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Sample records for chagas aguda vias

  1. Doença de Chagas aguda: vias de transmissão, aspectos clínicos e resposta à terapêutica específica em casos diagnosticados em um centro urbano Acute Chagas' disease: transmission mechanisms, clinical features and specific therapeutic response in cases diagnosed in an urban center

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    M.A. Shikanai-Yasuda

    1990-02-01

    Full Text Available Relata-se o quadro clínico de 27 pacientes com doença de Chagas aguda, acompanhados no ambulatório da Clínica de Doenças Infecciosas e Parasitárias do Hospital das Clínicas da FM-USP no período de 1974 a 1987. As vias de transmissão envolvidas foram: vetorial em 7 casos, transfusional em 9, transplante de rim e/ou transfusional em 4, acidental em 1, via oral em 3, provável aleitamento materno em 1, congênita ou aleitamento materno em 1, congênita ou transfusional em 1. Pacientes com infecção por via vetorial eram procedentes da Bahia e Minas Gerais, tendo 6 apresentado a doença de 1974 a 1980 e um em 1987. Já os pacientes infectados por via transfusional adquiriram a doença na Grande São Paulo, 7 deles após 1983. O quadro clínico foi oligossintomático ou assintomático em 4 pacientes, sendo 3 deles imunodeprimidos por doença de base ou por medicamentos. Em outros 2 pacientes imunodeprimidos ocorreu miocardite grave com insuficiência cardíaca congestiva. O quadro clínico foi também mais grave em 5 de 6 crianças menores de dois anos de idade, qualquer que fosse a via de transmissão. A avaliação de 16 pacientes tratados na fase aguda com benzonidazol (4-10mg/kg/dia por 30 a 60 dias mostrou falha terapêutica em 4/16 (25,0%, possível sucesso terapêutico em 9/16 (56,2%, sendo inconclusivos os resultados em 3/16 (18,8%. A reação de LMC foi concordante com o xenodiagóstico em 18 e 22 casos (agudos e na fase crônica inicial, e se negativou mais precocemente que as RSC. No seguimento pós-terapêutico, observou-se aparecimento de doença linfoproliferativa em um paciente com anemia aplástica e que recebia corticosteróide 6 anos após o emprego de benzonidazol.The authors report clinical features and therapeutic response of 24 outpatients with acute Chagas' disease, and 3 in the initial chronic phase, referred to the Clinic for Infectious and Parasitic Diseases of the FMUSP "Clínicas" Hospital between 1974 and 1987

  2. Enfermedad de Chagas aguda, en un adulto tratado con benznidazol (Rochagan® en Costa Rica

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    Víctor M. Montenegro

    2004-06-01

    Full Text Available Se da a conocer un caso agudo de la enfermedad de Chagas en un adulto de 48 años con signo de Romaña, infectado al recibir un chorro de orina de una chinche (T. dimidiata, cuando trataba de destripada con un palo de café. Es el primer adulto con enfermedad de Chagas aguda tratado en Costa Rica con benznidazol. Se citan los síntomas encontrados, así como los aspectos epidemiológicos relacionados con su presentación. Se enfatizan el tratamiento y la evolución del caso. Se hace un llamado de atención a los clínicos, ya que este caso no fue diagnosticado apropiadamente desde un inicio, lo que evidencia el desconocimiento que existe de la enfermedad de Chagas como motivo de consulta.An acute case of Chagas "disease with Romañas" sign, in a 48 years old man, is described. Treatment with Benznidazol was succesfull. This is the first acute case in an adult treated with this drug in Costa Rica. Reference is made to the epidemiological aspects involved in this case and to the mechanism of infection. This person became infected when he was trying to kiU a nymph of T. dimidiata with a coffe stick and received a jet of urine directly in the right eye. The case was not diagnosed by the clinicians while the patient was at the hospital indicating the poor knowledge of practitioners about the characteristics of the disease in our country.

  3. Acometimento cardíaco em pacientes com doença de Chagas aguda em microepidemia familiar, em Abaetetuba, na Amazônia Brasileira

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    Pinto, Ana Yecê das Neves; Harada,Geraldo Saburo; Valente,Vera da Costa; Abud,José Elson Araújo; Gomes,Francisco dos Santos; Souza,Gilberto César Rodrigues de; Valente,Sebastião Aldo da Silva

    2001-01-01

    Os autores mostram os principais achados clínicos relativos ao acometimento cardíaco, em pacientes portadores de doença de Chagas aguda em mais um episódio de microepidemia familiar na Amazônia brasileira. Foram estudados 13 pacientes com doença de Chagas aguda, procedentes do município de Abaetetuba-PA e submetidos à avaliação clínica e cardiológica, eletrocardiograma e ecocardiograma. As extra-sístoles supraventriculares e/ou ventriculares ocorreram em 38,5% dos casos. Bloqueios de ramo dir...

  4. Doença de Chagas aguda pós-transfusional sem miocardite

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    Evanil Pires de Campos; Izilda Maestá; Fernando C. de L. Schmidt; Roberto Sogayar; Cláudia E. O. Pires de Campos

    1988-01-01

    Trata-se de paciente do sexo feminino, com 59 anos de idade, procedente de Itaporanga (SP), diabética e nefropata crônica, internada em virtude de surtos de pielonefnte e insuficiência renal aguda. Dentre outras medidas terapêuticas, recebeu transfusão de sangue. Cerca de dois dias após a última transfusão (sangue oriundo de doador, posteriormente identificado como chagásico) encontraram-se formas tripomastigotas de Trypanosoma cruzi em lâmina preparada para execução de hemograma. Iniciou-se ...

  5. Doença de chagas aguda em mulher de 80 anos no México. Relato anatomopatológico

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    Felipe Lozano Kasten

    1993-12-01

    Full Text Available Mulher de 80 anos de idade, com doença de Chagas aguda diagnosticada à necrópsia, adquirida, provavelmente, através de triatomíneos no município de Zacoelo de Torres, no Estado de Jalisco, México. Assinala-se a raridade do encontro de casos de doença de Chagas agudo, na faixa etária da paciente. O exame anatomopatológico mostrou comprometimento do coração, esôfago e intestino grosso. Encontrou-se lesões no sistema nervoso autônomo intramural do esôfago e do intestino grosso, sendo estes achados de interesse, por ocorrer em área geográfica onde os megas tem sido pouco relatados.

  6. Aspectos clínico-diagnósticos relativos à fase aguda da doença de Chagas, em pacientes submetidos a transplante de rim e imunodeprimidos

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    Pedro Renato Chocair; Vicente Amato Neto; Emil Sabbaga; Pedro Henrique Torrecillas

    1985-01-01

    Em sete pacientes submetidos a transplante de rim e imonodeprimidos reconheceram os Autores a ocorrência de doença de Chagas, em fase aguda. Tais eventos permitiram verificações sem dúvida expressivas e, entre elas, afigurou-se conveniente salientar as seguintes: presença de febre como manifestação proeminente; valor elucidativo da pesquisa do Trypanosoma cruzi no "creme" leucocitário em etapa de realização de diagnóstico diferencial, quando escassos os elementos orientadores; utilidade da ev...

  7. Doença de Chagas aguda pós-transfusional sem miocardite

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    Evanil Pires de Campos

    1988-12-01

    Full Text Available Trata-se de paciente do sexo feminino, com 59 anos de idade, procedente de Itaporanga (SP, diabética e nefropata crônica, internada em virtude de surtos de pielonefnte e insuficiência renal aguda. Dentre outras medidas terapêuticas, recebeu transfusão de sangue. Cerca de dois dias após a última transfusão (sangue oriundo de doador, posteriormente identificado como chagásico encontraram-se formas tripomastigotas de Trypanosoma cruzi em lâmina preparada para execução de hemograma. Iniciou-se tratamento com Benzonidazol. A paciente cursou para, pleuropneumonia e de secreção purulenta cirúrgica isolou-se Klebsiella spp. A septicemia conduziu a paciente ao êxito letal. Nenhuma lesão tecidual foi observada no miocárdio, no sistema nervoso central, adrenal ou nos demais órgãos examinados.

  8. Moléstia de Chagas aguda experimental: parasitismo do hipotálamo Experimental acute Chagas disease in the rat: parasitism of hypothalamus

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    Edymar Jardim

    1971-06-01

    Full Text Available O autor procurou relações entre alterações funcionais atribuídas ao hipotálamo e lesões orgânicas do mesmo, na vigência da moléstia de Chagas. Usou em seu trabalho ratos inoculados com T. cruzi por via intraperitonial. Realizou estudo histopatológico e quantitativo neuronal das várias regiões hipotalâmicas, em cortes seriados corados com a hematoxilina-eosina. Encontrou considerável percentagem de parasitismo hipotalâmico (70%, sendo que a região anterior é mais parasitada que a média ou a posterior. A destruição neuronal foi também mais evidente na região anterior. Sugere que as alterações do metabolismo glicídico, tireoidiano, da sudação e da potassemia, devam ser consideradas como seqüelas destas lesões.This work search relations between functional impairments imputed to hypothalamus and organic lesions in Chagas' disease. The author used rats with T. cruzi inoculation by intraperitonial way. Histopathologic and quantitative neuronal studies were done by serial sections of hypothalamus. It was demonstrated that the anterior hypothalamic region is more parasited than others, with greater neuronal destruction also. The author suggests that impairments of glycidic and thyroidian metabolism, of sweating and potassium blood level, must be considered as sequels of these lesions.

  9. Doença de Chagas aguda pós-transfusional sem miocardite

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    Evanil Pires de Campos

    1988-12-01

    Full Text Available Trata-se de paciente do sexo feminino, com 59 anos de idade, procedente de Itaporanga (SP, diabética e nefropata crônica, internada em virtude de surtos de pielonefnte e insuficiência renal aguda. Dentre outras medidas terapêuticas, recebeu transfusão de sangue. Cerca de dois dias após a última transfusão (sangue oriundo de doador, posteriormente identificado como chagásico encontraram-se formas tripomastigotas de Trypanosoma cruzi em lâmina preparada para execução de hemograma. Iniciou-se tratamento com Benzonidazol. A paciente cursou para, pleuropneumonia e de secreção purulenta cirúrgica isolou-se Klebsiella spp. A septicemia conduziu a paciente ao êxito letal. Nenhuma lesão tecidual foi observada no miocárdio, no sistema nervoso central, adrenal ou nos demais órgãos examinados.D.E. O., a 59 years old white female bom in Paranagua (PR, came from Itaporanga with Kimmelstiel Wilson nephropathy diabetes and pyelonephritis with acute renal failure followed by a nephrectomy. Anaemia and malnutrition led to blood transfusions before and after surgery. On the 34th day, she developed high fever, prostration, agressivity with mental confusion, abdominal cramps and diarrhea. Trypanosomes were seen in peripheral blood smears. Haemoculture and xenodiagnosis was positive. A complement fixation test was negative. Benznidazole (6 mg/kg/day was started. During treatment she presented pulmonary infection and a surgical purulent secretion showed Klebsiella sp. Despite intensive medical care she died of sepsis. Autopsy revealed evidence of diabetes mellitus (glomerulosclerosis, hepatic lesions, pancreatic fibrosis and generalised arteriolar disease. No chagasic lesions were detected in the heart, central nervous system, adrenal or other tissues.

  10. Miocardite na forma aguda da doença de Chagas

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    Eitel Duarte

    1948-12-01

    Full Text Available The autopsy of a case of CHAGAS'S disease or American tryponosomiasis (a girl, 5 years old, dead in the 22nd day of illness is reported. The anatomic diagnosis was a follows: Acute diffuse chagasic nyocarditis. Chagasic encephalitis. Chagasic lymphadenitis of the right posterior auricular node. Tuberculosis of the bronchial and pulmonary nodes. Chronic passive hyperemia and atelectasia of the lungs. Chronic passive congestion and hemorrhages of the spleen. Serous hepatitis. Parotiditis. Edema of the right eyelids. Bilateral hydrothorax. Hydropericardium. Hydroperitoneum. The morphology of Schizotrypanum cruzi in the myocardium is considered. Besides agglomerates with typical small oval or round intracellular bodies, pre-flagellate and flagellate organisms, others are found in which the great amount of parasites and marked pressure exerted by them against each other render very difficult their identification; sometimes the similitude of such agglamerates to Toxoplasma is striking (Fig. 1 and 1 A. In such a case, the structure of the blepharoplast (Fig. 1 and IA, usually preserved, is profitable and allows the identification of the pre-flagellate and flagellate forms of Schizotrypanum cruzi. Most of the small sensitive nerves in the epicardium shows mononuclear infiltration of the perineurium (perineuritis, Figs. 12-14. Microscopically there is extensive Zenker's degeneration (Figs. 6-8 and parasitism of the heart muscle fibers, marked cellular infiltration of the interstitial connective tissue, which are found in the ordinary musculature of every chamber of the heart (Figs. 10-11 as well as in Tawara's node (Fig. 9, main bundle (Fig. 2 and right (Fig. 4 and left (Fig. 5 septal divisions of the bundle of His, and perineuritis. Those anatomic changes are associated to an abnormal electrocardiogram presenting some similitude to that of an anemic infarct of the anterior wall of the heart and which will be discussed elsewhere (unpublished paper by

  11. Estudo imunobiológico de estoques de Trypanosoma cruzi isolados de pacientes na fase aguda da doença de Chagas

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    T.L. Kipnis

    1983-12-01

    Full Text Available Estoques de tripanossomas isolados de pacientes na fase aguda da doença de Chagas foram injetados em grupos de camundongos albinos não isogênicos nas doses de 10³, 10(4 e 10(5 parasitas/camundongos. O curso da infecção foi seguido por três meses. A pctrasitemia foi em geral baixa, com picos recorrentes, na maioria das vezes os animais evoluiam para cronicidade. Somente um estoque induziu alto índice de mortalidade. Os parasitas e as lesões apesar de detectadas no pico da parasitemia e restritos ao coração estavam ausentes aos três meses. Nesta época os perfis de Igs apresentaram diferenças marcantes. Grupos de animais que foram inoculados com estes estoques foram desafiados com doses letais da cepa Y ou CL. Em alguns casos obteve-se uma parasitemia, mas patente.

  12. Aspectos clínico-diagnósticos relativos à fase aguda da doença de Chagas, em pacientes submetidos a transplante de rim e imunodeprimidos

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    Pedro Renato Chocair

    1985-03-01

    Full Text Available Em sete pacientes submetidos a transplante de rim e imonodeprimidos reconheceram os Autores a ocorrência de doença de Chagas, em fase aguda. Tais eventos permitiram verificações sem dúvida expressivas e, entre elas, afigurou-se conveniente salientar as seguintes: presença de febre como manifestação proeminente; valor elucidativo da pesquisa do Trypanosoma cruzi no "creme" leucocitário em etapa de realização de diagnóstico diferencial, quando escassos os elementos orientadores; utilidade da evidenciação, por imunofluorescência, de anticorpos IgM antitripanossomo no soro; falta de participação de enfartamento de linfonodos superficiais ao exame clínico e de linfocitose, com linfócitos atípicos, ao hemograma; decurso não grave, sendo que, para tanto, pode ter contribuído a administração de benzonidazol; possibilidade de manutenção do uso de medicamentos imonossupressores; ausência de prejuízo quanto ao transplante. Julgaram os Autores oportuno relatar esses fatos, em virtude de implicações que eles ensejam quando em desenvolvimento trabalhos de natureza assistencial.The Authors detected the acute stage of Chagas'diseasein seven immunosuppressedpatients, following renal transplantation. The outstanding clinical and diagnostic features seen in these patients were as follows: fever was an important clinical sign of disease; the direct microscopic demonstration of Trypanosoma cruzi in the buffy layer of blood samples yielded positive results; immunofluorescent IgM antibodies may befound in sera; no lymph node enlargement was noticed on clinical examination and lymphocytosis was not seen on blood smears. The clinical course of the disease was not severe, although this could in part be due to treatment with benznidazole. The immunoppressive therapy could be maintained and no damage occurred to the transplanted organ.

  13. Aspectos clínico-diagnósticos relativos à fase aguda da doença de Chagas, em pacientes submetidos a transplante de rim e imunodeprimidos

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    Pedro Renato Chocair

    1985-03-01

    Full Text Available Em sete pacientes submetidos a transplante de rim e imonodeprimidos reconheceram os Autores a ocorrência de doença de Chagas, em fase aguda. Tais eventos permitiram verificações sem dúvida expressivas e, entre elas, afigurou-se conveniente salientar as seguintes: presença de febre como manifestação proeminente; valor elucidativo da pesquisa do Trypanosoma cruzi no "creme" leucocitário em etapa de realização de diagnóstico diferencial, quando escassos os elementos orientadores; utilidade da evidenciação, por imunofluorescência, de anticorpos IgM antitripanossomo no soro; falta de participação de enfartamento de linfonodos superficiais ao exame clínico e de linfocitose, com linfócitos atípicos, ao hemograma; decurso não grave, sendo que, para tanto, pode ter contribuído a administração de benzonidazol; possibilidade de manutenção do uso de medicamentos imonossupressores; ausência de prejuízo quanto ao transplante. Julgaram os Autores oportuno relatar esses fatos, em virtude de implicações que eles ensejam quando em desenvolvimento trabalhos de natureza assistencial.

  14. Primer caso de enfermedad de Chagas aguda en la Selva Central del Perú: investigación de colaterales, vectores y reservorios

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    Silvia Vega

    2006-10-01

    Full Text Available A partir del caso de una niña de seis años con diagnóstico confirmado de enfermedad de Chagas aguda, procedente de la localidad de Pozuzo (Oxapampa-Junín en al selva central del Perú, un área no señalada como endémica en el país, se realizó un estudio epidemiológico a partir de la vivienda de la niña y se extendió a la población cercana. Las viviendas visitadas no presentaron condiciones apropiadas para la colonización de triatominos, no se encontraron en la búsqueda activa durante el día, sin embargo, en búsqueda nocturna se capturaron dos ejemplares en casa de la niña y siete en casas vecinas que fueron identificados como Panstrongylus geniculatus adultos, dos estaban infestados con trypanosomatideos. Todos los entrevistados identificaron al vector, 8/13 manifestaron haber sufrido picaduras de "chirimachas", nombre por el cual lo conocen. El examen clínico y serológico en busca de reactivos a T. cruzi entre los pobladores de las viviendas cercanas fue negativo. Consideramos que siendo el vector de hábitos silvestres, su presencia en la vivienda está relacionada con la ampliación de la zona agrícola ganada a la selva. El alejamiento de los mamíferos y aves silvestres esta determinando cambios en el biotopo de los triatominos, que buscan su alimento en el interior de las viviendas e infectan en forma esporádica a la población humana.

  15. Acometimento cardíaco em pacientes com doença de Chagas aguda em microepidemia familiar, em Abaetetuba, na Amazônia Brasileira Cardiac attacks in patients with acute Chagas' disease in microepidemic familiar episode, in Abaetetuba City, Brazilian Amazon

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    Ana Yecê das Neves Pinto

    2001-10-01

    Full Text Available Os autores mostram os principais achados clínicos relativos ao acometimento cardíaco, em pacientes portadores de doença de Chagas aguda em mais um episódio de microepidemia familiar na Amazônia brasileira. Foram estudados 13 pacientes com doença de Chagas aguda, procedentes do município de Abaetetuba-PA e submetidos à avaliação clínica e cardiológica, eletrocardiograma e ecocardiograma. As extra-sístoles supraventriculares e/ou ventriculares ocorreram em 38,5% dos casos. Bloqueios de ramo direito e bloqueios átrio-ventriculares de 1º e 2º graus, foram encontrados em 30,8% dos doentes. Chamam atenção dois achados no ecodopplercardiograma: derrame pericárdico e imagem sugestiva de formação aneurismática em dois pacientes respectivamente. Os achados revelam comprometimento cardíaco agudo, com evidências de miocardiopatia e alterações no sistema de condução do coração, havendo similaridade com a descrição da doença em áreas endêmicas.The authors describe the main clinical findings relative to cardiac involvement, in patients with acute Chagas' disease (CD in yet another familial micro-epidemic episode of CD in Amazon region. Thirteen patients were studied with acute Chagas' disease, resident in the city of Abaetetuba in Pará state; they were submitted to clinical and heart evaluation, with electrocardiograph and echocardiograph exams. Ventricular extrasystole occurred in 38.5% of the cases. Right bundle branch block and 1st and 2nd degree atrioventricular block were found in 30.8% of the patients. Attention is called to two findings in the Doppler echocardiography: pericardiac involvement and an image suggestive of aneurismatic formation in two patients. The findings reveal acute heart disease, with evidence of cardiomyopathy and alterations in the conduction system of the heart, bearing similarity with the description of the disease in endemic areas.

  16. TOXICIDAD AGUDA DE Aleurites moluccana POR VIA ORAL EN RATAS SPRAGUE-DAWLEY

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    Laura Rocío Orellana-Cuéllar

    2014-12-01

    Full Text Available Objetivo: Determinar la toxicidad aguda por Aleurites moluccana por administración oral en ratas Sprague-Dawley. Metodología: Estudio experimental realizado en el Instituto de Patología de la Facultad de Medicina-UNMSM. Se usaron treinta ratas Sprague-Dawley, hembras y machos, de 6 semanas de edad. Se formaron aleatoriamente tres grupos de diez ratas: grupo A1, recibió 8,2 mg/Kg de peso de A. moluccana; grupo  A2, recibió 2000 mg/Kg de peso de A. moluccana; grupo control, recibió agua ad libitum. Se evaluaron los signos clínicos de toxicidad, los pesos, variables bioquímicas y las características histopatológicas de hígado, riñón, corazón, intestino, bazo y gónadas. Se consideró significativo un p0,05. Los grupos  A1 y A2 presentaron signos clínicos de toxicidad y la muerte de tres ratas; células hepáticas binucleadas y regenerativas en el hígado; y hemorragia glomerular en el riñón. Conclusiones: Las variables clínicas e histopatológicas en hígado y riñón demostraron que la Aleurites moluccana produce toxicidad aguda, las variables bioquímicas no demostraron este efecto. Palabras Claves: Aleurites moluccana, Toxicidad aguda, Ratas Sprague-Dawley.

  17. Eosinophil levels in the acute phase of experimental chagas' disease Níveis de eosinófilos na fase aguda da doença de Chagas experimental

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    Maria Cristina Nakhle

    1989-12-01

    Full Text Available Eosinophil dynamics, in bone marrow, blood and peritoneal exudate, of resistant C57B1/6 (C57 and susceptible A/Snell (A/Sn mice was comparatively studied during the acute phase of infection by Trypanosoma cruzi Y strain. A decline was observed in bone marrow eosinophil levels in A/Sn, but not in C57 mice, soon after infection, those of the former remaining significantly below those of the latter up to the 4th day of infection. Bone marrow eosinophil levels of C57 mice declined subsequently to levels comparable to those of A/Sn mice, the number of these cells in this compartment remaining 50% those of non infected controls, in both strains, up to the end of the experiment on the 14th day of infection. The fluctuations in eosinophil levels in blood and peritoneal space were similar in both mice strains studied. Concomitantly with depletion of eosinophils in the marrow, depletion in blood and a marked rise of these cells in the peritoneal space, initial site of infection, occurred in both strains. The difference in eosinophil bone marrow levels, between C57 and A/Sn mice, observed in the first four days of infection, suggests a higher eosinopoiesis capacity of the former in this period, which might contribute to their higher resistance to T. cruzi infection.A dinâmica de eosinófilos, na medula óssea, sangue e exsudato peritoneal, de uma linhagem de camundongos resistente (C57B1/6 e de uma susceptível (A/Snell foi comparativamente estudada durante a fase aguda da infecção com a cepa Y do Trypanosoma cruzi. Foi observada uma queda nos níveis de eosinófilos da medula óssea nos camundongos A/Sn, mas não nos C57, logo após a infecção, os dos primeiros permanecendo significativamente abaixo dos níveis dos últimos até o 4? dia de infecção. Os níveis de eosinófilos da medula óssea nos camundongos C57 caíram subseqüentemente a níveis próximos aos dos camundongos A/Sn, o número destas células neste compartimento permanecendo em

  18. Chagas' disease: IgA, IgM and IgG antibodies to T. cruzi amastigote, trypomastigote and epimastigote antigens in acute and in different chronic forms of the disease Doença de Chagas: anticorpos IgG, IgM e IgA contra antígenos de amastigota, tripomastigota e epimastigota de T. cruzi em formas agudas e em diferentes formas crônicas da doença

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    Kátia S. C. Primavera

    1990-06-01

    Full Text Available In an attempt to find a better T. cruzi antigen and possible immunological markers for the diagnosis of different clinical forms of Chagas' disease, amastigote and trypomastigote antigens obtained from immunosuppressed mice infected with T. cruzi (Y strain were assessed in comparison with conventional epimastigote antigens. A total of 506 serum samples from patients with acute and with chronic (indeterminate, cardiac and digestive forms, from nonchagasic infections, and from healthy individuals were assayed in immunofluorescence (IF tests, to search for IgG, IgM and IgA antibodies. Amastigote proved to be the most convenient antigen for our purposes, providing higher relative efficiency indexes of 0.946, 0.871 and 0.914 for IgG, IgM and IgA IF tests, respectively. Anti-amastigote antibodies presented higher geometric mean titers (GMT than anti-trypomastigote and anti-epimastigote. Anti-amastigote IgG antibodies were found in all forms of Chagas' disease, and predominantly IgA antibodies, in chronic digestive and in acute forms, as well as IgM antibodies, in latter forms. Thus, tests with amastigote antigen could be helpful for screening chagasic infections in blood banks. Practical and economical aspects in obtaining amastigotes as here described speak in favour of its use in developing countries, since those from other sources require more complex system of substruction, specialized personnel or equipment.Com o intúito de se aperfeiçoar o diagnóstico sorológico das diferentes formas clínicas da doença de Chagas, foram estudados antígenos de formas amastigota e tripomastigota, obtidas de camundongos imunossuprimidos infectados com cepa Y de T. cruzi, em comparação com o de epimastigota convencionalmente utilizado. Um total de 506 amostras de soro de pacientes chagásicos com formas aguda e crônicas (indeterminada, cardíaca e digestiva, de indivíduos com infecções não relacionadas e de indivíduos sadios foi analisado por rea

  19. Estudo parasitológico e anátomo-patológico da fase aguda da doença de Chagas em cães inoculados com duas diferentes cepas do Trypanosoma cruzi

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    Maria Alice Pedreira de Castro

    1985-12-01

    Full Text Available Cães jovens foram infectados com as cepas Y e CL do T. cruzi usando-se como inóculos 107 formas sangüíneas inoculadaspor via intraperitoneal e 2 x 10³ tripomastigotas metacíclicos obtidos do inseto vetor e inoculadospor via conjuntival. As cepas Ye CL induziram nos cães curvas deparasitemia totalmente distintas, confirmando dados parasitológicos obtidos em camundongos e coelhos. Com a cepa CL a parasitemia, com ambos os inóculos, foi gradualmente ascencional ao passo que com Y a parasitemia foi extremamente baixa, irregular e, com freqüência, subpatente. Com ambas as cepas o parasitismo e as lesões predominaram no miocárdio. Entretanto, com a cepa Y a miocardite foi sempre intensa desde as fases mais precoces da infecção, ao passo que com a cepa CL o processo inflamatório tomou-se acentuado somente a partir do 20.° dia. Freqüentemente a intensidade da miocardite observada em alguns animais não guardava relação com a parasitemia; em alguns cães com parasitemia subpatente, nos quais a infecção só foi diagnosticada pelo xenodiagnóstico, a intensidade da miocardite foi comparável àquela observada nos animais com parasitemia patente. Idêntica correlação também não foi assinalada em relação ao parasitismo tissular. Esses achados sugerem a participação de mecanismo imunológicos na gênese das lesões, ainda na fase aguda da infecção.Young dogs were inoculated with T. cruzi Y and CL strains either by intraperitoneal route with 107 blood forms or by ocular route with 2 x 10³ vector-derived trypomastigotes. With both inocula the patterns of parasitemia were significantly different, confirming data previously obtained in experimentally infected mice and rabbits. CL strain induced a gradual ascencional parasitemia whereas with Y the parasitemia was either subpatent or the number of parasites was very low, rapidly declining. Although myocarditis was present in most animals regardless of the strain used, the

  20. Ventricular arrhythmias in Chagas disease

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    Marco Paulo Tomaz Barbosa

    2015-02-01

    Full Text Available Sudden death is one of the most characteristic phenomena of Chagas disease, and approximately one-third of infected patients develop life-threatening heart disease, including malignant ventricular arrhythmias. Fibrotic lesions secondary to chronic cardiomyopathy produce arrhythmogenic substrates that lead to the appearance and maintenance of ventricular arrhythmias. The objective of this study is to discuss the main clinical and epidemiological aspects of ventricular arrhythmias in Chagas disease, the specific workups and treatments for these abnormalities, and the breakthroughs needed to determine a more effective approach to these arrhythmias. A literature review was performed via a search of the PubMed database from 1965 to May 31, 2014 for studies of patients with Chagas disease. Clinical management of patients with chronic Chagas disease begins with proper clinical stratification and the identification of individuals at a higher risk of sudden cardiac death. Once a patient develops malignant ventricular arrhythmia, the therapeutic approach aims to prevent the recurrence of arrhythmias and sudden cardiac death by the use of implantable cardioverter defibrillators, antiarrhythmic drugs, or both. In select cases, invasive ablation of the reentrant circuit causing tachycardia may be useful. Ventricular arrhythmias are important manifestations of Chagas cardiomyopathy. This review highlights the absence of high-quality evidence regarding the treatment of ventricular arrhythmias in Chagas disease. Recognizing high-risk patients who require specific therapies, especially invasive procedures such as the implantation of cardioverter defibrillators and ablative approaches, is a major challenge in clinical practice.

  1. Apendicitis Aguda

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    Jorge Fallas González

    2012-03-01

    Full Text Available La apendicitis aguda, descrita desde 1886, es la emergencia quirúrgica más común. Tiene su mayor incidencia durante la adultez joven y su menor incidencia en niños y adultos mayores. Su diagnóstico se basa en una historia clínica completa, un examen físico bien orientado y en una adecuada interpretación de los exámenes de laboratorio y gabinete. A pesar de ser una entidad de resolución quirúrgica, su tratamiento engloba diferentes aspectos médicosAcute appendicitis, described since 1886, is the most common surgical emergency. It has its highest incidence during early adulthood, and its lowest incidence in infants and elders. The base of the diagnosis is a complete medical history, an oriented physical exam and an appropriate interpretation of the laboratory and complementary exams. Even though its resolution is a surgical procedure, its treatment involves different medical aspects

  2. Fase aguda da doença de Chagas na Amazônia brasileira: estudo de 233 casos do Pará, Amapá e Maranhão observados entre 1988 e 2005 Acute phase of Chagas disease in the Brazilian Amazon region: study of 233 cases from Pará, Amapá and Maranhão observed between 1988 and 2005

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    Ana Yecê das Neves Pinto

    2008-12-01

    Full Text Available Foram estudados 233 casos de fase aguda da doença de Chagas, oriundos do Pará, Amapá e Maranhão, observados no período de 1988 a 2005, cento e sessenta deles retrospectivamente de 1988 a 2002 e setenta e três prospectivamente de 2003 a 2005. Entre os casos estudados 78,5% (183/233 faziam parte de surtos provavelmente por transmissão oral, acometendo em média 4 pessoas e 21,5% (50/233 eram casos isolados. Foram considerados casos agudos aqueles que apresentaram exames parasitológicos diretos (a fresco, gota espessa ou Quantitative Buffy Coat - QBC e/ou IgM anti-Trypanosoma cruzi positivos. Foram feitos ainda xenodiagnósticos em 224 pacientes e hemoculturas em 213. Todos foram avaliados clinica e epidemiologicamente. As manifestações clínicas mais freqüentes foram febre (100%, cefaléia (92,3%, mialgia (84,1%, palidez (67%, dispnéia (58,4%, edema de membros inferiores (57,9%, edema de face (57,5% dor abdominal (44,2%, miocardite (39,9% e exantema (27%. O eletrocardiograma mostrou alterações de repolarização ventricular em 38,5% dos casos, baixa voltagem de QRS em 15,4% e desvio de SAQRS em 11,5%, extra-sístoles ventriculares em 5,8%, bradicardia em 5,8% e taquicardia em 5,8%, bloqueio de ramo direito em 4,8% e fibrilação atrial em 4,8%. A alteração mais freqüente vista no ecocardiograma foi o derrame pericárdico em 46,2% dos casos. Treze (5,6% pacientes evoluíram para o óbito, 10 (76,9% dos quais por comprometimento cardiovascular, dois por complicações de origem digestiva e um de causa mal definida.Two hundred and thirty-three cases of the acute phase of Chagas disease, from Pará, Amapá and Maranhão, were observed between 1988 and 2005. One hundred and sixty were studied retrospectively from 1988 to 2002 and seventy-three were prospectively followed up from 2003 to 2005. Among the cases studied, 78.5% (183/233 formed part of outbreaks, probably due to oral transmission (affecting a mean of 4 individuals, and 21

  3. Chagas disease in an area of recent occupation in Cochabamba, Bolivia Doença de Chagas numa área de ocupação recente em Cochabamba, Bolívia

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    Hugo Albarracin-Veizaga

    1999-06-01

    profiláticas e trabalho educativo sobre as vias de transmissão da doença de Chagas, inclusive transfusional e congênita.

  4. Experimental Chagas' disease in dogs

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    Marta de Lana

    1992-03-01

    Full Text Available This paper describes the development of experimental Chagas' disease in 64 out-bred young dogs. Twenty-nine animals were inoculated with the Be-62 and 35 with Be-78 Trypanosoma cruzi strains. Twenty-six were infected with blood trypomastigotes by different inoculation routes and 38 with metacyclic trypomastigotes from the vector via the conjunctival route. Twenty of the 26 dogs infected with blood trypomastigotes were autopsied during the acute phase. Eleven died spontaneously and nine were sacrificed. Six remained alive until they died suddenly (two or were autopsied (four. Twelve of the 38 dogs infected with metacyclic trypomastigotes evolved naturally to the chronic phase and remained alive for 24-48 months. The parasitemia, clinical aspects and serology (IgM and IgG as well as electrocardiogram, hemogram and heart anatomo-histopathologic patterns of acute and chronic cardiac forms of Chagas' disease as seen in human infections, were reproduced. The most important finding is the reproductibility of diffuse fibrosing chronic chagasic cardiopathy in all dogs infected with Be-78 T. cruzi strain autopsied between the 90th and 864th days of infection. Thus, the dog can be considered as a suitable experimental model to study Chagas' disease according to the requisites of the World Health Organization (1984. Futhermore the animal is easily obtained and easy to handle and maintain in experimental laboratory conditions.

  5. Treatment of Chagas Cardiomyopathy

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    Fernando A. Botoni

    2013-01-01

    Full Text Available Chagas' disease (ChD, caused by the protozoa Trypanosoma cruzi (T. cruzi, was discovered and described by the Brazilian physician Carlos Chagas in 1909. After a century of original description, trypanosomiasis still brings much misery to humanity and is classified as a neglected tropical disease prevalent in underdeveloped countries, particularly in South America. It is an increasing worldwide problem due to the number of cases in endemic areas and the migration of infected subjects to more developed regions, mainly North America and Europe. Despite its importance, chronic chagas cardiomyopathy (CCC pathophysiology is yet poorly understood, and independently of its social, clinical, and epidemiological importance, the therapeutic approach of CCC is still transposed from the knowledge acquired from other cardiomyopathies. Therefore, the objective of this review is to describe the treatment of Chagas cardiomyopathy with emphasis on its peculiarities.

  6. Estudo preditivo termográfico sistêmico na intoxicação aguda por anestésico local via intraperitoneal em ratos

    OpenAIRE

    Carstens,Angelo Manoel Grande

    2013-01-01

    Resumo: O estudo do valor preditivo termográfico sistêmico na intoxicação aguda por um anestésico local (AL) é de fundamental importância para o aumento da segurança nos procedimentos anestésico-cirúrgicos, pois complicações neurotóxicas e cardiotóxicas estão relacionadas com repercussões na microcirculação e alterações no estado vasomotor e com o aumento da taxa de transferência de calor intercompartimental. O presente estudo experimental teve como objetivo a avaliação do valor preditivo ter...

  7. Gingivitis ulceronecrosante aguda

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    Eduardo de la Teja-Ángeles

    2015-11-01

    Full Text Available La gingivitis ulcerativa necrosante, conocida por sus siglas en inglés como GUN (anteriormente se le conocía como enfermedad de Vincent o “boca de trinchera” por afectar a soldados en guerra, es una enfermedad poco frecuente.1-6 Se caracteriza por ser una infección aguda y dolorosa en la que las encías sangran, hay necrosis de las papilas interdentales y ataque al estado general.

  8. Alterações quantitativas das células de purkinje na moléstia de chagas experimental no camundongo Quantitative study of Purkinje cells in the acute phase of experimental Chagas' disease

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    Edymar Jardim

    1967-09-01

    Full Text Available O autor estudou quantitativamente as células de Purkinje em cortes semi-seriados do cerebelo de camundongos inoculados experimentalmente com T. cruzi,tendo verificado considerável destruição neuronal na fase aguda da enfermidade.A quantitative study of Purkinje cells was done through semi-serial sections of cerebellum of mice experimentally innoculated by Trypanosoma cruzi. Avery marked neuronal destruction was found in the acute phase of Chagas' disease.

  9. Chagas disease in Andean countries

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    Felipe Guhl

    2007-10-01

    Full Text Available The Andean Countries' Initiative (ACI for controlling Chagas disease was officially created in 1997 within the framework of the Hipolito Unanue Agreement (UNANUE between the Ministries of Health of Colombia, Ecuador, Peru, and Venezuela. Its objective was to interrupt transmission via vector and transfusion in the region, taking into account that there are 12.5 million people at risk in the four Andean countries forming the initiative in the area and around 3 million people are infected by Trypanosoma cruzi. The progress of control activities for the vector species present in the Andean sub-region, for different reasons, has been slow and control interventions have still not been installed in all geographical areas occupied by the target species. This has been partly due to lack of knowledge about these vector populations' biological characteristics, and consequent uncertainty about which are the appropriate control measures and strategies to be implemented in the region. The main vector species present important similarities in Venezuela and Colombia and in Ecuador and Northern Peru and they can be approached in a similar way throughout the whole regions, basing approaches on and adapting them to the current strategies being developed in Venezuela during the 1960s which have been progressively adopted in the Southern Cone and Central-American region. Additional measures are needed for keeping endemic areas free from Rhodnius prolixus silvatic populations, widely spread in the Orinoco region in Colombia and Venezuela. Regarding aetiological treatment, it is worth mentioning that (with the exception of Colombia none of the other countries forming the ACI have registered medicaments available for treating infected young people. There are no suitable follow-up programmes in the sub-region or for treating cases of congenital Chagas disease. An integral and integrated programme encompassing all the aspects including transmission by transfusion which

  10. Enfermedad de Chagas o Tripanosomiasis Americana.

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    Felipe Guhl

    2000-08-01

    Latinoamérica persista la vivienda inadecuada, la migración frecuente de personas y la rápida urbanización. Hasta que no cambien estas condiciones, para lo cual habrán de transcurrir muchos años, deberá continuarse la lucha contra la enfermedad.

    La enfermedad de Chagas representa un problema de salud grave en 17 países Latinoamericanos, con un total estimado por la Organización Mundial de la Salud de 100 millones de personas expuestas a la enfermedad, y al rededor de 20 millones de personas infectadas (1. Fuera de los focos naturales de transmisión, se ha notificado la transmisión por transfusión sanguínea con creciente frecuencia.

    Se estima que cada año se infectan alrededor de 500.000 personas y de éstas 300.000 son niños. La mortalidad asciende al 10-15% durante la fase aguda de la enfermedad.

    En Colombia, el T. cruzi se detecta frecuentemente a todo lo largo del Valle del Río Magdalena, en la región del Catatumbo, la Sierra Nevada de Santa Marta, el piedemonte de los Llanos Orientales y la Serranía de la Macarena...

  11. Insuficiencia renal aguda.

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    Carlos Hernán Mejía

    2009-10-01

    Full Text Available La insuficiencia renal aguda se diagnostica aproximadamente en 5% de los pacientes hospitalizados. Sus principales causas se relacionan con la alteración del flujo sanguíneo renal, sea por depleción de volumen, baja perfusión renal o por distribución intrarrenal inadecuada y obstrucción del árbol urinario. El diagnóstico parte de la historia clínica y un buen examen físico que corrobore el estado de volemia del paciente y se complementa con el uso adecuado de los índices urinarios (excreción de sodio y osmolaridad, el uroanálisis y la ecografía renal. Su tratamiento consiste en una adecuada recuperación del volumen, manejo de los diuréticos, soporte nutricional, conservación del equilibrio hidroelectrolítico y brindar terapia de diálisis si hay toxicidad urémica, hipercaliemia severa (>6.5 mEq/l, acidosis metabólica o sobrecarga severa de volumen.

  12. Adipocytes in both brown and white adipose tissue of adult mice are functionally connected via gap junctions: implications for Chagas disease.

    Science.gov (United States)

    Burke, Shoshana; Nagajyothi, Fnu; Thi, Mia M; Hanani, Menachem; Scherer, Philipp E; Tanowitz, Herbert B; Spray, David C

    2014-11-01

    Adipose tissue serves as a host reservoir for the protozoan Trypanosoma cruzi, the causative organism in Chagas disease. Gap junctions interconnect cells of most tissues, serving to synchronize cell activities including secretion in glandular tissue, and we have previously demonstrated that gap junctions are altered in various tissues and cells infected with T. cruzi. Herein, we examined the gap junction protein connexin 43 (Cx43) expression in infected adipose tissues. Adipose tissue is the largest endocrine organ of the body and is also involved in other physiological functions. In mammals, it is primarily composed of white adipocytes. Although gap junctions are a prominent feature of brown adipocytes, they have not been explored extensively in white adipocytes, especially in the setting of infection. Thus, we examined functional coupling in both white and brown adipocytes in mice. Injection of electrical current or the dye Lucifer Yellow into adipocytes within fat tissue spread to adjacent cells, which was reduced by treatment with agents known to block gap junctions. Moreover, Cx43 was detected in both brown and white fat tissue. At thirty and ninety days post-infection, Cx43 was downregulated in brown adipocytes and upregulated in white adipocytes. Gap junction-mediated intercellular communication likely contributes to hormone secretion and other functions in white adipose tissue and to nonshivering thermogenesis in brown fat, and modulation of the coupling by T. cruzi infection is expected to impact these functions.

  13. Efeito vasomotor após intoxicação aguda com bupivacaína e levobupivacaína via intraperitoneal em ratos, analisado por imagem infravermelha digital

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    Angelo Manoel Grande Carstens

    2011-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O estudo do efeito vasomotor dos anestésicos locais (AL é de suma importância para a análise da ocorrência de efeitos cardiotóxicos, neurotóxicos e interações medicamentosas. Com a finalidade de encontrar um fármaco mais seguro do que a bupivacaína racêmica, o presente estudo teve por objetivo a análise por imagem infravermelha digital do efeito vasomotor da intoxicação aguda da bupivacaína e da levobupivacaína via intraperitoneal em ratos. MÉTODO: Utilizaram-se 30 ratos machos da linhagem Wistar, alocados em três grupos (n = 10 e submetidos a uma injeção intraperitoneal de AL. No Grupo C (Controle, foi realizada injeção intraperitoneal de soro fisiológico 0,9% 1 mL. No Grupo B (bupivacaína, injeção intraperitoneal de bupivacaína racêmica a 0,5% (R50-S50, dose de 20 mg.kg-1 de peso. No Grupo L (levobupivacaína, injeção intraperitoneal de levobupivacaína a 0,5%, excesso enantiomérico (S75-R25 em dose de 20 mg.kg-1 de peso. Procedeu-se à filmagem termográfica contínua desde o momento da pré-injeção até 30 minutos após a injeção. Os resultados das filmagens foram analisados em forma gráfica, verificando-se a temperatura máxima de cada rato e a temperatura média do sistema que abrigava o animal. RESULTADOS: Os resultados da análise gráfica revelaram que não houve diferença entre o Grupo L e o Grupo C, e a temperatura média permaneceu estável durante todo o experimento em ambos os grupos. No Grupo B, houve um fenômeno de aumento de temperatura após a injeção intraperitoneal de bupivacaína. CONCLUSÕES: Os resultados demonstraram que o efeito vasomotor da toxicidade aguda da levobupivacaína foi semelhante ao Grupo C com soro fisiológico, por meio de estudos macroscópicos por filmagem digital infravermelha, e que houve alterações vasomotoras (vasoconstrição com a intoxicação por bupivacaína em relação ao Grupo C e em relação ao Grupo L.

  14. Colecistitis aguda por Streptococcus constellatus

    OpenAIRE

    M Sandra Gómez-Canosa; Cristina Lijó-Carballeda; Begoña Vázquez-Vázquez; M José Bello-Peón

    2016-01-01

    Presentamos el caso de una paciente de edad avanzada y significativa comorbilidad que se diagnosticó de colecistitis aguda por Streptococcus constellatus. El drenaje de la vesícula biliar por colecistostomía percutánea, asociado a penicilinas, ha conseguido una evolución favorable. We report the case of a patient of advanced age and significant comorbidity diagnosed acute cholecystitis by Streptococcus constellatus. Gallbladder drainage by percutaneous cholecystostomy associated ...

  15. Ataxias agudas en la infancia

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    Yaline Betancourt Fursow

    2013-09-01

    Full Text Available La ataxia cerebelosa aguda infantil (ACAI es la forma más frecuente de complicación neurológica por el virus de la varicela.Descritas dentro del grupo de las cerebelitis agudas. Los objetivos de este estudio fueron: evaluar la presentación clínica, manejo y seguimiento de niños hospitalizados con ACAI en un hospital pediátrico terciario donde la inmunización para varicela no está disponible (parte I y describir los diagnósticos diferenciales de la cerebelitis aguda (parte II. Estudiamos 95 pacientes. Los criterios diagnósticos de ataxia aguda se basaron en: pérdida aguda de la coordinación o dificultad para la marcha con o sin nistagmo asociado y duración menor de 48 horas, en un niño previamente sano. Estos criterios se cumplían en todos los casos valorados, excepto en las ataxias secundarias a ingesta de tóxicos, en los que la duración debía ser menor de 24 horas para su inclusión en el estudio. Se registraron los datos en una historia clínica pediátrica y neurológica. Entre los pacientes inmunosuprimidos la incidencia mayor fue la complicación por varicela. La mayoría de los pacientes fueron varones. El rango de edad fue la preescolar, 5 años . El intervalo entre la presentación del rash y el ingreso fue de 1 a 3 días. El estudio de LCR se practicó en 59.5% de los casos. La TAC y la resonancia magnética cerebral (RM presentaron edema en el 33.3%. El aciclovir endovenoso fue utilizado en 23 pacientes; pero no hubo diferencias significativas en las manifestaciones clínicas y seguimiento entre tratados y no tratados. La ataxia fue la primera manifestación clínica. La estadía hospitalaria fue de 4 días (rango: 2-11 días.

  16. Uso do suporte ventilatório com pressão positiva contínua em vias aéreas (CPAP por meio de máscara nasofacial no tratamento da insuficiência respiratória aguda

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    Scarpinella-Bueno M.A.

    1997-01-01

    Full Text Available OBJETIVO. O objetivo dos autores foi avaliar o efeito da ventilação com CPAP oferecida por meio de máscara nasofacial como método de suporte ventilatório em pacientes com insuficiência respiratória aguda com critérios de indicação para intubação traqueal. CASUÍSTICA E MÉTODO. Foram estudados 11 pacientes com idade média de 41,3 anos em insuficiência respiratória aguda internados na Unidade Respiratória do Hospital São Paulo - Escola Paulista de Medicina. À admissão, era colhida gasometria arterial em ar ambiente e monitorizava-se freqüência respiratória (f, freqüência cardíaca (FC e pressão arterial (PA. Os mesmos parâmetros eram avaliados após oxigenoterapia via máscara facial aberta e com máscara facial de CPAP usando PEEP de 5cm H2O. RESULTADOS. Com o uso de CPAP através de máscara nasofacial, houve melhora significativa dos níveis de PaO2 e diminuição da freqüência respiratória (p<0,05, quando comparados aos valores em ar ambiente e com máscara facial aberta. CONCLUSÃO. Este trabalho permitiu concluir que a máscara facial de CPAP com 5cm H2O foi eficiente em melhorar a oxigenação arterial e diminuir a freqüência respiratória dos pacientes com insuficiência respiratória aguda, proporcionando-lhes maior conforto, constituindo uma medida terapêutica capaz de evitar o suporte ventilatório invasivo.

  17. Transmissão oral da doença de Chagas pelo consumo de açaí: um desafio para a Vigilância Sanitária / Oral transmission of Chagas disease by consumption of açaí: a challenge for Health Surveillance

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    Maria Regina Branquinho

    2014-11-01

    Full Text Available Até o ano de 2004, a ocorrência de doença de Chagas aguda (DCA por transmissão oral, relacionada ao consumo de alimentos, constituía um evento pouco conhecido ou investigado. Atualmente tornou-se frequente na região amazônica e está relacionada à ocorrência de surtos recentes em diversos estados brasileiros. Os casos recentes notificados no Brasil de DCA estão relacionados ao consumo do suco de açaí, considerado um alimento essencial na dieta da população da Região Norte e muito apreciado nos demais estados brasileiros e em outros países. O objetivo deste trabalho foi destacar os novos desafios a serem enfrentados pelos órgãos de saúde pública na prevenção da transmissão da doença de Chagas pelo consumo de açaí. Apesar de existirem importantes estratégias sendo implementadas pelo Brasil no combate à doença de Chagas transmitida via alimento, ainda há a necessidade de incentivos à pesquisa para que conhecimentos gerados auxiliem na compreensão da transmissão oral e sua melhor interpretação epidemiológica, de prevenção e controle. A implementação das Boas Práticas de Higiene, Boas Práticas de Manufatura e a aproximação entre instituições de ciência e os produtores de açaí também poderão contribuir na solução deste problema. ========================================== The occurrence of acute Chagas disease (ACD by oral transmission related to food consumption, untill 2004, was a little known or investigated event. Currently becomes frequent in the Amazon region and is related to the occurrence of recent outbreaks in several states. Recent cases in Brazil of ACD are related to the consumption of acai juice, considered essencial food in the diet of the population in the Northern Region. The acai berry has been appreciated both for its nutritional value, as by its characteristic flavor, ceasing to be consumed in the producing regions, extending throughout the brazilian territory and even exported to

  18. Control of Chagas disease vectors

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    Ramsey JM

    2003-01-01

    Full Text Available Most Latin American countries are making dramatic progress in controlling Chagas disease, through a series of national and international initiatives focusing on elimination of domestic populations of Triatominae, improved screening of blood donors, and clinical support and treatment of persons infected with Trypanosoma cruzi. Some countries, particularly Uruguay, Chile and Brazil, are sufficiently advanced in their programmes to initiate detailed planning of the subsequent phases of Chagas disease control, while others such as Peru, Ecuador, and Mexico, are currently applying only the initial phases of the control campaigns. In this review, we seek to provide a brief history of the campaigns as a basis for discussion of future interventions. Our aim is to relate operational needs to the underlying biological aspects that have made Chagas disease so serious in Latin America but have also revealed the epidemiological vulnerability of this disease.

  19. Dacriocistite aguda: relato de 2 casos

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    Silvia Helena Tavares Lorena

    2011-02-01

    Full Text Available A obstrução da via lacrimal no adulto pode ser congênita ou adquirida. No caso da forma adquirida, a etiologia se classifica em não específicas (o que envolve o epitélio de revestimento e/ou o plexo vascular submucoso do ducto lácrimo-nasal e específicas (infecções, inflamações, traumatismos, tumores e iatrogenias. O diagnóstico é estabelecido por meio da anamnese, seguida de avaliação clínica baseada na semiologia das vias lacrimais. Os pacientes acometidos pela obstrução da via lacrimal apresentam epífora, dores agudas e tumefação, principalmente na região do saco lacrimal, ocasionando ainda ectasia do mesmo em grau variável, podendo culminar com fistulização cutânea. Ao exame por imagem, utilizamos rotineiramente a dacriocistografia, que representa um ótimo meio de indicar a técnica cirúrgica mais viável. A dacriocistorrinostomia é indicada assim que for tratado o quadro clínico agudo inflamatório.

  20. Transfusion-transmitted Chagas' disease.

    Science.gov (United States)

    Wendel, S

    1998-11-01

    Transfusion-transmitted Chagas' disease has been recognized since 1952. Until recently, no cases were reported outside of Latin America. However, emigration during the past 20 years expanded its transfusional geographic borders to North America. Trypanosoma cruzi-infected donors usually are asymptomatic, often for a lifetime. This situation complicates donor screening, particularly in regions where blood bank personnel are not familiar with the risk factors and natural history of this transfusion-transmitted infection. This review addresses the main aspects of epidemiology, risks of infection, clinical symptoms in donors and recipients, preventive measures, and blood donor screening to prevent transfusion-transmitted Chagas' disease.

  1. Colecistitis aguda por Streptococcus constellatus

    Directory of Open Access Journals (Sweden)

    M Sandra Gómez-Canosa

    2016-03-01

    Full Text Available Presentamos el caso de una paciente de edad avanzada y significativa comorbilidad que se diagnosticó de colecistitis aguda por Streptococcus constellatus. El drenaje de la vesícula biliar por colecistostomía percutánea, asociado a penicilinas, ha conseguido una evolución favorable. We report the case of a patient of advanced age and significant comorbidity diagnosed acute cholecystitis by Streptococcus constellatus. Gallbladder drainage by percutaneous cholecystostomy associated with penicillins has achieved a favorable outcome.

  2. Chagas Disease: No Longer Exotic

    Centers for Disease Control (CDC) Podcasts

    2008-04-03

    This podcast is designed to inform health care providers about Chagas disease, diagnosis, and treatment and to assist in identifying infected patients.  Created: 4/3/2008 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 4/8/2008.

  3. Sertralina e pancreatite aguda: relato de caso

    OpenAIRE

    Malbergier,André; Oliveira Júnior,Hercílio Pereira de

    2004-01-01

    A pancreatite aguda é uma patologia grave e com considerável morbidade e mortalidade. Vários fatores são apontados como possíveis causas de pancreatite aguda. Neste relato, será apresentado um caso de pancreatite aguda com possível associação causal com um inibidor seletivo de recaptura de serotonina: sertralina. Após um mês de tratamento com sertralina, uma paciente do sexo feminino, 55 anos, desenvolveu forte dor abdominal e elevação da amilase sérica. Após internação e retirada da sertrali...

  4. Fase aguda da esquistossomose mansoni

    Directory of Open Access Journals (Sweden)

    Edward Tonelli

    1972-10-01

    Full Text Available O A. faz um estudo panorâmico sobre a fase aguda da esquistossomose mansoni, abordando o quadro clínico e seu diagnóstico, os exames subsidiários, o diagnóstico diferencial, a terapêutica e os aspectos evolutivos. As manifestações clinicas dos períodos de incubação, de estado e de supressão são abordados. O diagnóstico da fase aguda é baseado em dado epidemiológico, 110 exame fisico e em exames subsidiários. O dado epidemiológico. em geral, é positivo, com menção a banho infectante, comumente 30 a 40 dias antes do início do quadro clínico e ao exame físico, encontramos hipertermia (38 - 4G°C, prostração, micropoliadenia hepatomegalia dolorosa em 95%, dos casos e esplenomegalia em 70% dos casos. Os exames prioritários para o diagnóstico são o exame parasiiológico de fezes seriado, que é positivo para ovos viáveis de S. mansoni e o leucograma seriado, que, geralmente, acusa leucocitose com eosinofilia. Em caso de dúvida ou para complementação diagnostica, podemos recorrer à endoscovia retal, ao oograma e á biópsia hepática. A endoscopia acusa, comumente, mucosa hiperêmica, edemaciada, friável, granulosa, com pontos hemorrágicos e o exame colhido por punção biópsia revela, entre outros achados, granulomas na fase necrótica-exsudativa. O diagnóstico diferencial deve ser feito com as seguintes entidades clínicas: gastroenterites. febre tifóide, disenteria bacilar, amebíase aguda, salmonelose septicêrnica prolongada, devendo, ainda, figurar a tuberculose miliar, abdome agudo, a G.N.D.A., a mononucleose infecciosa, a leptospirose, a hepatite e as poaneurites. A terapeutica é baseada nos cuidados gerais, na córticoterapia e na terapêutica específica. Observamos regressão dramática do quadro toxinfeccioso. nas primeiras 24 a 48 horas com a córticoterapia (prednisona que tem duração aproximada de 7 a 10 dias. A terapêutica específica (derivado nitrotiazolico = ambilhar e derivado hidroximet

  5. Mapping of Chagas disease research: analysis of publications in the period between 1940 and 2009

    Directory of Open Access Journals (Sweden)

    José Manuel Ramos

    2011-12-01

    Full Text Available INTRODUCTION: Publications are often used as a measure of success in research work. Chagas disease occurs in Central and Southern America. However, during the past years, the disease has been occurring outside Latin America due to migration from endemic zones. This article describes a bibliometric review of the literature on Chagas disease research indexed in PubMed during a 70-year period. METHODS: Medline was used via the PubMed online service of the U.S. National Library of Medicine from 1940 to 2009. The search strategy was: Chagas disease [MeSH] OR Trypanosoma cruzi [MeSH]. RESULTS: A total of 13,989 references were retrieved. The number of publications increased steadily over time from 1,361 (1940-1969 to 5,430 (2000-2009 (coefficient of determination for linear fit, R²=0.910. Eight journals contained 25% of the Chagas disease literature. Of the publications, 64.2% came from endemic countries. Brazil was the predominant country (37%, followed by the United States (17.6% and Argentina (14%. The ranking in production changed when the number of publications was normalized by estimated cases of Chagas disease (Panama and Uruguay, population (Argentina and Uruguay, and gross domestic product (Bolivia and Brazil. CONCLUSIONS: Several Latin American countries, where the prevalence of T. cruzi infection was not very high, were the main producers of the Chagas disease literature, after adjusting for economic and population indexes. The countries with more estimated cases of Chagas disease produced less research on Chagas disease than some developed countries.

  6. Enfermedad de Chagas en Nicaragua

    Directory of Open Access Journals (Sweden)

    Carlos N. Talavera - López

    2008-04-01

    Full Text Available LA ENFERMEDAD DE CHAGAS ES UN PROBLEMA DE SALUD pública en toda Latinoamérica; alrededor de 20 millones de personas están infectadas y 200 millones están en riesgo de contraer la enfermedad. En 2006, la prevalencia en Centroamérica era del 7%. Actualmente no existe vacuna contra el protozoo y el tratamiento disponible resulta, aparte de poco efectivo, muy tóxico para el paciente. Los programas de control de vectores han ayudado a reducir los índices de infestación en Latinoamérica, pero aún falta mucho por hacer. En Nicaragua, la enfermedad de Chagas está subvalorada y los trabajos publicados son muy pocos. Es necesario investigar sobre esta enfermedad en nuestro país con otro enfoque, uno que no subvalore la enfermedad y ayude a desarrollar métodos diagnósticos y posibles tratamientos. Este artículo recopila información sobre los trabajos realizados porlos grupos más importantes de investigación en Chagas de Nicaragua en cuanto a epidemiología, control vectorial, diagnóstico y caracterización molecular.

  7. The chronic gastrointestinal manifestations of Chagas disease

    Directory of Open Access Journals (Sweden)

    Nilce Mitiko Matsuda

    2009-01-01

    Full Text Available Chagas disease is an infectious disease caused by the protozoan Trypanosoma cruzi. The disease mainly affects the nervous system, digestive system and heart. The objective of this review is to revise the literature and summarize the main chronic gastrointestinal manifestations of Chagas disease. The chronic gastrointestinal manifestations of Chagas disease are mainly a result of enteric nervous system impairment caused by T. cruzi infection. The anatomical locations most commonly described to be affected by Chagas disease are salivary glands, esophagus, lower esophageal sphincter, stomach, small intestine, colon, gallbladder and biliary tree. Chagas disease has also been studied in association with Helicobacter pylori infection, interstitial cells of Cajal and the incidence of gastrointestinal cancer.

  8. Comportamento do método quimioluminescente-ELISA em relação a resultados considerados discordantes por meio de três técnicas convencionais para diagnóstico da doença de Chagas Behavior of the chemiluminescent ELISA method in relation to results considered discordant via three conventional techniques for diagnosing Chagas disease

    Directory of Open Access Journals (Sweden)

    Cláudia Regina De Marchi

    2007-02-01

    Full Text Available Quando utilizadas, em conjunto, a hemaglutinação indireta, a imunofluorescência indireta e ELISA para diagnóstico sorológico da doença de Chagas por vezes ocorrem resultados considerados discordantes, por não haver concordância entre o que indicam essas técnicas. A disponibilidade do método quimioluminescente-ELISA permitiu executá-lo com 200 soros que examinados pelos três testes citados que motivaram a obtenção de resultados discordantes. Com o método quimioluminescente-ELISA sucederam 193 negativos e sete positivos. O emprego desse novo procedimento trouxe mais um subsídio para compreensão do assunto, mas avanço mais concreto dependerá de documentação com soros de pessoas infectadas ou não pelo Trypanosoma cruzi conforme comprovação parasitológica.When indirect hemagglutination, indirect immunofluorescence and enzyme-linked immunosorbent assay are used together for serologically diagnosing Chagas disease, results that are considered discordant sometimes occur because there is disagreement between what these tests indicate. The availability of the chemiluminescent ELISA method enabled tests on 200 serum samples that had previously produced discordant results from the three abovementioned methods. CL-ELISA revealed that 193 of these samples were negative and seven were positive. The use of this new procedure provides further support for understanding this subject, but more concrete advances will depend on documentation with blood analyses from people previously demonstrated to be unquestionably infected or uninfected with Trypanosoma cruzi.

  9. [Oral transmission of Chagas' disease].

    Science.gov (United States)

    Toso M, Alberto; Vial U, Felipe; Galanti, Norbel

    2011-02-01

    The traditional transmission pathways of Chagas' disease are vectorial, transfusional, transplacental and organ transplantation. However, oral transmission is gaining importance. The first evidence of oral transmission was reported in Brazil in 1965. Nowadays the oral route is the transmission mode in 50% of cases in the Amazon river zone. Oral infection is produced by the ingestion of infected triatomine bugs or their feces, undercooked meat from infested host animals and food contaminated with urine or anal secretion of infected marsupials. Therefore travelers to those zones should be advised about care to be taken with ingested food. In Chile, this new mode of transmission should be considered in public health policies.

