Clinical safety of zafirlukast treatment during acute inflammatory reaction in nile tilapia (Oreochromis Niloticus)

Little is known about the toxicity of immune modulators in fish. Zafirlukast is an anti-inflammatory that antagonizes cysteine leukotriene receptors (CysLTR1). Aiming to study immunomodulatory treatments on fish health, this study evaluated the clinical safety of oral zafirlukast treatment, through biochemical and hematological analyzes during acute inflammatory reaction in Nile tilapia (Oreochromis niloticus), induced by Aeromonas hydrophilabacterins. 72 young tilapias were randomly divided in 9 aquariums (100 L each, n=8) to compose the following treatments: T0 (control), T1 (Treatment with 250 μg zafirlukast) and T2 (Treatment with 500 μg zafirlukast). Eight animals were evaluated per treatment in three periods: six, 24 and 48 hours post-inoculation (HPI), blood collection was performed for hematological and serum biochemical evaluation. The study of hepatic and renal functionality revealed that treatment with both doses of zafirlukast did not result in changes in the circulating values of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase, creatinine, triglycerides, cholesterol, and total protein, suggesting that the drug has not presented hepatotoxicity, as well as compromised liver and kidney functions. Tilapia submitted to treatment with 500 μg showed adverse hematological effects characterizedby polycythemia associated with microcytosis. Therefore, oral treatment with zafirlukast has demonstrated clinical safety at a therapeutic dose of 250 μg in tilapia during acute aerocystitis, although hematological changes were observed in tilapia treatedwith overdose of this leukotriene blocker.

Pouco se sabe sobre a toxicidade de imunomoduladores em peixes. Zafirlukast é um anti-inflamatório que antagoniza os receptores de leucotrienos cisteínicos (CysLTR1). Com o objetivo de estudar o efeito de tratamentos imunomoduladores sobre a saúde dos peixes, este estudo avaliou a segurança clínica do tratamento com zafirlucaste oral, por meio de análises bioquímicas e hematológicas durante reação inflamatória aguda em tilápia do Nilo (Oreochromis niloticus), induzida por bacterinas de Aeromonas hydrophila.Para tal, 72 tilápias jovens foram divididas aleatoriamente em 9 aquários (100 L cada, n=8) para compor os seguintes tratamentos: T0 (controle), T1 (Tratamento com 250 μg de zafirlucaste) e T2 (Tratamento com 500 μg de zafirlucaste). Oito animais foram avaliados por tratamento em três períodos: seis, 24 e 48 horas pós-inoculação (HPI), foi realizada coleta de sangue para avaliação hematológica e bioquímica sérica. O estudo da funcionalidade hepática e renal revelou que o tratamento com ambas as doses de zafirlucaste não resultou em alterações nos valores circulantes de aspartato aminotransferase (AST), alanina aminotransferase (ALT), fosfatase alcalina, creatinina, triglicerídeos, colesterol e proteína total, sugerindo que a droga não comprometeu as funçõeshepáticas e renais. As tilápias tratadas com 500 μg apresentaram efeitos hematológicos adversos caracterizados por policitemia associada a microcitose. Portanto, o tratamento oral com zafirlucaste demonstrou segurança clínica nadose de 250 μg em tilápiasdurante aerocistite aguda, embora alterações hematológicas tenham sido observadas em tilápias tratadas com sobredosagem deste bloqueador de leucotrieno.

[Problematics of subarachnoid hemorrhage in developing countries: The case of Togo]. / Problématique des hémorragies méningées dans les pays en développement : cas du Togo.

OBJECTIVE: To analyze the diagnostic and therapeutic strategies as well as the results of the treatment of spontaneous subarachnoid hemorrhage (SAH) in Togo, before creating a neurosurgery department. METHODS: We conducted a case series of subarachnoid hemorrhage collected from 30 June 2005 to 30 June 2010 in the Universities Hospital of Lomé. It involved patients older than 15 years of age hospitalized for subarachnoid hemorrhage with clinical and/or radiation confirmation. RESULTS: Thirty-five cases of SAH were found and corresponded to 0.20 % of neurological emergencies. The average age was 48 years with a range of 22 to 78 years with a sex-ratio F/H 1.33. The consciousness disorders (48.57 %) and headaches (42.85 %) were the main reasons for admission. Seventeen patients (48.57 %) had hypertension and 14 (40 %) were ethylic. Lumbar puncture performed in 9 patients (25.71 %) and CT scan in 29 patients (82.86 %), respectively, had a sensitivity of 100 % and 93.10 %. Four cases of intracranial aneurysm were diagnosed. The admission average was 3.07±3.69 days. The treatment was mainly symptomatic. Mortality was 22.85 % and severe disability was observed in 8 patients (22.85 %). CONCLUSION: The profile of the SAH in Lomé appeared to differ from the literature. Too low a proportion of aneurysm is diagnosed. The equipment of Hospital and neurosurgeons training would be needed to improve the management of this pathology.

