Investigation of Rabies virus in wild mammals of the atlantic forest in Rio de Janeiro, Brazil.

With the successful control of rabies transmitted by dogs in Brazil, wild animals have played a relevant epidemiological role in the transmission of rabies virus (RABV). Bats, non-human primates and wild canines are the main wild animals that transmit RABV in the country. It is worth highlighting the possibility of synanthropic action of these species, when they become adapted to urban areas, causing infections in domestic animals and eventually in humans. This work aimed to evaluate the circulation of RABV in the Pedra Branca Forest, an Atlantic Forest area, located in the state of Rio de Janeiro, Southeast Brazil. Saliva and blood samples were obtained from 60 individuals of eight species of bats, captured with mist nets, and 13 individuals of callitrichid primates, captured with tomahawk traps. Saliva samples were subjected to Reverse Transcription Polymerase Chain Reaction (RT-PCR), targeting the RABV N gene, with all samples being negative. Blood samples of all animals were submitted to the Rapid Fluorescent Focus Inhibition Test (RFFIT) to detect neutralizing antibodies (Ab) for RABV. Six bat samples (8%) were seropositive for RABV with antibody titers greater than or equal to 0.1 IU/mL. The detection of Ab but not viral RNA indicates exposure rather than current RABV transmission in the analyzed populations. The results presented here reinforce the importance of serological studies in wildlife to access RABV circulation in a region.

Cosmovisión ancestral y comprensión de los conceptos salud, cuidado y enfermería en habitantes del resguardo muisca de Chía, 2010 / Ancestral worldview and understanding of the concepts of health, care and nursing in the population of a muisca reservation in Chía, 2010

El reconocimiento, fortalecimiento y recuperación de prácticas de cuidado en culturas diversas favorece la calidad de las acciones de enfermería; el Enfoque Biopsicosocial, cultural y espiritual y la teoría Transcultural aportan a este objetivo y sirven de soporte al diseño de estrategias orientadas a preservar, adaptar y reestructurar los cuidados culturales; acciones que desde la comprensión de la salud en este grupo, se propone sean lideradas por el profesional de enfermería. La investigación descriptiva cualitativa contó con la participación voluntaria de familias y líderes muiscas reconocidos como cuidadores por la comunidad; se presenta como abordaje metodológico que posibilita reconocer la comprensión actual de los conceptos salud, cuidado y enfermería. La información recolectada mediante la observación, encuestas y entrevistas, en las categorías enunciadas, se analizó por triangulación de fuentes y de investigadores. Se identificó un marcado proceso de aculturación en las tres categorías analizadas: el concepto “cuidado” guarda mayor proximidad con la cosmovisión ancestral; la comprensión de la salud no incorpora dimensiones reconocidas ancestralmente; y, la enfermería se identifica como un “quehacer” propio del género femenino que articula las dimensiones comunicacional, afectiva y de protección próximas a lo descrito como cuidado por los líderes en salud ancestrales.

Neumonía tuberculosa: Reporte de 20 casos y estudio caso-control / Tubercular pneumonia: Report of 20 cases and a study case-control

La neumonía tuberculosa es una forma de presentación especial de la tuberculosis pulmonar que no es registrada adecuadamente en nuestro medio, y por consiguiente poco estudiada. El presente estudio se realizó en el Servicio de Medicina del Hospital Arzobispo Loayza de Lima-Perú y sus objetivos fueron describir las características clínicas y radiográficas en 20 mujeres adultas con neumonía tuberculosa y frotis positivo y luego establecer las diferencias de mayor significación con un grupo control de 23 pacientes con diagnóstico de neumonía bacteriana lobar y/o basal. La neumonía tuberculosa se caracterizó por una edad media de 28 años, tiempo de enfermedad promedio de 28 días; fiebre, tos productiva y disnea en todos los casos; hiporexia-anorexia en el 95%, dolor torácico en 50%, hemoptisis en 15%, historia de contacto tuberculoso en 60%, síndrome de condensación con o sin síndrome de derrame pleural en el 75% de los casos, consolidación pulmonar en la radiografía de tórax localizada en 1 lóbulo en 75% y en el campo pulmonar inferior en 80%, otros hallazgos radiográficos que acompañaron a la consolidación pulmonar en 70%, leucocitosis en 65%, velocidad de eritrosedimentación entre 49-58 mm/h e hipoxemia de algún grado en el 100% de los casos. Concluímos que la neumonía tuberculosa en nuestro medio es una enfermedad predominante de sujetos menores de 35 años, con tiempo de enfermedad promedio de 4 semanas y su localización más común es el campo pulmonar inferior, las características que permiten diferenciarla de la neumonía bacteriana lobar y/o basal con un tiempo de enfermedad de 15 días, dolor torácico de tipo pleurítico o ausencia de este, anorexia, pérdida de peso marcado, anemia, historia de contacto tuberculoso, hallazgos radiográficos que acompañan a la consolidación pulmonar como la presencia de infiltrado apical, granulia y diseminación broncógena...