  10. Mucocele apendicular y colecistitis aguda gangrenada

    OpenAIRE

    Mauricio de la Fuente-Lira; Erick Rolando Rocha-Guevara; María Luisa Márquez-Rocha; Carlos Salazar-Lozano; Omar Jaramillo-Solís; Alma Lilia Ortiz-Maldonado

    2006-01-01

    Objetivo: descripción de un caso de mucocele apendicular y colecistitis aguda gangrenada, atendido en el Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS. Caso clínico: hombre de 80 años de edad que ingresó al hospital con diagnóstico de colecistitis aguda y tumor abdominal de etiología desconocida, dolor abdominal de 10 días de evolución localizado en hipocondrio derecho, sin fiebre ni pérdida importante de peso. Los exámenes de laboratorio mostraron únicamente leucocitosis...

  11. Melatonin in Chagas´ disease: Possible therapeutic value La melatonina en la enfermedad de Chagas: Su posible valor terapéutico

    Directory of Open Access Journals (Sweden)

    Daniel P. Cardinali

    2011-10-01

    ón microbicida eficaz necesaria para controlar la parasitemia. La melatonina es detectable en T. cruzi y podría desempeñar un papel en la promoción de la infección como lo hace en el paludismo, mientras que, cuando se administra en dosis farmacológicas altas durante la fase aguda de la infección por T. cruzi, disminuye la parasitemia, aun en presencia de una reducción de la producción de NO. Durante la progresión de la enfermedad de Chagas a la cronicidad, el estrés oxidativo aumentado con el concomitante daño miocárdico podría reducirse por la administración de melatonina, de reconocida acción antioxidante. Se propone como un nuevo enfoque complementario en el tratamiento de la enfermedad de Chagas la administración durante la fase aguda de un agonista MT1/MT2 de la melatonina como el ramelteon, que carece de actividad antioxidante y podría no afectar a la producción de NO, y de melatonina durante la fase crónica de en dosis suficientemente altas como para disminuir el daño oxidativo y prevenir la miocardiopatía.

  12. Doença de Chagas por transfusão de sangue em Londrina

    Directory of Open Access Journals (Sweden)

    José Luis da Silveira Baldy

    1978-11-01

    Full Text Available The author emphasizes the importance of Chagas'disease transmited by blood transfusion in Brazil, and particularly in North region of Parana State. One serological survey for American Trypanosomiasis performed in two blood banks (4,500 blood donor candidates of tondrina, Parana State, Brazil, showed positive results in 7.4%. Six cases of acute pos-transfusion Oiagas'disease diagnosed in Londrina are presented. Two patients died and the further four cases were treated with nifurtimox, with good clinical response. The author points out the discrepancy between the small number of reported Ctiagas'disease acute cases and the high prevalence of positive serologic reactions fort his infection in donor candidates of blood hanks in Brazil He emphasizes the importance, in this country, of blood transfusion as infectious source of Trypanosoma cnizi, and remembers rules to follow when it will be necessary to use blood transfusions in countries where Chagas'disease is endemic. The early administration of trypanosomicidal drugs is mandatory, in cases of acute post-transfusion Chagas 'disease, eventually diagnosed.Nesta pesquisa apresenta-se o resultado de inquérito sorológien realizado em 1975, em dois bancos de sangue de Londrina-Paraná, e os primeiros seis casos agudos de doença de Chagas pós-transfusional, diagnosticados no Paraná Chama-se a atenção para a importância, no Brasil e, em particular, no Norte do Paraná, da doença de Chagas transmitida por transfusão de sangue. Reações sorológicas para o diagnóstico de tripanosomiase americana foram positivas em 7,4% dos 4.500 candidatos a doadores examinados nos dois bancos de sangue estudados. Seis casos de doença de Chagas aguda pós-transfusional - um prócer dente de Cianorte, outro de Cornélio Procópio e os demais de Londrina, estado do Paraná, foram diagnosticados. Dois dos pacientes faleceram e os outros quatro foram tratados com nifurtimox. Enfatiza-se a discrepância entre o

  13. Carlos Chagas Discoveries as a Drop Back to Scientific Construction of Chronic Chagas Heart Disease

    Energy Technology Data Exchange (ETDEWEB)

    Bestetti, Reinaldo B., E-mail: rbestetti44@gmail.com; Restini, Carolina Baraldi A.; Couto, Lucélio B. [Universidade de Ribeirão Preto, Ribeirão Preto, São Paulo, SP (Brazil)

    2016-07-15

    The scientific construction of chronic Chagas heart disease (CCHD) started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922. In 1928, Chagas detected fibrosis of the conductive system, and pointed out the presence of marked cardiomegaly at the chest X-Ray associated with minimal symptomatology. The use of serological reaction to diagnose CCHD was put into clinical practice in 1936, after Chagas' death, which along with the 12-lead ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long period between initial infection and appearance of CCHD was established, whereas the annual incidence of CCHD from patients with the indeterminate form of the disease was established in 1956. The use of heart catheterization in 1965, exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of CCHD as described by Carlos Chagas.

  14. Carlos Chagas Discoveries as a Drop Back to Scientific Construction of Chronic Chagas Heart Disease

    Directory of Open Access Journals (Sweden)

    Reinaldo B. Bestetti

    2016-01-01

    Full Text Available Abstract The scientific construction of chronic Chagas heart disease (CCHD started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922. In 1928, Chagas detected fibrosis of the conductive system, and pointed out the presence of marked cardiomegaly at the chest X-Ray associated with minimal symptomatology. The use of serological reaction to diagnose CCHD was put into clinical practice in 1936, after Chagas' death, which along with the 12-lead ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long period between initial infection and appearance of CCHD was established, whereas the annual incidence of CCHD from patients with the indeterminate form of the disease was established in 1956. The use of heart catheterization in 1965, exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of CCHD as described by Carlos Chagas.

  15. Carlos Chagas Discoveries as a Drop Back to Scientific Construction of Chronic Chagas Heart Disease

    Science.gov (United States)

    Bestetti, Reinaldo B.; Restini, Carolina Baraldi A.; Couto, Lucélio B.

    2016-01-01

    The scientific construction of chronic Chagas heart disease (CCHD) started in 1910 when Carlos Chagas highlighted the presence of cardiac arrhythmia during physical examination of patients with chronic Chagas disease, and described a case of heart failure associated with myocardial inflammation and nests of parasites at autopsy. He described sudden cardiac death associated with arrhythmias in 1911, and its association with complete AV block detected by Jacquet's polygraph as Chagas reported in 1912. Chagas showed the presence of myocardial fibrosis underlying the clinical picture of CCHD in 1916, he presented a full characterization of the clinical aspects of CCHD in 1922. In 1928, Chagas detected fibrosis of the conductive system, and pointed out the presence of marked cardiomegaly at the chest X-Ray associated with minimal symptomatology. The use of serological reaction to diagnose CCHD was put into clinical practice in 1936, after Chagas' death, which along with the 12-lead ECG, revealed the epidemiological importance of CCHD in 1945. In 1953, the long period between initial infection and appearance of CCHD was established, whereas the annual incidence of CCHD from patients with the indeterminate form of the disease was established in 1956. The use of heart catheterization in 1965, exercise stress testing in 1973, Holter monitoring in 1975, Electrophysiologic testing in 1973, echocardiography in 1975, endomyocardial biopsy in 1981, and Magnetic Resonance Imaging in 1995, added to the fundamental clinical aspects of CCHD as described by Carlos Chagas. PMID:27223644

  16. Immunosuppression and Chagas disease: a management challenge.

    Directory of Open Access Journals (Sweden)

    María-Jesús Pinazo

    Full Text Available Immunosuppression, which has become an increasingly relevant clinical condition in the last 50 years, modifies the natural history of Trypanosoma cruzi infection in most patients with Chagas disease. The main goal in this setting is to prevent the consequences of reactivation of T. cruzi infection by close monitoring. We analyze the relationship between Chagas disease and three immunosuppressant conditions, including a description of clinical cases seen at our center, a brief review of the literature, and recommendations for the management of these patients based on our experience and on the data in the literature. T. cruzi infection is considered an opportunistic parasitic infection indicative of AIDS, and clinical manifestations of reactivation are more severe than in acute Chagas disease. Parasitemia is the most important defining feature of reactivation. Treatment with benznidazole and/or nifurtimox is strongly recommended in such cases. It seems reasonable to administer trypanocidal treatment only to asymptomatic immunosuppressed patients with detectable parasitemia, and/or patients with clinically defined reactivation. Specific treatment for Chagas disease does not appear to be related to a higher incidence of neoplasms, and a direct role of T. cruzi in the etiology of neoplastic disease has not been confirmed. Systemic immunosuppressive diseases or immunosuppressants can modify the natural course of T. cruzi infection. Immunosuppressive doses of corticosteroids have not been associated with higher rates of reactivation of Chagas disease. Despite a lack of evidence-based data, treatment with benznidazole or nifurtimox should be initiated before immunosuppression where possible to reduce the risk of reactivation. Timely antiparasitic treatment with benznidazole and nifurtimox (or with posaconazole in cases of therapeutic failure has proven to be highly effective in preventing Chagas disease reactivation, even if such treatment has not been

  17. Leucemia promielocítica aguda

    OpenAIRE

    Durigon, Giovanna Steffenello

    2014-01-01

    Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Farmácia, Florianópolis, 2014. A leucemia promielocítica aguda (LPA) é um subtipo distinto de leucemia mieloide aguda (LMA), caracterizado pela presença de um acúmulo de promielócitos anormais na medula óssea e/ou sangue periférico, com risco de coagulopatia e a presença da translocação recíproca e balanceada entre os cromossomas 15 e 17 t(15;17)(q22;q12) e variantes. ...

  18. Bases moleculares de las leucemias agudas

    Directory of Open Access Journals (Sweden)

    G. Martínez Antuña

    2006-04-01

    Full Text Available El gran desarrollo de la biología molecular en los últimos años ha contribuido a un importante avance en los conocimientos relacionados con las bases moleculares de las leucemias agudas (LA. Ademas de profundizar en la biología de estas enfermedades y conocer las bases moleculares, ha renido también gran impacto en mejorar el resultado de los tratamientos y disminuir la toxicidad de las terapias.

  19. Cardiac beta-receptors in experimental Chagas' disease Receptores beta cardíacos na doença de Chagas experimental

    Directory of Open Access Journals (Sweden)

    Julio E. Enders

    1995-02-01

    Full Text Available Experimental Chagas' disease (45 to 90 days post-infection showed serious cardiac alterations in the contractility and in the pharmacological response to beta adrenergic receptors in normal and T. cruzi infected mice (post-acute phase. Chagasic infection did not change the beta receptors density (78.591 ± 3.125 fmol/mg protein and 73.647 ± 2.194 fmol/mg protein for controls but their affinity was significantly diminished (Kd = 7.299 ± 0.426 nM and Kd = 3.759 ± 0.212 nM for the control p Estudaram-se os receptores beta cardíacos de camundongos infectados pelo Trypanosoma cruzi na fase pós-aguda da doença de Chagas para estabelecer em que medida os mesmos contribuem a gerar respostas anômalas às catecolaminas observadas nestes miocardios. Utilizara-se 3-H/DHA para a marcação dos receptores beta cardíacos dos camundongos normais e dos infectados na fase pós-aguda (45 a 90 dias pós-infecção. O número dos sítios de fixação foi similar nos dois grupos, 78.591 ± 3.125 fmol/mg. Proteína nos chagásicos e 73.647 ± 2.194 fmol/mg. Proteína no grupo controle. Em vez disso, a afinidade verificou-se significativamente diminuida no grupo chagásico (Kd = 7.299 ± 0.426 nM respeito do controle (Kd = 3.759 ± 0.212 nM p < 0.001. Os resultados obtidos demonstram que as modificações observadas na estimulação adrenérgica do miocárdio chagásico se correlacionam com a menor afinidade dos receptores beta cardíacos e que estas alterações exerceriam uma parte determinante para as consequências funcionais que são detectadas na fase crônica.

  20. Uso do sulfato de magnésio por via venosa e nebulização para o tratamento da asma aguda na emergência Use of the intravenous and nebulized magnesium sulfate for the treatment of the acute asthma in the emergence

    Directory of Open Access Journals (Sweden)

    Fabiano Timbó Barbosa

    2007-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Tem sido mostrado que o sulfato de magnésio apresenta benefícios em adultos e crianças asmáticos, com fraca resposta aos agentes beta-agonistas e corticóides sistêmicos no departamento de emergência. O objetivo deste estudo foi realizar uma revisão não sistemática acerca do tratamento da asma aguda com sulfato de magnésio por via venosa e nebulização na emergência. CONTEÚDO: As primeiras investigações que demonstraram benefício no uso do sulfato de magnésio na asma são de 1938. Os efeitos do sulfato de magnésio podem ser mediados através da ação antagonista do cálcio ou através da função de co-fator em sistemas enzimáticos envolvendo o fluxo iônico através da membrana celular. Foi realizada uma revisão de literatura através da base de dados MedLine nos últimos seis anos (2000 a 2006 e incluídos os artigos publicados na língua inglesa, através do cruzamento dos unitermos asma e sulfato de magnésio. CONCLUSÕES: A administração de rotina do sulfato de magnésio por via venosa e nebulização em pacientes com asma aguda grave que se apresentam no serviço de emergência não é recomendado; entretanto, como um tratamento adjuvante obtém-se algum benefício.BACKGROUND AND OBJECTIVES: Magnesium sulfate has been shown to benefit asthmatic children and adults with poor responses to initial beta-agonist therapy and systemic corticoids in the emergency department. The aim of this study was to realize a no systematic review about the treatment of the acute asthma with intravenous and nebulized magnesium sulfate in the emergence. CONTENTS: The first investigations that demonstrate the benefit in the use of the magnesium sulfate in asthma date to 1938. The effects of magnesium sulfate may be mediated through its action as a calcium antagonist or through its function as a cofactor in enzyme systems involving ion flux across cell membranes. We realized a literature review using Med

  1. Clínica e terapêutica da doença de Chagas

    Directory of Open Access Journals (Sweden)

    Francisco S. Laranja

    1948-06-01

    Full Text Available 1 - Baseados na experiência adquirida nos últimos cinco anos em Bambuí, Minas Gerais, onde mais de seiscentos casos de doença de Chagas tém sido estudados, os autores fazem uma revisão das manifestações clínicas desta doença. mencionam alguns dados sôbre a incidência da esquizotripanose e chamam a atenção para a importância social desta moléstia. 2 - Sugerem a seguinte sistematização das fórmas clinicas da esquizotripanose: a Forma aguda; b Formas crônicas: 1 - Forma indeterminada (cardiacos potenciais, 2 - Forma cardíaca (cardiopatia crônica. Os autores não encontraram no material estudado em Bambuí casos classificaveis como forma nervosa crônica. 3 - Apresentam evidências de ordem clínica e experimental que justificam admitir-se a cardiopatia crônica da doença de Chagas como entidade clinica definida. 4 - As manifestações da infecção aguda são estudadas à luz da experiência adquirida com os 103 casos agudos diagnosticados em Bambuí. Dois tipos de fenômenos edematosos podem ocorrer em pacientes com esquizotripanose aguda: o edema local, de porta de entrada do parasito, e o edema generalizado (o chamado "mixedema". A patogenia dêste último é revista e sugere-se que ele seja devido a uma hipoproteinemia. O edema local parece de natureza inflamatória. As manifestações da cardiopatia aguda da doença de Chagas são descritas. Ritmo de galope, aumento da area cardíaca (em alguns casos devido a transudato pericárdico, prolongamento do espaço P-R, alterações primárias da onda T e extra-sístoles ventriculares - constituem os sinais mais importantes para o diagnóstico da cardiopatia aguda. Bloqueio de ramo direito foi encontrado em três casos fatais de cardiopatia aguda, um dos quais apresentou também pronunciado desnivelamento de ST (padrão de injúria. A morte durante a infecção aguda é usualmente precedida por manifestações convulsivas. Na maioria dos casos as manifestações, da infec

  2. Intoxicación aguda por plaguicidas

    OpenAIRE

    Durán-Nah Jaime Jesús; Collí-Quintal Julián

    2000-01-01

    OBJETIVO: Describir la epidemiología de la intoxicación aguda por plaguicidas (IAP) en el Hospital General O'Horán de Mérida, Yucatán, México. MATERIAL Y MÉTODOS: Se revisaron los expedientes de 33 pacientes superscript three 13 años, tratados en una unidad de cuidados intensivos (UCI), entre 1994 y 1998. Se recopilaron variables demográficas y clínicas relevantes, y se aplicó estadística descriptiva. RESULTADOS: En la población estudiada predominó el sexo masculino (82%) del medio rural (70%...

  3. Serodiagnosis of chronic Chagas infection by using EIE-Recombinant-Chagas-Biomanguinhos kit

    Directory of Open Access Journals (Sweden)

    Gomes Yara M

    2001-01-01

    Full Text Available A kit based on an enzyme immunoassay, EIE-Recombinant-Chagas-Biomanguinhos, developed by the Oswaldo Cruz Foundation, was evaluated for the serodiagnosis of chronic Chagas disease. Evaluation was performed with 368 serum samples collected from individuals living in an endemic area for Chagas disease: 131 patients in the chronic phase with confirmed clinical, epidemiological, and serological diagnosis (indirect immunofluorescence, indirect hemagglutination or enzyme-linked immunosorbent assay and 237 nonchagasic seronegative individuals were considered negative control. The EIE-Recombinant-Chagas-Biomanguinhos kit showed high sensitivity, 100% (CI 95%: 96.4-100% and high specificity, 100% (CI 95%: 98-100%. The data obtained were in full agreement with clinical and conventional serology data. In addition, no cross-reaction was observed with sera from patients with cutaneous (n=14 and visceral (n=3 leishmaniasis. However, when these sera were tested by conventional serological assays for Chagas disease, cross-reactions were detected in 14.3% and 33.3% of the patients with cutaneous and visceral leishmaniasis, respectively. No cross-reactions were observed when sera from nonchagasic seronegative patients bearing other infectious disease (syphilis, n=8; HTLV, n=8; HCV, n=7 and HBV, n=12 were tested. In addition, sera of patients with inconclusive results for Chagas disease by conventional serology showed results in agreement with clinical evaluation, when tested by the kit. These results are relevant and indicate that the refered kit provides a safe immunodiagnosis of Chagas disease and could be used in blood bank screening.

  4. INSUFICIENCIA RENAL AGUDA CON UREMIA NORMAL EN PACIENTE MONO-RENO SECUNDARIA A PIELONEFRITIS AGUDA

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    Musso CG

    2006-03-01

    Full Text Available RESUMEN:La insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia.En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal. SUMMARYAcute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one.In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels.

  5. INSUFICIENCIA RENAL AGUDA CON UREMIA NORMAL EN PACIENTE MONO-RENO SECUNDARIA A PIELONEFRITIS AGUDA

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    Musso CG

    2007-04-01

    Full Text Available RESUMENLa insuficiencia renal aguda es un sindrome que característicamente cursa con niveles plasmáticos elevados de urea y creatinina. Sin embargo, hay situaciones clínicas en las cuales este sindrome puede cursar con un incremento de la creatininemia sin presentar elevación de la uremia. En este reporte presentamos un caso clínico de una insuficiencia renal aguda con uremia normal secundaria a una pielonefritis aguda en un paciente con riñón único. El paciente presentaba una elevada excreción fraccional de urea lo cual podía explicar su uremia normal pese a estar cursando una caída del filtrado gomerular. Dicha excreción de urea elevada fue interpretada como secundaria a una diabetes insipida nefrogénica y una alteración en el recirculado intra-renal de la urea ambos producto de la pielonefritis aguda. Concluimos que la pielonefritis aguda en un paciente mono-reno puede presentarse con un patrón de insuficiencia renal aguda con uremia normal.SUMMARYAcute renal failure is a syndrome that usually runs with an increase in creatinine and urea plasma levels. However, there are clinical situations in which this syndrome may run with an increase in plasma creatinine keeping normal the urea one. In this report we present a case of acute renal failure with normal plasma urea level secondary to an acute pyelonephritis in a single kidney patient. The patient had an increased fractional excretion of urea which could explain the normal plasma urea levels found despite of his reduced glomerular filtration. This increased urea excretion state was interpreted as a consequence of the nephrogenic diabetes insipidus and alteration of the intra-renal urea reciclying process that the acute pyelonephritis induced. In conclusion: Acute pyelonephritis in a single kidney patient can appear as a pattern of acute renal failure with normal plasma urea levels.

  6. Current epidemiological trends for Chagas disease in Latin America and future challenges in epidemiology, surveillance and health policy

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    Álvaro Moncayo

    2009-07-01

    Full Text Available Chagas disease, named after Carlos Chagas, who first described it in 1909, exists only on the American Continent. It is caused by a parasite, Trypanosoma cruzi, which is transmitted to humans by blood-sucking triatomine bugs and via blood transfusion. Chagas disease has two successive phases: acute and chronic. The acute phase lasts six-eight weeks. Several years after entering the chronic phase, 20-35% of infected individuals, depending on the geographical area, will develop irreversible lesions of the autonomous nervous system in the heart, oesophagus and colon, and of the peripheral nervous system. Data on the prevalence and distribution of Chagas disease improved in quality during the 1980s as a result of the demographically representative cross-sectional studies in countries where accurate information was not previously available. A group of experts met in Brasilia in 1979 and devised standard protocols to carry out countrywide prevalence studies on human T. cruzi infection and triatomine house infestation. Thanks to a coordinated multi-country programme in the Southern Cone countries, the transmission of Chagas disease by vectors and via blood transfusion was interrupted in Uruguay in 1997, in Chile in 1999 and in Brazil in 2006; thus, the incidence of new infections by T. cruzi across the South American continent has decreased by 70%. Similar multi-country initiatives have been launched in the Andean countries and in Central America and rapid progress has been reported towards the goal of interrupting the transmission of Chagas disease, as requested by a 1998 Resolution of the World Health Assembly. The cost-benefit analysis of investment in the vector control programme in Brazil indicates that there are savings of US$17 in medical care and disabilities for each dollar spent on prevention, showing that the programme is a health investment with very high return. Many well-known research institutions in Latin America were key elements of a

  7. Chagas' Disease: an acute transfusional case report

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    Dalva Marli Valério Wanderley

    1988-12-01

    Full Text Available Report of a case of acute transfusional Chagas'disease in a four-year-old child with a previous diagnosis of acute lymphocytic leukemia, transmitted in São Paulo, the Capital of São Paulo State, Brazil. Epidemiological investigation disclosed the donor's serological positivity and his previous residence in an area where Chagas' disease is endemic. The importance of adequate sorological screening in blood donors is evident. It should be stressed that this is the first case notified to the Superintendência de Controle de Endemias (SUCEN (Superintendency for the Endemy Control of the State Secretariat of Health, São Paulo, for the last five years.

  8. The Southern Cone Initiative against Chagas disease.

    Science.gov (United States)

    Schofield, C J; Dias, J C

    1999-01-01

    Chagas disease (also known as American trypanosomiasis) is now ranked as the most serious parasitic disease of the Americas, with an economic impact far outranking the combined effects of other parasitic diseases such as malaria, schistosomiasis and leishmaniasis. Although the chronic infection remains virtually incurable, transmission can be halted by eliminating the domestic insect vectors and screening blood donors to avoid transfusional transmission. In line with this strategy, governments of the six Southern Cone countries (Argentina, Bolivia, Brazil, Chile, Paraguay and Uruguay) launched in 1991 an ambitious initiative to control Chagas disease through elimination of the main vector, Triatoma infestans, and large-scale screening of blood donors. Now at its mid-point, the programme has achieved remarkable success, with transmission halted over vast areas of the previously endemic regions. Well over 2 million rural houses have been sprayed to eliminate T. infestans, and the programme has already shown significant economic rates of return in addition to the medical and social benefits.

  9. Ticks, ivermectin, and experimental Chagas disease

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    João Carlos Pinto Dias

    2005-12-01

    Full Text Available Following an infestation of dogticks in kennels housing dogs used for long-term studies of the pathogenesis of Chagas disease, we examined the effect of ivermectin treatment on the dogs, ticks, trypanosome parasites, and also on triatomine vectors of Chagas disease. Ivermectin treatment was highly effective in eliminating the ticks, but showed no apparent effect on the dogs nor on their trypanosome infection. Triatominae fed on the dogs soon after ivermectin treatment showed high mortality, but this effect quickly declined for bugs fed at successive intervals after treatment. In conclusion, although ivermectin treatment may have a transient effect on peridomestic populations of Triatominae, it is not the treatment of choice for this situation. The study also showed that although the dogticks could become infected with Trypanosoma cruzi, this only occurred when feeding on dogs in the acute phase of infection, and there was no evidence of subsequent parasite development in the ticks.

  10. [Chagas Carlos Justiniano Ribeiro (1879-1934)].

    Science.gov (United States)

    Pays, J F

    2009-12-01

    The story of the life of Carlos Chagas is closely associated with the discovery of American Human Trypanosomiasis, caused by Trypanosoma cruzi. Indeed, he worked on this for almost all of his life. Nowadays he is considered as a national hero, but, when he was alive, he was criticised more severely in his own country than elsewhere, often unjustly and motivated by jealousy, but sometimes with good reason. Cases of Chagas disease in non-endemic countries became such a concern that public health measures have had to be taken. In this article we give a short account of the scientific journey of this man, who can be said to occupy his very own place in the history of Tropical Medicine.

  11. Fatal acute Chagas Disease in a Chimpanzee

    Science.gov (United States)

    2009-08-01

    protozoan parasite belonging to the order Kinetoplastida, family Trypanosomatidae. Arthropod vectors (Reduviidae, assassin bugs or cone nosed bugs or...Laranja FS. Experimental Chagas’ disease in rhesus monkeys. I. Clinical, parasitological , hematological and anatomo- pathological studies in the acute...of infection and immunity from mother to young. Parasitology . 1972; 65:1–9. [PubMed: 4626452] 21. Miles MA, Marsden PD, Pettitt LE, Draper CC, Watson

  12. Coréia aguda na gravidez

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    Walter C. Pereira

    1967-12-01

    Full Text Available São apresentados doze casos de coréia aguda observados entre 150.000 gestantes (1/12.500. A maioria dos surtos ocorreu no segundo trimestre da primeira gravidez. A duração média dos sintomas foi de três meses, não tendo sido registrado caso algum de óbito materno. Todos os partos foram espontâneos e normais. Houve apenas um óbito fetal conseqüente a choque hemorrágico. São tecidas considerações a propósito dos aspectos clínico, laboratorial e prognóstico da coréia gravídica, sendo focalizado mais pormenorizadamente o problema fisiopatogênico dessa afecção.

  13. Un test per la faringits aguda

    OpenAIRE

    Madurell, Jordi

    2013-01-01

    La faringitis aguda és una de les raons més freqüents de consulta del metge d’atenció primària i en la major part dels casos es prescriu un antibiòtic. Ara bé, segons l'evidència científica només han de ser tractats amb antibiòtics aquells episodis de faringitis causats per un bacteri determinat, l'estreptococ β-hemolític del grup A (EBHGA). Segons sembla, només un 10-30% dels episodis aguts en nens i 10-15% dels casos en adults són causats per EBHGA. Aquesta tesi, presentada al Departament d...

  14. O etanercepte induz QRS de baixa tensão e disfunção autonômica em camundongos com doença de Chagas experimental

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    Héctor Rodríguez-Angulo

    2013-09-01

    Full Text Available FUNDAMENTO: A doença de Chagas é uma doença parasitária tropical causada pelo protozoário flagelado Trypanosoma cruzi. A cardiomiopatia chagásica é caracterizada por distúrbios na regulação autonômica e na condução do potencial de ação nas fases aguda e crônica da infecção. Embora o fator de necrose tumoral alfa (TNF-α tenha sido associadoà cardiomiopatia em modelos experimentais e em pacientes com doença de Chagas, outros relatos sugerem que o TNF-α pode exercer ações antiparasitárias durante a fase aguda da infecção. OBJETIVOS: Este estudo teve como objetivo determinar os efeitos de um blocker TNF-α solúvel, o etanercepte, em parâmetros eletrocardiográficos na fase aguda da infecção experimental com Trypanosoma cruzi. MÉTODOS: Foram feitos eletrocardiogramas em camundongos infectados não tratados e camundongos infectados que foram tratados com etanercepte 7 dias após a infecção. Os parâmetros de variabilidade onda do eletrocardiograma e frequência cardíaca foram determinados utilizando o Chart para Windows. RESULTADOS: O tratamento com etanercepte resultou em uma baixa tensão do complexo QRS e uma redução da variabilidade da frequência cardíaca em comparação com a ausência de tratamento. No entanto, os camundongos tratados apresentaram um atraso na queda da curva de sobrevivência durante a fase aguda. CONCLUSÃO: Os resultados deste estudo sugerem que, embora o tratamento com etanercepte promova a sobrevivência em camundongos infectados com uma linhagem virulenta de T. cruzi, o bloqueio do TNF-α gera um complexo de baixa tensão e disfunção autonômica durante a fase aguda da infecção. Esses resultados indicam que a mortalidade durante a fase aguda pode ser atribuída a uma resposta inflamatória sistêmica, em vez da disfunção cardíaca.

  15. Insufici??ncia renal aguda em pacientes com doen??a glomerular: aspectos histol??gicos e papel da necrose tubular aguda

    OpenAIRE

    Tavares, Maria Brand??o

    2011-01-01

    A insufici??ncia renal aguda ?? comum em pacientes com s??ndrome nefr??tica, podendo requerer terapia de substitui????o renal e ser irrevers??vel. A insufici??ncia renal aguda nesses pacientes pode ser precipitada por processos infecciosos, hipovolemia, drogas nefrot??xicas; entretanto na maioria dos casos a etiologia n??o ?? identificada e a insufici??ncia renal aguda ?? considerada idiop??tica. A necrose tubular aguda foi associada ?? insufici??ncia renal aguda em adultos com les??o m??nima...

  16. Cecílio Romaña, o sinal de Romaña e a doença de Chagas

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    João Carlos Pinto Dias

    1997-10-01

    Full Text Available Recentemente falecido em Barcelona, Cecílio Romaña foi um importante tropicologista argentino com muitas contribuições à clínica, ao controle e à patologia da doença de Chagas entre 1930 e 1960. Em 1935, Romaña tornou-se famoso por sua precisa descrição do complexo oftalmo-ganglionar, o mais típico dos sinais de porta de entrada da doença de Chagas humana, sinal este que logo ficou conhecido em toda a América Latina com o nome de "sinal de Romaña", por proposição de dois pesquisadores brasileiros, Emmanuel Dias e Evandro Chagas. O achado de Romaña causou enorme polêmica com o grande Salvador Mazza, que não reconheceu a especificidade do sinal e, muito menos, aceitou a proposta nomenclatura. Estes fatos são relatados no presente artigo, que homenageia Cecílio Romaña e destaca o enorme impacto de sua descoberta para o conhecimento da doença de Chagas aguda em toda sua área endêmica.Cecílio Romaña was an important Argentinean researcher dedicated to tropical diseases in the period 1930-1960, recently died in Barcelona. Working mainly on the epidemiological, clinical and pathological aspects of American trypanosomiasis, Romaña became very famous in 1935 when he accurately described the most typical portal recognized in all the endemic area with the cognomen of "Romaña sign". This description caused an enormous polemic with Romaña's then director, the great Salvador Mazza, who never accepted the specificity of the sign and, much less, its popular name (which was proposed by the Brazilian researchers Emmanuel Dias and Evandro Chagas. This history is briefly summarized in the present article, as well as the great impact of Romaña's discovery in the recognition of the acute Chagas' disease in all the endemic area.

  17. Bronquiolite aguda, uma revisão atualizada

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    Werther Brunow de Carvalho

    Full Text Available A bronquiolite aguda (BA é um diagnóstico freqüente de internação hospitalar em pediatria, ocasionada principalmente pelo vírus sincicial respiratório (VSR. Ocorre epidemicamente nos meses de outono e inverno. Algumas populações de crianças (recém-nascidos pré-termo, cardiopatia congênita, doença pulmonar crônica, imunocomprometidos, desnutridos, entre outros apresentam maior risco de morbidade e mortalidade. Os vírus multiplicam-se nas células epiteliais ciliadas, e a inflamação e os debris celulares ocasionam obstrução da via aérea, hiperinsuflação, atelectasia localizada, chiado e alterações das trocas gasosas. Não existem evidências definitivas em relação aos tratamentos utilizados para esta doença. O tratamento inclui a utilização de oxigênio, hidratação, beta-2 agonistas por via inalatória, epinefrina racêmica, DNase recombinante, fisioterapia respiratória, entre outros. Medidas profiláticas: administração de anticorpos monoclonais (palivizumab. A maioria das crianças com BA, independentemente da gravidade da doença, recuperam-se sem seqüelas. O curso natural desta doença, habitualmente, varia entre sete a dez dias, mas algumas crianças permanecem doentes por semanas.

  18. Efficacy of Lychnopholide Polymeric Nanocapsules after Oral and Intravenous Administration in Murine Experimental Chagas Disease.

    Science.gov (United States)

    de Mello, Carlos Geraldo Campos; Branquinho, Renata Tupinambá; Oliveira, Maykon Tavares; Milagre, Matheus Marques; Saúde-Guimarães, Dênia Antunes; Mosqueira, Vanessa Carla Furtado; Lana, Marta de

    2016-09-01

    The etiological treatment of Chagas disease remains neglected. The compounds available show several limitations, mainly during the chronic phase. Lychnopholide encapsulated in polymeric nanocapsules (LYC-NC) was efficacious in mice infected with Trypanosoma cruzi and treated by intravenous administration during the acute phase (AP). As the oral route is preferred for treatment of chronic infections, such as Chagas disease, this study evaluated the use of oral LYC-NC in the AP and also compared it with LYC-NC administered to mice by the oral and intravenous routes during the chronic phase (CP). The therapeutic efficacy was evaluated by fresh blood examination, hemoculture, PCR, and enzyme-linked immunosorbent assay (ELISA). The cure rates in the AP and CP were 62.5% and 55.6%, respectively, upon oral administration of LYC-poly(d,l-lactide)-polyethylene glycol nanocapsules (LYC-PLA-PEG-NC) and 57.0% and 30.0%, respectively, with LYC-poly-ε-caprolactone nanocapsules (LYC-PCL-NC). These cure rates were significantly higher than that of free LYC, which did not cure any animals. LYC-NC formulations administered orally during the AP showed cure rates similar to that of benznidazole, but only LYC-NC cured mice in the CP. Similar results were achieved with intravenous treatment during the CP. The higher cure rates obtained with LYC loaded in PLA-PEG-NC may be due to the smaller particle size of these NC and the presence of PEG, which influence tissue diffusion and the controlled release of LYC. Furthermore, PLA-PEG-NC may improve the stability of the drug in the gastrointestinal tract. This work is the first report of cure of experimental Chagas disease via oral administration during the CP. These findings represent a new and important perspective for oral treatment of Chagas disease.

  19. Comparison of seven diagnostic tests to detect Trypanosoma cruzi infection in patients in chronic phase of Chagas disease

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    Luisa Fernanda Duarte

    2014-07-01

    Full Text Available Objective: To compare the diagnostic performance of seven methods to determine Trypanosoma cruzi infection in patients with chronic Chagas disease.Methods: Analytical study, using the case-control design, which included 205 people (patients with Chagasic cardiomyopathy, n= 100; control group, n= 105. Three enzyme linked immunosorbent assays, one indirect hemagglutination assay and one immunochromatographic test were assessed. Additionally, DNA amplification was performed via the PCR method using kinetoplast and nuclear DNA as target sequences. For the comparative analysis of diagnostic tests, the parameters used were sensitivity, specificity, positive and negative predictive values, Receiver Operator Characteristic (ROC, positive and negative likelihood ratio, as well as κ quality analysis.Results: The commercial Bioelisa Chagas test showed the highest sensitivity (98%, specificity (100%, and positive and negative predictive values; additionally it had the highest discriminatory power. Otherwise, the amplification of T. cruzi DNA in blood samples showed low values of sensitivity (kinetoplast DNA= 51%, nuclear DNA= 22%, but high values of specificity (100%, and moderate to low discriminatory ability.Conclusion: The comparative analysis among the different methods suggests that the diagnostic strategy of T. cruzi infection in patients with chronic Chagas disease can be performed using ELISA assays based on recombinant proteins and/or synthetic peptides, which show higher diagnosis performance and can confirm and exclude the diagnosis of T. cruzi infection. The molecular methods show poor performance when used in the diagnosis of patients with chronic Chagas disease.

  20. O papel da fisioterapia respiratória na bronquiolite viral aguda = Role of chest physiotherapy in acute viral bronchiolitis

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    Luisi, Fernanda

    2008-01-01

    Conclusões: mesmo que não existem evidências diretas, a fisioterapia respiratória tem sido utilizada na bronquiolite aguda com objetivo de desobstrução, higiene brônquica, prevenção de atelectasias e recrutamento alveolar, podendo contribuir para diminuição da resistência das vias aéreas, promover melhor ventilação-perfusão e diminuir o trabalho ventilatório pela remoção do excesso de muco. São necessários estudos clínicos randomizados, controlados e cegados, que avaliem as técnicas mais modernas, para que se possa definir o papel da fisioterapia respiratória no tratamento da bronquiolite viral aguda

  1. Intoxicación aguda por plaguicidas

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    Durán-Nah Jaime Jesús

    2000-01-01

    Full Text Available OBJETIVO: Describir la epidemiología de la intoxicación aguda por plaguicidas (IAP en el Hospital General O'Horán de Mérida, Yucatán, México. MATERIAL Y MÉTODOS: Se revisaron los expedientes de 33 pacientes superscript three 13 años, tratados en una unidad de cuidados intensivos (UCI, entre 1994 y 1998. Se recopilaron variables demográficas y clínicas relevantes, y se aplicó estadística descriptiva. RESULTADOS: En la población estudiada predominó el sexo masculino (82% del medio rural (70%, y la edad media fue de 34 ± 15.8 años. El intento de suicidio fue causa frecuente de IAP (79%, y en 33% de los casos la intoxicación se produjo por la utilización de organofosforados. La mortalidad fue de 12%. CONCLUSIONES: La IAP fue baja entre los sujetos del medio rural, por lo que los resultados de este estudio parecen no reflejar la realidad del problema. Es importante añadir que los plaguicidas son utilizados con relativa frecuencia para el intento de suicidio.

  2. Esofagitis necrotizante aguda: Una entidad inusual

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    Silvana E. Pramparo

    2010-12-01

    Full Text Available La esofagitis necrotizante aguda (ENA, también denominada esófago negro, es una rara enfermedad poco descripta en la literatura médica. Describimos el caso de un hombre de 80 años, con hemorragia digestiva alta quien desarrolló un esófago negro luego de un episodio de hipotensión. La necrosis fue confirmada histológicamente. Los pacientes se presentan con hematemesis y melena en más del 70% de los casos. Los hallazgos endoscópicos muestran una coloración negruzca de la mucosa esofágica. El diagnóstico se realiza con endoscopia y confirmación histológica. La mortalidad es alta (más del 50% aunque relacionada a las enfermedades de base del paciente. Por último, podemos decir que la sospecha es muy importante en el diagnóstico de ENA, particularmente en pacientes ancianos con enfermedades asociadas y evidencia de hemorragia digestiva alta. En este trabajo describimos las características clínicas, endoscópicas e histopatológicas de un paciente con ENA.

  3. Dobutamine Stress Echocardiography Safety in Chagas Disease Patients

    Science.gov (United States)

    Rassi, Daniela do Carmo; Vieira, Marcelo Luiz Campos; Furtado, Rogerio Gomes; Turco, Fabio de Paula; Melato, Luciano Henrique; Hotta, Viviane Tiemi; Nunes, Colandy Godoy de Oliveira; Rassi Jr., Luiz; Rassi, Salvador

    2017-01-01

    Background A few decades ago, patients with Chagas disease were predominantly rural workers, with a low risk profile for obstructive coronary artery disease (CAD). As urbanization has increased, they became exposed to the same risk factors for CAD of uninfected individuals. Dobutamine stress echocardiography (DSE) has proven to be an important tool in CAD diagnosis. Despite being a potentially arrhythmogenic method, it is safe for coronary patients without Chagas disease. For Chagas disease patients, however, the indication of DSE in clinical practice is uncertain, because of the arrhythmogenic potential of that heart disease. Objectives To assess DSE safety in Chagas disease patients with clinical suspicion of CAD, as well as the incidence of arrhythmias and adverse events during the exam. Methods Retrospective analysis of a database of patients referred for DSE from May/2012 to February/2015. This study assessed 205 consecutive patients with Chagas disease suspected of having CAD. All of them had their serology for Chagas disease confirmed. Results Their mean age was 64±10 years and most patients were females (65.4%). No patient had significant adverse events, such as acute myocardial infarction, ventricular fibrillation, asystole, stroke, cardiac rupture and death. Regarding arrhythmias, ventricular extrasystoles occurred in 48% of patients, and non-sustained ventricular tachycardia in 7.3%. Conclusion DSE proved to be safe in this population of Chagas disease patients, in which no potentially life-threatening outcome was found. PMID:28099588

  4. Chagas disease prevention through improved housing using an ecosystem approach to health Prevención de la enfermedad de Chagas vía mejoramiento de la vivienda com un enfoque ecosistémico de la salud

    OpenAIRE

    Antonieta Rojas-de-Arias

    2001-01-01

    This Chagas disease prevention project via housing improvement aims to determine the efficiencyof different interventions in vector control. The following study describes the target communities, disease magnitude, and housing improvements. Transmission levels are analysed from an ecological and socioeconomic perspective. Special interest was focused on the peridomicile as the origin of domiciliary reinfestation. In the original project, three intervention programs were proposed, one for each ...

  5. Cognitive impairment in human chronic Chagas' disease

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    C.A. Mangone

    1994-06-01

    Full Text Available We proposed to investigate subclinical cognitive impairment secondary to chronic Chagas' disease (CCD. No similar study was previously done. The neuropsychological performance of 45 chronic Chagasic patients and 26 matched controls (age, education place and years of residency in endemic area was compared using the Mini Mental State Exam (MMSE, Weschler Memory Scale (WMS and the Weschler Adult Intelligent Scale (WAIS. Non-parametric tests and Chi2 were used to compare group means and multivariate statistics in two way frequency tables for measures of independence and association of categorical variables with the disease. Results: Chagasic patients showed lower MMSE scores (p<004, poor orientation (p<.004, and attention (p<.007. Lower WMS MQ were associated with CCD (Chi2 5.9; p<.01; Fisher test p<.02. Lower WAIS IQ were associated with CCD (Chi2 6.3, p<.01; Fisher test p<.01 being the digit symbol (p<.03, picture completion (p<.03, picture arrangement (p<.01 and object assembly (p<.03 subtests the most affected. The impairment in non-verbal reasoning, speed of information processing, problem solving, learning and sequencing observed in chronic Chagas disease patients resembles the cognitive dysfunction associated with white matter disease.

  6. Immunoregulatory networks in human Chagas disease

    Science.gov (United States)

    Dutra, Walderez O.; Menezes, Cristiane A.S.; Magalhães, Luisa M. D.; Gollob, Kenneth J.

    2014-01-01

    Summary Chagas disease, caused by the infection with Trypanosoma cruzi, is endemic in all Latin America. Due to the increase in population migration, Chagas disease has spread worldwide and is now considered a health issue not only in endemic countries. While most chronically infected individuals remain asymptomatic, approximately 30% of the patients develop a potentially deadly cardiomyopathy. The exact mechanisms that underlie the establishment and maintenance of the cardiac pathology are not clear. However, there is consistent evidence that immunoregulatory cytokines are critical for orchestrating the immune response and, thus, influence disease development or control. While the asymptomatic (indeterminate) form represents a state of balance between the host and the parasite, the establishment of the cardiac form represents the loss of this balance. Analysis of data obtained from several studies have led to the hypothesis that the indeterminate form is associated with an anti-inflammatory cytokine profile, represented by high expression of IL-10, while cardiac form is associated with a high production of IFN-gamma and TNF-alpha in relation to IL-10, leading to an inflammatory profile. Here, we discuss the immunoregulatory events that might influence disease outcome, as well as the mechanisms that influence the establishment of these complex immunoregulatory networks. PMID:24611805

  7. Chagas disease: changes in knowledge and management.

    Science.gov (United States)

    Lescure, François-Xavier; Le Loup, Guillaume; Freilij, Hector; Develoux, Michel; Paris, Luc; Brutus, Laurent; Pialoux, Gilles

    2010-08-01

    More than 100 years after the discovery of human American trypanosomiasis by Carlos Chagas, our knowledge and management of the disease are profoundly changing. Substantial progress made by disease control programmes in most endemic areas contrasts with persisting difficulties in the Gran Chaco region in South America and the recent emergence of the disease in non-endemic areas because of population movements. In terms of pathogenesis, major discoveries have been made about the life cycle and genomics of Trypanosoma cruzi, and the role of the parasite itself in the chronic phase of the disease. From a clinical perspective, a growing number of arguments have challenged the notion of an indeterminate phase, and suggest new approaches to manage patients. New methods such as standardised PCR will be necessary to ensure follow-up of this chronic infection. Although drugs for treatment of Chagas disease are limited, poorly tolerated, and not very effective, treatment indications are expanding. The results of the Benznidazole Evaluation For Interrupting Trypanosomiasis (BENEFIT) trial in 2012 will also help to inform treatment. Mobilisation of financial resources to fund research on diagnosis and randomised controlled trials of treatment are international health priorities.

  8. Tratamiento fisioterápico en la bronquiolitis aguda infantil

    OpenAIRE

    Calonge García, Paula

    2016-01-01

    Introducción: La bronquiolitis aguda infantil es una de las principales causas de morbimortalidad en los niños cuya máxima incidencia está aumentando mucho en los últimos años generando así multitud de costes socioeconómicos. Objetivo: Realizar una revisión bibliográfica sobre las principales técnicas que se utilizan en fisioterapia respiratoria para conocer su evidencia y efectividad en los lactantes con bronquiolitis aguda infantil. Metodología: Se utilizaron las bases de datos MEDLIN...

  9. Pancreatitis aguda recurrente: Presentación de caso

    OpenAIRE

    López Valdés, Julio César

    2014-01-01

    La pancreatitis aguda recurrente (PAR) es un trastorno de origen multifactorial, con una manifestación clínica variable, lo cual incrementa las dificultades para distinguir una crisis de pancreatitis crónica de otra aguda; cuyo diagnóstico dependerá ampliamente de la historia clínica y de los estudios paraclínicos pertinentes a su sospecha. Asimismo, su adecuado tratamiento será subordinado a la diferenciación entre sus causas. Por ello, debe tenerse en mente que es una enfermedad inflamatori...

  10. Comparação das alterações hemodinâmicas na intoxicação aguda com bupivacaína e ropivacaína por via venosa em suínos Comparación de las alteraciones hemodinámicas en la intoxicación aguda con bupivacaina y ropivacaína por vía venosa en cerdos Comparison of hemodynamic changes in acute intoxication with intravenous bupivacaine and ropivacaine in swine

    Directory of Open Access Journals (Sweden)

    Marcos De Simone Melo

    2009-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A ropivacaína apresentada na forma levógira pura foi introduzida para proporcionar alternativa mais segura que a bupivacaína nas anestesias locorregionais. O objetivo deste estudo foi comparar as repercussões hemodinâmicas após injeção por via venosa dos dois agentes em suínos, simulando intoxicação que pode ocorrer durante anestesia locorregional em humanos. MÉTODO: Suínos da raça Large-White foram anestesiados com tiopental, realizada intubação traqueal e instituída ventilação controlada mecânica. As variáveis hemodinâmicas foram medidas através de monitorização invasiva da pressão arterial e cateterização de artéria pulmonar. Após período de repouso de 30 minutos os animais foram aleatoriamente divididos em dois grupos e receberam por via venosa 4 mg.kg-1 de um ou outro agente sem conhecimento do pesquisador. Os resultados hemodinâmicos foram avaliados em repouso e 1, 5, 10, 15, 20 e 30 minutos após a intoxicação. RESULTADOS: As repercussões hemodinâmicas da intoxicação aguda com bupivacaína foram mais importantes e mais prolongadas do que as com ropivacaína. Com bupivacaína o índice cardíaco teve diminuição maior e mais prolongado, a pressão arterial média e a frequência cardíaca diminuições mais prolongadas, a pressão venosa central aumento mais prolongado e a pressão capilar pulmonar aumentou mais e por mais tempo. O impacto no índice de resistência vascular sistêmica mostrou que a vasomotricidade foi parcialmente mantida, houve aumento nos dois grupos e, paradoxalmente, maior e por mais tempo com bupivacaína. CONCLUSÕES: Em suínos a ropivacaína causou menos repercussões hemodinâmicas do que a bupivacaína quando as mesmas doses foram injetadas por via venosa.JUSTIFICATIVA Y OBJETIVOS: La ropivacaina, presentada bajo la forma de levógira pura, se introdujo para proporcionar una alternativa más segura que la bupivacaina en las anestesias

  11. The noble enigma: Chagas' nominations for the Nobel Prize

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    Marilia Coutinho

    1999-09-01

    Full Text Available Carlos Chagas, a Brazilian physician, discovered the American trypanosomiasis in 1909. Like other remarkable discoveries of those days, his work helped to articulate the insect-vector theory and other theoretical guidelines in tropical medicine. Unlike all other discoveries, all the stages of this work were accomplished in a few months and by a single man. Chagas' discovery was widely recognized at home and abroad. He was twice nominated for the Nobel Prize - in 1913 and in 1921-, but never received the award. Evidence suggests that the reasons for this failure are related to the violent opposition that Chagas faced in Brazil. The contentions towards Chagas were related to a rejection of the meritocratic procedures that gave him prominence, as well as to local petty politics.

  12. American Trypanosomiasis (Also Known as Chagas Disease) Detailed FAQs

    Science.gov (United States)

    ... the Caribbean (for example, in Puerto Rico or Cuba). Rare vectorborne cases of Chagas disease have been ... constructed facilities (for example, air-conditioned or screened hotel rooms), are at low risk for exposure to ...

  13. American Trypanosomiasis (Also Known as Chagas Disease) Triatomine Bug FAQs

    Science.gov (United States)

    ... the blood of mammals (including humans), birds, and reptiles. Triatomine bugs live in a wide range of environmental settings, generally within close proximity to a blood host. In areas of Latin America where human Chagas disease is an important public ...

  14. Experimental Vaccines against Chagas Disease: A Journey through History

    OpenAIRE

    Olivia Rodríguez-Morales; Víctor Monteón-Padilla; Carrillo-Sánchez, Silvia C; Martha Rios-Castro; Mariana Martínez-Cruz; Alejandro Carabarin-Lima; Minerva Arce-Fonseca

    2015-01-01

    Chagas disease, or American trypanosomiasis, which is caused by the protozoan parasite Trypanosoma cruzi, is primarily a vector disease endemic in 21 Latin American countries, including Mexico. Although many vector control programs have been implemented, T. cruzi has not been eradicated. The development of an anti-T. cruzi vaccine for prophylactic and therapeutic purposes may significantly contribute to the transmission control of Chagas disease. Immune protection against experimental infecti...

  15. A Multi-disciplinary Overview of Chagas in Periurban Peru

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    Sarah McCune

    2010-04-01

    Full Text Available There are between 8 and 11 million cases of America Human Trypanosomiasis, commonly known as Chagas disease, in Latin America. Chagas is endemic in southern Peru, especially the Arequipa region, where it has expanded from poor, rural areas to periurban communities. This paper summarizes the findings of four studies in periurban Arequipa: on determinants of disease-vector infestation; on prevalence, spatial patterns, and risk factors of Chagas; on links between migration, settlement patterns, and disease-vector infestation; and on the relationship between discordant test results and spatially clustered transmission hotspots. These studies identified two risk factors associated with the disease: population dynamics and the urbanization of poverty. Understanding the disease within this new urban context will allow for improved public health prevention efforts and policy initiatives. Discovered in 1909 by Brazilian physician Carlos Chagas, American Human Trypanosomiasis is a chronic and potentially life-threatening illness found throughout Latin America (Moncayo, 2003. Indeed, it is estimated that there are between 8 and 11 million cases in Mexico and Central and South America (Centers for Disease Control [CDC], 2009. Chagas disease, as it is most commonly known, is endemic in southern Peru, especially in the region of Arequipa. Once thought to be limited to poor, rural areas, the disease is now appearing in the periurban communities that surround Arequipa City, the capital of the region (Cornejo del Carpio, 2003. Understanding the urbanization of Chagas disease will allow public health and medical professionals to better combat the further transmission of the disease. After providing an overview of Chagas and introducing the scope of the disease in Latin America, this paper will summarize the findings of four recent studies conducted in periurban districts in Arequipa. Ultimately, this paper seeks to identify the risk factors associated with Chagas

  16. Control of Chagas disease vectors Control de vectores de la enfermedad de Chagas

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    JM Ramsey

    2003-04-01

    Full Text Available Most Latin American countries are making dramatic progress in controlling Chagas disease, through a series of national and international initiatives focusing on elimination of domestic populations of Triatominae, improved screening of blood donors, and clinical support and treatment of persons infected with Trypanosoma cruzi. Some countries, particularly Uruguay, Chile and Brazil, are sufficiently advanced in their programmes to initiate detailed planning of the subsequent phases of Chagas disease control, while others such as Peru, Ecuador, and Mexico, are currently applying only the initial phases of the control campaigns. In this review, we seek to provide a brief history of the campaigns as a basis for discussion of future interventions. Our aim is to relate operational needs to the underlying biological aspects that have made Chagas disease so serious in Latin America but have also revealed the epidemiological vulnerability of this disease.La mayoría de los países en América Latina está avanzando, con pasos importantes, en las tareas de control de la enfermedad de Chagas por medio de iniciativas nacionales e internacionales enfocadas en la eliminación de poblaciones domésticas de Triatominae, en el tamizaje de la sangre de transfusión, y en el apoyo terapeútico para los casos infectados con Trypanosoma cruzi. Algunos países como Uruguay, Chile y Brasil, están ya adelantados en sus programas y en la planeación de las siguientes fases de vigilancia y control. Sin embargo, otros países como Perú, Ecuador y México se encuentran apenas en las fases iniciales de planeación de las campañas de control. Este ensayo revisa brevemente la historia de las campañas, como fundamento para entender las estrategias para intervenciones futuras. Nuestro propósito es relacionar las necesidades operacionales con los aspectos biológicos que han provocado las dimensiones de la enfermedad de Chagas en toda América Latina, y que también han

  17. Involvement of the autonomic nervous system in Chagas heart disease

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    Edison Reis Lopes

    1983-12-01

    Full Text Available The autonomic nervous system and especially the intracardiac autonomic nervous system is involved in Chagas' disease. Ganglionitis and periganglionitis were noted in three groups ofpatients dying with Chagas'disease: 1 Those in heart failure; 2 Those dying a sudden, non violent death and; 3 Those dying as a consequence ofaccidents or homicide. Hearts in the threegroups also revealed myocarditis and scattered involvement of intramyocardial ganglion cells as well as lesions of myelinic and unmyelinic fibers ascribable to Chagas'disease. In mice with experimentally induced Chagas' disease weobserved more intensive neuronal lesions of the cardiac ganglia in the acute phase of infection. Perhaps neuronal loss has a role in the pathogenesis of Chagas cardiomyopathy. However based on our own experience and on other data from the literature we conclude that the loss of neurones is not the main factor responsible for the manifestations exhibited by chronic chagasic patients. On the other hand the neuronal lesions may have played a role in the sudden death ofone group of patients with Chagas'disease but is difficult to explain the group of patients who did not die sudderly but instead progressed to cardiac failure.

  18. Infección aguda por el VHC

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    A. Martínez Echeverría

    Full Text Available La infección aguda por el virus C de la hepatitis produce un cuadro clínico y bioquímico no específico e indistinguible de los causados por otros virus hepatotropos. El diagnóstico específico de la hepatitis aguda por virus C se basa en la detección en sangre del RNA-VHC mediante una técnica de reacción en cadena de la polimerasa cuyo resultado será positivo a partir de 1-2 semanas tras el contacto inicial con el virus. Los anticuerpos frente al VHC se detectan más tardíamente (a las 7-8 semanas por término medio no siendo útiles, como determinación aislada, para distinguir infección aguda de infección crónica o aclaramiento del virus (espontáneo o tras tratamiento. El 55-85% de los pacientes con infección aguda por el VHC no aclaran el virus y desarrollan una infección crónica con riesgo de evolución a cirrosis y de desarrollo de hepatocarcinoma. Por ello, la tendencia actual es tratar con interferón a todos aquellos pacientes en los que el RNA-VHC se mantenga positivo más allá de 3-4 meses tras el diagnóstico de la infección aguda.

  19. Controvérsias no manejo farmacológico da asma aguda infantil

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    Amantéa Sérgio Luís

    2002-01-01

    Full Text Available Objetivos: apresentar uma revisão acerca de questões controversas, relativas ao manejo farmacológico utilizado nos pacientes pediátricos portadores de asma aguda. Fontes dos dados: foram utilizadas informações de artigos publicados em revistas científicas nacionais e internacionais, selecionadas das bases de dados Lilacs e Medline. Síntese dos dados: o artigo foi estruturado em tópicos, apresentando aspectos consensuais no tratamento farmacológico da asma infantil. Questões relacionadas à utilização de inaladores dosimetrados versus nebulizadores, o papel das drogas ß2-adrenérgicas utilizadas pela via endovenosa, bem como das metilxantinas e do sulfato de magnésio, são abordados de maneira crítica. Conclusões: os ß2-agonistas administrados pela via inalatória, associados aos coricosteróides, permanecem o tratamento de eleição para episódios agudos de asma na população pediátrica. Tanto os nebulizadores quanto os inaladores dosimetrados, acoplados a espaçadores, são efetivos para alívio dos sintomas agudos. Pacientes refratários ao tratamento convencional, que evoluem para quadros de asma aguda grave, devem ter considerada a utilização de drogas ß2-agonistas pela via endovenosa, desde que adequadamente monitorizados. Quanto às metilxantinas e ao sulfato de magnésio, devem ser considerados alternativas secundárias para pacientes selecionados.

  20. Evolução dos conhecimentos sôbre a cardiopatia da doenca de Chagas: revisão crítica da literatura

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    Francisco S. Laranja

    1949-12-01

    Full Text Available Foi feita uma revisão critica da literatura sobre cardiopatia da Doença de Chagas, discutindo-se os principais aspectos clínicos desta cardiopatia á luz da experiência por nós adquirida nestes últimos anos. A evolução dos conhecimentos clínicos sobre esquisotripanose pode ser sintetisada em três fases: a A primeira corresponde á descoberta da doença, feita por Chagas, e á descrição por ele e seus primeiros colaboradores das manifestações clínicas essenciais da nova entidade mórbida, na qual distinguiu a forma aguda e várias formas crônicas. b Na segunda fase, a pesquisa orientou-se essencialmente pela busca dos casos de infecção aguda, havendo considerável duvida a respeito da realidade clinica das formas crônicas da infecção. Durante um longo período raros casos de cardiopatia crônica foram publicados. Ate o momento acual (1948 encontram-se na literatura estrangeira 134 casos de cardiopatia crônica chagásica, dos quais 9 autopsiados; ate fins de 1944, o numero de casos publicados no Brasil, fora de Lassance, era de 45, dos quais 3 autopsiados. c A terceira fase ou fase atual, tende a caracterisar-se por um interesse particular nos casos de infecção crônica, orientando-se porém a pesquisa cli¬nica essencialmente pelas manifestações da cardiopatia. Contribuições recentes de ordem clínica e experimental trouxeram ampla confirmação as idéias de Chagas a respeito desta cardiopatia e colocaram-na em posição de entidade clinica de realidade indiscutível. Sua importância social esta sendo determinada e os dados disponíveis já lhe apontam relevante significação em certas regiões. Mais de 600 casos de cardiopatia crônica chagásica foram publicados no Brasil nestes últimos quatro anos.

  1. Acute Chagas disease in El Salvador 2000-2012 - Need for surveillance and control

    OpenAIRE

    Emi Sasagawa; Ana Vilma Guevara de Aguilar; Marta Alicia Hernández de Ramírez; José Eduardo Romero Chévez; Jun Nakagawa; Rafael Antonio Cedillos; Kiyoshi Kita

    2014-01-01

    Several parasitological studies carried out in El Salvador between 2000-2012 showed a higher frequency of acute cases of Chagas disease than that in other Central American countries. There is an urgent need for improved Chagas disease surveillance and vector control programs in the provinces where acute Chagas disease occurs and throughout El Salvador as a whole.

  2. Chronic Chagas disease: from basics to laboratory medicine.

    Science.gov (United States)

    Haberland, Annekathrin; Saravia, Silvia Gilka Munoz; Wallukat, Gerd; Ziebig, Reinhard; Schimke, Ingolf

    2013-02-01

    Chagas disease, caused by Trypanosoma cruzi infection, is ranked as the most serious parasitic disease in Latin America and has huge potential to become a worldwide problem, due to increasing migration, and international tourism, as well as infectant transfer by blood contact and transfusion, intrauterine transfer, and organ transplantation. Nearly 30% of chronically-infected patients become symptomatic, often with a latency of 10-30 years, developing life-threatening complications. Of those, nearly 90% develop Chagas heart disease, while the others manifest gastrointestinal disease and neuronal disorders. Besides interrupting the infection cycle and chemo therapeutic infectant elimination, starting therapy early in symptomatic patients is important for counteracting the disease. This would be essentially supported by optimized patient management, involving risk assessment, early diagnosis and monitoring of the disease and its treatment. From economic and logistic viewpoints, the tools of laboratory medicine should be especially able to guarantee this. After summarizing the basics of chronic Chagas disease, such as the epidemiological data, the pathogenetic mechanisms thought to drive symptomatic Chagas disease and also treatment options, we present tools of laboratory medicine that address patient diagnosis, risk assessment for becoming symptomatic and guidance, focusing on autoantibody estimation for risk assessment and heart marker measurement for patient guidance. In addition, increases in levels of inflammation and oxidative stress markers in chronic Chagas disease are discussed.

