Zoonotic Sporotrichosis outbreak: Emerging public health threat in the Amazon State, Brazil.

BACKGROUND: Sporotrichosis is the most common subcutaneous mycosis caused by Sporothrix spp. Traditionally, it is transmitted through injuries involving plant debris. However, over the past few decades, there has been an epidemic increase in human cases resulting from contact with infected animals, particularly cats, in various regions of Brazil. In this report, we report a notable increase in both human and animal cases within the Brazilian Amazon state. METHODOLOGY/PRINCIPAL FINDINGS: An ecological study was conducted by analyzing official records of human and animal sporotrichosis diagnosed in the state of Amazon from 2020 to 2023. Data including patient demographics, clinical manifestations, mycological examination results, and species identification through PCR confirmation were evaluated. During this period, a total of 950 human cases and 2,823 animal cases of sporotrichosis were reported at an exponential rate, since no human cases were registered in 2020. The spatial and temporal dispersion of human sporotrichosis followed that of animal cases, moving from downtown areas to the periphery. Contact with infected animals was reported in 77.7% of cases, with cats being the most commonly implicated (73.5%). Only 66.7% of individuals underwent mycological examination. Among the positive cultures for Sporothrix spp., 65.4% were identified as S. brasiliensis. All patients were treated with systemic antifungals. CONCLUSIONS/SIGNIFICANCE: This study highlights a rising incidence of sporotrichosis among animals and humans in the Brazilian Amazon region over the past four years, with S. brasiliensis being the predominant agent. Collaborative efforts involving healthcare professionals, veterinarians, and public health authorities are crucial to implement effective control measures, educate populations at risk, and promote responsible guidance for pet guardians. These measures are essential to mitigate the burden of epidemic sporotrichosis in Brazil.

Shotgun Metagenomics of Gastric Biopsies Reveals Compositional and Functional Microbiome Shifts in High- and Low-Gastric-Cancer-Risk Populations from Colombia, South America.

Along with Helicobacter pylori infection, the gastric microbiota is hypothesized to modulate stomach cancer risk in susceptible individuals. Whole metagenomic shotgun sequencing (WMS) is a sequencing approach to characterize the microbiome with advantages over traditional culture and 16S rRNA sequencing including identification of bacterial and non-bacterial taxa, species/strain resolution, and functional characterization of the microbiota. In this study, we used WMS to survey the microbiome in extracted DNA from antral gastric biopsy samples from Colombian patients residing in the high-risk gastric cancer town Túquerres (n = 10, H. pylori-positive = 7) and low-risk town of Tumaco (n = 10, H. pylori-positive = 6). Kraken2/Bracken was used for taxonomic classification and abundance. Functional gene profiles were inferred by InterProScan and KEGG analysis of assembled contigs and gene annotation. The most abundant taxa represented bacteria, non-human eukaryota, and viral genera found in skin, oral, food, and plant/soil environments including Staphylococus, Streptococcus, Bacillus, Aspergillus, and Siphoviridae. H. pylori was the predominant taxa present in H. pylori-positive samples. Beta diversity was significantly different based on H. pylori-status, risk group, and sex. WMS detected more bacterial taxa than 16S rRNA sequencing and aerobic, anaerobic, and microaerobic culture performed on the same gastric biopsy samples. WMS identified significant differences in functional profiles found between H. pylori-status, but not risk or sex groups. H. pylori-positive samples were significantly enriched for H. pylori-specific genes including virulence factors such as vacA, cagA, and urease, while carbohydrate and amino acid metabolism genes were enriched in H. pylori-negative samples. This study shows WMS has the potential to characterize the taxonomy and function of the gastric microbiome as risk factors for H. pylori-associated gastric disease. Future studies will be needed to compare and validate WMS versus traditional culture and 16S rRNA sequencing approaches for characterization of the gastric microbiome.

The Effect of Perioperative Fluid Management and Operative Modifications on Mortality and Morbidity in Patients Undergoing Pulmonary Endarterectomy

