Comparação da qualidade seminal de caprinos das raças Canindé e Alpina Britânica no Nordeste brasileiro / Comparison of the seminal quality of Canindé and British Alpine goats in the Brazilian Northeast

O estudo objetivou avaliar a qualidade seminal de caprinos das raças Canindé (autóctone) e Alpina Britânica (exótica) no Nordeste brasileiro. O experimento foi realizado nos períodos de julho a setembro dos anos de 2015 e 2016. As coletas seminais foram realizadas com auxílio de vagina artificial, de machos das raças Canindé (n = 4) e Alpina Britânica (n = 7). Após a coleta, o sêmen foi avaliado quanto a: volume (ml), concentração (sptz/ml), motilidade (%) e vigor (1-5). Em seguida, diluído em ACP-101c e criopreservado em máquina TK3000TM. Posteriormente, foram analisados os parâmetros cinéticos, através do software SCA®, e a atividade mitocondrial. No sêmen fresco, as duas raças apresentaram valores de motilidade e concentração dentro do preconizado para a espécie. Entretanto, os valores de volume e circunferência escrotal foram superiores na raça Alpina Britânica (0,73 ml ± 0,32; 27,35 cm ± 2,09) do que na raça Canindé (0,36 ml ± 0,07; 23,25 cm ± 0,95) (p < 0,05). Já no sêmen descongelado, os parâmetros motilidade total - MT (36,96% ± 11,16 vs. 20,50% ± 14,15), motilidade progressiva - MP (26,67% ± 11,13 vs. 11,29% ± 9,42), vigor (2,91 ± 0,90 vs. 1,88 ± 0,67), velocidade curvilinear - VCL (78,12 µm/s ± 12,41 vs. 59,28 µm/s ± 15,57), velocidade linear - VSL (49,23 µm/s ± 9,87 vs. 29,9 µm/s ± 9,48), velocidade média da trajetória - VAP (66,08 µm/s ± 12,77 vs. 45,70 µm/s ± 12,20), linearidade - LIN (62,97% ± 6,96 vs. 49,54%±9,50), retilinearidade - STR (74,63% ± 6,44 vs. 65,77% ± 8,92), e oscilação - WOB (84,32% ± 5,94 vs. 74,42% ± 7,31) foram superiores para a raça Canindé em detrimento à Alpina Britânica (p < 0,05). Portanto, o sêmen fresco das duas raças podem ser utilizados em biotécnicas reprodutivas. Já o sêmen pós-descongelação da raça Canindé apresentou melhor qualidade, provavelmente pelos animais estarem mais adaptados às condições adversas da região Nordeste, sendo recomendado para programas de inseminação artificial.(AU)

The objective of this study was to evaluate the sperm quality of Canindé (native) and British Alpine (exotic) goats in the Northeast of Brazil. The experiment was carried out from July to September of the years 2015 and 2016. Sperm collections of Canindé (n = 4) and British Alpine (n = 7) males were performed using artificial vagina. After collection, the sperm was evaluated for volume (ml), concentration (sptz/ml), motility (%), and vigor (1-5). Then diluted in ACP-101c and cryopreserved in TK3000TM machine. Subsequently, kinetic parameters were analyzed through SCA TM software and mitochondrial activity. In fresh sperm, the two races presented values of motility and concentration within the recommended for the specie. However, volume and scrotal circumference values were higher in the British Alpine breed (0.73 mL ± 0.32; 27.35 cm ± 2.09) than in the Canindé breed (0.36 mL ± 0.07; 23 , 25 cm ± 0.95) (p <0.05). In the thawed sperm, the parameters total motility - TM (36.96% ± 11.16 vs. 20.50% ± 14.15), progressive motility - PM (26.67% ± 11.13 vs. 11.29 % ± 9.42), vigor (2.91 ± 0.90 vs. 1.88 ± 0.67), curvilinear velocity - VCL (78.12 µm/s ± 12.41 vs. 59.28 µm/s ± 15.57), linear velocity - VSL (49.23 µm/s ± 9.87 vs. 29.9 µm/s ± 9.48), mean velocity of the trajectory - VAP (66.08 µm/s ± 12.77 vs. 45.70 µm/s ± 12.20), linearity - LIN (62.97% ± 6.96 vs. 49.54% ± 9.50), rectilinearity - STR (74.63% ± 6.44 vs. 65.77% ± 8.92), and oscillation -WOB (84.32% ± 5.94 vs. 74.42% ± 7.31) were higher for Canindé breed than for British Alpine ( p < 0.05). Therefore, fresh sperm from both breeds can be used in reproductive biotechniques. On the other hand, the post-thawed sperm of the Canindé breed showed better quality, probably because the animals were more adapted to the adverse conditions of the Northeast region and are recommended for artificial insemination programs.(AU)

