Organ tropism during the acute and chronic phases of Trypanosoma cruzi infection in BALB/c mice

The aim of the present study was to investigate the presence of Trypanosoma cruzi in the heart, liver, lung, and kidneys, using hemoculture and PCR analysis, of mice infected with different parasite strains during the acute and chronic phases of infection. Parasitemia curves revealed strain-specific biological behaviors. For the Y and JLP strains, the acute phase of infection started at days six and ten post-infection, parasitemia peaked at days seven and 15 post-infection, the chronic phase started at days nine and 28 post-infection, and animals started dying at days 19 and 120 post-infection, respectively. When the two strains were compared, the JLP strain exhibited reduced and slower replication rates associated with a delayed peak of parasitism and reduced parasite burdens. However, parasites were detected in all studied organs using PCR analysis. The capacity of both strains to infect different organs likely influences disease pathogenesis.

Trends in multidrug-resistant tuberculosis: [review]

Multidrug-resistant tuberculosis (MDR-TB) is an increasing global problem. The extent and burden of MDR-TB varies significantly from country to country and region to region. Globally, about three per cent of all newly diagnosed patients have MDR-TB and the proportion is higher in patients who had previously received anti-tuberculosis (anti-TB) treatment reflecting the failure of programs designed to ensure complete cure of patients with tuberculosis. The management of MDR-TB is a challenge that should be undertaken by experienced clinicians at centers equipped with reliable laboratory services and implementation of DOTS-Plus strategy.

Pulmonary tuberculosis: hematology, serum biochemistry and the relation with the disease duration

The aim of the present study was to analyze the relationship between hematological and biochemical parameters and tuberculosis process activity time according to clinical complaint duration. It was a retrospective study analyzing medical records from 80 pulmonary tuberculosis patients at Botucatu Medical School University Hospital (Botucatu, São Paulo State, Brazil), who were divided into 2 groups according to clinical complaint duration: Group 1 (G1) - up to three months; Group 2 (G2) - over three months. Parameters included: age, gender, bacilloscopy, erythrocyte sedimentation rate (ESR), platelet count, alpha1-globulin, alpha2-globulin, gamma globulin, mucoprotein, alpha1-acid glycoprotein values, and the presence of risk factors such as smoking, alcoholism, drug addiction, sexual promiscuity, contact with tuberculosis carriers, and previous treatment. Groups were compared by calculating t and p, and Chi-square (X²) and p. Comparisons revealed a tendency towards smoking with a higher frequency of smokers in G1 (0.050.05). A correlation was found between ESR, platelet count, smoking and less than three months clinical duration.

Dysphonia and laryngeal sequelae in paracoccidioidomycosis patients: a morphological and phoniatric study.

The larynx is the third most commonly involved organ in paracoccidioidomycosis (PCM). While a few studies have evaluated laryngeal sequelae, there have not been any investigations of voice abnormalities in PCM patients. To evaluate persistent dysphonia and laryngeal lesions, we studied 15 normal subjects and 30 post-treatment PCM patients, i.e., 15 with only pulmonary and 15 with both laryngeal and pulmonary involvement. Perceptual and acoustic voice analysis were performed with all patients, while endoscopic studies were also conducted with the 15 laryngeal patients. Voice analysis showed instability by perceptual analysis (P<0.01) in both groups, but more severe dysphonia was noted in the laryngeal group (P<0.01). The dysponia, seen in 66.7% of these patients (dysphonia index < 7.0), was characterized by roughness and breathness. The Dr. Speech (Tiger Electronics) analysis program did not accept five voices from the laryngeal group due to the severe dysphonia. Jitter was elevated in five laryngeal lesion patients. Endoscopy showed that 80% of patients with laryngeal lesion had two or more laryngeal structures involved. Vocal fold alterations were seen in all laryngeal lesion patients, which included involvement of the arythenoids, epiglottis, and vestibular folds. This first functional study of laryngeal sequelae in PCM revealed frequent and severe dysphonia that may have important social consequences for patients.

Trypanosomatids in dogs belonging to individuals with chronic chagas'disease living in Botucatu town and surrounding region, São Paulo State, Brazil

Among domestic animals, dogs are considered to be the major reservoirs of trypanosomatids and, due to their proximity to man, the presence of these parasites in dogs is an alert to actions aiming at triatomine control. Fifty dogs (26 males and 24 females), aged from 2 months to 15 years, belonging to 30 chronic Chagas’ disease individuals from 15 different municipalities in the western region of São Paulo State, Brazil, were subjected to blood collection for the following tests: artificial xenodiagnosis, blood culture, and Polymerase Chain Reaction (PCR). Forty-three (86%) out of 50 dogs were positive to at least one of the tests performed; 34 (68%) were positive to xenodiagnosis, 30 (60%) to blood culture, and 25 (50%) to PCR for T. cruzi and/or T. rangeli. Although triatomines were not detected during the intra and peridomiciliary inspections in the dog owners’ residences, the results obtained demonstrate that there is a transmission cycle whereby triatomine vector may be participating in the infection epidemiological chain