ABSTRACT Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe disease treated with pulmonary endarterectomy. Our study aims to reveal the differences in liquid modalities and operation modifications, which can affect the patients' mortality and morbidity. Methods: One hundred twenty-five patients who were diagnosed with CTEPH and underwent pulmonary thromboendarterectomy (PTE) at our center between February 2011 and September 2013 were included in this retrospective study with prospective observation. They were in New York Heart Association functional class II, III, or IV, and mean pulmonary artery pressure was > 40 mmHg. There were two groups, the crystalloid (Group 1) and colloid (Group 2) liquid groups, depending on the treatment fluids. P-value < 0.05 was considered statistically significant. Results: Although the two different fluid types did not show a significant difference in mortality between groups, fluid balance sheets significantly affected the intragroup mortality rate. Negative fluid balance significantly decreased mortality in Group 1 (P<0.01). There was no difference in mortality in positive or negative fluid balance in Group 2 (P>0.05). Mean duration of stay in the intensive care unit (ICU) for Group 1 was 6.2 days and for Group 2 was 5.4 days (P>0.05). Readmission rate to the ICU for respiratory or non-respiratory reasons was 8.3% (n=4) in Group 1 and 11.7% (n=9) in Group 2 (P>0.05). Conclusion: Changes in fluid management have an etiological significance on possible complications in patient follow-up. We believe that as new approaches are reported, the number of comorbid events will decrease.

Acquirement of HRP conjunct IgG anti-IgMs from most widely cultured freshwater fishes in China and its immunoreactivity.

Until now, custom-made or commercial polyclonal antibody against only one kind of fish IgM limited application of the antibody. During our research on development of vaccine against infection of Clonorchis sinensis (C. sinensis) in several kinds of fish, we were conscious of the urgency of secondary antibody to evaluate immune effect and screen C. sinensis infection with immunological technology instead of labor-intensive and time-consuming squash or artificial digestion of fish flesh. So that, we purified IgM of grass carp, bighead carp, crucian carp, common carp and tilapia which were widely cultured freshwater fishes in most areas of China. On this basis, we generated HRP-conjunct rabbit IgG anti-fish IgMs with high titers. IgM of other freshwater fishes including oshima, yellow catfish, bream, silver carp and so on could be recognized by the IgG sensitively. Additionally, The ELISA detection displayed that the IgG could be more specific and sensitive than custom-made rabbit IgG anti-grass carp IgM. The acquirement of HRP-conjunct rabbit IgG anti-fish IgMs was the cornerstone for studying the immune system of teleost fish, developing immunoassay methods and evaluation of fish vaccine with more convenience.

Helicobacter pylori Antimicrobial Resistance and Gene Variants in High- and Low-Gastric-Cancer-Risk Populations.

Colombia, South America has one of the world's highest burdens of Helicobacter pylori infection and gastric cancer. While multidrug antibiotic regimens can effectively eradicate H. pylori, treatment efficacy is being jeopardized by the emergence of antibiotic-resistant H. pylori strains. Moreover, the spectrum of and genetic mechanisms for antibiotic resistance in Colombia is underreported. In this study, 28 H. pylori strains isolated from gastric biopsy specimens from a high-gastric-cancer-risk (HGCR) population living in the Andes Mountains in Túquerres, Colombia and 31 strains from a low-gastric-cancer-risk (LGCR) population residing on the Pacific coast in Tumaco, Colombia were subjected to antibiotic susceptibility testing for amoxicillin, clarithromycin, levofloxacin, metronidazole, rifampin, and tetracycline. Resistance-associated genes were amplified by PCR for all isolates, and 29 isolates were whole-genome sequenced (WGS). No strains were resistant to amoxicillin, clarithromycin, or rifampin. One strain was resistant to tetracycline and had an A926G mutation in its 16S rRNA gene. Levofloxacin resistance was observed in 12/59 isolates and was significantly associated with N87I/K and/or D91G/Y mutations in gyrA Most isolates were resistant to metronidazole; this resistance was significantly higher in the LGCR (31/31) group compared to the HGCR (24/28) group. Truncations in rdxA and frxA were present in nearly all metronidazole-resistant strains. There was no association between phylogenetic relationship and resistance profiles based on WGS analysis. Our results indicate H. pylori isolates from Colombians exhibit multidrug antibiotic resistance. Continued surveillance of H. pylori antibiotic resistance in Colombia is warranted in order to establish appropriate eradication treatment regimens for this population.

Subcutaneous phaeohyphomycosis due to Cladophialophora bantiana: a first case report in an immunocompetent patient in Latin America and a brief literature review.

We report a rare case of subcutaneous phaeohyphomycosis caused by Cladophialophora bantiana in an immunocompetent patient in Amazonas, Brazil. This dematiaceous fungus has been mainly associated with life-threatening infections affecting the central nervous systems of immunosuppressed patients. We present the clinical, laboratory, and therapeutic aspects, and in vitro susceptibility test results for different antifungal drugs. A brief review of the cases reported in the literature over the past 20 years has also been discussed. According to the literature review, the present case is the first report of subcutaneous phaeohyphomycosis due to C. bantiana in an immunocompetent patient in Latin America.