Protective role of γδ T cells in cigarette smoke and influenza infection.

Airborne pathogens commonly trigger severe respiratory failure or death in smokers with lung disease. Cigarette smoking compromises the effectiveness of innate immunity against infections but the underlying mechanisms responsible for defective acquired immune responses in smokers remains less clear. We found that mice exposed to chronic cigarette smoke recovered poorly from primary Influenza A pneumonia with reduced type I and II interferons (IFNs) and viral-specific immunoglobulins, but recruited γδ T cells to the lungs that predominantly expressed interleukin 17A (IL-17A). Il-17a-/- mice exposed to smoke and infected with Influenza A also recruited γδ T cells to the lungs, but in contrast to wild-type mice, expressed increased IFNs, made protective influenza-specific antibodies, and recovered from infection. Depletion of IL-17A with blocking antibodies significantly increased T-bet expression in γδ T cells and improved recovery from acute Influenza A infection in air, but not smoke-exposed mice. In contrast, when exposed to smoke, γδ T cell deficient mice failed to mount an effective immune response to Influenza A and showed increased mortality. Our findings demonstrate a protective role for γδ T cells in smokers and suggest that smoke-induced increase in IL-17A inhibits the transcriptional programs required for their optimal anti-viral responses. Cigarette smoke induces IL-17A expression in the lungs and inhibits γδ T-cell-mediated protective anti-viral immune responses.

Restless legs syndrome in Wilson's disease: frequency, characteristics, and mimics.

OBJECTIVE: To determine characteristics, clinical significance, frequency, and mimics of restless legs syndrome (RLS) in a cohort of Wilson's disease (WD, n = 42/f = 18), compared to healthy, matched controls. MATERIALS AND METHODS: Structured clinical interviews (patients and caregiving family members), repeated neurological examinations (afternoon and presleep), comprehensive laboratory tests, WD-, RLS-, and sleep-specific rating scales, and video-polysomnography. RESULTS: Thirteen patients with WD (13/42 = 31.0%) clearly fulfilled the five diagnostic criteria of RLS; in eight patients (19.1%), the burden of RLS was clinically significant. The RLS was of moderate severity, equally distributed among sexes, manifested mainly in the evening and before falling asleep, and had developed mostly after clinical manifestation of WD (time elapsed 10.2 ± 14.5 years), still at a young mean age (27.5 ± 11.5 years). The known RLS-associated features were absent (normal iron and kidney parameters) or rare (positive family history, polyneuropathy). Compared to WD patients without RLS, patients with RLS were significantly elder and had suffered longer from WD. WD-specific RLS mimics as well as RLS confounding motor comorbidities (dystonia, tremor, chorea) were frequent and a diagnostic challenge; in difficult cases, the differentiation was reached by clinical observation of the motor behavior in the evening or at nighttime. CONCLUSION: RLS was frequent in this cohort of WD and might be causally related to WD. RLS should be included in the diagnostic work-up of WD. In complex motor disorders, differential diagnosis of RLS might require evening/nighttime examination and video-polysomnography. In WD patients with a clinically significant RLS, treatment with dopaminergic substances may be considered.

