Neurocysticercosis in Ceará State, northeastern Brazil: a review of 119 cases.

Relatively little is known about the occurrence of neurocysticercosis in northeastern Brazil. There have been no published reports from the state of Ceará, but a review of the records at the Hospital São José in Fortaleza, Brazil identified 119 patients with neurocysticercosis diagnosed between January 1988 and April 1994. Patients came from 43 municipalities in Ceará. Their ages ranged from five to 74 years; the greatest number of cases were in persons 10-40 years of age; 63% were males. Seizures were the presenting complaint in 64% of the patients and headache in 22%. Two patients, each with several hundred intracranial lesions, presented with mental status changes; one was initially given the clinical diagnosis of viral meningoencephalitis. Computed tomography scans showed that 44% of the patients had five or more lesions. Cysts were found throughout the brain. The parietal lobe was the most frequent site of involvement; 85% of patients had one or more lesions there. The brain stem was involved in 8%. There was no consistent association between the severity of the clinical abnormalities and the radiologic findings. Computed tomography of the thighs was done in 10 persons; cysts were identified in nine.

Humoral and cellular immune response of adults from northeastern Brazil with chronic Trypanosoma cruzi infection: depressed cellular immune response to T. cruzi antigen among Chagas' disease patients with symptomatic versus indeterminate infection.

Infection with Trypanosoma cruzi can cause chronic Chagas' disease manifestations (cardiac, gastrointestinal), although most persons with chronic infection have no ill effects (indeterminate form). Cell-mediated immunity (CMI) responses are believed to be intrinsically important in the containment of T. cruzi and in the pathogenesis of Chagas' disease. Humoral and CMI responses were investigated in 70 T. cruzi-infected persons from an endemic area in northeastern Brazil and in 30 uninfected controls. An epidemiologic survey, physical examination, and blood evaluation were conducted for each subject. The 70 chronically infected persons were subclassified into three clinical groups: indeterminate, cardiac, and gastrointestinal. Serum was tested for antibodies to T. cruzi by hemagglutination assay, indirect immunofluorescent assay, and enzyme-linked immunosorbent assay, and for autoantibodies to tubulin. Serum levels of soluble interleukin-2 receptor (sIL-2R), albumin, and C-reactive protein (CRP) were also measured to assess one parameter each of immunosuppression, nutritional status, and inflammation. The proliferative response of peripheral blood mononuclear cells (PBMC) to T. cruzi antigens, mitogen (phytohemagglutinin), and antigen-free controls was also assessed. Our data did not reveal any significant differences in serum levels of antibodies to T. cruzi, antibodies to tubulin, albumin, CRP, or sIL-2R among the subgroups of infected individuals. The data demonstrate differences in CMI responses. Trypanosoma cruzi trypomastigote lysate stimulated proliferation of PBMC from infected persons, but not uninfected controls. Patients with symptomatic Chagas' disease (cardiac and gastrointestinal groups) had decreased cellular responses to T. cruzi lysate (median proliferation index [PI] = 3), compared with those in the indeterminate group (median PI = 9; P < 0.005). Further investigations of the mechanism of this reduced CMI response in those with chronic disease may yield insights into the pathogenesis of Chagas' disease.

Tetano - revisao de 964 casos. / Tetanusreview of 964 cases

Os autores tecem alguns comentarios sobre o tetano e e feita uma revisao de 964 casos do Hospital Sao Jose. Fazem comentarios sobre os dados obtidos e sugerem possivel maneira de reduzir a incidencia