Subcutaneous phaeohyphomycosis due to cladophialophora bantiana: a first case report in an immunocompetent patient in Latin America and a brief literature review

Abstract We report a rare case of subcutaneous phaeohyphomycosis caused by Cladophialophora bantiana in an immunocompetent patient in Amazonas, Brazil. This dematiaceous fungus has been mainly associated with life-threatening infections affecting the central nervous systems of immunosuppressed patients. We present the clinical, laboratory, and therapeutic aspects, and in vitro susceptibility test results for different antifungal drugs. A brief review of the cases reported in the literature over the past 20 years has also been discussed. According to the literature review, the present case is the first report of subcutaneous phaeohyphomycosis due to C. bantiana in an immunocompetent patient in Latin America.

Chronic tophaceous gout in patients with psoriasis.

Psoriasis is a chronic inflammatory disease of multifactorial etiology influenced by genetic, immunological, and environmental factors. We report the case of a patient with psoriasis for more than 25 years who developed hyperuricemia and chronic tophaceous gout with unusual appearance. In psoriasis, hyperuricemia may occur by increased epidermal cell turnover, which accelerates purine metabolism and has uric acid as the product of its catabolism. The association of psoriasis with hyperuricemia can trigger the onset of gouty arthritis, and pose a greater risk of developing other inflammatory comorbidities. Therefore, it is important to periodically investigate uric acid levels in order to treat changes triggered by hyperuricemia.

Chronic tophaceous gout in patients with psoriasis

Abstract: Psoriasis is a chronic inflammatory disease of multifactorial etiology influenced by genetic, immunological, and environmental factors. We report the case of a patient with psoriasis for more than 25 years who developed hyperuricemia and chronic tophaceous gout with unusual appearance. In psoriasis, hyperuricemia may occur by increased epidermal cell turnover, which accelerates purine metabolism and has uric acid as the product of its catabolism. The association of psoriasis with hyperuricemia can trigger the onset of gouty arthritis, and pose a greater risk of developing other inflammatory comorbidities. Therefore, it is important to periodically investigate uric acid levels in order to treat changes triggered by hyperuricemia.

Detection of Campylobacter in stool and determination of significance by culture, enzyme immunoassay, and PCR in developing countries.

Campylobacter is a common bacterial enteropathogen that can be detected in stool by culture, enzyme immunoassay (EIA), or PCR. We compared culture for C. jejuni/C. coli, EIA (ProSpecT), and duplex PCR to distinguish Campylobacter jejuni/C. coli and non-jejuni/coli Campylobacter on 432 diarrheal and matched control stool samples from infants in a multisite longitudinal study of enteric infections in Tanzania, Bangladesh, and Peru. The sensitivity and specificity of culture were 8.5% and 97.6%, respectively, compared with the results of EIA and 8.7% and 98.0%, respectively, compared with the results of PCR for C. jejuni/C. coli. Most (71.6%) EIA-positive samples were positive by PCR for C. jejuni/C. coli, but 27.6% were positive for non-jejuni/coli Campylobacter species. Sequencing of 16S rRNA from 53 of these non-jejuni/coli Campylobacter samples showed that it most closely matched the 16S rRNA of C. hyointestinalis subsp. lawsonii (56%), C. troglodytis (33%), C. upsaliensis (7.7%), and C. jejuni/C. coli (2.6%). Campylobacter-negative stool spiked with each of the above-mentioned Campylobacter species revealed reactivity with EIA. PCR detection of Campylobacter species was strongly associated with diarrhea in Peru (odds ratio [OR] = 3.66, P < 0.001) but not in Tanzania (OR = 1.56, P = 0.24) or Bangladesh (OR = 1.13, P = 0.75). According to PCR, Campylobacter jejuni/C. coli infections represented less than half of all infections with Campylobacter species. In sum, in infants in developing country settings, the ProSpecT EIA and PCR for Campylobacter reveal extremely high rates of positivity. We propose the use of PCR because it retains high sensitivity, can ascertain burden, and can distinguish between Campylobacter infections at the species level.

Endogenous gas gangrene after laparoscopic cholecystectomy / Gangrena Gaseosa endógena tras la colecistectomía laparoscópica

Clostridial gas gangrene of the abdominal wall is rare, and it is usually associated with organ perforation, immunosuppression or gastrointestinal malignancies. In this paper, we present a case of fulminant, endogenous gas gangrene in a 58-year old diabetic female with arterial hypertension and atherosclerosis, following uneventful laparoscopic cholecystectomy. She developed gas gangrene of the abdominal wall 12-hours after cholecystectomy and died 24-hours after the onset of the first symptoms, in spite oftreatment.

