Encapsulation of benznidazole in nanostructured lipid carriers and increased trypanocidal activity in a resistant Trypanosoma cruzi strain

Abstract Chagas disease is a neglected parasitic disease caused by Trypanosoma cruzi, whose treatment has remained unsatisfactory for over 50 years, given that it is limited to two drugs. Benznidazole (BZN) is an efficient antichagasic drug used as the first choice, although its poor water-solubility, irregular oral absorption, low efficacy in the chronic phase, and various associated adverse effects are limiting factors for treatment. Incorporating drugs with such characteristics into nanostructured lipid carriers (NLC) is a promising alternative to overcome these limiting obstacles, enhancing drug efficacy and bioavailability while reducing toxicity. Therefore, this study proposed NLC-BZN formulations in different compositions prepared by hot-melt homogenization followed by ultrasound, and the optimized formulation was characterized by FTIR, DRX, DSC, and thermogravimetry. Biological activities included in vitro membrane toxicity (red blood cells), fibroblast cell cytotoxicity, and trypanocidal activity against epimastigotes of the Colombian strain of T. cruzi. The optimized NLC-BZN had a small size (110 nm), negative zeta potential (-18.0 mV), and high encapsulation (1.64% of drug loading), as shown by infrared spectroscopy, X-ray diffraction, and thermal analysis. The NLC-BZN also promoted lower in vitro membrane toxicity (<3% hemolysis), and 50% cytotoxic concentration (CC50) for NLC-BZN in L929 fibroblast cells (110.7 µg/mL) was twice the value as the free BZN (51.3 µg/mL). Our findings showed that the NLC-BZN had higher trypanocidal activity than free BZN against the epimastigotes of the resistant Colombian strain, and this novel NLC-BZN formulation proved to be a promising tool in treating Chagas disease and considered suitable for oral and parenteral administration

Meglumina en series terapéuticas de 10 días en niños con leishmaniosis tegumentaria americana / Meglumine therapeutic series of 10 days in children with american tegumentary leishmaniasis

La cátedra de Medicina Tropical de la Universidad Central de Venezuela viene empleando el antimoniato de meglumina en series terapéuticas de 10 días en el tratamiento de leishmaniosis tegumentaria americana, la cual continúa como problema de salud del medio rural venezolano. Se evalúa una experiencia con una dosis de 70 mg/kg/día de meglumina en niños con la enfermendad. A los pacientes con presunción diagnóstica de leishmaniosis tegumentaria americana (clínica y antecedentes epidemiológicos) se les efectuó la prueba de leishmania, la demostración de anticuerpos flurescentes antileishmania y la visualización de amastigotes en frotis teñidos con Giemsa. Los casos identificados ingresaron al Hospital Universitario (Pediatría médica infecciosa), recibieron 70 mg/kg/día de antimoniato de meglumina en series terapéuticas de 10 días con reposo intercalados por el mismo número de días. Se incluyeron 33 niños con la enfermedad, 21 de género femenino (64%) con promedio de edad 7,12 años y predominio de escolar (70%). Del Estado Miranda procedía el 85%, una sola úlcera la tenía el 88%, localizada en miembros inferiores (49%). La Leishmanina y los anticuerpos fluorescentes antileishmania fueron positivos en todos los pacientes y el frotis para amastigotes en 45%. Dos series de antimoniato de meglumina las recibió 91% de los pacientes; una de 10 días 6%. Egresaron con cicatrizaciones de sus procesos ulcerosos y fueron evaluados durante seis meses en la consulta de endemias rurales y no se evidenciaron recaídas. La variedad cutánea localizada de la enfermedad fue la única identificada, el Estado Miranda continúa aportando la mayoría de los pacientes atendidos en medicina tropical. El antimoniato de meglumina en leishmaniosis tegumentaria americana a la dosis de 70 mg/kg/día en series terapéuticas fue tan eficaz como la anterior de 100 mg/kg/día que dejó de administrarse hace ocho años.

