Cutaneous schistosomiasis and leishmaniasis coinfection: a case report.

BACKGROUND: The polymorphic clinical presentations of schistosomiasis and leishmaniasis allow their inclusion in the differential diagnoses of several conditions. Although an overlap in distribution of these diseases has been reported in endemic areas, coinfection with cutaneous schistosomiasis and cutaneous leishmaniasis in the same patient is rare. OBJECTIVES: We report an unusual case of concomitant cutaneous schistosomiasis and cutaneous leishmaniasis. Actions for the management and diagnosis were proposed. METHODS: A patient presented with cutaneous lesions on the abdomen and left elbow. The presence of degenerated ova of Schistosoma mansoni in the skin biopsy led to perform a complementary investigation with immunohistochemical techniques, rectal biopsy and abdominal ultrasonography. After the left elbow lesions had failed to improve after several weeks of standard treatment, a new biopsy was performed and led to diagnosis of another infection. RESULTS: The patient lived in an endemic area for two infectious diseases (schistosomiasis and leishmaniasis). Biopsies revealed chronic granulomatous dermatitis. Degenerated S. mansoni eggs were found in the abdominal lesion and in a rectal biopsy specimen. Ultrasonography revealed hepatic involvement. Despite combination treatment with oxamniquine and praziquantel, a cutaneous lesion persisted on the left elbow; a new biopsy revealed amastigote forms of Leishmania. The patient was successfully treated with intramuscular and intralesional meglumine antimoniate. CONCLUSIONS: The presence of a similar granulomatous infiltrate in lesions caused by the two different infectious agents led to a delay in the diagnosis of cutaneous leishmaniasis. This report serves as a warning of the unusual possibility of cutaneous schistosomiasis and leishmaniasis coinfection in an endemic area.

Cutaneous schistosomiasis and leishmaniasis coinfection: a case report

Background The polymorphic clinical presentations of schistosomiasis and leishmaniasis allow their inclusion in the differential diagnoses of several conditions. Although an overlap in distribution of these diseases has been reported in endemic areas, coinfection with cutaneous schistosomiasis and cutaneous leishmaniasis in the same patient is rare.

Morita-Baylis-Hillman adduct shows in vitro activity against Leishmania (Viannia) braziliensis associated with a reduction in IL-6 and IL-10 but independent of nitric oxide.

Current treatments for different clinical forms of leishmaniasis are unsatisfactory, highly toxic and associated with increasing failure rates resulting from the emergence of resistant parasites. Leishmania (Viannia) braziliensis is the main aetiological agent of different clinical forms of American tegumentary leishmaniasis, including the mucosal form for which treatment has high failure rates. The aim of this work was to investigate the activity of the Morita-Baylis-Hillman adduct, methyl 2-{2-[hydroxy(2-nitrophenyl)methyl])acryloyloxy} benzoate in vitro against isolates of L. (V.) braziliensis obtained from patients with different clinical manifestations of tegumentary leishmaniasis: localized cutaneous leishmaniasis, mucosal leishmaniasis and disseminated cutaneous leishmaniasis. The adduct effectively inhibited the growth of promastigotes of the different isolates of L. (V.) braziliensis (IC(50) ≤ 7·77 µg/ml), as well as reduced the infection rate of macrophages infected with these parasites (EC(50) ≤ 1·37 µg/ml). It is remarkable to state that the adduct was more effective against intracellular amastigotes (P ≤ 0·0045). The anti-amastigote activity correlated with an immunomodulatory effect, since the adduct was able to decrease the production of IL-6 and IL-10 by the infected macrophages. However, its effect was independent of nitric oxide production. This work demonstrates the anti-leishmanial activity of methyl 2-{2-[hydroxy(2-nitrophenyl)methyl])acryloyloxy} benzoate and suggests its potential in the treatment of human infections caused by L. (V.) braziliensis.

