A Randomized Clinical Trial Comparing Itraconazole and a Combination Therapy with Itraconazole and Potassium Iodide for the Treatment of Feline Sporotrichosis.

Feline sporotrichosis is an endemic disease with high occurrence in Brazil. Itraconazole (ITZ) remains the drug of choice for treating this disease in cats, despite the increasing reports of therapeutic failure. A controlled, randomized clinical trial was performed on 166 naive cats with sporotrichosis to assess the effectiveness and safety of the combination therapy with ITZ and potassium iodide (KI) compared with ITZ monotherapy. Cats were randomly allocated into two treatment groups: G1-ITZ 100 mg/cat/day-and G2-ITZ 100 mg/cat/day + KI 2.5-20 mg/kg/day. Cats treated in G2 presented 77% more risk of reaching a clinical cure (a positive effect) than those treated in G1, even when controlled by negative predictors. The survival curves of the two treatment protocols indicate that a clinical cure was achieved faster in G2. An increase in the KI dose was necessary in 28 cats due to the persistence of clinical signs. Adverse reactions were equally frequent in both groups and manageable with a temporary drug suspension and/or a hepatoprotective therapy. The combination therapy was associated with a higher cure rate and a shorter treatment time, suggesting that ITZ+KI arises as a better option for treating feline sporotrichosis and should be considered the first-line treatment, especially in the presence of negative predictors.

Could the acute strongyloides venezuelensis infection cause non-reversible host morphological changes? / A infecção aguda por strongyloides venezuelensis pode causar alterações morfológicas irreversíveis no hospedeiro? / ¿Puede la infección aguda por las strongyloides venezuelensis causar cambios morfológicos irreversibles en el hostal?

Although research has investigated the host-parasite relationship in Strongyloides venezuelensis infection in the scope of its immunological implications, the morphological consequences of this response for the host organism are yet to be explored. Our objective was to perform an organ morphometric analysis in Wistar rats infected with the intestinal parasite Strongyloides venezuelensis compared with infected rats treated with ivermectin. Twenty-six animals composed three groups: control (non-infected), infected (infected with 2,000 Strongyloides venezuelensis larvae), and infected treated (infected with 2,000 Strongyloides venezuelensis larvae and treated with ivermectin). All rodents were killed 21 days after infection and morphometric analysis of different organs was performed. The results showed significantly higher body and fecal weight in the infected-treated group. The weight of the small intestine increased considerably in the infected group and decreased in the infected-treated group. Pancreas, right kidney, and heart volume increased in the infected group compared with the control group. Despite treatment, the volumes of the stomach, brain, and left kidney increased in both the infected groups compared with the control group indicating the possibility of non- reversible host morphological adaptations. S. venezuelensis infection can augment both, volume and weight of organs ­ not necessarily related to the Strongyloides expulsion process ­ even if the acute infection had been in remission. A potential explanation for these host adaptations, including the occurrence of organ plasticity, are briefly discussed. The following steps encompass a histological analysis to verify the occurrence of hypertrophy/hyperplasia and observe if such morphological alterations remain after infection.

Embora pesquisas tenham investigado a relação parasita-hospedeiro na infecção por Strongyloides venezuelensis no âmbito de suas implicações imunológicas, as consequências morfológicas dessa resposta para o organismo hospedeiro ainda precisam ser exploradas. Nosso objetivo foi realizar uma análise morfométrica de órgãos em ratos Wistar infectados com o parasito intestinal Strongyloides venezuelensis em comparação com ratos infectados tratados com ivermectina. Vinte e seis animais compuseram três grupos: controle (não infectados), infectados (infectados com 2.000 larvas de Strongyloides venezuelensis) e tratados infectados (infectados com 2.000 larvas de Strongyloides venezuelensis e tratados com ivermectina). Todos os roedores foram sacrificados 21 dias após a infecção e a análise morfométrica de diferentes órgãos foi realizada. Os resultados mostraram peso corporal e fecal significativamente maior no grupo tratado infectado. O peso do intestino delgado aumentou consideravelmente no grupo infectado e diminuiu no grupo infectado tratado. O volume do pâncreas, rim direito e coração aumentou no grupo infectado em comparação com o grupo controle. Apesar do tratamento, os volumes do estômago, cérebro e rim esquerdo aumentaram em ambos os grupos infectados em comparação com o grupo controle, indicando a possibilidade de adaptações morfológicas não reversíveis do hospedeiro. A infecção por S. venezuelensis pode aumentar tanto o volume quanto o peso dos órgãos ­ não necessariamente relacionado ao processo de expulsão de Strongyloides ­ mesmo que a infecção aguda estivesse em remissão. Uma possível explicação para essas adaptações do hospedeiro, incluindo a ocorrência de plasticidade de órgãos, é brevemente discutida. As etapas a seguir compreendem uma análise histológica para verificar a ocorrência de hipertrofia/hiperplasia e observar se tais alterações morfológicas permanecem após a infecção.