The Tropical Medicine Department of the Universidad Central de Venezuela employs the meglumine pentavalent antimonial in series of 10 days of treatment for American Tegumentary Leishmaniosis, which continues being a health problem in the Venezuelan rural areas. We are reporting a clinical experience of treatment in children at a dose of 70 mg/kg/day. Patients with diagnostic suspición of American Tegumentary Leishmaniosis (clinical and epidemiologic antecedents) who attended the Rural Endemics Clinic at the Instituto de Medicina Tropical of the Universidad Central de Venezuela and to the Medical Infectious Pediatrics Service at the Hospital Universitario de Caracas (HUC), were tested for leishmanine, fluorescent antileishmania antibodies and for the presence of amastigotes of the parasite in smear for apposition from the ulcer that were treated by the Giemsa method. Patients hospitalized at the Medical Infectious Pediatric Service (Hospital Universitario de Caracas) received 70 mg/kg/day of meglumine pentavalent antimonial during 10 days, a rest period of 10 days without treatment and, if 20 days after ulcers were unhealed, was administred a new 10 days meglumine pentavalent antimonial series. We included 33 children with the disease with a mean age of 7,12 years, 70% in school age and 30% preschool children, and 21 (64%) were girls. The 85% of patients came from Miranda`s state, 88% had only ulcer and in 49% of them the lesions where localized in the legs. The apposition smear showed Leishmania amastigotes in 45% od cases. One series of treatment was given to 91% of cases, two children received two series and one three. At discharge from the hospital all ulcers were healed and follow-up control for a 6 months period showed no relapses. The cutaneous localized from was the clinical form of presentation in the children studied. The great majority of patients that assits to the Tropical Medicine Institute come from the Miranda`s state area...

Parasitismo intestinal en hogares comunitarios de dos municipios del departamento del Atlántico, norte de Colombia / Intestinal parasitism in home day care of two municipality of departamento del Atlántico, Northern of Colombia

Entre los meses de enero y junio de 2004 fue realizado un estudio epidemiológico de corte transversal, cuyo objetivo fue determinar la prevalencia de parásitos intestinales en la población infantil entre 2 y 6 años de edad en Hogares Comunitarios del Instituto Colombiano del Bienestar Familiar de los municipios de Santo Tomás y Galapa en el departamento del Atlántico (norte de Colombia). El diagnóstico se realizó a través de montaje húmedo de muestras fecales en solución salina y solución de lugol. También se empleó la técnica de concentración éter-formalina y coloración de Ziehl Neelsen. Se realizó un análisis exploratorio de los datos y la prueba Chi-cuadrada (χ²) para determinar diferencias significativas entre las prevalencias de parásitos intestinales de cada municipio y Odds Ratio para evaluar factores de riesgo. La prevalencia para Santo Tomás fue de 82% y el parásito intestinal de mayor frecuencia fue Trichiuris trichiura (39,8%), para Galapa la prevalencia fue de 72% y el parásito de mayor frecuencia fue Giardia duodenalis con 37,3%. La prueba de independencia χ² con α = 0,05 mostró diferencias significativas para la prevalencia general entre municipios y para los parásitos Ascaris lumbricoides, T. trichiura, Blastocystis hominis y Entamoeba coli. La presencia de madres con infecciones causadas por parásitos intestinales se presentó como el factor de mayor riesgo en la epidemiología de las parasitosis intestinales en las comunidades evaluadas.

In order to determine the intestinal parasite population of children from 2 and 6 years old, an epidemiological cross section study was done during January to June 2004, at the community homes in the Colombian Wellbeing Family Institute (Instituto Colombiano del Bienestar Familiar), at the Santo Tomas and Galapa municipalities, Atlántico, Colombia. The procedure was achieved by wet mounting in saline and iodine solutions, also an ether-formalin concentration technique was employed and then the coloration was done with the Ziehl Neelsen technique. A tentative data analysis and a Chi square (χ²) test determined a significant difference of intestinal parasite prevalence in each municipality and the risk factor with an odds ratio test. The results were as follows: the prevalence in Santo Tomas 82% and the most frequent intestinal parasite in the zone was Trichiuris trichiura with 39.8%. In Galapa, the prevalence was 72% and the most common parasite was Giardia duodenalis (37.3%). The Chi square (χ²) test (α = 0.05) showed significant difference between the municipalities and among the following parasites Ascaris lumbricoides, T. trichiura, Blastocystis hominis and Entamoeba coli. The principal risk factor was found to be the presence of intestinal parasite infections at the mother´s population level.