  3. Behavioural biology of Chagas disease vectors

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    Claudio Ricardo Lazzari

    2013-01-01

    Full Text Available Many arthropod species have adopted vertebrate blood as their main food source. Blood is rich in nutrients and, except for the presence of parasites, sterile. However, this food source is not freely available, nor is obtaining it devoid of risk. It circulates inside vessels hidden underneath the skin of mobile hosts that are able to defend themselves and even predate the insects that try to feed on them. Thus, the haematophagous lifestyle is associated with major morphological, physiological and behavioural adaptations that have accumulated throughout the evolutionary history of the various lineages of blood-sucking arthropods. These adaptations have significant consequences for the evolution of parasites as well as for the epidemiology of vector-transmitted diseases. In this review article, we analyse various aspects of the behaviour of triatomine bugs to illustrate how each behavioural trait represents a particular adaptation to their close association with their hosts, which may easily turn into predators. Our aim is to offer to the reader an up-to-date integrative perspective on the behaviour of Chagas disease vectors and to propose new research avenues to encourage both young and experienced colleagues to explore this aspect of triatomine biology.

  4. Differential regional immune response in Chagas disease.

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    Juliana de Meis

    Full Text Available Following infection, lymphocytes expand exponentially and differentiate into effector cells to control infection and coordinate the multiple effector arms of the immune response. Soon after this expansion, the majority of antigen-specific lymphocytes die, thus keeping homeostasis, and a small pool of memory cells develops, providing long-term immunity to subsequent reinfection. The extent of infection and rate of pathogen clearance are thought to determine both the magnitude of cell expansion and the homeostatic contraction to a stable number of memory cells. This straight correlation between the kinetics of T cell response and the dynamics of lymphoid tissue cell numbers is a constant feature in acute infections yielded by pathogens that are cleared during the course of response. However, the regional dynamics of the immune response mounted against pathogens that are able to establish a persistent infection remain poorly understood. Herein we discuss the differential lymphocyte dynamics in distinct central and peripheral lymphoid organs following acute infection by Trypanosoma cruzi, the causative agent of Chagas disease. While the thymus and mesenteric lymph nodes undergo a severe atrophy with massive lymphocyte depletion, the spleen and subcutaneous lymph nodes expand due to T and B cell activation/proliferation. These events are regulated by cytokines, as well as parasite-derived moieties. In this regard, identifying the molecular mechanisms underlying regional lymphocyte dynamics secondary to T. cruzi infection may hopefully contribute to the design of novel immune intervention strategies to control pathology in this infection.

  5. Miopia aguda induzida por topiramato: relato de dois casos

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    Kathy Dadam Sgrott

    2011-06-01

    Full Text Available RESUMO A miopia aguda pode ser desencadeada pelo uso de medicações sistêmicas, dentre elas, o anticonvulsivante topiramato. Este trabalho descreve dois casos de pacientes jovens com quadro agudo bilateral de miopia induzida por terapia com topiramato para controle de síndrome depressiva, fazendo relação com casos semelhantes descritos na literatura e revisão bibliográfica pertinente.

  6. ANEMIA AGUDA DE NOVO: O MESMO SINAL, DIFERENTES ETIOLOGIAS

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    Inês Falcão

    2015-12-01

    Conclusão: Na investigação etiológica de uma anemia aguda grave é fundamental a sua caracterização correta com base em todos os parâmetros hematológicos disponíveis. O diagnóstico assertivo é fundamental, atendendo às diferentes implicações no que diz respeito à abordagem, orientação e prognóstico.

  7. Toxicología aguda del D-004 en conejos

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    Ariadne Gutiérrez Martínez

    2007-01-01

    entre los grupos tratados y el control en ninguno de los sexos. El D-004 presentó una toxicidad intrínseca baja, al mostrar una DL50 superior a los 2 000 mg/kg de peso corporal, dosis con la que no se evidenciaron signos indicativos de toxicidad en ninguno de los sexos, por lo que su toxicidad se puede declarar como no clasificable según el método de las clases de toxicidad aguda.

  8. Training the Next Generation of Scientists: System Dynamics Modeling of Chagas Disease (American Trypanosomiasis) transmission.

    Science.gov (United States)

    Goff, P.; Hulse, A.; Harder, H. R.; Pierce, L. A.; Rizzo, D.; Hanley, J.; Orantes, L.; Stevens, L.; Justi, S.; Monroy, C.

    2015-12-01

    A computational simulation has been designed as an investigative case study by high school students to introduce system dynamics modeling into high school curriculum. This case study approach leads users through the forensics necessary to diagnose an unknown disease in a Central American village. This disease, Chagas, is endemic to 21 Latin American countries. The CDC estimates that of the 110 million people living in areas with the disease, 8 million are infected, with as many as 300,000 US cases. Chagas is caused by the protozoan parasite, Trypanosoma cruzi, and is spread via blood feeding insect (vectors), that feed on vertebrates and live in crevasses in the walls and roofs of adobe homes. One-third of the infected people will develop chronic Chagas who are asymptomatic for years before their heart or GI tract become enlarged resulting in death. The case study has three parts. Students play the role of WHO field investigators and work collaboratively to: 1) use genetics to identify the host(s) and vector of the disease 2) use a STELLA™ SIR (Susceptible, Infected, Recovered) system dynamics model to study Chagas at the village scale and 3) develop management strategies. The simulations identify mitigation strategies known as Ecohealth Interventions (e.g., home improvements using local materials) to help stakeholders test and compare multiple optima. High school students collaborated with researchers from the University of Vermont, Loyola University and Universidad de San Carlos, Guatemala, working in labs, interviewing researchers, and incorporating mulitple field data as part of a NSF-funded multiyear grant. The model displays stable equilibria of hosts, vectors, and disease-states. Sensitivity analyses show measures of household condition and presence of vertebrates were significant leverage points, supporting other findings by the University research team. The village-scale model explores multiple solutions to disease mitigation for the purpose of producing

  9. Prevalence of Chagas' Disease in Mulungu do Morro Northeastern Brazil

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    Roque Aras

    2002-05-01

    Full Text Available OBJECTIVE - The aim of this paper is to describe the prevalence of T. Cruzi infection in patients of from Mulungu do Morro, a rural tropical region of Northeastern Brazil. METHODS - A cross-sectional study was performed. After randomly selecting samples of the population, and obtaining their consents , patients completed pretested epidemiological and clinical questionnaires. Serum samples from all patients were collected and screened for the presence of T. cruzi antibodies. RESULTS - Of 694 patients examined, 174 patients (25.1% tested had a positive serology for Chagas' disease. Of the study population, 341 patients were male with 27% Chagas' disease prevalence, without a statistical difference. Illiteracy was the only variable related to T. cruzi infection in our population. CONCLUSION - In conclusion, our study points to the high prevalence of Chagas' disease among patients in Mulungu do Morro, suggesting that this region has a high frequency of infection and probably active vectorial transmission.

  10. Pathology of intracardiac nerves in experimental Chagas disease

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    Ribeiro Lídia Cristina Villela

    2002-01-01

    Full Text Available Severe destruction of intrinsic cardiac nerves has been reported in experimental acute Chagas myocarditis, followed by extensive regeneration during the chronic phase of the infection. To further study this subject, the sympathetic and para-sympathetic intracardiac nerves of mice infected with a virulent Trypanosoma cruzi strain were analyzed, during acute and chronic infection, by means of histological, histochemical, morphometric and electron microscopic techniques. No evidences of destructive changes were apparent. Histochemical demonstration for acetylcholinesterase and catecholamines did not reveal differences in the amount and distribution of intracardiac nerves, in mice with acute and chronic Chagas myocarditis or in non-infected controls. Mild, probably reversible ultrastructural neural changes were occasionally present, especially during acute myocarditis. Intrinsic nerves appeared as the least involved cardiac structure during the course of experimental Chagas disease in mice.

  11. Cardiac Magnetic Resonance-Verified Myocardial Fibrosis in Chagas Disease: Clinical Correlates and Risk Stratification

    Science.gov (United States)

    Uellendahl, Marly; de Siqueira, Maria Eduarda Menezes; Calado, Eveline Barros; Kalil-Filho, Roberto; Sobral, Dário; Ribeiro, Clébia; Oliveira, Wilson; Martins, Silvia; Narula, Jagat; Rochitte, Carlos Eduardo

    2016-01-01

    Background Chagas disease (CD) is an important cause of heart failure and mortality, mainly in Latin America. This study evaluated the morphological and functional characteristics of the heart as well the extent of myocardial fibrosis (MF) in patients with CD by cardiac magnetic resonance (CMR). The prognostic value of MF evaluated by myocardial-delayed enhancement (MDE) was compared with that via Rassi score. Methods This study assessed 39 patients divided into 2 groups: 28 asymptomatic patients as indeterminate form group (IND); and symptomatic patients as Chagas Heart Disease (CHD) group. All patients underwent CMR using the techniques of cine-MRI and MDE, and the amount of MF was compared with the Rassi score. Results Regarding the morphological and functional analysis, significant differences were observed between both groups (p < 0.001). Furthermore, there was a strong correlation between the extent of MF and the Rassi score (r = 0.76). Conclusions CMR is an important technique for evaluating patients with CD, stressing morphological and functional differences in all clinical presentations. The strong correlation with the Rassi score and the extent of MF detected by CMR emphasizes its role in the prognostic stratification of patients with CD. PMID:27982271

  12. Chagas Cardiomyopathy: Clinical Presentation and Management in the Americas.

    Science.gov (United States)

    Benziger, Catherine Pastorius; do Carmo, Gabriel Assis Lopes; Ribeiro, Antonio Luiz Pinho

    2017-02-01

    The initial infection of Chagas disease is typically asymptomatic, but approximately 30% of people will progress to a chronic cardiac form, and others develop the gastrointestinal form. Death is often sudden due to arrhythmias or progressive heart failure. Prevention through vector control programs and blood bank screening, along with strengthened surveillance systems and rapid information sharing, are key to decreasing disease burden globally. The epidemiology, diagnostic evaluation, diagnosis, and treatment of acute and chronic Chagas cardiac disease are discussed with focus on educating the primary care professionals and general cardiologists in nonendemic areas who have limited experience treating this disease.

  13. Aspectos neurológicos da moléstia de chagas Neurological aspects of Chagas disease

    Directory of Open Access Journals (Sweden)

    Fritz Köberle

    1967-09-01

    Full Text Available Carlos Chagas related in more than two 200 cases, what he called "nervous forms" of trypanosomiasis, that is neurological manifestations from central origin (idiotism, infantilism, pseudo-bulbar paralysis, aphasia, cerebellar ataxia, atetosis, espostic or paralytic diplegia, disbasia. At that time Chagas expressed his concepts as follows: "In relation to the frequency of trypanosomiasis nervous forms we have performed many observations which allow us to state that this disease is the one which causes the largest number of organic affections of the central nervous system, in human pathology". We are plenty convinced by Chagas's statement. By experiments on animals of laboratory we have very often noticed a rather varied neurological symptomatology, being worth point out identical syndromes to those observed by Chagas. Our autopsy material non-rarely include chronic Chagas cases presenting a most varied symtomatology. Among them we have named only three cases of discerebral nanism, a rather rare affection in other parts of the world and relatively frequent in our material. The fact which we have demonstrated, i.e., a relatively great decreasing of number of nervous cells in the peripheral system could happen in the central nervous system as well. Provided that there are only two quantitative works on neuron number diminishing in the central nervous system in mice and rats we decline to go into further details about central neuropathies in man. We emphasized the necessity to perform researches on this field by means of intimate collaboration between clinicians and pathologists, as the only way to confirm on scientific basis all that was observed by the panoramic and genial vision of Carlos Chagas.

  14. Enfermedad de Chagas congenita en la Ciudad de Salta, Argentina Congenital Chagas' disease in Salta, Argentina

    Directory of Open Access Journals (Sweden)

    Mario Zaidenberg

    1993-02-01

    Full Text Available Se estudió la respuesta clínica y serológica a la infección chagásica de 937 embarazadas y sus 929 recién nacidos (RN vivos, grupo I; 4 RN de origen diverso, grupo II y 35 RN derivados de otros centros, grupo III. Las embarazadas se estudiaron con 3 reacciones serológicas; se definió infección cuando 2 o más reacciones eran positivas. En los RN el diagnóstico se confirmó por observación directa del T. cruzi en una muestra de sangre. Los RN con Chagas congénita (RN-ChC fueron tratados y seguidos con estudios clínicos y de laboratorio. Se detectaron 149 embarazadas chagásicas (15.9%, de las cuales se diagnosticaron 6 RN-ChC (4%. En el total de 968 RN estudiados se detectaron 12 RN infectados. El micro-hematócrito fue el método parasitológico de lectura rápida más efectivo para el diagnóstico de infección en nuestra serie. El par de reacciones serológicas específicas constituyó un criterio de mayor seguridad para el control y seguimiento de la infección congénita. Las expresiones clínicas más comunes de infección fueron hepatomegalia, esplenomegalia, ictericia, anemia y prematurez, con distintos grados de asociación. Se concluye que dadas las características clínicas de la enfermedad de Chagas congénita en nuestro medio, se impone como estrategia el diagnóstico serológico para la enfermedad de Chagas en todas las embarazadas y el control y seguimiento de sus RN hasta descartar o confirmar infección congénita.The immune response to Trypanosoma cruzi was studied in our hospital in 937 pregnant women (PW and their 929 newborns (NB, group I; 4 NB from this center not included in the first group, group II and 35 NB derived from other centers, group III. Two positive results among indirect hemagglutination (IHA, complement fixation (CF and indirect hemagglutination (IHA, complement fixation (CF and indirect immunofluorescence (IIF tests were considered as the criterion of previous infection with T. cruzi in PW. The

  15. Experimental Vaccines against Chagas Disease: A Journey through History.

    Science.gov (United States)

    Rodríguez-Morales, Olivia; Monteón-Padilla, Víctor; Carrillo-Sánchez, Silvia C; Rios-Castro, Martha; Martínez-Cruz, Mariana; Carabarin-Lima, Alejandro; Arce-Fonseca, Minerva

    2015-01-01

    Chagas disease, or American trypanosomiasis, which is caused by the protozoan parasite Trypanosoma cruzi, is primarily a vector disease endemic in 21 Latin American countries, including Mexico. Although many vector control programs have been implemented, T. cruzi has not been eradicated. The development of an anti-T. cruzi vaccine for prophylactic and therapeutic purposes may significantly contribute to the transmission control of Chagas disease. Immune protection against experimental infection with T. cruzi has been studied since the second decade of the last century, and many types of immunogens have been used subsequently, such as killed or attenuated parasites and new DNA vaccines. This primary prevention strategy appears feasible, effective, safe, and inexpensive, although problems remain. The objective of this review is to summarize the research efforts about the development of vaccines against Chagas disease worldwide. A thorough literature review was conducted by searching PubMed with the terms "Chagas disease" and "American trypanosomiasis" together with "vaccines" or "immunization". In addition, reports and journals not cited in PubMed were identified. Publications in English, Spanish, and Portuguese were reviewed.

  16. Experimental Vaccines against Chagas Disease: A Journey through History

    Directory of Open Access Journals (Sweden)

    Olivia Rodríguez-Morales

    2015-01-01

    Full Text Available Chagas disease, or American trypanosomiasis, which is caused by the protozoan parasite Trypanosoma cruzi, is primarily a vector disease endemic in 21 Latin American countries, including Mexico. Although many vector control programs have been implemented, T. cruzi has not been eradicated. The development of an anti-T. cruzi vaccine for prophylactic and therapeutic purposes may significantly contribute to the transmission control of Chagas disease. Immune protection against experimental infection with T. cruzi has been studied since the second decade of the last century, and many types of immunogens have been used subsequently, such as killed or attenuated parasites and new DNA vaccines. This primary prevention strategy appears feasible, effective, safe, and inexpensive, although problems remain. The objective of this review is to summarize the research efforts about the development of vaccines against Chagas disease worldwide. A thorough literature review was conducted by searching PubMed with the terms “Chagas disease” and “American trypanosomiasis” together with “vaccines” or “immunization”. In addition, reports and journals not cited in PubMed were identified. Publications in English, Spanish, and Portuguese were reviewed.

  17. Chagas cardiomyopathy in the context of the chronic disease transition.

    Directory of Open Access Journals (Sweden)

    Alicia I Hidron

    Full Text Available BACKGROUND: Patients with Chagas disease have migrated to cities, where obesity, hypertension and other cardiac risk factors are common. METHODOLOGY/PRINCIPAL FINDINGS: The study included adult patients evaluated by the cardiology service in a public hospital in Santa Cruz, Bolivia. Data included risk factors for T. cruzi infection, medical history, physical examination, electrocardiogram, echocardiogram, and contact 9 months after initial data collection to ascertain mortality. Serology and PCR for Trypanosoma cruzi were performed. Of 394 participants, 251 (64% had confirmed T. cruzi infection by serology. Among seropositive participants, 109 (43% had positive results by conventional PCR; of these, 89 (82% also had positive results by real time PCR. There was a high prevalence of hypertension (64% and overweight (body mass index [BMI] >25; 67%, with no difference by T. cruzi infection status. Nearly 60% of symptomatic congestive heart failure was attributed to Chagas cardiomyopathy; mortality was also higher for seropositive than seronegative patients (p = 0.05. In multivariable models, longer residence in an endemic province, residence in a rural area and poor housing conditions were associated with T. cruzi infection. Male sex, increasing age and poor housing were independent predictors of Chagas cardiomyopathy severity. Males and participants with BMI Chagas cardiomyopathy remains an important cause of congestive heart failure in this hospital population, and should be evaluated in the context of the epidemiological transition that has increased risk of obesity, hypertension and chronic cardiovascular disease.

  18. Chagas disease: control, elimination and eradication. Is it possible?

    Directory of Open Access Journals (Sweden)

    Jose Rodrigues Coura

    2013-12-01

    Full Text Available From an epidemiological point of view, Chagas disease and its reservoirs and vectors can present the following characteristics: (i enzooty, maintained by wild animals and vectors, with broad occurrence from southern United States of America (USA to southern Argentina and Chile (42ºN 49ºS, (ii anthropozoonosis, when man invades the wild ecotope and becomes infected with Trypanosoma cruzi from wild animals or vectors or when the vectors and wild animals, especially marsupials, invade the human domicile and infect man, (iii zoonosis-amphixenosis and exchanged infection between animals and humans by domestic vectors in endemic areas and (iv zooanthroponosis, infection that is transmitted from man to animals, by means of domestic vectors, which is the rarest situation in areas endemic for Chagas disease. The characteristics of Chagas disease as an enzooty of wild animals and as an anthropozoonosis are seen most frequently in the Brazilian Amazon and in the Pan-Amazon region as a whole, where there are 33 species of six genera of wild animals: Marsupialia, Chiroptera, Rodentia, Edentata (Xenarthra, Carnivora and Primata and 27 species of triatomines, most of which infected with T. cruzi . These conditions place the resident populations of this area or its visitors - tourists, hunters, fishermen and especially the people whose livelihood involves plant extraction - at risk of being affected by Chagas disease. On the other hand, there has been an exponential increase in the acute cases of Chagas disease in that region through oral transmission of T. cruzi , causing outbreaks of the disease. In four seroepidemiological surveys that were carried out in areas of the microregion of the Negro River, state of Amazonas, in 1991, 1993, 1997 and 2010, we found large numbers of people who were serologically positive for T. cruzi infection. The majority of them and/or their relatives worked in piassava extraction and had come into contact with and were stung by

  19. Soropositividade para doença de Chagas entre doadores de sangue em Araraquara, Estado de São Paulo, no período de 2004 a 2008

    Directory of Open Access Journals (Sweden)

    Julio César Rente Ferreira Filho

    2011-02-01

    Full Text Available INTRODUÇÃO: A transfusão sanguínea é uma fonte potencial importante para transmissão da doença de Chagas. MÉTODOS: Foi verificado, nos arquivos do Hemonúcleo Regional de Araraquara, o resultado dos exames para doença de Chagas entre janeiro de 2004 e dezembro de 2008. RESULTADOS: Foram diagnosticadas com sorologia positiva 0,04% das 49541 doações de sangue realizadas. A idade dos soropositivos situou-se entre 51 e 60 anos. CONCLUSÕES: O baixo índice de doadores soropositivos pode reduzir o risco de transmissão via transfusional da doença de Chagas. A alta ocorrência de resultados inconclusivos indicam que os métodos diagnósticos devem ser melhorados.

  20. O falso dilema sobre a luta antivetorial e as perspectivas de controle da doença de Chagas no Brasil: BHC ou BNH?

    Directory of Open Access Journals (Sweden)

    José R. Coura

    1993-12-01

    Full Text Available As bases técnicas para o controle da doença de Chagas no Brasil foram estabelecidas com a criação do posto avançado de pesquisa do Instituto Oswaldo Cruz em Bambuí, no oeste de Minas Gerais, no começo da década de 40, sob a liderança de Emmanuel Dias. Entretanto, somente com a criação do Departamento Nacional de Endemias Rurais (DNERu, em março de 1956, sob a direção de Mario Pinotti, no governo de Juscelino Kubitschek, as medidas de controle foram implementadas. Das "campanhas" de controle das 12 endemias rurais estabelecidas pelo DNERu, a malária, pelo seu caráter de doença aguda e explosiva, sempre teve a maior parte orçamentária. A doença de Chagas e as outras endemias foram sempre relegadas a um plano secundário de prioridade. Por outro lado, a partir da década de 60, os "novos ecologistas" passaram a criticar o uso de inseticidas, com o slogan de que para controlar a doença de Chagas era necessário o BNH (construção de casas, e não o BHC (uso de inseticidas. Esta opinião, embora equivocada para o controle a curto prazo, teve uma enorme influência negativa sobre o controle dos vetores domiciliados. Apesar disso, algum progresso foi feito neste sentido. Na década de 70, a epidemia de meningite meningocócica e a priorização do Programa Especial de Controle da Esquistossomose (PECE, pelo Ministro Almeida Machado, com deslocamento de verbas e de pessoal da Superintendência de Campanhas (Sucam para esses programas, atrasaram ainda mais o controle da doença de Chagas. Somente na década de 80, com a decisão política do Banco Nacional de Desenvolvimento Econômico e Social (BNDES de alocar 10 bilhões de cruzeiros do Finsocial, o programa de controle da doença de Chagas teve um importante desenvolvimento em 2.000 municípios de 19 Estados brasileiros. Mais uma vez o programa sofre um atraso nesta década, com o deslocamento do pessoal da Sucam para a campanha contra a epidemia da dangue. Finalmente, conclu

  1. Toxicología aguda del D-004 en conejos

    OpenAIRE

    Ariadne Gutiérrez Martínez; Rafael Gámez Menéndez; Rosa Más Ferreiro; Miriam Noa Puig; Balia Pardo Acosta; Eddy Goicochea Carrero; Dayisell Curveco Sánchez; Haydée García Cambián

    2007-01-01

    El D-004 es un extracto lipídico obtenido del fruto de la palma real (Roystonea regia) (Arecaceae) que consiste en una mezcla reproducible de ácidos grasos, en la cual el ácido oleico, el láurico y el palmítico son los más abundantes. El tratamiento oral con D-004 inhibe significativamente la hiperplasia prostática inducida por testosterona en roedores. La toxicología preclínica de un nuevo compuesto incluye la evaluación aguda en una especie no roedora. Con este objetivo se realizó el ensayo...

  2. Tratamiento médico de la pancreatitis aguda

    OpenAIRE

    Huerta-Mercado, Jorge

    2013-01-01

    Se revisan los últimos avances en el manejo médico de la pancreatitis aguda. Estos se basan en los cambios que van desde el mayor conocimiento de la fisiopatología y la clínica y el desarrollo de técnicas para el manejo de las complicaciones. El reconocimiento del mal pronóstico dado por la falla persistente de órganos (mayor a 48 horas) y la evolución lenta pero sin severidad de los pacientes con complicaciones locales, ha hecho redefinir la clasificación de la pancreatitis, estratificándose...

  3. Factores de riesgo de mortalidad en la mediastinitis aguda

    OpenAIRE

    2009-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada La mediastinitis aguda se define como la infección del tejido conectivo laxo que envuelve las estructuras mediastínicas. Sus causas son la infección postesternotomía, la perforación esofágica, la mediastinitis necrosante descendente (MND), y la lesión traqueobronquial. Es una enfermedad grave, poco frecuente y sobre la cual no existe consenso en las pautas diagnósticas y terapéuticas a seguir. Al revisar la literatura se...

  4. Pancreatitis Aguda como consecuencia del uso de Orlistat

    OpenAIRE

    2011-01-01

    La pancreatitis aguda es un proceso inflamatorio del páncreas desencadenada por la auto digestión ante la activaciónde sus pro fermentos, tiene un manejo urgente ya que pone en peligro la vida del paciente. El recienteingreso de Orlistat, un fármaco inhibidor de la lipasa gástrica y pancreática para tratar la obesidad, a través de suventa creciente sin receta se ha estado traduciendo en una mayor frecuencia de eventos adversos sobre todogastrointestinales (diarrea grasa, esteatorrea, incontin...

  5. Parotiditis aguda en recién nacido

    OpenAIRE

    Cabezón A,Rodrigo; Kreft V,Javiera; Ramírez R,Constanza; Witker J,Daniela

    2010-01-01

    La parotiditis aguda supurativa es una enfermedad extremadamente infrecuente en el recién nacido, sin casos publicados hasta ahora en la literatura nacional y con pocos casos descritos en la literatura médica mundial. La infección ocurre habitualmente por vía ascendente desde la cavidad oral al conducto de Stenon, o asociado a sialectasia, aunque también se ha descrito a la deshidratación y la septicemia con extensión hacia la glándula parótida como probables mecanismos patogénicos. Se presen...

  6. Comportamiento de la enfermedad diarreica aguda en Guatemala

    OpenAIRE

    Mario Enrique Plá Acevedo; Eddy Mario Collejo Acevedo; Odalis Elena Acevedo Tristá; Learelis Fernández Cruz; Yanet Marbelis Plá Acevedo

    2015-01-01

    Se realizó un estudio descriptivo de corte transversal, con el objetivo de conocer el comportamiento de la Enfermedad Diarreica Aguda (EDA) en Tierra Blanca, Departamento Petén, Guatemala; en el período comprendido de enero a diciembre del año 2011. El universo de estudio lo formaron todos los individuos que fueron evaluados en el puesto de salud de Tierra Blanca con diagnóstico clínico de EDA. La muestra estuvo constituida por 529 pacientes. Se trabajó con el Sistema de Información Gerencial...

  7. Diagnóstico y manejo de la bronquiolitis aguda

    OpenAIRE

    Maamar el Asri, Meryam

    2016-01-01

    La bronquiolitis aguda es una enfermedad pediátrica muy frecuente en todo el mundo y una importante causa del ingreso hospitalario en niños menores de un año, sobre todo en los meses de invierno. Tiene una correlación directa con el virus respiratorio sincitial, siendo el principal agente causal de esta patología. Sin embargo, el desarrollo y aplilación de las técnicas de amplificación genética ha permitido conocer la existencia de otros virus implicados,y, con ello, aportar un mayor conocimi...

  8. Recomendaciones para el manejo de la faringoamigdalitis aguda del adulto

    OpenAIRE

    Cots, Josep M; Juan-Ignacio Alós; Mario Bárcena; Xavier Boleda; José L. Cañada; Niceto Gómez; Ana Mendoza; Isabel Vilaseca; Carles Llor

    2015-01-01

    La faringoamigdalitis aguda (FAA) en el adulto es una de las enfermedades infecciosas más comunes en la consulta del médico de familia. La etiología más frecuente es viral. Dentro de la etiología bacteriana, el principal agente responsable es Streptococcus pyogenes o estreptococo β-hemolítico del grupo A (EBHGA), causante del 5-30% de los casos. En el manejo diagnóstico, las escalas de valoración clínica para predecir la posible etiología bacteriana, son una buena ayuda para seleccionar a qué...

  9. Enfoque clínico de la pancreatitis aguda

    Directory of Open Access Journals (Sweden)

    Dra. Jeanneth Torrez Salazar

    2010-06-01

    Full Text Available La Pancreatitis Aguda(PA es un proceso inflamatorio agudo del páncreas, que puede afectar también tejidos peripancreáticos y órganos o sistemas distantes. Las principales causas son la Litiasis Biliar y el uso excesivo de alcohol que constituyen aproximadamente un 75%. Un 20% de los pacientes con PA tienen un curso severo de la enfermedad, de los cuales 10-30% mueren y a pesar de los avances tecnológicos en la UCI, la mortalidad no ha variado significativamente.

  10. O sofrimento espiritual do doente adulto com leucemia aguda internado

    OpenAIRE

    2010-01-01

    Tese de mestrado, Ciências da Dor, Faculdade de Medicina, Universidade de Lisboa, 2011 O presente estudo teve como objectivo saber quais os factores que influenciam o sofrimento espiritual no doente adulto (faixa etária dos 30 aos 65 anos) com leucemia aguda internado. A amostra foi de 30 doentes, 14 homens e 16 mulheres e o estudo teve a duração de 6 meses, decorrendo no Serviço de Hematologia do CHLC-EPE (Hospital de Santo António dos Capuchos). O instrumento de colheita de dados apli...

  11. Insuficiencia renal aguda asociada a picadura de abeja africanizada

    Directory of Open Access Journals (Sweden)

    Verny Huertas-Franco

    2008-03-01

    Full Text Available Se presenta el caso de un adulto mayor diabético tipo 2, que sufrió un ataque masivo de abejas africanizadas, y llegó a la sala de emergencias tres horas después del inicio del ataque. El paciente presentó insuficiencia renal aguda por combinación de factores, y se recuperó con tratamiento de diálisis temprana. Se discuten los problemas que refieren estos pacientes, y cuál sería el manejo ideal de tales casos.

  12. O gênero Schizotrypanum Chagas, 1909

    Directory of Open Access Journals (Sweden)

    Emmanuel Dias

    1939-01-01

    Full Text Available No presente trabalho, em que foram analisados os caractéres de Schizotrypanum e consideradas suas relações com os de outros flagelados digenéticos, acreditamos ter ficado bem demonstrado que este gênero encontra sólidos fundamentos em que se baseie. Schizotrypanum possue caractéres morfológicos peculiares, que o aproximam de Leishmania no periodo de multiplicação e de Trypanosoma na fase sanguinea. Os flagelados pertencentes a esse gênero caracterisam-se não só pela morfologia da fórma de tripanosoma, como pela evolução no organismo do vertebrado. No S. cruzi, como no S. vespertilionis, a multiplicação se processa nos tecidos, constando da divisão binaria das formas intracelulares de leishmania; os tripanosomas sanguicolas não se multiplicam. Nenhum Trypanosoma apresenta no mamífero uma evolução morfológicamente e ecológicamente identica á de Schizotrypanum. S. cruzi aproxima-se dos tripanosomas patogenicos pela morfologia da fórma sanguicola e pela virulencia ás vezes mortal para o homem e diversos animais; deles se afasta entretanto pela evolução no inséto, modo de transmissão e facil cultivabilidade, caractéres biológicos estes que são comuns aos tripanosomas não patogenicos. Em nenhum dos grupos de tripanosomas póde o S. cruzi ser rigorosamente incluido, deles se distinguindo facilmente seja por sua morfologia, seja por sua biologia. O conjunto de caractéres próprios fundamenta perfeitamente a manutenção do gênero de Chagas, indicando-lhe como situação mais adequada, na classificação dos tripanosomídeos de mamíferos, o logar intermediario entre Leishmania e Trypanosoma. A separação do gênero Schizotrypanum é o melhor caso, quiça o unico justificado, dentre as numerosas tentativas para o desmembramento de Trypanosoma. Ela se impõe como medida compreensiva e util para a coordenação dos membros da complexa familia dos tripanosomideos e se justifica á luz dos mais exigentes crit

  13. O falso dilema sobre a luta antivetorial e as perspectivas de controle da doença de Chagas no Brasil: BHC ou BNH? The false dilemma about antivectorial strategies and possibilities for controlling Chagas' disease in Brazil: BHC or BNH?

    Directory of Open Access Journals (Sweden)

    José R. Coura

    1993-12-01

    Full Text Available As bases técnicas para o controle da doença de Chagas no Brasil foram estabelecidas com a criação do posto avançado de pesquisa do Instituto Oswaldo Cruz em Bambuí, no oeste de Minas Gerais, no começo da década de 40, sob a liderança de Emmanuel Dias. Entretanto, somente com a criação do Departamento Nacional de Endemias Rurais (DNERu, em março de 1956, sob a direção de Mario Pinotti, no governo de Juscelino Kubitschek, as medidas de controle foram implementadas. Das "campanhas" de controle das 12 endemias rurais estabelecidas pelo DNERu, a malária, pelo seu caráter de doença aguda e explosiva, sempre teve a maior parte orçamentária. A doença de Chagas e as outras endemias foram sempre relegadas a um plano secundário de prioridade. Por outro lado, a partir da década de 60, os "novos ecologistas" passaram a criticar o uso de inseticidas, com o slogan de que para controlar a doença de Chagas era necessário o BNH (construção de casas, e não o BHC (uso de inseticidas. Esta opinião, embora equivocada para o controle a curto prazo, teve uma enorme influência negativa sobre o controle dos vetores domiciliados. Apesar disso, algum progresso foi feito neste sentido. Na década de 70, a epidemia de meningite meningocócica e a priorização do Programa Especial de Controle da Esquistossomose (PECE, pelo Ministro Almeida Machado, com deslocamento de verbas e de pessoal da Superintendência de Campanhas (Sucam para esses programas, atrasaram ainda mais o controle da doença de Chagas. Somente na década de 80, com a decisão política do Banco Nacional de Desenvolvimento Econômico e Social (BNDES de alocar 10 bilhões de cruzeiros do Finsocial, o programa de controle da doença de Chagas teve um importante desenvolvimento em 2.000 municípios de 19 Estados brasileiros. Mais uma vez o programa sofre um atraso nesta década, com o deslocamento do pessoal da Sucam para a campanha contra a epidemia da dangue. Finalmente, conclu

  14. Justice where justice is due: A posthumous Nobel Prize to Carlos Chagas (1879-1934), the discoverer of American Trypanosomiasis (Chagas' disease).

    Science.gov (United States)

    Bestetti, Reinaldo B; Martins, Cláudia A; Cardinalli-Neto, Augusto

    2009-05-01

    Working in the Brazilian backland, Chagas described a new disease. He discovered the etiologic agent, the vector, the reservoir, the acute stage, the several clinical aspects of the chronic stage (particularly the heart disease), role of autoimmunity in its pathogenesis, and anticipated the social impact of the disease. Chagas was nominated to Nobel Prize twice: in 1913, and in 1921. In 1913, Richet won the prize because his work on anaphylaxis. In 1921, no one received the Nobel Prize. It is believed that detraction of Chagas' work at the National Academy of Medicine, made by jealousy, mediocrity, and political rivalries can be maculated the image of the scientist. Furthermore, misperception of Chagas' work may also have led the Nobel Committee not to award him. One-hundred years after the discovery, we can appreciate the greatness of the discovery of Carlos Chagas, never seem in the realm of biological research. Time to make justice, therefore, has finally come.

  15. Oclusión arterial aguda asociada a hidatidosis diseminada

    Directory of Open Access Journals (Sweden)

    Jose Somocurcio

    Full Text Available Hidatidosis o equinococosis son términos usados para denominar a la infestación zoonótica causada por los estadios adulto y larvario (metacéstode del céstode del género Equinococcus (familia tenidae. El término hidatidosis debe ser aplicado a la infestación por el metacéstode mientras que el de equinococosis a los estadios larvario y adulto. En el Perú existe una alta prevalencia de esta infección siendo el hígado y pulmón los órganos más afectados. Existen factores tanto del agente infeccioso como del hospedero que contribuyen a esta infección, donde el componente inmunológico del hospedero es un punto importante tanto en la infección como en la diseminación. En el presente artículo se reporta un caso de oclusión arterial aguda asociada a hidatidosis diseminada en un paciente de 54 años de edad, natural y procedente de Huancavelica, de inicio súbito con un cuadro de obstrucción arterial aguda; que no mejoró luego de la cirugía con fallecimiento a las 48 horas de la presentación

  16. Oclusión arterial aguda asociada a hidatidosis diseminada

    Directory of Open Access Journals (Sweden)

    Jose Somocurcio

    2014-06-01

    Full Text Available Hidatidosis o equinococosis son términos usados para denominar a la infestación zoonótica causada por los estadios adulto y larvario (metacéstode del céstode del género Equinococcus (familia tenidae. El término hidatidosis debe ser aplicado a la infestación por el metacéstode mientras que el de equinococosis a los estadios larvario y adulto. En el Perú existe una alta prevalencia de esta infección siendo el hígado y pulmón los órganos más afectados. Existen factores tanto del agente infeccioso como del hospedero que contribuyen a esta infección, donde el componente inmunológico del hospedero es un punto importante tanto en la infección como en la diseminación. En el presente artículo se reporta un caso de oclusión arterial aguda asociada a hidatidosis diseminada en un paciente de 54 años de edad, natural y procedente de Huancavelica, de inicio súbito con un cuadro de obstrucción arterial aguda; que no mejoró luego de la cirugía con fallecimiento a las 48 horas de la presentación

  17. Carambola como causa de lesão renal aguda

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    Karilla Lany Scaranello

    2014-04-01

    Full Text Available A carambola pertence à família das Oxalidáceas, espécie Averrhoa carambola. É rica em sais minerais, vitaminas A, C, complexo B e ácido oxálico. Estudos recentes demonstram que a toxicidade da fruta difere entre os indivíduos e pode ser explicada pelas respostas biológicas individuais como idade, quantidade da ingestão, neurotoxinas em cada tipo de fruta. Adicionalmente, a nefrotoxicidade causada pela fruta é dose dependente, podendo levar ao desenvolvimento de lesão renal aguda pela deposição de cristais de oxalato de cálcio intratubular, assim como por lesão direta das células epiteliais tubulares, levando à apoptose das mesmas. Relatamos o caso de uma paciente que, após a ingestão do suco da fruta e fruta in natura, desenvolveu lesão renal aguda, necessitando de terapia dialítica, evoluindo com desfecho favorável e recuperação da função renal.

  18. Terapia cognitivo-conductual en las psicosis agudas

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    María Isabel Gutiérrez López

    2012-01-01

    Full Text Available El tratamiento de las psicosis agudas era, hasta hace unos años, algo relegado al tratamiento farmacológico (a excepción del psicoanálisis. En los últimos tiempos esa tendencia ha ido cambiando y diversos estudios han puesto de manifiesto la ventaja de las intervenciones cognitivo conductuales en las fases agudas de las psicosis. A esta tendencia se ha unido un nuevo y prometedor paradigma de intervención temprana en psicosis. En el presente estudio se muestra una revisión bibliográfica de las investigaciones más relevantes publicadas hasta la fecha en torno a esta temática. Se incluyeron aquellos trabajos con un diseño controlado y aleatorio, que garantizaban requisitos de fiabilidad y validez. Los estudios muestran resultados esperanzadores, en cuanto que avalan la eficacia de la TCC como medida de tratamiento. Sin embargo, todavía se hace necesario un mayor número de investigaciones que avalen estos datos.

  19. Megabladder in experimental Chagas disease: pathological features of the bladder wall Mega bexiga na Doença de Chagas experimental. Caracteristicas patológicas da parede vesical

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    Luciano Henrique Gazoni Scremin

    1999-04-01

    Full Text Available Mega-organs, primarily in the digestive tract, are well known to occur in chronic Chagas disease. Acute experimental infection with Trypanosoma cruzi results in parasitism of a wide range of cells, tissues, and organs, including the urinary bladder. Infection of BALB/c mice with 100,000 bloodstream forms of the Y strain of T. cruzi induced acute infection with intense parasitism of all layers of the urinary bladder. Parasites were found in the mucosa, lamina propria, muscular, adventitial connective, and fat tissue. Desquamate epithelial cells with amastigotes in the bladder lumen were also found. After 60 days of infection, mice inoculated with 50 bloodstream forms developed dilated, thin-walled bladders that had inflammatory infiltrates and foci of fibrosis replacing areas of damaged muscular layer. These lesions result from direct damage to the muscle fibers by the T. cruzi, leading to myosites, muscle damage, and scarring. Direct damage of paraganglia cells secondary to parasitism, leading to dilatation, damage of muscle fibers, and scarring with replacement of muscular tissue with connective tissue, should also be considered as a cause of functional disturbance of the urinary bladder.Os "mega-órgãos" na Doença de Chagas são bem conhecidos, especialmente os desenvolvidos no sistema digestivo. A infecção aguda apresenta parasitismo de diversas células, tecidos e órgãos, dentre eles a bexiga urinária. Camundongos Balb/c infectados com 100.000 formas sanguíneas de cepa Y de T. cruzi mostraram intenso parasitismo de todas camadas da bexiga urinária na fase aguda. Os parasitas foram encontrados na mucosa, submucosa, lâmina própria, muscular, adventícia e tecido adiposo, além das células descamadas para a luz do órgão. Para produzir a fase crônica, os animais foram inoculados com a mesma cepa, porém apenas inóculo com 50 formas sangüíneas. Após sessenta dias de infecção, detectamos dilatações da parede vesical, assim

  20. A case of megacolon in Rio Grande Valley as a possible case of Chagas disease

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    Karl Reinhard

    2003-01-01

    Full Text Available We have been searching for evidence of Chagas disease in mummified human remains. Specifically, we have looked for evidence of alteration of intestinal or fecal morphology consistent with megacolon, a condition associated with Chagas disease. One prehistoric individual recovered from the Chihuahuan Desert near the Rio Grande exhibits such pathology. We present documentation of this case. We are certain that this individual presents a profoundly altered large intestinal tract and we suggest that further research should focus on confirmation of a diagnosis of Chagas disease. We propose that the prehistoric activity and dietary patterns in Chihuahua Desert hunter/gatherers promoted the pathoecology of Chagas disease.

  1. [Experience of targeted screening of Chagas disease in Ile-de-France].

    Science.gov (United States)

    Lescure, F-X; Paris, L; Elghouzzi, M H; Le Loup, G; Develoux, M; Touafek, F; Mazier, D; Pialoux, G

    2009-12-01

    present. These results confirm that metropolitan France is subject to the emergence of Chagas' disease in a non-endemic zone. This confirms the value of screening in at-risk populations, in particular because of the recent broadening of indications for antiparasitic treatment. In addition it is relevant to the prevention of vertical transmission or infection via organ donation, which could arise in France. These results also demonstrate continuing difficulties in the interpretation of serological results and the usefulness of PCR, which might increase sensitivity substantially.

  2. [Representations, myths, and behaviors among Chagas disease patients with pacemakers].

    Science.gov (United States)

    Magnani, Claudia; Oliveira, Bruna Guimarães; Gontijo, Eliane Dias

    2007-07-01

    This anthropological study aimed to evaluate the incorporation of pacemakers into the lives of individuals with Chagas disease. An ethnographic methodology was used, based on an open interview focusing on the personal perceptions of 15 patients with chronic Chagas cardiopathy who had required pacemaker implants at the Federal University Hospital in Belo Horizonte, Minas Gerais State, Brazil. As part of a broader quality of life analysis, the study investigated the cultural, physical, and psychological resources used by patients to confront, explain, and accept the disease process, including mental representations on the cultural perception of the illness and definition of social relations. The study was intended to contribute to comprehensive patient care by health professionals, including psychosocial aspects. Decoded and integrated orientation in the cultural sphere assumes an important role in order to prevent disinformation from perpetuating the dissemination of popular myths as active elements in patient stigmatization.

  3. Prevalencia de enfermedad diverticular del apéndice cecal en pacientes apendicectomizados por apendicitis aguda

    OpenAIRE

    Muñoz C,César; Mansilla E,Juan; Roa S,Juan Carlos; Heider C,Claudia

    2011-01-01

    Introducción: La enfermedad diverticular del apéndice cecal es un hallazgo infrecuente en apendicectomizados por sospecha clínica de apendicitis aguda. Nuestro objetivo es evaluar la prevalencia de enfermedad diverticular del apéndice cecal en pacientes apendicectomizados por sospecha clínica de apendicitis aguda. Material y Método: Diseño de estudio: Estudio de corte transversal. Criterios de inclusión: Pacientes apendicectomizados por sospecha clínica de apendicitis aguda. Período de estudi...

  4. Algunas observaciones sobre la apendicitis aguda en los niños

    OpenAIRE

    Piñeros Suárez, Luis

    2011-01-01

    La apendicitis aguda en los niños, presenta actitudes particulares que diferencian de la apendicitis aguda del adulto y que vienen a formar grupos clínicos casi exclusivamente de la infancia. De una manera general, las formas más graves, las formas fulminantes de la apendicitis aguda se encuentran especialmente en la infancia y en estas formas graves llama poderosamente la atención, la falta de relación entre los signos clínicos observados y la importancia de las lesiones encontradas en el ap...

  5. Vasculite necrosante na glomerulonefrite difusa aguda pós-infecciosa

    OpenAIRE

    Riyuso Márcia C; Carvalho Maria Fernanda C; Trindade Amélia A. T; Mendonça Luciana B.; Saggioro Fabiano P; Viero Rosa M

    2004-01-01

    Os autores relatam dois casos de glomerulonefrite difusa aguda pós-infecciosa com evolução clinicomorfológica incomum. As biópsias renais mostraram alterações características de glomerulonefrite difusa aguda associada à extensa necrose fibrinóide e infiltrado inflamatório leucocitário na parede de arteríolas e artérias interlobulares. Foram também observadas crescentes. Ambos os pacientes cursaram com insuficiência renal aguda severa, sendo que um dos pacientes recuperou a função renal e outr...

  6. Chagas Cardiomyopathy in the Context of the Chronic Disease Transition

    Science.gov (United States)

    Hidron, Alicia I.; Gilman, Robert H.; Justiniano, Juan; Blackstock, Anna J.; LaFuente, Carlos; Selum, Walter; Calderon, Martiza; Verastegui, Manuela; Ferrufino, Lisbeth; Valencia, Eduardo; Tornheim, Jeffrey A.; O'Neal, Seth; Comer, Robert; Galdos-Cardenas, Gerson; Bern, Caryn

    2010-01-01

    Background Patients with Chagas disease have migrated to cities, where obesity, hypertension and other cardiac risk factors are common. Methodology/Principal Findings The study included adult patients evaluated by the cardiology service in a public hospital in Santa Cruz, Bolivia. Data included risk factors for T. cruzi infection, medical history, physical examination, electrocardiogram, echocardiogram, and contact 9 months after initial data collection to ascertain mortality. Serology and PCR for Trypanosoma cruzi were performed. Of 394 participants, 251 (64%) had confirmed T. cruzi infection by serology. Among seropositive participants, 109 (43%) had positive results by conventional PCR; of these, 89 (82%) also had positive results by real time PCR. There was a high prevalence of hypertension (64%) and overweight (body mass index [BMI] >25; 67%), with no difference by T. cruzi infection status. Nearly 60% of symptomatic congestive heart failure was attributed to Chagas cardiomyopathy; mortality was also higher for seropositive than seronegative patients (p = 0.05). In multivariable models, longer residence in an endemic province, residence in a rural area and poor housing conditions were associated with T. cruzi infection. Male sex, increasing age and poor housing were independent predictors of Chagas cardiomyopathy severity. Males and participants with BMI ≤25 had significantly higher likelihood of positive PCR results compared to females or overweight participants. Conclusions Chagas cardiomyopathy remains an important cause of congestive heart failure in this hospital population, and should be evaluated in the context of the epidemiological transition that has increased risk of obesity, hypertension and chronic cardiovascular disease. PMID:20502520

  7. Methodological advances in drug discovery for Chagas disease

    Science.gov (United States)

    Bustamante, Juan M.; Tarleton, Rick L.

    2011-01-01

    Introduction Chagas disease is the highest impact human infectious disease in Latin America, and the leading worldwide cause of myocarditis. Despite the availability of several compounds that have demonstrated efficacy in limiting the effects of T. cruzi, these compounds are rarely used due to their variable efficacy, substantial side effects and the lack of methodologies for confirming their effectiveness. Furthermore, the development of more efficacious compounds is challenged by limitations of systems for assessing drug efficacy in vitro and in vivo. Areas covered Herein, the authors review the development of Chagas disease drug discovery methodology, focusing on recent developments in high throughput screening, in vivo testing methods and assessments of efficacy in humans. Particularly, this review documents the significant progress that has taken place over the last 5 years that have paved the way for both target-focused and high-throughput screens of compound libraries. Expert opinion The tools for in vitro and in vivo screening of anti-T. cruzi compounds have improved dramatically in the last few years and there are now a number of excellent in vivo testing models available; this somewhat alleviates the bottleneck issue of quickly and definitively demonstrating in vivo efficacy in a relevant host animal system. These advances emphasize the potential for additional progress resulting in new treatments for Chagas disease in the coming years. That being said, national and international agencies must improve the coordination of research and development efforts in addition to cultivating the funding sources for the development of these new treatments. PMID:21712965

  8. Prophylactic and therapeutic DNA vaccines against Chagas disease.

    Science.gov (United States)

    Arce-Fonseca, Minerva; Rios-Castro, Martha; Carrillo-Sánchez, Silvia del Carmen; Martínez-Cruz, Mariana; Rodríguez-Morales, Olivia

    2015-01-01

    Chagas disease is a zoonosis caused by Trypanosoma cruzi in which the most affected organ is the heart. Conventional chemotherapy has a very low effectiveness; despite recent efforts, there is currently no better or more effective treatment available. DNA vaccines provide a new alternative for both prevention and treatment of a variety of infectious disorders, including Chagas disease. Recombinant DNA technology has allowed some vaccines to be developed using recombinant proteins or virus-like particles capable of inducing both a humoral and cellular specific immune response. This type of immunization has been successfully used in preclinical studies and there are diverse models for viral, bacterial and/or parasitic diseases, allergies, tumors and other diseases. Therefore, several research groups have been given the task of designing a DNA vaccine against experimental infection with T. cruzi. In this review we explain what DNA vaccines are and the most recent studies that have been done to develop them with prophylactic or therapeutic purposes against Chagas disease.

  9. Scrutinizing the Biomarkers for the Neglected Chagas Disease: How Remarkable!

    Science.gov (United States)

    Pinho, Rosa T.; Waghabi, Mariana C.; Cardillo, Fabíola; Mengel, José; Antas, Paulo R. Z.

    2016-01-01

    Biomarkers or biosignature profiles have become accessible over time in population-based studies for Chagas disease. Thus, the identification of consistent and reliable indicators of the diagnosis and prognosis of patients with heart failure might facilitate the prioritization of therapeutic management to those with the highest chance of contracting this disease. The purpose of this paper is to review the recent state and the upcoming trends in biomarkers for human Chagas disease. As an emerging concept, we propose a classification of biomarkers based on plasmatic-, phenotype-, antigenic-, genetic-, and management-related candidates. The available data revisited here reveal the lessons learned thus far and the existing challenges that still lie ahead to enable biomarkers to be employed consistently in risk evaluation for this disease. There is a strong need for biomarker validation, particularly for biomarkers that are specific to the clinical forms of Chagas disease. The current failure to achieve the eradication of the transmission of this disease has produced determination to solve this validation issue. Finally, it would be strategic to develop a wide variety of biomarkers and to test them in both preclinical and clinical trials. PMID:27563302

  10. Opportunity cost for early treatment of Chagas disease in Mexico.

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    Janine M Ramsey

    2014-04-01

    Full Text Available BACKGROUND: Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations. METHODOLOGY/PRINCIPAL FINDINGS: A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment. CONCLUSIONS/SIGNIFICANCE: In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life.

  11. The Role of Haptoglobin Genotypes in Chagas Disease

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    Ninomar Mundaray Fernández

    2014-01-01

    Full Text Available Although the number of people infected with T. cruzi is on the rise, host genetic and immune components that are crucial in the development of the Chagas disease have been discovered. We investigated the frequency of polymorphisms in the gene encoding haptoglobin of patients with chronic Chagas disease. The results suggest that while the HP1-1 genotype may confer protection against infection and the development of chronic Chagas disease due to the rapid metabolism of the Hp1-1-Hb complex and its anti-inflammatory activity, the presence of HP2-2 genotype may increase susceptibility towards a chronic condition of the disease due to a slow metabolism of the Hp2-2-Hb complex, lower antioxidant activity, and increased inflammatory reactivity, which lead to cell damage and a deterioration of the cardiac function. Finally, correlations between HP genotypes in different age groups and cardiac manifestations suggest that HP polymorphism could influence the prognosis of this infectious disease. This study shows some of the relevant aspects of the haptoglobin gene polymorphism and its implications in the T. cruzi infection.

  12. The Role of Haptoglobin Genotypes in Chagas Disease

    Science.gov (United States)

    Mundaray Fernández, Ninomar; Fernández-Mestre, Mercedes

    2014-01-01

    Although the number of people infected with T. cruzi is on the rise, host genetic and immune components that are crucial in the development of the Chagas disease have been discovered. We investigated the frequency of polymorphisms in the gene encoding haptoglobin of patients with chronic Chagas disease. The results suggest that while the HP1-1 genotype may confer protection against infection and the development of chronic Chagas disease due to the rapid metabolism of the Hp1-1-Hb complex and its anti-inflammatory activity, the presence of HP2-2 genotype may increase susceptibility towards a chronic condition of the disease due to a slow metabolism of the Hp2-2-Hb complex, lower antioxidant activity, and increased inflammatory reactivity, which lead to cell damage and a deterioration of the cardiac function. Finally, correlations between HP genotypes in different age groups and cardiac manifestations suggest that HP polymorphism could influence the prognosis of this infectious disease. This study shows some of the relevant aspects of the haptoglobin gene polymorphism and its implications in the T. cruzi infection. PMID:25147423

  13. Chagas' disease: an emergent urban zoonosis. The caracas valley (Venezuela) as an epidemiological model.

    Science.gov (United States)

    Urdaneta-Morales, Servio

    2014-01-01

    The unprecedented emergence of important public health and veterinary zoonoses is usually a result of exponential population growth and globalization of human activities. I characterized Chagas' disease as an emergent zoonosis in the Caracas Valley (Venezuela) due to the following findings: the presence of reservoirs (Didelphis marsupialis, Rattus rattus) and vectors (Panstrongylus geniculatus, Panstrongylus rufotuberculatus) infected with Trypanosoma cruzi in urbanized or marginalized areas; the elevated contact between P. geniculatus and human beings detected by parasitological and molecular examinations of triatomine feces demonstrated the possibility of transmission risks; a study of outbreaks of urban Chagas' disease reported the first proven case of oral transmission of T. cruzi to human beings; the risk of transmission of glandular metacyclic stages from marsupials by experimental ocular and oral instillation; mice genitalia infected with T. cruzi contaminated blood resulted in the formation of amastigotes very close to the lumen suggesting that there may be a possibility of infection via their release into the urine and thence to the exterior; the ubiquitous histotropism and histopathology of T. cruzi was demonstrated using a mouse model; the presence of experimental T. cruzi pseudocysts in adipose, bone-cartilage, and eye tissue indicated a potential risk for transplants. Socio-sanitary programs that include improvements in housing, vector control, and access to medical treatment, as well as strategies aimed at combating social inequalities, poverty, and underdevelopment should be undertaken in those areas where zoonoses are most prevalent. Disciplines, such as Ecology, Epidemiology, Medical Entomology, Human and Veterinary Medicine, Environmental Studies, Public Health, Social and Political Studies, Immunology, Microbiology, and Pharmacology could all provide important contributions that aim to reduce the occurrence of factors governing the spread of

  14. Radiological findings in megaesophagus secondary to Chagas disease: chest X-ray and esophagogram*

    Science.gov (United States)

    Abud, Thiago Giansante; Abud, Lucas Giansante; Vilar, Vanessa Sales; Szejnfeld, Denis; Reibscheid, Samuel

    2016-01-01

    Objective To identify and classify the radiographic patterns of megaesophagus in Chagas disease, as seen on esophagograms and chest X-rays. Materials and Methods This was a prospective study of 35 patients diagnosed with esophageal disease via manometry. The changes found on esophagograms were stratified according to Rezende's classification, divided into four categories (grades I through IV) determined by the degree of dilatation and impairement of esophageal motility. We subsequently correlated that ranking with the chest X-ray findings: gastric air bubble; air-fluid level; and mediastinal widening. Results Among the 35 patients, the esophageal disease was classified as grade I in 9 (25.7%), grade II in 3 (8.6%), grade III in 19 (54.3%), and grade IV in 4 (11.4%). None of the patients with grade I esophageal disease showed changes on chest X-rays. In two of the three patients with grade II disease, there was no gastric air-bubble, although there were no other findings in any of the grade II patients. Of the 19 patients with grade III disease, 15 had abnormal findings on X-rays. All four patients with grade IV disease showed abnormalities. Conclusion The use of Rezende's classification is feasible, encompassing findings ranging from the subtle changes that characterize the initial phases of esophageal disease to the complete akinesia seen in dolicomegaesophagus. Chest X-ray findings are more common in patients with advanced stages of the disease and indicate the degree of esophageal involvement in Chagas disease. PMID:28100930

  15. Sudorese em pacientes com moléstia de chagas crônica Sweating in patients with chronic Chagas' disease

    Directory of Open Access Journals (Sweden)

    Edymar Jardim

    1967-09-01

    Full Text Available Foi estudada a sudoração em pacientes com moléstia de Chagas crônica, mediante estímulo térmico (teste de Minor. As perdas hídricas dos pacientes chagásicos foram significativamente menores do que as dos pacientes não chagásicos.The sweating in patients with chronic Chagas' disease by using thermic stimulus (Minor test is studied. The loss of water was significantly lower in the patients with Chagas' disease when compared with the loss in non chagasic patients.

  16. Miocitólise e fibrose do miocárdio na doença de Chagas

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    C. Magarinos Torres

    1960-11-01

    Full Text Available A fibrose do miocárdio foi, primitivamente, atribuída á cicatrização de infartos e á miocardite intersticial. Em data relativamente recente maior atenção veio despertar a miocitólise como outra causa capaz de produzi-la (SCHLESINGER & REINER, MAGARINOS TORRES. Descrevemos, neste trabalho, a miocitólise difusa do miocárdio como diversa da miocitólise focal, estudada por SCHLESINGER & REINER. Na cardiopatia crônica chagásica, a fibrose do miocárdio é aparentemente, o resultado da miocitólise difusa em menor escala associada á da miocaedite específica. Embora não patognomônica da doença de Chagas, a miocitólise difusa, em sua fase crõnica (figs. 3 a 11, por vêzes distinguida, devidamente, da miocardite intersticial, é constante e, não raro, extensa na cardiopatia crônica chagásica, fato a ser levado em conta quando tentado o seu diagnóstico microscópico. A raridade, porém com que é surpreendida a sua fase aguda (figs. 13 e 14 indica que ela se processa de maneira lenta, atingindo, apenas, raras fibras musculares, em cada momento concreto, circunstãncia essa que, de certo modo, virá dificultar o seu estudo pelo microscópio electrônico. A lesão de C. Magarinos torres (figs. 15, 16 e 17 não parece relacionada com a miocitólise, embora reconheça, provàvelmente, uma patogenia semelhante: anemia local condicionando perturbações no metabolismo das células musculares cardíacas. A destruição de células musculares, discreta em cada campo microscópico, porém difundida, exige evidentemente menos afluxo de sangue arterial, nas zonas em que a miocitólise é mais acentuada, fato que não poderia explicar o colapso das finas ramificações arteriais ocasionalmente encontrado (figs. 18, 20 e 22. A conservação de capilares sanguíneos do primitivo estroma do miocárdio distingue a fibrose resultante da miocitólise difusa (figs. 8, 9, 11 e 12 da que produz a miocardite intersticial crõnica. A acentuada congest

  17. Oclusão arterial aguda por derivados da ergotamina

    OpenAIRE

    Souza,Edison Barreto de; Araújo,Márcia Marinho Gomes de

    2009-01-01

    Os derivados da ergotamina compõem diversas drogas amplamente utilizadas no tratamento de ataques agudos de migrânea. A intoxicação por estas substâncias resulta geralmente de sua administração crônica, promovendo sintomas secundários ao espasmo arterial e à consequente isquemia distal. Neste artigo, é relatado o caso de uma paciente de 47 anos com diagnóstico de oclusão arterial aguda em membros inferiores secundária ao uso de derivados da ergotamina. Após a suspensão da droga e a prescrição...

  18. Comportamiento de la enfermedad diarreica aguda en Guatemala

    Directory of Open Access Journals (Sweden)

    Mario Enrique Plá Acevedo

    2015-12-01

    Full Text Available Se realizó un estudio descriptivo de corte transversal, con el objetivo de conocer el comportamiento de la Enfermedad Diarreica Aguda (EDA en Tierra Blanca, Departamento Petén, Guatemala; en el período comprendido de enero a diciembre del año 2011. El universo de estudio lo formaron todos los individuos que fueron evaluados en el puesto de salud de Tierra Blanca con diagnóstico clínico de EDA. La muestra estuvo constituida por 529 pacientes. Se trabajó con el Sistema de Información Gerencial en Salud 18 (SIGSA, las fichas de salud individual de cada paciente, así como una entrevista estructurada que se le aplicó a los mismos, previo consentimiento informado; información con la cual se obtuvieron las variables relacionadas con los aspectos socio-demográficos, epidemiológicos y clínicos. Los meses donde más casos se reportaron fueron entre mayo y septiembre, coincidiendo esto con los meses de lluvias. Las edades más frecuentes fueron de uno a diez años y el sexo que predominó fue el masculino. El 40,3% consumían agua procedente de chorro intradomiciliario; las infecciones respiratorias agudas fueron las patologías que con más frecuencia se asociaron a las EDA y el 88,1% recibió tratamiento con sales de rehidratación oral.

  19. Benznidazole Shortage Makes Chagas Disease a Neglected Tropical Disease in Developed Countries: Data from Spain

    Science.gov (United States)

    Navarro, Miriam; Norman, Francesca F.; Pérez-Molina, José Antonio; López-Vélez, Rogelio

    2012-01-01

    Chagas disease is a neglected tropical disease endemic in Latin America. The first-line treatment option is benznidazole, but stocks are expected to run out in the coming months. Spain would need around 5 million benznidazole tablets. This drug shortage could make Chagas disease a neglected tropical disease also in developed countries. PMID:22826485

  20. Investigación del INISA sobre la diarrea aguda del niño, estudios hospitalarios y comunitarios en Costa Rica 1976-1984

    OpenAIRE

    Simhon-Edgar, Alberto; Mata, Leonardo

    1985-01-01

    Artículo científico -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1985 Actualmente es posible detectar agentes entéricos potencialmente patógenos en más del 70% de los casos con diarrea aguda que requieren atención médica. Los rotavirus son responsables de casi la mitad de los casos, seguidos en importancia por ECET (toxina estable), Campylobacter, Shigella y Cryptospoidium. La rehidratación por via oral con solución de sales y azúcar es eficaz para rehidratar niños ...