Growth inhibitory effects of 3'-nitro-3-phenylamino nor-beta-lapachone against HL-60: a redox-dependent mechanism.

In this study, the cytotoxicity, genotoxicity and early ROS generation of 2,2-dimethyl-(3H)-3-(N-3'-nitrophenylamino)naphtho[1,2-b]furan-4,5-dione (QPhNO(2)) were investigated and compared with those of its precursor, nor-beta-lapachone (nor-beta), with the main goal of proposing a mechanism of antitumor action. The results were correlated with those obtained from electrochemical experiments held in protic (acetate buffer pH 4.5) and aprotic (DMF/TBABF(4)) media in the presence and absence of oxygen and with those from dsDNA biosensors and ssDNA in solution, which provided evidence of a positive interaction with DNA in the case of QPhNO(2). QPhNO(2) caused DNA fragmentation and mitochondrial depolarization and induced apoptosis/necrosis in HL-60 cells. Pre-treatment with N-acetyl-l-cysteine partially abolished the observed effects related to the QPhNO(2) treatment, including those involving apoptosis induction, indicating a partially redox-dependent mechanism. These findings point to the potential use of the combination of pharmacology and electrochemistry in medicinal chemistry.

Chronic contamination assessment integrating biomarkers' responses in transplanted mussels--a seasonal monitoring.

This study aimed to provide the first biomonitoring integrating biomarkers and bioaccumulation data in São Paulo coast, Brazil and, for this purpose, a battery of biomarkers of defense mechanisms was analyzed and linked to contaminants' body burden in a weigh-of-evidence approach. The brown mussel Perna perna was selected to be transplanted from a farming area (Caraguatatuba) to four possibly polluted sites: Engenho D'Água, DTCS (Dutos e Terminais do Centro-Oeste de São Paulo) oil terminal (Sao Sebastiao zone), Palmas Island, and Itaipu (It; Santos Bay zone). After 3 months of exposure in each season, mussels were recollected and the cytochrome P4501A (CYP1A)- and CYP3A-like activities, glutathione-S-transferase and antioxidants enzymes (catalase, glutathione peroxidase, and glutathione reductase) were analyzed in gills. The concentrations of polycyclic aromatic hydrocarbons, linear alkylbenzenes, and nonessential metals (Cr, Cd, Pb, and Hg) in whole tissue were also analyzed and data were linked to biomarkers' responses by multivariate analysis (principal component analysis-factor analysis). A representation of estimated factor scores was performed to confirm the factor descriptions and to characterize the studied stations. Biomarkers exhibited most significant alterations all year long in mussels transplanted to It, located at Santos Bay zone, where bioaccumulation of organic and inorganic compounds was detected. This integrated approach using transplanted mussels showed satisfactory results, pointing out differences between sites, seasons, and critical areas, which could be related to land-based contaminants' sources. The influence of natural factors and other contaminants (e.g., pharmaceuticals) on biomarkers' responses are also discussed.

Genotoxic effects of aluminum, iron and manganese in human cells and experimental systems: a review of the literature.

There is considerable evidence indicating an increase in neurodegenerative disorders in industrialized countries. The clinical symptoms and the possible mutagenic effects produced by acute poisoning and by chronic exposure to metals are of major interest. This study is a review of the data found concerning the genotoxic potential of three metals: aluminum (Al), iron (Fe) and manganese (Mn), with emphasis on their action on human cells.

Cyclic fatigue resistance of rotary nickel-titanium instruments submitted to nitrogen ion implantation.