Factores predictivos de infección para estrongiloidosis en pacientes procedentes de áreas urbanas / Predictors of infection in strongyloidiasis patients from urban areas

La estrongiloidosis constituye una enfermedad endémica de países en regiones tropicales y subtropicales y es menos ocurrente en países desarrollados donde se informa de casos esporádicos procedentes de países endémicos. Este trabajo persiguió investigar los factores de riesgo que permitieran predecir esta infección en pacientes urbanos en un país endémico para estrongiloidosis, así como también determinar la ocurrencia de las coinfecciones parasitarias para la enfermedad. Se estudiaron prospectivamente 2815 pacientes de la Sección de Geohelmintiasis del Instituto de Medicina Tropical, Universidad Central de Venezuela, desde enero 2006 hasta julio de 2009, a los que se les realizó estudio coproparasitológico directo (Lugolsalina), formol tritón éter (FTE) y Baermann, evidenciando 44 pacientes positivos para Strongyloides stercoralis (ocurrencia de 1,56%) y 37 pacientes controles negativos. La moyoría de los participantes (92%) procedían de zonas urbanas de los estados norte-costeros de Venezuela. El FTE determinó 100% de los casos positivos para Strongyloides stercoralis, el examen directo 70% (31/44) y el Baermann solo 45% (20/44). Al comparar el grupo infectado con el grupo control, se evidenciaron diferencias en relación a la presencia de diarrea (P = 0,001), dolor abdominal (P = 0,022), eosinofilia (P < 0,0001) y cristales de Charcot-Leyden (P = 0,023). El análisis de los factores predictivos de riesgo para estrongiloidosis demostró que el contacto con tierra (OR = 4,7; P = 0,027), dolor abdominal (OR = 3,6; P = 0,017), diarrea (OR = 6,4; P = 0,001), eosinofilia (OR = 22,5; P = 0,000) y presencia de cristales de Charcot-Leyden (OR = 3,6; P = 0,017) son importantes como indicadores de infección por Strongyloides stercoralis.

Strongyloidiasis is endemic in tropical and subtropical countries, where sporadic cases are reported from endemic countries. This study pursued investigate the risk factors that allowed predicting Strongyloides sterocoralis infection in urban patients in an endemic country for strongyloidiasis, as well as to determine the ocurrence of parasitic coinfections for the disease. This is a prospective study of 2815 patients from the soil transmittedm helminthes section of the Tropical Medicine Institute, Univesidad Central de Venezuela, from January 2006 until July 2009. Stool examination was performed by different methods: direct (Lugol-saline), formaldehyde triton ether (FTE) and Baermann, identifying 44 positive patients for Strongyloides stercoralis (ocurrence of 1.56%) and 37 negative controls. Most participants (92%) were from urban areas of the north-coastal states of Venezuela. FTE identified 100% of cases positive for Strongyloides stercoralis, direct 70% (31/44) and Baermann only 45% (20/44). There were difference when comparing infected group with control group in terms of presence of diarrhea (P = 0.001), abdominal pain (P = 0.022), eosinophilia (P < 0.0001) and Charcot-Leyden crystals (P = 0.023). The analysis of risk factors for strongyloidiasis showed that contact with soil (OR = 4.7, P = 0.027), abdominal pain (OR = 3.6, P = 0.017), diarrhea (OR = 6.4; P = 0.001), eosinophilia (OR = 22.5, P = 0.000) and presence of Charcot-Leyden crystals (OR = 3.6, P = 0.017), are important as indicators of Strongyloides stercoralis infection.