Non-completion of latent tuberculous infection treatment among children in Rio de Janeiro State, Brazil.

BACKGROUND: Children with latent tuberculous infection (LTBI) are particularly vulnerable to progression to active tuberculosis (TB), and are thus a priority target for isoniazid preventive therapy (IPT). However, adherence to IPT is poor. We hypothesised that children from poorer families, with reduced access to health care and lack of understanding about the disease are more likely to default from IPT. METHODS: A questionnaire was administered to close child contacts or their parents at the time of prescribing IPT in three cities in Rio de Janeiro State. The children were followed prospectively. Treatment adherence was defined as taking 80% of prescribed doses. RESULTS: Among 1078 children screened for LTBI, 97 (8.9%) did not return for tuberculin skin test (TST) reading; 332 (30.8%) were TST-positive; 115/332 (34.6%) were prescribed IPT, 6 of whom did not initiate treatment and 11 did not adhere during the first 2 months; 25 additional children did not complete IPT. Overall non-completion was four times more frequent among those with lower income. Health care access and knowledge did not improve treatment completion. CONCLUSIONS: Substantial losses to follow-up occurred before IPT prescription; this should be further investigated. Among the children who started isoniazid, low income, but not difficult access or poor knowledge, increased the risk of treatment non-completion.

[Neurological manifestations of Gougerot and Sjögren disease: a Black African case]. / Les manifestations neurologiques du syndrome de Gougerot et Sjögren: à propos d'un cas en Afrique noire.

Primitive Gougerot-Sjögren syndrome (PGSS) is a systemic autoimmune exocrinopathy in which twenty percent of affected patients develop neurological manifestations. It has been little described in the Black African literature. We report a case of PGSS in a 64-year-old Black woman as revealed by neurological manifestations in an inflammatory context. Central neuropathy was present and the patient fulfilled at least four of the six Vitali American-European diagnostic criteria. There were abnormal aspects on the sylvian artery and hyperintense lesions of periventricular predominance. PGSS is a serious disease which we must consider when we encounter any unexplained neurological manifestations especially those associated with vasculitic lesions.

[Vascular age and cardiovascular risk in patients suffering from stroke]. / Âge vasculaire et risque cardiovasculaire chez les patients victimes d'accident vasculaire cérébral.

AIMS: To determine the vascular age of patients suffering from stroke and their cardiovascular risk at 10 years and to compare their vascular age to their real age. MATERIAL AND METHODS: It was about a descriptive and retrospective study carried up from 1st January 2012 to 31st December 2013 at the neurologic clinic of the University teaching hospital Sylvanus Olympio of Lome from patients' files with a confirmed diagnostic of stroke according to the clinical examination and the scanner data. RESULTS: One hundred and ninety-four patients were related to our study. They were shared-out into 101 men and 93 women equal to a sex-ratio (man/woman) of 1.08. The average real age was of 57.6 ± 13.7 years. High blood pressure was the main risk factor with a prevailing rate of 86.6%, followed by the total hypercholesterolemia (54.3%), the hypocholesterolemia HDL (22.7%), diabetes (10.8%) and nicotinism addiction (4.1%). The average vascular age for all patients was of 68.23 years. The average difference between the real age and the vascular age was of 10 years. The average cardiovascular risk at 10 years in our study was of 13.2%. CONCLUSION: The vascular age of patients suffering from stroke at the University teaching hospital Sylvanus Olympio of Lome is 10 years higher than their real age. This condition considerably increases their risk of cardiovascular diseases. The screening and the early care about vascular risk factors appear therefore of utmost importance.

Changes in QuantiFERON®-TB Gold In-Tube results during treatment for tuberculous infection.