INTRODUCTION: The aim of this study was to assess cyclic fatigue resistance in rotary nickel-titanium instruments submitted to nitrogen ion implantation by using a custom-made cyclic fatigue testing apparatus. METHODS: Thirty K3 files, size #25, taper 0.04, were divided into 3 experimental groups as follows: group A, 12 files exposed to nitrogen ion implantation at a dose of 2.5 x 10(17) ions/cm(2), accelerating voltage of 200 kV, currents of 1 microA/cm(2), 130 degrees C temperature, and vacuum conditions of 10 x 10(-6) torr for 6 hours; group B, 12 nonimplanted files; and group C, 6 files submitted to thermal annealing for 6 hours at 130 degrees C. One extra file was used for process control. All files were submitted to a cyclic fatigue test that was performed with an apparatus that allowed the instruments to rotate freely, simulating rotary instrumentation of a curved canal (40-degree, 5-mm radius curve). An electric motor handpiece was used with a contra-angle of 16:1 at an operating speed of 300 rpm and a torque of 2 N-cm. Time to failure was recorded with a stopwatch in seconds and subsequently converted to number of cycles to fracture. Data were analyzed with the Student t test (P < .05). RESULTS: Ion-implanted instruments reached significantly higher cycle numbers before fracture (mean, 510 cycles) when compared with annealed (mean, 428 cycles) and nonimplanted files (mean, 381 cycles). CONCLUSIONS: Our results showed that nitrogen ion implantation improves cyclic fatigue resistance in rotary nickel-titanium instruments. Industrial implementation of this surface modification technique would produce rotary nickel-titanium instruments with a longer working life.

The population density effects on the reproductive biology of the snail Bradybaena similaris (Férussac, 1821) (Mollusca, Gastropoda).

The influence of population density on some aspects of the reproductive biology of the snail Bradybaena similaris was studied. Molluscs were maintained under 0.2 (isolated), 0.3, 0.6, 1.0, 1.3 and 1.7 snail/m(2) densities. The animals maintained under 0.3 and 0.6 snail/m(2) showed the lowest numbers of eggs laid/snail, being the highest value observed to the 1.7 snail/m(2). The hatching of the snails maintained under 0.3 snail/m(2) density, begun at the 21st day after laying, and the maximum time required to the hatching was 36 days was observed to the eggs came from snails maintained under the densities 0.6, 1.0, 1.3 snail/m(2), respectively. The highest percentage hatchability (55.56%) was observed to isolated snails. The galactogen content in the albumen gland did not seem to accompany the alterations occurred in the reproduction of B. similaris in response to the different population densities.

Joint sampling programme--verification of data obtained in environmental monitoring.

The objective of the Environmental Radiological Monitoring Control programme carried out by the Institute of Radiation Protection and Dosimetry (IRD) in Brazil is to verify the licensee's compliance with the requirements for environmental monitoring of Brazilian facilities. The Joint Sampling Programme (JSP) is just one part of the control programme. In order to verify that the data reported by the licensees is representative and legitimate, this programme verifies sampling procedures, accuracy and precision of the data and the changes in the environmental conditions. This paper discusses the main findings of this programme that allowed IRD to optimize its available resources to control the monitoring of the eight facilities in Brazil.

The population density effects on the reproductive biology of the snail Bradybaena similaris (Férussac, 1821) (Mollusca, Gastropoda) / Efeitos da densidade populacional na biologia reprodutiva do molusco Bradybaena similaris (Molusca, Gastropoda)

The influence of population density on some aspects of the reproductive biology of the snail Bradybaena similaris was studied. Molluscs were maintained under 0.2 (isolated), 0.3, 0.6, 1.0, 1.3 and 1.7 snail/m² densities. The animals maintained under 0.3 and 0.6 snail/m² showed the lowest numbers of eggs laid/snail, being the highest value observed to the 1.7 snail/m². The hatching of the snails maintained under 0.3 snail/m² density, begun at the 21st day after laying, and the maximum time required to the hatching was 36 days was observed to the eggs came from snails maintained under the densities 0.6, 1.0, 1.3 snail/m², respectively. The highest percentage hatchability (55.56 percent) was observed to isolated snails. The galactogen content in the albumen gland did not seem to accompany the alterations occurred in the reproduction of B. similaris in response to the different population densities.