Ocurrencia de Isospora belli, Cryptosporidium spp y Cyclospora cayetanenesis en pacientes urbanos evaluados por síntomas gastrointestinales con o sin imnunosupresión / Occurrence of Isospora belli, Cryptosporidium and Cyclospora cayetanenesis spp in urban patients evaluated for gastrointestinal symptoms with or without immunosuppresion

Este estudio de corte transversal, estimó la ocurrencia de infecciones por coccidias intestinales (CI) en pacientes urbanos procedentes de Caracas-Venezuela. Se analizaron, 1 831 referencias de pacientes externos de ambos sexos y con edad promedio ± desviación estándar de 28,8 ± 22,93 años. En la Sección de Geohelmintiasis del Instituto de Medicina Tropical (SGH-IMT), se evaluaron 4 650 muestras de heces seriadas, por examen directo, formol tritón éter y Baermann, pertenecientes a 1 550 pacientes. Adicionalmente, la prueba de Ziehl-Neelsen modificada, se aplicó a las muestras fecales de 150 pacientes, por solicitud del médico tratante o sugerencia de SGH-IMT. La eosinofilia (40,54 por ciento; 225/555) constituyó el principal motivo de referencia y consulta. El promedio ± DS de contaje absoluto de eosinófilo (3 151 ± 5 161) demostró eosinofilias leves (63/204) y moderadas (25/204). Otros motivos de consulta fueron: dolor abdominal (27,72 por ciento; 122/440), náuseas/vómitos (19,03 por ciento; 83/436), pujo/tenesmo (16,05 por ciento; 70/436) y por último, la consistencia líquida de las heces (4,87 por ciento; 74/1 477). Los parasitados (43,7 por ciento; 677/1 550) presentaron evacuaciones pastosa (81,25 por ciento; 494/608) y blandas (37 por ciento; 57/608). Sólo, 5,92. por ciento (36/608) presentaron consistencia líquida. La prueba de Ziehl-Neelsen modificada demostró 12 casos positivos (8 por ciento) para CI: Isospora belli (5,33 por ciento; 8/150), Cryptosporidium spp (2 por ciento; 3/150) y Cyclospora cayetanensis (0,66 por ciento; 1/150). El único caso de ciclosporiosis estaba co-infectado con Blastocystis hominis y no presentó cambios en la consistencia de las heces. Estos resultados apoya la idea de que los médicos interconsultantes soliciten la aplicación de exámenes coproparasitológicos adicionales, en forma seriada, de bajo costo, para evaluar pacientes inmunocompetentes urbanos, con síntomas gastrointestinales/ eosinofilia, ...

These two years follow up; cross-sectional study estimates the occurrence of intestinal coccidias in urban patients from the metropolitan area of Caracas-Venezuela. One thousand eight hundred thirty one outpatient case reports were analyzed, both sex and 28.8 ± 22.93 years. Soil-transmitted helminthes laboratory of the Tropical Medicine Institute (SGH-IMT) evaluated 4 650 feces samples from 1 550 outpatients by direct, formol triton ether and Baermann techniques, Additionally, modified Ziehl-Neelsen, were done because of clinicians or SGH-IMT suggestion for 150 outpatients. Eosinophilia (40.54 percent; 225/555) was the major cause of referral and consultation. The mean of the absolute count of eosinophils (3 151+ 5 161) showed low (63/204) and moderate (25/204) eosinophila. Other causes of consultation were: abdominal pain (27.72 percent; 122/440), nausea/ vomiting (19.03 percent; 83/436), tenesmus/constipation (16.05 percent; 70/436) and finally, liquid fecal consistency (4.87 percent; 74/1477). Parasite infected patients (43.7 percent; 677/1550) had normal (81.25 percent; 494/608) and semi liquid feces (37 percent; 57/608). Only, 5.92 percent (36/608) had liquid consistency. Modified Ziehl-Neelsen demonstrates 12 positive IC (8 percent) for: Isospora belli (5.33. percent; 8/150), Cryptosporidium spp (2 percent; 3/150) and Cyclospora cayetanensis (0.66 percent; 1/150). The only case of cyclosporidiosis was co-infected with Blastocystis hominis and had normal feces. These results agrees with the idea for clinicians to ask for additional, low cost, serial parasitological test in feces, to evaluate urban inmunocompetent outpatients, with gastrointestinal symptoms/eosinophilia, even without diarrhea, because the basic feces techniques, used routinely, fails to make the precise parasite diagnostic, underestimating coccidiosis