Measurement of IL-10 serum levels in balb/c mice treated with beta-1, 3 polyglucose or sulfadiazine and acutely infected by Toxoplasma gondii

Acute infection by Toxoplasma gondii leads to suppression of cell-mediated immunity, facilitating chronic infection. One of the causes of immunosuppression is Interleukin-10 (IL-10) production. Glucan is used to stimulate phagocytosis. Our objective was to study IL-10 induction in male BALB/c mice with acute T. gondii BTU-2 strain infection, glucan immunostimulation, and sulfadiazine treatment. Animals were distributed into 7 groups: G1: infected with T. gondii; G2: infected with T. gondii and treated with sulfadiazine; G3: infected with T. gondii and immunostimulated with glucan; G4: infected with T. gondii, immunostimulated with glucan, and treated with sulfadiazine; G5: imunostimulated with glucan; G6: treated with saline; and G7: treated with sulfadiazine. IL-10 levels were determined by ELISA; the highest levels were found in G2, G3 and G4, and the lowest in G1 (p<0.001). Groups G1 to G5 and G7 had substantially higher levels than G6 (p<0.001). In this study, the highest IL-10 levels were found in groups treated with glucan

Correlation between cytokine serum levels, number of CD4+ T cells/mm³ and viral load in HIV-1 infected individuals with or without antiretroviral therapy

Seventy-nine HIV-1 infected patients were studied in three groups: Group G1 - 11 patients with no antiretroviral therapy; G2 - 40 patients undergoing antiretroviral therapy, 33 with only two nucleoside reverse transcriptase inhibitors (NRTI), and seven with two NRTI and one protease inhibitor (PI), all with viral load (VL) equal or higher than 80 copies of plasma RNA/ml; Group G3 - 28 patients, 23 on highly active antiretroviral therapy (HAART), 18 with two NRTI and one PI, and five with two NRTI and one non-nucleoside reverse transcriptase inhibitor (NNRTI), the remaining five with combination of two NRTI. All G3 patients had undetectable viral load for at least the past six months. The control group (Gc) included 20 normal blood donors without clinical complaints or signs of disease and negative for anti-HIV-1/2 antibodies. Serum cytokine levels pg/ml (TNF-alpha, INF-gamma, IL-2, IL-4, and IL-10) were determined in all patients including controls. CD4+ T and CD8+ T lymphocyte counts were made in the 79 patients by flow cytometry; VL determination was by NASBA technology. Analysis of results showed that the number of CD4+ T and CD8+ T lymphocytes were higher in G2 than G1, while VL was 0.5 log lower. G3 patients had similar lymphocyte values to G2, however they were chosen for G3 because their VL was undetectable, different by 4.0 log to G2. These results show the effect of antiretroviral treatment in G2 and G3 patients with better performance in the latter. Statistical difference was seen between the three groups and controls for serum cytokine behavior: TNF-alpha [H=48.323; p<0.001;(G1=G2=G3)>Gc]; INF-gamma[H=28.992; p<0.001; (G1=G2=G3)>Gc]; IL-4[H=48.323; p<0.001; (G1=G2=G3)>Gc]; IL-10[H=47.256; p<0.001; (G1=G2=G3)>Gc. There was no statistical difference in IL-2 values between all groups (H=6.071; p>0.10; G1=G2=G3=Gc). In absolute values however, G3 showed slightly lower TNF-alpha, IL-4, and IL-10, and higher INF-gamma and IL-2, to G1 and G2. This suggests a better performance in G3 patients, especially in IL-2 behavior. For cytokine profile, the three groups showed mature Th0 subset. In G1 72.73 percent were mature Th0, and 27.27 percent Th2; G2, 72.50 percent mature Th0, and 27.50 percent Th2; and G3, 89.29 percent mature Th0, and 10.71 percent Th2. There was no statistical difference between groups (chi(2)2=3.014; p>0.10; G1=G2=G3). Statistical difference was seen between G2 and G3 for antiretroviral regimes used...

Use of a condom in sex relations by HIV carriers.