La gangrena gaseosa clostridial de la pared abdominal es rara, y normalmente se halla asociada con la perforación de órganos, inmunosupresión o malignidades gastrointestinales. En este trabajo, se presenta un caso de gangrena gaseosa endógena fulminante en una mujer diabética de 58 años con hipertensión arterial y ateroesclerosis, tras una colecistectomía laparoscópica sin incidentes. Doce horas después de la colecistectomía, la mujer desarrolló una gangrena gaseosa de la pared abdominal, y murió 24 horas después del comienzo de los primeros síntomas, a pesar del tratamiento.

Aspectos clínicos de pacientes com pitiríase versicolor atendidos em um centro de referência em dermatologia tropical na cidade de Manaus (AM), Brasil / Clinical aspects of patients with pityriasis versicolor seen at a referral center for tropical dermatology in Manaus, Amazonas, Brazil

FUNDAMENTOS: A pitiríase versicolor (tinha versicolor) é uma micose superficial crônica, causada por leveduras do gênero Malassezia spp. comensais das camadas queratinizadas da pele e que, sob determinadas condições ainda não esclarecidas, se torna patogênica, determinando as manifestações clínicas da doença. É uma dermatose recidivante e, mesmo após tratamento, pode deixar hipopigmentação persistente, causando problemas sociais aos indivíduos acometidos. OBJETIVO: Descrever as características clínicas e epidemiológicas de pacientes com diagnóstico de tinha versicolor atendidos em uma unidade de referência em Dermatologia (Fundação Alfredo da Matta). MÉTODOS: Estudo de série de casos em que foram detalhadas as manifestações cutâneas e as características epidemiológicas de pacientes atendidos na Fundação Alfredo da Matta com diagnóstico de tinha versicolor. RESULTADOS: Cento e dezesseis pacientes foram incluídos no estudo no período de janeiro a agosto de 2008. A maioria dos indivíduos é do sexo masculino, de cor parda, da faixa etária jovem e formada por estudantes, que apresentavam fatores predisponentes ao surgimento das manchas. Também a maioria apresentava lesões extensas e história passada da doença. CONCLUSÃO: O estudo mostrou alta proporção de indivíduos com quadros extensos e de longa duração da doença.

BACKGROUND: Pityriasis versicolor (tinea versicolor) is a chronic superficial mycosis caused by yeasts of the Malassezia spp. genus commensal of the keratinized layers of the skin. Under conditions not yet understood, it becomes pathogenic determining the clinical manifestations of the disease. It is a recurrent skin condition and persistent hypopigmentation may remain after treatment, causing social problems to those affected. OBJECTIVE: To describe the clinical and epidemiological features of patients diagnosed with tinea versicolor treated at a referral center for dermatology (Alfredo da Matta Foundation). METHODS: Case-studies in which cutaneous manifestations and epidemiological characteristics of patients diagnosed with tinea versicolor treated at Alfredo da Matta Foundation were detailed. RESULTS: One hundred and sixteen patients were included in the study from January to August 2008. Most subjects were male, of mixed ethnicity and young age. Most were students who were predisposed to the development of macules. The majority had extensive injuries and past history of the disease. CONCLUSION: The results revealed a high proportion of individuals with extensive clinical manifestations and duration of the disease.

Clinical aspects of patients with pityriasis versicolor seen at a referral center for tropical dermatology in Manaus, Amazonas, Brazil.

BACKGROUND: Pityriasis versicolor (tinea versicolor) is a chronic superficial mycosis caused by yeasts of the Malassezia spp. genus commensal of the keratinized layers of the skin. Under conditions not yet understood, it becomes pathogenic determining the clinical manifestations of the disease. It is a recurrent skin condition and persistent hypopigmentation may remain after treatment, causing social problems to those affected. OBJECTIVE: To describe the clinical and epidemiological features of patients diagnosed with tinea versicolor treated at a referral center for dermatology (Alfredo da Matta Foundation). METHODS: Case-studies in which cutaneous manifestations and epidemiological characteristics of patients diagnosed with tinea versicolor treated at Alfredo da Matta Foundation were detailed. RESULTS: One hundred and sixteen patients were included in the study from January to August 2008. Most subjects were male, of mixed ethnicity and young age. Most were students who were predisposed to the development of macules. The majority had extensive injuries and past history of the disease. CONCLUSION: The results revealed a high proportion of individuals with extensive clinical manifestations and duration of the disease.