Efecto de las parasitosis intestinales sobre los parámetros antropométricos en niños de un área rural de Río Chico Estado Miranda, Venezuela / Effect of intestinal parasites on anthropometric parameters in children from a rural area of Rio Chico Miranda State, Venezuela

Las infecciones parasitarias tienen una alta prevalencia en poblaciones de países en desarrollo y modifican la condición nutricional afectando mayormente los grupos con mayor déficit nutricional. De 166 niños, pertenecientes a familias de la comunidad Madre Nueva de Río Chico, Estado Miranda - Venezuela; 51 escolares (28 niñas, 54,9 por ciento y 23 niños, 45,1. por ciento) siendo el 30,7 por ciento del total de los niños, entregaron muestra de heces para realizar examen al fresco. Las variables peso (kg), talla parada (cm), circunferencia de brazo izquierdo (CBI) (cm), pliegues de tríceps y subescapular (mm), índice de masa corporal (IMC) (kg/m2), área magra (mm) y área grasa (mm) fueron seleccionadas para establecer la relación. El 75 por ciento del grupo total presentó normalidad en crecimiento dimensional. El examen de heces mostró que 74 por ciento estaban parasitados, con similar incidencia en niños y niñas, la carga parasitaria fue leve según criterios de la OMS. Los parásitos mayormente encontrados fueron: Ascaris lumbricoides, Tenia y Giardia intestinalis. La media de las variables resultó ser menor en el grupo de parasitados, sin diferenciarse significativamente, del grupo no parasitado. La diferencia de las variables entre los niños, rango de edad de 10 - 13 años y los niños, rango de edad ≤ 6 años, fue una tendencia a la disminución en la ganancia de todas las variables excepto talla, para el grupo de parasitados. La alta prevalencia y la baja carga parasitaria no afectaron el estado nutricional de los niños; por lo que a los indicadores relacionados al acceso a los alimentos y recursos económicos suficientes a los hogares, se les debería prestar mayor atención

Intestinal parasitic infections have a high prevalence in populations of developing countries and affect mainly those individuals who have greater nutritional deficit. From 166 children, belonging to families of the community of "Nueva Madre de Rio Chico, Edo. Miranda, Venezuela"; 51 (28 girls, 54.9 percent and 23 boys, 45.1 percent) 30, 7 percent from the total children, delivered stool and fresh examination was made. The following variables were selected: weight (kg), tall (cm), left arm circumference (LAC) (cm), triceps folds (mm) and subscapular folds (mm), body mass index (BMI) (kg/m2), lean area (mm) and fat area (mm), to establish a relationship between parasites and anthropometric variables. 75 percent of the total group presented normal dimensional growth. The stool examination showed that 74 percent were infected, with similar incidence between boys and girls; the parasite load was mild according to criteria of WHO. The parasites with bigger frequency were: Ascaris lumbricoides, Taenia and Giardia intestinalis. The media of the anthropometric variables were lower in subjects with parasites and did not differ significantly from the group without parasites. The difference observed between the anthropometric values found for children in the age range: 10 - 13 years, and children in the age range ≤ 6 years was a trend towards a decrease in gain for all variables except tall for the group of parasitized children. The high prevalence and low parasite load did not affect the nutritional status of children, therefore, the indicators related to access to food and adequate financial resources to households, should be paid more attention