The frequency with which condoms are used in sex relations by subjects with HIV was determined by interviewing 132 individuals, 82 men and 50 women, most of them from São Paulo state and some from other regions of the country, all of them seen at an outpatient clinic of the School of Medicine in Botucatu. The women were younger, were of lower educational level and had poorer professional qualification than men. Also, a greater proportion of women were widowed, separated or divorced. We observed that 43.9% of men and 72% of women had been contaminated by the sexual route, but only 41.2% of the men and 31.8% of the women reported the use of a condom after the diagnosis of infection, with most men and women preferring sexual abstinence. The results enable the conclusion that there is still a need to continue to provide information about the use of condoms and to guarantee their free-of-charge distribution due to the low levels of education and professional qualification of the individuals studied. The data also suggest that campaigns for the dissemination of preventive measures should consider the social and cultural differences of infected women.

Use of a condom in sex relations by HIV carriers

The frequency with which condoms are used in sex relations by subjects with HIV was determined by interviewing 132 individuals, 82 men and 50 women, most of them from São Paulo state and some from other regions of the country, all of them seen at an outpatient clinic of the School of Medicine in Botucatu. The women were younger, were of lower educational level and had poorer professional qualification than men. Also, a greater proportion of women were widowed, separated or divorced. We observed that 43.9% of men and 72% of women had been contaminated by the sexual route, but only 41.2% of the men and 31.8% of the women reported the use of a condom after the diagnosis of infection, with most men and women preferring sexual abstinence. The results enable the conclusion that there is still a need to continue to provide information about the use of condoms and to guarantee their free-of-charge distribution due to the low levels of education and professional qualification of the individuals studied. The data also suggest that campaigns for the dissemination of preventive measures should consider the social and cultural differences of infected women.

Para estudar a ocorrência da utilização do preservativo masculino em relações sexuais pelos portadores do HIV, foram entrevistados 132 indivíduos, sendo 82 homens e 50 mulheres. A maioria do Estado de São Paulo e algumas de outras regiões do País, atendidas na Faculdade de Medicina de Botucatu. As mulheres eram mais jovens, tinham menor escolaridade, pior qualificação profissional que os homens, e ainda, maior proporção era de viúvas, separadas, desquitadas e divorciadas. Verificou-se que 43,9% dos homens e 72% das mulheres foram contaminados pela via sexual, mas apenas 41,2% dos primeiros e 31,8% das mulheres referiram utilização do preservativo após o diagnóstico de infecção, a maioria de homens e mulheres preferindo observar abstinência sexual. Os resultados permitem concluir que ainda há necessidade de se manter informação continuada sobre a importância do uso do preservativo, além de se garantir sua distribuição gratuita, pelos baixos níveis de instrução e qualificação profissional dos indivíduos. Sugerem, ainda, que as campanhas de divulgação de medidas preventivas considerem as diferenças sociais e culturais das mulheres que se infectam.

The use of glucan as immunostimulant in the treatment of paracoccidioidomycosis.

A group of 10 patients, nine of them seriously infected with Paracoccidioides brasiliensis (G1), received glucan (beta-1,3 polyglucose) as an immunostimulant intravenously once a week for one month, followed by monthly doses (10 mg) over an 11-month period, together with a specific anti-fungal agent as an immunostimulant. A second group of eight moderately infected patients (G2) was treated with only the anti-fungal agent. Among the patients in G1, there was only one case of relapse compared with five in G2. Values for the erythrocyte sedimentation rate (ESR) showed a significant difference (P < 0.001) post-treatment in G1 patients, when compared with the pretreatment levels. There was also a significant reduction (P < 0.001) in the level of serum antibodies to P. brasiliensis in the G1 patients in post-treatment examinations. The phytohemagglutinin (PHA) skin test showed a positive reaction among the patients in G1 (P < 0.01) post-treatment and there was a tendency towards an increase in the number of CD4+ T lymphocytes in both groups after treatment. The serum level of tumor necrosis factor (TNF) proved to be significantly higher (P < 0.02) in the G1 patients during treatment. In the G1 patients, the correlation between ESR and TNF tended to be negative whereas that between ESR and serum antibodies was positive. The present results indicate that the patients who received glucan, in spite of being more seriously ill, had a stronger and more favorable response to therapy.

Sputum cytology in the diagnosis of pulmonary paracoccidioidomycosis.

The presence of Paracoccidioides brasiliensis was determined in sputum samples from 50 patients with paracoccidioidomycosis using four different techniques: (a) cell-block preparations stained with silver methenamine, (b) direct microbiologic examination, (c) smears stained with Shorr, and (d) smears stained with silver methenamine. Overall, cell-block preparations and smears stained with silver methenamine proved to be the most sensitive techniques, followed by smears stained with Shorr and direct microbiologic examination in decreasing order of sensitivity. Sputum cytology tended to be less positive in patients with interstitial pulmonary lesions as determined by chest X-ray than in patients with alveolar lesions. In addition to its high sensitivity, cell-block preparation technique allows storage of blocks and slides for further studies.