. Objetivo: Avaliar aspectos clínico-imunológicos e terapêuticos da LRC em pacientes da região do Vale de Jiquiriçá, Bahia, Brasil. Metodologia: O estudo foi realizado no Município de Jiquiriçá, pertencente à região Sudoeste da Bahia. Os pacientes foram atendidos no ambulatório de Doenças infecciosas e Parasitárias do Centro de Referência em Doenças Endêmicas do Vale do Jiquiriçá (CERDEJJC)...

Introduction: Leishmaniasis represent a major public health problem being considered as emerging and uncontrolled disease - disease of category 1 - and the focus of research should be new knowledge and effective control measures. In relation clinical modalities, cutaneous leishmaniasis (CL) in the Americas presents the following forms: inapparent infection, lymphnode and localized cutaneous leishmaniasis (LCL), disseminated cutaneous leishmaniasis (DL), diffuse cutaneous leishmaniasis (DCL), cutis recidivans leishmaniasis (CRL) and mucosal form. The first description of CRL occurred in Orient leishmaniasis called "chronic lupus-like lesions” defined as a late compromise and refractory to treatment or as a peculiar reaction of the immune response of the host to the parasite. The CRL is a variant of the conventional TL, a form of wound healing. Objective: To evaluate clinical, immunological and therapeutic aspects of the CRL in patients of the Jiquiriçá Valley region, Bahia, Brazil. Methodology: The study was conducted in Jiquiriçá municipality, belonging to southwest Bahia state. The patients were enrolled at the outpatient Infectious and Parasitic Diseases of the Reference Center for Endemic Diseases Jiquiriçá Valley (CERDEJJC)...

Circulação e produção de saberes e práticas científicas na América meridional no século XVIII: uma análise do manuscrito Materia medica misionera de Pedro Montenegro (1710) / Circulation and production of knowledge and scientific practices in southern America in the eighteenth century: an analysis of Materia medica misionera, a manuscript by Pedro Montenegro (1710)

Analisa uma versão manuscrita de 1790, do livro escrito originalmente em 1710 pelo jesuíta Pedro Montenegro, Materia medica misionera. Além da persistência de saberes mágico-religiosos e dos exóticos ingredientes para as receitas, encontram-se na obra a inconfundível presença das concepções hipocráticas e galênicas e o crescente empirismo que marca as transformações científicas do século XVIII. Sua análise permite, ainda, a reflexão sobre difusão, circulação e produção de conhecimentos farmacológicos e médicos na primeira metade do século XVIII, no âmbito das reduções e dos colégios instalados na região Província Jesuítica do Paraguai, na América meridional.

The article analyzes a 1790 manuscript copy of Materia medica misionera, a book written in 1710 by a Jesuit, Pedro Montenegro. Alongside knowledge of a magical or religious nature, and exotic ingredients for the recipes, this work also contains the unmistakable presence of Hippocratic and Galenic conceptions and a growing empiricism, characteristic of the scientific transformations seen in the eighteenth century. The analysis of this work also prompts reflections about the diffusion, circulation and production of pharmacological and medical knowledge in the first half of the eighteenth century within the missions and colleges installed in the area that was the Jesuit Province of Paraguay, southern America.

Risk factors for Leishmania chagasi infection in an endemic area in Raposa, State of Maranhão, Brazil / Fatores associados à infecção por Leishmania chagasi em uma área endêmica em Raposa, Estado do Maranhão, Brasil

INTRODUCTION: Infection with Leishmania chagasi is the most common clinical presentation for visceral leishmaniaisis in endemic areas. The municipality of Raposa is an endemic area in State of Maranhão, Brazil, and have had registration cases of visceral leishmaniasis disease. For this reason, a cross- sectional study was conducted to evaluate the risk factors for infection with L. chagasi detected by Montenegro skin test. METHODS: The sample comprised 96 percent of the inhabitants of the villages of Maresia, Pantoja, and Marisol located in the municipality of Raposa, corresponding to 1,359 subjects. Data were collected using a questionnaire. Univariate and multivariate logistic regression models were applied to evaluate the association between the variables studied and infection of L. chagasi. RESULTS: The variables associated with infection upon nonadjusted analysis were a straw roof, mud walls, floors of beaten earth, presence of sand flies inside or outside of the dwelling, and bathing outdoors. Adjusted analysis showed that the presence of sand flies inside/outside the dwelling was a risk factor, and age younger than 10 years was a protective factor against asymptomatic infection. CONCLUSIONS: The results highlight the extent to which precarious living conditions of the population strengthen the epidemiological chain of visceral leishmaniasis.