  1. Síndrome de Kelley-Seegmiller: apresentação sob a forma de insuficiência renal aguda

    OpenAIRE

    Ribeiro, Maria do Céu

    2014-01-01

    Resumo: A nefropatia por ácido úrico é rara em idade pediátrica, estando mais frequentemente associada à síndrome de lise tumoral. Um rapaz, actualmente com 10 anos de idade, aos 2 meses de vida apresentou insuficiência renal aguda e nefrocalcinose, associadas a hiperuricemia marcada. O estudo analítico da via das purinas permitiu o diagnóstico de défice parcial de hipoxantina guanina fosforibosiltransferase (HPRT) na criança e em familiares afectados. O tratamento precoce e o acompanhamento ...

  2. Avaliação toxicológica do óleo-resina de copaíba em ratos : estudos de toxidade aguda, neurotoxidade e embriofetotoxidade

    OpenAIRE

    Sachetti,Camile Giaretta

    2011-01-01

    Conhecida popularmente como copaíba, o gênero Copaifera L., Fabaceae, é uma das plantas com uso medicinal mais conhecido e utilizado no Brasil. Embora haja vários estudos mostrando algumas das atividades farmacológicas desse óleo-resina, existem poucos trabalhos relacionados à sua toxicidade. No presente estudo, ratas Wistar foram expostas a diferentes doses do óleo-resina de Copaifera reticulata, via gavagem, dissolvida em Tween 80 2%, para se avaliar sua toxicidade aguda e neurotóxica, seu ...

  3. Insuficiência renal aguda e febre prolongada – um caso de nefrite intersticial aguda induzida por fármacos

    OpenAIRE

    Melo, Cláudia; Santos Silva, Rita; Tomé, Soraia; Carvalho, Sónia; Teixeira, Paulo

    2013-01-01

    A nefrite intersticial aguda (NIA) é uma causa de insuficiência renal aguda em idade pediátrica. A etiologia medicamentosa é a mais frequente e o tratamento primário da NIA consiste na eliminação do agente etiológico suspeito. Descreve-se o caso de uma adolescente, de 15 anos, com uma síndrome febril com 24 dias de evolução, acompanhado de exantema maculopapular e insuficiência renal aguda (IRA). Após exclusão de etiologias mais frequentes, foi diagnosticada NIA induzida por fármacos e após d...

  4. Chagas disease prevention through improved housing using an ecosystem approach to health Prevención de la enfermedad de Chagas vía mejoramiento de la vivienda com un enfoque ecosistémico de la salud

    Directory of Open Access Journals (Sweden)

    Antonieta Rojas-de-Arias

    2001-01-01

    Full Text Available This Chagas disease prevention project via housing improvement aims to determine the efficiencyof different interventions in vector control. The following study describes the target communities, disease magnitude, and housing improvements. Transmission levels are analysed from an ecological and socioeconomic perspective. Special interest was focused on the peridomicile as the origin of domiciliary reinfestation. In the original project, three intervention programs were proposed, one for each of the three communities: (a an insecticide spraying program; (b a housing improvement program; and (c a combined program of spraying and housing improvement. The three communities currently have different risks of exposure to triatominae reinfestation as a consequence of the type of intervention carried out. A new multidisciplinary approach which integrates participatory, community-based research and socioeconomic dimensions will allow to determine the efficiency of models for territorial ordering, community education, and environmental interventions in Chagas disease control.El proyecto de prevención de la enfermedad de Chagas vía mejoramiento de la vivienda tuvo como objetivo determinar la efectividad de diferentes intervenciones para el control vectorial. El siguiente trabajo describe las comunidades intervenidas, la dimensión de la enfermedad y el mejoramiento de la vivienda en el contexto familiar. Los niveles de transmisión se analizan con una perspectiva ecológica y socioeconómica. Especial interés se ha dado al peridomicilio como lugar de origen de las reinfestaciones domiciliares. Tres programas de intervención fueron propuestos para estas tres comunidades: (a rociado con insecticidas; (b mejoramiento de la vivienda; y (c combinado de rociamiento y mejoramiento de la vivienda. En la actualidad, las tres comunidades tienen riesgos de exposición diferentes al proceso de reinfestación triatomínica como consecuencia del tipo de intervenci

  5. Epidemiological characteristics of patients with Chagas Disease Características epidemiológicas dos pacientes com Doença de Chagas

    OpenAIRE

    2010-01-01

    The Chagas Disease is an infection caused by Trypanosoma cruzy, transmitted to a hematophague insect, transfused blood or birth, with evolution divided in acute and chronic phases. Object: Analyses variables from patients with Chagas Disease (CD): age, gender, education, prevalence, and presence of co morbid and work. Methodology: The study region is constituted by many peripheral neighborhoods from Montes Claros City- Minas Gerais- Brazil. The study was made with 7150 registered peo...

  6. Community-Based Entomological Surveillance Reveals Urban Foci of Chagas Disease Vectors in Sobral, State of Ceará, Northeastern Brazil

    Science.gov (United States)

    Bezerra, Fernando S. M.; Parente, Plutarco I.; Dias-Neto, Raimundo V.; Xavier, Samanta C. C.; Ramos, Alberto N.

    2017-01-01

    Background The aim of this work was to explore the potential risk of vector-borne Chagas disease in urban districts in northeastern Brazil, by analyzing the spatiotemporal distributions and natural infection rates with Trypanosoma cruzi of triatomine species captured in recent years. The main motivation of this work was an acute human case of Chagas disease reported in 2008 in the municipality of Sobral. Methodology/principal findings We analyzed data from community-based entomological surveillance carried out from 2010 to 2014. Triatomine natural T. cruzi infection was assessed by examination of insect feces by optical microscopy. Sites of triatomine capture were georeferenced through Google Earth and analyzed with ArcGIS. A total of 191 triatomines were collected, consisting of 82.2% Triatoma pseudomaculata, 7.9% Rhodnius nasutus, 5.8% T. brasiliensis, 3.7% Panstrongylus lutzi, and 0.5% P. megistus, with an overall natural infection index of 17.8%. Most infestations were reported in the districts of Dom José (36.2%), Padre Palhano (24.7%), and Alto do Cristo (10.6%). The overwhelming majority of insects (185/96.9%) were captured inside houses, and most insects tended to be collected in intermittent peaks. Moreover, captured triatomines tended to constitute colonies. The acute case reported in 2008 was found to be situated within a T. pseudomaculata hotspot. Conclusion The triatomine collection events carried out by dwellers were aggregated in time and space into distinct foci, suggesting that insects are intermittently and artificially introduced into the city, possibly via accidental migration from their natural reservoirs. The relatively high T. cruzi infection rate indicates considerable circulation of the parasite in these areas, increasing the risk of vector-borne Chagas disease infection. These data suggest a need to strengthen epidemiological surveillance and integrate appropriate control actions targeting triatomines, T. cruzi reservoirs, and human

  7. Apendicitis aguda: incidencia y factores asociados. Hospital Nacional “Dos de Mayo” Lima, Perú 2009

    OpenAIRE

    Gamero, Marco; Barreda, Jorge; Hinostroza, Gerardo

    2011-01-01

     OBJETIVODeterminar la incidencia de la apendicitis aguda y sus factores asociados en el Hospital Nacional “Dos de Mayo”.MATERIAL Y MÉTODOEs un estudio observacional, descriptivo, transversal y retrospectivo. Las variables fueron: edad, sexo, tipo de apendicitis aguda, tipo de cirugía, apendicitis aguda complicada y no complicada, tipo de sutura de herida, tratamiento del muñón apendicular y drenaje en apendicitis agudaSe revisaron los Reportes Operatorios en los libros de Emergencia del cita...

  8. Retracing micro-epidemics of Chagas disease using epicenter regression.

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    Michael Z Levy

    2011-09-01

    Full Text Available Vector-borne transmission of Chagas disease has become an urban problem in the city of Arequipa, Peru, yet the debilitating symptoms that can occur in the chronic stage of the disease are rarely seen in hospitals in the city. The lack of obvious clinical disease in Arequipa has led to speculation that the local strain of the etiologic agent, Trypanosoma cruzi, has low chronic pathogenicity. The long asymptomatic period of Chagas disease leads us to an alternative hypothesis for the absence of clinical cases in Arequipa: transmission in the city may be so recent that most infected individuals have yet to progress to late stage disease. Here we describe a new method, epicenter regression, that allows us to infer the spatial and temporal history of disease transmission from a snapshot of a population's infection status. We show that in a community of Arequipa, transmission of T. cruzi by the insect vector Triatoma infestans occurred as a series of focal micro-epidemics, the oldest of which began only around 20 years ago. These micro-epidemics infected nearly 5% of the community before transmission of the parasite was disrupted through insecticide application in 2004. Most extant human infections in our study community arose over a brief period of time immediately prior to vector control. According to our findings, the symptoms of chronic Chagas disease are expected to be absent, even if the strain is pathogenic in the chronic phase of disease, given the long asymptomatic period of the disease and short history of intense transmission. Traducción al español disponible en Alternative Language Text S1/A Spanish translation of this article is available in Alternative Language Text S1.

  9. Retracing micro-epidemics of Chagas disease using epicenter regression.

    Science.gov (United States)

    Levy, Michael Z; Small, Dylan S; Vilhena, Daril A; Bowman, Natalie M; Kawai, Vivian; Cornejo del Carpio, Juan G; Cordova-Benzaquen, Eleazar; Gilman, Robert H; Bern, Caryn; Plotkin, Joshua B

    2011-09-01

    Vector-borne transmission of Chagas disease has become an urban problem in the city of Arequipa, Peru, yet the debilitating symptoms that can occur in the chronic stage of the disease are rarely seen in hospitals in the city. The lack of obvious clinical disease in Arequipa has led to speculation that the local strain of the etiologic agent, Trypanosoma cruzi, has low chronic pathogenicity. The long asymptomatic period of Chagas disease leads us to an alternative hypothesis for the absence of clinical cases in Arequipa: transmission in the city may be so recent that most infected individuals have yet to progress to late stage disease. Here we describe a new method, epicenter regression, that allows us to infer the spatial and temporal history of disease transmission from a snapshot of a population's infection status. We show that in a community of Arequipa, transmission of T. cruzi by the insect vector Triatoma infestans occurred as a series of focal micro-epidemics, the oldest of which began only around 20 years ago. These micro-epidemics infected nearly 5% of the community before transmission of the parasite was disrupted through insecticide application in 2004. Most extant human infections in our study community arose over a brief period of time immediately prior to vector control. According to our findings, the symptoms of chronic Chagas disease are expected to be absent, even if the strain is pathogenic in the chronic phase of disease, given the long asymptomatic period of the disease and short history of intense transmission. Traducción al español disponible en Alternative Language Text S1/A Spanish translation of this article is available in Alternative Language Text S1.

  10. Resveratrol Reverses Functional Chagas Heart Disease in Mice

    Science.gov (United States)

    Mata-Santos, Hilton; Vicentino, Amanda R. R.; Feijó, Daniel F.; Meyer-Fernandes, José R.; Paula-Neto, Heitor A.; Medei, Emiliano; Bozza, Marcelo T.; Lannes-Vieira, Joseli; Paiva, Claudia N.

    2016-01-01

    Chronic chagasic cardiomyopathy (CCC) develops years after acute infection by Trypanosoma cruzi and does not improve after trypanocidal therapy, despite reduction of parasite burden. During disease, the heart undergoes oxidative stress, a potential causative factor for arrhythmias and contractile dysfunction. Here we tested whether antioxidants/ cardioprotective drugs could improve cardiac function in established Chagas heart disease. We chose a model that resembles B1-B2 stage of human CCC, treated mice with resveratrol and performed electrocardiography and echocardiography studies. Resveratrol reduced the prolonged PR and QTc intervals, increased heart rates and reversed sinus arrhythmia, atrial and atrioventricular conduction disorders; restored a normal left ventricular ejection fraction, improved stroke volume and cardiac output. Resveratrol activated the AMPK-pathway and reduced both ROS production and heart parasite burden, without interfering with vascularization or myocarditis intensity. Resveratrol was even capable of improving heart function of infected mice when treatment was started late after infection, while trypanocidal drug benznidazole failed. We attempted to mimic resveratrol’s actions using metformin (AMPK-activator) or tempol (SOD-mimetic). Metformin and tempol mimicked the beneficial effects of resveratrol on heart function and decreased lipid peroxidation, but did not alter parasite burden. These results indicate that AMPK activation and ROS neutralization are key strategies to induce tolerance to Chagas heart disease. Despite all tissue damage observed in established Chagas heart disease, we found that a physiological dysfunction can still be reversed by treatment with resveratrol, metformin and tempol, resulting in improved heart function and representing a starting point to develop innovative therapies in CCC. PMID:27788262

  11. Chagas disease diagnostic applications: present knowledge and future steps

    Science.gov (United States)

    Balouz, Virginia; Agüero, Fernán; Buscaglia, Carlos A.

    2017-01-01

    Chagas disease, caused by the protozoan Trypanosoma cruzi, is a life-long and debilitating illness of major significance throughout Latin America, and an emergent threat to global public health. Being a neglected disease, the vast majority of Chagasic patients have limited access to proper diagnosis and treatment, and there is only a marginal investment into R&D for drug and vaccine development. In this context, identification of novel biomarkers able to transcend the current limits of diagnostic methods surfaces as a main priority in Chagas disease applied research. The expectation is that these novel biomarkers will provide reliable, reproducible and accurate results irrespective of the genetic background, infecting parasite strain, stage of disease, and clinical-associated features of Chagasic populations. In addition, they should be able to address other still unmet diagnostic needs, including early detection of congenital T. cruzi transmission, rapid assessment of treatment efficiency or failure, indication/prediction of disease progression and direct parasite typification in clinical samples. The lack of access of poor and neglected populations to essential diagnostics also stress the necessity of developing new methods operational in Point-of-Care (PoC) settings. In summary, emergent diagnostic tests integrating these novel and tailored tools should provide a significant impact on the effectiveness of current intervention schemes and on the clinical management of Chagasic patients. In this chapter, we discuss the present knowledge and possible future steps in Chagas disease diagnostic applications, as well as the opportunity provided by recent advances in high-throughput methods for biomarker discovery. PMID:28325368

  12. Occurrence of dolichocolon without megacolon in chronic Chagas disease patients

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    Cleudson Castro

    2012-06-01

    Full Text Available INTRODUCTION: Since 1970, lengthening of the rectosigmoid has been suspected to be a solitary manifestation of Chagas colopathy. METHODS: To test this hypothesis, opaque enema was administered on 210 seropositive and 63 seronegative patients, and radiographs in the anteroposterior and posteroanterior positions were examined blind to the serological and clinical findings. The distal colon was measured using a flexible ruler along the central axis of the image from the anus to the iliac crest. RESULTS: Dolichocolon was diagnosed in 31 (14.8% seropositive and 3 (4.8% seronegative patients. The mean length was 57.2 (±12.2cm in seropositive patients and 52.1 (±8.8cm in the seronegative patients (p = 0.000, that is, the distal colon in Chagas patients was, on average, 5.1cm longer. Seropositive female patients presented a mean length of 58.8 (±12.3cm, and seronegative female patients presented 53.2 (±9.1cm (p = 0.002. Seropositive male patients had a mean length of 55 (±11.6cm, and seronegative male patients had 49.9 (±7.8cm (p = 0.02. Among 191 patients without megacolon and suspected megacolon, the mean length was 56.3 (±11.6cm in seropositive individuals and 52 (±8.8cm in seronegative patients (p = 0.003. Among individuals with distal colon >70cm, there were 31 Chagas patients with mean length of 77.9 (±7.1cm and three seronegative with 71.3 (±1.1cm (p = 0.000. Among 179 with distal colon <70cm, seropositive individuals had a mean length of 53.6 (±8.8cm, and seronegative patients had 51.2 (±7.8cm (p = 0.059. Serological positive women had longer distal colon than men (p = 0.02, whereas the mean length were the same among seronegative individuals (p = 0.16. CONCLUSIONS: In endemic areas of Brazil Central, solitary dolichocolon is a radiological Chagas disease signal.

  13. Recomendaciones para el manejo de la faringoamigdalitis aguda del adulto

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    Josep M. Cots

    2015-10-01

    Full Text Available La faringoamigdalitis aguda (FAA en el adulto es una de las enfermedades infecciosas más comunes en la consulta del médico de familia. La etiología más frecuente es viral. Dentro de la etiología bacteriana, el principal agente responsable es Streptococcus pyogenes o estreptococo β-hemolítico del grupo A (EBHGA, causante del 5-30% de los casos. En el manejo diagnóstico, las escalas de valoración clínica para predecir la posible etiología bacteriana, son una buena ayuda para seleccionar a qué pacientes se deben practicar las técnicas de detección rápida de antígeno estreptocócico. Es conocido que, en general, sin estas técnicas se tiende al sobrediagnóstico de FAA estreptocócica, con la consiguiente prescripción innecesaria de antibióticos, muchas veces de amplio espectro. Así, con el manejo de las escalas y la técnica de diagnóstico rápido, elaboramos los algoritmos de manejo de la FAA. Los objetivos del tratamiento son acelerar la resolución de los síntomas, reducir el tiempo de contagio y prevenir las complicaciones supurativas locales y no supurativas. Los antibióticos de elección para el tratamiento de la FAA estreptocócica son penicilina y amoxicilina. La asociación de amoxicilina y clavulánico no está indicada en el tratamiento inicial en la infección aguda. Los macrólidos tampoco son un tratamiento de primera elección; su uso debe reservarse para pacientes con alergia a la penicilina. Es importante en nuestro país adecuar tanto el diagnóstico de la FAA bacteriana y la prescripción de antibióticos a la evidencia científica disponible. La implantación de protocolos de actuación en las farmacias comunitarias puede ser de utilidad para identificar y cribar los casos que no requieran tratamiento antibiótico.

  14. When a misperception favors a tragedy: Carlos Chagas and the Nobel Prize of 1921.

    Science.gov (United States)

    Bestetti, Reinaldo B; Couto, Lucélio B; Cardinalli-Neto, Augusto

    2013-11-20

    Carlos Chagas, the discoverer of Chagas' disease was nominated to the Nobel Prize in 1921, but none did win the prize in that year. As a leader of a young scientist team, he discovered all aspects of the new disease from 1909 to 1920. It is still obscure why he did not win the Nobel Prize in 1921. Chagas was discarded by Gunnar Hedrèn on April 16, 1921. Hedrèn should have made a written report about the details of his evaluation to the Nobel Committee. However, such a document has not been found in the Nobel Committee Archives. No evidence of detractions made by Brazilian scientists on Chagas was found. Since Chagas nomination was consistent with the Nobel Committee requirements, as seen in the presentation letter by until now unknown Cypriano de Freitas, it become clear that Chagas did not win the Nobel Prize exclusively because the Nobel Committee did not perceive the importance of his discovery. Thus, it would be fair a posthumous Nobel Prize of 1921 to Carlos Chagas. A diploma of the Nobel Prize, as precedent with Dogmack in 1947, would recognize the merit of the scientist who made the most complete medical discovery of all times.

  15. Risks of endemicity, morbidity and perspectives regarding the control of Chagas disease in the Amazon Region.

    Science.gov (United States)

    Coura, José Rodrigues; Junqueira, Angela Cv

    2012-03-01

    Chagas disease, in the Amazon Region as elsewhere, can be considered an enzootic disease of wild animals or an anthropozoonosis, an accidental disease of humans that is acquired when humans penetrate a wild ecosystem or when wild triatomines invade human dwellings attracted by light or searching for human blood. The risk of endemic Chagas disease in the Amazon Region is associated with the following phenomena: (i) extensive deforestation associated with the displacement of wild mammals, which are the normal sources of blood for triatomines, (ii) adaptation of wild triatomines to human dwellings due to the need for a new source of blood for feeding and (iii) uncontrolled migration of human populations and domestic animals that are already infected with Trypanosoma cruzi from areas endemic for Chagas disease to the Amazon Region. Several outbreaks of severe acute cases of Chagas disease, as well as chronic cases, have been described in the Amazon Region. Control measures targeted to avoiding endemic Chagas disease in the Amazon Region should be the following: improving health education in communities, training public health officials and communities for vector and Chagas disease surveillance and training local physicians to recognise and treat acute and chronic cases of Chagas diseases as soon as possible.

  16. Melatonin in Chagas´ disease: Possible therapeutic value

    Directory of Open Access Journals (Sweden)

    Daniel P. Cardinali

    2011-10-01

    Full Text Available Chagas' disease is a severe health problem in Latin America, causing approximately 50 000 deaths a year, with approximately 18 million infected people. About 25-30% of the patients infected with Trypanosoma cruzi develop the chronic form of the disease. The protective response against T. cruzi depends on both innate and acquired immunity involving macrophages, natural killer cells, T and B lymphocytes, and the production of proinflammatory Th-1 cytokines. In addition, an increased nitric oxide (NO production in macrophages leading to effective microbicidal action is needed to control parasitemia. Melatonin is detectable in T. cruzi and may play a role in promoting infection whereas, when administered in high doses during the acute phase of T. cruzi infection, it can decrease parasitemia while reducing NO production. During chronic disease progression, the sustained oxidative stress concomitant to myocardial damage could be reduced by administering melatonin. It is hypothesized that the coordinated administration of a melatonin agonist like the MT1/MT2 agonist ramelteon, that lacks antioxidant activity and may not affect NO production during the acute phase, and of melatonin in doses high enough to decrease oxidative damage, to preserve mitochondrial and to prevent cardiomyopathy during the chronic phase, could be a novel add-on treatment of Chagas´ disease.

  17. Chagas Disease in Dogs from Endemic Areas of Costa Rica

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    Montenegro Victor M

    2002-01-01

    Full Text Available Dogs with the presumptive diagnosis of Chagas disease are commonly sent to our School of Veterinary Medicine by independent veterinarians. This prompted us to evaluate the prevalence of canine trypanosomiasis in some villages of the Central Valley of Costa Rica. A total of 54 dogs (21 males and 33 females from five rural villages, with ages between 3 months and 10 years old, were bled and submitted to three serological tests: indirect immunofluorescence, indirect hemagglutination and ELISA. Among all animals, 15 (27.7% revealed antibodies (6 pure bred and 9 mongrels and in 3 of them the parasite was also demonstrated by xenodiagnosis. All positive animals except 1, and 9 negative animals (control group were examined by X-rays and electrocardiography, revealing different degrees of cardiomegaly and ECG alteration, consistent with Chagas disease pathology in one dog (SA-11 of the infected ones. Examination of 50 inhabitants living in the houses where dogs and Triatoma dimidiata were found, yielded negative serological reactions. This was assumed to support the hypothesis that dogs are commonly infected by the oral route, a more effective means of infection compared with the vector transmission mechanism that occurs in humans.

  18. Clinical and nutritional profile of individuals with chagas disease

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    Juliana Geraix

    2007-08-01

    Full Text Available Chagas disease (CD, caused by the protozoan Trypanossoma cruzi, affects approximately 18 million individuals in the Americas, 5 million of which live in Brazil. Most chronic sufferers have either the indeterminate form of the disease, without organic compromise, or the cardiac or digestive forms. Despite the importance of this disease, there is no information on the effect of nutrition on CD evolution. We evaluated the clinical-nutritional profile of individuals with CD treated at the Tropical Diseases Nutrition Out-Patient Clinic of the Botucatu School of Medicine, UNESP. A retrospective cohort study was performed between 2002 and 2006, on 66 patients with serum and parasitological diagnosis of CD. Epidemiological, clinical, nutritional, and biochemical data were collected, including gender, age, skin color, smoking, alcoholism, physical activity, weight, stature, body mass index, abdominal circumference, glycemia, and lipid profile. Fifty-three percent were male and 47% female; 96% were white skinned. Mean age was 49.6±6.36 years. The predominant form was indeterminate in 71%; smoking and drinking were recorded in 23% and 17%, respectively. Sedentariness predominated in 83%, and 55% presented increased abdominal circumference. Most, 94%, were overweight or obese. The biochemical exams revealed hyperglycemia in 12% and dyslipidemia in 74%. These findings suggest that the Chagas population presents co-morbidities and risk factors for developing chronic non-transmissible diseases, including cardiovascular diseases, making CD evolution even worse.

  19. Clinical and nutritional profile of individuals with Chagas disease.

    Science.gov (United States)

    Geraix, Juliana; Ardisson, Lidiane Paula; Marcondes-Machado, Jussara; Pereira, Paulo Câmara Marques

    2007-08-01

    Chagas disease (CD), caused by the protozoan Trypanossoma cruzi, affects approximately 18 million individuals in the Americas, 5 million of which live in Brazil. Most chronic sufferers have either the indeterminate form of the disease, without organic compromise, or the cardiac or digestive forms. Despite the importance of this disease, there is no information on the effect of nutrition on CD evolution. We evaluated the clinical-nutritional profile of individuals with CD treated at the Tropical Diseases Nutrition Out-Patient Clinic of the Botucatu School of Medicine, UNESP. A retrospective cohort study was performed between 2002 and 2006, on 66 patients with serum and parasitological diagnosis of CD. Epidemiological, clinical, nutritional, and biochemical data were collected, including gender, age, skin color, smoking, alcoholism, physical activity, weight, stature, body mass index, abdominal circumference, glycemia, and lipid profile. Fifty-three percent were male and 47% female; 96% were white skinned. Mean age was 49.6 +/- 6.36 years. The predominant form was indeterminate in 71%; smoking and drinking were recorded in 23% and 17%, respectively. Sedentariness predominated in 83%, and 55% presented increased abdominal circumference. Most, 94%, were overweight or obese. The biochemical exams revealed hyperglycemia in 12% and dyslipidemia in 74%. These findings suggest that the Chagas population presents co-morbidities and risk factors for developing chronic non-transmissible diseases, including cardiovascular diseases, making CD evolution even worse.

  20. Research priorities for Chagas disease, human African trypanosomiasis and leishmaniasis.

    Science.gov (United States)

    2012-01-01

    This report provides a review and analysis of the research landscape for three diseases - Chagas disease, human African trypanosomiasis and leishmaniasis - that disproportionately afflict poor and remote populations with limited access to health services. It represents the work of the disease reference group on Chagas Disease, Human African Trypanosomiasis and Leishmaniasis (DRG3) which was established to identify key research priorities through review of research evidence and input from stakeholders' consultations. The diseases, which are caused by related protozoan parasites, are described in terms of their epidemiology and diseases burden, clinical forms and pathogenesis, HIV coinfection, diagnosis, drugs and drug resistance, vaccines, vector control, and health-care interventions. Priority areas for research are identified based on criteria such as public health relevance, benefit and impact on poor populations and equity, and feasibility. The priorities are found in the areas of diagnostics, drugs, vector control, asymptomatic infection, economic analysis of treatment and vector control methods, and in some specific issues such as surveillance methods or transmission-blocking vaccines for particular diseases. This report will be useful to researchers, policy and decision-makers, funding bodies, implementation organizations, and civil society. This is one of ten disease and thematic reference group reports that have come out of the TDR Think Tank, all of which have contributed to the development of the Global Report for Research on Infectious Diseases of Poverty, available at: www.who.int/tdr/stewardship/global_report/en/index.html.

  1. Current status and perspectives of cell therapy in Chagas disease

    Directory of Open Access Journals (Sweden)

    Milena Botelho Pereira Soares

    2009-07-01

    Full Text Available One century after its discovery, Chagas disease, caused by the protozoan, Trypanosoma cruzi, remains a major health problem in Latin America. Mortality and morbidity are mainly due to chronic processes that lead to dysfunction of the cardiac and digestive systems. About one third of the chronic chagasic individuals have or will develop the symptomatic forms of the disease, with cardiomyopathy being the most common chronic form. This is a progressively debilitating disease for which there are no currently available effective treatments other than heart transplantation. Like in other cardiac diseases, tissue engineering and cell therapy have been investigated in the past few years as a means of recovering the heart function lost as a consequence of chronic damage caused by the immune-mediated pathogenic mechanisms elicited in individuals with chronic chagasic cardiomyopathy. Here we review the studies of cell therapy in animal models and patients with chronic Chagas disease and the perspectives of the recovery of the heart function lost due to infection with T. cruzi.

  2. Specific circulating immune complexes in acute chagas' disease

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    Ricardo Corral

    1987-02-01

    Full Text Available The presence of circulating immune complexes formed by IgM and IgG (CIC-IgM and CIC-IgG was investigated, using antigen-specific enzyme-immunoassays (ELISA, in 30 patients with acute Chagas' disease who showed parasitemia and inoculation chagoma. Control population consisted of patients with chronic T. cruzi infection (30, acute toxoplasmosis 10, leishmaniasis (8, rheumatoid arthritis (3 and healthy individuals with negative serology for Chagas* disease (30. Acute chagasic patients were 100% CIC-IgG and 96.66% CIC-IgM positive whereas immunofluorescence tests yielded 90% and 86.66% of positivity for specific IgG and IgM antibodies, respectively. Chronic patients were 68% CIC-IgG and 0% CIC-IgM positive. The 30 negative and the 21 cross-reaction controls proved negative for ELISA (CIC-IgM and CIC-IgG. The high sensitivity of ELISA assays would allow early immunologic diagnosis, as well as prompt treatment, of acute T. cruzi infection, thus eliminating the problem of the false-positive and false-negative results which affects traditional methods for detection of circulating antibodies.

  3. Epidemiology of Chagas disease in Ecuador. A brief review

    Directory of Open Access Journals (Sweden)

    Aguilar V H Marcelo

    1999-01-01

    Full Text Available Chagas disease is a complex public health problem that has been underestimated in Ecuador. Here we review the relevant published information, and present unpublished and new data that help to understand the current Chagas disease epidemiological situation and its evolution in the country. Three main characteristics have been identified: (i persistence of Trypanosoma cruzi transmission in already known foci; (ii a marked endemicity in some urban areas of Guayaquil; and (iii the transformation of new Amazon foci into truly endemic areas. The situation in other suspect areas remains uncertain. Five Triatominae species have been implicated in the transmission of T. cruzi to people in Ecuador (Triatoma dimidiata, Rhodnius ecuadoriensis, R. pictipes, R. robustus and Panstrongylus geniculatus, but some others may also play a role in some areas (P. rufotuberculatus, P. howardi, T. carrioni and P. chinai. Other Triatominae reported seem to have little or no epidemiological relevance (T. venosa, T. dispar, Eratyrus mucronatus, E. cuspidatus, P. lignarius and Cavernicola pilosa. High frequency of acute cases and severe chronic disease has been observed. Although cardiomyopathy is more frequent, serious digestive disease is also present. It is estimated that around 120,000-200,000 people may be infected. 2.2 to 3.8 million people are estimated to live under transmission risk conditions.

  4. Squalene synthase as a target for Chagas disease therapeutics.

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    Na Shang

    2014-05-01

    Full Text Available Trypanosomatid parasites are the causative agents of many neglected tropical diseases and there is currently considerable interest in targeting endogenous sterol biosynthesis in these organisms as a route to the development of novel anti-infective drugs. Here, we report the first x-ray crystallographic structures of the enzyme squalene synthase (SQS from a trypanosomatid parasite, Trypanosoma cruzi, the causative agent of Chagas disease. We obtained five structures of T. cruzi SQS and eight structures of human SQS with four classes of inhibitors: the substrate-analog S-thiolo-farnesyl diphosphate, the quinuclidines E5700 and ER119884, several lipophilic bisphosphonates, and the thiocyanate WC-9, with the structures of the two very potent quinuclidines suggesting strategies for selective inhibitor development. We also show that the lipophilic bisphosphonates have low nM activity against T. cruzi and inhibit endogenous sterol biosynthesis and that E5700 acts synergistically with the azole drug, posaconazole. The determination of the structures of trypanosomatid and human SQS enzymes with a diverse set of inhibitors active in cells provides insights into SQS inhibition, of interest in the context of the development of drugs against Chagas disease.

  5. Squalene Synthase As a Target for Chagas Disease Therapeutics

    Science.gov (United States)

    Chan, Hsiu-Chien; Li, Jikun; Zheng, Yingying; Huang, Chun-Hsiang; Ren, Feifei; Chen, Chun-Chi; Zhu, Zhen; Galizzi, Melina; Li, Zhu-Hong; Rodrigues-Poveda, Carlos A.; Gonzalez-Pacanowska, Dolores; Veiga-Santos, Phercyles; de Carvalho, Tecia Maria Ulisses; de Souza, Wanderley; Urbina, Julio A.; Wang, Andrew H.-J.; Docampo, Roberto; Li, Kai; Liu, Yi-Liang; Oldfield, Eric; Guo, Rey-Ting

    2014-01-01

    Trypanosomatid parasites are the causative agents of many neglected tropical diseases and there is currently considerable interest in targeting endogenous sterol biosynthesis in these organisms as a route to the development of novel anti-infective drugs. Here, we report the first x-ray crystallographic structures of the enzyme squalene synthase (SQS) from a trypanosomatid parasite, Trypanosoma cruzi, the causative agent of Chagas disease. We obtained five structures of T. cruzi SQS and eight structures of human SQS with four classes of inhibitors: the substrate-analog S-thiolo-farnesyl diphosphate, the quinuclidines E5700 and ER119884, several lipophilic bisphosphonates, and the thiocyanate WC-9, with the structures of the two very potent quinuclidines suggesting strategies for selective inhibitor development. We also show that the lipophilic bisphosphonates have low nM activity against T. cruzi and inhibit endogenous sterol biosynthesis and that E5700 acts synergistically with the azole drug, posaconazole. The determination of the structures of trypanosomatid and human SQS enzymes with a diverse set of inhibitors active in cells provides insights into SQS inhibition, of interest in the context of the development of drugs against Chagas disease. PMID:24789335

  6. A multi-species bait for Chagas disease vectors.

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    Theo Mota

    2014-02-01

    Full Text Available BACKGROUND: Triatomine bugs are the insect vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. These insects are known to aggregate inside shelters during daylight hours and it has been demonstrated that within shelters, the aggregation is induced by volatiles emitted from bug feces. These signals promote inter-species aggregation among most species studied, but the chemical composition is unknown. METHODOLOGY/PRINCIPAL FINDINGS: In the present work, feces from larvae of the three species were obtained and volatile compounds were identified by solid phase microextraction-gas chromatography-mass spectrometry (SPME-GC-MS. We identified five compounds, all present in feces of all of the three species: Triatoma infestans, Panstrongylus megistus and Triatoma brasiliensis. These substances were tested for attractivity and ability to recruit insects into shelters. Behaviorally active doses of the five substances were obtained for all three triatomine species. The bugs were significantly attracted to shelters baited with blends of 160 ng or 1.6 µg of each substance. CONCLUSIONS/SIGNIFICANCE: Common compounds were found in the feces of vectors of Chagas disease that actively recruited insects into shelters, which suggests that this blend of compounds could be used for the development of baits for early detection of reinfestation with triatomine bugs.

  7. Urban transmission of Chagas disease in Cochabamba, Bolivia

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    N Medrano-Mercado

    2008-08-01

    Full Text Available Chagas disease is a major public health problem in Bolivia. In the city of Cochabamba, 58% of the population lives in peripheral urban districts ("popular zones" where the infection prevalence is extremely high. From 1995 to 1999, we studied the demographics of Chagas infections in children from five to 13 years old (n = 2218 from the South zone (SZ and North zone (NZ districts, which differ in social, environmental, and agricultural conditions. Information gathered from these districts demonstrates qualitative and quantitative evidence for the active transmission of Trypanosoma cruzi in urban Cochabamba. Seropositivity was high in both zones (25% in SZ and 19% in NZ. We observed a high risk of infection in children from five to nine years old in SZ, but in NZ, a higher risk occurred in children aged 10-13, with odds ratio for infection three times higher in NZ than in SZ. This difference was not due to triatomine density, since more than 1,000 Triatoma infestans were captured in both zones, but was possibly secondary to the vector infection rate (79% in SZ and 37% in NZ. Electrocardiogram abnormalities were found to be prevalent in children and pre-adolescents (SZ = 40%, NZ = 17%, indicating that under continuous exposure to infection and re-infection, a severe form of the disease may develop early in life. This work demonstrates that T. cruzi infection should also be considered an urban health problem and is not restricted to the rural areas and small villages of Bolivia.

  8. Pericarditis aguda: diagnóstico electrocardiográfico

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    Abraham enrique Katime Zúñiga

    2014-06-01

    Full Text Available La pericarditis es un proceso inflamatorio del pericardio, por lo general relacionado con procesos virales respiratorios o gastrointestinales; esta entidad es una de las principales causas de dolor torácico en el servicio de urgencias. El médico debe estar familiarizado con las manifestaciones clínicas y el flujograma diagnóstico. El diagnóstico de la pericarditis usualmente es clínico, los estudios paraclínicos evidencian inflamación sistémica (leucocitosis, aumento de la VSG y PCR. Las enzimas cardíacas (CPK MB – Troponinas se encuentran elevadas en casos de compromiso miocárdico asociado (Miopericarditis. El ecocardiograma revela derrame pericárdico, y el electrocardiograma se caracteriza por elevación difusa del segmento ST. En este artículo revisaremos los principales cambios electrocardiográficos relacionados a la pericarditis aguda y sus complicaciones. (Duazary 2009-II 159-164

  9. Meningoencefalite na fase aguda do sarampo : relato de seis casos

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    EL-FAR FABIANE

    2000-01-01

    Full Text Available Apresentamos 6 casos de meningoencefalite aguda por sarampo, diagnosticados durante epidemia na cidade de São Paulo, em 1997. Os prontuários dos 6 pacientes foram analisados retrospectivamente. O diagnóstico de meningoencefalite baseou-se nas alterações clínicas e liquóricas, e foi confirmado por sorologia específica. Dos 467 pacientes com sarampo atendidos no Instituto de Infectologia Emílio Ribas nesse período, estes 6 evoluíram com alterações neurológicas e liquóricas durante a fase exantemática, sendo a sonolência e rigidez de nuca os achados mais frequentes. Os pacientes tinham entre 2 meses e 28 anos de idade. O exame do líquor mostrou pleocitose em todos. Não houve correlação entre a severidade do quadro clínico e liquórico com a evolução. Em 4 casos foi necessária internação na unidade de terapia intensiva; destes, 2 foram intubados. Apenas 2 pacientes apresentaram alterações na tomografia computadorizada de crânio. Todos tiveram boa evolução, sem sequelas.

  10. Linfonodo pulmonar na paracoccidioidomicose aguda infantil (relato de um caso

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    Evanil Pires de Campos

    1992-09-01

    Full Text Available Observou-se a evolução de um linfonodo pulmonar na paracoccidioidomicose (PCM aguda infantil. Doente, masculino, 6 anos, branco, natural de Curitiba (PR, procedente de Guaratinguetá (SP, que há 3 meses desenvolveu quadro gripal, febre diária, bimodal, prolongada, precedida de calafrio, acompanhada de sudorese inodora, cefaléia frontal e anorexia. Diagnosticado e tratado como pneumonia por cinco dias, sem melhora do quadro. Há 2 meses, apresentou dor óssea nos braços e articulações do pé, com edema inflamatório e emagrecimento de 6 kg em 3 meses. Exame físico revelou: peso 20 kg; estatura 120 cm; P. A. 90/60 mmHg; facies atípica, hipoativo, palidez cutâneo-mucosa (+ +, hipotrofia muscular, adenopatiageneralizada, sopro sistólico suave em foco aórtico acessório e hepatesplenomegalia. Imunodifusão com exoantígeno glicoprotéico 43 kdpositiva (1/32. A biópsia de gânglio revelou Paracoccidioides brasiliensis. A radiologia demonstrou na primeira consulta, discreto infiltrado intersticial bilateral com linfoadenomegaliapara-hilar que desaparecu em 30 dias. Observou- se, ainda, massa tumoral mediastínica superior, hiperplasia do sistema fagocítico mononuclear e lesões osteolíticas nos 60 dias iniciais da evolução.

  11. Controle da transmissão transfusional da doença de Chagas na Iniciativa do Cone Sul Transfusional transmission control of Chagas' disease in the Southern Cone Iniciative

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    João Carlos Pinto Dias

    1998-08-01

    Full Text Available Integrando os objetivos principais da iniciativa dos 6 Países do Cone Sul para a eliminação da doença de Chagas, a partir de 1991, foram intensificadas as ações de controle das atividades hemoterápicas, em paralelo com o combate intensivo ao Triatoma infestans, principal vetor da doença da Região. Através das atividades específicas e também como produto direto do controle vetorial, nota-se importante diminuição dos riscos da transmissão transfusional do Trypanosoma cruzi nas áreas trabalhadas. Além de legislação específica sobre a qualidade da hemoterapia, implementaram-se laboratórios nacionais e regionais de referência, com a assistência da OPS, objetivando-se uma boa sorologia pré-transfusional dos doadores, cuja cobertura tem aumentado. Observa-se ainda uma progressiva diminuição na prevalência da infeção chagásica entre doadores e também um progressivo deslocamento dos doadores infetados para grupos etários mais elevados, como fruto do controle vetorial e do próprio descarte de doadores soro-positivos em doações anteriores. São analisados dados e tendências do problema pelos Países, sendo mais preocupante a situação da Bolívia, com maiores taxas de prevalência e menores de cobertura do programa, ali sendo indicadas ações de quimioprofilaxia, conforme os critérios da OMS. Antevê-se a médio prazo o controle da transmissão da doença de Chagas humana na maior parte da Região, desde que cumpridas corretamente as etapas do programa em andamento, devidamente consolidadas através de efetiva vigilância epidemiológica.The Southern Cone Initiative against Chagas' disease, was launched in 1991. The aim was to interrupt the transmission of Chagas disease by elimination of domestic populations of the major vector, Triatoma infestans, and by improved screening of blood donors. As a result of these activities, a marked reduction in the risk of transfusional transmission can now be seen throughout the

  12. Nefronía lobar aguda en un niño: reporte de caso

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    Angie Vanessa Vergara-Espitia

    2015-04-01

    Full Text Available La nefronía lobar aguda o nefritis aguda focal es una entidad poco frecuente en los niños. Se trata de una infección renal con presentación clínica variada e inusual. Su diagnóstico se realiza a través de la tomografía axial computarizada (TAC, que actualmente es considerada como la prueba más sensible y especifica. Una terapia antibiótica adecuada, según el germen aislado, es la clave de un tratamiento exitoso que evite la progresión a absceso renal. Se presenta el caso de un paciente pediátrico que cursó con fiebre de origen prolongado y fue diagnosticado con nefronía lobar aguda después de varios días de estudio intrahospitalario.

  13. Vasculite necrosante na glomerulonefrite difusa aguda pós-infecciosa

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    Riyuso Márcia C

    2004-01-01

    Full Text Available Os autores relatam dois casos de glomerulonefrite difusa aguda pós-infecciosa com evolução clinicomorfológica incomum. As biópsias renais mostraram alterações características de glomerulonefrite difusa aguda associada à extensa necrose fibrinóide e infiltrado inflamatório leucocitário na parede de arteríolas e artérias interlobulares. Foram também observadas crescentes. Ambos os pacientes cursaram com insuficiência renal aguda severa, sendo que um dos pacientes recuperou a função renal e outro evoluiu para insuficiência renal crônica e óbito.

  14. Piomiosite bacteriana aguda (PBA em crianças eutróficas

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    Mirtha B. Talavera

    2003-08-01

    Full Text Available A infecção aguda do músculo esquelético é denominada piomiosite bacteriana aguda (PBA. Ocorre mais freqüentemente em regiões tropicais e é mais prevalecente em crianças em idade escolar. A maioria dos casos relatados aconteceu em crianças desnutridas, com parasitoses. Relatamos quatro casos de PBA em crianças previamente eutróficas. A presença de dor muscular aguda localizada, com ou sem sintomas inflamatórios, ocorreu em todos os quatro casos. Osteomielite e/ou artrite séptica também ocorreram em todos os casos. O exame de escolha para o diagnóstico definitivo foi a ressonância nuclear magnética. A terapia foi realizada com antibioticoterapia endovenosa e drenagem cirúrgica dos abscessos.

  15. On palms, bugs, and Chagas disease in the Americas.

    Science.gov (United States)

    Abad-Franch, Fernando; Lima, Marli M; Sarquis, Otília; Gurgel-Gonçalves, Rodrigo; Sánchez-Martín, María; Calzada, José; Saldaña, Azael; Monteiro, Fernando A; Palomeque, Francisco S; Santos, Walter S; Angulo, Victor M; Esteban, Lyda; Dias, Fernando B S; Diotaiuti, Liléia; Bar, María Esther; Gottdenker, Nicole L

    2015-11-01

    Palms are ubiquitous across Neotropical landscapes, from pristine forests or savannahs to large cities. Although palms provide useful ecosystem services, they also offer suitable habitat for triatomines and for Trypanosoma cruzi mammalian hosts. Wild triatomines often invade houses by flying from nearby palms, potentially leading to new cases of human Chagas disease. Understanding and predicting triatomine-palm associations and palm infestation probabilities is important for enhancing Chagas disease prevention in areas where palm-associated vectors transmit T. cruzi. We present a comprehensive overview of palm infestation by triatomines in the Americas, combining a thorough reanalysis of our published and unpublished records with an in-depth review of the literature. We use site-occupancy modeling (SOM) to examine infestation in 3590 palms sampled with non-destructive methods, and standard statistics to describe and compare infestation in 2940 palms sampled by felling-and-dissection. Thirty-eight palm species (18 genera) have been reported to be infested by ∼39 triatomine species (10 genera) from the USA to Argentina. Overall infestation varied from 49.1-55.3% (SOM) to 62.6-66.1% (dissection), with important heterogeneities among sub-regions and particularly among palm species. Large palms with complex crowns (e.g., Attalea butyracea, Acrocomia aculeata) and some medium-crowned palms (e.g., Copernicia, Butia) are often infested; in slender, small-crowned palms (e.g., Euterpe) triatomines associate with vertebrate nests. Palm infestation tends to be higher in rural settings, but urban palms can also be infested. Most Rhodnius species are probably true palm specialists, whereas Psammolestes, Eratyrus, Cavernicola, Panstrongylus, Triatoma, Alberprosenia, and some Bolboderini seem to use palms opportunistically. Palms provide extensive habitat for enzootic T. cruzi cycles and a critical link between wild cycles and transmission to humans. Unless effective means to

  16. IL18 Gene Variants Influence the Susceptibility to Chagas Disease

    Science.gov (United States)

    Leon Rodriguez, Daniel A; Carmona, F. David; Echeverría, Luis Eduardo; González, Clara Isabel; Martin, Javier

    2016-01-01

    Chagas disease is a parasitic disorder caused by the infection with the flagellated protozoan Trypanosoma cruzi. According to the World Health Organization, more than six million people are currently infected in endemic regions. Genetic factors have been proposed to influence predisposition to infection and development of severe clinical phenotypes like chronic Chagas cardiomyopathy (CCC). Interleukin 18 (IL18) encodes a proinflammatory cytokine that has been proposed to be involved in controlling T. cruzi infection. In this study, we analyzed the possible role of six IL18 gene variants (rs5744258, rs360722, rs2043055, rs187238, rs1946518 and rs360719), which cover most of the variation within the locus, in the susceptibility to infection by T. cruzi and/or CCC. In total, 1,171 individuals from a Colombian region endemic for Chagas disease, classified as seronegative (n = 595), seropositive asymptomatic (n = 175) and CCC (n = 401), were genotyped using TaqMan probes. Significant associations with T. cruzi infection were observed when comparing seronegative and seropositive individuals for rs187238 (P = 2.18E-03, OR = 0.77), rs360719 (P = 1.49E-03, OR = 0.76), rs2043055 (P = 2.52E-03, OR = 1.29), and rs1946518 (P = 0.0162, OR = 1.22). However, dependence analyses suggested that the association was mainly driven by the polymorphism rs360719. This variant is located within the promoter region of the IL18 gene, and it has been described that it creates a binding site for the transcription factor OCT-1 affecting IL-18 expression levels. In addition, no evidence of association was observed between any of the analyzed IL18 gene polymorphisms and the development of CCC. In summary, our data suggest that genetic variation within the promoter region of IL18 is directly involved in the susceptibility to infection by T. cruzi, which provides novel insight into disease pathophysiology and adds new perspectives to achieve a more effective disease control. PMID:27027876

  17. Barriers to Testing and Treatment for Chagas Disease among Latino Immigrants in Georgia.

    Science.gov (United States)

    Minneman, Rebecca M; Hennink, Monique M; Nicholls, Andrea; Salek, Sahar S; Palomeque, Francisco S; Khawja, Amina; Albor, Lauren C; Pennock, Chester C; Leon, Juan S

    2012-01-01

    Background. The lack of testing and treatment of Chagas disease (CD), caused by Trypanosoma cruzi, amongst infected immigrants in the USA increases the risk of serious health complications and transmission (congenital or via blood transfusions). Goal. Our goal was to identify the barriers to testing and treatment of CD and understand the process of seeking healthcare amongst Latino immigrants in Georgia. Methods. In this qualitative study, eleven focus group discussions were conducted with 82 Latino immigrants, including migrant farm workers. Grounded theory was used to collect and analyze the data to develop an inductive conceptual framework to explain the context and process of seeking healthcare for CD amongst this at-risk population. Results. Participants were not aware of CD. Three healthcare seeking behaviors were identified: delaying treatment, using traditional remedies, and using either mainstream or alternative health providers. Behaviors and motivations differed by gender, and the use of licensed medical providers was considered a last resort due to the cost of healthcare, loss of earnings while seeking care, and fear of diagnosis with fatal illness. Discussion. Providing free or low cost services, mobile clinics, and education regarding CD is critical to increase testing and treatment of CD in the US.

  18. Barriers to Testing and Treatment for Chagas Disease among Latino Immigrants in Georgia

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    Rebecca M. Minneman

    2012-01-01

    Full Text Available Background. The lack of testing and treatment of Chagas disease (CD, caused by Trypanosoma cruzi, amongst infected immigrants in the USA increases the risk of serious health complications and transmission (congenital or via blood transfusions. Goal. Our goal was to identify the barriers to testing and treatment of CD and understand the process of seeking healthcare amongst Latino immigrants in Georgia. Methods. In this qualitative study, eleven focus group discussions were conducted with 82 Latino immigrants, including migrant farm workers. Grounded theory was used to collect and analyze the data to develop an inductive conceptual framework to explain the context and process of seeking healthcare for CD amongst this at-risk population. Results. Participants were not aware of CD. Three healthcare seeking behaviors were identified: delaying treatment, using traditional remedies, and using either mainstream or alternative health providers. Behaviors and motivations differed by gender, and the use of licensed medical providers was considered a last resort due to the cost of healthcare, loss of earnings while seeking care, and fear of diagnosis with fatal illness. Discussion. Providing free or low cost services, mobile clinics, and education regarding CD is critical to increase testing and treatment of CD in the US.

  19. Nutrición en pancreatitis aguda Nutrition acute pancreatitis

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    F. J. García-Alonso

    2012-04-01

    Full Text Available La pancreatitis aguda es una patología frecuente y potencialmente grave en la que el manejo nutricional influye de manera importante en su desarrollo, de tal forma que se puede considerar un tratamiento específico en los casos graves. Éstos suponen aproximadamente el 20% de los pacientes y presentan una mortalidad entre el 8-39%. En los casos leves se suele proceder a un ingreso en dieta absoluta y posterior reintroducción progresiva de la dieta. Aunque se ha demostrado que una reintroducción temprana acorta la duración del ingreso, existe incertidumbre acerca del momento y del tipo de dieta idóneos. Las pancreatitis graves son estados hipercatabólicos que se presentan en pacientes que frecuentemente presentan déficits nutricionales basales. El soporte nutricional iniciado precozmente por vía enteral ha demostrado un beneficio significativo respecto a la vía parenteral en cuanto a tasa de infección, control de glucemia y mortalidad. Este beneficio puede relacionarse con una disminución de la traslocación bacteriana. Si bien tradicionalmente se ha empleado la vía nasoyeyunal, existen estudios que apoyan la vía nasogástrica, mucho más accesible. En el siguiente texto ofrecemos una revisión actualizada del manejo nutricional en la pancreatitis aguda, intentando responder de manera clara y con un enfoque práctico a las preguntas que más frecuentemente se presentan en el manejo de esta patología.Acute pancreatitis is a common and potentially severe disease where nutritional support does affect its development in a way it may be considered a treatment in severe cases. These include around 20% of patients and present mortality rates of 8%-39%. In mild acute pancreatitis patients are prescribed nil per os at admission and advance diet in a progressive manner the following days. Although early introduction of diet has proven to shorten the length of stay, it is still not clear when and how to introduce diet. Severe disease is a

  20. Quinoxaline 1,4-di-N-oxide Derivatives: Interest in the Treatment of Chagas Disease [ Derivados 1,4- i-N-óxido Quinoxalinas: O Interesse no Tratamento da Doença de Chagas

    OpenAIRE

    Elsa Moreno - Viguri; Silvia Pérez-Silanes

    2013-01-01

    More than 100 million people are at risk of contracting Chagas disease. It is estimated that in 2008, Chagas disease was responsible for the death of more than 10,000 people. Despite the fact that there are more than 100 years since the disease was discove red, safe and effective treatments still have to be found. Therefore, new drugs active against Chagas disease are urgently required. Quinoxaline derivatives show very interesting biological properties (anti-infective, cytotoxic, anticandida...

  1. Metallothionein-1 and nitric oxide expression are inversely correlated in a murine model of Chagas disease

    OpenAIRE

    2014-01-01

    Chagas disease, caused by Trypanosoma cruzi, represents an endemic among Latin America countries. The participation of free radicals, especially nitric oxide (NO), has been demonstrated in the pathophysiology of seropositive individuals with T. cruzi. In Chagas disease, increased NO contributes to the development of cardiomyopathy and megacolon. Metallothioneins (MTs) are efficient free radicals scavengers of NO in vitro and in vivo. Here, we developed a murine model of the chronic phase of C...

  2. Evaluation of a Recombinant Trypanosoma cruzi Mucin-Like Antigen for Serodiagnosis of Chagas' Disease ▿

    OpenAIRE

    2011-01-01

    Chagas' disease is caused by the protozoan parasite Trypanosoma cruzi and is one of the most important endemic problems in Latin America. Lately, it has also become a health concern in the United States and Europe. Currently, a diagnosis of Chagas' disease and the screening of blood supplies for antiparasite antibodies are achieved by conventional serological tests that show substantial variation in the reproducibility and reliability of their results. In addition, the specificity of these as...

  3. Accelerating the development of a therapeutic vaccine for human Chagas disease: rationale and prospects

    OpenAIRE

    2012-01-01

    Chagas disease is a leading cause of heart disease affecting approximately 10 million people in Latin America and elsewhere worldwide. The two major drugs available for the treatment of Chagas disease have limited efficacy in Trypanosoma cruzi-infected adults with indeterminate (patients who have seroconverted but do not yet show signs or symptoms) and determinate (patients who have both seroconverted and have clinical disease) status; they require prolonged treatment courses and are poorly t...

  4. Aortic distensibility measured by pulse-wave velocity is not modified in patients with Chagas' disease

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    Arteaga Edmundo

    2006-06-01

    Full Text Available Abstract Background Experimental studies demonstrate that infection with trypanosoma cruzi causes vasculitis. The inflammatory lesion process could hypothetically lead to decreased distensibility of large and small arteries in advanced Chagas' disease. We tested this hypothesis. Methods and results We evaluated carotid-femoral pulse-wave velocity (PWV in 53 Chagas' disease patients compared with 31 healthy volunteers (control group. The 53 patients were classified into 3 groups: 1 16 with indeterminate form of Chagas' disease; 2 18 with Chagas' disease, electrocardiographic abnormalities, and normal systolic function; 3 19 with Chagas' disease, systolic dysfunction, and mild-to-moderate congestive heart failure. No difference was noted between the 4 groups regarding carotid-femoral PWV (8.4 ± 1.1 vs 8.2 ± 1.5 vs 8.2 ± 1.4 vs 8.7 ± 1.6 m/s, P = 0.6 or pulse pressure (39.5 ± 7.6 vs 39.3 ± 8.1 vs 39.5 ± 7.4 vs 39.7 ± 6.9 mm Hg, P = 0.9. A positive, significant, similar correlation occurred between PWV and age in patients with Chagas' disease (r = 0.42, P = 0.002, in controls (r = 0.48, P = 0.006, and also between PWV and systolic blood pressure in both groups (patients with Chagas' disease, r = 0.38, P = 0.005; healthy subjects, r = 0.36, P = 0.043. Conclusion Carotid femoral pulse-wave velocity is not modified in patients with Chagas' disease, suggesting that elastic properties of large arteries are not affected in this disorder.

  5. Intoxicación aguda por hidrato de hidracina

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    Santiago Nogué Xarau

    2008-06-01

    Full Text Available Se aporta un caso de exposición aguda, debido a un vertido accidental de unos 25 litros de hidrato de hidracina, que el trabajador estuvo recogiendo sin ningún tipo de equipo de protección individual. El trabajador presentó alteraciones bucales, cutáneas y dolores abdominales difusos. De las pruebas complementarias únicamente se detectó un aumento de la bilirrubina total con predominio de la indirecta. Se le separó de la exposición, se le administró un tratamiento sintomático y en un periodo de un mes se recuperó íntegramente. Se comenta los principales casos de intoxicación por hidracina descritos en la literatura médica y se enfatiza en las medidas preventivas que se deben tomar para evitar casos como éste.We report a case of poisoning by acute exposure to hydrazine hydrate in a worker clearing up an accidental spillage of about 25 litres of the product who had no type of individual protective equipment. The patient presented buccal and cutaneous involvement and diffuse abdominal pain. Complementary tests were unremarkable except for an increase in total bilirubin with a predominance of indirect bilirubin. The patient was removed from the occupational exposure, symptomatic treatment was administered and the patient recovered completely after one month. We review the main reported cases of hydrazine poisoning and emphasize the preventive measures that should be taken to avoid this type of poisoning.

  6. Plasmaférese como modalidade terapêutica na pancreatite aguda por hipertrigliceridemia

    OpenAIRE

    Felipe Soares Castelliano Lucena de Castro; Ana Maria Reis Nascimento; Igor Amorim Coutinho; Fernanda Ribeiro de Fernandez Y Alcazar; Jorge Mugayar Filho

    2012-01-01

    Pancreatite aguda é uma condição inflamatória manifestada clinicamente por dor abdominal e níveis séricos elevados das enzimas pancreáticas. A hipertrigliceridemia é sua terceira causa mais comum. O presente relato teve por objetivo descrever um caso de pancreatite aguda por hipertrigliceridemia, cuja modalidade terapêutica utilizada foi a plasmaférese. Paciente, gênero feminino, 48 anos, apresentou-se ao hospital com queixa de "dor muito forte na barriga". Relatou início do quadro com náusea...

  7. PANCREATITIS AGUDA EN EL EMBARAZO: A PROPÓSITO DE UN CASO CLÍNICO

    OpenAIRE

    Sanhueza R,Pablo; Yaksic B,Nicole; Chahuán I,Karina; Corvalán A,Jaime

    2004-01-01

    Se describe el caso clínico de un embarazo complicado con pancreatitis aguda, destacándose la importancia del diagnóstico correcto y las opciones terapéuticas en pacientes embarazadas. Paciente primigesta de 35 semanas con sospecha clínica de pancreatitis aguda y confirmación mediante amilasemia de 2.236 U/L y lipasemia de 1.930 U/L, es tratada en forma conservadora. Al cuarto día de hospitalización se realiza operación cesárea por sufrimiento fetal. Evoluciona en buenas condiciones y es dada...

  8. Plan de cuidados en una paciente con insuficiencia renal aguda. Caso Clínico

    OpenAIRE

    Delgado-Hito, Pilar; Romero García, Marta

    1999-01-01

    La Insuficiencia Renal Aguda puede definirse como una reducción o cese brusco de la función renal. Debido a la importancia del riñón en el mantenimiento del medio extracelular, la disminución aguda de la función renal afectará muchos, en realidad, la mayoría de los sistemas orgánicos. Los síntomas de presentación, curso clínico y complicaciones son manifestaciones de estos...

  9. Intoxicaciones agudas en pacientes mayores de 65 años

    OpenAIRE

    P. Miranda Arto; A. Ferrer Dufol; Ruiz Ruiz, F. J.; S. Menao Guillén; E. Civeira Murillo

    2014-01-01

    Fundamento. Los estudios sobre la intoxicación aguda en sujetos de edad avanzada en nuestro país son escasos, a pesar de los riesgos asociados que presenta este grupo de pacientes. Material y métodos. Estudio descriptivo retrospectivo de las intoxicaciones agudas atendidas en el servicio de Urgencias del Hospital Clínico Universitario de Zaragoza entre 1995 y 2009, en pacientes con edad igual o mayor a 65 años. Resultados. Se registraron 762 casos, el 4,74% del total de intoxicados, con una e...

  10. Efectividad de la magnetoterapia como tratamiento en pacientes con lumbalgia aguda

    OpenAIRE

    Raidel González Rodríguez; Juan Cardentey García

    2015-01-01

    Son numerosos los pacientes aquejados de algias vertebrales, tanto lumbares como dorsales y cervicales. Se realizó esta investigación con el objetivo de determinar la efectividad de la magnetoterapia como tratamiento en la lumbalgia aguda, en pacientes atendidos en el policlínico universitario “Raúl Sánchez” de la provincia de Pinar del Río, Cuba. Se realizó un estudio descriptivo, prospectivo, de corte transversal en pacientes con lumbalgia aguda, pertenecientes a dicha área de salud. La mue...

  11. Manifestacoes orais decorrentes da quimioterapia em criancas portadoras de leucemia linfocitica aguda

    OpenAIRE

    Everton Freitas de Morais; Jadson Alexandre da Silva Lira; Romulo Augusto de Paiva Macedo; Klaus Steyllon dos Santos; Cassandra Teixeira Valle Elias; Maria de Lourdes Silva de Arruda Morais

    2014-01-01

    Introdução: A leucemia linfocítica aguda é um dos tipos de câncer mais comuns em crianças e é caracterizada pela produção excessiva e desordenada de leucócitos imaturos na medula óssea. Objetivo: Identificar as manifestações orais mais frequentes em crianças portadoras de leucemia linfocítica aguda sob o tratamento quimioterápico. Metodologia: A pesquisa foi realizada nas bases de dados eletrônicas PubMed/Medline, Science Direct, Scielo e Scopus. Procurou-se por artigos apresentados ...