A influência da densidade populacional em alguns aspectos da biologia reprodutiva do molusco Bradybaena similaris foi estudada. Os moluscos foram mantidos em densidades de 0.2 (isolados), 0.3, 0.6, 1.0,1.3 e 1.7 moluscos/m². Nas densidades de 0.3 e 0.6 moluscos/m², os moluscos apresentaram os menores números de ovos postos por molusco, sendo o maior valor observado para essa variável na densidade de 1.7 molusco/m². A eclosão dos moluscos mantidos a uma densidade de 0.3 molusco/m², iniciou-se aos 21 dias após a postura, sendo o tempo máximo necessário para a eclosão 36 dias para ovos oriundos de moluscos mantidos nas densidades de 0.6, 1.0, 1.3 moluscos/m². O maior percentual de eclosão (55.56 por cento) foi observado para os moluscos isolados. O conteúdo de galactogênio na glândula de albúmem parece não acompanhar as alterações na reprodução de B. similaris em resposta a diferentes densidades populacionais.

Genotoxic and cytotoxic effects of manganese chloride in cultured human lymphocytes treated in different phases of cell cycle.

Manganese (Mn) has a natural occurrence and is necessary during the initial periods of the development. However, in high concentrations, Mn can be related to neurodegenerative disorders. The aim of the present study was to evaluate the mutagenic potential of manganese chloride (MnCl2.4H2O). Comet assay and chromosome aberrations analysis were applied to determine the DNA-damaging and clastogenic effects of MnCl2.4H2O. Cultured human lymphocytes were treated with 15, 20 and 25 microM manganese chloride during the G1, G1/S, S (pulses of 1 and 6h), and G2 phases of the cell cycle. All tested concentrations were cytotoxic and reduced significantly the mitotic index in G1, G1/S and S (1 and 6h) treatments, while in G2 treatment only the higher concentrations (20 and 25 microM) showed cytotoxic effects. Clastogenicity and DNA damage were found only in treatments with the highest concentration (25 microM). Chromosome aberrations were found exclusively in the G2 phase of the cell cycle. The absence of polyploidy in mitosis, suggests that manganese does not affect the formation of the mitotic spindle with the concentrations tested. The genotoxicity found in G2 phase and in the comet assay can be related to the short time of treatment in both cases.

Genotoxic and cytotoxic effects of iron sulfate in cultured human lymphocytes treated in different phases of cell cycle.

Iron (Fe) is a common chemical element that is essential for organisms as a co-factor in oxygen transport, but that in high amounts presents a significant risk of neurodegenerative disorders. The objective of this study was to evaluate the mutagenic potential of iron sulfate. The comet assay and chromosome aberration (CA) analysis were applied to determine the DNA-damaging and clastogenic effects of iron sulfate. Human lymphocytes were treated in the quiescent phase for the comet assay and proliferative phase during the G1, G1/S, S (pulses of 1 and 6 h), and G2 phases of the cell cycle for CA analysis, with 1.25, 2.5 and 5 microg/mL concentrations of FeSO(4).7H2O. All tested concentrations were cytotoxic and reduced significantly the mitotic index (MI) in all phases of the cell cycle. They also induced CA in G1, G1/S and S (pulses of 1 and 6 h) phases. Iron sulfate also induced polyploidy in cells treated during G1. In the comet assay, this metal did not induce significant DNA damage. Our results show that Fe causes alteration and inhibition of DNA synthesis only in proliferative cells, which explain the concomitant occurrence of mutagenicity and cytotoxicity, respectively, in the lymphocytes studied.

Genotoxic effects of aluminum chloride in cultured human lymphocytes treated in different phases of cell cycle.