SETTING: Randomised trial comparing 9 months of isoniazid with 4 months of rifampicin for the treatment of high-risk tuberculin skin test positive subjects in Rio de Janeiro, Brazil. OBJECTIVES: To compare QuantiFERON®-TB Gold In-Tube (QFT-GIT) responses before and 1, 4 and 9 months after starting treatment for latent tuberculous infection (LTBI) according to adherence to one of the two regimens. DESIGN: Participants in the trial were invited to undergo serial QFT-GIT. Within-subject differences at different time points were analysed as quantitative responses and categorised as positive or negative using different cut-off points. RESULTS: Of 215 participants, 118 completed treatment, of whom 58 underwent all three tests; and 97 did not complete treatment, of whom 10 underwent all tests. After 1 month of treatment, there was no significant difference in QFT-GIT response between the groups. After 4 and 9 months, reversions were more frequent in non-adherent subjects. Marked within-subject fluctuations were observed. No cut-off point could be established at which QFT-GIT responses were consistently positive or associated with adherence or type of treatment. CONCLUSION: Frequent within-subject variability in QFT-GIT responses, not associated with LTBI treatment, makes it difficult for clinicians to interpret QFT-GIT conversions and reversions.

Haematological response of curimbas Prochilodus lineatus, naturally infected with Neoechinorhynchus curemai.

This study evaluated the haematological response of curimbas Prochilodus lineatus, naturally infected with Neoechinorhynchus curemai (Acanthocephala: Neoechinorhynchidae). Thirty-seven fish were captured in October 2010 from the Mogi Guaçu River, Porto Ferreira, SP, Brazil. Infected fish presented increased mean corpuscular volume of erythrocytes, and lower thrombocyte and higher monocyte counts than uninfected fish.

Low-power laser therapy for repairing acute and chronic-phase bone lesions.

To evaluate the therapeutic activity of low-power laser (InGaAlP: 670 nm/30 mW), at doses of 90 J/cm(2), on the process of acute and chronic-phase repair of bone lesions of Wistar rats. Sixty-three adult males were divided into nine groups subjected to bone injury, in order to form the following treatments: T1 (control); T2 (acute-phase); T3 (chronic-phase) which were subdivided into three subgroups (n=7), analyzed on the 9th, 17th and 28th days post-surgery, after a period of daily treatment with laser. The animals with acute-phase treatment presented a more extensive endochondral ossification process. Laser-treated animals showed significant increases in serum alkaline phosphatase levels and had an effect on biomechanical property, resulting in a gradual increase in bone stiffness. Laser therapy aided the bone consolidation process and favored the physiopathologic mechanisms involved in bone tissue repair, and its effects were more prominent when treatment started during the acute phase of the injury.

Distribution of Taenia saginata metacestodes: a comparison of routine meat inspection and carcase dissection results in experimentally infected calves.

A comparison of techniques for detecting the presence of Cysticercus bovis in bovine carcasses was made by using carcass dissection and routine beef inspection guidelines. In the study, 28 calves were used after they were tested and found to be negative for the presence of anti-C. bovis serum antibodies and were inoculated orally with aliquots containing 6×10(4) Taenia saginata eggs. One hundred and twenty days after inoculation, the animals were slaughtered and a post mortem evaluation was done following Brazilian Federal Beef Inspection guidelines. This routine meat inspection was able to identify 71·42% of the assessed infected carcasses as being parasitized. This result implies that 28·58% of the infected carcasses would have been released as fit for human consumption since they would have been considered as free of C. bovis infection when using this method for carcass assessment. Only 3·07% of the total 2311 metacestodes present in the carcasses were identified by the conventional procedures of sanitary inspection. The assessment of different parts of the carcasses showed high infestation rates in shoulder clod (14·37%), head (11·21%), neck+chuck roll (8·05%), heart (7·75%) and top (inside) round (7·18%) which, together, were responsible for housing 48·51% of all the cysts found in the 24 beef cuts assessed. These numbers contrasted to the low incidence of cysts found in organs such as tongue (3·12%), diaphragm (1·69%) and esophagus (1·60%) which are usually described as predilection sites for the parasite.

Evaluation of carbamazepine uptake and metabolization by Typha spp., a plant with potential use in phytotreatment.

Phytoremediation technologies such as constructed wetlands have shown higher efficiencies in removal of pharmaceuticals from wastewaters than conventional wastewater treatment processes, and plants seem to have an important role in the removal of some of those compounds. In this context, a study was conducted to assess tolerance, uptake, and metabolism of the epilepsy drug, carbamazepine, by the macrophyte Typha spp. This evaluation was conducted in hydroponic solutions with 0.5-2.0mg/L of this pharmaceutical for a maximum period of 21 days. The removal of carbamazepine from nutrient solutions by the plants reached values of 82% of the initial contents. Furthermore, a metabolite (10,11-dihydro-10,11-epoxycarbamazepine) was detected in leaf tissues indicating carbamazepine translocation and metabolism inside plants. Activities of antioxidant enzymes catalase, superoxide dismutase, and guaiacol peroxidase generally increase (after some mild initial inhibition in the case of the latter enzyme) as result of the abiotic stress caused by the exposure to carbamazepine, but ultimately Typha seemed able to cope with its toxicity. The results obtained in this study suggest the ability of Typha spp., to actively participate in the removal of carbamazepine from water when used in phytotreatment systems.