  12. Usefulness of serology for the evaluation of Trypanosoma cruzi transmission in endemic areas of Chagas' disease

    Directory of Open Access Journals (Sweden)

    Roberto Chuit

    1989-09-01

    Full Text Available Thirteen communities from 7 Argentinian provinces were selected for the evaluation of serology as an indicator of transmission of Chagas disease. Of the communities appraised, 6 did not have a history of previous treatment with insecticides and 7 had received sporadic or continuous insecticide treatment. The inhabitants of 20% of the houses of each locality were studied by serology. The samples were obtained byfinger pricking and 50 fil of blood were mixed with 150μl of 50% glycerine solution in tissue culture media to be assayed by Indirect Hemagglutination and Indirect Immunofluorescence tests. In untreated areas, the prevalence of infection in infants 0-4 years old was 17.5%, reaching to over 22% for the 5-9 year old group, and to 33.3% in 10-14 year old individuals. The prevalence in treated and surveyed areas was 2.6% in 0-4 year old children, 5.4% in 5-9 year old and 6,2% in 10-14 year old youngsters. The differences between both areas were statistically significant (p Treze comunidades de 7 províncias argentinas foram escolhidas para avaliação de sorologia como indicador da transmissão da Doença de Chagas. Das comunidades mencionadas, seis não tinham história prévia de tratamento com inseticidas e sete tinham recebido tratamento esporádico ou continuado. Vinte por cento dos moradores das casas de cada localidade foram estudados por sorologia. As amostras foram obtidas por punção da ponta do dedo e 50 microlitros de sangue foram misturadas com 150 microlitros de uma solução conservadora de glicerina a 50% em meio de cultivo, para serem estudados por hemaglutinação indireta, e imunofluorescência indireta. Nas áreas não tratadas a prevalência da infecção em crianças de 0-4 anos foi de 17,5% chegando a mais de 22% para as de 5-9 anos e a 33,3% no grupo 10-14 anos. A prevalência nas áreas tratadas e sob vigilância foi de 2.6% em crianças de 0-4 anos, 5,4% anos de 5-9 anos e de 6,2% em jovens de 10-14 sendo as diferen

  13. Pancreatite aguda grave: resultados do tratamento cirúrgico em 68 pacientes Severe acute pancreatitis: results of surgical treatment in 68 patients

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    Olívio Louro Costa

    2004-04-01

    Full Text Available OBJETIVO: Analisar os resultados do tratamento cirúrgico das formas necrosantes, ou graves, da pancreatite aguda e da forma crônica agudizada. MÉTODO: Foi preenchido um protocolo, de modo consecutivo e prospectivo, de 68 pacientes operados por pancreatite aguda grave e crônica agudizada, no período de 1982 a 2000. Os pacientes foram classificados em três categorias: 1. Pancreatite aguda biliar; 2. Pancreatite aguda de causa indeterminada; 3. Pancreatite crônica agudizada. RESULTADOS: As indicações para o tratamento cirúrgico foram: diagnóstico incerto (32,3%; necrose infectada (60,3% e para necrosectomia (7,4%. As operações realizadas foram: desbridamento de necrose infectada(70,6%; operações sobre as vias biliares (20,6% e desbridamento de grandes necroses (7,4%. Os óbitos hospitalares incidentes, por categoria foram: 1. Pancreatite aguda biliar (33,3%; 2. Pancreatite aguda indeterminada (45,0%; 3. Pancreatite crônica agudizada (37,0%. A média de óbitos foi de 38,2%. Vinte e cinco pacientes foram reoperados, uma ou várias vezes, e nestes a mortalidade foi de 40,0%. Os abscessos foram responsáveis por 52,0% dos óbitos e as outras complicações que resultaram em óbitos, sempre evoluiram para infecção. CONCLUSÕES: Ocorreu um alto índice de operações por diagnóstico incerto. Esta indicação deve se restringir aos casos onde não seja possível o diagnóstico diferencial com certas causas de abdome agudo. As indicações para tratar precocemente a litíase biliar devem ser evitadas ou reduzidas a situações específicas. As reoperações são freqüentemente indicadas nesses pacientes e a infecção foi a principal causa de morte.BACKGROUND: To evaluate the results of surgical treatment of acute necrotizing pancreatitis, as well as its necrotizing alcoholic form. METHODS: Patients were analyzed according to a prospective protocol. Surgery was performed on 68 patients due to necrotizing acute pancreatitis and acutized

  14. Low prevalence of Chagas parasite infection in a nonhuman primate colony in Louisiana.

    Science.gov (United States)

    Dorn, Patricia L; Daigle, Megan E; Combe, Crescent L; Tate, Ashley H; Stevens, Lori; Phillippi-Falkenstein, Kathrine M

    2012-07-01

    Chagas disease, an important cause of heart disease in Latin America, is caused by the parasite Trypanosoma cruzi, which typically is transmitted to humans by triatomine insects. Although autochthonous transmission of the Chagas parasite to humans is rare in the United States, triatomines are common, and more than 20 species of mammals are infected with the Chagas parasite in the southern United States. Chagas disease has also been detected in colonies of nonhuman primates (NHP) in Georgia and Texas, and heart abnormalities consistent with Chagas disease have occurred at our NHP center in Louisiana. To determine the level of T. cruzi infection, we serologically tested 2157 of the approximately 4200 NHP at the center; 34 of 2157 primates (1.6%) tested positive. Presence of the T. cruzi parasite was confirmed by hemoculture in 4 NHP and PCR of the cultured parasites. These results strongly suggest local transmission of T. cruzi, because most of the infected NHP were born and raised at this site. All 3 species of NHP tested yielded infected animals, with significantly higher infection prevalence in pig-tailed macaques, suggesting possible exploration of this species as a model organism. The local T. cruzi strain isolated during this study would enhance such investigations. The NHP at this center are bred for use in scientific research, and the effects of the Chagas parasite on infected primates could confuse the interpretation of other studies.

  15. Urban Chagas disease in children and women in primary care centres in Buenos Aires, Argentina

    Science.gov (United States)

    Moscatelli, Guillermo; Berenstein, Ada; Tarlovsky, Ana; Siniawski, Susana; Biancardi, Miguel; Ballering, Griselda; Moroni, Samanta; Schwarcz, Marta; Hernández, Susana; García-Bournissen, Facundo; Cozzi, Andrés Espejo; Freilij, Héctor; Altcheh, Jaime

    2015-01-01

    The primary objective of this study was to estimate the prevalence of this disease in women of childbearing age and children treated at health centres in underserviced areas of the city of Buenos Aires. Demographic and Chagas disease status data were collected. Samples for Chagas disease serology were obtained on filter paper and the reactive results were confirmed with conventional samples. A total of 1,786 subjects were screened and 73 positive screening results were obtained: 17 were from children and 56 were from women. The Trypanosoma cruzi infection risk was greater in those individuals who had relatives with Chagas disease, who remember seeing kissing bugs, who were of Bolivian nationality or were born in the Argentine province of Santiago del Estero. The overall prevalence of Chagas disease was 4.08%. Due to migration, Chagas disease is currently predominantly urban. The observed prevalence requires health programme activities that are aimed at urban children and their mothers. Most children were infected congenitally, which reinforces the need for Chagas disease screening of all pregnant women and their babies in Argentina. The active search for new cases is important because the appropriate treatment in children has a high cure rate. PMID:26222020

  16. Urban Chagas disease in children and women in primary care centres in Buenos Aires, Argentina

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    Guillermo Moscatelli

    2015-08-01

    Full Text Available The primary objective of this study was to estimate the prevalence of this disease in women of childbearing age and children treated at health centres in underserviced areas of the city of Buenos Aires. Demographic and Chagas disease status data were collected. Samples for Chagas disease serology were obtained on filter paper and the reactive results were confirmed with conventional samples. A total of 1,786 subjects were screened and 73 positive screening results were obtained: 17 were from children and 56 were from women. The Trypanosoma cruziinfection risk was greater in those individuals who had relatives with Chagas disease, who remember seeing kissing bugs, who were of Bolivian nationality or were born in the Argentine province of Santiago del Estero. The overall prevalence of Chagas disease was 4.08%. Due to migration, Chagas disease is currently predominantly urban. The observed prevalence requires health programme activities that are aimed at urban children and their mothers. Most children were infected congenitally, which reinforces the need for Chagas disease screening of all pregnant women and their babies in Argentina. The active search for new cases is important because the appropriate treatment in children has a high cure rate.

  17. Chagas Disease: Increased Parasitemia during Pregnancy Detected by Hemoculture

    Science.gov (United States)

    da Rocha Siriano, Liliane; Luquetti, Alejandro Ostermayer; Avelar, Juliana Boaventura; Marra, Neusa Leal; de Castro, Ana Maria

    2011-01-01

    One hundred fifty-two Trypanosoma cruzi seropositive women were submitted to a single hemoculture; 101 were pregnant, and 51 were not pregnant. Seven tubes from each individual were harvested with liver infusion tryptose (LIT) medium and observed monthly until the fifth month. Hemocultures were positive in 50% (76 of 152) of the women. Results showed that the positivity was 29.4% (15 of 51) among non-pregnant women and 60.4% (61 of 101) in pregnant women (P < 0.05). In relation to gestational age, there were significant differences in positivity, with a higher proportion of women with positive hemocultures (20 of 25) before 21 weeks and lower after 30 weeks (10 of 21; P = 0.02). We conclude that pregnancy enhances the parasitemia in Chagas disease, with a higher effect early in pregnancy. PMID:21460012

  18. Agrochemicals against malaria, sleeping sickness, leishmaniasis and Chagas disease.

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    Matthias Witschel

    Full Text Available In tropical regions, protozoan parasites can cause severe diseases with malaria, leishmaniasis, sleeping sickness, and Chagas disease standing in the forefront. Many of the drugs currently being used to treat these diseases have been developed more than 50 years ago and can cause severe adverse effects. Above all, resistance to existing drugs is widespread and has become a serious problem threatening the success of control measures. In order to identify new antiprotozoal agents, more than 600 commercial agrochemicals have been tested on the pathogens causing the above mentioned diseases. For all of the pathogens, compounds were identified with similar or even higher activities than the currently used drugs in applied in vitro assays. Furthermore, in vivo activity was observed for the fungicide/oomyceticide azoxystrobin, and the insecticide hydramethylnon in the Plasmodium berghei mouse model, and for the oomyceticide zoxamide in the Trypanosoma brucei rhodesiense STIB900 mouse model, respectively.

  19. Cost-effectiveness analysis in Chagas' disease vectors control interventions

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    A. M. Oliveira Filho

    1989-01-01

    Full Text Available After a large scale field trial performed in central Brazil envisaging the control of Chagas' disease vectors in an endemic area colonized by Triatoma infestans and T. sordida the cost-effectiveness analysis for each insecticide/formulation was performed. It considered the operational costs and the prices of insecticides and formulations, related to the activity and persistence of each one. The end point was considered to be less than 90% of domicilliary unitis (house + annexes free of infestation. The results showed good cost-effectiveness for a slow-release emulsifiable suspension (SRES based on PVA and containing malathion as active ingredient, as well as for the pyrethroids tested in this assay-cyfluthrin, cypermethrin, deltamethrin and permethrin.

  20. Enfermedad de Chagas-Mazza congenita en Salta

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    Contreras Silvia

    1999-01-01

    Full Text Available Se estudió la infección por T. cruzi en mujeres embarazadas en la localidad de General Güemes, provincia de Salta. La misma fue del 12,3 %. El 8,8% de los recién nacidos estudiados tuvieron diagnóstico de Enfermedad de Chagas utilizando la técnica directa (microhematocrito. Todos fueron tratados con benznidazol a razón de 5mg/kg/día durante 30 dias. Todos presentaron anemia, que fue interpretada como reacción adversa medicamentosa. Se estima que la técnica directa representa la mejor opción para llevar a cabo el diagnóstico de esta enfermedad en el recién nacido. Se ha propuesto un flujograma para el seguimiento de la infección por T. cruzi en el recién nacido.

  1. Membranous nephropathy PLA2R+ associated with Chagas disease.

    Science.gov (United States)

    Xavier-Júnior, José Cândido Caldeira; Silva, Vanessa Dos Santos; Viero, Rosa Marlene

    2015-01-01

    Chagas disease (CD) - a tropical parasitic disease caused by the protozoan Trypanosoma cruzi - is a major health problem in Latin America. The immune response against the parasite is responsible for chronic CD lesions. Currently, there are no reports of an association between CD and membranous nephropathy (MN). The detection of the phospholipase A2 receptor (PLA2R) as a target antigen in idiopathic MN can improve the differential diagnosis of primary and secondary forms of MN. The authors report the case of a male patient with positive serology for CD who presented sudden death and underwent autopsy. Histological sections of the heart showed multifocal inflammatory infiltrate composed mainly of mononuclear cells, leading to myocardiocytes necrosis and interstitial fibrosis. The kidneys showed a MN with positive expression for PLA2R. As far as we know, this is the first report of a case of primary MN in a patient with CD, with severe chronic cardiomyopathy and heart failure.

  2. Clinical forms of Trypanosoma cruzi infected individuals in the chronic phase of Chagas disease in Puebla, Mexico

    OpenAIRE

    2006-01-01

    In Mexico, despite the relatively high seroprevalence of Trypanosoma cruzi infection in humans in some areas, reported morbidity of Chagas disease is not clear. We determined clinical stage in 71 individuals seropositive to T. cruzi in the state of Puebla, Mexico, an area endemic for Chagas disease with a reported seroprevalence of 7.7%. Diagnosis of Chagas disease was made by two standardized serological tests (ELISA, IHA). Individuals were stratified according to clinical studies. All patie...

  3. Chagas disease: current epidemiological trends after the interruption of vectorial and transfusional transmission in the Southern Cone countries

    OpenAIRE

    Moncayo Alvaro

    2003-01-01

    Chagas disease, named after Carlos Chagas who first described it in 1909, exists only on the American Continent. It is caused by a parasite, Trypanosoma cruzi, transmitted to humans by blood-sucking triatomine bugs and by blood transfusion. Chagas disease has two successive phases, acute and chronic. The acute phase lasts 6 to 8 weeks. After several years of starting the chronic phase, 20% to 35% of the infected individuals, depending on the geographical area will develop irreversible lesions...

  4. Tratamento da Doença de Chagas pelo Nifurtimox (Bayer 2502

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    Aluizio Prata

    1975-12-01

    Full Text Available Foram tratados 77 pacientes com doença de Chagas pelo nifurtimox, subdivididos em quatro grupos. Grupo I, com 30 pacientes na fase aguda. Somente oito doentes usaram a droga durante 120 dias, na dose inicial de 15 mg/kg de peso corporal e posteriormente de 10 mg. Vinte e dois pacientes tomaram dose insuficiente. Em quatro doentes (50% o xenodiagnóstico tornou-se negativo pós-tratamento; destes, três fizeram reação de Machado Guerreiro, a qual estava negativa. Houve um óbito por insuficiência cardíaca no 59 dia de tratamento. Seis pacientes apresentaram polineuropatia periférica. Grupo II, com 15 pacientes na fase crônica, tratados em ambulatório. Oito abandonaram o tratamento, mas cinco em dez que tomaram placebo fizeram o mesmo. Dos seis que tomaram a droga durante 120 dias e fizeram pelo menos um xenodiagnóstico pós-tratamento, havia quatro que estavam com os exames negativos. O tratamento não alterou o eletrocardiograma, a área cardíaca ou a radiografia do esôfago dos doentes e não evitou que um paciente viesse a desenvolver insuficiência cardíaca e um outro arritmia. Grupo III, com 15 pacientes na fase crônica, tratados com 10 mg/kg, durante 120 dias. Fizeram 12 xenodiagnósticos mensalmente, cada um com oito caixas contendo 10 T. infestans após o tratamento e somente 28,5% dos pacientes apresentaram todos os exames negativos. Houve acentuada redução da parasitemia, mesmo nos doentes não curados. O número de xenos positivos passou de 43% antes do tratamento para 24,4% após o mesmo e o número de caixas positivas caiu de 29,6% para 7%. Grupo IV, com 17 pacientes na fase crônica, tratados com 8 mg/kg ao dia, sendo que em oito durante 120 dias, em cinco durante 100 dias e em quatro durante 60 dias. A percentagem de doentes com os 12 xenos negativos pós-tratamento foi de 56,25. Também neste grupo houve redução de parasitemia, caindo a percentagem de xenos positivos de 76,5 antes do tratamento para 10,3 e a de

  5. Epicuticular lipids induce aggregation in Chagas disease vectors

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    Juárez M Patricia

    2009-01-01

    Full Text Available Abstract Background The triatomine bugs are vectors of the protozoan parasite Trypanosoma cruzi, the causative agent of Chagas disease. Aggregation behavior plays an important role in their survival by facilitating the location of refuges and cohesion of aggregates, helping to keep them safely assembled into shelters during daylight time, when they are vulnerable to predators. There are evidences that aggregation is mediated by thigmotaxis, by volatile cues from their faeces, and by hexane-extractable contact chemoreceptive signals from their cuticle surface. The epicuticular lipids of Triatoma infestans include a complex mixture of hydrocarbons, free and esterified fatty acids, alcohols, and sterols. Results We analyzed the response of T. infestans fifth instar nymphs after exposure to different amounts either of total epicuticular lipid extracts or individual lipid fractions. Assays were performed in a circular arena, employing a binary choice test with filter papers acting as aggregation attractive sites; papers were either impregnated with a hexane-extract of the total lipids, or lipid fraction; or with the solvent. Insects were significantly aggregated around papers impregnated with the epicuticular lipid extracts. Among the lipid fractions separately tested, only the free fatty acid fraction promoted significant bug aggregation. We also investigated the response to different amounts of selected fatty acid components of this fraction; receptiveness varied with the fatty acid chain length. No response was elicited by hexadecanoic acid (C16:0, the major fatty acid component. Octadecanoic acid (C18:0 showed a significant assembling effect in the concentration range tested (0.1 to 2 insect equivalents. The very long chain hexacosanoic acid (C26:0 was significantly attractant at low doses (≤ 1 equivalent, although a repellent effect was observed at higher doses. Conclusion The detection of contact aggregation pheromones has practical

  6. AUMENTO DA EXPRESSÃO DE ?-CATENINA E CADERINA NO CORAÇÃO DE CAMUNDONGOS NA FASE AGUDA E CRÔNICA DA INFECÇÃO EXPERIMENTAL POR Trypanosoma cruzi UPREGULATION OF ?-CATENIN AND CADHERIN EXPRESSION IN HEARTS OF MICE IN ACUTE AND CHRONIC PHASE OF EXPERIMENTAL Trypanosoma cruzi infection

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    Tatyane Penha Sales

    2008-12-01

    Full Text Available As proteínas das junções de aderência têm sido associadas ao mecanismo patológico da miocardiopatia chagásica. Objetivando determinar a natureza dessas alterações, infectaram-se dez camundongos machos Swiss Webster com 25 dias de idade por via intraperitoneal com uma cepa tipo III de Trypanosoma cruzi na dose de 1,0 x 104 tripomastigotas/camundongo. Cinco camundongos infectados foram sacrificados no 14° dia (pico de parasitemia de infecção (grupo A e outros cinco camundongos (grupo C três meses após a inoculação, representando a fase crônica da infecção. Inocularam-se dez animais com solução estéril de cloreto de sódio 0,9%, sendo sacrificados no 14° dia (grupo CA e cinco ao final do terceiro mês (grupo CC, para servirem como controles não-infectados. As junções de aderência foram analisadas a partir do lisado total dos corações submetido a western blotting para pan-caderina e β-catenina. A análise do western blotting revelou aumento da expressão de pan-caderina na fase aguda (2,1x ± 0,89, p= 0,048 e crônica (2,1x ± 0,92, p= 0,05 quando comparadas com seus respectivos controles. Em relação à β-catenin, os resultados mostraram o mesmo padrão caracterizado pelo aumento de seus níveis na fase aguda (6,8x ± 4,65, p= 0,047 e crônica (3,65x ± 1,93, p= 0,033 em comparação aos controles. Assim, estes resultados indicam a associação das proteínas de junção de aderência aos eventos patológicos em corações de camundongos infectados por T. cruzi.

    PALAVRAS-CHAVES: Doença de Chagas, junções de aderência, miocardite, western blotting.
    Adherens junctions proteins have also been envolved in pathological mechanism of chagasic myocardiopathy. Aimed to determine the nature of these alterations, ten Swiss Webster male mice, 25 days-old were infected with a Type III strain of Trypanosoma cruzi through intraperitoneal (IP route with 1.0 x 104 trypomastigotes/mouse. Five infected mice were

  7. Update on Chagas' disease in Mexico Actualización sobre la enfermedad de Chagas en México

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    Eric Dumonteil

    1999-07-01

    Full Text Available Chagas' disease, caused by the protozoan parasite Trypanosoma cruzi, represents a major public health problem in most of the American continent. As transmission of the parasite is being interrupted in most of South America, the disease remains endemic in various areas of Mexico. We review here some of the information gathered in recent years. Seroprevalence of T. cruzi infection in humans remains relatively high in some areas, and there has been a general increase in the number of chronic cases reported to health authorities in recent years. In fact, chronic chagasic cardiomyopathy appears to be affecting a large number of patients with heart disease, but many cases may be misreported because of the unspecific nature of the clinical symptoms. Epidemiological monitoring of vector and reservoir populations, as well as of human cases is helping focus on endemic areas, but a better coordination and development of these efforts is still needed. Recent studies of parasite biology are in agreement with previous work showing the great diversity of parasite characteristics, and support the need for a regional approach to this zoonosis. Strong and continuing support from health and academic authorities is thus still needed to further improve our understanding of Chagas' disease in Mexico and implement efficient control programs.La enfermedad de Chagas, causada por el parásito protozoario Trypanosoma cruzi, constituye un importante problema de salud pública en el continente americano. La transmisión del parásito se ha ido interrumpiendo en la mayor parte de América del Sur, pero la enfermedad sigue siendo endémica en varias regiones de México. En este artículo se revisa la información más reciente sobre dicha enfermedad. La seroprevalencia de la infección por T. cruzi se ha mantenido a niveles relativamente altos en algunas regiones, y se observa un aumento general en el número de casos reportados a las autoridades de salud en los últimos a

  8. Chagas disease and globalization of the Amazon La enfermedad de Chagas y la globalización de la Amazonia

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    Roberto Briceño-León

    2007-01-01

    Full Text Available The increasing number of autochthonous cases of Chagas disease in the Amazon since the 1970s has led to fear that the disease may become a new public health problem in the region. This transformation in the disease's epidemiological pattern in the Amazon can be explained by environmental and social changes in the last 30 years. The current article draws on the sociological theory of perverse effects to explain these changes as the unwanted result of the shift from the "inward" development model prevailing until the 1970s to the "outward" model that we know as globalization, oriented by industrial forces and international trade. The current article highlights the implementation of five new patterns in agriculture, cattle-raising, mining, lumbering, and urban occupation that have generated changes in the environment and the traditional indigenous habitat and have led to migratory flows, deforestation, sedentary living, the presence of domestic animals, and changes in the habitat that facilitate colonization of human dwellings by vectors and the domestic and work-related transmission of the disease. The expansion of Chagas disease is thus a perverse effect of the globalization process in the Amazon.El incremento de casos autóctonos de la enfermedad de Chagas en la Amazonia a partir de los años setenta hace temer que pueda convertirse en un novedoso problema de salud pública en la región. Este cambio del patrón epidemiológico de la enfermedad en la región amazónica debe ser explicado por las transformaciones ambientales y sociales que han ocurrido en los pasados treinta años. Este artículo utiliza la teoría sociológica de los efectos perversos para explicar esos cambios como el resultado indeseado del cambio de modelo de desarrollo "hacia adentro", que había existido hasta los años setenta, por otro "hacia fuera" que está orientado por las fuerzas de la producción y el comercio internacional que conocemos como globalización. El art

  9. A doença de Chagas no Paraná Chagas disease in the state of Paraná

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    H. C. de Souza-Araujo

    1954-06-01

    Full Text Available In recent speech in Curitiba (May 22nd, 1954, Dr. Mario Pinotti, Director, Serviço Nacional da Malaria, informed that his personnel started on February, 1953, a survey upon chagas Disease in 23 counties of the State of Paraná, South Brazil. out of 895 places surveyed, 678, or 75.7%, were infected by Triatoma infestans klug 1834 and in 234 out of those 678, or 34.5%, this vector was infected by Trypanosoma cruzi. The general natural infection of the insects examined reached 18.86%. The serological survey (Machado-Guerreiro test was positive in 10.7% of the persons examined in jacarezinho and in 28.3% of those living in Bôa Vista. These data suggested the author to actualise the subject. During his control of severe outbreack of malaria in the North part of Paraná, from march to June 1917 he worked in 8 counties. March 1917 he photographed in Boa Vista four girls, severe cases of chronic malaria, two of which showed bi-palpebral oedema, later on considered by Dr. Pinho Simões (1943 as Romanã syndrome (created in 1935 and Prof. Salvador Mazza (1946 classified as typical cases of Chagas' Disease. now, being elapsed 36 years, the National Service of Malaria confirmed the discovery. The region surveyed was populated, in the beginning of this century, by immigrants from the State of Minas Gerais, from where the author believes that were imported the disease and its vectors. In April 1917 the A. discovered that the old town Jatahy was a big focus of Triatoma megista (now Panstrongylus megistus0. All its 43 houses were strongly infested by such hematophagus and amongst the 200 inhabitants seen many were suspicious cases of chronic cases of Chagas's Disease. In the Indians town (three tribes of S. Pedro D' Alcantara, situated in front of Jatahy, in the left side of the river Tibagy, there were no Triatomas nor suspicious cases of trypanosomiasis. In 1919 the author started the control of the endemics by destroying the foci of Triatomas and reforming

  10. Chagas y SIDA, la importancia del diagnóstico precoz

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    Sergio R. Auger

    2005-01-01

    Full Text Available Objetivos: Evaluar las vías de contagio, la reactivación y la evolución de la enfermedad de Chagas en pacientes con HIV. Material y métodos Se incorporaron pacientes internados con SIDA y Chagas reactivo. Se evaluaron la epidemiología, la adicción a drogas, la reactivación de la enfermedad de Chagas y el órgano blanco más afectado, la demora del inicio de tratamiento antiparasitario y la evolución posterior. Se realizaron serologías, estudios parasitológicos en sangre y líquido cefalorraquídeo y exámenes complementarios cardiológicos y neurológicos. El estudio fue retrospectivo observacional y como método estadístico se emplearon las pruebas de chi cuadrado y exacta de Fischer. Resultados Se incluyeron en el estudio 8 pacientes con Chagas y SIDA. La vía de contagio de Chagas fue la vectorial en 5 pacientes (62,5% y la drogadicción endovenosa como hipótesis de alta probabilidad en 3 pacientes (37,5%. De estos últimos, 2 presentaron serología negativa para Chagas con parasitemias positivas. El motivo de internación fue reactivación de la enfermedad de Chagas en 5 pacientes (62,5% y de éstos, 4 sufrieron afección del sistema nervioso central y 1, miocarditis. De los 5 pacientes con agudización de la enfermedad de Chagas, 4 fallecieron a pesar del tratamiento con benznidazol. La iniciación de tratamiento demoró entre 7 y 15 días. Conclusiones La drogadicción endovenosa como nueva vía de contagio de la enfermedad de Chagas se transforma en una hipótesis de alta probabilidad, donde la serología no es relevante para el diagnóstico en pacientes con HIV+ y compromiso neurológico. La reactivación de la enfermedad de Chagas fue frecuente y la mortalidad elevada se relacionó con la falta de diagnóstico y el tratamiento tardío.

  11. Bronquiolite aguda, uma revisão atualizada Acute bronchiolitis, an updated review

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    Werther Brunow de Carvalho

    2007-04-01

    Full Text Available A bronquiolite aguda (BA é um diagnóstico freqüente de internação hospitalar em pediatria, ocasionada principalmente pelo vírus sincicial respiratório (VSR. Ocorre epidemicamente nos meses de outono e inverno. Algumas populações de crianças (recém-nascidos pré-termo, cardiopatia congênita, doença pulmonar crônica, imunocomprometidos, desnutridos, entre outros apresentam maior risco de morbidade e mortalidade. Os vírus multiplicam-se nas células epiteliais ciliadas, e a inflamação e os debris celulares ocasionam obstrução da via aérea, hiperinsuflação, atelectasia localizada, chiado e alterações das trocas gasosas. Não existem evidências definitivas em relação aos tratamentos utilizados para esta doença. O tratamento inclui a utilização de oxigênio, hidratação, beta-2 agonistas por via inalatória, epinefrina racêmica, DNase recombinante, fisioterapia respiratória, entre outros. Medidas profiláticas: administração de anticorpos monoclonais (palivizumab. A maioria das crianças com BA, independentemente da gravidade da doença, recuperam-se sem seqüelas. O curso natural desta doença, habitualmente, varia entre sete a dez dias, mas algumas crianças permanecem doentes por semanas.Acute bronchiolitis (AB is a frequent cause of hospitalization among children and its main etiological agent is respiratory syncytial virus (RSV. It occurs epidemically during autumn and winter. Some populations of children such as premature newborns, infants with congenital heart disease and those with chronic lung disease, immunocompromised, undernourished, among others, present increased morbidity and mortality risk. The virus multiplies in epithelial ciliated cells while inflammation and cellular debris cause obstruction of the airways, hyperinflation, atelectasis, and wheezing and gas exchange imbalance. Definitive evidence still does not exist about treatment of this disease, Treatment includes oxygen therapy, hydration

  12. Efectividad de la magnetoterapia como tratamiento en pacientes con lumbalgia aguda

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    Raidel González Rodríguez

    2015-05-01

    Full Text Available Son numerosos los pacientes aquejados de algias vertebrales, tanto lumbares como dorsales y cervicales. Se realizó esta investigación con el objetivo de determinar la efectividad de la magnetoterapia como tratamiento en la lumbalgia aguda, en pacientes atendidos en el policlínico universitario “Raúl Sánchez” de la provincia de Pinar del Río, Cuba. Se realizó un estudio descriptivo, prospectivo, de corte transversal en pacientes con lumbalgia aguda, pertenecientes a dicha área de salud. La muestra quedó conformada por 68 pacientes de ambos sexos con lumbalgia aguda, diagnosticados clínicamente y mayores de 17 años de edad. En la investigación predominó el sexo femenino (67,6 % y el rango de edad estuvo entre 40 y 49 años. El esfuerzo físico fue el principal factor desencadenante (47,1 %. Con el tratamiento de la magnetoterapia aplicado a los pacientes se redujeron los estadios del dolor. La mayoría de los pacientes presentaron una respuesta clínica excelente y mejoraron los síntomas entre los siete y diez días (61,8 %. No se reportaron efectos adversos. La magnetoterapia resultó efectiva en el tratamiento de pacientes aquejados de lumbalgia aguda

  13. Incidencia de la enfermedad diarreica aguda en menores de cinco años

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    Mayelín Ávila Labrada

    2015-05-01

    Full Text Available La enfermedad diarreica aguda es motivo frecuente de consulta pediátrica, representando un problema grave de salud pública. Los agentes infecciosos son causa frecuente de diarrea aguda. Se realizó un estudio descriptivo, retrospectivo sobre la prevalencia de la enfermedad diarreica aguda en menores de cinco años, atendidos en la clínica “Simón Bolívar” en la ciudad de Mariara del municipio Diego Ibarra, Carabobo, Venezuela; en el periodo comprendido entre enero de 2008 y diciembre de 2012, lo cual ofreció información de cinco años completos. La prevalencia de la enfermedad diarreica aguda disminuyó significativamente en el intervalo 2009-2011, sin embargo, se caracterizó por tener la mayor prevalencia en los años extremos, 2012 y 2008, por ese orden. Los varones y los del grupo de uno a cuatro años fueron los que más incidieron en cada uno de los años estudiados

  14. Potencial de risco da transmissão transfusional da doença de Chagas em Belo Horizonte (MG

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    Elisabeth Bronfen

    1988-03-01

    Full Text Available Com o objetivo de se isolar amostras do Trypanosoma cruzi de chagásicos crônicos, foram submetidos a xenodiagnóstico e hemocultura, 59 pacientes provenientes do ambulatório de um dos Hospitais de Belo Horizonte. Esses pacientes informaram, em entrevista prévia, serem ou terem sido doadores de sangue ou candidatos à uma primeira doação. 44 deles (74,6% já haviam doado sangue de la mais de 20 vezes em diferentes bancos de sangue de Belo Horizonte. O resultado conferido através da realização concomitante de apenas 1 xenodiagnóstico e 1 hemocultura, revelou, no grupo de doadores, 47,7% depositividade parasitológica. Considerando todos os doadores chagásicos crônicos, parasitologicamente comprovados ou não, ocorreram mais de 112 doações. Esse é um dado altamente significativo em relação ao problema de transmissão transfusional da doença de Chagas em bancos de sangue de Belo Horizonte, MG.Fifty nine chronic chagasic individuals from a out-patient clinics in Belo Horizonte, who use to act as blood donors were submitted to xenodiagnosis and hemocultures for isolating Trypanosoma cruzi. Forty four of them (74.5% had already given blood 1 to 20 times. The results, based on only one xenodiagnosis and one blood culture per patient revealed 47. 7% of parasitological positivity. The whole population studied wes responsible for 112 donations. These data stress the importance of transmission of Chagas disease through blood transfusion in Belo Horizonte.

  15. Chagas' disease in the Amazon Basin: V. Periurban palms as habitats of Rhodnius robustus and Rhodnius pictipes - triatomine vectors of Chagas' disease

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    M. A. Miles

    1983-12-01

    Full Text Available Trypanosoma cruzi infected Rhodnius robustus and/or Rhodnius pictipes were commonly found, in large numbers, in the Brazilian Amazonian palms Maximiliana regia ("inajá", Acrocomia sclerocarpa ("mucajá" and Orbignya speciosa ("babaçu". The common opossum, Didelphis marsupialis, was the animal most frequently associated with triatomine infested palms. R. pictipes, frequently light-attracted into houses from palm trees, was the probable source of an acute case of Chagas' disease in the vicinity of Belém. It is considered that triatomine infested palms are likely to cause some cases of acute Chagas' disease in the States of Amazonas and Rondônia. Possible control methods are suggested.Rhodnius robustus e/ou Rhodnius pictipes, infectados com Trypanosoma cruzi foram comumente encontrados, em grande numero, nas palmeiras Maximiliana regia (inaja, Acrocomia sclerocarpa (mucaja e Orbignya speciosa (babacu na Amazonia brasileira. O marsupial Didelphis marsupialis foi o animal encontrado mais frequentemente nas palmeiras associadas a alta prevalencia de triatomineos. R. pictipes que e atraido pela luz nas residencias de palmeiras vizinhas, provavelmente e a fonte de um caso agudo de doenca de Chagas nas vizinhancas de Belem. Sugere-se que as palmeiras albergando triatomineos poderiam ser relacionadas com infeccoes humanas de doenca de Chagas nos Estados de Amazonas e Rondonia. Sugere-se, tambem, possiveis metodos de controle.

  16. La enfermedad de Chagas en las Américas: una perspectiva de ecosalud Chagas disease in the Americas: an ecohealth perspective

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    Roberto Briceño-León

    2009-01-01

    Full Text Available El proceso de transmisión de la enfermedad de Chagas ha estado históricamente relacionado con los patrones de ocupación territorial de los asentamientos humanos. En las áreas rurales puede ocurrir más fácilmente el encuentro del vector, los agentes patógenos y los seres humanos, por las condiciones de la vivienda y la pobreza existente en estas zonas. Los procesos migratorios permanentes o estacionales han jugado un papel igualmente importante en el transporte de los vectores y en la infección de la población en las zonas urbanas. Las nuevas fronteras agrícolas del Amazonas se han establecido nuevas áreas de transmisión de la enfermedad. La atención dada a los bancos de sangre ha permitido disminuir la transmisión transfusional, pero la inmigración internacional ha cambiado la situación epidemiológica, pues en Estados Unidos y España viven miles de enfermos que habían sido infectados décadas antes y no encuentran adecuada atención. Los avances en el conocimiento y el control de la enfermedad son mostrados en el artículo, señalando las limitaciones existentes en cuanto al mejoramiento de las condiciones ambientales y de vivienda de los pobres.The historical processes involved in Chagas disease transmission relate to the patterns and conditions of human settlements, especially in rural areas, due to proximity to forest areas, where both vectors and Trypanosoma cruzi can occur, combined with precarious housing conditions and underlying poverty. However, seasonal and permanent rural-urban migration has played a major role in re-mobilizing vectors, T. cruzi, and Chagas-infected individuals. A new agricultural frontier in the Amazon has led to a new transmission pattern, especially with palm trees located close to houses. Improved blood bank surveillance has decreased transmission by blood transfusions. International migration also plays a role in Chagas disease epidemiology. The United States and Spain, where specific health

  17. Epilepsia e doença de chagas cronica

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    Edymar Jardim

    1981-03-01

    Full Text Available A síndrome epiléptica em chagásicos crônicos, foi referida raramente na literatura especializazda, não tendo sido feito até o momento, um estudo detalhado das suas manifestações. Partindo-se da premissa de que a moléstia de Chagas tem por substrato anatômico uma destruição neuronal, procurou-se comparar dois grupos de epilépticos, um dos quais com moléstia de Chagas crônica. Foram estudados 167 pacientes epilépticos, dos quais 44 eram comprovadamente chagásicos. O estudo permitiu coletar dados referentes à procedência dos pacientes, resultado soro-lógico, sexo, idade, época de incidência das manifestações epilépticas, elementos dos exames neurológicos, do líquido cefalorraqueano, eletrencefalográfico e os resultados da terapêutica anticonvulsivante. Como resultados principais destacamos o início tardio da epilepsia nos chagásicos, e o predomínio acentuado das crises parciais com sintomatologia elementar de tipo autonômico. O exame neurológico e o do líquido cefalorraqueano, apesar de apresentarem percentualmente nos seus resultados, taxas moderadamente mais elevadas na incidência de alterações, não caracterizaram síndromes neurológicas bem definidas. O exame eletrencefalográfico, revelou alterações sugestivas de comprometimento orgânico cerebral difuso. A terapêutica anticonvulsivante, baseada na utilização de hidantoinatos, barbitúricos, primidona e benzodiazepínicos, mostrou que o controle das crises foi mais difícil nos chagásicos, exigindo maiores quantidades de medicação, com resultados menos satisfatórios.

  18. Four TDR diseases can be "eliminated". 3. Chagas success in Brazil and Colombia.

    Science.gov (United States)

    1996-03-01

    Recent figures published by Brazil's Chagas disease control program indicate that the disease will soon be eradicated in Brazil. For example, in 1982, 711 Brazilian municipalities reported infestation with Triatoma infestans, the most important domiciliary vector of Chagas disease. However, in 1993, only 83 municipalities reported any infestation. Disease transmission through blood transfusion in the country has also been dramatically reduced. In 1982, 6.5% of blood donations in Brazil were infected with Trypanosoma cruzi, but by 1992 the level of infection had fallen to only 1%. 4.2% of infected individuals aged 7-14 years converted serologically in 1980, compared to only 0.15% in 1994, indicating a 95% decline in the incidence of newly infected cases in that age group. Furthermore, 84,000 infected triatomine insects were captured in households in endemic areas in 1983, far more than the 2500 collected throughout the entire country in 1993. The complete interruption of Chagas disease transmission in Brazil is expected in 1998. Work is also progressing with a control plan by countries in which the disease is transmitted by insects with an extradomiciliary life cycle. Colombia is the 15th of the 21 Chagas-endemic countries in Latin America where, due to blood bank screening, the transfusional transmission of Chagas disease has been interrupted.

  19. Scintigraphy for the detection of myocardial damage in the indeterminate form of Chagas disease

    Energy Technology Data Exchange (ETDEWEB)

    Pedroso, Enio Roberto Pietra; Rezende, Nilton Alves de, E-mail: narezende@terra.com.b [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Faculdade de Medicina; Abuhid, Ivana Moura [Instituto de Medicina Nuclear e Diagnostico Molecular, Belo Horizonte, MG (Brazil)

    2010-07-15

    Background: non-invasive cardiological methods have been used for the identification of myocardial damage in Chagas disease. Objective: to verify whether the rest/stress myocardial perfusion scintigraphy is able to identify early myocardial damage in the indeterminate form of Chagas disease. Methods: eighteen patients with the indeterminate form of Chagas Disease and the same number of normal controls, paired by sex and age, underwent rest/stress myocardial scintigraphy using sestamibi-99mTc, aiming at detecting early cardiac damage. Results: the results did not show perfusion or ventricular function defects in patients at the indeterminate phase of Chagas disease and in the normal controls, except for a patient who presented signs of ventricular dysfunction in the myocardial perfusion scintigraphy with electrocardiographic gating. Conclusion: the results of this study, considering the small sample size, showed that the rest/stress myocardial scintigraphy using sestamibi-99mTc is not an effective method to detect early myocardial alterations in the indeterminate form of Chagas disease (author)

  20. Pupillary Light Reflexes are Associated with Autonomic Dysfunction in Bolivian Diabetics But Not Chagas Disease Patients.

    Science.gov (United States)

    Halperin, Anthony; Pajuelo, Monica; Tornheim, Jeffrey A; Vu, Nancy; Carnero, Andrés M; Galdos-Cardenas, Gerson; Ferrufino, Lisbeth; Camacho, Marilyn; Justiniano, Juan; Colanzi, Rony; Bowman, Natalie M; Morris, Tiffany; MacDougall, Hamish; Bern, Caryn; Moore, Steven T; Gilman, Robert H

    2016-06-01

    Autonomic dysfunction is common in Chagas disease and diabetes. Patients with either condition complicated by cardiac autonomic dysfunction face increased mortality, but no clinical predictors of autonomic dysfunction exist. Pupillary light reflexes (PLRs) may identify such patients early, allowing for intensified treatment. To evaluate the significance of PLRs, adults were recruited from the outpatient endocrine, cardiology, and surgical clinics at a Bolivian teaching hospital. After testing for Chagas disease and diabetes, participants completed conventional autonomic testing (CAT) evaluating their cardiovascular responses to Valsalva, deep breathing, and orthostatic changes. PLRs were measured using specially designed goggles, then CAT and PLRs were compared as measures of autonomic dysfunction. This study analyzed 163 adults, including 96 with Chagas disease, 35 patients with diabetes, and 32 controls. PLRs were not significantly different between Chagas disease patients and controls. Patients with diabetes had longer latency to onset of pupil constriction, slower maximum constriction velocities, and smaller orthostatic ratios than nonpatients with diabetes. PLRs correlated poorly with CAT results. A PLR-based clinical risk score demonstrated a 2.27-fold increased likelihood of diabetes complicated by autonomic dysfunction compared with the combination of blood tests, CAT, and PLRs (sensitivity 87.9%, specificity 61.3%). PLRs represent a promising tool for evaluating subclinical neuropathy in patients with diabetes without symptomatic autonomic dysfunction. Pupillometry does not have a role in the evaluation of Chagas disease patients.

  1. Triatominae Biochemistry Goes to School: Evaluation of a Novel Tool for Teaching Basic Biochemical Concepts of Chagas Disease Vectors

    Science.gov (United States)

    Cunha, Leonardo Rodrigues; de Oliveria Cudischevitch, Cecília; Carneiro, Alan Brito; Macedo, Gustavo Bartholomeu; Lannes, Denise; da Silva-Neto, Mário Alberto Cardoso

    2014-01-01

    We evaluate a new approach to teaching the basic biochemistry mechanisms that regulate the biology of Triatominae, major vectors of "Trypanosoma cruzi," the causative agent of Chagas disease. We have designed and used a comic book, "Carlos Chagas: 100 years after a hero's discovery" containing scientific information obtained by…

  2. Bolivian migrants with Chagas disease in Barcelona, Spain: a qualitative study of dietary changes and digestive problems

    NARCIS (Netherlands)

    Posada, E.; Pell, C.; Angulo, N.; Pinazo, M.J.; Gimeno, F.; Elizalde, I.; Gysels, M.H.; Muñoz, J.; Pool, R.; Gascón, J.

    2011-01-01

    Due to international migration, Chagas disease, endemic in Latin America, has become more common in non-endemic areas. Chronic Chagas disease can cause damage to the digestive system leading to constipation. However, a range of factors influences constipation and a better understanding of the role o

  3. Triatominae Biochemistry Goes to School: Evaluation of a Novel Tool for Teaching Basic Biochemical Concepts of Chagas Disease Vectors

    Science.gov (United States)

    Cunha, Leonardo Rodrigues; de Oliveria Cudischevitch, Cecília; Carneiro, Alan Brito; Macedo, Gustavo Bartholomeu; Lannes, Denise; da Silva-Neto, Mário Alberto Cardoso

    2014-01-01

    We evaluate a new approach to teaching the basic biochemistry mechanisms that regulate the biology of Triatominae, major vectors of "Trypanosoma cruzi," the causative agent of Chagas disease. We have designed and used a comic book, "Carlos Chagas: 100 years after a hero's discovery" containing scientific information…

  4. Histological and endoscopic features of the stomachs of patients with Chagas disease in the era of Helicobacter pylori

    OpenAIRE

    Fernanda Machado Fonseca; Renata Margarida Etchebehere; Dulciene Maria Magalhães Queiroz; Andreia Maria Camargos Rocha; Iracema Saldanha Junqueira; Daurin Narciso da Fonseca; Aline Libério Braga Rodrigues; Eduardo Crema; Adriana Gonçalves de Oliveira

    2014-01-01

    Introduction Most studies that have evaluated the stomachs of patients with Chagas disease were performed before the discovery of Helicobacter pylori and used no control groups. This study compared the gastric features of chagasic and non-chagasic patients and assessed whether gastritis could be associated with Chagas disease. ...

  5. RENDIMIENTO Y RECUPERACIÓN AGUDA EN CORREDORES DE RESISTENCIA

    Directory of Open Access Journals (Sweden)

    D. A. Boullosa

    2010-09-01

    Full Text Available

     

    RESUMEN

    Dieciséis corredores de fondo bien entrenados fueron evaluados en dos días diferentes mediante la prueba de carrera en pista de la Universidad de Montreal (UMTT y el tiempo límite a la velocidad aeróbica máxima (Tlim. Se examinó la respuesta de la frecuencia cardiaca y la lactatemia en la recuperación aguda (andando. La frecuencia cardiaca máxima fue diferente entre los dos días de valoración (p = 0,001, resultando superior en el UMTT respecto del Tlim. La recuperación de la frecuencia cardiaca en el primer minuto (RFC1 correlacionó con la velocidad aeróbica máxima (r = 0,611 y r = 0,615, p = 0,012; en el UMTT y el Tlim, respectivamente, correlacionando además los dos valores de RFC1 entre sí  (r = 0,824; p = 0,000. La diferencia en la lactatemia entre la finalización y el minuto diez de la recuperación fue estadísticamente significativa sólo después del UMTT (p = 0,013. Se concluye que: 1 fue hallada una relación moderada entre la recuperación cardiaca y la velocidad aeróbica máxima en corredores de resistencia; 2 la frecuencia cardiaca máxima obtenida en una prueba incremental en el campo es superior a la alcanzada en una prueba de tipo rectangular; 3 el descenso significativo de la lactatemia a los 10 min sólo se observó después del UMTT, lo que sugiere una influencia del protocolo de carrera en este parámetro.
    Palabras Clave: frecuencia cardiaca, lactato, recuperación, velocidad aeróbica máxima

     

    ABSTRACT

    Sixteen well-trained endurance runners were evaluated in two different days with the Université de Montréal Track Test (UMTT, and the time limit at maximum aerobic

  6. Detección molecular de las translocaciones más comunes en Leucemia aguda mediante RT-PCR

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    Guevara G.

    2001-06-01

    Full Text Available Evaluar la incidencia de las translocaciones t(4;11, t(1;19, t(9;22 y t(12;21 en leucemia linfoide aguda (LLA y t(15;17, t(8;21 e Inv.(16 en leucemia mieloide aguda (LMA. Correlacionar los resultados obtenidos con el diagnóstico morfológico y citogenético.

  7. Rabdomiólisis aguda masiva secundaria a neumonía con bacteriemia por Moraxella catarrhalis

    OpenAIRE

    Fajardo, Miguel; Vergara, Esther; Hernández-Blázquez, Antonia; Hernández-Rastrollo, Ramón

    2014-01-01

    Moraxella catarrhalis es una bacteria implicada en infecciones respiratorias, otitis, sinusitis, mastoiditis o conjuntivitis. Menos frecuente es su participación en bacteriemias y artritis, siendo éste el primer caso descrito de rabdomiolisis (RM) aguda difusa. La RM aguda difusa de etiología infecciosa generalmente está causada por virus, seguido de bacterias con un conocido poder patógeno, como Streptococcus pneumoniae, Mycoplasma pneumoniae o Legionella pneumophyla. Se diagnostica por la p...

  8. Urbanization, land tenure security and vector-borne Chagas disease.

    Science.gov (United States)

    Levy, Michael Z; Barbu, Corentin M; Castillo-Neyra, Ricardo; Quispe-Machaca, Victor R; Ancca-Juarez, Jenny; Escalante-Mejia, Patricia; Borrini-Mayori, Katty; Niemierko, Malwina; Mabud, Tarub S; Behrman, Jere R; Naquira-Velarde, Cesar

    2014-08-22

    Modern cities represent one of the fastest growing ecosystems on the planet. Urbanization occurs in stages; each stage characterized by a distinct habitat that may be more or less susceptible to the establishment of disease vector populations and the transmission of vector-borne pathogens. We performed longitudinal entomological and epidemiological surveys in households along a 1900 × 125 m transect of Arequipa, Peru, a major city of nearly one million inhabitants, in which the transmission of Trypanosoma cruzi, the aetiological agent of Chagas disease, by the insect vector Triatoma infestans, is an ongoing problem. The transect spans a cline of urban development from established communities to land invasions. We find that the vector is tracking the development of the city, and the parasite, in turn, is tracking the dispersal of the vector. New urbanizations are free of vector infestation for decades. T. cruzi transmission is very recent and concentrated in more established communities. The increase in land tenure security during the course of urbanization, if not accompanied by reasonable and enforceable zoning codes, initiates an influx of construction materials, people and animals that creates fertile conditions for epidemics of some vector-borne diseases.

  9. Urbanization, land tenure security and vector-borne Chagas disease

    Science.gov (United States)

    Levy, Michael Z.; Barbu, Corentin M.; Castillo-Neyra, Ricardo; Quispe-Machaca, Victor R.; Ancca-Juarez, Jenny; Escalante-Mejia, Patricia; Borrini-Mayori, Katty; Niemierko, Malwina; Mabud, Tarub S.; Behrman, Jere R.; Naquira-Velarde, Cesar

    2014-01-01

    Modern cities represent one of the fastest growing ecosystems on the planet. Urbanization occurs in stages; each stage characterized by a distinct habitat that may be more or less susceptible to the establishment of disease vector populations and the transmission of vector-borne pathogens. We performed longitudinal entomological and epidemiological surveys in households along a 1900 × 125 m transect of Arequipa, Peru, a major city of nearly one million inhabitants, in which the transmission of Trypanosoma cruzi, the aetiological agent of Chagas disease, by the insect vector Triatoma infestans, is an ongoing problem. The transect spans a cline of urban development from established communities to land invasions. We find that the vector is tracking the development of the city, and the parasite, in turn, is tracking the dispersal of the vector. New urbanizations are free of vector infestation for decades. T. cruzi transmission is very recent and concentrated in more established communities. The increase in land tenure security during the course of urbanization, if not accompanied by reasonable and enforceable zoning codes, initiates an influx of construction materials, people and animals that creates fertile conditions for epidemics of some vector-borne diseases. PMID:24990681

  10. An in-silico investigation of anti-Chagas phytochemicals.

    Science.gov (United States)

    McCulley, Stephanie F; Setzer, William N

    2014-01-01

    Over 18 million people in tropical and subtropical America are afflicted by American trypanosomiasis or Chagas disease. In humans, symptoms of the disease include fever, swelling, and heart and brain damage, usually leading to death. There is currently no effective treatment for this disease. Plant products continue to be rich sources of clinically useful drugs, and the biodiversity of the Neotropics suggests great phytomedicinal potential. Screening programs have revealed numerous plant species and phytochemical agents that have shown in-vitro or in-vivo antitrypanosomal activity, but the biochemical targets of these phytochemicals are not known. In this work, we present a molecular docking analysis of Neotropical phytochemicals, which have already demonstrated antiparasitic activity against Trypanosoma cruzi, with potential druggable protein targets of the parasite. Several protein targets showed in-silico selectivity for trypanocidal phytochemicals, including trypanothione reductase, pteridine reductase 2, lipoamide dehydrogenase, glucokinase, dihydroorotate dehydrogenase, cruzain, dihydrofolate-reductase/thymidylate-synthase, and farnesyl diphosphate synthase. Some of the phytochemical ligands showed notable docking preference for trypanothione reductase, including flavonoids, fatty-acid-derived oxygenated hydrocarbons, geranylgeraniol and the lignans ganschisandrine and eupomatenoid-6.

  11. Esofagitis necrosante aguda: análisis retrospectivo Acute esophageal necrosis: a retrospective case series

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    R. Ramos

    2008-09-01

    Full Text Available Introducción: la esofagitis necrosante aguda es una entidad rara. Se reconoce por el aspecto negro difuso del esófago a la endoscopia. Su incidencia e patogénesis se desconoce. Pacientes y métodos: se analizaron retrospectivamente 11 pacientes con esofagitis necrosante aguda desde el punto de vista de los datos clínicos, de laboratorio y endoscopicos en 2 años. Resultados: se analizaron las endoscopias realizadas a 3.976 pacientes, observándose esofagitis necrosante aguda en 11 pacientes. El estado nutricional era malo en 6 pacientes. La resolución completa de la esofagitis se observó en cuatro pacientes. Durante el seguimiento se observó una estenosis en un paciente y un nuevo episodio de esofagitis necrosante aguda en otro paciente. Siete pacientes fallecieron, pero esta elevada mortalidad parece deberse a las enfermedades de base y no es atribuible a las lesiones de la esofagitis necrosante. Conclusiones: la incidencia de esofagitis necrosante aguda en nuestra serie fue 0,28%. La esofagitis necrosante aguda tiene una elevada mortalidad.Background: acute esophageal necrosis has been considered a rare event. It is defined as the presence of diffuse dark pigmentation of the esophagus on upper endoscopy. Its incidence has not yet been established. The pathogenesis remains unknown. Patients and methods: a retrospective analysis of clinical, laboratory, endoscopic, and histological data, and of the clinical course of 11 patients with acute necrotizing esophagitis was carried out over a 2-year period. Results: among 3,976 patients who underwent upper endoscopy, 11 (0.28% with acute esophageal necrosis were identified. Nutritional status was poor for 6 patients. Complete resolution of acute esophageal necrosis without further recurrence was observed in 4. One stricture appeared during follow-up and other patient developed new-onset acute esophageal necrosis. Seven patients died, but no death was directly related to acute esophageal necrosis

  12. Estado oxidante e antioxidante de crianças com bronquiolite aguda

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    Rusen Dundaroz

    2013-08-01

    Full Text Available OBJETIVO: O estresse oxidativo demonstrou contribuir para a patogênese de doenças pulmonares inflamatórias agudas e crônicas. Nosso objetivo foi avaliar o estado oxidante/antioxidante de crianças com bronquiolite aguda por meio de mensuração da capacidade antioxidante total do plasma, estado oxidante total e índice de estresse oxidativo. MÉTODOS: As crianças com bronquiolite aguda encaminhadas para o Departamento de Emergência Pediátrica do hospital universitário entre janeiro e abril 2012 foram comparadas a controles saudáveis de mesma idade. Os pacientes com bronquiolite aguda tiveram essa doença classificada como leve e moderada. O estado oxidante e antioxidante foi avaliado pela mensuração da capacidade antioxidante total do plasma, estado oxidante total e índice de estresse oxidativo. RESULTADOS: Foram incluídas 31 crianças com bronquiolite aguda com idade de três meses a dois anos e 37 crianças saudáveis. O estado oxidante total (EOT foi maior em pacientes com bronquiolite aguda do que no grupo de controle (5,16±1,99 µmol H2O2 em comparação a 3,78±1,78 µmol H2O2 [p = 0,004]. A capacidade antioxidante total (CAT foi significativamente menor em crianças com bronquiolite que no grupo de controle (2,51±0,37 µmol Trolox equivalente/L em comparação a 2,75±0,39 µmol Trolox Eqv/L (p = 0,013. Os pacientes com bronquiolite moderada apresentaram níveis de EOT mais elevados que os com bronquiolite leve e os do grupo de controle (p = 0,03, p < 0,001. Os pacientes com bronquiolite moderada apresentaram níveis de IEO mais elevados que os do grupo de controle (p = 0,015. O nível de saturação de oxigênio de pacientes com bronquiolite foi inversamente correlacionado ao nível de EOT (r = -0,476, p < 0,05. CONCLUSÃO: O equilíbrio entre os sistemas oxidante e antioxidante é interrompido em crianças com bronquiolite moderada, indicando que o fator de estresse poderá ter um papel na patogênese da doença.

  13. A three-dimensional multi-agent-based model for the evolution of Chagas' disease.

    Science.gov (United States)

    Galvão, Viviane; Miranda, José Garcia Vivas

    2010-06-01

    A better understanding of Chagas' disease is important because the knowledge about the progression and the participation of the different types of cells in this disease are still lacking. To clarify this system, the kinetics of inflammatory cells and parasite nests was shown in an experiment. Using this experimental data, we have developed a three-dimensional multi-agent-based computational model for the evolution of Chagas' disease. Our model includes five different types of agents: inflammatory cell, fibrosis, cardiomyocyte, fibroblast, and Trypanosoma cruzi. Fibrosis is fixed and the other types of agents can move through the empty space. They move randomly by using the Moore neighborhood. This model reproduces the acute and chronic phases of Chagas' disease and the volume occupied by all different types of cells in the cardiac tissue.

  14. Ecological aspects of the vectorial control of Chagas' disease in Brazil

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    Dias João Carlos P.

    1994-01-01

    Full Text Available The feasibility and most important ecological aspects of vectorial Chagas' disease control are discussed. The spread and maintenance of this disease involve multiple ecological and sociopolitical factors that must be taken into account when control programs are planned, executed and evaluated. In spite of its complexity, Chagas disease can be controlled using methods that target specific mechanisms of transmission, the most important being vectorial and transfusional. Major ecological problems in Chagas' disease control do not exist, even in the case of the chemical control of triatomine vectors. The main challenges for the Brazilian Control Program at this moment are: its maintenance as a political priority; the threat of peridomestic vectors; and the consolidation of permanent horizontal and participative epidemiological surveillance systems against the vector.

  15. Chagas disease (Trypanosoma cruzi and HIV co-infection in Colombia

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    Carolina Hernández

    2014-09-01

    Full Text Available Chagas disease is a complex zoonotic pathology caused by the kinetoplastid Trypanosoma cruzi. This parasite presents remarkable genetic variability and has been grouped into six discrete typing units (DTUs. The association between the DTUs and clinical outcome remains unknown. Chagas disease and co-infection with HIV/AIDS has been reported widely in Brazil and Argentina. Herein, we present the molecular analyses from a Chagas disease patient with HIV/AIDS co-infection in Colombia who presented severe cardiomyopathy, pleural effusion, and central nervous system involvement. A mixed infection by T. cruzi genotypes was detected. We suggest including T. cruzi in the list of opportunistic pathogens for the management of HIV patients in Colombia. The epidemiological implications of this finding are discussed.

  16. [Knowledge, attitudes, and practices concerning Chagas disease in schoolchildren from an endemic area in Peru].

    Science.gov (United States)

    Cabrera, Rufino; Mayo, Carlos; Suárez, Nicolás; Infante, César; Náquira, César; García-Zapata, Marco Tulio A

    2003-01-01

    This study analyzes knowledge, attitudes, and practices concerning Chagas disease among 241 primary schoolchildren in "La Tinguiña", Ica, Peru (December 2000 - January 2001). Less than 1% of those interviewed knew that triatomines transmit Chagas disease, while nearly a quarter recognized the illness based on the appearance of "lumps" on the skin; 35.27% knew that vector infestation is controlled using insecticides; 26.56% recognized the adult stage of the vector, and 21.16% the nymphal instar; 14.11% knew triatomines or "kissing bugs" by the name "chirimacha"; 82.57% would accept an entomological survey, 66.80% would submit to a serological study, and 63.90% would participate in a triatomine search. The study shows that the population, despite having very limited knowledge on the disease and its vectors, shows interest in collaborating. Therefore, it is recommended that Chagas disease surveillance and control include educational programs and community participation.

  17. Aspectos neurológicos da moléstia de chagas

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    Fritz Köberle

    1967-09-01

    Full Text Available Carlos Chagas related in more than two 200 cases, what he called "nervous forms" of trypanosomiasis, that is neurological manifestations from central origin (idiotism, infantilism, pseudo-bulbar paralysis, aphasia, cerebellar ataxia, atetosis, espostic or paralytic diplegia, disbasia. At that time Chagas expressed his concepts as follows: "In relation to the frequency of trypanosomiasis nervous forms we have performed many observations which allow us to state that this disease is the one which causes the largest number of organic affections of the central nervous system, in human pathology". We are plenty convinced by Chagas's statement. By experiments on animals of laboratory we have very often noticed a rather varied neurological symptomatology, being worth point out identical syndromes to those observed by Chagas. Our autopsy material non-rarely include chronic Chagas cases presenting a most varied symtomatology. Among them we have named only three cases of discerebral nanism, a rather rare affection in other parts of the world and relatively frequent in our material. The fact which we have demonstrated, i.e., a relatively great decreasing of number of nervous cells in the peripheral system could happen in the central nervous system as well. Provided that there are only two quantitative works on neuron number diminishing in the central nervous system in mice and rats we decline to go into further details about central neuropathies in man. We emphasized the necessity to perform researches on this field by means of intimate collaboration between clinicians and pathologists, as the only way to confirm on scientific basis all that was observed by the panoramic and genial vision of Carlos Chagas.