Toxicidade aguda e risco ambiental do antibiótico oxitetraciclina para tilápia (Oreochromis niloticus), Daphnia magna e Lemna minor / Acute toxicity and environmental risk of oxytetracycline antibiotc for tilapia (Oreochromis niloticus), Daphnia magna, and Lemna minor

O objetivo deste estudo foi classificar o antibiótico Terramicina(r) de acordo com a toxicidade aguda e o risco de intoxicação ambiental para Oreochromis niloticus, Daphnia magna e Lemna minor, com base no seu ingrediente ativo oxitetraciclina (OTC). Além disso, observou-se a ocorrência de sinais de intoxicação aguda em peixes e o efeito da diluição do antibiótico sobre as variáveis de qualidade de água. Alevinos, neonatos e frondes foram expostos a concentrações de OTC. De acordo com os resultados dos testes de toxicidade aguda, a Terramicina(r) foi classificada pela toxicidade aguda e pelo risco de intoxicação ambiental. Para O. niloticus, a CL(I)50; 48h calculada foi de 6,92 mg L-1, para D. magna a CE(I)50; 48h foi de 0,17mg.L-1, enquanto para L. minor a CI(I)50;7d foi de 0,68 mg L-1. A Terramicina(r) foi classificada como muito tóxica para O. niloticus e extremamente tóxica para D. magna e L. minor e causa risco de intoxicação ambiental para os três organismos testados. Concentrações de 7,5 e 8,0 mg L-1 de OTC reduziram a concentração de oxigênio dissolvido na água. De acordo com este estudo, a Terramicina(r) não deve ser utilizada na aquicultura, pois é altamente tóxica e causa risco de intoxicação ambiental aos organismos teste.(AU)

The aim of this study was to classify the antibiotic Terramycin(r) according to acute toxicity and the environmental risk that it poses for Oreochromis niloticus, Daphnia magna, and Lemna minor based on its active ingredient oxytetracycline (OTC). In addition, the occurrence of acute poisoning signs in fish and antibiotic dilution effect in the water quality variables were observed. For this purpose, fingerlings, neonates, and while were exposed to the concentrations of OTC. According to OTC acute toxicity test results, the Terramycin(r) was classified by acute toxicity and environmental poisoning risk classes. To O. niloticus, the calculated LC(I)50;48h was 6.92 mg L-1, for D. magna the EC(I)50;48h was 0.17 mg L-1, while for L. minor, IC(I)50;7d was 0.68 mg L-1. Terramycin(r) was classified as very toxic to O. niloticus, and highly toxic to D. magna and L. minor and cause risk of environmental poisoning for the three organismis tested. Concentrations of 7.5 and 8.0 mg L-1 OTC reduce the concentration of dissolved oxygen in the water. According to this study, Terramycin(r) should not be used in aquaculture, as it is highly toxic and causes risk of environmental toxicity test organisms.(AU)

Assessment of indicators of vitamin A status in non-cirrhotic chronic hepatitis C patients.

Subjects with chronic liver disease are susceptible to hypovitaminosis A due to several factors. Therefore, identifying patients with vitamin deficiency and a requirement for vitamin supplementation is important. Most studies assessing vitamin A in the context of hepatic disorders are conducted using cirrhotic patients. A cross-sectional study was conducted in 43 non-cirrhotic patients with chronic hepatitis C to evaluate markers of vitamin A status represented by serum retinol, liver retinol, and serum retinol-binding protein levels. We also performed the relative dose-response test, which provides an indirect estimate of hepatic vitamin A reserves. These vitamin A indicators were assessed according to the stage of liver fibrosis using the METAVIR score and the body mass index. The sample study was predominantly composed of male subjects (63%) with mild liver fibrosis (F1). The relative dose-response test was <20% in all subjects, indicating vitamin A sufficiency. Overweight or obese patients had higher serum retinol levels than those with a normal body mass index (2.6 and 1.9 µmol/L, respectively; P<0.01). Subjects with moderate liver fibrosis (F2) showed lower levels of serum retinol (1.9 vs 2.5 µmol/L, P=0.01) and retinol-binding protein levels compared with those with mild fibrosis (F1) (46.3 vs 67.7 µg/mL, P<0.01). These results suggested an effect of being overweight on serum retinol levels. Furthermore, more advanced stages of liver fibrosis were related to a decrease in serum vitamin A levels.