INTRODUÇÃO: A infecção por Leishmania chagasi é a apresentação clínica mais comum de laishmaniose visceral em áreas endêmicas. O município de Raposa é área endêmica no Estado do Maranhão, tendo registrado casos da doença. Por isso, realizou-se um estudo transversal, com o objetivo de estudar os fatores de risco para infecção por L. chagasi detectada pelo teste intradérmico de Montenegro. MÉTODOS: O estudo envolveu 96 por cento dos moradores das localidades de Maresia, Pantoja e Marisol do município da Raposa, totalizando 1.359 indivíduos. O levantamento dos dados foi realizado utilizando um questionário. Para verificar a associação entre as variáveis estudadas e a infecção por L. chagasi, foram utilizados os modelos de regressão logística uni e multivariada. RESULTADOS: Na análise não ajustada, as variáveis associadas à infecção foram: cobertura da casa de palha, paredes de taipa, piso de chão batido, a presença de flebotomíneos dentro ou fora do domicílio e o local do banho fora de casa. Na análise ajustada, a presença de flebotomíneos dentro ou fora do domicílio foi considerada fator de risco e a idade menor que 10 anos revelou-se como fator de proteção para a infecção assintomática. CONCLUSÕES: Evidenciou-se também, o quanto a precariedade das condições de vida da população contribui para o fortalecimento da cadeia epidemiológica da doença.

Leishmaniose tegumentar americana: estudo clínico, epidemiológico e laboratorial realizado no Hospital Universitário de Campo Grande, Mato Grosso do Sul, Brasil / American cutaneous leishmaniasis: clinical, epidemiological and laboratory studies conducted at a university teaching hospital in Campo Grande, Mato Grosso do Sul, Brazil

FUNDAMENTOS: Leishmaniose Tegumentar Americana é zoonose de manifestações clínicas variadas, em expansão no Brasil, sendo o estado de Mato Grosso do Sul importante área endêmica. OBJETIVOS: Avaliar clínica, epidemiológica e laboratorialmente pacientes com Leishmaniose Tegumentar Americana , atendidos no Hospital Universitário Maria Aparecida Pedrossian, Universidade Federal de Mato Grosso do Sul, Brasil (HU/UFMS). MÉTODOS: Trata-se de um estudo observacional do tipo transversal com abordagem descritiva e analítica. Foram avaliados, retrospectivamente, dados de pacientes suspeitos de Leishmaniose Tegumentar Americana , atendidos no HU/UFMS de 1998 a 2008, e encaminhados ao Laboratório de Parasitologia/UFMS para complementação diagnóstica. Para a inclusão neste estudo foram considerados critérios clínicos e laboratoriais. RESULTADOS: Quarenta e sete pacientes foram incluídos no estudo. Houve predominância de homens de 45 a 59 anos, com a forma cutânea, lesão única, ulcerada, em áreas expostas do corpo e com duração menor que seis meses. O comprometimento de mucosas foi crescente com o aumento da idade e maior em pacientes que procuraram atendimento tardiamente. Intradermorreação de Montenegro foi o exame de maior sensibilidade e o encontro do parasito mostrou-se mais difícil em lesões antigas. CONCLUSÃO: Suspeição diagnóstica precoce é de extrema importância para diagnóstico preciso. Associação de exame parasitológico e imunológico torna mais seguro o diagnóstico laboratorial.

BACKGROUND: American cutaneous leishmaniasis is a disease with a wide variety of clinical manifestations that is expanding throughout Brazil, the state of Mato Grosso do Sul constituting a significant endemic area. OBJECTIVES: To evaluate the clinical, epidemiological and laboratory characteristics of patients with American cutaneous leishmaniasis. Patients were recruited among those attending the Maria Aparecida Pedrossian Teaching Hospital of the Federal University of Mato Grosso do Sul, Brazil. METHODS: This was a cross-sectional, observational study conducted using a descriptive and analytical approach. Data from patients suspected of having American cutaneous leishmaniasis who were receiving care at this institute between 1998 and 2008 and were referred to the institute's parasitology laboratory for confirmation of diagnosis were evaluated retrospectively. Clinical and laboratory criteria were taken into consideration for the inclusion of patients to the study. RESULTS: Forty-seven patients were included in the study, the majority of whom were male and between 45 and 59 years of age. Most had the cutaneous form of the disease with a single, ulcerated lesion on exposed areas of the body, which had generally been present for periods of less than six months. Mucosal involvement increased with age and was highest in patients who had sought medical care at a later stage. The Montenegro skin test showed the highest sensitivity. Finding the parasite was more difficult in older lesions. CONCLUSION: Suspicion of the disease at an early stage is of extreme importance for a precise diagnosis. A combination of parasitological and immunological tests renders laboratory diagnosis more reliable.

