Prevalência e distribuição espacial da ocorrência de helmintos em primatas não humanos de vida livre no estado do Rio de Janeiro, Brasil / [Prevalence and spatial distribution of the occurrence of helminths in free-living nonhuman primates in the State of Rio de Janeiro, Brazil]

Seiscentos primatas neotropicais foram submetidos a exames post mortem para avaliação da prevalência parasitária de helmintos gastrointestinais. Foram examinados 556 calitriquídeos (Callithrix spp.), 23 bugios (Alouatta guariba), 19 macacos-pregos (Sapajus nigritus), um mico-leão-dourado (Leontopithecus rosalia) e um mico-leão-da-cara-dourada (Leontopithecus chrysomelas). Do total de 600 animais, foram encontrados espécimes parasitos pertencentes aos filos Acanthocephala, Nemathelmintes e Platyhelminthes (classes Trematoda e Cestoda) em 110 primatas. A prevalência de primatas positivos para, pelo menos, uma espécie de helminto foi de 18,3% (110/600), sendo destes 83,6% (92/110) calitriquídeos, 8,2% (9/110) bugios, 6,4% (7/110) macacos-pregos, 0,9% (1/110) mico-leão-dourado e 0,9% (1/110) mico-leão-da-cara dourada. Em 80,4% (74/92) dos calitriquídeos foram encontrados nematoides Primasubulura sp. e em 1,1% (1/92) nematoides Trypanoxyuris callithrix, em 26,1% (24/92) acantocéfalos (Pachysentis sp.) e em 5,4% (5/92) digenéticos (Platynosomum sp.); em 77,8% (7/9) dos bugios foram encontrados nematoides (Trypanoxyuris minutus), em 11,1% (1/9) acantocéfalos (Pachysentis sp.) e em 11,1% (1/9) cestoides (Bertiella sp.); em 14,3% (1/7) dos macacos-pregos foram encontrados nematoides (Physaloptera sp.), em 28,6% (2/7) acantocéfalos (Prostenorchis sp.) e em 14,3% (1/7) digenéticos (Platynosomum sp.) e no mico-leão-da-cara-dourada foram encontrados acantocéfalos (Prostenorchis sp.). Foi realizado o georreferenciamento dos pontos de encontro dos cadáveres para pontuar a distribuição dos helmintos por região.(AU)

Six hundred neotropical primates underwent postmortem examinations to evaluate the parasitic prevalence of gastrointestinal helminths. Fifty-five callitrichids tamarins (Callithrix spp.), 23 howlers (Alouatta guariba), 19 nail monkeys (Sapajus nigritus), a golden lion tamarin (Leontopithecus rosalia) and a golden-faced lion tamarin (Leontopithecus chrysomelas) were examined. Parasitic specimens belonging to phylums Acantocephala, Nemathelmintes and Platyhelmintes (Trematoda and Cestoda Classes) were found. The prevalence of primates positive for at least one species of helminth was 18.3% (110/600), of which 83.6% (92/110) callitrichids, 8.2% (9/110) howler monkeys, 6.4% (7/110) capuchin monkeys, 0.9% (1/110) golden lion tamarin and 0.9% (1/110) golden faced lion tamarin. In 80.4% (74/92) of callitrichids nematodes (Primasubulura sp.) were found, and in 1.1% (1/92) nematodes (Trypanoxyuris callithricis), in 26.1% (24/92) acanthocephalus (Pachysentis sp.) and 5.4% (5/92) digenetics (Platynosomum sp.); in 77.8% (7/9) of howler monkeys presented nematodes (Trypanoxyuris minutus), 11.1% (1/9) acanthocephalus (Pachysentis sp.) and 11.1% (1/9) cestoids (Bertiella sp.); in 14.3% (1/7) of capuchin monkeys presented nematodes (Physaloptera sp.), 28.6% (2/7) acanthocephalus (Prostenorchis sp.) and 14.3% (1/7) digenetics (Platynosomum sp.) and in the golden-faced lion tamarin acanthocephalus (Prostenorchis sp.) were found. Georreferencing of the meeting points of the cadavers was performed in order to punctuate the distribution of helminths by region.(AU)

Ureteral clipping for the treatment of a non-functioning upper kidney moiety associated with a massive ureterocele: step-by-step description of a novel technique.