Tuberculosis treatment outcomes and socio-economic status: a prospective study in Duque de Caxias, Brazil.

A prospective study was conducted to evaluate tuberculosis treatment outcomes according to socio-economic status (SES) using different classification criteria. Patients aged ≥18 years under treatment for ≤8 weeks were interviewed. Outcomes were classified as successful (cure/completed) or unsuccessful (default/failure/death). The overall treatment default ratio was 20.9% and the unsuccessful outcome rate was 24.1%. Unsuccessful treatment was associated with SES according to any criteria used, except for the definition of poverty line. Poverty seems to be hampering the achievement of the World Health Organization targeted 90% cure rate in developing settings.

Genetic variability among natural populations of Zaprionus indianus (Drosophilidae) in the States of São Paulo and Minas Gerais, Brazil.

Random amplified polymorphic DNA (RAPD) was used to detect polymorphisms among Zaprionus indianus fly populations collected from six municipalities in the States of São Paulo and Minas Gerais, Brazil. This species is an important, recently introduced fruit fly pest of figs and other fruit. Among 21 primers, 16 produced 73 reproducible polymorphic fragments; primer AM-9 produced the greatest number of polymorphic bands (nine), with 52% genetic variability among populations. Genetic divergence analysis of the Z. indianus populations demonstrated two major groups, named Western and Eastern groups. There was greater gene flow within than between groups. The correlation coefficient for genetic and geographic distances (Mantel test) was significant, demonstrating isolation by distance.

Two-step tuberculin skin test and booster phenomenon prevalence among Brazilian medical students.

SETTING: Five medical schools in three cities in Rio de Janeiro State, Brazil, with different tuberculosis (TB) incidence rates. OBJECTIVE: To evaluate the prevalence of the booster phenomenon and its associated factors in a young universally BCG-vaccinated TB-exposed population. DESIGN: A two-step tuberculin skin test (TST) was performed among undergraduate medical students. Boosting was defined as an induration > or =10 mm in the second TST (TST2), with an increase of at least 6 mm over the first TST (TST1). The association of boosting with independent variables was evaluated using multivariate analysis. RESULTS: Of the 764 participants (mean age 21.9 +/- 2.7 years), 672 (87.9%) had a BCG scar. The overall booster phenomenon prevalence was 8.4% (95%CI 6.5-10.6). Boosting was associated with TST1 reactions of 1-9 mm (aOR 2.5, 95%CI 1.04-5.9) and with BCG vaccination, mostly after infancy, i.e., after age two years (aOR 9.1, 95%CI 1.2-70.7). CONCLUSION: The prevalence of the booster phenomenon was high. A two-step TST in young BCG-vaccinated populations, especially in those with TST1 reactions of 1-9 mm, can avoid misdiagnosis as a false conversion and potentially reduce unnecessary treatment for latent TB infection.

[Cerebral vascular accidents and embolic cardiovascular diseases]. / Accidents vasculaires cerebraux (AVC) et affections cardio-vasculaires emboligenes.

The cardiopathies occupy a place of choice in CVA (cerebro vascular accident) but in Togo no work have been done in this sector to realize it. Our work had for an objective to determine the prevalence of the association of cardiopathy and CVA (cerebro vascular accident). To determine the prevalence of embologenic cardiopathies. It was about a retrospective study on 91 files on 1102 cases of CVA (cerebro vascular accident) admitted from 1st January 2001 to 31st December 2005 in cardiological and neurological units in CHU Campus Lomé. The prevalence was of 8,25%, the average age was 59,19 years +/- 11,45. The sex ratio was 1,06. The principal affections found were embologenic cardiopathies 89,01% among which we can note troubles of the rhythm (41,75%), Ischaemia cardiopathies (27,47%), The valvulopathies (23,07%), The endocarditis (8,87%). The principal cardiovascular risk factors was arterial hypertension (60,43%), dyslipidémia (51,65%) and alcool (31,87%). The mortality rate was 27,47% and the morbidity rate was (50,55%), The association of the cardiopathies and C.V.A (cerebro vascular accident) constitute a public health problem in Togo. The embologenic cardiopathies occupy in this sector a preponderant place. The early prevention of this association must have for a target surely rhumatismal cardiopathy than arterial hypertension and its risk factors.