Anti-Leishmania titers and positive skin tests in patients cured of kala-azar

Visceral leishmaniasis (VL), also known as kala-azar, is an important public health problem. If not treated, virtually all clinically symptomatic patients die within months. The diagnosis is based on the Montenegro skin test (MST) and anti-Leishmania titers. Nevertheless, the time required for cured individuals living in a leishmaniasis-endemic area to present a positive skin test and negative anti-Leishmania serology is known. To determine the cellular and humoral immune response profile in relation to different times post-VL cure, a cross-sectional study was conducted on subjects from a kala-azar endemic area in Paço do Lumiar, MA, Brazil, on the basis of 1995-2005 notifications reported by the National Health Foundation/Regional Coordination of Maranhão. We visited cured individuals with a history of VL within the last 10 years. Seventy-four subjects (30 females) ranging in age from 1 to 44 years were included, all of them symptom free at the time of the study. A cellular immune response was observed in 73 (98.6 percent) subjects, whereas no significant antibody titers were detected by indirect immunofluorescence (IIF) in the sera of 69 (93.2 percent) cases. Ten years post-cure, 39 (52 percent) subjects had a positive MST and negative IIF reaction, while in one subject the skin and anti-Leishmania serology tests were negative. Two other subjects were positive in both tests 1 year after cure. These data suggest that a cellular immune response may still be present in subjects cured of VL regardless of post-cure time, and that the parasite persists in the host after clinical cure of the disease. This would explain the persistence of significant Leishmania sp antibody titers in some subjects after treatment.

Clinical, epidemiological and laboratory aspects of patients with American cutaneous leishmaniasis in the State of Pernambuco / Aspectos clínicos, epidemiológicos e laboratoriais de pacientes com leishmaniose cutânea americana no Estado de Pernambuco

The diagnosis for American cutaneous leishmaniasis is based on an association of clinical, epidemiological and laboratory characteristics. The present study identified the circulating species of Leishmania in the State of Pernambuco, described its clinical-epidemiological characteristics and diagnosed the disease. Nineteen patients presenting active lesions who had been diagnosed through clinical evaluation and laboratory tests were selected. The tests included direct investigation, in vitro culturing, Montenegro skin test, indirect immunofluorescence and polymerase chain reaction. The Montenegro Skin Test showed positive results in 89 percent of the patients; indirect immunofluorescence, in 79 percent; direct investigation, in 58 percent; and polymerase chain reaction in 75 percent. Seven Leishmania (Viannia) braziliensis samples were isolated from these patients and were characterized by means of specific monoclonal antibodies. These data confirm that a combination of different diagnosis techniques is needed in order to obtain efficient results and that, so far, Leishmania (Viannia) braziliensis is the only species responsible for American cutaneous leishmaniasis infection in Pernambuco. Thus, it is essential to identify the parasite species involved in cases of human disease in an endemic area in order to determine the clinical and epidemiological characteristics, especially with regard to diagnosis, therapy development and disease prognosis.

O diagnóstico da leishmaniose cutânea americana é baseado na associação dos aspectos clínicos, epidemiológicos e laboratoriais. O presente estudo identificou a espécie de Leishmania circulante no Estado de Pernambuco, descreveu os aspectos clínico-epidemiológicos e diagnosticou a doença. Foram selecionados 19 pacientes apresentando lesão ativa e diagnosticados através de avaliação clínica e pelos exames laboratoriais que incluíram a pesquisa direta, cultivo in vitro, intradermorreação de Montenegro, imunofluorescência indireta e reação em cadeia de polymerase. A intradermorreação de Montenegro apresentou resultado positivo em 89 por cento dos pacientes. A imunofluorescência indireta apresentou 79 por cento de positividade, a pesquisa direta apresentou 58 por cento e a reação em cadeia de polymerase 75 por cento de positividade. Sete amostras de Leishmania (Viannia) braziliensis foram isoladas desses pacientes e caracterizadas através de anticorpos monoclonais específicos. Esses dados confirmam que é necessário a combinação de diferentes técnicas diagnósticas para se obter resultados eficientes e que, até o momento, a Leishmania (Viannia) braziliensis é a única espécie responsável pela infecção da leishmaniose cutânea americana em Pernambuco. Portanto, a identificação da espécie do parasito envolvido nos casos da doença no homem em uma área endêmica é essencial para o conhecimento dos aspectos clínicos e epidemiológicos, sobretudo para o diagnóstico e para o desenvolvimento da terapia e prognóstico da doença.