Tuberculous pneumonia is a special from of pulmonary tuberculosis, inadequate registered in our population and therefore little stidied. The present study made in a Service of Medicine of the Hospital Arzobispo Loayza, Lima-Perú, and our goals were to describe the clinical and radiographics characteristics in 20 adult women with tuberculous pneumonia and positive smear, and to establish the differences of greater meaning with a control group of 23 patients with lobar and/or basal bacterial pneumonia. Tuberculous pneumonia was characterized by a mean age of 28 years, duration of symptoms with a mean of 28 days; fever, productive cough and dysnea in all the cases; hiporexia-anorexy in 95%, thoracic pain in 50%, hemoptisis in 15% tuberculous contact in 60%, condensation syndrome with or without pleural effusion in 75%, and in the lower field in 80%, other radiographics findings that accompanied the lung consolidation in 70%, leukocytosis in 65%, ESR between 49 and 58 mm/h and hipoxemia of some defree in 100% of the cases. We conclude, tuberculous pneumonia in our population is a predominant disease of subjects of 35% years or less, with a time of duration of symptoms of 4 weeks and the commonest localization is the low lung field; the characteristics that allow to differentiate it from lobar and/or basal bacterial pneumonia are the duration of symptoms greater than 15 days, with nonpleuritic pain or absent, anorexy, weight loss, anemia, tuberculous contact, radiographics findings that accompany the lung consolidation as the infiltrated presence by apical, granulia and bronchogenic dissemination, the outcome is slower the specific therapy and the hospital stay more prolonged.

Ascitis quilosa: reporte de un caso y revisión de la literatura / Chylous ascitis: case report and literature review

Se reporta el caso de una paciente con ascitis quilosa masiva, debida a una neoplasia maligna de origen epitelial y cuyo foco primario no se puede precisar, a pesar de utilizar todos los procedimientos diagnósticos disponibles, que incluyó laparatomía exploradora. Siendo una entidad poco común en la práctica clínica se hace una revisión de la literatura sobre aspectos etiológicos, fisiopatológicos y terapeúticos

[Gnathostomiasis in Mexico]. / La gnatostomiasis en México.

Since 1975, increasing numbers of patients with inflammatory, migrant, recidivant nodules were observed in the towns of Temazcal, state of Oaxaca, Tierra Blanca, Veracruz and others along the Papaloapan river. Larvae of Gnathostoma sp. have been obtained from some of them. The local species, although not completely identified, must be very close to G. spinigerum. Infection is related to ingestion of "ceviche", a very popular mexican delicacy made with raw Cyclid fishes of the Miguel Aleman dam. Ecological and social changes provoked by the construction of the dam and hypotheticaly related to the dissemination of the parasite are described. As the Temazcal Fish Culture Center has delivered tilapia fishes to many secondary culture centers, it is feared that the infection could spread through the country, so signs and symptoms of the disease are described in order to help Mexican doctors make the diagnosis if they were to encounter the disease.

Regulation of lactogenic hormone binding in rat liver by steroid hormones.

