Food web connections and the transmission cycles of Trypanosoma cruzi and Trypanosoma evansi (Kinetoplastida, Trypanosomatidae) in the Pantanal Region, Brazil.

We examined by parasitological tests (hemocultures and buffy coat) infection by Trypanosoma cruzi and T. evansi in blood samples from Leopardus pardalis, Cerdocyon thous and domestic dogs. Besides, 25 T. cruzi isolates previously derived from feral pigs and small wild mammals were here characterized by miniexon gene and demonstrated to be in the TcI genotype. Herein, we make an overall analysis of the transmission cycle of both trypanosome species in the light of the assemblage of data collected over the last seven years. The carnivore Nasua nasua was confirmed to play a major role in the transmission cycles of both T. cruzi and T. evansi since it was the species that had the higher prevalence and higher parasitemias by both flagellate species. In addition, our results show that both trypanosomatid species may be found throughout the Pantanal landscape, in all forest strata, as shown by the infection of carnivore, arboreal and terrestrial scansorial marsupial species in complex and seasonal transmission cycles. We propose that transmission of T. cruzi and T. evansi in the southern Pantanal region takes place via an intricate ecological trophic network involving generalist and specialist mammal species that are linked through a robust food-web connection.

The coati (Nasua nasua, Carnivora, Procyonidae) as a reservoir host for the main lineages of Trypanosoma cruzi in the Pantanal region, Brazil.

We have focused on the role played by a carnivore, the coati (Nasua nasua), in the transmission cycle of Trypanosoma cruzi in the Brazilian Pantanal biome. We collected data during 2000/01 and 2005-07. Prevalence and pattern of T. cruzi infection were determined by serological tests and hemoculture. Isolates were characterized by miniexon molecular assay. Our results demonstrate that T. cruzi transmission cycle among coatis in the southern Pantanal seems to be well established, as we found high serum prevalences and high parasitemias throughout the two studied periods. Single infections by TCII (32.1%), TCI (28.0%) and Z3 (7.1%) were observed. Mixed infections by TCI/TCII (10.7%) and TCI/Z3 (3.6%) were also detected. Distinct genotypes of T. cruzi could be recovered during the 8 months follow-up of the same animals. As free-living coatis have high densities and inhabit all habitats, they may play an important role in the maintenance and dispersion of the main T. cruzi subpopulations. Considering that the Pantanal connects some of the major biomes of South America, it may be acting as a corridor for the spread of the main T. cruzi subpopulations. Our data give support that predator-prey links are important mechanisms for T. cruzi transmission and perpetuation in the wild.

Anabolic steroids induce cardiac renin-angiotensin system and impair the beneficial effects of aerobic training in rats.

We evaluated the effects of swimming and anabolic steroids (AS) on ventricular function, collagen synthesis, and the local renin-angiotensin system in rats. Male Wistar rats were randomized into control (C), steroid (S; nandrolone decanoate; 5 mg/kg sc, 2x/wk), steroid + losartan (SL; 20 mg.kg(-1).day(-1)), trained (T), trained + steroid (T+S), and trained + steroid + losartan (T+SL; n = 14/group) groups. Swimming was performed 5 times/wk for 10 wk. Serum testosterone increased in S and T+S. Resting heart rate was lower in T and T+S. Percent change in left ventricular (LV) weight-to-body weight ratio increased in S, T, and T+S. LV systolic pressure declined in S and T+S. LV contractility increased in T (P < 0.05). LV relaxation increased in T (P < 0.05). It was significantly lower in T+S compared with C. Collagen volumetric fraction (CVF) and hydroxyproline were higher in S and T+S than in C and T (P < 0.05), and the CVF and LV hypertrophy were prevented by losartan treatment. LV-ANG I-converting enzyme activity increased (28%) in the S group (33%), and type III collagen synthesis increased (56%) in T+S but not in T group. A positive correlation existed between LV-ANG I-converting enzyme activity and collagen type III expression (r(2) = 0.88; P < 0.05, for all groups). The ANG II and angiotensin type 1a receptor expression increased in the S and T+S groups but not in T group. Supraphysiological doses of AS exacerbated the cardiac hypertrophy in exercise-trained rats. Exercise training associated with AS induces maladaptive remodeling and further deterioration in cardiac performance. Exercise training associated with AS causes loss of the beneficial effects in LV function induced by exercising. These results suggest that aerobic exercise plus AS increases cardiac collagen content associated with activation of the local renin-angiotensin system.