Intradermorreação de Montenegro em cães (Mammalia: Canidae) experimentalmente inoculados por Leishmaniaguyanensis e Leishmania braziliensis (Kinetoplastida: Trypanosomatidae), principais agentes causadores de Leishmaniose Tegumentar na Amazônia / Montenegro's skin test in dogs (Mammalia: Canidae) experimentally inoculated with Leishmaniaguyanensis and Leishmania braziliensis (Kinetoplastida: Trypanosomatidae) the main agents of Amazônia Tegumentary Leishmaniasis

O teste de intradermorreação de Montenegro é utilizado para detectar infecção por Leishmania em humanos. A técnica se baseia numa reação de hipersensibilidade tardia. Os antígenos de Montenegro utilizados no experimento são soluções de antígenos homólogos brutos de Leishmania (Viannia) braziliensis e L.(V)guyanensis. Este experimento demonstrou que os animais inoculados com as espécies de Leishmania inoculadas desenvolveram enduração no local do teste mais acentuada que os animais controle. Os resultados sugerem que o teste cutâneo pode vir a ser indicado como método auxiliar de diagnóstico em cães infectados por Leishmania sp.

Positive Montenegro's skin test is a delayed type hypersensitivity reaction widely used as indicative of infection with Leishmania. Montenegro's antigen consisted of a crude Leishmania homologous antigen solution that was used as a skin test in five dogs experimentally inoculated with Leishmania (Viannia) spp. In this work it is shown that all animals infected presented an induration at the site of injection in contrast of the dogs non infected used as a control group. This demonstrated that the skin tests in dogs could be used to make an diagnosis of the Leishmania infection.

First encounter of subclinical human Leishmania (Viannia) infection in State of Rio Grande do Sul, Brazil

The objective of the present study was to evaluate the specificity of the Montenegro skin test (MST) in an area in Brazil, state of Grande do Sul State (RS), which was considered to be non-endemic for leishmaniasis. Sixty subjects presented a positive MST and were reevaluated by clinical examination, serology and polymerase chain reaction (PCR) of peripheral blood for the detection of subclinical Leishmania infection. None of the subjects presented clinical signs or symptoms of current leishmaniasis or a history of the disease.Leishmania (Viannia) DNA was detected in blood by PCR and hybridization in one subject. The PCR skin test-positive individual remained asymptomatic throughout the study. Clinical examination showed no scars suggestive of past cutaneous leishmaniasis. Human subclinical infection with Leishmania (Viannia) in RS was confirmed by PCR. This is the first report of subclinical infection with this parasite in the human population of this area.

Leishmaniose tegumentar americana em centro de treinamento militar localizado na zona da mata de pernambuco, Brasil / American cutaneous leishmaniasis in a military training center located in Zona da Mata, Pernambuco, Brazil

An outbreak of American cutaneous leishmaniasis has been occurred in military training unit localized in 'Zona da Mata' of Pernambuco State, Brazil, where were registered 26 human cases. An epidemiological survey was carried out by entomological investigation and Montenegro skin test (MST). Lutzomyia choti presents predominance (89.9%) in sandflies identified. Out of 545 men who realized training activities were 24.12% positive to MST.

Um surto de leishmaniose tegumentar americana ocorreu em 1996 em unidade de treinamento militar situada na Zona da Mata de Pernambuco, com o registro de 26 casos humanos. Um inquérito epidemiológico foi realizado através da realização de levantamento entomológico e da aplicação do Teste de Montenegro. Lutzomyia choti apresentou predominância de 89,9% dos flebótomos identificados. De 545 homens que participaram de treinamentos no período, 24,1% (incluindo os casos clínicos) foram positivo para o Teste de Montenegro.