OBJECTIVE: The objective of this video is to illustrate feasibility of the ureteral ligation for the treatment of massive ureteroceles associated with non-functioning upper kidney moieties in duplex kidneys. MATERIALS AND METHODS: In this video, one case is presented to demonstrate this novel technique. A nine-year-old boy presented with progressive lower urinary tract symptoms. Radiological workup depicted a duplex kidney on the left side with the absence of function on the upper pole and hydroureteronephrosis with a massive ureterocele. Laparoscopic ureteral transection, drainage, and ligation of both extremities of the enlarged ureter (upper pole ureter) were performed. RESULTS: Immediately after ureteral ligation, ultrasonic evidence of ureterocele decompression and improved hydroureteronephrosis was observed. This patient remained asymptomatic without postoperative complications after 3 years. De novo reflux was not observed. CONCLUSION: Ureteral ligation, as demonstrated in the video, is a good approach for the treatment of massive ureteroceles associated with non-functioning upper kidney moieties in duplex kidneys. Compared with the current standard techniques (incision/puncture), ureteral ligation has the clear advantage of not causing 'de novo reflux' or unsuccessful de-obstruction, and is not as surgically demanding as other reconstructive/ablative techniques. The disadvantage is the need of regular clinical and ultrasonographic follow-up.

Revictimization of violence suffered by those diagnosed with alcohol dependence in the general population.

OBJECTIVE: To verify the association between violence and alcohol dependence syndrome in sample populations. METHOD: Population-wide survey with multistage probabilistic sample. 3,744 individuals of both genders, aged from 15 to 75 years, were interviewed from the cities of São Paulo and Rio de Janeiro using the Composite International Diagnostic Interview (CIDI 2.1). RESULTS: In both cities, alcohol dependence was associated with the male gender, having suffered violence related to criminality, and having suffered familial violence. In both cities, urban violence, in more than 50% of cases, and familial violence, in more than 90% of cases, preceded alcohol dependence. The reoccurrence of traumatic events occurred in more than half of individuals dependent on alcohol. In São Paulo, having been diagnosed with PTSD is associated with violence revictimization (P = 0.014; Odds = 3.33). CONCLUSION: Alcohol dependence syndrome is complexly related to urban and familial violence in the general population. Violence frequently precedes alcoholism, but this relationship is dependent on residence and traumatic events. This vicious cycle contributes to perpetuating the high rates of alcoholism and violence in the cities. Politicians ordering the reduction of violence in the large metropolises can, potentially, reduce alcoholism and contribute to the break of this cycle.

Immunohistochemical identification of Toxoplasma gondii in tissues from Modified Agglutination Test positive sheep.

Toxoplasma gondii is a zoonotic agent of great importance in veterinary and public health. The aim of this study was to identify T. gondii by IHC (immunohistochemistry) in different sheep tissues and to determine if an association exists between the results obtained by this method and those obtained by the Modified Agglutination Test (MAT). Tissue specimens of twenty-six sheep seroreactive for T. gondii were selected for histopathological evaluation. The presence of T. gondii was investigated in brain, liver and heart samples by IHC and a possible anti-T. gondii antibody cross reactions with other parasites. McNemar's, Chi-square and Fisher's Exact Tests were applied for the statistical analysis of the results. The analysed tissues showed at least one of the following histopathological changes: mild-to-moderate congestion, focal polymorphonuclear inflammatory infiltrate and multifocal or focal mononuclear inflammatory infiltrate. Sarcocystis spp. were identified in the histological sections from both the heart and diaphragm tissues of 88.5% (23/26) of the animals. A total of 46.2% (12/26) of the T. gondii seroreactive sheep was also positive for T. gondii by IHC in at least one organ (brain, liver or heart). The liver IHC-positivity for T. gondii was statistically equivalent to the global individual IHC-positivity, according to McNemar's test. In addition, IHC allowed the detection of T. gondii in infected animals regardless of the titration observed in the MAT. The statistical difference observed between the three organs when comparing the low titration group, suggested that the heart might be the most suitable organ to detect T. gondii infection by IHC. The IHC results in this study revealed that almost half of MAT positive animals could serve as potential sources of infection for humans because bradyzoites were identified in different tissues, regardless of the MAT titration.

Lymphatic vessel density and expressions of lymphangiogenic growth factors in salivary carcinomas.

Nodal metastasis is an important prognostic indicator in head and neck cancers, including salivary carcinomas. In these, the risk for lymph node metastasis is variable and strongly associated with the tumor histologic type. The aim of the current study was to evaluate the lymphatic vessel density (LVD) and expressions of lymphangiogenic growth factors by tumor cells in different histologic types of salivary carcinomas subdivided according to the risk for nodal metastasis. In 15 high-risk (undifferentiated, high-grade mucoepidermoid and salivary duct carcinomas) and 60 low/moderate-risk tumors (adenoid cystic, low/intermediate-grade mucoepidermoid, acinic cell, myoepithelial, epithelial-myoepithelial and polymorphic low-grade carcinomas) the expressions of vascular endothelial growth factor-C (VEGF-C), hepatocyte growth factor (HGF) and D2-40 (for assessing LVD) were examined. No significant differences were encountered between high- and low/moderate/-risk carcinomas regarding LVD and VEGF-C or HGF expressions. Furthermore, the expression of these proteins did not correlate with LVD. Lymphatic vascular invasion was found mainly in high-risk carcinomas. Intratumoral LVD was significantly lower than peritumoral, regardless of the risk for metastasis and primary site of the lesion. The histologic types of salivary carcinomas which are associated with high-risk for nodal metastasis do not present increased LVD or VEGF-C and HGF expressions. The greater tendency for metastasis in these carcinomas seems to be related to their capacity to invade lymph vessels. Further studies on tumor cell interactions with lymphatic endothelial cells are needed to improve our understanding of the metastatic potential of salivary carcinomas.