Lacaziose simulando hanseníase dimorfa tuberculóide / Lacaziosis mimicking borderline tuberculoid leprosy

Lacaziose é infecção crônica causada pelo fungo Lacazia loboi, originalmente descrita por Jorge Lobo (1931) em paciente oriundo da Amazônia brasileira. Manifesta-se, sobretudo, por lesões cutâneas queloidiformes. Relata-se o caso de paciente com placa eritêmato-violácea, cuja hipótese diagnóstica inicial foi de hanseníase dimorfa tuberculóide, doença também endêmica na região amazônica. Ressalta-se a importância da inclusão de formas paucibacilares de hanseníase no diagnóstico diferencial da lacaziose.

Lacaziosis is a chronic skin infectious disease caused by the fungus Lacazia loboi, which usually results in indolent cutaneous keloid-like lesions. It was first described by Jorge Lobo, in 1931, in a patient from the Amazon region. We report a case of lacaziosis, manifested by an erythematous infiltrated plaque, causing misdiagnosis with paucibacillary leprosy, since both diseases are endemic in Amazon basin.

Influência do processo de envelhecimento na qualidade de vida do ser humano (re)desvelando significados / Influence of the process of aging in the quality of life of human beings: discovering meanings / Influencia del proceso de envejecimiento en la calidad de vida del ser humano: revelando significados

Atualmente, inúmeros fatores interferem e/ou influenciam o processo de envelhecimento humano. Tais fatores estão estreitamente interligados com as necessidades humanas básicas.Trata-se de um estudo exploratório e descritivo com abordagem qualitativa cujo objetivo foi identificar as percepções e os significados do ser humano em relação ao seu processo de envelhecimento. Os dados foram coletados no período de 2 de maio a 2 de junho de 2006, por meio de questionário aplicado a 35 indivíduos com idade mínima de 45 anos. O projeto foi aprovado pelo CEP/Unisul - Brasil. Como categorias significativas marcadoras do processo de envelhecimento destacaram-se: alterações da sexualidade, mudanças no corpo, ser avô/avó e aposentadoria. Constatou-se, de forma ampla, que o envelhecimento populacional vem progredindo e que os seres humanos estão envelhecendo ao mesmo tempo sem o cuidado adequado para chegar à terceira idade com qualidade de vida. Para garantir a qualidade de vida dos idosos, são imprescindíveis ações educativas em todas as fases do desenvolvimento humano.

Nowadays, innumerable factors intervene and/or influence the process of human aging. Such factors are closely linked to the basic necessities of human beings, both psycho-social and spiritual. This is an exploratory and descriptive study with a qualitative approach with the objective of identifying perceptions and meanings people have towards the aging process. The data was collected from May 2 to June 2, 2006, using a questionnaire applied to 35 individuals with minimum age of 45. The project was approved by the Ethics Committee of Unisul - Brazil. Significant categories of the aging process were found: alterations of sexuality, body changes, being grandfather and grandmother and retiring. Plenty of evidence was found for the in the aging of the population, and also that human beings are aging without adequate care for quality of life as senior citizens. In order to assure quality of life for the elderly, education actions are essential in all phases of human development.

Actualmente, hay una gran cantidad de factores que interfieren y / o influyen en el proceso de envejecimiento humano. Tales factores están estrechamente vinculados a las necesidades humanas básicas, psicosociales y espirituales. Se trata de un estudio exploratorio descriptivo con enfoque cualitativo cuyo objetivo es identificar las percepciones y significados del ser humano en relación a su proceso de envejecimiento. Los datos fueron recogidos entre el 2 de mayo y el 2 de junio de 2006 mediante un cuestionario aplicado a 35 individuos con edad mínima de 45 años. El proyecto fue aprobado por CEP/UNISUL. Como categorías significativas que marcan el proceso de envejecimiento, se destacaron: alteraciones de la sexualidad, cambios en el cuerpo, ser abuelo/abuela y jubilación. Se constató que el envejecimiento de la población está aumentando y que los seres humanos están envejeciendo sin el cuidado adecuado para llegar a la tercera edad con calidad de vida. Para garantizar calidad de vida a los ancianos es imprescindible que se pongan en práctica acciones educativas en todas las etapas del desarrollo humano.

Prevençäo de úlceras de pressäo: uma maneira barata e eficiente de cuidar

A prevençäo das úlceras de pressäo foram e continuaräo sendo um cuidado importante na enfermagem, e por que näo dizer: retrata a qualidade da assistência de enfermagem. Compreender a prática do cuidar em terapia intensiva, hoje, a partir do vertiginoso desenvolvimento tecnológico e científico, só é possível a partir de uma profunda concepçäo holística, ou seja, um cuidar que veja diante de si a pessoa integralmente...