Aunque la investigación ha investigado la relación parásito-huésped en la infección con Strongyloides venezuelensis dentro del alcance de sus implicaciones inmunológicas, aún deben explorarse las consecuencias morfológicas de esta respuesta para el organismo huésped. Nuestro objetivo fue realizar un análisis morfométrico de órganos en ratas Wistar infectadas con el parásito intestinal Strongyloides venezuelensis en comparación con ratas infectadas tratadas con ivermectina. Veintiséis animales conformaron tres grupos: control (no infectado), infectados (infectados con 2.000 larvas de Strongyloides venezuelensis) y tratados infectados (infectados con 2.000 larvas de Strongyloides venezuelensis y tratados con ivermectina). Todos los roedores fueron sacrificados 21 días después de la infección y se realizó un análisis morfométrico de diferentes órganos. Los resultados mostraron un peso corporal y fecal significativamente mayor en el grupo tratado infectado. El peso del intestino delgado aumentó considerablemente en el grupo infectado y disminuyó en el grupo tratado. El volumen de páncreas, riñón derecho y corazón aumentó en el grupo infectado en comparación con el grupo control. A pesar del tratamiento, los volúmenes de estómago izquierdo, cerebro y riñón aumentaron en ambos grupos infectados en comparación con el grupo control, lo que indica la posibilidad de adaptaciones morfológicas irreversibles del huésped. La infección con S. venezuelensis puede aumentar tanto el volumen como el peso de los órganos -no necesariamente relacionados con el proceso de expulsión de Strongyloides-, incluso si la infección aguda estaba en remisión. Se discute brevemente una posible explicación de estas adaptaciones del huésped, incluida la aparición de plasticidad de los órganos. Los siguientes pasos incluyen un análisis histológico para comprobar la hipertrofia/hiperplasia y para ver si estos cambios morfológicos permanecen después de la infección.

Spatial Distribution of Canine Sporotrichosis in Rio de Janeiro, Brazil (1998-2018) and Its Correlation with Socioeconomic Conditions.

Canine sporotrichosis is a poorly described global disease and a spatial approach has not yet been used to assess the disease in dogs. Therefore, this study aimed to describe the occurrence of canine sporotrichosis in the state of Rio de Janeiro, Brazil, from 1998 to 2018 and its correlation with socioeconomic characteristics using exploratory spatial data analysis. A total of 295 cases of canine sporotrichosis were identified and 249 were georeferenced. There was a higher concentration of cases in the municipality of Rio de Janeiro, as well as along the border of the city and the adjacent municipalities in the great metropolitan area. The cases occurred in areas where most of the dwellings are houses. Moreover, no focus of disease density was found in the southern part of Rio de Janeiro city over the period studied, possibly due to better socioeconomic conditions. Areas with a high concentration of canine sporotrichosis cases coincided with regions that possessed a low proportion of households without paving, suggesting that the disease is not necessarily linked to extreme poverty. The mapping of areas with a greater density of cases is fundamental to formulate targeted and strategic plans in order to implement effective public health prevention and control measures.

Sporothrix brasiliensis and Feline Sporotrichosis in the Metropolitan Region of Rio de Janeiro, Brazil (1998-2018).

Feline sporotrichosis is enzootic in different regions of Brazil, especially in Rio de Janeiro. This study compared the genotype profiles of Sporothrix sp. isolated from cats in Rio de Janeiro between 1998 and 2018 and evaluated their association with clinical and epidemiological characteristics. One hundred nineteen Sporothrix sp. isolates from a cohort of cats with sporotrichosis seen at INI/Fiocruz were included. Clinical and epidemiological data were obtained from the medical records of the animals. T3B PCR fingerprinting was used for molecular identification of the Sporothrix species. All isolates were characterized as Sporothrix brasiliensis, with the observation of low intraspecific variation in 31 isolates (31.3%). The interval between lesion onset and first medical visit at INI/Fiocruz, as well as treatment duration until clinical cure, was longer in cats from the first decade of the epizootic. In addition, the frequency of the variables "good general status" and "presence of lymphadenomegaly" was higher among cats whose strains did not exhibit intraspecific variation. So far, S. brasiliensis has been the only species identified in feline cases of sporotrichosis since the beginning of the epizootic in Rio de Janeiro at INI/Fiocruz.