Mycological evaluation of bronchoalveolar lavage in cats with respiratory signs from Rio de Janeiro, Brazil.

Twenty-three cats with respiratory signs who had domiciliary contact with cats with sporotrichosis were studied. Sneezing was the predominant extracutaneous sign. Twelve cats had no skin lesions and 11 had ulcerated skin lesions. Mycological culture of material obtained from the nasal cavity, oral cavity, bronchoalveolar lavage (BAL) and skin lesions, when present, was performed for all cats. In the case of autopsy, lung fragments were cultured. Sporothrix schenckii was isolated from four of the 12 cats without skin lesions: BAL (one cat) and oral and/or nasal cavity (three cats). The latter three animals developed nasal and distant skin lesions within the following 2-4 weeks. The cat with S. schenckii isolated from BAL did not develop skin lesions or lower respiratory tract symptoms during the 6 months of follow-up. S. schenckii was isolated from one or more biological samples of all 11 cats with skin lesions: oral cavity (five), nasal cavity (eight), BAL fluid (four), skin lesions (eight), and blood culture (one). No yeast-like structures were observed upon BAL cytology in any of the 23 cats. The results suggest that S. schenckii can cause infection of skin contiguous to the natural facial orifices through colonisation of the mucosal surfaces of the upper airways.

A randomized controlled trial comparing moclobemide and moclobemide plus interpersonal psychotherapy in the treatment of dysthymic disorder.

The authors compared the outcomes of 35 outpatients with dysthymic disorder randomized to receive either treatment with moclobemide and interpersonal therapy (IPT) or moclobemide and routine clinical management. Diagnosis was based on the ICD-10 symptom checklist. Patients were evaluated by trained raters using the 17-item Hamilton Rating Scale for Depression (Ham-D), Montgomery-Asberg Depression Rating Scale (MADRS), Global Assessment of Functioning, and Quality of Life and Satisfaction Questionnaire at baseline, 12, 24, and 48 weeks. Patients in both treatment groups showed statistically significant improvement in all measures across time. There was a nonsignificant trend toward lower scores on Ham-D and MADRS for patients in the moclobemide plus IPT group. Longer, better-powered trials should be carried out to study the efficacy of IPT plus antidepressant medication in the treatment of dysthymic disorder.

[Suicide and its psychopathological relations: a qualitative analysis of 6 cases of rational suicide]. / O suicídio e suas relações com a psicopatologia: análise qualitativa de seis casos de suicídio racional.

UNLABELLED: We studied the meaning given to the terms "death" and "suicide" among psychiatric inpatients. Forty-four patients who had been admitted in a psychiatric inpatient unit following a suicide attempt underwent a qualitative interview, using a "general guide interview" approach. The results were analyzed systematically to investigate the relationship between attempted suicide and mental disorder. In 6 cases there was no correlation between the attempted suicide and psychopathological symptoms. One of these patients had a psychiatric diagnosis, but this did not seem to be related to the suicide attempt. All of them made a rational a deliberate suicidal act. CONCLUSION: even in a psychiatric inpatient setting, suicide attempts are not always a behavioural expression of underlying psychopathological disturbances - individual and social factors also play a decisive role.

Mirtazapine effectiveness in a patient with refractory psychotic depression.

The author describes a patient with recurrent depression, according to DSM-IV diagnostic criteria. The features were of a delusional depressive episode lasting 5 years, associated with severe impairment of psychosocial functioning. The patient also had chronic hepatitis, of unknown aetiology, and portal hypertension with some high gastrointestinal bleeding episodes. The depressive episode had been treated unsuccessfully with therapeutic doses of imipramine and lithium augmentation associated with haloperidol and, afterwards, with risperidone. Mirtazapine was introduced, coadministered with haloperidol and after 8 weeks there was an improvement in delusional depressive and other negative symptoms. The patient remained well for 9 months. This case indicates that mirtazapine is an option for patients with psychotic depression who are refractive to tricyclic antidepressants. Mirtazapine is also a safe drug, well tolerated in this severe clinical condition.