Management of epilepsy patients in Batamariba district, Togo.

OBJECTIVE: To describe the feasibility of managing epilepsy in a rural setting in a developing country. METHODS: The project comprised four phases. After a study of the perception of epilepsy, we conducted a sensitization campaign in November 2001. The third phase was a survey, to detect epilepsy patients, in which 6249 persons were asked to complete a questionnaire. Persons with epilepsy were then examined, treated, mainly with phenobarbital, and followed up. RESULTS: The prevalence of epilepsy was estimated to be 15.7 per thousand. Ninety-two patients took antiepileptic drugs from 1 February 2002. By November 2005, 92.7% of all treated patients had achieved complete suppression of seizures, and 7.3% had reduced seizure frequency. CONCLUSIONS: Despite the stigma attached to epilepsy in many developing countries, it can be controlled by relatively simple measures. At present, 601 epilepsy patients are being followed up at the Nadoba health centre, where epilepsy is now the second commonest disease.

Latent tuberculosis infection among undergraduate medical students in Rio de Janeiro State, Brazil.

SETTING: Five medical schools in three cities with different tuberculosis (TB) incidence rates in Rio de Janeiro State, Brazil. OBJECTIVE: To estimate prevalence of and associated factors for latent tuberculosis infection (LTBI) among medical students. DESIGN: A cross-sectional survey was conducted among undergraduate students in pre-clinical, early and late clinical years from schools in cities with low (28/100,000), intermediate (63/100,000) and high (114/100,000) TB incidence rates. Information on socio-demographic profile, previous BCG vaccination, potential TB exposure, co-morbidity and use of respiratory protective masks was obtained. A tuberculin skin test (TST) was performed using the Mantoux technique by an experienced professional. A positive TST, defined as induration > or = 10 mm, was considered LTBI. RESULTS: LTBI prevalence was 6.9% (95%CI 5.4-8.6). In multivariate analysis, male sex (adjusted odds ratio [aOR] 1.8; 95% CI 1.1-3.0), late clinical years (aOR 1.9; 95% CI 1.01-3.5), intermediate TB incidence (aOR 4.3; 95% CI 1.3-14.6) and high TB incidence in the city of medical school (aOR 5.1; 95% CI 1.6-16.8) were significantly associated with LTBI. CONCLUSIONS: The higher prevalence of LTBI in late clinical years suggests that medical students are at increased risk for nosocomial Mycobacterium tuberculosis infection. The implementation of a TB control program may be necessary in medical schools, particularly in cities with higher TB incidence.

Effect of dietary supplementation with vitamin E and stocking density on macrophage recruitment and giant cell formation in the teleost fish, Piaractus mesopotamicus.

The effect of dietary supplementation with 0, 100 and 450 mg of vitamin E (DL-alpha tocopheryl acetate)/kg of a dry diet on the kinetics of macrophage recruitment and giant cell formation in the pacu, maintained at different stocking densities (5 kg/m(3) and 20 kg/m(3)), was investigated by insertion of round glass coverslips into the subcutaneous connective tissue. After a feeding period of 18 weeks, the coverslips were implanted and later removed for examination at 2, 7 and 15 days post-implantation. Fish fed diets supplemented with 450 mg of vitamin E showed an increase (P<0.05) in the accumulation of macrophages, foreign body giant cells and Langhans type cells. The kinetics of macrophage recruitment and giant cell formation on the glass coverslips appeared to be strongly influenced by vitamin E supplementation, since fish fed a basal diet and held at high stocking densities showed low numbers of adhering cells on the coverslips, and high concentrations of plasma corticosteroids. On the other hand, fish given a diet supplemented with 450 mg of vitamin E did not show a similar difference in plasma cortisol concentrations related to stocking density. The effect of cortisol concentrations on carbohydrate metabolism, analysed by assessment of plasma glycaemia, was not clear. Blood glucose concentrations did not vary substantially with the different treatments examined. These results suggest that vitamin E may contribute to the efficiency of the fish's inflammatory response by increasing macrophage recruitment and giant cell formation in the foreign body granulomatous reaction. Vitamin E appeared to act on the stress response of pacus by preventing a stress-related immunosuppression.