Searching for plant-derived antivirals against dengue virus and Zika virus.

BACKGROUND: The worldwide epidemics of diseases as dengue and Zika have triggered an intense effort to repurpose drugs and search for novel antivirals to treat patients as no approved drugs for these diseases are currently available. Our aim was to screen plant-derived extracts to identify and isolate compounds with antiviral properties against dengue virus (DENV) and Zika virus (ZIKV). METHODS: Seven thousand plant extracts were screened in vitro for their antiviral properties against DENV-2 and ZIKV by their viral cytopathic effect reduction followed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method, previously validated for this purpose. Selected extracts were submitted to bioactivity-guided fractionation using high- and ultrahigh-pressure liquid chromatography. In parallel, high-resolution mass spectrometric data (MSn) were collected from each fraction, allowing compounds into the active fractions to be tracked in subsequent fractionation procedures. The virucidal activity of extracts and compounds was assessed by using the plaque reduction assay. EC50 and CC50 were determined by dose response experiments, and the ratio (EC50/CC50) was used as a selectivity index (SI) to measure the antiviral vs. cytotoxic activity. Purified compounds were used in nuclear magnetic resonance spectroscopy to identify their chemical structures. Two compounds were associated in different proportions and submitted to bioassays against both viruses to investigate possible synergy. In silico prediction of the pharmacokinetic and toxicity (ADMET) properties of the antiviral compounds were calculated using the pkCSM platform. RESULTS: We detected antiviral activity against DENV-2 and ZIKV in 21 extracts obtained from 15 plant species. Hippeastrum (Amaryllidaceae) was the most represented genus, affording seven active extracts. Bioactivity-guided fractionation of several extracts led to the purification of lycorine, pretazettine, narciclasine, and narciclasine-4-O-ß-D-xylopyranoside (NXP). Another 16 compounds were identified in active fractions. Association of lycorine and pretazettine did not improve their antiviral activity against DENV-2 and neither to ZIKV. ADMET prediction suggested that these four compounds may have a good metabolism and no mutagenic toxicity. Predicted oral absorption, distribution, and excretion parameters of lycorine and pretazettine indicate them as candidates to be tested in animal models. CONCLUSIONS: Our results showed that plant extracts, especially those from the Hippeastrum genus, can be a valuable source of antiviral compounds against ZIKV and DENV-2. The majority of compounds identified have never been previously described for their activity against ZIKV and other viruses.

Visitas domiciliares e diagramação familiar na Atenção Primária à Saúde: reflexões de estudantes participantes do PET-Saúde Interprofissionalidade / Home visits and family diagramming in Primary Health Care: reflections of students participating in PET-Health Interprofessionality

Objetivo: Descrever as reflexões de graduandos participantes do Programa de Educação pelo Trabalho (PET) sobre a experiência de inserção na Atenção Primária em Saúde por meio da realização de visitas domiciliares e diagramação familiar. Método: Pesquisa descritiva com abordagem qualitativa, desenvolvida em município do interior do estado de Mato Grosso, que teve por população estudantes de cursos de graduação em Saúde participantes do PET-Interprofissionalidade. Resultados: Participaram da pesquisa oito estudantes distribuídos entre os cursos de Biomedicina, Educação Física, Enfermagem e Farmácia com idade entre 19 e 34 anos, a maioria do sexo feminino. A partir da análise dos achados surgiram três categorias: percepções sobre as visitas domiciliares, reflexões sobre a diagramação familiar para o trabalho na atenção primária em saúde e aprendizagem compartilhada e trabalho em equipe. Considerações finais: O desenvolvimento das atividades demostrou positivos resultados frente à imersão na comunidade e no trabalho em equipe, consistiu em incentivo para a formação de profissionais mais humanizados e qualificados.