Giardíase: aspectos gerais / Giardiasis: general aspects

A parasitose por Giardia intestinalis é de distribuição mundial. Sua prevalência no Brasil é alta em algumas regiões, principalmente naquelas onde o saneamento básico e as medidas higiênicas são precários. Acomete com mais frequência crianças de zero a seis anos. Geralmente é uma parasitose sem intercorrências graves, mas cabe maior atenção quando acomete pessoas com desnutrição, fibrose cística ou algumas imunodeficiências. O diagnóstico clínico é impreciso, sendo, então, necessários os métodos laboratoriais. O tratamento é simples e eficaz. Embora a Giardia intestinalis seja extremamente infecciosa, a doença pode ser prevenida. O objetivo deste artigo é discorrer sobre os principais aspectos da giardíase.

Comportamiento natural de las fases no parasíticas de Rhipicephalus sanguineus (Latreille, 1806) (Acari: Ixodidae): en un bioterio canino de Venezuela / Natural behavior of non parasitic stages of Rhipicephalus sanguineus (Latreille, 1806) (Acari: Ixodidae): in a canine bioterio in Venezuela

El presente estudio determinó la fluctuación poblacional de las fases no parasíticas de Rhipicephalus sanguineus durante octubre 2000 - septiembre 2001. Mensualmente se recolectaron todas las garrapatas presentes en los distintos ambientes identificados dentro de las instalaciones del Bioterio de la Facultad de Ciencias Veterinarias de la Universidad Central deVenezuela, Maracay, estado Aragua, Venezuela. Se recolectaron 16.065 ejemplares de R. sanguineus en diferentes fases de desarrollo: 5.981 larvas, 7.378 ninfas, 796 machos y 1.916 hembras; el mayor número se obtuvo en el interior de las jaulas (13.364), representando las ninfas la fase más abundante, tanto en el interior como en el exterior. El área pared/piso se destacó con el mayor número de ejemplares (6.830), seguida de huecos/grietas (6.068), ambas con predominio de ninfas; el análisis estadístico mostró significancia (P<0,05) solamente para los machos, demostrando que el área influyó en la presencia de esta fase. Las mayores poblaciones de garrapatas se obtuvieron en agosto, septiembre, enero y julio en el interior de las jaulas y en diciembre, en el exterior de las mismas. Se determinó significancia estadística (P<0,05) del ambiente interno sobre la presencia de los estadios larvas, ninfas y machos, no así para las hembras. En el ambiente externo, la presencia de garrapatas fue escasa (21) siendo las hembras la fase más recolectada (12); no hubo diferencias estadísticamente significativas (P>0,05) del ambiente externo sobre la presencia de hembras. Al correlacionar las distintas fases con la temperatura interna, se encontraron diferencias significativas (P<0,05); en relación con la humedad sólo se estableció significancia para la presencia de machos en el área huecos-grietas (P<0,05). Estos resultados confirman la adaptabilidad de R. sanguineus a las edificaciones urbanas y su alta prolificidad en microhábitantes internos y externos, afectados por condiciones ambientales como humedad y temperatura.

This study determined poblational fluctuations of all non-parasitic forms in each developmental stage of Rhipicephalus sanguineus between October 2000 and September 2001. Through monthly sampling, all ticksfound in each identified area of the kennel at the Universidad Central de Venezuela, college of Veterinay Sciences, Maracay, Venezuela. A total of 16,065 specimens of R. sanguineus in all developmental stages were collected: 5,981 larvae, 7,378 nymphs, 796 adult and 1.916 females; the highest was found inside the dog as well outside the dog cage. The area between wall and floor had the highest number of specimens (6,830), followed by the area of holes and cracks (6,068); both showed prevalence of nymphs. Statistical analysis on developmental stage and internal environment was a significative association (P<0.05) only for males, indicating that the area affected the presence this stage. The largest populations of the ticks were found inside the cages in August, September, January and July and outside of them in December. Statistical tests showed significative differences in the internal environment for the presence of larvae, nymph and male stages, but not for female. In the external environment, ticks were scarcely present (21) being the females the most collected specimen (12). There was no significant effect (P<0.05) of external environment on the presence of females. Applying correlation tests between different stages and internal temperature, significant differences were found (P<0.05). Regarding humidity, there was only statistical significant differences for males found in holes and cracks (P<0.05). These results confirm R. sanguineus adaptability to urban buildings and its high rate of reproduction in internal and external microhabitats, both being affected by environmental conditions, such as humidity and temperature.