The burden of social phobia in a Brazilian community and its relationship with socioeconomic circumstances, health status and use of health services: the Bambuí study.

AIMS: Social phobia in the environment of poverty and major social inequalities, as observed in most developing countries, has received little attention. This population-based study was carried out in a poor community in Brazil (15,000 inhabitants), aiming at determining the prevalence of social phobia and its associated factors. METHOD: The Composite International Diagnostic Interview was applied in a random sample of 1037 residents aged > or = 18 years. RESULTS: The 1-month, 1-year and lifetime prevalence of social phobia were 7.9, 9.1 and 11.8%, respectively. One-month social phobia was independently associated with age (45-64 years), marital status (divorced/separated), worse socioeconomic indicators (family income and education), number of months worked, worse health status and use of health services and medications. CONCLUSION: There was an important burden of social phobia in the study community, due to its high prevalence (similar or superior to those observed in most developed countries), and due to its association with worse health status and use of health services and medications. The strong association between social phobia and socioeconomic circumstance, even in a small and poor community, is certainly a reflex of the major social inequalities in Brazil.

Dosagem de Lítio: Alerta / Lithium; Lithium`s serum level

A partir da observaçäo de incoerências entre dados clínicos e resultados laboratoriais, os autores formularam a hipótese de que a mensuraçäo sérica de Lítio pode näo ser confiável em pelo menos alguns laboratórios. Coletaram-se amostras de sangue de dez pacientes internados portadores de distúrbio bipolar e em tratamento com carbonato de Lítio. Foram realizadas dosagens séricas de Lítio de cada amostra em cinco laboratórios. Encontraram-se discrepâncias significativas entre os resultados das dosagens. Os resultados sugerem que as dosagens séricas de Lítio em pelo menos alguns laboratórios estäo sujeitas a variaçöes clínicamente significativas. Recomenda-se a realizaçäo de estudos mais abrangentes para se avaliar a extensäo do problema

Placebo-controlled study of tianeptine in major depressive episodes.

The efficacy and safety of tianeptine were compared, in the course of a multicentre randomised, double-blind, parallel group study, to those of placebo in the treatment of Major Depressions and Bipolar Disorder, Depressed with or without melancholia, without psychotic features. After a 1-week run-in placebo period, 126 depressed out-patients presenting DSM-III-R Major Depression or Bipolar Disorder, Depressed, with a total MADRS score of at least 25, were treated for 42 days with either tianeptine (25-50 mg/day) or placebo. Efficacy assessments were MADRS, CGI, HARS, Zung Depression Self Rating Scale and a VAS. Better efficacy of tianeptine was shown, and confirmed by covariance analyses, in final MADRS scores of the intention-to-treat population, of patients treated for at least 14 days and of completers; also in CGI items 1 and 2, MADRS item 10, and VAS. The results confirmed the efficacy of tianeptine (mean dosage: 37.5 mg/day) in the treatment of Major Depression and Bipolar Disorder, Depressed, with or without melancholia, compared to placebo. Tianeptine's acceptability did not differ from that of placebo. For adverse events, a higher incidence of headaches was found with tianeptine.

Vitamin B12 deficiency and dementia.

We set out to investigate the possible beneficial effects on cognitive function of demented patients with cobalamin deficiency after cobalamin replacement. A total of 181 consecutive, demented (DSM-III or DSM-III-R criteria and score below 24 on the Mini-Mental State Examination [MMSE]) outpatients (mean age 77.5 years) were prospectively evaluated and had their vitamin B12 level measured by radioimmunoassay. The frequency of vitamin B12 deficiency (less than 200 pg/mliter) was 25% (46 patients). Treatment outcome was obtained in 19 patients (19 of 46). Despite cobalamin replacement, 16 of 19 patients persisted in showing progressive decline during follow-up visits (3 to 24 months). The nonresponse to vitamin B12 replacement in most cases seems to reflect the presence of associated irreversible dementia or a follow-up of shorter duration in a few patients. All of the patients who showed some improvement (MMSE returned to normal values) had mild dementia with a history of less than 2 years. Thus, screening for B12 deficiency should be considered in patients with recent onset of mild mental status changes.

Kleptomania, mood disorder and lithium.

Kleptomania has been found in association with major depression in a fairly large number of reports in recent years. We describe a patient with concurrent DSM-III-R Bipolar Mood Disorder and Kleptomania, whose symptoms remitted completely, apparently in response to lithium therapy, which raised the possibility that pharmacological treatment may benefit kleptomania. Further studies are needed to establish the possible relationship between kleptomania, mood disorders and lithium therapy.