Objective: To describe the reflections of undergraduate students participating in the Work Education Program (PET) on the experience of insertion in Primary Health Care through home visits and family diagramming. Method: Descriptive research with a qualitative approach, developed in a municipality in the interior of the state of Mato Grosso, which had as population students of undergraduate Health courses participating in PET- Interprofessionality. Results: Eight students distributed among Biomedicine, Physical Education, Nursing and Pharmacy courses participated in the research, aged between 19 and 34 years, most females. From the analysis of the findings three categories emerged: perceptions about home visits, reflections on family diagramming for work in primary health care and shared learning and teamwork. Final considerations: The development of the activities showed positive results in the face of immersion in the community and teamwork, consisted of incentive for the training of more humanized and qualified professionals.

Social conditions and immune response in human immunodeficiency virus-seropositive pregnant women: a cross-sectional study in Brazil.

INTRODUCTION: The functioning of the immune system during pregnancy is altered in both human immunodeficiency virus (HIV)-infected and uninfected women. Unfavorable socioeconomic conditions have been indicative of higher morbidity and mortality and worsening of the immune system. The aim of this study was to correlate social status with levels of interleukin (IL)-10 (non-inflammatory) and interferon-gamma (IFN-γ; inflammatory) cytokines. METHODS: A cross-sectional study was conducted with three groups of women: 33 pregnant HIV-infected (G1); 40 non-pregnant, HIV-infected (G2); and 35 pregnant, HIV-uninfected. To measure the social status, a compound indicator called the social status index (SSI), was established using sociodemographic variables (i.e., education level, housing conditions, per capita income, and habitation and sanitary conditions). RESULTS: The HIV-infected women had a higher proportion of unfavorable SSI (73% and 75% of G1 and G2, respectively). There were significantly lower IL-10 levels in the G1 group with both unfavorable and favorable SSI than in the other groups. No significant difference in IFN-γ levels was observed among groups. However, the G1 group had higher IFN-γ values among both favorable and unfavorable SSI groups. CONCLUSIONS: Higher rates of unfavorable conditions, including lower education levels, IL-10 levels, and a trend for higher IFN-γ levels, were identified among HIV-infected women, pregnant and non-pregnant. These factors may interfere in health care and lead to poor outcomes during pregnancy. Therefore, we suggest that health policies could be created to specifically address these factors in this population.

Feline sporotrichosis: associations between clinical-epidemiological profiles and phenotypic-genotypic characteristics of the etiological agents in the Rio de Janeiro epizootic area

BACKGROUND Sporotrichosis is caused by species of the genus Sporothrix. From 1998 to 2015, 4,703 cats were diagnosed at the Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil. Even after the description of the Sporothrix species, the characterisation of feline isolates is not performed routinely. OBJECTIVES To characterise the clinical isolates from cats at the species level and correlate them with the clinical and epidemiological characteristics of the cats. METHODS Forty seven Sporothrix spp. isolates from cats assisted at Fiocruz from 2010 to 2011 were included. Medical records were consulted to obtain the clinical and epidemiological data. The isolates were identified through their morphological and physiological characteristics. T3B polymerase chain reaction (PCR) fingerprinting was used for molecular identification of the species. FINDINGS In phenotypic tests, 34 isolates were characterised as S. brasiliensis, one as S. schenckii and 12 as Sporothrix spp. PCR identified all isolates as S. brasiliensis. MAIN CONCLUSIONS S. brasiliensis is the only etiological agent of feline sporotrichosis in Rio de Janeiro to date. None association was found between the isolates and the clinical and epidemiological data. In addition, we strongly recommend the use of molecular techniques for the identification of isolates of Sporothrix spp.

Feline sporotrichosis: associations between clinical-epidemiological profiles and phenotypic-genotypic characteristics of the etiological agents in the Rio de Janeiro epizootic area.

BACKGROUND: Sporotrichosis is caused by species of the genus Sporothrix. From 1998 to 2015, 4,703 cats were diagnosed at the Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil. Even after the description of the Sporothrix species, the characterisation of feline isolates is not performed routinely. OBJECTIVES: To characterise the clinical isolates from cats at the species level and correlate them with the clinical and epidemiological characteristics of the cats. METHODS: Forty seven Sporothrix spp. isolates from cats assisted at Fiocruz from 2010 to 2011 were included. Medical records were consulted to obtain the clinical and epidemiological data. The isolates were identified through their morphological and physiological characteristics. T3B polymerase chain reaction (PCR) fingerprinting was used for molecular identification of the species. FINDINGS: In phenotypic tests, 34 isolates were characterised as S. brasiliensis, one as S. schenckii and 12 as Sporothrix spp. PCR identified all isolates as S. brasiliensis. MAIN CONCLUSIONS: S. brasiliensis is the only etiological agent of feline sporotrichosis in Rio de Janeiro to date. None association was found between the isolates and the clinical and epidemiological data. In addition, we strongly recommend the use of molecular techniques for the identification of isolates of Sporothrix spp.