  18. Evolution of the clinical and epidemiological knowledge about Chagas disease 90 years after its discovery

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    Prata Aluízio

    1999-01-01

    Full Text Available Three different periods may be considered in the evolution of knowledge about the clinical and epidemiological aspects of Chagas disease since its discovery: (a early period concerning the studies carried out by Carlos Chagas in Lassance with the collaboration of other investigators of the Manguinhos School. At that time the disease was described and the parasite, transmitters and reservoirs were studied. The coexistence of endemic goiter in the same region generated some confusion about the clinical forms of the disease; (b second period involving uncertainty and the description of isolated cases, which lasted until the 1940 decade. Many acute cases were described during this period and the disease was recognized in many Latin American countries. Particularly important were the studies of the Argentine Mission of Regional Pathology Studies, which culminated with the description of the Romaña sign in the 1930 decade, facilitating the diagnosis of the early phase of the disease. However, the chronic phase, which was the most important, continued to be difficult to recognize; (c period of consolidation of knowledge and recognition of the importance of Chagas disease. Studies conducted by Laranja, Dias and Nóbrega in Bambuí updated the description of Chagas heart disease made by Carlos Chagas and Eurico Villela. From then on, the disease was more easily recognized, especially with the emphasis on the use of a serologic diagnosis; (d period of enlargement of knowledges on the disease. The studies on denervation conducted in Ribeirão Preto by Fritz Köberle starting in the 1950 decade led to a better understanding of the relations between Chagas disease and megaesophagus and other visceral megas detected in endemic areas.

  19. Estado actual de nuestros conocimientos sobre la enfermedad de chagas en la Republica Mexicana

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    Jorge Tay

    1981-06-01

    Full Text Available Se presentan los datos obtenidos de la revisión minuciosa en relación a enfermedad de Chagas de la literatura médica de la República Mexicana y extranjera desde el afio de 1939 en que por primeira vez se reporta a Trypanosoma cruzi en México, hasta el ano de 1976. Mediante mapas, tablas y cuadros se senalan las localidades en donde se han encontrado casos humanos, reservorios no humanos y transmisores. Se hacen comentários acerca de los resultados obtenidos y se seffala la importancia de incrementar los estúdios sobre enfermedades de Chagas en nuestro país.É a apresentação dos dados obtidos a partir de uma minuciosa revisão feita na literatura médica mexicana e estrangeira com relação à doença de Chagas no México. O estudo refere-se ao período de 1939 quando, pela primeira vez, menciona-se Trypanosoma cruzi no México, até 1976. Através de mapas, tabelas e quadros são mostrados os lugares onde foram encontrados casos humanos, reservatórios e transmissores. São feitos comentários sobre os resultados obtidos e é ressaltada a necessidade de ampliação dos estudos sobre a doença de Chagas no México.A thorough review of the literature is made regarding Chagas disease in Mexico and else- where since 1939, when Trypanosoma cruzi was first reported in this country until 1976. The location where human cases, non human reservoirs and transmitters have been found is pointed out by means of maps, tables and charts comments are made regarding the results reported. The importance of increasing the studies of Chagas' disease in our country is stressed.

  20. [Transfusion transmission of Chagas disease in Honduras and other Central American countries].

    Science.gov (United States)

    Ponce, C

    1999-01-01

    The transmission of Trypanosoma cruzi through blood transfusion is the second most important way of acquiring Chagas disease. This form of transmission transcends the vectorial transmission in many geographical areas. Honduras has developed a successful program for the control of transfusional transmission, based on the serological screening of blood donors, which is supported by law, making it mandatory. This experience has been extended to other Central American countries, supported by PAHO. Actually in the framework of the Initiative of the Central American countries for the elimination of the transmission of Chagas disease, launched in 1997, the control of transfusional transmission is becoming a reality.

  1. Drug discovery for Chagas disease should consider Trypanosoma cruzi strain diversity

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    Bianca Zingales

    2014-09-01

    Full Text Available This opinion piece presents an approach to standardisation of an important aspect of Chagas disease drug discovery and development: selecting Trypanosoma cruzi strains for in vitro screening. We discuss the rationale for strain selection representing T. cruzi diversity and provide recommendations on the preferred parasite stage for drug discovery, T. cruzi discrete typing units to include in the panel of strains and the number of strains/clones for primary screens and lead compounds. We also consider experimental approaches for in vitro drug assays. The Figure illustrates the current Chagas disease drug-discovery and development landscape.

  2. Insuficiência renal aguda em pacientes com Síndrome Hellp

    OpenAIRE

    Sílvia Maria Dorigoni

    2001-01-01

    A síndrome HELLP ocorre em gestantes ou puérperas e é caracterizada pelo surgimento de hemólise, elevação de enzimas hepáticas e plaquetopenia. Desenvolve-se em aproximadamente 10% das gestantes com pré-eclampsia, sendo mais freqüente entre a 22a e 36a semanas de gestação. Insuficiência renal aguda é uma complicação freqüente e grave nessas pacientes. O objetivo deste estudo foi avaliar, em pacientes com síndrome HELLP, a prevalência de insuficiência renal aguda e estudar fatores a ela associ...

  3. Cerebelite aguda causada por vírus Epstein-Barr: relato de caso

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    Teive Hélio A.G.

    2001-01-01

    Full Text Available A cerebelite aguda pode ocorrer em associação a infecção pelo vírus da varicela-zoster, enterovirus, caxumba, micoplasma e outros agentes infecciosos. A cerebelite aguda é uma complicação rara da infecção pelo vírus Epstein-Barr (EBV. Relatamos o caso de uma mulher de 21 anos com história de 12 dias de evolução com náuseas, vômitos, ataxia de marcha e membros, tremor cefálico e de membros, opsoclono, mioclonias e rash cutâneo. Sorologia para EBV foi positiva. A infecção pelo EBV, com complicações neurológicas, pode não se apresentar com os sinais e sintomas clássicos da mononucleose infeciosa.

  4. Leucemia Mieloblástica Aguda | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available . E.4Principal exclusion criteria 1. Diagnóstico de leucemia aguda promielocítica (LPA, clasificación franco...realizado una prostatectomía radical.16. Evidencia clínica que puede indicar afectación del sistema nervioso central (SNC) con leucem...ia a menos que la punción lumbar confirme la ausencia de blastos leucémicos en el l

  5. Dor aguda no joelho do paciente idoso Acute knee pain in elderly patients

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    Gilberto Luís Camanho

    2008-09-01

    Full Text Available A dor aguda no joelho de pacientes idosos é freqüente, sendo caracterizada por seu aparecimento súbito, sem causa aparente, com exame radiográfico dentro dos padrões da normalidade, na maioria dos casos. A etiologia da dor aguda no joelho é decorrente de insuficiência das estruturas, e seu quadro clínico difere completamente daquele determinado pela osteoartrose, sendo sempre unilateral e ocorre na grande maioria em pacientes do sexo feminino, após a quinta década de vida, e na região medial do joelho (local de maior carga. Com o propósito de analisar as possíveis etiologias para a dor aguda do joelho de pacientes acima de 60 anos de idade, suas características e tratamento, os autores discutem as etiologias relacionadas à dor aguda: lesão meniscal, fratura por fadiga e osteonecrose idiopática.Acute knee pain in elderly patients is not uncommon, and is characterized by a sudden onset, no apparent cause, and by normal radiographic findings in most cases. The etiology of acute knee pain is the result of insufficient structures, and clinical symptoms are totally different from the symptoms seen in osteoarthrosis. This acute pain in the knee is always unilateral and in the medial region of the knee joint (site with the heaviest load, predominantly in females after the fifth decade of live. In order to consider the possible etiologies for acute knee joint pain in patients older than 60 years, its characteristics and treatment, the authors discuss etiologies related to acute pain: lesion of the meniscus, stress fracture, and idiopathic osteonecrosis.

  6. Sertralina e pancreatite aguda: relato de caso Sertraline and acute pancreatitis: a case-report

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    André Malbergier

    2004-03-01

    Full Text Available A pancreatite aguda é uma patologia grave e com considerável morbidade e mortalidade. Vários fatores são apontados como possíveis causas de pancreatite aguda. Neste relato, será apresentado um caso de pancreatite aguda com possível associação causal com um inibidor seletivo de recaptura de serotonina: sertralina. Após um mês de tratamento com sertralina, uma paciente do sexo feminino, 55 anos, desenvolveu forte dor abdominal e elevação da amilase sérica. Após internação e retirada da sertralina, seus sintomas remitiram e os níveis de amilase voltaram ao normal. Pela potencial gravidade do quadro e pelo amplo uso desta medicação, tal associação deve ser lembrada em investigações de casos de pancreatite aguda.Acute pancreatitis is a severe disease with considerable morbidity and mortality. Many risk factors are causally related to acute pancreatitis. In this report, a case of acute pancreatitis with possible causal relationship with the use of a selective serotonin reuptake inhibitor, sertraline, will be discussed. After one month of treatment with sertraline, a female patient, 55 years-old, developed a severe abdominal pain and showed a serum amylase elevation. She was admitted to the hospital and the use of sertraline was interrupted. After that, the symptoms remitted and the serum amylase level returned to normal. Because of the potential severity of this disease and the widespread use of sertraline, this association should be reminded when investigating possible causes for acute pancreatitis.

  7. Manifestacoes orais decorrentes da quimioterapia em criancas portadoras de leucemia linfocitica aguda

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    Everton Freitas de Morais

    2014-01-01

    Full Text Available Introdução: A leucemia linfocítica aguda é um dos tipos de câncer mais comuns em crianças e é caracterizada pela produção excessiva e desordenada de leucócitos imaturos na medula óssea. Objetivo: Identificar as manifestações orais mais frequentes em crianças portadoras de leucemia linfocítica aguda sob o tratamento quimioterápico. Metodologia: A pesquisa foi realizada nas bases de dados eletrônicas PubMed/Medline, Science Direct, Scielo e Scopus. Procurou-se por artigos apresentados na íntegra, escritos em português, inglês e espanhol, publicados entre janeiro de 1992 e abril de 2013. Resultados: Dos estudos selecionados primariamente, apenas oito atenderam aos critérios de inclusão. A população avaliada foi um grupo de crianças portadoras de leucemia linfócitica aguda. Todos os estudos realizaram exames intraorais para o diagnóstico das lesões bucais. De acordo com os resultados, as lesões mais frequentes foram mucosite, candidíase, periodontite e gengivite. A condição de saúde bucal dos portadores de leucemia linfócitica aguda variou de acordo com a higiene bucal do paciente. Conclusão: Pacientes com LLA podem apresentar alguma lesão na cavidade oral durante ou após o início da quimioterapia. O cirurgião dentista necessita reconhecer as manifestações orais e intervir na saúde bucal do paciente com LLA, contribuindo e auxiliando no seu tratamento.

  8. Porfiria aguda intermitente la importancia de ampliar la perspectiva del diagnóstico diferencial

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    Boris Espinoza Balderrama

    2012-12-01

    Full Text Available La porfiria aguda intermitente es un trastorno autosómico dominante, producido por deficiencia genética de porfobilinogeno desaminasa, enzima que participa en la biosíntesis del grupo hem, es una patología con elevada mortalidad, y poco observada en nuestro medio. En octubre del 2011, en el Hospital del Seguro Social Universitario se reportó un caso de porfiria aguda intermitente, paciente de 23 años, sexo femenino, ingresa con dolor abdominal agudo de gran intensidad a nivel de mesogastrio y síndrome miccional, durante su internación presento taquicardia, fiebre y leucocitosis sin focoinfeccioso aparente, llevando Insuficiencia renal aguda, acidosis metabólica y neuropatía periférica.Las sintomatología inespecífica plantea patologías quirúrgicas o médicas, que requieren análisis exhaustivo para la aproximación diagnostica, mediante prueba de fotosensibilidad en orina se sospecha el diagnóstico definitivo, la cual se confirmó con la determinación de porfirinas totales en sangre y en orina, de porfobilinógeno y de ácidodelta - aminolevulínico en orina realizada en Buenos Aires donde recibió tratamiento oportuno.

  9. Doença de Chagas em Lassance, MG: Reavaliação clínico-epidemiológica 90 anos após a descoberta de Carlos Chagas Chagas' disease in Lassance, Minas Gerais State: Clinical-epidemiological re-evaluation ninety years after the discovery by Carlos Chagas

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    João Carlos Pinto Dias

    2002-04-01

    Full Text Available Analisa-se a trajetória da doença de Chagas em Lassance (município da descoberta de Carlos Chagas entre 1.908 a 2.001, através de registros históricos e pesquisas atuais. O município foi importante foco da tripanossomíase entre Chagas e os anos 1.980, mercê de infestação significativa das casas por Panstrongylus megistus e, mais tarde, Triatoma infestans, espécies que foram eficazmente controladas, nos últimos 20 anos. Importante no passado, a infecção chagásica é hoje residual, com uma prevalência geral de 5,03% e afetando basicamente os grupos etários elevados, não se encontrando soropositivos abaixo dos 20 anos de idade. O perfil clínico-epidemiológico dos chagásicos detectados é o habitual de áreas com transmissão interrompida, com a maioria dos casos em formas cardíacas benignas ou na forma crônica indeterminada, havendo ainda indicativos de formas digestivas, sendo a mortalidade ainda significativa, em grupos etários elevados. O município apresenta-se infestado por T. sordida, em baixas densidades e grande dispersão, não infectado por T. cruzi e restrito ao peridomicílio. Conclui-se que Lassance está hoje livre da transmissão da doença, devendo manter-se sob vigilância epidemiológica frente aos triatomíneos nativos no município e garantir-se a atenção médica às pessoas infectadas no passado.The history and present situation of Chagas' disease in Lassance (the county where Carlos Chagas discovered American trypanosomiasis were studied through a historical analysis and clinical and epidemiological research performed from 1999 to 2001. Lassance was an important focus of Chagas' disease from Carlos Chagas up until the 1980's, because of intensive infestation in dwellings by Panstrongylus megistus and Triatoma infestans, two important species which were efficiently controlled in the last twenty years. Human Chagas' disease was important in the past but today is only residual, affecting basically the

  10. Papel do óxido nítrico no desenvolvimento de lesões cardíacas na fase aguda da infecção experimental pelo Trypanosoma cruzi Role of nitric oxide in the development of cardiac lesions during the acute phase of experimental infection by Trypanosoma cruzi

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    Cláudia Renata Bibiano Borges

    2009-04-01

    Full Text Available A doença de Chagas é causada pelo Trypanosoma cruzi e o coração é o órgão mais acometido. O óxido nítrico apresenta importante ação anti-Trypanosoma, porém, com pouca evidência de seu papel no mecanismo de lesão tecidual. O objetivo deste estudo foi analisar a contribuição do óxido nítrico no desenvolvimento da inflamação e da fibrose cardíaca na fase aguda da infecção experimental por cepas Y e Colombiana do Trypanosoma cruzi. A inflamação foi significativamente maior nos animais infectados pela cepa Colombiana, comparada com os infectados com a cepa Y, tanto nos animais C57BL/6 (3,98x1,87%; p=0,004 quanto nos animais C57BL/6 deficientes na sintase do óxido nítrico induzível (3,99x2,4%; p=0,013. O parasitismo cardíaco dos animais C57BL/6 deficientes na sintase do óxido nítrico induzível infectados pela cepa Colombiana foi significativamente maior que o destes mesmos animais infectados com a cepa Y (2,78x0,17 ninhos/mm²; p=0,004 assim como, os animais C57BL/6 infectados com a cepa Colombiana (2,78x1,33 ninhos/mm²; p=0,006 ou cepa Y (2,78x0,53 ninhos/mm²; p=0,005. Os dados reforçam o papel do óxido nítrico no controle do parasitismo e sugerem seu papel na proteção tecidual, controlando a inflamação e potencialmente diminuindo lesões cardíacas durante a fase aguda na doença de Chagas experimental.Chagas disease is caused by Trypanosoma cruzi and the heart is the organ most affected. Nitric oxide has notable anti-Trypanosoma action, but with little evidence regarding its role in the mechanism for tissue injury. The objective of this study was to analyze the contribution of nitric oxide towards the development of inflammation and cardiac fibrosis during the acute phase of experimental infection by Y and Colombian strains of Trypanosoma cruzi. The inflammation was significantly more intense in animals infected with the Colombian strain, compared with those infected with the Y strain, both in C57BL/6

  11. Técnica do xenodiagnostico na molestia de Chagas

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    Emmanuel Dias

    1940-01-01

    Full Text Available O xenodiagnostico é um processo muito valioso para o diagnostico etiologico da moléstia de Chagas. Consiste em alimentar-se barbeiros normais em supótos portadores da infecção e determinar-se, depois, si eles adquirem ou não o parasitismo. Em cada região deve ser empregada, de preferência, o transmissor local mais importante. Três a seis ninfas famintas são geralmente empregadas em cada prova, devendo ficar em contacto com o doador até encherem-se completamente (15-30 minutos. Si o exame de fezes – espontaneamente eliminadas ou obtidas por punção anal – não revelar a presença de flagelados, os insetos devem ser dissecados 40 a 60 dias depois da sucção, para exame do conteúdo duodenal.Xenodiagnosis is a very valuable method for the etiological diagnosis of Chagas’s disease. It consists in allowing the clean insect transmitter to feed upon the suspected carrier, and in ascertaining whether the bugs become infected. The principal local vector is the most suitable species to be used in a given region. Three to six hungry nymphs are usually employed in each test and must feed until repletion (15-30 minutes. It flagellates are not detected in the faeces or in the rectal contents, obtained by anal puncture, insects are dissected 40-60 days after the and the duodenal contents is examined.

  12. Community Participation in Chagas Disease Vector Surveillance: Systematic Review

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    Abad-Franch, Fernando; Vega, M. Celeste; Rolón, Miriam S.; Santos, Walter S.; Rojas de Arias, Antonieta

    2011-01-01

    Background Vector control has substantially reduced Chagas disease (ChD) incidence. However, transmission by household-reinfesting triatomines persists, suggesting that entomological surveillance should play a crucial role in the long-term interruption of transmission. Yet, infestation foci become smaller and harder to detect as vector control proceeds, and highly sensitive surveillance methods are needed. Community participation (CP) and vector-detection devices (VDDs) are both thought to enhance surveillance, but this remains to be thoroughly assessed. Methodology/Principal Findings We searched Medline, Web of Knowledge, Scopus, LILACS, SciELO, the bibliographies of retrieved studies, and our own records. Data from studies describing vector control and/or surveillance interventions were extracted by two reviewers. Outcomes of primary interest included changes in infestation rates and the detection of infestation/reinfestation foci. Most results likely depended on study- and site-specific conditions, precluding meta-analysis, but we re-analysed data from studies comparing vector control and detection methods whenever possible. Results confirm that professional, insecticide-based vector control is highly effective, but also show that reinfestation by native triatomines is common and widespread across Latin America. Bug notification by householders (the simplest CP-based strategy) significantly boosts vector detection probabilities; in comparison, both active searches and VDDs perform poorly, although they might in some cases complement each other. Conclusions/Significance CP should become a strategic component of ChD surveillance, but only professional insecticide spraying seems consistently effective at eliminating infestation foci. Involvement of stakeholders at all process stages, from planning to evaluation, would probably enhance such CP-based strategies. PMID:21713022

  13. Insecticide resistance in vector Chagas disease: evolution, mechanisms and management.

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    Mougabure-Cueto, Gastón; Picollo, María Inés

    2015-09-01

    Chagas disease is a chronic parasitic infection restricted to America. The disease is caused by the protozoa Trypanosoma cruzi, which is transmitted to human through the feces of infected triatomine insects. Because no treatment is available for the chronic forms of the disease, vector chemical control represents the best way to reduce the incidence of the disease. Chemical control has been based principally on spraying dwellings with insecticide formulations and led to the reduction of triatomine distribution and consequent interruption of disease transmission in several areas from endemic region. However, in the last decade it has been repeatedly reported the presence triatomnes, mainly Triatoma infestans, after spraying with pyrethroid insecticides, which was associated to evolution to insecticide resistance. In this paper the evolution of insecticide resistance in triatomines is reviewed. The insecticide resistance was detected in 1970s in Rhodnius prolixus and 1990s in R. prolixus and T. infestans, but not until the 2000s resistance to pyrthroids in T. infestans associated to control failures was described in Argentina and Bolivia. The main resistance mechanisms (i.e. enhanced metabolism, altered site of action and reduced penetration) were described in the T. infestans resistant to pyrethrods. Different resistant profiles were demonstrated suggesting independent origin of the different resistant foci of Argentina and Bolivia. The deltamethrin resistance in T. infestans was showed to be controlled by semi-dominant, autosomally inherited factors. Reproductive and developmental costs were also demonstrated for the resistant T. infestans. A discussion about resistance and tolerance concepts and the persistence of T. infestans in Gran Chaco region are presented. In addition, theoretical concepts related to toxicological, evolutionary and ecological aspects of insecticide resistance are discussed in order to understand the particular scenario of pyrethroid

  14. Molecular epidemiology of human oral Chagas disease outbreaks in Colombia.

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    Juan David Ramírez

    Full Text Available BACKGROUND: Trypanosoma cruzi, the causative agent of Chagas disease, displays significant genetic variability revealed by six Discrete Typing Units (TcI-TcVI. In this pathology, oral transmission represents an emerging epidemiological scenario where different outbreaks associated to food/beverages consumption have been reported in Argentina, Bolivia, Brazil, Ecuador and Venezuela. In Colombia, six human oral outbreaks have been reported corroborating the importance of this transmission route. Molecular epidemiology of oral outbreaks is barely known observing the incrimination of TcI, TcII, TcIV and TcV genotypes. METHODOLOGY AND PRINCIPAL FINDINGS: High-throughput molecular characterization was conducted performing MLMT (Multilocus Microsatellite Typing and mtMLST (mitochondrial Multilocus Sequence Typing strategies on 50 clones from ten isolates. Results allowed observing the occurrence of TcI, TcIV and mixed infection of distinct TcI genotypes. Thus, a majority of specific mitochondrial haplotypes and allelic multilocus genotypes associated to the sylvatic cycle of transmission were detected in the dataset with the foreseen presence of mitochondrial haplotypes and allelic multilocus genotypes associated to the domestic cycle of transmission. CONCLUSIONS: These findings suggest the incrimination of sylvatic genotypes in the oral outbreaks occurred in Colombia. We observed patterns of super-infection and/or co-infection with a tailored association with the severe forms of myocarditis in the acute phase of the disease. The transmission dynamics of this infection route based on molecular epidemiology evidence was unraveled and the clinical and biological implications are discussed.

  15. Pathology of complete atrioventricular block in chronic chagas' myocarditis

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    Zilton A. Andrade

    1988-03-01

    Full Text Available Sclero-atrophy, fibrosis, vascular ectasia, phlebosclerosis and mild non-specific chronic inflammatory changes were observed in variable location and proportion involving the atrioventricular conducting tissue of the heart in five human cases of chronic Chagas' myocarditis associated with complete atrioventricular block. One case presented complete destruction of the A-V conduction system. In three cases the lesions were disseminated all along the conducting tissue but did not cause anywhere a complete disruption in the continuity of the system. The distal portion of the bundle branches were the most damaged sector of the system, exceptfor the fasciculi of the posterior division of the left bundle branch which were relatively preserved. One case exhibited bilateral sclero-atrophy of the bundle branches as the main change; and another showed early and mild fibrocalcific damage of the penetrating portion of the His bundle. The A-V node appeared as the least involved part of the conducting system in the cases studied. Demonstration of the lesions in this series of cases seems important because: a it reveals that complete atrioventriculr block in chronic Chagas' disease results from disseminated lesions and not from focal disruptive change as has been commonly observed in cases of other etiologies; b it shows that chronic inflammation can produce at the end variable and widespread vascular, degenerative andfibrotic alterations within the conducting tissue of the heart, which may lead to its total destruction.O estudo do sistema de condução atrioventricular através cortes seriados completos em cinco casos humanos de miocardite crônica chagásica e bloqueio A-V total revelou a presença de lesões de esclero-atrofia, fibrose, ectasia vascular, fleboesclerose e inflamação crônica inespeclfica envolvendo o sistema de maneira disseminada, mas com distribuição e intensidade variáveis de caso para caso. Em um caso, todo o sistema, do nódulo A

  16. Effects of aspirin-triggered resolvin D1 on peripheral blood mononuclear cells from patients with Chagas' heart disease.

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    Ogata, Haline; Teixeira, Maxelle Martins; Sousa, Rodrigo Cunha de; Silva, Marcos Vinícius da; Correia, Dalmo; Rodrigues Junior, Virmondes; Levy, Bruce David; Rogério, Alexandre de Paula

    2016-04-15

    Chagas disease is caused by Trypanosoma cruzi (T. cruzi). In some patients with Chagas disease, symptoms progress to chronic chagasic cardiomyopathy. Endogenously, inflammation is resolved in the presence of lipid mediators such as aspirin-triggered RvD1 (AT-RvD1) which has anti-inflammatory and pro-resolution effects. Here, we demonstrated, for the first time, the effects of AT-RvD1 on T. cruzi antigen-stimulated peripheral blood mononuclear cells (PBMCs) from patients with Chagas heart disease. The levels of IFN-γ, TNF-α, IL-10, and IL-13 increased in PBMCs from cardiac-form Chagas patients in stage B1 (patients with fewer heart abnormalities) stimulated with T. cruzi antigen compared to those in non-stimulated PBMCs. AT-RvD1 reduced the IFN-γ concentrations in PBMCs from patients with Chagas disease stimulated with T. cruzi antigen compared to stimulated with T. cruzi antigen cells. AT-RvD1 treatment resulted in no observable changes in TNF-α, IL-10, and IL-13 levels. AT-RvD1 significantly decreased the percentage of necrotic cells and caused a significant reduction in the proliferation rate of T. cruzi antigen-stimulated PBMCs from patients with Chagas disease. These findings demonstrate that AT-RvD1 modulates the immune response in Chagas disease patients and might have potential to be used as an alternative approach for slowing the development of further heart damage.

  17. Comparação entre o reagente Chagas-latex e a imunofluorescência no diagnóstico sorológico da doença de Chagas na zona sul do Rio Grande do Sul

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    Giovanni Baruffa

    1973-10-01

    Full Text Available Os Autores submeteram 142 amostras de soros de casos agudos e crônicos de Doença de Chagas, já examinados com o Reagente Chagas-Latex, ao exame de Imunofluorescência, obtendo correspondência de resultados em 139 (97,9%. O alto índice de fidelidade, provavelmente devido à ausência na zona de doenças que possam proporcionar resultados falsamente positivos, fez do Reagente Chagas-Latex um método simples e fácil para a triagem sorológica nos casos suspeitos em zona endêmica.

  18. Quimioterapia da doença de Chagas: estado da arte e perspectivas no desenvolvimento de novos fármacos Chemotherapy of Chagas' disease: state of the art and perspectives for the development of new drugs

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    Luiz C. Dias

    2009-01-01

    Full Text Available Neglected diseases are a major global cause of illness, long-term disability and death. Chagas' disease is a parasitic infection widely distributed throughout Latin America, with devastating consequences in terms of human morbidity and mortality. The existing drug therapy suffers from a combination of drawbacks including poor efficacy, resistance and serious side effects. In 2009, we celebrate the 100th anniversary of the discovery of Chagas' disease, facing the challenges of developing new, safe and effective drugs for the treatment of this disease. This brief review attempts to highlight the state of the art, limitations and perspectives of Chagas' disease drug development.

  19. Novo procedimento de xenodiagnóstico na forma crônica da doença de Chagas New xenodiagnostic procedure in chronic Chagas' disease

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    Saulo P. Almeida

    1976-01-01

    Full Text Available Xenodiagnósticos feitos com Triatoma infestans durante 24 horas consecutivas, a intervalos de duas horas, demonstraram o Trypanosoma cruzi em 9 de 10 pacientes suspeitos de infecção chagástica crônica.Positive xenodiagnostic was obtained in 9 out of 10 chronic Chagas' disease patients on which triatoma infestans were allowed to feed at 2hr intervals along a period of 24hr.

  20. FC-TRIPLEX Chagas/Leish IgG1: a multiplexed flow cytometry method for differential serological diagnosis of chagas disease and leishmaniasis.

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    Andréa Teixeira-Carvalho

    Full Text Available Differential serological diagnosis of Chagas disease and leishmaniasis is difficult owing to cross-reactivity resulting from the fact that the parasites that cause these pathologies share antigenic epitopes. Even with optimized serological assays that use parasite-specific recombinant antigens, inconclusive test results continue to be a problem. Therefore, new serological tests with high sensitivity and specificity are needed. In the present work, we developed and evaluated the performance of a new flow cytometric serological method, referred to as FC-TRIPLEX Chagas/Leish IgG1, for the all-in-one classification of inconclusive tests. The method uses antigens for the detection of visceral leishmaniasis, localized cutaneous leishmaniasis, and Chagas disease and is based on an inverted detuned algorithm for analysis of anti-Trypanosomatidae IgG1 reactivity. First, parasites were label with fluorescein isothiocyanate or Alexa Fluor 647 at various concentrations. Then serum samples were serially diluted, the dilutions were incubated with suspensions of mixed labeled parasites, and flow cytometric measurements were performed to determine percentages of positive fluorescent parasites. Using the new method, we obtained correct results for 76 of 80 analyzed serum samples (95% overall performance, underscoring the outstanding performance of the method. Moreover, we found that the fluorescently labeled parasite suspensions were stable during storage at room temperature, 4 °C, and -20 °C for 1 year. In addition, two different lots of parasite suspensions showed equivalent antigen recognition; that is, the two lots showed equivalent categorical segregation of anti-Trypanosomatidae IgG1 reactivity at selected serum dilutions. In conclusion, we have developed a sensitive and selective method for differential diagnosis of Chagas disease, visceral leishmaniasis, and localized cutaneous leishmaniasis.

  1. Further genetic characterization of the two Trypanosoma cruzi Berenice strains (Be-62 and Be-78) isolated from the first human case of Chagas disease (Chagas, 1909).

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    Cruz, R E; Macedo, A M; Barnabé, C; Freitas, J M; Chiari, E; Veloso, V M; Carneiro, C M; Bahia, M T; Tafuri, Washington L; Lana, M

    2006-03-01

    We describe here an extension of a previous genetic characterization of Trypanosoma cruzi strains (Be-62 and Be-78) isolated from the patient Berenice, the first human case of Chagas disease [Chagas, C., 1909. Nova Tripanomíase humana. Estudos sobre morfologia e o ciclo evolutivo do Schizotrypanum cruzi, n. gen., n. sp., agente etiolójico da nova entidade morbida do homem. Mem. Inst. Oswaldo Cruz 1, 159-218]. We wanted to verify the composition of T. cruzi populations originated from these two isolates. In the present work, 22 enzymatic loci (MLEE), nine RAPD primers and 7 microsatellite loci were analyzed. Clones from both strains were also characterized to verify whether these strains are mono or polyclonal. Be-62 and Be-78 strains were different in 3 out of 22 enzymatic systems, in 3 out of 9 RAPD primers tested and in all microsatellite loci investigated. However, our data suggests that both strains are phylogenetically closely related, belonging to genetic group 32 from Tibayrenc and Ayala [Tibayrenc, M., Ayala, F.J., 1988. Isoenzime variability in Trypanosoma cruzi, the agent of Chagas' disease: genetical, taxonomical, and epidemiological significance. Evolution 42, 277-292], equivalent to zymodeme 2 and T. cruzi II major lineage which, in Brazil, comprises parasites from the domestic cycle of the disease. Microsatellite analyses showed differences between the parental strains but suggested that both populations are monoclonal since each strain and their respective clones showed the same amplification products.

  2. Infección aguda por el VHC Acute hepatitis C virus infection

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    A. Martínez Echeverría

    2004-01-01

    Full Text Available La infección aguda por el virus C de la hepatitis produce un cuadro clínico y bioquímico no específico e indistinguible de los causados por otros virus hepatotropos. El diagnóstico específico de la hepatitis aguda por virus C se basa en la detección en sangre del RNA-VHC mediante una técnica de reacción en cadena de la polimerasa cuyo resultado será positivo a partir de 1-2 semanas tras el contacto inicial con el virus. Los anticuerpos frente al VHC se detectan más tardíamente (a las 7-8 semanas por término medio no siendo útiles, como determinación aislada, para distinguir infección aguda de infección crónica o aclaramiento del virus (espontáneo o tras tratamiento. El 55-85% de los pacientes con infección aguda por el VHC no aclaran el virus y desarrollan una infección crónica con riesgo de evolución a cirrosis y de desarrollo de hepatocarcinoma. Por ello, la tendencia actual es tratar con interferón a todos aquellos pacientes en los que el RNA-VHC se mantenga positivo más allá de 3-4 meses tras el diagnóstico de la infección aguda.Acute hepatitis C virus infection produces clinical and biochemical features that is non-specific and indistinguishable from those caused by other hepatotropic viruses. The specific diagnosis of acute hepatitis C virus infection is based on the detection of serum RNA-HCV through a technique of PCR whose result will be positive after 1-2 weeks of the initial contact with the virus. The anti-bodies against HCV are detected later (after 7-8 weeks on average, and are not useful, as an isolated determination, in distinguishing acute infection from chronic infection or in clearing the virus (spontaneous or following treatment. Fifty-five to eighty-five percent of patients with acute HCV infection do not clear the virus and develop a chronic infection with risk of evolution to cirrhosis and of developing hepatocellular carcinoma. For this reason, the present tendency is to treat with interferon

  3. Intoxicaciones agudas graves en un servicio de medicina intensiva durante doce años

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    Palazón Sánchez C

    2000-01-01

    Full Text Available Fundamento: Conocer la epidemiología de las intoxicaciones agudas graves en un servicio de medicina intensiva y evaluar el pronóstico de la PCR y mortalidad asociada a los distintos tóxicos Métodos: Estudio retrospectivo realizado en el servicio de medicina intensiva polivalente de 10 camas, ubicado en un Hospital General de adultos. Período de estudio 12 años. Revisión de las historias clínicas de las personas ingresadas en el servicio de medicina intensiva por intoxicaciones agudas graves. Se recogieron datos demográficos, existencia de PCR al ingreso, necesidad de VM, complicaciones de las intoxicaciones agudas graves y mortalidad de la serie. Se realizó un análisis global y por año de estudio. El tratamiento estadístico de los datos se realizó con el paquete SPSS mediante la "t" de Student o la "chi" cuadrado, considerando valores significativos si p<0,05 Resultados: Se han incluido 233 sujetos, de los que 130 fueron varones. La estancia media fue de 4 días. El 63% de los pacientes fueron menores de 40 años (p<0,05. La intoxicación más frecuente fue la medicamentosa debida a un solo producto (72%. La supervivencia tras la PCR fue del 40% (4/10. La mortalidad global se situó en el 5,6% (n=13, habiendo precisado el 92% de los sujetos que posteriormente murieron, VM en algún momento de su ingreso en la unidad de cuidados intensivos. Conclusiones: En nuestro medio, la intoxicación más frecuente es la medicamentosa. La mortalidad se muestra dependiente del carácter de voluntariedad, pero independiente del tipo de tóxico (medicamentoso o no. La PCR asociada a las intoxicaciones agudas graves tiene, en nuestra serie, un mejor pronostico que la asociada a otras patologías. La VM asociada a las intoxicaciones agudas graves tiene una mortalidad baja (15,7%

  4. Infarto esplénico secundario a pancreatitis aguda Splenic infarction secondary to acute pancreatitis

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    J. J. Arenal Vera

    2008-05-01

    Full Text Available Fundamento y objetivo: la estrecha relación anatómica del páncreas con los vasos esplénicos y el bazo es responsable de complicaciones esplénicas en el curso de la pancreatitis aguda. El objetivo es presentar dos casos clínicos de pancreatitis aguda grave que sufrieron infarto esplénico como complicación de la enfermedad pancreática. Pacientes, participantes: en un periodo de tres meses, dos pacientes fueron diagnosticados de infarto esplénico secundario a pancreatitis aguda. En ambos casos el diagnóstico y seguimiento evolutivo del infarto esplénico se hizo a través de tomografía axial computerizada. Resultados: en el primer paciente, las imágenes muestran de forma inequívoca la afectación de la arteria esplénica por el proceso inflamatorio pancreático. En el segundo, no se pudo demostrar afectación de los vasos esplénicos, por lo que la única posible explicación etiológica es un incremento de coagulabilidad intravascular. Conclusiones: sería recomendable añadir las complicaciones esplénicas al conjunto de complicaciones graves extrapancreáticas de la pancreatitis aguda. La tomografía axial computerizada es de gran utilidad para la detección y seguimiento de las complicaciones esplénicas de la pancreatitis aguda.Background and objective: the close anatomic relationship of the pancreas with the splenic vessels and the spleen is responsible for splenic complications in the course of acute pancreatitis. Our objective was to report two cases of severe acute pancreatitis complicated by splenic infarction. Patients: in a three-month period of time two patients were diagnosed with splenic infarction secondary to acute pancreatitis. In both cases splenic infarction diagnosis and follow-up were carried out using computed tomography. Results: in the first case images clearly showed a narrowing of the splenic artery due to the inflammatory pancreatic condition. In the second case no involvement of the splenic vessels could

  5. Mode of death on Chagas heart disease: comparison with other etiologies. a subanalysis of the REMADHE prospective trial.

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    Silvia M Ayub-Ferreira

    Full Text Available Sudden death has been considered the main cause of death in patients with Chagas heart disease. Nevertheless, this information comes from a period before the introduction of drugs that changed the natural history of heart failure. We sought to study the mode of death of patients with heart failure caused by Chagas heart disease, comparing with non-Chagas cardiomyopathy.We examined the REMADHE trial and grouped patients according to etiology (Chagas vs non-Chagas and mode of death. The primary end-point was all-cause, heart failure and sudden death mortality; 342 patients were analyzed and 185 (54.1% died. Death occurred in 56.4% Chagas patients and 53.7% non-Chagas patients. The cumulative incidence of all-cause mortality and heart failure mortality was significantly higher in Chagas patients compared to non-Chagas. There was no difference in the cumulative incidence of sudden death mortality between the two groups. In the Cox regression model, Chagas etiology (HR 2.76; CI 1.34-5.69; p = 0.006, LVEDD (left ventricular end diastolic diameter (HR 1.07; CI 1.04-1.10; p<0.001, creatinine clearance (HR 0.98; CI 0.97-0.99; p = 0.006 and use of amiodarone (HR 3.05; CI 1.47-6.34; p = 0.003 were independently associated with heart failure mortality. LVEDD (HR 1.04; CI 1.01-1.07; p = 0.005 and use of beta-blocker (HR 0.52; CI 0.34-0.94; p = 0.014 were independently associated with sudden death mortality.In severe Chagas heart disease, progressive heart failure is the most important mode of death. These data challenge the current understanding of Chagas heart disease and may have implications in the selection of treatment choices, considering the mode of death.ClinicalTrials.gov NCT00505050 (REMADHE.

  6. Acute pancreatitis associated with acute viral hepatitis: case report and review of literature Pancreatite aguda associada com hepatite A aguda: relato de caso e revisão da literatura

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    Danilo Bora Moleta

    2009-12-01

    Full Text Available This case report, along with the review presented, describes a patient diagnosed with acute viral hepatitis, who developed a framework of intense abdominal pain and laboratorial alterations compatible with acute pancreatitis. The association of acute pancreatitis complicating fulminant and non-fulminant acute hepatitis virus (AHV has been reported and several mechanisms have been proposed for this complication, but so far none is clearly involved. As acute hepatitis is a common disease, it is important to stimulate the development of other studies in order to determine local incidence and profile of patients presenting this association in our environment.Este relato de caso, junto com a revisão de literatura, descreve um paciente com diagnóstico de hepatite viral aguda, que desenvolveu quadro de dor abdominal intensa e alterações laboratoriais compatíveis com pancreatite aguda. Casos de pancreatite aguda complicando hepatites virais agudas fulminantes e não fulminantes tem sido esporadicamente relatados e vários mecanismos são propostos para explicar esta complicação, no entanto sua causa ainda se mantém desconhecida. Como a hepatite aguda é doença comum, é importante estimular o desenvolvimento de mais estudos na América Latina que visem determinar a incidência local e o perfil dos pacientes que apresentam esta complicação.

  7. Spatial patterns in discordant diagnostic test results for Chagas disease: links to transmission hotspots.

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    Levy, Michael Z; Bowman, Natalie M; Kawai, Vivian; Plotkin, Joshua B; Waller, Lance A; Cabrera, Lilia; Steurer, Frank; Seitz, Amy E; Pinedo-Cancino, Viviana V; Cornejo del Carpio, Juan Geny; Cordova Benzaquen, Eleazar; McKenzie, F Ellis; Maguire, James H; Gilman, Robert H; Bern, Caryn

    2009-04-15

    Diagnosis of Chagas disease is hindered by discordance between screening and confirmatory test results for Trypanosoma cruzi infection. In periurban Arequipa, Peru, spatial analysis revealed that individuals with discordant test results are spatially clustered in hotspots of T. cruzi transmission, suggesting that discordant results likely represent true infections in this setting.

  8. Metallothionein-1 and nitric oxide expression are inversely correlated in a murine model of Chagas disease

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    Gonzalez-Mejia, Martha Elba; Torres-Rasgado, Enrique; Porchia, Leonardo M; Salgado, Hilda Rosas; Totolhua, José-Luis; Ortega, Arturo; Hernández-Kelly, Luisa Clara Regina; Ruiz-Vivanco, Guadalupe; Báez-Duarte, Blanca G; Pérez-Fuentes, Ricardo

    2014-01-01

    Chagas disease, caused by Trypanosoma cruzi, represents an endemic among Latin America countries. The participation of free radicals, especially nitric oxide (NO), has been demonstrated in the pathophysiology of seropositive individuals with T. cruzi. In Chagas disease, increased NO contributes to the development of cardiomyopathy and megacolon. Metallothioneins (MTs) are efficient free radicals scavengers of NO in vitro and in vivo. Here, we developed a murine model of the chronic phase of Chagas disease using endemic T. cruzi RyCH1 in BALB/c mice, which were divided into four groups: infected non-treated (Inf), infected N-monomethyl-L-arginine treated (Inf L-NAME), non-infected L-NAME treated and non-infected vehicle-treated. We determined blood parasitaemia and NO levels, the extent of parasite nests in tissues and liver MT-I expression levels. It was observed that NO levels were increasing in Inf mice in a time-dependent manner. Inf L-NAME mice had fewer T. cruzi nests in cardiac and skeletal muscle with decreased blood NO levels at day 135 post infection. This affect was negatively correlated with an increase of MT-I expression (r = -0.8462, p < 0.0001). In conclusion, we determined that in Chagas disease, an unknown inhibitory mechanism reduces MT-I expression, allowing augmented NO levels. PMID:24676665

  9. Science, health and development: Chagas disease in Brazil, 1943-1962.

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    Kropf, S Petraglia

    2005-12-01

    The present paper discusses the historical construction and legitimacy of Chagas disease as a distinct nosological entity and as a public health issue in Brazil. It focuses on the activities of a group of researchers from Oswaldo Cruz Institute who worked at the Centre for the Study and Prevention of Chagas disease, located in Bambuí, Minas Gerais. Led in the 1940s and 50s by Emmanuel Dias, disciple of Carlos Chagas, the group made important contributions to the clinical characterization of Chagas disease as a cardiac illness, established the fact that it was technically possible to control the disease by using residual insecticides, and engaged in intense political mobilization to have the disease included as part of the Health Ministry sanitation campaigns. My hypothesis is that the group's work was a determining factor in the overcoming of certain unresolved controversies that had surrounded the medical and social identity of the disease since the 1920s. I examine to what extent this process was directly linked both to post-war optimism over new possibilities of combating infectious diseases and to the national and international debate on the relation between health and economic and social development.

  10. Chronic phase of Chagas disease: why should it be treated? A comprehensive review

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    José Rodrigues Coura

    2011-09-01

    Full Text Available The pathogenesis and evolutive pattern of Chagas disease suggests that the chronic phase should be more widely treated in order to (i eliminate Trypanosoma cruzi and prevent new inflammatory foci and the extension of tissue lesions, (ii promote tissue regeneration to prevent fibrosis, (iii reverse existing fibrosis, (iv prevent cardiomyopathy, megaoesophagus and megacolon and (v reduce or eliminate cardiac block and arrhythmia. All cases of the indeterminate chronic form of Chagas disease without contraindications due to other concomitant diseases or pregnancy should be treated and not only cases involving children or recently infected cases. Patients with chronic Chagas cardiomyopathy grade II of the New York Heart Association classification should be treated with specific chemotherapy and grade III can be treated according to medical-patient decisions. We are proposing the following new strategies for chemotherapeutic treatment of the chronic phase of Chagas disease: (i repeated short-term treatments for 30 consecutive days and interval of 30-60 days for six months to one year and (ii combinations of drugs with different mechanisms of action, such as benznidazole + nifurtimox, benznidazole or nifurtimox + allopurinol or triazole antifungal agents, inhibition of sterol synthesis.

  11. [Serologic study of the diagnosis of Chagas disease in Nicaraguan students in the Juventud island].

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    Montes de Oca, N V; Cabrera Alonso, C; Martínez, R; Cantelar de Francisco, N; Pérez Insueta, O

    1989-01-01

    The results obtained during the serologic study for the diagnosis of Chagas' disease in 868 Nicaraguan students in the Isle of Youth are reported. Qualitative hemagglutination and indirect immunofluorescence were used. It was found that 8.5% of these students showed antibodies specific to Trypanosoma cruzi by means of this diagnostic test.

  12. Situação atual da doença de Chagas na Guiana Francesa

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    Philippe Esterre

    1987-09-01

    Full Text Available Localizada entre dois focos endêmicos da doença de Chagas, a Venezuela e o Brasil, a Guiana Francesa conheceu poucos casos dessa afecção de 1940 até 1956. Um inquérito sorológico, utilizando-se uma pesquisa ativa sobre pacientes cardiopáticos e uma pesquisa passiva, permitiu evidenciar a existência de dois casos autóctones. Apesar da presença de vetores domésticos, o risco da doença de Chagas na Guiana Francesa parece limitado à aparição episódica de escassos casos humanos.Although located between two endemic areas of Chagas' disease (Venezuela and Brazil, French Guiana recorded only few cases of this infection between 1940 and 1956. A serological survey, using either active detection in cardiopathic patients or a passive one resulted in the finding of two autochthonous cases. In spite ofthe presence of a peridomiciliary cycle the risk of Chagas' disease in French Guiana seems to be limited to the episodic occurrence of rare sporadic human cases.

  13. ADENOSINE DEAMINASE ACTIVITY AND SERUM C-REACTIVE PROTEIN AS PROGNOSTIC MARKERS OF CHAGAS DISEASE SEVERITY

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    Iván Darío BRAVO-TOBAR

    2015-10-01

    Full Text Available SUMMARY Chagas disease is a public health problem worldwide. The availability of diagnostic tools to predict the development of chronic Chagas cardiomyopathy is crucial to reduce morbidity and mortality. Here we analyze the prognostic value of adenosine deaminase serum activity (ADA and C-reactive protein serum levels (CRP in chagasic individuals. One hundred and ten individuals, 28 healthy and 82 chagasic patients were divided according to disease severity in phase I (n = 35, II (n = 29, and III (n = 18. A complete medical history, 12-lead electrocardiogram, chest X-ray, and M-mode echocardiogram were performed on each individual. Diagnosis of Chagas disease was confirmed by ELISA and MABA using recombinant antigens; ADA was determined spectrophotometrically and CRP by ELISA. The results have shown that CRP and ADA increased linearly in relation to disease phase, CRP being significantly higher in phase III and ADA at all phases. Also, CRP and ADA were positively correlated with echocardiographic parameters of cardiac remodeling and with electrocardiographic abnormalities, and negatively with ejection fraction. CRP and ADA were higher in patients with cardiothoracic index ≥ 50%, while ADA was higher in patients with ventricular repolarization disturbances. Finally, CRP was positively correlated with ADA. In conclusion, ADA and CRP are prognostic markers of cardiac dysfunction and remodeling in Chagas disease.

  14. Chagas' Disease and HIV Co-infection: Genotypic Characterization of the Trypanosoma cruzi Strain

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    Pacheco Raquel S

    1998-01-01

    Full Text Available In the past few years, new aspects of the immunopathology of Chagas' disease have been described in immunosuppressed patients, such as fatal central nervous system lesions related to the reactivation of the parasite. This article is the first description of the genotypic characterization, at the strain level, of Trypanosoma cruzi isolated from a patient with Chagas` disease/AIDS co-infection. The presence of four hypodense lesions was observed in the cranial compute tomographic scan. The diagnosis of AIDS was assessed by the detection of anti-HIV antibodies using enzyme-linked immunosorbent assay (ELISA and Western blot techniques. The CD4+ lymphocyte counts were maintained under 200 cells/mm3 during one year demonstrating the severity of the state of immunosuppression. Chagas' disease was confirmed by serological and parasitological methods. Trypomastigote forms were visualized in a thick blood smear. The parasite isolated is genotypically similar to the CL strain. The paper reinforces that cerebral Chagas' disease can be considered as another potential opportunistic infection in AIDS resulting from the reactivation of a dormant T. cruzi infection acquired years earlier.

  15. Chagas Disease in Mexico: Report of 14 Cases of Chagasic Cardiomyopathy in Children.

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    Salazar-Schettino, Paz María; Cabrera-Bravo, Margarita; Vazquez-Antona, Clara; Zenteno, Edgar; Alba-Alvarado, Mariana De; Gutierrez, Elia Torres; Gomez, Yolanda Guevara; Perera-Salazar, María Gabriela; Torre, Guadalupe Garcia de la; Bucio-Torres, Martha Irene

    2016-01-01

    Chagas disease is a parasitic infection mainly found in Latin America; it is transmitted by a triatomine, also known as assassin bug or kissing bug. In humans, the parasite causes mostly cardiac disorders. Two-thirds of the Mexican territory are regarded as risk areas for vector transmission of Trypanosoma cruzi, the causal agent. The parasite can be found as a blood-borne trypomastigote or as an intracellular amastigote. The progression and severity of lesions could be due to frequent reinfections or to infection by highly virulent strains. A total of 3,327 individuals younger than 18 years old, living in risk areas for this disease in the rural setting of the States of Queretaro, San Luis Potosi, and Veracruz, underwent a seroepidemiological study. Among them, 37 subjects were seropositive for T. cruzi, and were studied to look for signs of cardiac pathology, which has only been reported in adults. A clinical record was prepared for all included individuals, and electrocardiography (ECG) and echocardiography (ECHO) studies were performed; 25 cases showed lesions compatible with the onset of Chagas cardiomyopathy. The other 12 patients showed either normal ECG and ECHO data or showed abnormal parameters that were not regarded as significant. Lesions found in the onset of Chagas cardiomyopathy in children are herein reported, along with 14 cases of cardiac pathology compatible with Chagas disease. Our results indicate that patients younger than 18 years can show a cardiac pathology similar to that observed in adults.

  16. Chagas' disease: study of congenital transmission in cases of acute maternal infection

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    Moretti Edgardo

    2005-01-01

    Full Text Available We studied three pregnant women with acute chagasic infection. Two patients, infected in the third trimester of pregnancy, had uninfected children. The third patient, infected earlier, had an infected newborn. These results encourage research on risk factors of transmission and on medical decisions concerning pregnant women with acute Chagas' disease.

  17. Metallothionein-1 and nitric oxide expression are inversely correlated in a murine model of Chagas disease

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    Martha Elba Gonzalez-Mejia

    2014-04-01

    Full Text Available Chagas disease, caused by Trypanosoma cruzi, represents an endemic among Latin America countries. The participation of free radicals, especially nitric oxide (NO, has been demonstrated in the pathophysiology of seropositive individuals with T. cruzi. In Chagas disease, increased NO contributes to the development of cardiomyopathy and megacolon. Metallothioneins (MTs are efficient free radicals scavengers of NO in vitro and in vivo. Here, we developed a murine model of the chronic phase of Chagas disease using endemic T. cruzi RyCH1 in BALB/c mice, which were divided into four groups: infected non-treated (Inf, infected N-monomethyl-L-arginine treated (Inf L-NAME, non-infected L-NAME treated and non-infected vehicle-treated. We determined blood parasitaemia and NO levels, the extent of parasite nests in tissues and liver MT-I expression levels. It was observed that NO levels were increasing in Inf mice in a time-dependent manner. Inf L-NAME mice had fewer T. cruzi nests in cardiac and skeletal muscle with decreased blood NO levels at day 135 post infection. This affect was negatively correlated with an increase of MT-I expression (r = -0.8462, p < 0.0001. In conclusion, we determined that in Chagas disease, an unknown inhibitory mechanism reduces MT-I expression, allowing augmented NO levels.

  18. ADENOSINE DEAMINASE ACTIVITY AND SERUM C-REACTIVE PROTEIN AS PROGNOSTIC MARKERS OF CHAGAS DISEASE SEVERITY

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    BRAVO-TOBAR, Iván Darío; NELLO-PÉREZ, Carlota; FERNÁNDEZ, Alí; MOGOLLÓN, Nora; PÉREZ, Mary Carmen; VERDE, Juan; CONCEPCIÓN, Juan Luis; RODRIGUEZ-BONFANTE, Claudina; BONFANTE-CABARCAS, Rafael

    2015-01-01

    SUMMARY Chagas disease is a public health problem worldwide. The availability of diagnostic tools to predict the development of chronic Chagas cardiomyopathy is crucial to reduce morbidity and mortality. Here we analyze the prognostic value of adenosine deaminase serum activity (ADA) and C-reactive protein serum levels (CRP) in chagasic individuals. One hundred and ten individuals, 28 healthy and 82 chagasic patients were divided according to disease severity in phase I (n = 35), II (n = 29), and III (n = 18). A complete medical history, 12-lead electrocardiogram, chest X-ray, and M-mode echocardiogram were performed on each individual. Diagnosis of Chagas disease was confirmed by ELISA and MABA using recombinant antigens; ADA was determined spectrophotometrically and CRP by ELISA. The results have shown that CRP and ADA increased linearly in relation to disease phase, CRP being significantly higher in phase III and ADA at all phases. Also, CRP and ADA were positively correlated with echocardiographic parameters of cardiac remodeling and with electrocardiographic abnormalities, and negatively with ejection fraction. CRP and ADA were higher in patients with cardiothoracic index ≥ 50%, while ADA was higher in patients with ventricular repolarization disturbances. Finally, CRP was positively correlated with ADA. In conclusion, ADA and CRP are prognostic markers of cardiac dysfunction and remodeling in Chagas disease. PMID:26603224

  19. The endless race between Trypanosoma cruzi and host immunity: lessons for and beyond Chagas disease.

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    Junqueira, Caroline; Caetano, Braulia; Bartholomeu, Daniella C; Melo, Mariane B; Ropert, Catherine; Rodrigues, Maurício M; Gazzinelli, Ricardo T

    2010-09-15

    Infection with the protozoan parasite Trypanosoma cruzi, the agent of Chagas disease, is characterised by a variable clinical course - from symptomless cases to severe chronic disease with cardiac and/or gastrointestinal involvement. The variability in disease outcome has been attributed to host responses as well as parasite heterogeneity. In this article, we review studies indicating the importance of immune responses as key determinants of host resistance to T. cruzi infection and the pathogenesis of Chagas disease. Particular attention is given to recent studies defining the role of cognate innate immune receptors and immunodominant CD8+ T cells that recognise parasite components - both crucial for host-parasite interaction and disease outcome. In light of these studies we speculate about parasite strategies that induce a strong and long-lasting T-cell-mediated immunity but at the same time allow persistence of the parasite in the vertebrate host. We also discuss what we have learned from these studies for increasing our understanding of Chagas pathogenesis and for the design of new strategies to prevent the development of Chagas disease. Finally, we highlight recent studies employing a genetically engineered attenuated T. cruzi strain as a vaccine shuttle that elicits potent T cell responses specific to a tumour antigen and protective immunity against a syngeneic melanoma cell line.

  20. Update on oral Chagas disease outbreaks in Venezuela: epidemiological, clinical and diagnostic approaches.

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    Noya, Belkisyolé Alarcón de; Díaz-Bello, Zoraida; Colmenares, Cecilia; Ruiz-Guevara, Raiza; Mauriello, Luciano; Muñoz-Calderón, Arturo; Noya, Oscar

    2015-05-01

    Orally transmitted Chagas disease has become a matter of concern due to outbreaks reported in four Latin American countries. Although several mechanisms for orally transmitted Chagas disease transmission have been proposed, food and beverages contaminated with whole infected triatomines or their faeces, which contain metacyclic trypomastigotes of Trypanosoma cruzi, seems to be the primary vehicle. In 2007, the first recognised outbreak of orally transmitted Chagas disease occurred in Venezuela and largest recorded outbreak at that time. Since then, 10 outbreaks (four in Caracas) with 249 cases (73.5% children) and 4% mortality have occurred. The absence of contact with the vector and of traditional cutaneous and Romana's signs, together with a florid spectrum of clinical manifestations during the acute phase, confuse the diagnosis of orally transmitted Chagas disease with other infectious diseases. The simultaneous detection of IgG and IgM by ELISA and the search for parasites in all individuals at risk have been valuable diagnostic tools for detecting acute cases. Follow-up studies regarding the microepidemics primarily affecting children has resulted in 70% infection persistence six years after anti-parasitic treatment. Panstrongylus geniculatus has been the incriminating vector in most cases. As a food-borne disease, this entity requires epidemiological, clinical, diagnostic and therapeutic approaches that differ from those approaches used for traditional direct or cutaneous vector transmission.

  1. Update on oral Chagas disease outbreaks in Venezuela: epidemiological, clinical and diagnostic approaches

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    Belkisyolé Alarcón de Noya

    2015-05-01

    Full Text Available Orally transmitted Chagas disease has become a matter of concern due to outbreaks reported in four Latin American countries. Although several mechanisms for orally transmitted Chagas disease transmission have been proposed, food and beverages contaminated with whole infected triatomines or their faeces, which contain metacyclic trypomastigotes of Trypanosoma cruzi, seems to be the primary vehicle. In 2007, the first recognised outbreak of orally transmitted Chagas disease occurred in Venezuela and largest recorded outbreak at that time. Since then, 10 outbreaks (four in Caracas with 249 cases (73.5% children and 4% mortality have occurred. The absence of contact with the vector and of traditional cutaneous and Romana’s signs, together with a florid spectrum of clinical manifestations during the acute phase, confuse the diagnosis of orally transmitted Chagas disease with other infectious diseases. The simultaneous detection of IgG and IgM by ELISA and the search for parasites in all individuals at risk have been valuable diagnostic tools for detecting acute cases. Follow-up studies regarding the microepidemics primarily affecting children has resulted in 70% infection persistence six years after anti-parasitic treatment. Panstrongylus geniculatus has been the incriminating vector in most cases. As a food-borne disease, this entity requires epidemiological, clinical, diagnostic and therapeutic approaches that differ from those approaches used for traditional direct or cutaneous vector transmission.

  2. Accelerating the development of a therapeutic vaccine for human Chagas disease: rationale and prospects.

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    Dumonteil, Eric; Bottazzi, Maria Elena; Zhan, Bin; Heffernan, Michael J; Jones, Kathryn; Valenzuela, Jesus G; Kamhawi, Shaden; Ortega, Jaime; Rosales, Samuel Ponce de Leon; Lee, Bruce Y; Bacon, Kristina M; Fleischer, Bernhard; Slingsby, B T; Cravioto, Miguel Betancourt; Tapia-Conyer, Roberto; Hotez, Peter J

    2012-09-01

    Chagas disease is a leading cause of heart disease affecting approximately 10 million people in Latin America and elsewhere worldwide. The two major drugs available for the treatment of Chagas disease have limited efficacy in Trypanosoma cruzi-infected adults with indeterminate (patients who have seroconverted but do not yet show signs or symptoms) and determinate (patients who have both seroconverted and have clinical disease) status; they require prolonged treatment courses and are poorly tolerated and expensive. As an alternative to chemotherapy, an injectable therapeutic Chagas disease vaccine is under development to prevent or delay Chagasic cardiomyopathy in patients with indeterminate or determinate status. The bivalent vaccine will be comprised of two recombinant T. cruzi antigens, Tc24 and TSA-1, formulated on alum together with the Toll-like receptor 4 agonist, E6020. Proof-of-concept for the efficacy of these antigens was obtained in preclinical testing at the Autonomous University of Yucatan. Here the authors discuss the potential for a therapeutic Chagas vaccine as well as the progress made towards such a vaccine, and the authors articulate a roadmap for the development of the vaccine as planned by the nonprofit Sabin Vaccine Institute Product Development Partnership and Texas Children's Hospital Center for Vaccine Development in collaboration with an international consortium of academic and industrial partners in Mexico, Germany, Japan, and the USA.