Aluminum (Al) is the most abundant metal and the third common chemical element on earth. It is known that Al is toxic, especially its trivalent form (Al(3+)), that represents the its most soluble form. Al intoxication is related to some pathogenic disorders, principally neurodegeneratives ones as Parkinson and Alzheimer diseases. The present study aimed to evaluate the mutagenic potential of aluminum chloride (AlCl(3)). Comet assay and chromosome aberrations analysis were applied to evaluate the DNA-damaging and clastogenic effects of AlCl(3), respectively, in different phases of the cell cycle. Cultured human lymphocytes were treated with 5, 10, 15 and 25 microM aluminum chloride during the G1, G1/S, S (pulses of 1 and 6h), and G2 phases of the cell cycle. All tested concentrations were cytotoxic and reduced significantly the mitotic index in all phases of cell cycle. They also induced DNA damage and were clastogenic in all phases of cell cycle, specially in S phase. AlCl(3) also induced endoreduplication and polyploidy in treatments performed during G1 phase. The presence of genotoxicity and polyploidy on interphase and mitosis, respectively, suggests that aluminum chloride is clastogenic and indirectly affects the construction of mitotic fuse in all tested concentrations.

High selective leishmanicidal activity of 3-hydroxy-2-methylene-3-(4-bromophenyl)propanenitrile and analogous compounds.

Sixteen not new aromatic compounds were prepared by one-pot reaction i.e. through Baylis-Hillman reaction and were the first time evaluated against promastigote Leishmania amazonensis and infected mammalian cells. Most of the compounds were selectively more active against amastigotes than the reference drug sodium stibogluconate (Pentostam, IC(50)=44.7 microM). We found that 3-hydroxy-2-methylene-3-(4-bromophenyl) propanenitrile (13) was the most active (IC(50)=12.5 microM) and safer compound (0.0 (0.9); % macrophage LDH release), being the lead compound.

Efficacy and safety of combined piroxicam, dexamethasone, orphenadrine, and cyanocobalamin treatment in mandibular molar surgery.

Third molar extraction is a common procedure frequently accompanied by moderate or severe pain, and involves sufficient numbers of patients to make studies relatively easy to perform. The aim of the present study was to determine the efficacy and safety of the therapeutic combination of 10 mg piroxicam, 1 mg dexamethasone, 35 mg orphenadrine citrate, and 2.5 mg cyanocobalamin (Rheumazin) when compared with 20 mg piroxicam alone (Feldene) in mandibular third molar surgery. Eighty patients scheduled for removal of the third molar were included in this randomized and double-blind study. They received (vo) Rheumazin or Feldene 30 min after tooth extraction and once daily for 4 consecutive days. Pain was determined by a visual analogue scale and by the need for escape analgesia (paracetamol). Facial swelling was evaluated with a measuring tape and adverse effects and patient satisfaction were recorded. There was no statistically significant difference in facial swelling between Rheumazin and Feldene (control group). Both drugs were equally effective in the control of pain, with Rheumazin displaying less adverse effects than Feldene. Therefore, Rheumazin appears to provide a better risk/benefit ratio in the mandibular molar surgery. Since the side effects resulting from nonsteroidal anti-inflammatory drug administration are a severe limitation to the routine use of these drugs in clinical practice, our results suggest that Rheumazin can be a good choice for third molar removal treatment.

Efficacy and safety of combined piroxicam, dexamethasone, orphenadrine, and cyanocobalamin treatment in mandibular molar surgery

Third molar extraction is a common procedure frequently accompanied by moderate or severe pain, and involves sufficient numbers of patients to make studies relatively easy to perform. The aim of the present study was to determine the efficacy and safety of the therapeutic combination of 10 mg piroxicam, 1 mg dexamethasone, 35 mg orphenadrine citrate, and 2.5 mg cyanocobalamin (Rheumazin®) when compared with 20 mg piroxicam alone (Feldene®) in mandibular third molar surgery. Eighty patients scheduled for removal of the third molar were included in this randomized and double-blind study. They received (vo) Rheumazin or Feldene 30 min after tooth extraction and once daily for 4 consecutive days. Pain was determined by a visual analogue scale and by the need for escape analgesia (paracetamol). Facial swelling was evaluated with a measuring tape and adverse effects and patient satisfaction were recorded. There was no statistically significant difference in facial swelling between Rheumazin and Feldene (control group). Both drugs were equally effective in the control of pain, with Rheumazin displaying less adverse effects than Feldene. Therefore, Rheumazin appears to provide a better risk/benefit ratio in the mandibular molar surgery. Since the side effects resulting from nonsteroidal anti-inflammatory drug administration are a severe limitation to the routine use of these drugs in clinical practice, our results suggest that Rheumazin can be a good choice for third molar removal treatment.