Descricão das lesões microscópicas das pregas vestibulares de adultos autopsiados e sua relacão com as causas de óbito e doenca de base / Description of microscopic lesions of vestibular folds of autopsied adults and their relationship with cause of death and underlying disease

Com o aumento dos métodos invasivos que são utilizados para o diagnóstico de doencas do trato respiratório é de se esperar que as alteracões das pregas vestibulares (PV) sejam mais freqüentes. Além disso, recentemente tem sido discutida a importância das PV na protecão do organismo contra agentes infecciosos e pouco se sabe sobre as lesões microscópicas em pacientes autopsiados, pois o estudo das cordas vocais não é rotina no exame post mortem. OBJETIVO: O objetivo deste estudo foi descrever as alteracões microscópicas das pregas vestibulares e realizar a sua relacão com as causas de óbito e doenca de base de adultos autopsiados. FORMA DE ESTUDO: coorte transversal. MATERIAIS E MÉTODOS: Foram estudadas microscopicamente 82 laringes coletadas de adultos autopsiados sendo realizada a coloracão da Hematoxilina-eosina para visualizar as alteracões morfológicas microscópicas das PV. RESULTADOS: Das 82 PV analisadas, observamos que 42 (51 por cento) apresentaram reacão inflamatória, sendo esta a única lesão encontrada. Quinze (18,3 por cento) casos apresentaram hiperplasia dos folículos linfóides, onze (13,4 por cento) casos infiltrado inflamatório difuso intenso e 16 (19,5 por cento), reacão inflamatória aguda. As doencas de base mais freqüentemente encontradas foram as do grupo de doencas do aparelho circulatório 31 (37,8 por cento) e nestas 20 (67,8 por cento) apresentavam reacão inflamatória das PV. As doencas infecciosas foram a causa de morte mais freqüente nos pacientes com reacão inflamatória das pregas vestibulares. CONCLUSAO: Além da funcão anatômica as PV parecem possuir uma funcão imunológica em relacão à infecccão das vias aéreas inferiores. Nosso estudo demonstrou a presenca de reacão inflamatória nas cordas vocais em pacientes com doencas infecciosas como causa de morte, podendo este achado estar relacionado com o processo séptico generalizado que levou o indivíduo à morte ou ser uma das formas do organismo prevenir a penetracão de agentes infecciosos.

Pyogenic abscesses and parasitic diseases

Parasitic diseases which during their course in the host switch the immune system from a T helper 1 to a T helper 2 response may be detrimental to the host, contributing to granuloma formation, eosinophilia, hyper-IgE, and increased susceptibility to bacterial and fungal infections. Patients and animals with acute schistosomiasis and hyper-IgE in their serum develop pyogenic liver abscess in the presence of bacteremia caused by Staphylococcus aureus. The Salmonella-S. mansoni association has also been well documented. The association of tropical pyomyositis (pyogenic muscle abscess) and pyogenic liver abscess with Toxocara infection has recently been described in the same context. In tropical countries that may be an interesting explanation for the great morbidity of bacterial diseases. If the association of parasitic infections and pyogenic abscesses and/or fungal diseases are confirmed, there will be a strong case in favor of universal treatment for parasitic diseases to prevent or decrease the morbidity of superinfection with bacteria and fungi

Aspectos anátomo-patológicos da parasitose por Lernaea cyprinacea (L) (Crustacea: Copepoda) em tambaqui (Colossoma macropomum Cuvier, 1818) / Anatomo-pathological aspects of the parasitism caused by Lernaea cyprinacea (L) (Crustacea: Copepoda) in the "tambaqui" (Colossoma macropomum Cuvier, 1818)

