Hepatitis Relapse after Yellow Fever Infection: Is There Another Wave?

Abstract During the yellow fever (YF) outbreak in Brazil, many cases of fulminant hepatitis were seen, although mild to moderate hepatitis was mostly observed with complete recovery. This report presents a case of late-onset hepatitis due to YF relapse. The patient sought medical attention after jaundice recurrence 40 days after the first YF hepatitis episode. This case highlights the importance of patient follow-up after the complete resolution of YF symptoms and discharge.

Identification of candidate antigens from adult stages of Toxocara canis for the serodiagnosis of human toxocariasis

In the present work, we identified adult Toxocara canis antigens through sodium dodecyl sulfate-polyacrylamide gel electrophoresis for potential use in human toxocariasis immunodiagnosis. The sensitivity and specificity of several semi-purified antigens, as well as their cross-reactivity with other parasitic infections, were assessed by IgM and IgG-enzime linked immunosorbent assay. Whilst we found that the crude extract of the parasite presented limited sensitivity, specificity and high cross-reactivity against other parasites, we identified 42, 58, 68 and 97-kDa semi-purified antigens as the most promising candidates for immunodiagnosis. Moreover, the 58 and 68-kDa antigens presented the lowest IgM cross-reactivity. When tested as a combination, a mixture of the 58 and 68-kDa antigens presented 100 percent sensitivity and specificity, as well as minor cross-reactivity. Although the combination of the 42, 58, 68 and 97-kDa antigens presented 100 percent sensitivity at a dilution of 1:40, the low specificity and high cross-reactivity observed suggested a limited use for diagnostic purposes. Our data suggested that the 58 and 68-kDa antigens might be most suitable for the immunodiagnosis of human toxocariasis.

Estudo comparativo da pressão arterial sistêmica aferida por três métodos distintos não-invasivos / Comparative study of arterial blood pressure using threedifferent non-invasive methods

Introdução: a hipertensão arterial sistêmica apresenta alta prevalência em praticamente todos os países do mundo, sendo considerada dos principais fatores de risco paramorbimortalidade cardiovascular. A aferição precisa da pressão arterial é procedimento fundamental na avaliação semiológica do sistema cardiovascular, permitindo estabelecer condutas terapêuticas individualizadas. A reprodutibilidade dos valores de pressão arterial aferidos por diferentes métodos, entretanto, permanece controversa. Objetivo: verificar a confiabilidade e reprodutibilidade de três métodos distintos de aferiçãoo da pressão arterial empregados na rotina clínica habitual e compará-los entresi. Métodos: trata-se de estudo comparativo das medidas de pressão arterial sistêmica de 115 pessoas residentes em Belo Horizonte. Foram realizadas múltiplas aferições da pressão arterial sistêmica por meio de aparelhos distintos: digital (Omron 705-CP), esfigmomanômetro aneroide (Welch-Allyn) e esfigmomanômetro de coluna de mercúrio. Resultados: as médias da pressão arterial sistólica e diastólica medidas pelo esfigmomanômetro de coluna de mercúrio foram significativamente mais altas que as obtidas pelos aparelhos aneroide e digital (p<0,05). Os três aparelhos apresentaram correlação positiva aceitável, sendo a maior semelhança obtida entre as medidas obtidas pelos aparelhos digital e aneroide e entre os esfigmomanômetros de coluna de mercúrio e aneroide. Conclusões: ambos os métodos, auscultatório e oscilométrico, apresentamconcordância satisfatória entre si. Observam-se, entretanto, diferenças significativas nos valores de pressão arterial aferidos pelos diferentes métodos. Dessa maneira, essesequipamentos podem levar a diagnósticos distintos de hipertensão arterial sistêmica,culminando em diferentes condutas. Sugere-se, então, que os pacientes tenham suapressão arterial sistêmica aferida sempre com o mesmo aparelho/método, visando à redução dessa variabilidade.

Introduction: systemic blood arterial hypertension presents high prevalence in practically all over the world and is considered one of the main risk factors for cardiovascular morbi-mortality. The blood pressure precise measurement is a basic procedure in the cardiovascular system semiologic evaluation, allowing setting individual therapeutic conducts. The reproducibility of the arterial pressure values measured through different methods, however, remains controversial. Objective: to verify the reliability and reproducibility of three different methods applied in the clinic routine and compare them to each other. Methods: the comparative study of the systemic arterial blood pressure measurements of 115 individuals living in Belo Horizonte.Multiple measurements of the systemic arterial blood pressure were carried out by different devices: digital (Omron 705-CP), aneroid sphygmomanometer(Welch-Allyn) and mercury column sphygmomanometer. Results: the medians of systolic and diastolic arterial blood pressure measured by the mercury column sphygmomanometer were significantly higher than those obtained by the aneroid and digital devices (p<0,05). The three devices presented positive acceptable co-relation, with the highest similarity obtained between the measures by the digital and aneroid devices and between the mercury and aneroid sphygmomanometers.Conclusion: both methods, auscultatory and oscillometric, are satisfactorily concordant to each other. However, it was noted significant differences in the arterial pressure values measured by different behaviors. Thus, it is suggested that the patients have their systemic arterial pressure measured always with the same device/method, aiming at the reduction in this variability.