Assessment of indicators of vitamin A status in non-cirrhotic chronic hepatitis C patients

Subjects with chronic liver disease are susceptible to hypovitaminosis A due to several factors. Therefore, identifying patients with vitamin deficiency and a requirement for vitamin supplementation is important. Most studies assessing vitamin A in the context of hepatic disorders are conducted using cirrhotic patients. A cross-sectional study was conducted in 43 non-cirrhotic patients with chronic hepatitis C to evaluate markers of vitamin A status represented by serum retinol, liver retinol, and serum retinol-binding protein levels. We also performed the relative dose-response test, which provides an indirect estimate of hepatic vitamin A reserves. These vitamin A indicators were assessed according to the stage of liver fibrosis using the METAVIR score and the body mass index. The sample study was predominantly composed of male subjects (63%) with mild liver fibrosis (F1). The relative dose-response test was <20% in all subjects, indicating vitamin A sufficiency. Overweight or obese patients had higher serum retinol levels than those with a normal body mass index (2.6 and 1.9 µmol/L, respectively; P<0.01). Subjects with moderate liver fibrosis (F2) showed lower levels of serum retinol (1.9 vs 2.5 µmol/L, P=0.01) and retinol-binding protein levels compared with those with mild fibrosis (F1) (46.3 vs 67.7 µg/mL, P<0.01). These results suggested an effect of being overweight on serum retinol levels. Furthermore, more advanced stages of liver fibrosis were related to a decrease in serum vitamin A levels.

Late emergence of A594V and L595W mutations related to ganciclovir resistance in a patient with HCMV retinitis and long-term HIV progression.

The emergence of ganciclovir (GCV) resistance during the treatment of human cytomegalovirus (HCMV) infection is a serious clinical challenge, and is associated with high morbidity and mortality. In this case report, we describe the emergence of two consecutive mutations (A594V and L595W) related to GCV resistance in a patient with HCMV retinitis and long-term HIV progression after approximately 240 days of GCV use. Following the diagnosis of retinitis, the introduction of GCV did not result in viral load reduction. The detected mutations appeared late in the treatment, and we propose that other factors (high initial HCMV load, previous GCV exposure, low CD4+ cell count), in addition to the presence of resistance mutations, may have contributed to the treatment failure of HCMV infection in this patient.

TNF microsatellite alleles may confer protection against the development of lipodystrophy syndrome in Brazilian HIV patients.

The aim of this study was to evaluate the frequency of TNFa-e microsatellites and the promoter region (TNF-308 and TNF-238) in HIV/AIDS-infected patients presenting or not lipodystrophy syndrome (LS). The design is the genetic case-control association study. Microsatellite and the TNF promoter region polymorphisms were amplified by PCR and submitted to polyacrylamide gel electrophoresis. The genotypes and allele frequencies for 67 HIV-positive patients with lipodystrophy were compared with 50 HIV-positive patients with no evidence of lipodystrophy and with 131 healthy HIV-negative individuals. The presence of the TNFa5 allele could provide HIV/AIDS patients with protection against developing LS. The presence of TNF-308G allele, as well as of its homozygote TNF-308GG, were associated with susceptibility to developing LS. In addition, the presence of the haplotype TNFe3-d3-238G-308A-c1-a5-b7 suggests protection against developing that syndrome. This study highlights that polymorphic sites spanning the region nearby the TNF locus are associated with LS development in HIV/AIDS patients.