Uma amostragem de trinta tambaquis (Colossoma macropomum Cuvier, 1818), com idade e peso variados, foi examinada para a detecção de parasitismo por Lernaea cyprínacea; sete deles apresentam o ectoparasita. Os peixes com lerneose possuíam idade entre quatro meses e um ano, com peso máximo de 1 kg. Vinte peixes adultos com idade acima de quatro anos, não mostraram a presença de L. cyprínacea. O número máximo de copépodes encontrados por hospedeiro foi três. As nadadeiras e suas bases de inserção no corpo foram o local mais comum de fixação nos peixes pesquisados. A lesão provocada por L. cyprínacea se apresentou, macroscopicamente, como uma hemorragia discreta e limitada ao ponto de inserção do copépode. A análise histopatológica demonstrou infiltração leococitária mononuclear e neovascularização com intensa hemorragia nos tecidos ao redor da estrutura de fixação do parasita. Em um exemplar, a reação inflamatória foi seguida de ulceração e pelo início de um processo de fibrose no local de penetração do parasita.

A sample of thirty specimens of the "tambaqui" (Colossoma macropomum Cuvier, 1818), was collected in the fish pond of the Agricultural College ldelfonso Bastos Borges at Bom Jesus de ltabapoana, State of Rio de Janeiro. They had varied ages and weights and were examined to detect the ectoparasite L. cyprinacea. Seven of them presented lerneosis and had from four months to one year with a maximum of 1 kg. Twenty adults specimens with more than four years did not present the parasitis. The maximum number of copepods per host was three and these parasites were usually fixed in the fins and in their attachment bases in the fish body. Macroscopically, the injury caused by L. cyprinacea showed a discrete and localized hermorrhage at the attachment area. The histopathological analysis exhibited a mononuclear leococitic infiltration and neovascularization with hemorrhage around the tissues of the appendages of the parasite. In some cases, the inflamatory reaction involved them, trying to isolate copepod from the tissue of the host. In one specimen, it was observed that the inflamatory reaction was followed by ulceration and by a fibrous process in the penetrating area of the parasite.

Parasitological and histopathological studies on the grass carp, ctenopharyngodon idella val. Infected with trichophrya piscium

In fish /<4 g, the parasite caused proliferation of the epithelial lining of the secondary gill lamelae resulting in fusion of the lamellae. Blood vessels feeding lamellae congested resulting in a degeneration of the lamellae epithelium. There was a high incident of mortality among small fish harboring the parasite. Large fish [>/10 g] were also adversely affected by T. piscium although morality was reduced. Branchial epithelial cells increased in size, blood vessels in the primary and secondary gill lamellae became dilated, and there was extensive hyperplasia in the epithelial lining of the primary gill filaments. Short term [30 minutes] treatments with formalin at three concentrations [300, 400 and 500 ppm] and copper sulfate at one concentration [20 ppm were unsuccessful in eradicating the parasites from the gills. However, treatment with 5 ppm of formalin over a 4 day period and 1, 2 and 5 ppm copper sulfate cleared the parasites from the fish completely within 24 hours period

Extracellular matrix degradation in parasitic diseases

Fibrosis is an important manifestation of several parasitic diseases, but is not irreversible. A marked degree of extracellular matrix degradation can occur after cure of parasitism. Patients with the hepatosplenic form of schistosomiasis undergo considerable resorption of portal fibrosis monts or years after curative treatment as demonstrated by ultrasonography and pathological exmaination. 2. Studies of the post-treatment degradation of extracellular matrix in schistosomal periocular granulomas have demosntrated two forms of collagen degradation: in hepatic granulomas formed during early infection a rapid process occurs, with extracellular breakdown of fibers and internalization of collagen fragments, whereas during late infection, degradation in slow and is accompanied by focal electrondense and/or lytic changes. 3. Extensive extracellular matrix degradation and resorption occuring after curative treatment was recently described in the liver of a man with advanced visceral leishmaniasis and in the heart of mice with chronic Chagas' disease