Social conditions and immune response in human immunodeficiency virus-seropositive pregnant women: a cross-sectional study in Brazil

Abstract INTRODUCTION The functioning of the immune system during pregnancy is altered in both human immunodeficiency virus (HIV)-infected and uninfected women. Unfavorable socioeconomic conditions have been indicative of higher morbidity and mortality and worsening of the immune system. The aim of this study was to correlate social status with levels of interleukin (IL)-10 (non-inflammatory) and interferon-gamma (IFN-γ; inflammatory) cytokines. METHODS A cross-sectional study was conducted with three groups of women: 33 pregnant HIV-infected (G1); 40 non-pregnant, HIV-infected (G2); and 35 pregnant, HIV-uninfected. To measure the social status, a compound indicator called the social status index (SSI), was established using sociodemographic variables (i.e., education level, housing conditions, per capita income, and habitation and sanitary conditions). RESULTS The HIV-infected women had a higher proportion of unfavorable SSI (73% and 75% of G1 and G2, respectively). There were significantly lower IL-10 levels in the G1 group with both unfavorable and favorable SSI than in the other groups. No significant difference in IFN-γ levels was observed among groups. However, the G1 group had higher IFN-γ values among both favorable and unfavorable SSI groups. CONCLUSIONS Higher rates of unfavorable conditions, including lower education levels, IL-10 levels, and a trend for higher IFN-γ levels, were identified among HIV-infected women, pregnant and non-pregnant. These factors may interfere in health care and lead to poor outcomes during pregnancy. Therefore, we suggest that health policies could be created to specifically address these factors in this population.

Successful Treatment of Canine Sporotrichosis with Terbinafine: Case Reports and Literature Review.

Sporotrichosis occurs worldwide, and the metropolitan region of Rio de Janeiro, Brazil, is a main endemic area, with a large number of human and animal cases in the last 19 years. This mycosis is more frequently described in cats rather than in dogs. There are a limited number of oral antifungal agents for the treatment of sporotrichosis in animals. In this context, the effectiveness of terbinafine in the treatment of sporotrichosis in humans, as well as the promising results of in vitro susceptibility tests, inspired us to use this drug in the therapy of this mycosis in dogs. We reported for the first time the use of terbinafine in the treatment of two dogs with sporotrichosis caused by Sporothrix brasiliensis. Moreover, we provided an overview of therapeutic features of canine sporotrichosis cases reported since the 1960s. One of the dogs presented the fixed cutaneous form of the disease, while the other patient presented hyperemia of the nasal mucosa and respiratory signs only. Terbinafine showed high antifungal activity in vitro against the canine Sporothrix isolates. The dogs were successfully treated with terbinafine, with remission of all clinical signs initially presented. The current reports indicate that this drug can emerge as a therapeutic option for canine sporotrichosis.

Land use, land cover, and prevalence of canine visceral leishmaniasis in Teresina, Piauí State, Brazil: an approach using orbital remote sensing. / Uso e cobertura do solo e prevalência de leishmaniose visceral canina em Teresina, Piauí, Brasil: uma abordagem utilizando sensoriamento remoto orbital.

This study examines the association between land use and land cover and the occurrence of canine visceral leishmaniasis (VL). This is a case-control study in which cases were households with seropositive dogs for canine VL and controls were households with seronegative dogs. We used remote sensing images (CBERS: 2/CCD and 2B/HRC) to describe land use and cover in squares of 625m2 in the study area. Odds of canine VL were twice as high in households located in squares with an area ≤ 25m2 covered by residential structures with little vegetation in comparison to those where the cover reached ≥ 600m2. Households located in squares with up to half of the area covered by residential structures with extensive vegetation showed 65% lower odds of canine VL in comparison to those situated in areas almost totally covered by this characteristic. Since canine infection usually precedes the occurrence de human cases, identification of the characteristics of land use and cover associated with canine VL can contribute to the demarcation of risk areas for human VL.