Interleukin-18 and interferon-gamma polymorphisms in Brazilian human immunodeficiency virus-1-infected patients presenting with lipodystrophy syndrome.

Cytokines play important roles in the pathogenesis of lipodystrophy syndrome (LS). Single nucleotide polymorphisms (SNPs) at positions -607(C/A) and -137(C/G) in the promoter region of the interleukin-18 (IL-18) gene and at position +874(T/A) of the interferon-gamma (IFN-gamma) gene are related to the expression of these cytokines. To examine whether IL-18 and IFN-gamma polymorphisms are associated with LS, these SNPs were genotyped in 88 human immunodeficiency virus (HIV)-infected patients presenting LS, 79 HIV-infected without LS, and 133 healthy controls. The -607A allele, -607AA genotype, and -137G/-607A and -137C/-607A haplotypes in the IL-18 gene were over-represented in HIV patients presenting LS. The -137G/-607C haplotype was associated with protection against LS. These results indicate that the -607(C/A) SNP is associated with LS development in HIV-infected patients.

A genetic polymorphism of matrix metalloproteinase 9 (MMP-9) affects the changes in circulating MMP-9 levels induced by highly active antiretroviral therapy in HIV patients.

We examined whether two functional polymorphisms (g.-1562C>T and g.-90(CA)14-24) in the matrix metalloproteinase (MMP)-9 gene or MMP-9 haplotypes affect the circulating levels of pro-MMP-9 and pro-MMP-9/TIMP-1 (tissue inhibitor of metalloproteinase-1) ratios in AIDS patients, and modulate alterations in these biomarkers after highly active antiretroviral therapy (HAART). We studied 82 patients commencing HAART. Higher pro-MMP-9 concentrations and pro-MMP-9/TIMP-1 ratios were found in CT/TT patients compared with CC patients. HAART decreased pro-MMP-9 levels and pro-MMP-9/TIMP-1 ratios in CT/TT patients, it did not modify pro-MMP-9 levels and it increased pro-MMP-9/TIMP-1 ratios in CC patients. The g.-90(CA)14-24 polymorphism, however, produced no significant effects. Moreover, we found no significant differences in HAART-induced changes in plasma pro-MMP-9, TIMP-1 and pro-MMP-9/TIMP-1 ratios when different MMP-9 haplotypes were compared. These findings suggest that the g.-1562C>T polymorphism affects pro-MMP-9 levels in patients with AIDS and modulates the alterations in pro-MMP-9 levels caused by HAART, thus possibly affecting the risk of cardiovascular complications.

Measurement of the D(s)+ lifetime.

A high statistics measurement of the D(s)+ lifetime from the Fermilab fixed-target FOCUS photoproduction experiment is presented. We describe the analysis of the two decay modes, D(s)+ --> phi(1020)pi+ and D(s)+ -->K*(892)0K+, used for the measurement. The measured lifetime is 507.4 +/- 5.5(stat) +/- 5.1(syst) fs using 8961 +/- 105 D(s)+ --> phi(1020)pi+ and 4680 +/- 90 D(s)+ --> K*(892)0K+ decays. This is a significant improvement over the present world average.

Occurrence and severity of infections caused by subgroup A and B respiratory syncytial virus in children in southeast Brazil.

The frequency and severity of infections caused by respiratory syncytial virus (RSV) were assessed in children <2 years of age seen at the emergency department. The frequency of RSV detection in the clinical virology laboratory during the past 3 years was also analyzed retrospectively. RSV was found in 21.6% (188/869) of the samples collected from children seen at the emergency department and was found to be more frequent during the autumn, being less frequent or negligible by midwinter. RSV subgroups A and B co-circulated within the same time period in children seen at the emergency department, with varying predominance of either subgroup. There was no significant association of RSV subgroup with disease severity, but only a trend for RSV subgroup B being more frequent in children with risk factors for severe disease.