  3. Effect of hyperthermia on experimental acute pancreatitis Efeito da hipertermia na pancreatite aguda experimental

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    José Luiz Jesus de Almeida

    2006-12-01

    Full Text Available BACKGROUD: Recent studies indicate that hyperthermia can change inflammatory mechanisms and protect experimental animals from deleterious effects of secretagogue-induced acute pancreatitis AIM: To evaluate the effects of hyperthermia post-treatment on cerulein-induced acute pancreatitis in rats METHODS: Twenty animals were divided in two groups: group I (n = 10, rats with cerulein-induced acute pancreatitis undergone hyperthermia, and group II (n = 10, animals with cerulein-induced acute pancreatitis that were kept normothermic. In all groups, amylase serum levels, histologic damage, vascular permeability and pancreatic water content were assessed. Acute pancreatitis was induced by administration of two cerulein injections (20 mcg/kg. A single dose of Evans' blue dye was administered along with the second dose of cerulein. All animals also received a subcutaneous injection of saline solution. After this process, animals undergone hyperthermia were heated in a cage with two 100 W lamps. Body temperature was increased to 39.5ºC and maintained at that level for 45 minutes. Normothermia rats were kept at room temperature in a second cage RESULTS: Control animals had typical edema, serum amylase activity and morphologic changes of this acute pancreatitis model. Hyperthermia post-treatment ameliorated the pancreatic edema, whereas the histologic damage and the serum amylase level remained unchanged CONCLUSIONS: The findings suggest a beneficial effect of the thermal stress on inflammatory edema in experimental acute pancreatitis.RACIONAL: Estudos recentes indicam que a hipertermia pode modificar mecanismos inflamatórios e proteger animais experimentais dos efeitos deletérios da pancreatite aguda induzida por secretagogos OBJETIVO: Avaliar a eficácia da hipertermia como tratamento da pancreatite aguda induzida por ceruleína em ratos MÉTODOS: Vinte animais foram divididos em dois grupos: grupo I (n = 10, ratos com pancreatite aguda induzida por

  4. Microcristais biliares na pancreatite aguda idiopática: indício para etiologia biliar oculta subjacente

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    CHEBLI Júlio Maria Fonseca

    2000-01-01

    Full Text Available As principais causas de inflamação pancreática no mundo são a litíase biliar e o alcoolismo crônico. Admite-se que 10 a 30% das pancreatites agudas sejam idiopáticas. Sugere-se que parte destas são causadas por microlitíase ou barro biliar, identificados pela presença de microcristais no sedimento biliar. Neste estudo, realizou-se análise microscópica da bile obtida por colangiopancreatografia endoscópica, em pacientes com pancreatite aguda idiopática, pancreatite aguda biliar e pancreatite crônica alcoólica - 20 em cada grupo. Pacientes com pancreatite aguda idiopática e microcristais na bile foram submetidos a colecistectomia. Naqueles inaptos à cirurgia efetuou-se esfincterotomia endoscópica ou tratamento com ácido ursodesoxicólico. Pacientes com pancreatite aguda idiopática sem cristais não receberam tratamento específico. A prevalência de microcristais biliares em pacientes com pancreatite aguda idiopática (75% e pancreatite aguda biliar (90% foi significativamente maior que naqueles com pancreatite crônica alcoólica (15%. A detecção de microcristais apresentou sensibilidade de 90%, especificidade de 85%, valor preditivo positivo de 85,7%, valor preditivo negativo de 89,4% e acurácia de 87,5% em identificar pancreatite de origem biliar. Nos pacientes com pancreatite aguda idiopática recurrente, cursando com microcristais, houve redução significante dos episódios de pancreatite após tratamento específico. No seguimento deste grupo durante 23,3 meses, recidiva ocorreu apenas naqueles que apresentavam "fator biliar persistente" (coledocolitíase ou microcristais. Todos os pacientes com pancreatite aguda idiopática submetidos a colecistectomia apresentavam colecistite crônica, e microlitíase foi observada em um paciente. No seguimento ultra-sonográfico, colelitíase foi detectada em um dos casos. No subgrupo de cinco pacientes com pancreatite aguda idiopática sem microcristais houve uma recidiva. Estudo

  5. Assessment of Galectin-3 Polymorphism in Subjects with Chronic Chagas Disease

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    Gabriela da Silva Cruz

    2015-11-01

    Full Text Available AbstractBackground:Galectin-3, a β-galactoside binding lectin, has been described as a mediator of cardiac fibrosis in experimental studies and as a risk factor associated with cardiovascular events in subjects with heart failure. Previous studies have evaluated the genetic susceptibility to Chagas disease in humans, including the polymorphisms of cytokine genes, demonstrating correlations between the genetic polymorphism and cardiomyopathy development in the chronic phase. However, the relationship between the galectin-3 single nucleotide polymorphism (SNP and phenotypic variations in Chagas disease has not been evaluated.Objective:The present study aimed to determine whether genetic polymorphisms of galectin-3 may predispose to the development of cardiac forms of Chagas disease.Methods:Fifty-five subjects with Chagas disease were enrolled in this observational study. Real-time polymerase chain reaction (PCR was used for genotyping the variants rs4644 and rs4652 of the galectin-3 gene.Results:For the SNP rs4644, the relative risk for the cardiac form was not associated with the genotypes AA (OR = 0.79, p = 0.759, AC (OR = 4.38, p = 0.058, or CC (OR = 0.39, p = 0.127. Similarly, for the SNP rs4652, no association was found between the genotypes AA (OR = 0.64, p = 0.571, AC (OR = 2.85, p = 0.105, or CC (OR = 0.49, p = 0.227 and the cardiac form of the disease.Conclusion:Our results showed no association between the different genotypes for both SNPs of the galectin-3 gene and the cardiac form of Chagas disease. (Arq Bras Cardiol. 2015; [online].ahead print, PP.0-0

  6. RECUERDO DEL DESCUBRIMIENTO DE LA ENFERMEDAD DE CHAGAS

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    Hernando Groot Liévano

    2016-12-01

    Full Text Available A través de mis largos años, he vivido en el trópico y he visto el sufrimiento de nuestros campesinos por esta grave dolencia y, a la par que he sido testigo de tal situación, he presenciado también los esfuerzos extraordinarios realizados en Colombia para su estudio y para su control, que a todos nos deben enorgullecer. Estos fueron hechos en épocas recientes por personas como Augusto Corredor, Felipe Guhl y muchos otros investigadores que sería muy dispendioso enumerar. Años atrás, los nombres de Benjamín Otálora, Hernando Ucrós y especialmente Santiago Rengifo y César Uribe Piedrahita tienen que venir a nuestra mente. Santiago Rengifo, investigador infatigable de la enfermedad, fue además creador del Instituto Roberto Franco de Villavicencio y uno de los artífices más importantes de la Facultad de Medicina de la Universidad del Valle. A César Uribe Piedrahita, se debe el haber iniciado el interés en Colombia por el estudio de esta parasitosis; fue él quien identificó por primera vez el agente causal en nuestro país. Así mismo, formó un sinnúmero de investigadores que, con sus estudios, han dado luz sobre la dolencia y han sido lustre para la ciencia en América Latina. César Uribe Piedrahita, mi profesor y luego mi amigo, es una de las personas de la medicina nacional que se debe exaltar con más vehemencia porque era el individuo que no solamente dominaba el campo médico, sino que, como un Pico de la Mirándola del siglo XX, era experto en antropología, en arqueología, en botánica, habilísimo pintor y tallista, propulsor de las investigaciones sobre las bondades de las plantas, así como escritor de primera línea y dotado de excepcionales cualidades docentes para inculcar en sus estudiantes la disciplina por el estudio y la necesidad de trabajar cada vez más por este país. Parece oportuno que en estos momentos, al rememorar a Carlos Chagas, se haga un breve recuento de aquellas condiciones en las cuales se

  7. Microwave treatment of human milk to prevent transmission of Chagas disease Tratamento do leite humano pelo microondas para prevenir a transmissão de doença de Chagas

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    Cláudio Santos Ferreira

    2003-01-01

    Full Text Available It is recognized that breast feeding is an alternative means of transmission of Chagas disease. However, thermal treatment of milk can prevent this occurrence. As domestic microwave ovens are becoming commonplace, the efficacy of microwave thermal treatment in inactivating Trypanosoma cruzi trypomastigotes in human milk was tested. Human milk samples infected with T. cruzi trypomastigotes (Y strain from laboratory-infected mice, were heated to 63 °C in a domestic microwave oven (2 450 MHz, 700 W. Microscopical and serological examinations demonstrated that none of the animals inoculated orally or intraperitoneally with infected milk which had been treated, got the infection, while those inoculated with untreated, infected milk, became infected. It was concluded that the simple treatment prescribed, which can easily be done at home, was effective in inactivating T. cruzi trypomastigotes contained in human milk.A amamentação é reconhecidamente um modo alternativo de transmissão da doença de Chagas. Entretanto, o tratamento térmico do leite pode evitar tal acidente. Por ser atualmente comum o uso doméstico de fornos de microondas, projetou-se um experimento para avaliar a eficácia do tratamento térmico do leite por microondas na inativação de formas de Trypanosoma cruzi contidas no leite materno. Acrescentaram-se, a amostras de leite humano, tripomastigotas de T. cruzi (cepa Y provenientes de camundongos infectados em laboratório. Essas amostras foram aquecidas a 63 ºC (sete minutos, 45% de potência em forno de microondas doméstico (2 450 MHz, 700 W. Exames microscópicos e sorológicos dos animais inoculados, por via oral ou intraperitoneal, com leite infectado e tratado, foram negativos. Os resultados dos inoculados com leite infectado e não tratado foram positivos. Concluiu-se que este é um processo simples e eficaz para inativar tripomastigotas contidos em leite, podendo facilmente ser executado em ambiente doméstico.

  8. Avaliação do efeito antinociceptivo e da toxicidade aguda do extrato aquoso da Hyptis fruticosa Salmz. ex Benth Evaluation of the analgesic effect and acute toxicity of the aqueous extract of Hyptis fruticosa (Salmz. ex Benth.

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    Aline B.L. Silva

    2006-12-01

    Full Text Available Este trabalho descreve o efeito antinociceptivo e a toxicidade aguda do extrato aquoso das folhas da Hyptis fruticosa Salmz. ex Benth. (Lamiaceae. O extrato aquoso liofilizado, administrado por via oral, reduziu as contorções abdominais induzidas por ácido acético (200, 400 e 500 mg/kg e o tempo de reação dos animais na primeira fase do teste da formalina (100 mg/kg e 400 mg/kg. No teste da placa quente, o extrato aquoso aumentou o tempo de latência ao calor (100 e 200 mg/kg tendo este efeito sido revertido pelo antagonista opióide naloxona (5 mg/kg; i.p.. No ensaio de toxicidade aguda, não foi detectada a morte de nenhum animal após tratamento com doses de até 5 g/kg (v.o. do extrato. Em conclusão, os resultados obtidos indicam que o extrato aquoso da Hyptis fruticosa apresenta efeito antinociceptivo em camundongos e não apresenta toxicidade aguda nas doses testadas.The antinociceptive effect and the acute toxicity of Hyptis fruticosa leaves were evaluated through the administration of its aqueous extract in mice. The extract, administered orally (200, 400, and 500 mg/kg, reduced the nociceptive response in the writhing test as well as in the early phase of the formalin test (100 and 400 mg/kg and it increased the latency time in the hot plate test (100 and 200 mg/kg. The antinociceptive effect was reversed by naloxone (5 mg/kg, i.p.. Moreover, no animal deaths were observed in doses up to 5 g/kg. In conclusion, the aqueous extract of Hyptis fruticosa showed no acute toxicity at the evaluated doses and revealed antinociceptive effect in mice. Such effects are possibly associated with the opioid system activation.

  9. O viver do portador chagásico crônico: possibilidades de ações do enfermeiro para uma vida saudável El vivir del portador chagásico crónico: posibilidades de acciones del enfermero para una vida saludable The life of the patient with chronic Chagas disease: possible nursing actions towards a healthy life

    Directory of Open Access Journals (Sweden)

    Angélica Porto de Oliveira

    2010-09-01

    Full Text Available Objetivou-se conhecer como vivem os portadores chagásicos crônicos em dois municípios da região sul do Rio Grande do Sul, traçando possíveis ações do enfermeiro para uma vida mais saudável. O estudo foi de caráter descritivo e exploratório com uma abordagem qualitativa. Os dados foram coletados nos domicílios de dez clientes portadores crônicos da Doença de Chagas através de entrevista semiestruturada. Os resultados mostraram que a sintomatologia da doença não se manifestou na fase aguda, sendo que a maioria dos sujeitos faz uso de medicações paliativas para alívio dos sintomas, existindo grandes limitações no desenvolvimento das atividades cotidianas, principalmente nos portadores da forma cardíaca. Reitera-se o valor da equipe de saúde, em especial do enfermeiro, no manejo clínico, pois quando iniciado precocemente, propicia uma melhor qualidade de vida e uma elevação da expectativa de sobrevivência.El objetivo fue conocer cómo viven los portadores chagásicos crónicos en dos municipios de la región sur del Río Grande do Sul, Brasil, como enfrentan esa patología y trazar posibles acciones del enfermero para una vida más saludable. El estudio fue de carácter descriptivo y exploratorio con abordaje cualitativo. Los datos fueron colectados en los domicilios de diez clientes portadores crónicos de la enfermedad de Chagas a través de entrevista semiestructurada. Los resultados evidenciaron que la sintomatología de la enfermedad no se manifestó en la fase aguda siendo que la mayoría de los sujetos usa medicaciones paliativas para el alivio de los síntomas, existiendo grandes limitaciones en el desarrollo de las actividades cotidianas, sobre todo, en los portadores de la forma cardiaca. Se reitera el valor del equipo de salud, en especial, del enfermero, en el manejo clínico de estos clientes, pues cuando se inicia precozmente, puede propiciar una mejor calidad de vida y resultar en la elevación de la

  10. [Investigation of vectors and reservoirs in an acute Chagas outbreak due to possible oral transmission in Aguachica, Cesar, Colombia].

    Science.gov (United States)

    Soto, Hugo; Tibaduiza, Tania; Montilla, Marleny; Triana, Omar; Suárez, Diana Carolina; Torres Torres, Mariela; Arias, María Teresa; Lugo, Ligia

    2014-04-01

    Colombia recorded 11 cases of acute Chagas disease and 80 cases of oral contamination with Trypanosoma cruzi. The current study analyzes the entomological and parasitological characteristics of the outbreak in Aguachica, Cesar Department, in 2010. An interdisciplinary group of health professionals and regional university personnel conducted the laboratory tests in the patients and the investigation of the transmission focus. Eleven cases of acute Chagas diseases were detected in a single family in a dwelling with domiciliated triatomines and Rhodnius pallescens, Pantrongylus geniculatus, Eratyrus cuspidatus, and two Didelphis marsupialis opossums infected with T. cruzi in Attalea butyracea and Elaeis oleifera palm trees in the urban area of Aguachica. The study analyzes the role of R. pallescens and palm trees in the wild cycle of T. cruzi and in oral transmission of Chagas disease. Sporadic incursions by wild R. pallescens, P. geniculatus, and E. cuspidatus from the nearby palm trees into human dwellings may cause increasingly frequent outbreaks of oral Chagas disease.

  11. Hemocultures for the parasitological diagnosis of human chronic Chagas' disease

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    Egler Chiari

    1989-03-01

    Full Text Available With the purpose of standardization of an hemoculture technique presenting a higher positive rate in the parasitological diagnosis of chronic Chagas' disease in patients with reactive serology (IFT, HA, CFT the following schedule was used. Thirty ml of venous blood was collected with heparin and the plasma was separated by centrifugation (2.000 rpm/30'. The packed cells were washed with LIT medium or PBS which was then removed by centrifugation (2.000 rpm/15'. This material was sampled in 6 screw-tubes 18x200 with 6 ml of LIT medium and incubated at 28°C. These incubated cultures at 28°C were examined after 15, 30, 45 and 60 days. When the hemoculture was not immediately processed after blood collection, the plasma was removed and the sediment enriched with LIT medium and preserved at 4°C. The Xenodiagnosis was performed according to Schenones method used here as a reference technique. Among the various groups of patients examined by both techniques the best results obtained were: 55.08% ofpositivity for hemocultures against 27.5% forxenodiagnosis (X² = 4.54, p = 0.05, with a tubepositivity of 26.6%. Recommendation for screening trials of drug assays is the repetition of method on a same patient 2 or more times in different occasions, as used in xenodiagnosis.Objetivando a padronização de uma técnica de hemoculturas que apresente maior taxa de positividade no diagnóstico da fase crônica da doença de Chagas em pacientes com sorologia reativa (TIF, HA, RFC utilizamos o seguinte esquema: o volume de 30ml de sangue foi colhido heparinizado e o plasma separado por centrifugaçao (200 rpm/30'; o sedimento foi lavado com meio LIT ou salina fisiológica tamponada e removido por nova centrifugação (2000 rpm/15; as células sedimentadas foram distribuídas em 6 tubos tipo "screw" 18 x 200 contendo 6,0 ml de meio LIT; as culturas incubadas a 28°C, foram examinadas após 15, 30, 45 e 60 dias; quando a hemocultura não foi processada

  12. Potencial de risco da transmissão transfusional da doença de Chagas em Belo Horizonte (MG

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    Elisabeth Bronfen

    1988-03-01

    Full Text Available Com o objetivo de se isolar amostras do Trypanosoma cruzi de chagásicos crônicos, foram submetidos a xenodiagnóstico e hemocultura, 59 pacientes provenientes do ambulatório de um dos Hospitais de Belo Horizonte. Esses pacientes informaram, em entrevista prévia, serem ou terem sido doadores de sangue ou candidatos à uma primeira doação. 44 deles (74,6% já haviam doado sangue de la mais de 20 vezes em diferentes bancos de sangue de Belo Horizonte. O resultado conferido através da realização concomitante de apenas 1 xenodiagnóstico e 1 hemocultura, revelou, no grupo de doadores, 47,7% depositividade parasitológica. Considerando todos os doadores chagásicos crônicos, parasitologicamente comprovados ou não, ocorreram mais de 112 doações. Esse é um dado altamente significativo em relação ao problema de transmissão transfusional da doença de Chagas em bancos de sangue de Belo Horizonte, MG.

  13. Could the Chagas disease elimination programme in Venezuela be compromised by reinvasion of houses by sylvatic Rhodnius prolixus bug populations?

    Science.gov (United States)

    Sanchez-Martin, Maria J; Feliciangeli, M Dora; Campbell-Lendrum, Diarmid; Davies, Clive R

    2006-10-01

    The Andean Pact Initiative (1997) committed Andean countries to eliminate vectorial transmission of Chagas disease by 2010 via widespread residual insecticide spraying. In Venezuela, this aim could be compromised by reinvasion of houses by palm tree populations of the major vector Rhodnius prolixus. To test this hypothesis, a multivariate logistic regression was undertaken of risk factors for triatomine infestation and colonization in 552 houses and 1068 peri-domestic outbuildings in Barinas State. After adjusting for other risk factors, including palm roofs, R. prolixus infestation and colonization of outbuildings (and, to some extent, houses) was significantly associated with proximity to high densities of Attalea butyracea palm trees. House infestation and/or colonization was also positively associated with bug density in peri-domestic outbuildings, the presence of pigsties and nests. Hence, R. prolixus populations in ineffectively sprayed outbuildings could also provide an important source of house re-infestations. The secondary vector Triatoma maculata was mainly found associated with the presence of hens nesting both indoors and outdoors.

  14. The performance of laboratory tests in the management of a large outbreak of orally transmitted Chagas disease

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    Belkisyolé Alarcón de Noya

    2012-11-01

    Full Text Available Orally transmitted Chagas disease (ChD, which is a well-known entity in the Brazilian Amazon Region, was first documented in Venezuela in December 2007, when 103 people attending an urban public school in Caracas became infected by ingesting juice that was contaminated with Trypanosoma cruzi. The infection occurred 45-50 days prior to the initiation of the sampling performed in the current study. Parasitological methods were used to diagnose the first nine symptomatic patients; T. cruzi was found in all of them. However, because this outbreak was managed as a sudden emergency during Christmas time, we needed to rapidly evaluate 1,000 people at risk, so we decided to use conventional serology to detect specific IgM and IgG antibodies via ELISA as well as indirect haemagglutination, which produced positive test results for 9.1%, 11.9% and 9.9% of the individuals tested, respectively. In other more restricted patient groups, polymerase chain reaction (PCR provided more sensitive results (80.4% than blood cultures (16.2% and animal inoculations (11.6%. Although the classical diagnosis of acute ChD is mainly based on parasitological findings, highly sensitive and specific serological techniques can provide rapid results during large and severe outbreaks, as described herein. The use of these serological techniques allows prompt treatment of all individuals suspected of being infected, resulting in reduced rates of morbidity and mortality.

  15. The performance of laboratory tests in the management of a large outbreak of orally transmitted Chagas disease.

    Science.gov (United States)

    Noya, Belkisyolé Alarcón de; Díaz-Bello, Zoraida; Colmenares, Cecilia; Zavala-Jaspe, Reinaldo; Abate, Teresa; Contreras, Rosa; Losada, Sandra; Artigas, Domingo; Mauriello, Luciano; Ruiz-Guevara, Raiza; Noya, Oscar

    2012-11-01

    Orally transmitted Chagas disease (ChD), which is a well-known entity in the Brazilian Amazon Region, was first documented in Venezuela in December 2007, when 103 people attending an urban public school in Caracas became infected by ingesting juice that was contaminated with Trypanosoma cruzi. The infection occurred 45-50 days prior to the initiation of the sampling performed in the current study. Parasitological methods were used to diagnose the first nine symptomatic patients; T. cruzi was found in all of them. However, because this outbreak was managed as a sudden emergency during Christmas time, we needed to rapidly evaluate 1,000 people at risk, so we decided to use conventional serology to detect specific IgM and IgG antibodies via ELISA as well as indirect haemagglutination, which produced positive test results for 9.1%, 11.9% and 9.9% of the individuals tested, respectively. In other more restricted patient groups, polymerase chain reaction (PCR) provided more sensitive results (80.4%) than blood cultures (16.2%) and animal inoculations (11.6%). Although the classical diagnosis of acute ChD is mainly based on parasitological findings, highly sensitive and specific serological techniques can provide rapid results during large and severe outbreaks, as described herein. The use of these serological techniques allows prompt treatment of all individuals suspected of being infected, resulting in reduced rates of morbidity and mortality.

  16. Attraction of Chagas disease vectors (Triatominae to artificial light sources in the canopy of primary Amazon rainforest

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    Marcelo CM Castro

    2010-12-01

    Full Text Available Adult triatomines occasionally fly into artificially lit premises in Amazonia. This can result in Trypanosoma cruzi transmission to humans either by direct contact or via foodstuff contamination, but the frequency of such behaviour has not been quantified. To address this issue, a light-trap was set 45 m above ground in primary rainforest near Manaus, state of Amazonas, Brazil and operated monthly for three consecutive nights over the course of one year (432 trap-hours. The most commonly caught reduviids were triatomines, including 38 Panstrongylus geniculatus, nine Panstrongylus lignarius, three Panstrongylus rufotuberculatus, five Rhodnius robustus, two Rhodnius pictipes, one Rhodnius amazonicus and 17 Eratyrus mucronatus. Males were collected more frequently than females. The only month without any catches was May. Attraction of most of the known local T. cruzi vectors to artificial light sources is common and year-round in the Amazon rainforest, implying that they may often invade premises built near forest edges and thus become involved in disease transmission. Consequently, effective Chagas disease prevention in Amazonia will require integrating entomological surveillance with the currently used epidemiological surveillance.

  17. Molecular basis of Acute Myelogenous Leukemia As bases moleculares da leucemia mielóide aguda

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    Eduardo M. Rego

    2002-01-01

    Full Text Available Acute Myelogenous Leukemia (AML is frequently associated with recurring chromosomal translocations, which lead to the fusion of two genes encoding transcription factors. As the moieties of these fusion proteins retain part of the functional domains of the wild-type proteins, they may interfere directly or indirectly with the transcriptional regulation of the leukemic cell, conferring survival advantage. The majority of the transcription factors commonly involved in recurring chromosomal translocations may be grouped in one of the following families: core binding factor (CBF, retinoic acid receptor alpha (RARalpha, homeobox (HOX family, and mixed lineage leukemia (MLL. In vivo analysis of the molecular basis of leukemogenesis through the generation of transgenic mouse models revealed that a common theme is the recruitment of transcriptional co-activators and co-repressors by these fusion proteins. However, the expression of the fusion protein is not sufficient to induce full blown leukemia, as evidenced in part by the long latencies required for disease development in the transgenic models of leukemia, and therefore, second mutagenic events may contribute to AML pathogenesis.A leucemia mielóide aguda (LMA está freqüentemente associada a translocações cromossômicas recorrentes. Em muitos casos, os genes presentes nos pontos de quebra cromossômica são conhecidos e, quase todos codificam para fatores de transcrição. O gene híbrido, resultante da justaposição de exons de genes distintos, codifica para proteínas de fusão. Como estas retêm a maior parte dos domínios funcionais das proteínas selvagens, elas interferem direta ou indiretamente com regulação da transcrição gênica, conferindo vantagem à sobrevivência das células leucêmicas. A maioria dos fatores de transcrição afetados pelas translocações cromossômicas associadas a LMA pode ser agrupada numa das seguintes famílias: dos core binding factors (CBF, do receptor

  18. Formas encefalopaticas de enfermedad de Chagas cronica observadas en Argentina Encephalopathic form of chronic Chagas' disease observed in Argentine

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    Miguel Eduardo Jorg

    1981-12-01

    Full Text Available Se describen las características clínicas y las manifestaciones dominantes en 22 enfermos observados entre 1963 y 1978 sobre un total de 420 con neuropatías diversas examinados en el area central Norte de la Argentina; afectados por una encefalopatía crónica, que, por hallazgos de laboratorio (demostración del parasito en sangre o en su defecto confirmacion por mas de una prueba serológica positiva y por las correlaciones anatomoclínicas, puede ser imputada a la infección por el Trypanosoma cruzi. En la mitad o mas de los enfermos, son salientes las siguientes manifestaciones: disprosexia y confusión en 81,8%; cefalea y confusión en 72,7%; debilitamiento de reflejos músculo-tendinosos y trastornos del lenguaje en 63,6%; dispraxias en 59%; trastornos de la marcha y crisis mioclónicas en 54,5%; bradicinesias en 50%. En menor escala se encontraron: parestesias, ideas delirantes, perturbaciones cerebelares, crisis de vertigo, diplopia, lipotimias,humor fluctuante. Las menos frecuentes: disautonomia y excitacion. En 8 se hallaron evidencias semiologicas de cardiopatias y en 2 de compromiso digestivo grosero. Se analiza el alcance de esta casuistica en relación a los hallazgos anatomopatológicos en casos mortales y con referencia a lo ya conocido sobre la forma neuropatologica de la enfermedad de Chagas cronica.Among 420 patientes found with diverse subacute and chronic neuropathies, 22 were diagnosed as cases of true trypanosomic encephalopathy by means of the demonstration of parasites in blood (by xenodiagnosis or hemoculture or through serologic tests. In 50% or more of those patientes, following semiologic elements were prevalente: dysprosexia and depression in 81.8%; cephalea and confusion in 72.7%; weakness of muscular-tendineous reflexes and speech disturbance in 63.6% dispraxies in 59.0%; disturbances of gait and myoclonic crises in 54.5%; bradikinesias in 59.0%. Other symptoms were verified in a mirror scale: paresias

  19. Comportamento da síndrome coronariana aguda: resultados de um registro brasileiro

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    Leopoldo Soares Piegas

    2013-06-01

    Full Text Available FUNDAMENTO: O Brasil carece de registros multicêntricos publicados de síndrome coronariana aguda. OBJETIVO: O Registro Brasileiro de Síndrome Coronariana Aguda é um estudo multicêntrico nacional com objetivo de apresentar dados representativos das características clínicas, e manejo e evolução hospitalares dessa síndrome. MÉTODOS: Participaram 23 hospitais de 14 cidades. Foram elegíveis pacientes que se apresentaram com suspeita de síndrome coronariana aguda nas primeiras 24 horas, com quadro clínico sugestivo, associado a alterações eletrocardiográficas compatíveis e/ou marcadores de necrose. O seguimento foi realizado até o óbito ou a alta hospitalar. RESULTADOS: Entre os anos de 2003 e 2008, foram incluídos 2.693 pacientes com diagnóstico de síndrome coronariana aguda, sendo 864 (32,1% mulheres. O diagnóstico final foi de angina instável para 1.141 (42,4% pacientes, com mortalidade de 3,06% deles; de infarto agudo do miocárdio sem supradesnível de ST para 529 (19,6% pacientes, com mortalidade de 6,8% deles; e de infarto agudo do miocárdio com supradesnível de ST para 950 (35,3% pacientes, com mortalidade de 8,1% deles; tiveram diagnóstico não confirmado 73 (2,7% pacientes, com mortalidade de 1,36% deles. A mortalidade global foi de 5,53%. O modelo de regressão logística múltipla identificou o gênero feminino (OR=1,45, o diabetes melito (OR=1,59, o índice de massa corporal (OR=1,27 e a intervenção coronariana percutânea (OR=0,70 como fatores de risco de óbito, para demografia e intervenções. Um modelo para óbito por complicações maiores identificou choque cardiogênico/Edema Agudo de Pulmão (OR=4,57, reinfarto (OR=3,48, acidente vascular cerebral (OR=21,56, sangramento grave (OR=3,33, parada cardiorrespiratória (OR=40,27 e classe funcional de Killip (OR=3,37. CONCLUSÃO: Os dados do Registro Brasileiro de Síndrome Coronariana Aguda não diferem de outros coletados fora do país. Seus achados poder

  20. Infección aguda por el VHB Acute infection by Hepatitis B Virus

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    F. Alegre

    2004-01-01

    Full Text Available El espectro clínico de la infección aguda por el virus de la hepatitis B es muy amplio, con cuadros que van desde una hepatitis anictérica y subclínica a una hepatitis ictérica aguda grave e incluso, en algunos casos, a una hepatitis fulminante. El diagnóstico depende en gran medida del grado de sospecha clínica de la hepatitis, estableciéndose el origen etiológico por el virus B mediante el estudio de marcadores serológicos y/o DNA en sangre. Aunque en la mayor parte de los casos la evolución de la hepatitis aguda por virus B es favorable, con resolución espontánea de la clínica en 4-8 semanas, no es infrecuente en ciertos casos, sobre todo en la infancia, la progresión a hepatitis crónica. No existe ningún tratamiento específico para la infección aguda por virus B que reduzca su gravedad o prevenga su evolución a hepatitis crónica. Se recomienda, no obstante, el reposo relativo, y la administración de una dieta hipercalórica. En las hepatitis agudas graves debe indicarse ingreso hospitalario; en casos de hepatitis fulminante ingreso en UCI para monitorización intensiva y valoración de trasplante hepático si no se produce mejoría espontánea. En el presente artículo se revisa, de forma breve y esquemática, la clínica, el diagnóstico, el pronóstico y el tratamiento de la infección aguda por el virus de la hepatitis B.The clinical spectrum of acute hepatitis B virus infection is very broad, with clinical manifestations that range from anicteric and sub-clinical hepatitis to severe acute icteric hepatitis and even, in some cases, to fulminant hepatitis. Diagnosis depends to a large extent on the degree of clinical suspicion of hepatitis, establishing the aetiological origin of the B virus through the study of serological markers and/or DNA in the blood. Although in the majority of cases there is a favourable evolution of acute hepatitis B virus infection, with spontaneous resolution of the clinical manifestations

  1. Apendicite aguda isquêmica em coelhos: novo modelo com estudo histopatológico

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    Nunes Fernando Costa

    2005-01-01

    Full Text Available OBJETIVOS: Avaliar a isquemia parcial ou total, através da ligadura com fio inabsorvível dos vasos do mesoapêndice do apêndice vermiforme de coelhos, bem como a obstrução mecânica, através da ligadura com fio inabsorvível da base do apêndice vermiforme, a 1 cm do ceco. Avaliar a histologia do apêndice ( normal e acometido . Estudar a flora bacteriana residente no apêndice vermiforme ( normal e acometido e do exsudato peritoneal. MÉTODOS: Foram utilizados 72 coelhos ( "Oryctogalus cuniculos" , machos da linhagem Nova Zelândia, com peso médio de 3,000 gramas. Foram divididos em grupos: piloto ( A , flora bacteriana ( B , controle ( H e experimento ( C, D, E, F e G com períodos de observação de 96 horas e 192 horas. Fez-se a ligadura dos vasos do mesoapêndice, com fio inabsorvível nos grupos ( D, E, F e G e da base do apêndice vermiforme a 1 cm do ceco, no grupo ( C . No grupo experimento (D,E,F e G foi praticado o modelo isquêmico. No grupo experimento ( C foi realizada a obstrução mecânica e no grupo controle ( H foi feita somente a simulação da cirurgia. RESULTADOS: No grupo controle ( H , não ocorreu apendicite aguda. No grupo experimento ( C,D,E,F, e G ocorreu apendicite aguda. CONCLUSÃO: O procedimento utilizado causa apendicite aguda com alterações anatomopatológicas distintas. A bactéria residente encontrada na flora fisiológica do suco entérico do apêndice vermiforme e no exsudato peritoneal foi a Escherichia coli.

  2. Síndrome coronariana aguda em paciente jovem com sintomas atípicos

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    Gustavo Daher

    2012-08-01

    Full Text Available O diagnóstico da dor torácica aguda no setor de emergência pode ser difícil e desafiador, incluindo diversos diagnósticos diferenciais, dentre eles: causas benignas a causas potencialmente fatais. O diagnóstico na maioria das vezesé estabelecido através do quadro clínico e de exames complementares como: marcadores de necrose miocárdica, eletrocardiograma e radiografia de tórax.A angiotomografia coronariana tem sido utilizada nos casos de dor torácica aguda com baixa ou intermediária probabilidade de síndrome coronariana aguda, permitindo sua exclusão e conseqüente alta precoce dos pacientes. Apresentamosrelato de caso de uma paciente jovem com dor precordial atípica e marcadores de necrose miocárdica discretamente elevados. Considerando-se a epidemiologia e o quadro clínico da paciente, foi feita hipótese diagnóstica inicial de miocardite. A angiotomografia cardíaca com pesquisa de realce tardiofoi solicitada. Apesar do escore de cálcio ter sido zero, foi diagnosticada lesão estenosante grave no terço médio da artéria coronária descendente anterior com realce tardio na parede anterior do ventrículo esquerdo, compatível comnecrose miocárdica. A paciente foi submetida a cateterismo com angioplastia da lesão.

  3. The Role of Gender in Chagas Disease Prevention and Control in Honduras: An Analysis of Communication and Collaboration Networks.

    Science.gov (United States)

    Triana, Diana Rocío Rodríguez; Mertens, Frédéric; Zúniga, Concepción Valeriano; Mendoza, Yolanda; Nakano, Eduardo Yoshio; Monroy, Maria Carlota

    2016-09-01

    In Honduras, where Chagas disease is a serious health and environmental concern, prevention measures face the challenge of achieving widespread and long-term sustainable adoption by communities. The article integrates social network analysis and a gender-sensitive approach to understand the role of men and women in the implementation of a community-level intervention, based on the adoption of housing improvements to reduce the presence of the insect vector. A total of 108 people in the community of El Salitre were interviewed. Data were collected on socio-demographic characteristics, participation in project activities, communication and collaboration networks related to Chagas disease prevention, knowledge of Chagas disease, and adoption of housing improvements techniques. Communication mostly occurred between the same gender individuals and was associated with knowledge of Chagas disease. Socioeconomic status, Chagas disease knowledge, and collaboration with men were associated with women adopting housing improvements. For men, however, participation in project activities, formal education, and collaboration with women were associated with adoption. These findings suggest that men and women were driven by distinct concerns, interests, and motivations when adopting new Chagas disease prevention strategies. Participatory community interventions that seek to generate health knowledge and foster collaborations to reduce health risk should address gender differences.

  4. Revisión actualizada sobre la insuficiencia renal aguda: estudio de un caso

    OpenAIRE

    Andreu Periz, Lola; Force Sanmartín, Enriqueta

    2003-01-01

    La insuficiencia renal aguda (IRA) o fracaso renal agudo es un síndrome clínico caracterizado por un deterioro brusco, frecuentemente reversible, de la función renal que provoca fallo de la homeostasia y se acompaña de retención de productos terminales del metabolismo nitrogenado, como la urea y la creatinina, junto con alteraciones del equilibrio hidroelectrolítico y ácidobase. Suele observarse oliguria (diuresis inferior a 400 ml/24 h), aunque algunas formas clínicas...

  5. PARTO PRETÉRMINO Y SUFRIMIENTO FETAL SECUNDARIOS A PERITONITIS POR APENDICITIS AGUDA PERFORADA

    OpenAIRE

    Hidalgo M,Juan José; Molina P,Marta; Varo GM,Begoña; Rivas R,Salvador; Bernabeu A,José Ramón; Perales M,Alfredo

    2009-01-01

    La apendicitis aguda es la urgencia quirúrgica no obstétrica más frecuente durante el embarazo. Se ha asociado a parto pretérmino y a morbimortalidad fetal y materna, especialmente cuando se complica con peritonitis. Los cambios anatómicos, fisiológicos y bioquímicos que se producen durante la gestación pueden alterar los síntomas y signos típicos asociados a la apendicitis. Esto puede retrasar el diagnóstico y dar lugar a un aumento de la morbimortalidad materna y fetal. Presentamos el caso ...

  6. Protocolo de tratamiento y resultados de pancreatitis aguda: Estudio de cohorte

    OpenAIRE

    LOSADA M,HÉCTOR; Muñoz C,César; BURGOS S,LUIS; SILVA A,JORGE

    2010-01-01

    Introducción: La pancreatitis aguda (PA) es una patología asociada a una significativa morbilidad y mortalidad. La clasificación de gravedad se basa en los criterios de Atlanta. Diversas guías clínicas han sido desarrolladas para el diagnóstico y tratamiento de esta patología. Nuestro objetivo es describir la experiencia en el diagnóstico y tratamiento de la PA y evaluar los predictores de gravedad utilizados con la morbilidad y mortalidad asociada a esta patología en un centro de referencia....

  7. Síndrome de Gradenigo y trombosis de seno cavernoso secundaria a otitis media aguda

    OpenAIRE

    Pelegrín Hernández, Juan Pablo; Díaz Manzano, José A.; Menasalvas Ruíz, Ana I.; Hellín Meseguer, Diego

    2012-01-01

    [ES] El síndrome de Gradenigo se caracteriza por dolor facial en la zona inervada por el trigémino y una oftalmoplejía externa unilateral (parálisis del VI par craneal) secundaria a petrositis apical aguda, por complicación evolutiva de una otitis media. Se trata de una complicación grave que requiere de un tratamiento inmediato para evitar secuelas permanentes y puede asociarse a otras complicaciones intracraneales como la trombosis del seno cavernoso. Presentamos el caso de un varón de 4 añ...

  8. Soporte nutricional en la pancreatitis aguda Artificial nutrition in acute pancreatitis

    OpenAIRE

    Garnacho Montero, J.; A. García de Lorenzo y Mateos; F. J. Ordóñez González

    2005-01-01

    Los cambios metabólicos que tienen lugar en la pancreatitis aguda originan, como en otros pacientes graves, una situación de estrés metabólico que, en muchas ocasiones, requiere la aplicación de soporte nutricional especializado. Los pacientes que presentan mayores niveles de gravedad (definida como un índice de Ranson = 3 o un APACHE II = 10) son los candidatos a recibir apoyo nutricional. La nutrición enteral debe ser la primera vía de aporte de nutrientes a considerar y debe mantenerse sal...

  9. Inmunofenotipos aberrantes en leucemias agudas en una población hospitalaria de Buenos Aires

    Directory of Open Access Journals (Sweden)

    Viviana Novoa

    2013-02-01

    Full Text Available La citometría de flujo multiparamétrica es el método de elección para la caracterización inmunofenotípica de las células hematopoyéticas clonales presentes en los distintos procesos leucémicos agudos. El objetivo fue analizar la expresión de antígenos de membrana y evaluar la presencia de fenotipos aberrantes en los blastos de pacientes con diagnóstico de leucemia aguda, que permiten el monitoreo de la respuesta al tratamiento. Se revisaron los inmunofenotipos de 364 muestras de pacientes adultos derivadas a nuestro laboratorio en un período de 7 años. El inmunofenotipo se realizó por citometría de flujo con un amplio panel de anticuerpos monoclonales con el que se evaluó la expresión de antígenos de linaje linfoide, mieloide y también antígenos de maduración. De las 364 muestras estudiadas, 60.2% presentaron un fenotipo compatible con leucemia mieloide aguda (LMA, 28.8% con leucemia linfoblástica B (LLA-B, 6.6% con leucemia linfoblástica T (LLA-T y 4.4% con leucemias agudas poco frecuentes. La presencia de fenotipos aberrantes se observó en 89% de los casos, los fenotipos aberrantes identificados fueron: 1 infidelidad de linaje: LMA (54%, LLA-B (40%, LLA-T (29%; 2 ausencia de expresión antigénica: LMA (21%, LLA-B (35%, LLA-T (70%; 3 alteración de la expresión antigénica: LMA (67%, LLA-B (66%, LLA-T (84%; 4 asincronismo madurativo: LMA (26%, LLA-B (37% y 5 fenotipo ectópico: LLA-T 96%. El análisis por citometría de flujo multiparamétrica de las leucemias agudas permitió la identificación de fenotipos aberrantes en la mayoría de nuestros pacientes, que son de utilidad para el monitoreo de la respuesta al tratamiento.

  10. Intoxicación aguda por plaguicidas en edades pediátricas. Guatemala, 2011

    OpenAIRE

    Mario Enrique Pla Acevedo; Eddy Mario Collejo Acevedo; Odalis Elena Acevedo Tristá; Learelis Fernández Cruz; Yanet Marbelis Pla Acevedo

    2015-01-01

    Se realizó un estudio descriptivo retrospectivo de la Intoxicación Aguda por plaguicidas en edades pediátricas en Guatemala, que abarcó el  período de enero hasta diciembre del 2011. La muestra estuvo comprendida por 457 pacientes en edades pediátricas. Se analizaron las variables: edad y sexo, actividad que realizaba en el momento de la intoxicación, tipo de plaguicida, severidad, utilización de equipos de protección y lugar de asistencia médica. Las variables para el análisis de los indicad...

  11. Ensayo con el azacyclonol en algunas reacciones psicóticas agudas

    OpenAIRE

    Jerí, Raúl; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú; Sánchez, José; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú; Arellano, Alejandro; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú

    2014-01-01

    Se presentan en esta comunicación los primeros resultados de un ensayo con el azacyclonol en algunas reaccionas psicóticas agudas. El azacyclonol es una de las drogas más recientes para el tratamiento de las psicosis. Tiene acción sobre el sistema nervioso central, inhibiendo probablemente la serotonina y por tanto produce efectos similares a la reserpina y a la clorpromazina. La actividad fundamental consiste en que anula las alteraciones clínicas y bio-eléctricas producidas por las drogas a...

  12. Rinovirus: Frecuencia en niños con infección respiratoria aguda, no internados

    OpenAIRE

    Débora N. Marcone; Carmen Ricarte; Cristina Videla; Jorge Ekstrom; Guadalupe Carballal; Santiago Vidaurreta; Marcela Echavarría

    2012-01-01

    Los métodos moleculares para diagnosticar rinovirus humanos (RVH) han aumentado la sensibilidad de detección. Esto ha permitido documentar la asociación entre los RVH y las infecciones respiratorias agudas (IRA) altas y bajas. La infección por RVH durante la infancia se asoció con posterior desarrollo de asma. Se estudió la frecuencia de RVH en 186 niños menores de 6 años ambulatorios con IRA (alta o baja), durante 2 años consecutivos (1/6/2008 - 31/5/2010). Se correlacionó la presencia de RV...

  13. Leucemia Mieloide Aguda de novo | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available te ConcernedSpain - AEMPS A.2EudraCT number2012-000233-39 A.3Full title of the trial Tratamiento de la leucemia...a A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language Tratamiento de la leucemia...on quimioterapia distinta de hidroxiurea.Leucemia promielocítica aguda con t(15;17).Crisis blástica de la leucemia...l valor límite normal, excepto cuando la alteraciones sean atribuibles a la leucemia. Pacientes con fracción

  14. Diarrea aguda en trasplantes renales y reno-pancreáticos

    OpenAIRE

    2015-01-01

    La diarrea es una complicación frecuente y potencialmente grave del trasplante renal. Se describen aquí, en un estudio de corte transversal, las características epidemiológicas y microbiológicas de la diarrea aguda y persistente en pacientes internados con trasplante renal o reno-páncreas. Se incluyeron 52 pacientes internados en un hospital de la Ciudad de Buenos Aires, 42 (80.8%) habían recibido un trasplante renal y 10 (19.2%) reno-páncreas. La diarrea fue el motivo de ingreso en 34 casos ...

  15. Estudio de la recurrencia de la pancreatitis aguda litiàsica

    OpenAIRE

    Romaguera Monzonís, Andreu

    2012-01-01

    OBJETIVOS La pancreatitis aguda litiásica (PAL) es una enfermedad con tendencia a recurrir. La colecistectomía precoz (durante el mismo ingreso o antes de las dos semanas) o en determinados casos la CREP están recomendadas en la mayoría de guías clínicas, para evitar la recurrencia. Pero, el porcentaje de recurrencia y el intervalo de aparición de la misma no se conocen con exactitud. Nuestros objetivos son: 1) Determinar el porcentaje de recurrencia en nuestro entorno tras un primer episodio...

  16. Etiología de la diarrea aguda bacteriana en pacientes pediátricos ambulatorios

    OpenAIRE

    Giugno, Silvina; Oderiz, Sebastián

    2008-01-01

    La diarrea aguda es una causa importante de morbilidad y mortalidad en países en desarrollo y en pocos casos requiere tratamiento antimicrobiano. El correcto uso de éstos depende del conocimiento previo de la epidemiología local. Para conocer estos parámetros estudiamos en forma retrospectiva los resultados de las bacterias enteropatógenas aisladas en la ciudad de La Plata. Se estudiaron 7.075 muestras de materia fecal de niños ambulatorios hasta 15 a...

  17. Infecciones respiratorias agudas en los niños. Posibles medidas de control

    OpenAIRE

    Mohs-Villalta, Edgar

    1985-01-01

    Artículo científico -- Universidad de Costa Rica. Instituto de Investigaciones en Salud, 1985 Las infecciones respiratorias agudas que representan el 50% aproximadamente, de los casos de enfermedades que deben notificarse a las autoridades y de las consultas pediátricas de pacientes ambulatorios en los países en desarrollo, son también una de las principales causas de las enfermedades contraídas en los hospitales y de mortalidad por enfermedades nosocomiales. En 1982, por *mph:), fueron la...

  18. Subtipos moleculares de PML/RARα en pacientes con leucemia promielocítica aguda

    OpenAIRE

    2013-01-01

    El objetivo fue describir la frecuencia de los subtipos moleculares de PML/RARα en pacientes con leucemia promielocítica aguda (LPA) y su distribución según grupo de riesgo de recaída y citomorfología. Se realizó una serie de casos que incluyó a cincuenta pacientes registrados en el Instituto Nacional de Enfermedades Neoplásicas (INEN), durante el periodo 2010-2012, con diagnóstico molecular de LPA PML/RARα y subtipos bcr1, bcr2 y bcr3 por reacción en cadena de la polimerasa con transcriptasa...

  19. Função pulmonar de crianças com leucemia aguda

    OpenAIRE

    Macedo, Thalita Medeiros Fernandes de

    2012-01-01

    Introdução: As leucemias constituem a doença maligna mais frequente em crianças e adolescentes. Com a melhora no prognóstico, surge a necessidade de considerar a morbidade que os protocolos utilizados geram nas crianças em tratamento. Objetivo: Avaliar a função pulmonar de crianças com leucemia aguda. Método: Trata-se de um estudo observacional do tipo analítico transversal. Foram avaliadas 34 crianças, alocadas nos grupos A e B. O grupo A foi formado por 17 crianças com leu...

  20. CONOCIMIENTOS Y PRÁCTICAS DE INFECCIONES RESPIRATORIAS Y ENFERMEDADES DIARREICAS AGUDAS EN MADRES DE UNA COMUNIDAD DE PIURA, PERÚ

    OpenAIRE

    Valladares Garrido, Mario J.

    2016-01-01

    Objetivo: Determinar conocimientos y prácticas frente a enfermedades diarreicas agudas (IRAS) y las infecciones respiratorias agudas (EDAS) antes y después de una intervención educativa. Material y Métodos: Se realizó un estudio de intervención en un centro de salud de Piura aplicando un cuestionario a 60 madres, el cual estuvo constituido por 40 preguntas y dividido en 4 secciones: datos sociodemográficos maternos y del niño, signos de alarma y prácticas de IRAS y EDAS, y conocimiento sobre ...

  1. Osteomielite hematogênica aguda em Pediatria: análise de casos atendidos em hospital universitário

    OpenAIRE

    Puccini, Pedro Fiorini; Maria Aparecida G. Ferrarini; Iazzetti, Antônio Vladir [UNIFESP

    2012-01-01

    OBJETIVO: Descrever a ocorrência, a evolução e o desfecho de pacientes com osteomielite hematogênica aguda na faixa etária pediátrica. MÉTODOS: Estudo descritivo de 21 casos de pacientes de zero a 14 anos com diagnóstico de osteomielite hematogênica aguda, em acompanhamento no Ambulatório de Infectologia Pediátrica da Escola Paulista de Medicina entre 2005 e 2009. A coleta de dados ocorreu pelo levantamento de prontuários. Realizaram-se a análise descritiva e o teste de correlação de Spearman...

  2. O papel da fisioterapia respiratória na bronquiolite viral aguda = Role of chest physiotherapy in acute viral bronchiolitis

    OpenAIRE

    Luisi,Fernanda

    2008-01-01

    Objetivos: revisar a literatura médica sobre o uso da fisioterapia respiratória em crianças com bronquiolite viral aguda Fonte de dados: revisão, a partir do banco de dados PubMed, Medline e LILACS, de artigos publicados em revistas científicas nacionais e internacionais, bem como dos livros texto mais importantes publicados nos últimos anos Síntese dos dados: a bronquiolite viral aguda é uma infecção muito freqüente em crianças. Apesar da baixa morbidade, representa aproximadamente 75%...

  3. Colecistitis aguda : valoraci??n cl??nica y econ??mica de su tratamiento quir??rgico precoz

    OpenAIRE

    Garc??a Martos, Juan Bautista

    1991-01-01

    Desde el 1 de enero de 1986 al 30 de junio de 1989, 189 enfermos que presentaban una colecistitis aguda, han sido intervenidos bajo circunstancias diferentes, divididos en 3 grupos: grupo A.- 80 enfermos intervenidos por cirug??a precoz (dentro de los 5 primeros d??as del brote agudo). Grupo B.- 54 enfermos intervenidos de forma electiva (una vez superada la fase aguda). Grupo C. 55 enfermos intervenidos por fracaso del tratamiento m??dico conservador. Se estudian las dificultades t??cnicas e...

  4. Complicaciones de rinosinusitis aguda en niños del Hospital Sótero del Río

    OpenAIRE

    2008-01-01

    Introducción: La rinosonusitis aguda (RSA) es frecuente en niños, respondiendo bien a tratamiento médico en la mayoría de los casos. Sin embargo puede presentar complicaciones graves a nivel orbitario e intracerebral. Objetivo: Evaluaria frecuencia, describirias características clínicas, evaluare! tratamiento y evolución de la rinosinusitis aguda complicada, en niños del Hospital Sótero del Río. Material y método: Estudio retrospectivo-descriptivo realizado en el Hospital Sótero del Río, util...

  5. Aspectos disautonômicos da porfiria aguda intermitente: a propósito de seis casos

    Directory of Open Access Journals (Sweden)

    Charles P. Tilbery

    1979-06-01

    Full Text Available Foram estudados seis casos de porfiria aguda intermitente, sendo enfocados os aspectos disautonômicos apresentados durante a longa permanência hospitalar dos doentes (média de 64 dias. Foram observados taquicardia sinusal e hipertensão arterial (4 casos, parada cardíaca (3 casos e depressão respiratória (5 casos. Os autores tecem comentários a propósito da fisiopatologia destas alterações e chamam a atenção sobre o prognóstico sombrio da porfiria aguda intermitente.

  6. Insuficiência renal aguda: principais causas e a intervenção de enfermagem em UTI

    OpenAIRE

    Silva, Carla Monteiro Santos da; Silva, Doralice de Almeida Nascimento; Silva, Gleise Gonçalves Passos; Maia, Luiz Faustino dos Santos; Editor Científico; Oliveira, Tatiana Santana de

    2016-01-01

    A insuficiência renal aguda é uma patologia grave que pode ser reversível é considerada uma das principais complicações nos pacientes da unidade de terapia intensiva. Teve como objetivo descrever de acordo com a literatura as principais causas de insuficiência renal e a intervenção de enfermagem. Trata-se de uma pesquisa descritiva de revisão da literatura, por meio da qual realizou-se um levantamento da produção científica relacionada a insuficiência renal aguda nas bases de dados LILACS, Sc...

  7. Niveles de trombopoyetina en humor acuoso de pacientes con uveítis anterior aguda no infecciosa

    OpenAIRE

    Mondejar Garcia, José Juan

    2015-01-01

    Niveles de trombopoyetina en humor acuoso de pacientes con uveítis anterior aguda no infecciosa Introducción: Las uveítis anteriores agudas no infecciosas (UAANI) son idiopáticas, aunque ligadas a estímulos ambientales y genéticos. Están relacionadas con la respuesta inmune innata y adaptativa. Han sido aisladas citoquinas y factores de crecimiento celular (PEDF y VEGF) en el ojo y el suero de pacientes con uveítis. Los factores de crecimiento (FC) controlan el crecimiento y la diferencia...

  8. Masculino de 18 años con Leucemia Linfocitica aguda y Artritis de Rodilla por Candida Tropicalis

    OpenAIRE

    Sánchez Benavides, Marvin; Bonilla Trejos, Eduardo

    2013-01-01

    Paciente masculino de 18 años, con antecedente dede Leucemia Linfoblástica Aguda B común desde hace 8 meses, quien abandonó su control y tratamiento. Consultó por cuadro hemorrágico agudo, asociado a sensación febril no cuantificada. Se documentó bicitopenia con neutropenia absoluta, motivo por el que ingresó al Servicio de Hematología, donde se consignó leucemia aguda en recaída y se inició nuevo esquema quimioterapéutico. Durante el internamiento inició con gonalgia izquierda súbita, asocia...

  9. Studies in search of a suitable experimental insect model for xenodiagnosis of hosts with Chagas' disease: 2 - Attempts to upgrade the reliability and the efficacy of xenodiagnosis in chronic Chagas' disease Estudos em busca de um inseto modelo experimental para xenodiagnóstico em hospedeiros com doença de Chagas: 2. Tentativas para aumentar a credibilidade e a eficiência do xenodiagnóstico na doença de Chagas crônica

    Directory of Open Access Journals (Sweden)

    Alina Perlowagora Szumlewicz

    1987-06-01

    passo primordial na estratégia que visa a minimização de casos falso negativos, tanto nos levantamentos longitudinais da doença de Chagas, quanto na sua quimioterapia, apresentamos um estudo sobre a reconstrução do xenodiagnóstico, dando maior ênfase à dinâmica da população no xenodiagnóstico. Conseqüentemente, com o objetivo de levantar a credibilidade do xenodiagnóstico foram tomadas as seguintes medidas: 1. A densidade da população parasitária que em si não é um objetivo de investigações, mas retratando nitidamente a evolução e multiplicação do parasita, foi incorporada na triagem de insetos para o xenodiagnóstico. 2. Assumindo que a realimentação do inseto infectado é capaz de triplicar a densidade da população parasitária, este foi realimentado de duas em duas semanas em galinhas. 3. Na avaliação da resposta do inseto a infecção por T. cruzi foi medida no tubo digestivo completo no lugar da de fezes obtidas por compressão do barbeiro. 4. Sendo a densidade da população parasitária nos primeiros 15 dias após a infecção bem baixa, porém crescendo rapidamente nos 30 dias posteriores, adotou-se o intervalo de 45 dias para o exame do inseto alimentado no hospedeiro com a doença crônica. A eficácia do xenodiagnóstico parece estar associada com o inseto utilizado como seu agente. Das 9 espécies vetoras exploradas neste sentido o inseto da espécie Panstrongylus megistus mostrou-se o mais promissor, devido ao seu elevado índice de infectividade (91.2%, estando a maioria destes (61.9% com elevadas cargas parasitárias. Destaca-se também este inseto pela sua extraordinária capacidade de sustentar a rápida evolução e boa multiplicação de poucos parasitas ingeridos do hospedeiro na fase crônica. Isto está bem ilustrado na comparação do seu índice de positivos de 91.2% com este de 96.4% encontrado entre os insetos alimentados no mesmo hospedeiro com a infecção aguda, quando o numero estimado de...

  10. Edema pulmonar assimétrico por pressão negativa pós-obstrução de via aérea superior: relato de caso Edema pulmonar asimétrico por presión negativa pós-obstrucción aguda de vía aérea superior: relato de caso Asymmetric negative pressure pulmonary edema after acute upper airway obstruction: case report

    OpenAIRE

    Aldo José Peixoto

    2002-01-01

    JUSTIFICATIVA E OBJETIVOS: Edema pulmonar por pressão negativa pós-obstrução de via aérea é atualmente uma entidade bem descrita, porém, provavelmente pouco diagnosticada e os casos pouco publicados. O objetivo deste relato é apresentar um caso de edema pulmonar por pressão negativa pós-obstrução de via aérea superior, cuja principal característica foi a assimetria do edema pulmonar, sendo muito mais acentuado no pulmão direito. RELATO DO CASO: Menino de 4 anos, 17 kg, estado físico ASA I, fo...

  11. Pasteurization of human milk to prevent transmission of Chagas disease Pasteurização de leite humano para evitar a transmissão da doença de Chagas

    Directory of Open Access Journals (Sweden)

    Cláudio Santos FERREIRA

    2001-06-01

    Full Text Available Although admittedly transmission of Trypanosoma cruzi infection through breastfeeding is a rare event, it involves serious risks. To test the effectiveness of pasteurization in preventing this mode of infection, three sets of samples of human milk were tested: a - contaminated with T. cruzi and pasteurized; b - contaminated with T. cruzi and non-pasteurized; c - non-contaminated and pasteurized. Samples from all sets were orally and intraperitoneally administered to 90 BALB/c mice. The animals inoculated with contaminated, non-pasteurized samples, got the infection. Controls and the animals inoculated with contaminated and pasteurized milk were not infected. The hypothesis was accepted that pasteurization inactivates T. cruzi trypomastigotes.A amamentação é modo alternativo de transmitir-se a doença de Chagas. Embora admitida como evento raro, a infecção por esta via é preocupante. Para evitá-la é sugerida a pasteurização. Separaram-se para o ensaio três conjuntos de amostras de leite humano: a - contaminadas por Trypanosoma cruzi e pasteurizadas; b - contaminadas por T. cruzi e não pasteurizadas; c - não contaminadas e pasteurizadas. Frações dos três conjuntos foram inoculadas por vias oral e intraperitoneal em 90 camundongos BALB/c. Os animais inoculados com leite contaminado e não pasteurizado infectaram-se. Os controles e os inoculados com leite contaminado e pasteurizado não se infectaram. Aceitou-se a hipótese de a pasteurização ter inativado as formas tripomastigotas de T. cruzi em suspensão no leite.

  12. Seroepidemiological and clinical study of Chagas' disease in Nicaragua Estudio seroepidemiológico y clínico de la enfermedad de Chagas en Nicaragua

    Directory of Open Access Journals (Sweden)

    Teresa Rivera B

    1995-06-01

    Full Text Available With the aim of determining the prevalence, immunological profile, and knowing the electrocardiographic alterations, a clinical and Seroepidemiological study of Chagas' disease was performed in three rural settlements located at the North, East and West of Nicaragua. Anti T. cruzi antibodies were searched by indirect immunofluorescence (IFI and hemagglutination (IHA in a total of 803 subjects. Seropositives and the same number of seronegatives, matched by age and sex, were included in a case-control design for the electrocardiographic assessment. Antibody prevalence was 13.1, 4.3 and 3.2% in the respective settlements. In the first two the immunological profile corresponds to that of an endemic zone of long standing, were transmission has decreased, and in the third the pattern is of a zone under control. Electrocardiographic changes compatible with Chagas' disease were found in seropositive individuals, but difference with control group was not statistically significant. It is concluded that the disease is endemic in the three settlements and the clinical aspect requires further evaluation, including additional cardiologic techniques.Con el objetivo de determinar la prevalencia, perfil inmunológico de la población y conocer las alteraciones electrocardiográficas; se realizó un estudio seroepidemiológico y clínico de la enfermedad de Chagas en tres localidades ubicadas al Norte, Oriente y Occidente de Nicaragua. Como muestra se tomó suero a 803 personas, a las que se les realizó busqueda de anticuerpos anti T. cruzi por Inmunofluorescencia (IFI y Hemaglutinación Indirecta (HAI. Al total de los pacientes de dos de éstas localidades que resultaron con serología positiva, se les evaluó por electrocardiografía, estableciendo un grupo control con seronegativos con las mismas características de edad y sexo. La prevalencia de anticuerpos fué de 13.1, 4.3, y 3.2% en las tres localidades respectivamente. En las dos primeras el perfil

  13. Chagas' disease in the Brazilian Amazon: I - a short review Doença de Chagas na Amazônia Brasileira: I. revisão

    Directory of Open Access Journals (Sweden)

    José Rodrigues Coura

    1994-08-01

    Full Text Available At least eighteen species of triatominae have been found in the Brazilian Amazon, nine of them naturally infected with Trypanosoma cruzi or "cruzi-like" trypanosomes and associated with numerous wild reservoirs. Despite the small number of human cases of Chagas' disease described to date in the Brazilian Amazon the risk that the disease will become endemic in this area is increasing for the following reasons: a uncontrolled deforestation and colonization altering the ecological balance between reservoir hosts and wild vectors; b the adaptation of reservoir hosts of T.cruzi and wild vectors to peripheral and intradomiciliary areas, as the sole feeding alternative; c migration of infected human population from endemic areas, accompanied by domestic reservoir hosts (dogs and cats or accidentally carrying in their baggage vectors already adapted to the domestic habitat. In short, risks that Chagas' disease will become endemic to the Amazon appear to be linked to the transposition of the wild cycle to the domestic cycle in that area or to transfer of the domestic cycle from endemic areas to the Amazon.Pelo menos dezoito espécies de triatomíneos foram encontradas na Amazônia brasileira, nove das quais infectadas com Trypanosoma cruzi ou semelhante ("cruzi-like", associadas com numerosos reservatórios silvestres. A despeito do pequeno número de casos humanos da doença de Chagas descritos até agora na Amazônia brasileira, o risco que essa doença se torne endêmica é cada vez maior, pelas seguintes razões: a desmatamentos e colonização descontrolados, alterando o balanço entre reservatórios e vetores; b adaptação de reservatórios e vetores silvestres com T.cruzi ao peridomicílio, como única alternativa alimentar; c migração de populações humanas infectadas com T.cruzi acompanhadas de reservatórios domésticos (cães e gatos ou de vetores de suas regiões de origem na bagagem, já adaptados ao domicílio. Em resumo, o risco de que

  14. [Carlos Chagas Filho: an articulator of the history of sciences in Brazil].

    Science.gov (United States)

    Domingues, Heloisa Maria Bertol

    2012-06-01

    A letter sent in 1982 by a group of scientists to the president of Conselho Nacional de Desenvolvimento Científico e Tecnológico appealed for a policy of preservation of Brazilian scientific culture. The name of Carlos Chagas Filho topped the list of signatures thereby proving his commitment to that proposal, the ideological structure of which was part of his experience in scientific policy in Brazil and abroad. This document harks back to the practice of the history of the sciences in Brazil and the creation of places for the safeguard and organization of scientific memory, such as the Museu de Astronomia e Ciências Afins, Casa de Oswaldo Cruz and the Sociedade Brasileira de História da Ciência, of which Carlos Chagas Filho was an inaugural member of the board of directors.