Este estudo examina a associação entre uso e cobertura do solo e a ocorrência de leishmaniose visceral (LV) canina. Estudo caso-controle em que casos foram residências com cães soropositivos para LV canina e controles, as residências com cães soronegativos. Utilizaram-se imagens de sensoriamento remoto (CBERS: 2/CCD e 2B/HRC) para descrever o uso e cobertura do solo em quadrículas de 625m2 na região do estudo. A chance da LV canina foi duas vezes maior em domicílios localizados em quadrículas com área ≤ 25m2 coberta por estruturas residenciais com pouca vegetação em comparação com aquelas em que essa cobertura alcançou ≥ 600m2. Domicílios localizados em quadrículas com até metade da área coberta por estruturas residenciais com muita vegetação tiveram chances 65% menores de LV canina em comparação com aquelas situadas em áreas quase totalmente cobertas por essa característica. Como a infecção canina costuma preceder a ocorrência de casos humanos, a identificação de características de uso e cobertura do solo associadas à LV canina pode contribuir para a delimitação de áreas de risco para LV humana.

Este estudio examina la asociación entre uso y cobertura del suelo y la ocurrencia de leishmaniosis visceral (LV) canina. Es un estudio de caso-control, donde los casos fueron analizados en residencias con perros seropositivos para LV canina y controles, además de residencias con perros seronegativos. Se utilizaron imágenes de teledetección (CBERS: 2/CCD e 2B/HRC) para describir el uso y cobertura del suelo en cuadrículas de 625m2 en la región del estudio. La oportunidad de la LV canina fue dos veces mayor en domicilios localizados en cuadrículas con un área ≤ 25m2, cubierta por estructuras residenciales con poca vegetación, en comparación con aquellas donde esa cobertura alcanzó ≥ 600m2. Los domicilios localizados en cuadrículas con hasta la mitad del área cubierta por estructuras residenciales con mucha vegetación tuvieron oportunidades un 65% menores de LV canina, en comparación con aquellas situadas en áreas casi totalmente cubiertas por esa característica. Como la infección canina acostumbra preceder la ocurrencia de casos humanos, la identificación de las características de uso y cobertura del suelo, asociadas a la LV canina, puede contribuir a la delimitación de áreas de riesgo para LV humana.

Uso e cobertura do solo e prevalência de leishmaniose visceral canina em Teresina, Piauí, Brasil: uma abordagem utilizando sensoriamento remoto orbital / Uso y cobertura del suelo y prevalencia de leishmaniosis visceral canina en Teresina, Piauí, Brasil: un enfoque utilizando teledetección / Land use, land cover, and prevalence of canine visceral leishmaniasis in Teresina, Piauí State, Brazil: an approach using orbital remote sensing

Resumo: Este estudo examina a associação entre uso e cobertura do solo e a ocorrência de leishmaniose visceral (LV) canina. Estudo caso-controle em que casos foram residências com cães soropositivos para LV canina e controles, as residências com cães soronegativos. Utilizaram-se imagens de sensoriamento remoto (CBERS: 2/CCD e 2B/HRC) para descrever o uso e cobertura do solo em quadrículas de 625m2 na região do estudo. A chance da LV canina foi duas vezes maior em domicílios localizados em quadrículas com área ≤ 25m2 coberta por estruturas residenciais com pouca vegetação em comparação com aquelas em que essa cobertura alcançou ≥ 600m2. Domicílios localizados em quadrículas com até metade da área coberta por estruturas residenciais com muita vegetação tiveram chances 65% menores de LV canina em comparação com aquelas situadas em áreas quase totalmente cobertas por essa característica. Como a infecção canina costuma preceder a ocorrência de casos humanos, a identificação de características de uso e cobertura do solo associadas à LV canina pode contribuir para a delimitação de áreas de risco para LV humana.