Advantages of the rapid HIV-1 test in occupational accidents with potentially contaminated material among health workers.

In occupational accidents involving health professionals handling potentially contaminated material, the decision to start or to continue prophylactic medication against infection by Human Immunodeficiency Virus (HIV) has been based on the ELISA test applied to a blood sample from the source patient. In order to rationalize the prophylactic use of antiretroviral agents, a rapid serologic diagnostic test of HIV infection was tested by the enzymatic immunoabsorption method (SUDS HIV 1+2, MUREX) and compared to conventional ELISA (Abbott HIV-1/ HIV-2 3rd Generation plus EIA). A total of 592 cases of occupational accidents were recorded at the University Hospital of Ribeirão Preto from July 1998 to April 1999. Of these, 109 were simultaneously evaluated by the rapid test and by ELISA HIV. The rapid test was positive in three cases and was confirmed by ELISA and in one the result was inconclusive and later found to be negative by ELISA. In the 106 accidents in which the rapid test was negative no prophylactic medication was instituted, with an estimated reduction in costs of US$ 2,889.35. In addition to this advantage, the good correlation of the rapid test with ELISA, the shorter duration of stress and the absence of exposure of the health worker to the adverse effects of antiretroviral agents suggest the adoption of this test in Programs of Attention to Accidents with Potentially Contaminated Material.

Frequency of Mycoplasma hominis and Ureaplasma urealyticum infections in women with systemic lupus erythematosus.

Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) have been detected in the urine of women with systemic lupus erythematosus (SLE). We evaluated the presence of these mycoplasma in the endocervix of women presenting SLE. A total of 40 SLE patients (mean age 40.2 years), and 51 healthy women (mean age 30.9 years), were studied. Endocervical swabs were cultured in specific liquid media for MH or UU, detected by a quantitative color assay, and considered positive at >10(3) dilutions. Statistical analysis was performed using the two-tailed Fisher test. UU was detected in 52.5 % of patients and in 11.8% of controls (p= 0.000059). MH was detected in 20% of patients and 2% controls (p=0.003905). Both mycoplasmas were detected in 7.3% patients and 0% controls (p<0.000001). The results reported here corroborate the association of the mycoplasma infection and SLE. Thus, these agents may stimulate the production of autoreactive clones.

[Dermatophytic pseudomycetoma: report of a case caused by Trichophyton tonsurans]. / Pseudomicetoma dermatofítico: relato de um caso devido a Trichophyton tonsurans.

A case of dermatophytic pseudomycetoma, in a patient with a history of recurrent lesions in the scalp, for over two years, is reported. Histopathological examination of the affected tissues revealed the mycelial aggregates or pseudogranules characteristic of the disease. Cultures of fresh tissues samples detected a fungus identified as Trichophyton tonsurans. Additional examinations failed to demonstrate lesions of tinea capitis, a probable source of the deep infection. Dermatophytic pseudomycetoma is an extremely rare form of dermatophytosis, and the rarity of such cases is the motive for the present communication.

Pseudomicetoma dermatofítico: relato de um caso devido a Trichophyton tonsurans / Dermatophytic pseudomycetoma: report of a case caused by Trichophyton tonsurans

A case of dermatophytic pseudomycetoma, in a patient with a history of recurrent lesions in the scalp, for over two years, is reported. Histopathological examination of the affected tissues revealed the mycelial aggregates or pseudogranules characteristic of the disease. Cultures of fresh tissues samples detected a fungus identified as Trichophyton tonsurans. Additional examinations failed to demonstrate lesions of tinea capitis, a probable source of the deep infection. Dermatophytic pseudomycetoma is an extremely rare form of dermatophytosis, and the rarity of such cases is the motive for the present communication.