The impact of lupus erythematosus cutaneous on the Quality of life: the Brazilian-Portuguese version of DLQI.

OBJECTIVE: To translate into Brazilian-Portuguese, culturally adapt and validate the DLQI. PATIENTS AND METHODS: The DLQI was translated into Brazilian-Portuguese and cultural adaptation was performed following the methodology proposed by Falcão. Inter-observer reliability and validity were assessed. Seventy-one patients with lupus erythematosus with cutaneous lesions selected from the outpatient dermatology clinic had their quality of life assessed by DLQI and SF-36. The validity of the Brazilian-Portuguese version of the DLQI was evaluated by the correlation of DLQI scores with SF-36 component scores and other outcome measures. RESULTS: In the translation and cultural adaptation process the basic structure of DLQI was kept. Very few questions have very slightly modifications. Of the 71 patients, 83% were women and the median (SD) age was 38 (12) years. The patients had a mean (SD) disease duration of 8(6) years. There were 46 patients with active cutaneous lesions and 37 patients with alopecia. The DLQI inter-observer reliability coefficient was 0.96 (p<0.001). The DLQI mean (SD) score was 6.5 (5.6) and most of the SF-36 domains were between 60 and 70. The domains that had the lowest scores were 'general health' (62) and 'mental health' (62). The Pearson correlation coefficient between DLQI and each SF-36 component score were highly statistically significant (p<0.001), despite of being only moderate. As expected there was no correlation between DLQI or each one of the SF-36 components and age, disease duration or number of ACR criteria. Patients with active cutaneous lesions presented statistically significant lower scores of DLQI and SF-36 when compared to patients without active cutaneous lesions. Patients with alopecia presented a statistically significant lower score in DLQI when compared to patients without alopecia. CONCLUSIONS: The results suggest that the Brazilian-Portuguese version of the DLQI is a reliable and valid outcome measure to be used in LE clinical studies.

Characterization of trace elements in Casearia medicinal plant by neutron activation analysis.

Leaves of Casearia sylvestris, Casearia decandra and Casearia obliqua plant species, collected at the Atlantic Forest in Brazil, were analyzed by using instrumental neutron activation analysis (INAA). Short and long irradiations using thermal neutron flux of the IEA-R1 nuclear reactor were carried out for these analyses. Concentrations of Ca, K and Mg were found in these samples at the percentage levels, Br, Cl, Fe, Mn, Na, Rb and Zn at the microg g(-1) levels and Co, Cr, Cs, La, and Sc at the microg kg(-1) levels. Comparisons were made among the element concentrations obtained in these three Casearia species and significant differences were found for the elements Cl, Co, Cs, Cr, La, Mn, Na and Sc. The precision and the accuracy of the results were evaluated by analyzing the certified reference materials NIST-1515 Apple Leaves and NIST-1573a Tomato Leaves.

(+/-)-cis-(6-Ethyl-tetrahydropyran-2-yl)-formic acid: a novel substance with antinociceptive properties.

We described in this paper the first synthesis to the (+/-) cis (6-ethyl-tetrahydropyran-2-yl) formic acid (1) using the very efficient Prins cyclization reaction as strategy to construction of its tetrahydropyran skeleton. This new compound presented a significant antinociceptive property by the tail-flick model.