Resumen: Este estudio examina la asociación entre uso y cobertura del suelo y la ocurrencia de leishmaniosis visceral (LV) canina. Es un estudio de caso-control, donde los casos fueron analizados en residencias con perros seropositivos para LV canina y controles, además de residencias con perros seronegativos. Se utilizaron imágenes de teledetección (CBERS: 2/CCD e 2B/HRC) para describir el uso y cobertura del suelo en cuadrículas de 625m2 en la región del estudio. La oportunidad de la LV canina fue dos veces mayor en domicilios localizados en cuadrículas con un área ≤ 25m2, cubierta por estructuras residenciales con poca vegetación, en comparación con aquellas donde esa cobertura alcanzó ≥ 600m2. Los domicilios localizados en cuadrículas con hasta la mitad del área cubierta por estructuras residenciales con mucha vegetación tuvieron oportunidades un 65% menores de LV canina, en comparación con aquellas situadas en áreas casi totalmente cubiertas por esa característica. Como la infección canina acostumbra preceder la ocurrencia de casos humanos, la identificación de las características de uso y cobertura del suelo, asociadas a la LV canina, puede contribuir a la delimitación de áreas de riesgo para LV humana.

Abstract: This study examines the association between land use and land cover and the occurrence of canine visceral leishmaniasis (VL). This is a case-control study in which cases were households with seropositive dogs for canine VL and controls were households with seronegative dogs. We used remote sensing images (CBERS: 2/CCD and 2B/HRC) to describe land use and cover in squares of 625m2 in the study area. Odds of canine VL were twice as high in households located in squares with an area ≤ 25m2 covered by residential structures with little vegetation in comparison to those where the cover reached ≥ 600m2. Households located in squares with up to half of the area covered by residential structures with extensive vegetation showed 65% lower odds of canine VL in comparison to those situated in areas almost totally covered by this characteristic. Since canine infection usually precedes the occurrence de human cases, identification of the characteristics of land use and cover associated with canine VL can contribute to the demarcation of risk areas for human VL.

Evaluation of serum levels of IL-9 and IL-17 in human Schistosoma mansoni infection and their relationship with periportal fibrosis.

Serum levels of IL-9 and IL-17 cytokines were evaluated in patients in the acute, chronic phases and clinical forms of human schistosomiasis and in different classifications of periportal fibrosis. No significant differences between the groups of the disease with serum levels of cytokine were found. However, this study discusses the results of some cytokines that have not fully defined roles in the pathology of human schistosomiasis. Furthermore, an examination was made of subjects in the acute phase. This is an important group that is difficult to identify in areas where the disease is endemic. More studies are being undertaken to study the role of IL-9 and IL-17 in human Schistosoma mansoni infection and their relationship with the immunopathogenesis of disease.

Neurocutaneous Disorders for the Practicing Neurologist: a Focused Review.

The neurocutaneous disorders (NCDs) embrace an extensive group of developmental disorders associated with involvement of the skin, central nervous system (CNS), and/or the peripheral nervous system (PNS). The neurocutaneous manifestations relate to the common ectodermal origin of these organs. This review intended for the practicing clinical neurologist focuses on selected aspects of the NCDs primarily those associated with cerebrovascular disease. Our emphasis is primarily on those NCDs with genetic heterogeneity and their neurological manifestations.

Molecular profiling of drug resistant isolates ofMycobacterium tuberculosis in the state of Santa Catarina, southern Brazil

Drug resistance is a global threat and one of the main contributing factors to tuberculosis (TB) outbreaks. The goal of this study was to analyse the molecular profile of multidrug-resistant TB (MDR-TB) in the state of Santa Catarina in southern Brazil. Fifty-three MDR Mycobacterium tuberculosisclinical isolates were analysed by spoligotyping and a partial region of therpoB gene, which is associated with rifampicin resistance (RMP-R), was sequenced. Some isolates were also distinguished by their mycobacterial interspersed repetitive units (MIRU). S531L was the most prevalent mutation found within rpoBin RMP-R isolates (58.5%), followed by S531W (20.8%). Only two MDR isolates showed no mutations withinrpoB. Isolates of the Latin American Mediterranean (LAM) family were the most prevalent (45.3%) found by spoligotyping, followed by Haarlem (9.4%) and T (7.5%) families. SIT106 was found in 26.4% of isolates and all SIT106 isolates typed by MIRU-12 (5 out of 14) belong to MIT251. There was a high correlation between the S531W mutation and the LAM family mainly because all SIT2263 (LAM9) isolates carry this mutation. Among isolates with the S531W mutation in rpoB MIRU demonstrates a cluster formed by four isolates (SIT2263 and MIT163) and very similar profiles were observed between eight of the nine isolates. Better characterisation of TB isolates may lead to new ways in which to control and treat TB in this region of Brazil.