We have measured the effects of testosterone propionate, medroxy-progesterone acetate and cortisol on the binding of ovine [125I]iodoprolactin to 100,000 X g particulate fractions from liver of normal and estrogen-treated female rats. In untreated animals 6.7 +/- 1.1% (SD) of the radioactivity added to 0.5 mg of membrane protein was specifically bound to the hormone receptor. Specific binding was significantly (P less than .05) decreased after 7 daily doses of testosterone (1.0 mg) to 2.8 +/- 1.4%, medroxyprogesterone (0.25 mg) to 2.7 +/- 0.2% and cortisol (5.0 mg) to 3.1 +/- 1.3%. The serum prolactin concentration, 4.2 +/- 3.4 ng/ml in normal animals, was not affected by the hormone treatment. Ethinyl estradiol, 10 mug/day for 7 days, increasing the binding of [125I]iodo-prolactin to 16.6 +/- 6.0% and increased serum prolactin to 50.6 +/- 11.5 ng/ml. Simultaneous administration of testosterone, medroxyprogesterone or cortisol with estradiol did not diminish the estradiol-induced increase in serum prolactin, but completely prevented the increase in prolactin binding. Testosterone or cortisol given to animals pretreated with estradiol suppressed prolactin binding from 16.4 +/- 4.2% to less than 2.5% after 48-72 h. Parellel results were obtained with 125I labeled human growth hormone whereas 125I labeled-insulin binding was not affected by these treatments. Scatchard analysis showed that the decrease in lactogenic hormone binding was due to a reduced concentration of receptors with no significant change in affinity. Since serum levels of prolactin were not changed, we conclude that treatment with testosterone, medroxyprogesterone, and cortisol decreased lactogenic hormone binding by a direct action on the liver.

Serum estradiol response to gonadotropin-releasing hormone: studies in normal women and in women with secondary amenorrhea.

Serum estradiol (E2), luteinizing hormone (LH), and follicle stimulating hormone (FSH) levels were measured in blood samples obtained prior to and at frequent intervals for 360 or 480 minutes following the subcutaneous administration of gonadotropin releasing hormone (Gn-RH) to eight normal women and nine patients with hypothalamic secondary amenorrhea. In the normal subjects given 100 mug of Gn-RH on day 7 of the menstrual cycle, there was no significant increase in the mean E2 concentration above basal levels. Six women with secondary amenorrhea received Gn-RH, 100 mug, for 4 successive days; frequent blood samples were obtained on days 1 and 4. On day 1, the mean E2 concentration at 360 minutes was significantly greater than the mean basal level. On day 4 no significant increase in E2 was detected, although the mean LH and FSH responses and basal E2 level were not different from those of day 1. Four women with secondary amenorrhea received daily doses of 500 mug of Gn-RH for 7 days. Significant increases in mean serum E2 concentration (100 to 150 pg/ml) were noted at 6 and 8 hours after administration on day 1 and at 8 hours on day 4. No significant rise in E2 was detected on day 7. The mean LH and FSH responses did not differ from those observed in women who received the 100-mug dose, and there were no significant differences in responses on successive days of Gn-RH administration.

LH and FSH response to gonadotropin-releasing hormone in anorexia nervosa: Effect of nutritional rehabilitation.

The LH and FSH responses to the administration of synthetic gonadotropin-releasing hormone (GnRH) were assessed in 14 patients with anorexia nervosa before, during and following weight gain. In 8 patients studied prior to therapy when they were at 53-64% of idal body weight, the LH response to GnRH was strikingly impaired while the FSH response was equal to that observed in normally menstruating women. After return to 79-88% of ideal body weight the LH response was improved but remained less than in the normal women. In a second group of 6 patients who were studied 4-11 months after hospital discharge when they were 90-94% of ideal body weight, the LH response was always equal to or greater than that found in the normal women. The serum estradiol concentration was low in all of the patients and remained less than 33 pg/ml even in those who returned to more than 90% of ideal body weight. Treatment with 25 mug of ethinyl estradiol for 3 days prior to repeat administration of GnRH did not result in a statistically significant increase of the LH or FSH responses above those before treatment. These data suggest changes occur in both hypothalamic and pituitary regulation of gonadotropin secretion in the course of nutritional rehabilitation of patients with anorexia nervosa and that synthesis and secretion of LH and FSH are modulated independently at the level of the pituitary gland.