É descrito um caso de pseudomicetoma dermatofítico, recidivante, em paciente com lesões no couro cabeludo. O exame histopatológico de uma das lesões mostrou, nos tecidos, os agregados micelianos ou pseudogrânulos, característicos da enfermidade. Dos tecidos frescos de outras lesões foi isolado o dermatófito Trichophyton tonsurans. Exames micológicos adicionais falharam em demonstrar a existência de tinea capitis, possível fonte do pseudomicetoma. A raridade dessa forma de dermatofitose profunda justifica a presente publicação.

Frequency of Mycoplasma hominis and Ureaplasma urealyticum infections in women with systemic lupus erythematosus

Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) have been detected in the urine of women with systemic lupus erythematosus (SLE). We evaluated the presence of these mycoplasma in the endocervix of women presenting SLE. A total of 40 SLE patients (mean age 40.2 years), and 51 healthy women (mean age 30.9 years), were studied. Endocervical swabs were cultured in specific liquid media for MH or UU, detected by a quantitative color assay, and considered positive at >10(3) dilutions. Statistical analysis was performed using the two-tailed Fisher test. UU was detected in 52.5 % of patients and in 11.8% of controls (p= 0.000059). MH was detected in 20% of patients and 2% controls (p=0.003905). Both mycoplasmas were detected in 7.3% patients and 0% controls (p<0.000001). The results reported here corroborate the association of the mycoplasma infection and SLE. Thus, these agents may stimulate the production of autoreactive clones.

Ureaplasma urealyticum (UU) e Mycoplasma hominis (MH) têm sido detectados em urina de mulheres com lupus eritematoso sistêmico (LES). Avaliamos a presença destes mycoplasmas no endocervix de mulheres apresentando LES. Um total de 40 pacientes com LES (idade média de 40,2 anos), e 51 mulheres sadias (idade média de 30.9 anos), foram estudadas. Swabs do endocervix foram cultivados em meio líquido específico para MH e UU, detectados por teste colorimétrico quantitativo, considerando positivo diluições > 103 . Análise estatística foi feita usando teste de Fisher. UU foi detectado em 52,5% das pacientes e em 11,8% dos controles (p= 0.000059). MH foi detectado em 20% das pacientes e 2% dos controles (p=0.003905). Ambos mycoplasmas foram detectados em 7,3 % das pacientes e 0% dos controles (p<0.000001). Os resultados aqui reportados corroboram com a associação de infecção por mycoplasma e LES. Estes agentes podem estimular a produção de clones autoreativos.

[Disseminated cutaneous sporotrichosis as the initial manifestation of acquired immunodeficiency syndrome--case report]. / Esporotricose cutânea disseminada como manifestação inicial da síndrome da imunodeficiência adquirida--relato de caso.

The authors report a case of disseminated cutaneous infection with Sporothrix schenckii in a previously asymptomatic HIV-infected 30 year-old man. Extensive cutaneous involvement was observed with suppurative collections and ulcerations. The agent was isolated in culture. Treatment with liposomal amphotericin B proved to be effective.

[Concurrent leishmaniasis and human immunodeficiency virus (HIV) infection: a study of four cases]. / Concomitância de leishmanioses e infecção pelo vírus da imunodeficiência humana (HIV): estudo de quatro casos.

Few cases of concurrent leishmaniasis and HIV infection have been reported in Brazil, despite both infections being in expansion. Two cases of visceral leishmaniasis and two cases of mucocutaneous leishmaniasis are discussed. Disseminated skin and oral lesions were found in the patients with the cutaneous form of the disease. Prolonged fever, hepatosplenomegaly and pancytopenia were the main manifestations of the visceral form. The CD4 T lymphocyte count was low in all cases. Direct examination of bone marrow aspirate for leishmania and biopsy of cutaneous lesions are the techniques of choice to confirm diagnosis. Pentavalent antimonials and amphotericin B are preferred drugs for the treatment of leishmaniasis, including patients with AIDS. The authors recommend the inclusion of this parasitosis in the differential diagnosis of opportunistic diseases in patients with AIDS.