Molecular profiling of drug resistant isolates of Mycobacterium tuberculosis in the state of Santa Catarina, southern Brazil.

Drug resistance is a global threat and one of the main contributing factors to tuberculosis (TB) outbreaks. The goal of this study was to analyse the molecular profile of multidrug-resistant TB (MDR-TB) in the state of Santa Catarina in southern Brazil. Fifty-three MDR Mycobacterium tuberculosis clinical isolates were analysed by spoligotyping and a partial region of the rpoB gene, which is associated with rifampicin resistance (RMP-R), was sequenced. Some isolates were also distinguished by their mycobacterial interspersed repetitive units (MIRU). S531L was the most prevalent mutation found within rpoB in RMP-R isolates (58.5%), followed by S531W (20.8%). Only two MDR isolates showed no mutations within rpoB. Isolates of the Latin American Mediterranean (LAM) family were the most prevalent (45.3%) found by spoligotyping, followed by Haarlem (9.4%) and T (7.5%) families. SIT106 was found in 26.4% of isolates and all SIT106 isolates typed by MIRU-12 (5 out of 14) belong to MIT251. There was a high correlation between the S531W mutation and the LAM family mainly because all SIT2263 (LAM9) isolates carry this mutation. Among isolates with the S531W mutation in rpoB MIRU demonstrates a cluster formed by four isolates (SIT2263 and MIT163) and very similar profiles were observed between eight of the nine isolates. Better characterisation of TB isolates may lead to new ways in which to control and treat TB in this region of Brazil.

RAP1 GTPase overexpression is associated with cervical intraepithelial neoplasia.

RAP1 (RAS proximate 1), a small GTP-binding protein of the RAS superfamily, is a putative oncogene that is highly expressed in several malignant cell lines and types of cancers, including some types of squamous cell carcinoma. However, the participation of RAP1 in cervical carcinogenesis is unknown. We conducted a cross-sectional study of paraffin-embedded cervical biopsies to determine the association of RAP1 with cervical intraepithelial neoplasia (CIN). Standard and quantitative immunohistochemistry assessment of RAP1 expression in fixed tissue was performed on 183 paraffin-embedded cervical biopsies that were classified as normal or non-dysplastic mucosa (NDM) (n = 33); CIN grade 1 (n = 84) and CIN grade 2/3 (n = 66). A gradual increase in RAP1 expression in NDM < CIN 1 < CIN 2/3 (p<0.001) specimens was observed and was in agreement with the histopathologic diagnosis. A progressive increase in the RAP1 expression levels increased the risk of CIN 1 [odds ratio (OR) = 3.50; 95% confidence interval (CI) 1.30-10.64] 3.5 fold and the risk of CIN 2/3 (OR = 19.86, 95% CI 6.40-70.79) nearly 20 fold when compared to NDM. In addition, stereotype ordinal regression analysis showed that this progressive increase in RAP1 expression more strongly impacted CIN 2/3 than CIN 1. Our findings suggest that RAP1 may be a useful biomarker for the diagnosis of CIN.

Feline sporotrichosis: epidemiological and clinical aspects.

Feline sporotrichosis, which is caused by species of the Sporothrix schenckii complex, is endemic to Rio de Janeiro, Brazil. More than 4000 cases of the disease were diagnosed at Fundação Oswaldo Cruz, Brazil, between 1998 and 2012. Sporotrichosis in cats has been reported in several countries, but nowhere has an outbreak of animal sporotrichosis been as large as that seen in Brazil. The clinical manifestations of the disease range from an isolated skin lesion that can progress to multiple skin lesions and even fatal systemic involvement. Nodules and ulcers are the most common types of lesions, and respiratory signs and mucosa involvement are frequent. The definitive diagnosis depends on isolation of the etiologic agent in culture. Cytology, histopathology, and serology are useful tools for preliminary diagnosis. Severe pyogranulomatous inflammatory infiltrate, high fungal load, and extension of lesions to mucosa, cartilage, and bone in the nose of cats are indicative of an agent of high virulence in this endemic region. Itraconazole is the drug of choice, while, in refractory cases, amphotericin B or potassium iodide might be alternative treatments; however, recurrence after discharge may occur. Sporotrichosis persists as a neglected disease in Rio de Janeiro, and the treatment of cats remains a challenging and long-term endeavor.