  15. [Urbanization of Chagas disease in Peru: experiences in prevention and control].

    Science.gov (United States)

    Náquira, César

    2014-04-01

    In Peru, Chagas disease has an epidemiological significance in three macro-regions, one of them is the southern macro-region formed by the departments of Arequipa, Moquegua and Tacna. In 1965 a successful control was performed by house spraying insecticides, however, the persistence of the vector made it necessary for a second control plan that was implemented in 2000 and followed the guidelines of CONAL Plan, based on the elimination of Triatoma infestans and screening in blood banks.This plan was successful in Tacna and Moquegua, therefore these departments were considered free of vectorial transmission by the Pan American Health Organization. A ssimilar situation has not been achieved in the department of Arequipa because of the presence, among other factors, of rural migration to the city, in this way the urbanization of Chagas disease is a new epidemiological scenario of which we need to know more.

  16. [Vectorial transmission of Chagas' disease in Mulungu do Morro, Northeastern of Brazil].

    Science.gov (United States)

    Aras, Roque; Gomes, Irênio; Veiga, Marielza; Melo, Ailton

    2003-01-01

    A serological survey was carried out to determine the prevalence of Chagas' disease in municipality. The following variables were analyzed to identify the form of transmission of this disease: age, sex, clinical and transfusional history, degree of kinship and serology. Within the 863 municipalities we studied, we identified 265 individuals, with serology testing done on them and on their respective mothers. Of these, 232 tested negative serology for Chagas'disease and 33 (14.2%) positive. We found 9 (3.9%) patients, of 14.3 years. average age with vectorial transmission and 24 (10.3%), of 26.6 years. average age with probable, vertical and vectorial transmission. When we compare the two groups in regard to age averages and manner of transmission of Trypanosoma cruzi, we encounter a statistical significance. Our results suggest the existence of an active, vectorial transmission of Trypanosoma cruzi in Mulungu do Morro.

  17. [Progress towards the interruption of transmission of Chagas disease in the southern countries].

    Science.gov (United States)

    Moncayo, A

    1999-01-01

    The epidemiological and entomological data and the trends observed in the decreasing of the incidence of infection in young age groups indicate that only ninety years after the discovery of Chagas disease, the control of vectorial and transfusional transmission has reduced the incidence by 70% in the Southern Cone countries (Argentina, Bolivia, Brazil, Chile, Paraguay and Uruguay). This has been accomplished thanks to the political and financial engagement of the concerned governments who have invested US$340 millions since 1991 to the present. The initiatives to interrupt transmission of Chagas in the Andean countries and the Central American countries have begun their activities in 1997 and the evolution of the control operations allows to forecast the complete interruption in these areas before the year 2010 to comply with the mandate of Resolution WHA. 52.14 of the World Health Assembly in May 1998.

  18. Interferon-γ and other inflammatory mediators in cardiomyocyte signaling during Chagas disease cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    Ludmila; Rodrigues; Pinto; Ferreira; Amanda; Farage; Frade; Monique; Andrade; Baron; Isabela; Cunha; Navarro; Jorge; Kalil; Christophe; Chevillard; Edecio; Cunha-Neto

    2014-01-01

    Chagas disease cardiomyopathy(CCC), the main consequence of Trypanosoma cruzi(T.cruzi) infection, is an inflammatory cardiomyopathy that develops in up to 30% of infected individuals. The heart inflammation in CCC patients is characterized by a Th1 T cell-rich myocarditis with increased production of interferon(IFN)-γ, produced by the CCC myocardial infiltrate and detected at high levels in the periphery. IFN-γ has a central role in the cardiomyocyte signaling during both acute and chronic phases of T.cruzi infection. In this review, we have chosen to focus in its pleiotropic mode of action during CCC, which may ultimately be the strongest driver towards pathological remodeling and heart failure. We describe here the antiparasitic protective and pathogenic dual role of IFN-γ in Chagas disease.

  19. Circadian entrainment by light and host in the Chagas disease vector, Triatoma infestans.

    Science.gov (United States)

    Valentinuzzi, Verónica Sandra; Amelotti, Ivana; Gorla, David Eladio; Catalá, Silvia Susana; Ralph, Martin Roland

    2014-03-01

    Triatoma infestans (Reduviidae: Triatominae, "kissing bug") is the main insect vector of Trypanosoma cruzi, the causative agent of Chagas disease, a chronic trypanosomiasis infecting 10 million people world-wide. This hematophagous bug feeds on diurnal and nocturnal species during each host's quiescent time. As the hosts are also its major predators, kissing bugs are subjected to dual selective pressures from a single source. Therefore, synchronization of feeding with the host's behavior is critical to the insects' survival. We show that nonphotic signals linked to the host eclipse the role of light and dark as the primary circadian zeitgeber for these bugs, although light still strongly inhibits locomotor behavior directly. In nature, this combination provides the insect with great flexibility in organizing physiology and behavior: anticipating a quiescent host or avoiding its potential predation while remaining directly responsive to immediate environmental conditions. Manipulation of nonphotic entrainment could be a useful chronobiotic tool in the control of Chagas disease.

  20. Estado actual de nuestros conocimientos sobre la enfermedad de chagas en la Republica Mexicana

    Directory of Open Access Journals (Sweden)

    Jorge Tay

    1981-06-01

    Full Text Available Se presentan los datos obtenidos de la revisión minuciosa en relación a enfermedad de Chagas de la literatura médica de la República Mexicana y extranjera desde el afio de 1939 en que por primeira vez se reporta a Trypanosoma cruzi en México, hasta el ano de 1976. Mediante mapas, tablas y cuadros se senalan las localidades en donde se han encontrado casos humanos, reservorios no humanos y transmisores. Se hacen comentários acerca de los resultados obtenidos y se seffala la importancia de incrementar los estúdios sobre enfermedades de Chagas en nuestro país.

  1. Massive right-sided cardiac thrombosis in Chagas' heart disease without left ventricular dysfunction.

    Science.gov (United States)

    Bestetti, Reinaldo B; Corbucci, Hélio A R; Cardinalli-Neto, Augusto

    2011-02-01

    A 63-year-old woman with the diagnosis of mega-oesophagus secondary to chronic Chagas' disease and no past cardiac history was referred for cardiac evaluation. The resting ECG showed right bundle-branch block, whereas a 2-D echocardiogram revealed marked right ventricular dilatation with hypokinesia, right atrial dilatation, normal pulmonary artery pressure, and normal left ventricular ejection fraction. A large, irregularly shaped mass, arising from the right atrium and protruding into the right ventricle through the tricuspid valve, with several different bizarre forms inside the right atrium during systole and/or diastole was seen on 2-D echocardiogram. Therefore, massive right-sided thrombosis can be detected in Chagas' disease patients with no overt right- and left-sided ventricular failure.

  2. Population differentiation of the Chagas disease vector Triatoma maculata (Erichson, 1848) from Colombia and Venezuela.

    Science.gov (United States)

    Monsalve, Yoman; Panzera, Francisco; Herrera, Leidi; Triana-Chávez, Omar; Gómez-Palacio, Andrés

    2016-06-01

    The emerging vector of Chagas disease, Triatoma maculata (Hemiptera, Reduviidae), is one of the most widely distributed Triatoma species in northern South America. Despite its increasing relevance as a vector, no consistent picture of the magnitude of genetic and phenetic diversity has yet been developed. Here, several populations of T. maculata from eleven Colombia and Venezuela localities were analyzed based on the morphometry of wings and the mitochondrial NADH dehydrogenase subunit 4 (ND4) gene sequences. Our results showed clear morphometric and genetic differences among Colombian and Venezuelan populations, indicating high intraspecific diversity. Inter-population divergence is suggested related to East Cordillera in Colombia. Analyses of other populations from Colombia, Venezuela, and Brazil from distinct eco-geographic regions are still needed to understand its systematics and phylogeography as well as its actual role as a vector of Chagas disease.

  3. [Epidemiologic knowledge and current situation of Chagas disease in the state of Jalisco, Mexico].

    Science.gov (United States)

    Lozano-Kasten, Felipe; Magallón-Gastélum, Ezequiel; Soto-Gutiérrez, Margarita; Kasten-Monges, Marina; Bosseno, Marie-France; Brenière, Simone Frédérique

    2008-01-01

    Chagas disease in the state of Jalisco, Mexico was described for the first time in 1967; however, knowledge on the disease remains in a slow process. Between 1967 and 2006, the disease was described in its acute and chronic forms. The vector species have been identified, and the parasite Trypanosoma cruzi has been isolated and genetically characterized. Also, the magnitude of the infection in humans has been determined through serological studies of different populations as well as of blood donors. The up-to-dateness of knowledge of the disease in the state of Jalisco, unveils a necessity of increased research on the epidemiology of Chagas disease as well as on clinical studies to assess the health of individuals and the populations.

  4. Intoxicación aguda por plaguicidas en edades pediátricas. Guatemala, 2011

    Directory of Open Access Journals (Sweden)

    Mario Enrique Pla Acevedo

    2015-11-01

    Full Text Available Se realizó un estudio descriptivo retrospectivo de la Intoxicación Aguda por plaguicidas en edades pediátricas en Guatemala, que abarcó el  período de enero hasta diciembre del 2011. La muestra estuvo comprendida por 457 pacientes en edades pediátricas. Se analizaron las variables: edad y sexo, actividad que realizaba en el momento de la intoxicación, tipo de plaguicida, severidad, utilización de equipos de protección y lugar de asistencia médica. Las variables para el análisis de los indicadores fueron obtenidas por el Centro Nacional de Epidemiología. Como resultados fundamentales se observó que la Intoxicación Aguda por plaguicidas afectó principalmente al grupo de edades entre 17 y 19 años. El sexo masculino fue el más perjudicado, el mayor porciento de afectados, según causa, fue accidente de trabajo, con un 68% del total de casos; el tipo de plaguicida más utilizado que provocó intoxicación fue el paraquat; predominó la forma severa en los que no usaron medios de protección y el  lugar de atención médica y de notificación correspondió al hospital.

  5. Mielopatia transversa em adulto portador de leucemia aguda linfoblástica: relato de caso

    Directory of Open Access Journals (Sweden)

    Brito José Correia de Farias

    2001-01-01

    Full Text Available Relatamos um caso de mielopatia transversa aguda em paciente masculino de 31 anos de idade, branco, portador de leucemia aguda linfoblástica, subtipo L3 (LLA-L3. Esta é uma forma grave de leucemia e compromete mais crianças em relação aos adultos. Menos de 1% dos pacientes leucêmicos apresentam complicações espinais. No paciente em estudo, a sintomatologia instalou-se de modo abrupto e com as seguintes características: dores nas costas, paraplegia crural flácida e perda das funções sensitivas e vegetativas abaixo do segmento afetado. O diagnóstico etiológico foi estabelecido após a realização dos seguintes exames: hemograma, mielograma, análise do líquido cefalorraqueano e ressonância magnética de coluna dorsal. Foi instituído tratamento específico, que não interferiu com a evolução fatal da doença.

  6. Glomerulonefritis aguda con énfasis en compromiso rápidamente progresivo

    Directory of Open Access Journals (Sweden)

    José Fernando Huertas

    2011-11-01

    Full Text Available Las glomerulonefritis agudas (GNA constituyen un amplio grupo de enfermedades con la característica común de sucomienzo brusco y la proliferación de las células endocapilares del glomérulo. Clínicamente se manifestan como síndromenefrítico agudo: hematuria, insuficiencia renal aguda, hipertensión y proteinuria moderada, aunque pueden debutar comohematuria recurrente. Las GNA se pueden presentar en asociación con una variedad de infecciones bacterianas, víricas,micóticas y parasitarias, pero en la mayoría de los casos el estímulo antigénico inicial es desconocido. Los pacientes conglomerulonefritis rápidamente progresiva a menudo se presentan con aparición brusca de síntomas de la nefritis, comoazoemia, oliguria, edema, hipertensión, proteinuria y hematuria con un «sedimento urinario activo» que suele contenercilindros hemáticos, pigmentados y restos celulares. EscucharLeer fonéticamenteEn este artículo, dirigido a todo el personalde atención primaria y buscando aumentar su sensibilización hacia esta enfermedad, se exponen con mayor detalle la clínica,la etiopatogenia, la anatomía patológica y los tratamientos disponibles de una de las glomerulonefritis con mayor impactoen la sobrevida renal y del paciente.

  7. Retinopatia de Purtscher-like e pancreatite aguda Purtscher-like retinopathy and acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Kelly Fernandes de Paula Rodrigues

    2008-04-01

    Full Text Available Retinopatia de Purtscher-like é uma baixa súbita da visão associada à imagem de múltiplas áreas branco-amareladas (manchas algodonosas e hemorragias no pólo posterior de ambos os olhos. O exato mecanismo da injúria ainda não é claro, mas provavelmente seria de natureza embólica.Tem sido descrita em uma variedade de condições, incluindo pancreatite aguda, síndrome de embolia gordurosa, insuficiência renal, nascimento (parto e pós-parto, desordens do tecido conectivo, entre outras. Serão relatados três casos de pancreatite aguda confirmada pelos exames laboratoriais e história clínica, associadas a alterações no exame do fundo de olho, compatíveis com esta retinopatia.Purtscher-like retinopathy is acute loss of vision associated image of the multiple areas of retinal whitening and hemorrhage in the posterior pole of both eyes. The exact mechanism of injury remains unclear, current evidence suggests that it is embolic in nature. In a variety of conditions are been described including acute pancreatitis, fat embolism syndrome, renal failure, childbirth, and connective tissue disorders. Will are related three cases of the acute pancreatitis which was confirmed by complementary laboratory studies and clinical history, associated from exam of the fundus of the eye, similar is this retinopathy.

  8. [Chagas' disease in patients in chronic hemodialysis. Prevalence and risk of transmission by blood transfusion].

    Science.gov (United States)

    Lorca, M; Lorca, E; Atías, A; Plubins, L

    1989-06-01

    A serologic study of Chagas disease was performed in 110 patients submitted to chronic hemodialisis and blood transfusions. Immunofluorescence antibody testing (IgG and IgM) was positive in 6 out of 62 patients receiving multiple blood transfusions (9.7%), but negative in all 48 subjects without transfusions. Thus, repeated blood transfusion is a significant risk for T cruzi infection in chronic hemodialized patients.

  9. A scientometric evaluation of the Chagas disease implementation research programme of the PAHO and TDR.

    Directory of Open Access Journals (Sweden)

    Ana Laura Carbajal-de-la-Fuente

    2013-11-01

    Full Text Available The Special Programme for Research and Training in Tropical Diseases (TDR is an independent global programme of scientific collaboration cosponsored by the United Nations Children's Fund, the United Nations Development Program, the World Bank, and the World Health Organization. TDR's strategy is based on stewardship for research on infectious diseases of poverty, empowerment of endemic countries, research on neglected priority needs, and the promotion of scientific collaboration influencing global efforts to combat major tropical diseases. In 2001, in view of the achievements obtained in the reduction of transmission of Chagas disease through the Southern Cone Initiative and the improvement in Chagas disease control activities in some countries of the Andean and the Central American Initiatives, TDR transferred the Chagas Disease Implementation Research Programme (CIRP to the Communicable Diseases Unit of the Pan American Health Organization (CD/PAHO. This paper presents a scientometric evaluation of the 73 projects from 18 Latin American and European countries that were granted by CIRP/PAHO/TDR between 1997 and 2007. We analyzed all final reports of the funded projects and scientific publications, technical reports, and human resource training activities derived from them. Results about the number of projects funded, countries and institutions involved, gender analysis, number of published papers in indexed scientific journals, main topics funded, patents inscribed, and triatomine species studied are presented and discussed. The results indicate that CIRP/PAHO/TDR initiative has contributed significantly, over the 1997-2007 period, to Chagas disease knowledge as well as to the individual and institutional-building capacity.

  10. Factores de riesgo asociadas a la enfermedad Chagas en comunidades rurales en Lara, Venezuela

    OpenAIRE

    Zully Briceño; Giampaolo Orlandoni; Elizabeth Torres; Alexander Mogollón; Juan Luis Concepción; Claudina Rodríguez-Bonfante C; Elis Aldana

    2014-01-01

    La reinfestación por vectores secundarios es un problema emergente para la transmisión de la enfermedad de Chagas. Objetivo: Realizar un análisis comparativo para determinar los factores de riesgo asociados a la seropositividad en humanos. Materiales y Métodos: Estudio ecoentomológico y seroepidemiológico realizado en dos comunidades del Estado Lara, infestadas por Triatoma maculata o Panstrongylus geniculatus. Resultados: Guariquito (bosque húmedo tropical templado intervenido para actividad...

  11. Chagas infection transmission control: situation of transfusional transmission in Brazil and other countries of Latin America

    OpenAIRE

    Helio Moraes-Souza

    1999-01-01

    The transmission of the transfusion-associated Chagas disease is an important mechanism of its dissemination in several Latin American countries. The transmission risk depends on five factors: prevalence of infection in blood donors, degree of serological coverage, sensibility of used tests, safety of obtained results and infection risk. The Southern Cone Iniciative set off by the Pan-American Health Organization, in 1991, is contributing to the implementation of blood law in each endemic cou...

  12. Trypanocide treatment of women infected with Trypanosoma cruzi and its effect on preventing congenital Chagas.

    OpenAIRE

    Fabbro, Diana L.; Emmaria Danesi; Veronica Olivera; Maria Olenka Codebó; Susana Denner; Cecilia Heredia; Mirtha Streiger; Sergio Sosa-Estani

    2014-01-01

    With the control of the vectorial and transfusional routes of infection with Trypanosoma cruzi, congenital transmission has become an important source of new cases. This study evaluated the efficacy of trypanocidal therapy to prevent congenital Chagas disease and compared the clinical and serological evolution between treated and untreated infected mothers. We conducted a multicenter, observational study on a cohort of mothers infected with T. cruzi, with and without trypanocidal treatment be...

  13. [Regression of acute Chagas cardiopathy in an infant with a suspected transfusion infection].

    Science.gov (United States)

    Gónzalez-Zambrano, H; Amador Mena, J E; Delgadillo Jaime, C B

    1999-01-01

    Chagas disease was described in Mexico by Mazzotti in 1940. Post-transfusional cases have not been described. We report proved case of acute chagasic cardiopathy in a nine months old infant with suspected transfusional infection during neonatal period. She was treated with nifurtimox with disappearance of parasites and regression of cardiopathy. She is asymptomatic nine years afterwards with normal growth and negative parasitology and serology.

  14. Chagas disease in an area of recent occupation in Cochabamba, Bolivia

    OpenAIRE

    Albarracin-Veizaga Hugo; Carvalho Maria Esther de; Nascimento Elvira M M do; Rodrigues Vera Lúcia C. C.; Casanova Cláudio; Barata José Maria S

    1999-01-01

    INTRODUCTION: A descriptive, entomological and seroepidemiological study on Chagas disease was conducted in a place of recent occupation on the outskirts of Cochabamba, Bolivia: Avaroa/Primer de Mayo (population:3,000), where the socio-economic level is low and no control measures have been made available. METHODS: The immunofluorescent antibody test (IFAT) was used for IgG and IgM anti-Trypanosoma cruzi antibodies in filter paper bloodspot eluates from 128 subjects (73 females, 55 males) sel...

  15. Different infective forms trigger distinct immune response in experimental Chagas disease.

    OpenAIRE

    Vieira,PM.; Francisco, AF; Machado, EM; Nogueira, NC; Fonseca, KdaS; Reis, AB; Teixeira-Carvalho, A.; Martins-Filho, OA; Tafuri,WL; Carneiro, CM

    2012-01-01

    Although metacyclic and blood trypomastigotes are completely functional in relation to parasite-host interaction and/or target cell invasion, they differ in the molecules present on the surface. Thus, aspects related to the variability that the forms of T. cruzi interacts with host cells may lead to fundamental implications on the immune response against this parasite and, consequently, the clinical evolution of Chagas disease. We have shown that BT infected mice presented higher levels of pa...

  16. Transmisión de la enfermedad de Chagas por vía oral

    OpenAIRE

    TOSO M,ALBERTO; VIAL U,FELIPE; Galanti, Norbel

    2011-01-01

    The traditional transmission pathways of Chagas' disease are vectorial, transfusional, transplacental and organ transplantation. However, oral transmission is gaining importance. The first evidence of oral transmission was reported in Brazil in 1965. Nowadays the oral route is the transmission mode in 50% of cases in the Amazon river zone. Oral infection is produced by the ingestion of infected triatomine bugs or their feces, undercooked meat from infested host animals and food contaminated w...

  17. La enfermedad de Chagas ya no es tan exótica

    Centers for Disease Control (CDC) Podcasts

    2008-04-03

    Este podcast tiene el propósito de informar a los profesionales de la salud sobre la enfermedad de Chagas, su diagnóstico y tratamiento, así como orientar en la identificación de pacientes infectados.  Created: 4/3/2008 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 4/9/2008.

  18. Community resilience and Chagas disease in a rural region of Mexico

    Directory of Open Access Journals (Sweden)

    José Antonio Santana Rangel

    2016-01-01

    Full Text Available ABSTRACT OBJECTIVE To explore the pillars of community resilience in a region where Chagas disease is endemic, with the aim of promoting participatory processes to deal with this condition from the resilience of the population. METHODS Qualitative study using ethnographic record and six interviews of focus groups with young people, women and men. The research was carried out in a rural area of the state of Morelos, Mexico, between 2006 and 2007. We carried out educational sessions with the population in general, so that residents could identify the relationship between the vector Triatoma pallidipennis, the parasite (Trypanosoma cruzi, symptoms, and preventive actions for Chagas disease. The ethnographic record and groups were analyzed based on Taylor and Bogdan’s modification, and the focus was to understand the socio-cultural meanings that guide the speeches and activities of residents in relation to the pillars of community resilience. RESULTS The population felt proud of belonging to that location and three pillars of community resilience were clearly identified: collective self-esteem, cultural identity, and social honesty. Having these pillars as bases, we promoted the participation of the population concerning Chagas disease, and a Community Action Group was formed with young people, adult men and women, and social leaders. This Group initiated actions of epidemiological and entomological surveillance in the community to deal with this problem. CONCLUSIONS It is necessary to create more experiences that deepen the understanding of the pillars of community resilience, and how they contribute to enhance participation in health to deal with Chagas disease.

  19. Exposure to Citral, Cinnamon and Ruda Disrupts the Life Cycle of a Vector of Chagas Disease

    OpenAIRE

    2007-01-01

    The main vector of Chagas disease in Venezuela was exposed to the odors of citral, cinnamon and ruda. Cinnamon was found to stop the life cycle of Rhodnius prolixus relative to untreated animals. Citral and ruda also influenced the life cycle but not to the extent of animals exposed to cinnamon. We suggest that future research be directed toward using cinnamon in field and toxicity tests.

  20. Lower richness of small wild mammal species and chagas disease risk.

    Science.gov (United States)

    Xavier, Samanta Cristina das Chagas; Roque, André Luiz Rodrigues; Lima, Valdirene dos Santos; Monteiro, Kerla Joeline Lima; Otaviano, Joel Carlos Rodrigues; Ferreira da Silva, Luiz Felipe Coutinho; Jansen, Ana Maria

    2012-01-01

    A new epidemiological scenario involving the oral transmission of Chagas disease, mainly in the Amazon basin, requires innovative control measures. Geospatial analyses of the Trypanosoma cruzi transmission cycle in the wild mammals have been scarce. We applied interpolation and map algebra methods to evaluate mammalian fauna variables related to small wild mammals and the T. cruzi infection pattern in dogs to identify hotspot areas of transmission. We also evaluated the use of dogs as sentinels of epidemiological risk of Chagas disease. Dogs (n = 649) were examined by two parasitological and three distinct serological assays. kDNA amplification was performed in patent infections, although the infection was mainly sub-patent in dogs. The distribution of T. cruzi infection in dogs was not homogeneous, ranging from 11-89% in different localities. The interpolation method and map algebra were employed to test the associations between the lower richness in mammal species and the risk of exposure of dogs to T. cruzi infection. Geospatial analysis indicated that the reduction of the mammal fauna (richness and abundance) was associated with higher parasitemia in small wild mammals and higher exposure of dogs to infection. A Generalized Linear Model (GLM) demonstrated that species richness and positive hemocultures in wild mammals were associated with T. cruzi infection in dogs. Domestic canine infection rates differed significantly between areas with and without Chagas disease outbreaks (Chi-squared test). Geospatial analysis by interpolation and map algebra methods proved to be a powerful tool in the evaluation of areas of T. cruzi transmission. Dog infection was shown to not only be an efficient indicator of reduction of wild mammalian fauna richness but to also act as a signal for the presence of small wild mammals with high parasitemia. The lower richness of small mammal species is discussed as a risk factor for the re-emergence of Chagas disease.

  1. Lower richness of small wild mammal species and chagas disease risk.

    Directory of Open Access Journals (Sweden)

    Samanta Cristina das Chagas Xavier

    Full Text Available A new epidemiological scenario involving the oral transmission of Chagas disease, mainly in the Amazon basin, requires innovative control measures. Geospatial analyses of the Trypanosoma cruzi transmission cycle in the wild mammals have been scarce. We applied interpolation and map algebra methods to evaluate mammalian fauna variables related to small wild mammals and the T. cruzi infection pattern in dogs to identify hotspot areas of transmission. We also evaluated the use of dogs as sentinels of epidemiological risk of Chagas disease. Dogs (n = 649 were examined by two parasitological and three distinct serological assays. kDNA amplification was performed in patent infections, although the infection was mainly sub-patent in dogs. The distribution of T. cruzi infection in dogs was not homogeneous, ranging from 11-89% in different localities. The interpolation method and map algebra were employed to test the associations between the lower richness in mammal species and the risk of exposure of dogs to T. cruzi infection. Geospatial analysis indicated that the reduction of the mammal fauna (richness and abundance was associated with higher parasitemia in small wild mammals and higher exposure of dogs to infection. A Generalized Linear Model (GLM demonstrated that species richness and positive hemocultures in wild mammals were associated with T. cruzi infection in dogs. Domestic canine infection rates differed significantly between areas with and without Chagas disease outbreaks (Chi-squared test. Geospatial analysis by interpolation and map algebra methods proved to be a powerful tool in the evaluation of areas of T. cruzi transmission. Dog infection was shown to not only be an efficient indicator of reduction of wild mammalian fauna richness but to also act as a signal for the presence of small wild mammals with high parasitemia. The lower richness of small mammal species is discussed as a risk factor for the re-emergence of Chagas disease.

  2. Evolutionary and dispersal history of Triatoma infestans, main vector of Chagas disease, by chromosomal markers

    OpenAIRE

    Panzera, F.; Ferreiro, M. J.; Pita, S.; Calleros, L.; Perez, R.; Basmadjian, Y.; Guevara, Y.; Brenière, Simone Frédérique; Panzera, Y.

    2014-01-01

    Chagas disease, one of the most important vector-borne diseases in the Americas, is caused by Trypanosoma cruzi and transmitted to humans by insects of the subfamily Triatominae. An effective control of this disease depends on elimination of vectors through spraying with insecticides. Genetic research can help insect control programs by identifying and characterizing vector populations. In southern Latin America, Triatoma infestans is the main vector and presents two distinct lineages, known ...

  3. First century of Chagas' disease: an overview on novel approaches to nifurtimox and benzonidazole delivery systems.

    Science.gov (United States)

    Salomon, Claudio J

    2012-03-01

    Hundred years after the discovery of Chagas' disease, there is a lack of effective treatment to control this neglected disease caused by the parasite Trypanosoma cruzi. The transmission is primarily through vector-borne blood transfusion or during pregnancy, producing high mortality and morbidity among poor people in many countries of Latin America. In the last decades, the efforts have been focused mainly on the elimination of vectors. At the same time, screening of blood donors in order to avoid transfusional transmission has been improved all over the world. However, Chagas' disease is still a major public health problem, with estimates of nearly 90 million people at risk of infection and more than eight million infected in 18 endemic countries. Despite the high incidence in endemic regions and the dissemination of neglected diseases in North America and Europe, to date, there are only two drugs developed and prescribed for the treatment of Chagas' disease, nifurtimox (tablets of 120 mg) and benzonidazole (tablets of 100 mg). In this review, different approaches carried out in the last decades for developing novel pharmaceutical formulations for the delivery of nifurtimox and benznidazole are discussed.

  4. [The control of the transmission by transfusion of Chagas' disease in the Southern Cone Initiative].

    Science.gov (United States)

    Dias, J C; Schofield, C J

    1998-01-01

    The Southern Cone Initiative against Chagas' disease, was launched in 1991. The aim was to interrupt the transmission of Chagas disease by elimination of domestic populations of the major vector, Triatoma infestans, and by improved screening of blood donors. As a result of these activities, a marked reduction in the risk of transfusional transmission can now be seen throughout the programme area. In addition to specific legislation concerning the quality of transfused blood, a series of national and regional reference laboratories have been set up with the help of PAHO in order to improve the quality of pre-transfusional serodiagnosis. Results indicate a progressive reduction in the overall infection prevalence of blood donors, and show that the age-prevalence curve has shifted towards older age-groups. In this paper we analyse the changes in infection prevalence in the Southern Cone countries, drawing attention to the situation in Bolivia which has the highest indices of infection and lowest levels of coverage by the control programme. In this situation chemoprophylaxis of blood prior to transfusion may be recommended in accordance with PAHO criteria. In the medium term however, interruption of human Chagas disease transmission may be expected over most of the Southern Cone region, as long as the control activities are continued and consolidated through effective epidemiological surveillance.

  5. Positive deviance study to inform a Chagas disease control program in southern Ecuador.

    Science.gov (United States)

    Nieto-Sanchez, Claudia; Baus, Esteban G; Guerrero, Darwin; Grijalva, Mario J

    2015-05-01

    Chagas disease is caused by Trypanosoma cruzi, which is mainly transmitted by the faeces of triatomine insects that find favourable environments in poorly constructed houses. Previous studies have documented persistent triatomine infestation in houses in the province of Loja in southern Ecuador despite repeated insecticide and educational interventions. We aim to develop a sustainable strategy for the interruption of Chagas disease transmission by promoting living environments that are designed to prevent colonisation of rural houses by triatomines. This study used positive deviance to inform the design of an anti-triatomine prototype house by identifying knowledge, attitudes and practices used by families that have remained triatomine-free (2010-2012). Positive deviants reported practices that included maintenance of structural elements of the house, fumigation of dwellings and animal shelters, sweeping with "insect repellent" plants and relocation of domestic animals away from the house, among others. Participants favoured construction materials that do not drastically differ from those currently used (adobe walls and tile roofs). They also expressed their belief in a clear connection between a clean house and health. The family's economic dynamics affect space use and must be considered in the prototype's design. Overall, the results indicate a positive climate for the introduction of housing improvements as a protective measure against Chagas disease in this region.

  6. Polymorphisms of toll-like receptor 2 and 4 genes in Chagas disease

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    German Zafra

    2008-02-01

    Full Text Available The aim of this study was to test the possible implication of toll-like receptor 2 (TLR2 and TLR4 gene polymorphisms in determining the susceptibility to Chagas' disease. Genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism in 475 individuals from Colombia, 143 seropositive with chagasic cardiomyopathy, 132 seropositive asymptomatic and 200 seronegative. The TLR2 arginine to glutamine substitution at residue 753(Arg753Gln polymorphism was absent in the groups analyzed. The TLR4 Asp299Gly and Thr399Ile polymorphisms are in linkage disequilibrium and we observed a very low frequency of these polymorphisms in our study population (2.6% and 1.8% respectively. The overall TLR2 and TLR4 alleles and genotype distribution in seronegative and seropositive were not significantly different. We compared the frequencies between asymptomatic patients and those with chagasic cardiomyopathy and we did not observe any significant differences in the distribution of alleles or genotypes. In summary, this study corroborates the low frequency of TLR2 and TLR4 polymorphisms observed in other populations and suggest that these do not play an important role in Chagas' disease. The validation of these findings in independent cohorts is needed to firmly establish a role for TLR2 and TLR4 variants in Chagas' disease.

  7. Positive deviance study to inform a Chagas disease control program in southern Ecuador

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    Claudia Nieto-Sanchez

    2015-05-01

    Full Text Available Chagas disease is caused by Trypanosoma cruzi, which is mainly transmitted by the faeces of triatomine insects that find favourable environments in poorly constructed houses. Previous studies have documented persistent triatomine infestation in houses in the province of Loja in southern Ecuador despite repeated insecticide and educational interventions. We aim to develop a sustainable strategy for the interruption of Chagas disease transmission by promoting living environments that are designed to prevent colonisation of rural houses by triatomines. This study used positive deviance to inform the design of an anti-triatomine prototype house by identifying knowledge, attitudes and practices used by families that have remained triatomine-free (2010-2012. Positive deviants reported practices that included maintenance of structural elements of the house, fumigation of dwellings and animal shelters, sweeping with "insect repellent" plants and relocation of domestic animals away from the house, among others. Participants favoured construction materials that do not drastically differ from those currently used (adobe walls and tile roofs. They also expressed their belief in a clear connection between a clean house and health. The family's economic dynamics affect space use and must be considered in the prototype's design. Overall, the results indicate a positive climate for the introduction of housing improvements as a protective measure against Chagas disease in this region.

  8. Current and developing therapeutic agents in the treatment of Chagas disease

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    Werner Apt

    2010-09-01

    Full Text Available Werner AptUniversity of Chile, Faculty of Medicine, Santiago, ChileAbstract: Chagas disease must be treated in all its stages: acute, indeterminate, chronic, and initial and middle determinant chronic, due to the fact that DNA of the parasite can be demonstrated by PCR in chronic cases, where optical microscopy does not detect parasites. Nifurtimox (NF and benznidazole (BNZ are the drugs accepted to treat humans based upon ethical considerations and efficiency. However, both the drugs produce secondary effects in 30% of the cases, and the treatment must be given for at least 30–60 days. Other useful drugs are itraconazole and posaconazole. The latter may be the drug to treat Chagas disease in the future when all the investigations related to it are finished. At present, there is no criterion of cure for chronic cases since in the majority, the serology remains positive, although it may decrease. In acute cases, 70% cure with NF and 75% with BNZ is achieved. In congenital cases, 100% cure is obtained if the treatment is performed during the first year of life. In chronic acquired cases, 20% cure and 50% improvement of the electrocardiographic changes are obtained with itraconazole.Keywords: Chagas disease, treatment, nifurtimox, benznidazole, allopurinol, itraconazole, posaconazole

  9. Multi-epitope proteins for improved serological detection of Trypanosoma cruzi infection and Chagas Disease.

    Science.gov (United States)

    Duthie, Malcolm S; Guderian, Jeffery A; Vallur, Aarthy C; Misquith, Ayesha; Liang, Hong; Mohamath, Raodoh; Luquetti, Alejandro O; Carter, Darrick; Tavares, Suelene N B; Reed, Steven G

    2016-03-01

    We previously reported that tandem repeat (TR) proteins from Trypanosoma cruzi could serve as targets of the antibody response and be useful as diagnostic indicators. To optimize reagents for detecting T. cruzi infection we evaluated individual TR proteins and identified several that were recognized by the majority of Chagas patient's sera collected from individuals form Brazil. We then produced novel, recombinant fusion proteins to combine the reactive TR proteins into a single diagnostic product. Direct comparison of the antibody response of serum samples that were readily detected by the established fusion antigen used in commercial detection of Chagas disease, TcF, revealed strong responses to TcF43 and TcF26 proteins. While the TcF43 and TcF26 antigens enhanced detection and strength of signal, they did not compromise the specificity of detection compared to that obtained with TcF. Finally, it was apparent by testing against a panel of 84 serum samples assembled on the basis of moderate or weak reactivity against TcF (mostly signal:noise detected by many of the sera that had low TcF antibody levels. Taken together, these data indicate that TcF43 and TcF26 could be used to enhance the detection of T. cruzi infection as well as supporting a diagnosis of Chagas disease.

  10. Prevalence of Chagas disease in Latin-American migrants living in Europe: a systematic review and meta-analysis.

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    Ana Requena-Méndez

    2015-02-01

    Full Text Available Few studies have assessed the burden of Chagas disease in non-endemic countries and most of them are based on prevalence estimates from Latin American (LA countries that likely differ from the prevalence in migrants living in Europe. The aim of this study was to systematically review the existing data informing current understanding of the prevalence of Chagas disease in LA migrants living in European countries.We conducted a systematic review and meta-analysis of studies reporting prevalence of Chagas disease in European countries belonging to the European Union (EU before 2004 in accordance with the MOOSE guidelines and based on the database sources MEDLINE and Global Health. No restrictions were placed on study date, study design or language of publication. The pooled prevalence was estimated using random effect models based on DerSimonian & Laird method.We identified 18 studies conducted in five European countries. The random effect pooled prevalence was 4.2% (95%CI:2.2-6.7%; and the heterogeneity of Chagas disease prevalence among studies was high (I2 = 97%,p<0.001. Migrants from Bolivia had the highest prevalence of Chagas disease (18.1%, 95%CI:13.9-22.7%.Prevalence of Chagas in LA migrants living in Europe is high, particularly in migrants from Bolivia and Paraguay. Data are highly heterogeneous dependent upon country of origin and within studies of migrants from the same country of origin. Country-specific prevalence differs from the estimates available from LA countries. Our meta-analysis provides prevalence estimates of Chagas disease that should be used to estimate the burden of disease in European countries.

  11. Insuficiência renal aguda como manifestação inicial de linfoma de Burkitt renal

    OpenAIRE

    Carvalho,José Gastão Rocha de; Tafarel,Jean Rodrigo; Carvalho,Wilson Beleski de; Azambuja,Ana Paula; Zenaro,Elicéia Soraia; Bendlin, Rodrigo

    2006-01-01

    Relatamos o caso de um jovem de 14 anos que procurou atendimento médico por edema e hipertensão, sendo insuficiência renal aguda secundária a linfoma de Burkitt renal diagnosticada após avaliação laboratorial, de imagem e biópsia de massa tumoral renal.

  12. CONOCIMIENTOS Y PRÁCTICAS DE INFECCIONES RESPIRATORIAS Y ENFERMEDADES DIARREICAS AGUDAS EN MADRES DE UNA COMUNIDAD DE PIURA, PERÚ

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    Mario J. Valladares Garrido

    2016-07-01

    Full Text Available Objetivo: Determinar conocimientos y prácticas frente a enfermedades diarreicas agudas (IRAS y las infecciones respiratorias agudas (EDAS antes y después de una intervención educativa. Material y Métodos: Se realizó un estudio de intervención en un centro de salud de Piura aplicando un cuestionario a 60 madres, el cual estuvo constituido por 40 preguntas y dividido en 4 secciones: datos sociodemográficos maternos y del niño, signos de alarma y prácticas de IRAS y EDAS, y conocimiento sobre IRAS. Resultados: De 60 madres participantes del estudio, la mayoría presentó un deficiente conocimiento sobre IRAS (75%. Los signos de alarma menos reconocidos antes de la intervención fueron la presencia de sangre en deposiciones (11,7%, beber mal o no poder beber (13,3% y tiraje subcostal (8,3% y silbido de pecho (15%. Los signos más reconocidos post intervención fueron respiración rápida (86,7%, diarreas acuosas (88,3% y ojos hundidos (83,3%. Conclusión: Se presentó poco reconocimiento de los signos de alarma de IRAS y EDAS en las madres antes de la intervención educativa. Palabras clave: conocimientos, prácticas, infecciones respiratorias agudas, enfermedades diarreicas agudas. (DeCS

  13. O líquido cefalorraqueano nas encefalites psicóticas azotêmicas agudas (marchand

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    J. Baptista dos Reis

    1948-09-01

    Full Text Available Examinado o líqüido cefalorraqueano de 11 pacientes portadores de encefalite psicótica aguda de Marchand, os autores verificaram constante elevação das taxas de cloretos, glicose e uréia. Tais elementos constituem, pois, uma síndrome humoral peculiar a essa entidade mórbida.

  14. Development of a Fluorescence-based Trypanosoma cruzi CYP51 Inhibition Assay for Effective Compound Triaging in Drug Discovery Programmes for Chagas Disease.

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    Jennifer Riley

    2015-09-01

    Full Text Available Chagas disease, caused by the protozoan parasite Trypanosoma cruzi (T. cruzi, is a life threatening global health problem with only two drugs available for treatment (benznidazole and nifurtimox, both having variable efficacy in the chronic stage of the disease and high rates of adverse drug reactions. Inhibitors of sterol 14α-demethylase (CYP51 have proven effective against T. cruzi in vitro and in vivo in animal models of Chagas disease. Consequently two azole inhibitors of CYP51 (posaconazole and ravuconazole have recently entered clinical development by the Drugs for Neglected Diseases initiative. Further new drug treatments for this disease are however still urgently required, particularly having a different mode of action to CYP51 in order to balance the overall risk in the drug discovery portfolio. This need has now been further strengthened by the very recent reports of treatment failure in the clinic for both posaconazole and ravuconazole. To this end and to prevent enrichment of drug candidates against a single target, there is a clear need for a robust high throughput assay for CYP51 inhibition in order to evaluate compounds active against T. cruzi arising from phenotypic screens. A high throughput fluorescence based functional assay using recombinantly expressed T. cruzi CYP51 (Tulahuen strain is presented here that meets this requirement. This assay has proved valuable in prioritising medicinal chemistry resource on only those T. cruzi active series arising from a phenotypic screening campaign where it is clear that the predominant mode of action is likely not via inhibition of CYP51.

  15. Development of a Fluorescence-based Trypanosoma cruzi CYP51 Inhibition Assay for Effective Compound Triaging in Drug Discovery Programmes for Chagas Disease.

    Science.gov (United States)

    Riley, Jennifer; Brand, Stephen; Voice, Michael; Caballero, Ivan; Calvo, David; Read, Kevin D

    2015-09-01

    Chagas disease, caused by the protozoan parasite Trypanosoma cruzi (T. cruzi), is a life threatening global health problem with only two drugs available for treatment (benznidazole and nifurtimox), both having variable efficacy in the chronic stage of the disease and high rates of adverse drug reactions. Inhibitors of sterol 14α-demethylase (CYP51) have proven effective against T. cruzi in vitro and in vivo in animal models of Chagas disease. Consequently two azole inhibitors of CYP51 (posaconazole and ravuconazole) have recently entered clinical development by the Drugs for Neglected Diseases initiative. Further new drug treatments for this disease are however still urgently required, particularly having a different mode of action to CYP51 in order to balance the overall risk in the drug discovery portfolio. This need has now been further strengthened by the very recent reports of treatment failure in the clinic for both posaconazole and ravuconazole. To this end and to prevent enrichment of drug candidates against a single target, there is a clear need for a robust high throughput assay for CYP51 inhibition in order to evaluate compounds active against T. cruzi arising from phenotypic screens. A high throughput fluorescence based functional assay using recombinantly expressed T. cruzi CYP51 (Tulahuen strain) is presented here that meets this requirement. This assay has proved valuable in prioritising medicinal chemistry resource on only those T. cruzi active series arising from a phenotypic screening campaign where it is clear that the predominant mode of action is likely not via inhibition of CYP51.

  16. Indicaciones y resultados de la colecistostomía percutánea como opción terapéutica en la colecistitis aguda

    OpenAIRE

    Molina Rodríguez, José Luis

    2013-01-01

    Introducción La colecistitis, una enfermedad resultante de las complicaciones de la colelitiasis, puede ocurrir en dos maneras: aguda o crónica. La colecistitis aguda requiere un tratamiento urgente, normalmente con antibióticos seguidos de colecistectomía. Si la colecistectomía urgente no puede realizarse, la operación puede diferirse hasta que esté resuelto el episodio agudo y realizarse entonces de manera electiva (1). La causa más frecuente de la colecistitis aguda es la impactación...

  17. Enfermedad de Chagas en poblaciones prehistóricas del norte de Chile Chagas disease in prehistoric populations of northern Chile

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    NANCY ORELLANA-HALKYER

    2010-12-01

    Full Text Available La enfermedad de Chagas es producida por el parásito Trypanosoma cruzi, el cual afecta tanto a seres humanos como a animales, en particular mamíferos marsupiales y placentarios. Las vías de transmisión son diversas, siendo una de las más importantes la vía vectorial, en la que participan insectos infectados con este parásito, animales y humanos. En este artículo de revisión discutimos los postulados sobre la vía de transmisión oral, los hallazgos de T. cruzi en momias de América y especialmente en las del norte de Chile. Presentamos además información que apunta a que la enfermedad de Chagas estuvo presente mucho antes de la conquista europea y de la construcción de viviendas de adobe. Comentamos las hipótesis sobre el vector domiciliado más importante de Sudamérica, Triatoma infestans, su antigüedad en la costa de Arica y los reportes más recientes de otros vectores silvestres. También se discute la información relacionada a la participación en el ciclo de T. cruzi de distintos mamíferos silvestres de Chile y asimismo proponemos el estudio paleoparasitológico en restos zooarqueológicos para conocer las especies de mamíferos reservónos de T. cruzi en la antigüedad.Chagas diseases is produced by a parasite named Trypanosoma cruzi, that affects humans and other marsupial and placental mammals. Transmission routes are diverse, but the most important transmission is the vector route, which involves the triatomine insects, wild and domestic infected animáis, and humans. Here we review the data about oral transmission route and the evidences of the etiological agent (Trypanosoma cruzi of Chagas disease in pre-Columbian American mummies, making a critical review of the infection in northern Chile. Moreover, we comment on the hypotheses suggested in relation to the most important vector of the infection in South América Triatoma infestans, its antiquity in the Arica coast, and the recent reports about other wild infected

  18. Chagas disease: what is known and what is needed - A background article

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    José Rodrigues Coura

    2007-10-01

    Full Text Available Chagas disease began millions of years ago as an enzootic disease of wild animals and started to be transmitted to man accidentally in the form of an anthropozoonosis when man invaded wild ecotopes. Endemic Chagas disease became established as a zoonosis over the last 200-300 years through forest clearance for agriculture and livestock rearing and adaptation of triatomines to domestic environments and to man and domestic animals as a food source. It is estimated that 15 to 16 million people are infected with Trypanosoma cruzi in Latin America and 75 to 90 million people are exposed to infection. When T. cruzi is transmitted to man through the feces of triatomines, at bite sites or in mucosa, through blood transfusion or orally through contaminated food, it invades the bloodstream and lymphatic system and becomes established in the muscle and cardiac tissue, the digestive system and phagocytic cells. This causes inflammatory lesions and immune responses, particularly mediated by CD4+, CD8+, interleukin-2 (IL and IL-4, with cell and neuron destruction and fibrosis, and leads to blockage of the cardiac conduction system, arrhythmia, cardiac insufficiency, aperistalsis, and dilatation of hollow viscera, particularly the esophagus and colon. T. cruzi may also be transmitted from mother to child across the placenta and through the birth canal, thus causing abortion, prematurity, and organic lesions in the fetus. In immunosuppressed individuals, T. cruzi infection may become reactivated such that it spreads as a severe disease causing diffuse myocarditis and lesions of the central nervous system. Chagas disease is characterized by an acute phase with or without symptoms, and with entry point signs (inoculation chagoma or Romaña's sign, fever, adenomegaly, hepatosplenomegaly, and evident parasitemia, and an indeterminate chronic phase (asymptomatic, with normal results from electrocardiogram and x-ray of the heart, esophagus, and colon or with a

  19. Validade da amilasemia e da lipasemia no diagnóstico diferencial entre pancreatite aguda/crônica agudizada e outras causas de dor abdominal aguda Validity of serum amylase and lipase for the differential diagnosis between acute/acutized chronic pancreatitis and other causes of acute abdominal pain

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    Ricardo Custódio Pacheco

    2003-12-01

    Full Text Available RACIONAL: Várias doenças abdominais podem cursar com aumento de amilasemia e lipasemia. OBJETIVO: Avaliar a validade da amilasemia e lipasemia para os diagnósticos diferenciais entre pancreatite aguda/pancreatite crônica agudizada, doenças das vias biliares, úlcera gastroduodenal perfurada e apendicite aguda. PACIENTES E MÉTODOS: Foram avaliados, prospectivamente, 38 pacientes com pancreatite aguda/pancreatite crônica agudizada, 35 com doenças das vias biliares, 17 com úlcera gastroduodenal perfurada e 44 com apendicite aguda, com idade média (desvio padrão de 42,4 ± 17,7, 46,7 ± 18,3, 47,8 ± 12 e 33,7 ± 17,8 anos, respectivamente. A amilasemia e a lipasemia foram determinadas à admissão no pronto-socorro. RESULTADOS: Para o diagnóstico de pancreatite aguda/pancreatite crônica agudizada, quando o nível de corte da amilasemia variou entre o limite superior de referência e 5 vezes este limite, a sensibilidade diminuiu de 92% para 74%, a especificidade aumentou de 85% para 99%, o valor preditivo positivo aumentou de 71% para 97% e o valor preditivo negativo diminuiu de 96% para 91%. Para a lipasemia valores semelhantes foram obtidos para sensibilidade e valor preditivo negativo, mas a especificidade e o valor preditivo positivo foram mais baixos. Quando se considerou amilasemia ou lipasemia elevadas, houve pequeno aumento na sensibilidade e no valor preditivo negativo. CONCLUSÕES: Para o diagnóstico de pancreatite aguda/pancreatite crônica agudizada, 1 o melhor nível de corte para ambos os testes foi o de duas vezes o limite superior de referência; 2 as sensibilidades da amilasemia e da lipasemia foram semelhantes; 3 a especificidade e o valor preditivo positivo da amilasemia foram ligeiramente maiores do que as da lipasemia; 4 a sensibilidade, mas não a especificidade, aumentou quando pelo menos uma das enzimas estava elevada.BACKGROUND: Raised serum amylase and lipase levels are observed in several abdominal diseases

  20. Clinical forms of Trypanosoma cruzi infected individuals in the chronic phase of Chagas disease in Puebla, Mexico

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    María del Carmen Sánchez-Guillén

    2006-11-01

    Full Text Available In Mexico, despite the relatively high seroprevalence of Trypanosoma cruzi infection in humans in some areas, reported morbidity of Chagas disease is not clear. We determined clinical stage in 71 individuals seropositive to T. cruzi in the state of Puebla, Mexico, an area endemic for Chagas disease with a reported seroprevalence of 7.7%. Diagnosis of Chagas disease was made by two standardized serological tests (ELISA, IHA. Individuals were stratified according to clinical studies. All patients were submitted to EKG, barium swallow, and barium enema. Groups were identified as indeterminate form (IF asymptomatic individuals without evidence of abnormalities (n = 34 cases; those with gastrointestinal alterations (12 patients including symptoms of abnormal relaxation of the lower esophageal sphincter and absent peristalsis in the esophageal body, grade I megaesophagus, and/or megacolon; patients with clinical manifestations and documented changes of chronic Chagas heart disease who were subdivided as follows: mild (8 patients - mild electrocardiographic changes of ventricular repolarization, sinus bradychardia; moderate (6 patients - left bundle branch block, right bundle branch block associated with left anterior fascicular block; severe (8 patients - signs of cardiomegaly, dilated cardiomyopathy; and the associated form (3 cases that included presence of both cardiomyopathy and megaesophagus. These data highlight the importance of accurate evaluation of the prevalence and clinical course of Chagas disease in endemic and non-endemic areas of Mexico.

  1. [The assessment process within science and the nomination of Carlos Chagas for the Nobel prize for Physiology or Medicine].

    Science.gov (United States)

    Pittella, José Eymard Homem

    2009-01-01

    One of the greatest achievements in the history of medicine was the description of Chagas disease by the physician and scientist Carlos Chagas. A hundred years after the discovery of the disease, speculation still remains regarding the two official nominations of Carlos Chagas for the Nobel Prize, the biggest worldwide scientific award, in 1913 and in 1921. It has been accepted that the reason why the prize was not awarded to this brilliant scientist may have been the strong opposition that he faced in Brazil, from some physicians and researchers of that time. They went as far as questioning the existence of Chagas disease, thereby possibly influencing the decision of the Nobel Committee not to award the prize to him. Analysis of the database of the Nobel prize archives, with the revelation of the names of nominators, nominees and prizewinners spanning the years 1901-1951, brought information not only about what was considered to be a scientific achievement at that time, but also about who the important scientists were and what the relationships between them were. The non-recognition of Carlos Chagas' discoveries by the Nobel Committee appears to be more correctly explained by these factors than by the negative impact of the local opposition.

  2. Clinical forms of Trypanosoma cruzi infected individuals in the chronic phase of Chagas disease in Puebla, Mexico.

    Science.gov (United States)

    Sánchez-Guillén, María Del Carmen; López-Colombo, Aurelio; Ordóñez-Toquero, Guillermo; Gomez-Albino, Isidoro; Ramos-Jimenez, Judith; Torres-Rasgado, Enrique; Salgado-Rosas, Hilda; Romero-Díaz, Mónica; Pulido-Pérez, Patricia; Pérez-Fuentes, Ricardo

    2006-11-01

    In Mexico, despite the relatively high seroprevalence of Trypanosoma cruzi infection in humans in some areas, reported morbidity of Chagas disease is not clear. We determined clinical stage in 71 individuals seropositive to T. cruzi in the state of Puebla, Mexico, an area endemic for Chagas disease with a reported seroprevalence of 7.7%. Diagnosis of Chagas disease was made by two standardized serological tests (ELISA, IHA). Individuals were stratified according to clinical studies. All patients were submitted to EKG, barium swallow, and barium enema. Groups were identified as indeterminate form (IF) asymptomatic individuals without evidence of abnormalities (n = 34 cases); those with gastrointestinal alterations (12 patients) including symptoms of abnormal relaxation of the lower esophageal sphincter and absent peristalsis in the esophageal body, grade I megaesophagus, and/or megacolon; patients with clinical manifestations and documented changes of chronic Chagas heart disease who were subdivided as follows: mild (8 patients)--mild electrocardiographic changes of ventricular repolarization, sinus bradychardia); moderate (6 patients)--left bundle branch block, right bundle branch block associated with left anterior fascicular block); severe (8 patients)--signs of cardiomegaly, dilated cardiomyopathy); and the associated form (3 cases) that included presence of both cardiomyopathy and megaesophagus. These data highlight the importance of accurate evaluation of the prevalence and clinical course of Chagas disease in endemic and non-endemic areas of Mexico.

  3. Pancreatite aguda em pediatria: revisão sistemática da literatura

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    Eduardo Mekitarian Filho

    2012-04-01

    Full Text Available OBJETIVO: Descrever os principais aspectos epidemiológicos, clínicos, diagnósticos e do tratamento de crianças com pancreatite aguda. FONTES DOS DADOS: Realizada revisão sistemática das bases de dados MEDLINE e SciELO nos últimos 5 anos sobre pancreatite aguda em crianças, bem como consultadas referências relevantes dos textos obtidos. SÍNTESE DOS DADOS: Os casos de pancreatite aguda em crianças recebem crescente atenção nos últimos anos, sendo verificado um aumento na incidência da doença em diversos estudos. As principais etiologias em crianças envolvem doença biliar, pancreatite secundária a medicamentos, pancreatite hereditária recorrente e trauma, sendo até 30% dos casos sem etiologia definida. O diagnóstico baseia-se na combinação de aspectos clínicos, laboratoriais com elevação das enzimas acinares e testes radiológicos. Tratamento de suporte inicial, com reposição volêmica adequada e correção dos distúrbios metabólicos, além de terapêutica nutricional específica, são os pontos fundamentais no manejo dos quadros agudos. Complicações a longo prazo são incomuns, e as taxas de mortalidade, inferiores às da população adulta. CONCLUSÃO: O diagnóstico precoce e o manejo apropriado podem contribuir para a melhor evolução da criança com pancreatite e prevenir as complicações imediatas e tardias relacionadas à doença. Mais estudos são necessários para melhor elucidar aspectos relacionados ao diagnóstico clínico e radiológico da pancreatite em crianças, bem como aspectos da terapêutica nutricional nessa faixa etária.

  4. Leucemia linfoblástica aguda em lactentes: 20 anos de experiência

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    Amanda Ibagy

    2013-02-01

    Full Text Available OBJETIVO: Analisar pacientes com menos de dois anos de idade com leucemia linfoblástica aguda atendidos no período de 1990 a 2010, em um centro de referência estadual. MÉTODOS: Estudo clínico, epidemiológico, transversal, descritivo e observacional. Pacientes incluídos tinham menos de dois anos de idade, com leucemia linfoblástica aguda, tratados no período de 1990 a 2010 na unidade de oncologia pediátrica de um centro de referência estadual, totalizando 41 casos. RESULTADOS: Todos os pacientes eram Caucasianos e 60,9% eram do sexo feminino. Com relação à idade, 24,38% tinham menos de seis meses, 17,07% tinham entre seis meses e um ano e 58,53% mais do que um ano de idade. A idade de seis meses foi estatisticamente significante para o desfecho de óbito. Os sinais e sintomas predominantes foram febre, hematomas e petéquias. Uma contagem de leucócitos superior a 100.000 foi observada em 34,14% dos casos; hemoglobina inferior a 11 em 95,13% e contagem de plaquetas inferior a 100.000, em 75,61% dos casos. Infiltração do sistema nervoso central estava presente em 12,91% dos pacientes. Em relação à linhagem, a linhagem B predominou (73%, mas a linhagem de células T foi estatisticamente significativa para o óbito. Trinta e nove por cento dos pacientes tiveram recorrência da doença. Em relação ao estado vital, 70,73% dos pacientes morreram, sendo choque séptico a principal causa. CONCLUSÕES: leucemia linfoblástica aguda em crianças tem uma alta taxa de mortalidade, principalmente em crianças menores de um ano e linhagem derivada de células T.

  5. Incidencia de Enfermedades Diarreicas Agudas, 2010 (Enero–Junio), del Centro de Salud Lacma.

    OpenAIRE

    Paola Danitza Luizaga Velasco; Luis Antonio Luizaga Velasco; Ruth Jarro

    2010-01-01

    El objetivo principal de este trabajo es conocer la edad y el sexo más afectado por enfermedades diarreicas agudas en niños de 0 a 9 años. Asimismo, es importante saber cuál es el mes más afectado entre enero y junio de 2010 en el Centro de Salud Lacma.La metodología del trabajo se basa en un tipo de estudio descriptivo-retrospectivo. El universo: niños de 0 a 9 años del centro de Salud Lacma. Las variables son: sexo (niños y niñas), edad (0 a 9 años), enfermedad (EDAs) y lugar (Centro de Sal...

  6. Crisis aguda de Asma Bronquial. Diagnóstico y tratamiento estandarizado

    OpenAIRE

    Anelia de la Caridad Rojas-Pérez; Andrés Andrés-atos; Dalila Chacón-Bonet; Mariela Parra-Cruz

    2013-01-01

    Se realizó un estudio prospectivo de intervención en 150 pacientes con diagnóstico de Asma Bronquial que acudieron con crisis aguda al Servicio de Urgencias del Hospital Pediátrico de Holguín, de Enero del 2009 hasta Diciembre del 2010; para evaluar la evolución de los mismos después de la aplicación de Guías de Buenas Prácticas. Se aplicó tratamiento a los pacientes según lo establecido, observando su respuesta. Predominó el grupo de 4 a 8 años del sexo masculino, el 52 % de los pacientes pr...

  7. Enfermedad diarreica aguda por Escherichia coli patógenas en Colombia

    OpenAIRE

    Gómez-Duarte, Oscar G.

    2014-01-01

    Las cepas de E. coli patógenas intestinales son causas importantes de la enfermedad diarreica aguda (EDA) en niños menores de 5 años en América Latina, África y Asia y están asociadas a alta mortalidad en niños en las comunidades más pobres de África y el Sudeste Asiático. Estudios sobre el papel de las E. coli patógenas intestinales en la EDA infantil en Colombia y otros países de América Latina son limitados debido a la carencia de ensayos para detección de estos patógenos en los laboratori...

  8. Glomerulonefrites Agudas Pós-Infecciosas. Casuística de 7 Anos (90-96)

    OpenAIRE

    Neves, Victor; Gonçalves, Elisabete; Nabais, Isabel; Neto, Arlete; Sousa, Ferra de

    2014-01-01

    Os autores apresentam uma revisão casuística de 48 casos de Glomerulonefrite Aguda Pós-Infecciosa (GNAPI) seguidos na Unidade de Nefrologia Pediátrica do Hospital de D. Estefânia (HDE) entre 1990 e 1996.Foram analisadas as seguintes características: idade, sexo, história pessoal de infecção, apresentação clínica, critérios diagnósticos, tratamento e evolução.A incidência de GNAPI tem vindo a diminuir nos últimos anos, afectando tipicamente crianças dos 2 aos 10 anos. Na observação inicial 85%...

  9. Manejo da asma aguda em adultos na sala de emergência: evidências atuais

    OpenAIRE

    Dalcin, Paulo de Tarso Roth; Perin,Christiano

    2009-01-01

    Asma é uma doença com uma alta prevalência em nosso meio e ao redor do mundo. Embora novas opções terapêuticas tenham sido recentemente desenvolvidas, parece haver um aumento mundial na sua morbidade e mortalidade. Em muitas instituições, as exacerbações asmáticas ainda se constituem em uma emergência médica muito comum. As evidências têm demonstrado que o manejo da asma aguda na sala de emergência concentra decisões cruciais que podem determinar o desfecho desta situação clínica. Nesta revis...

  10. Diagnósticos de enfermagem em adultos com leucemia mielóide aguda

    OpenAIRE

    Souza, Luccas Melo de; Gorini, Maria Isabel Pinto Coelho

    2006-01-01

    Trata-se de um estudo de casos, que objetivou identificar os Diagnósticos de Enfermagem (DE) de pacientes adultos com Leucemia Mielóide Aguda, a fim de fornecer subsídios à Sistematização da Assistência de Enfermagem. Utilizaram-se as técnicas de entrevista e observação, além da aplicação do Processo de Enfermagem. Durantes os três meses da coleta de dados, outros DEs foram encontrados através de novas buscas nos prontuários dos 6 pacientes. Os 32 DEs encontrados foram agrupados conforme a Te...

  11. Estudio preliminar de la toxicidad aguda del sulfato y del cloruro de berberina

    Directory of Open Access Journals (Sweden)

    Edward J. Acero M.

    2010-07-01

    Full Text Available Se realizaron ensayos para determinar la Toxicidad Aguda (LD50 del Sulfato de Berberina en Hámster dorado administrado tópicamente, y del Cloruro de Berberina administrado vía subcutánea. No se halló LD 50 para el Sulfato de Berberina, y la evaluación hemática de Colesterol, Urea y transaminasas ALAT y ASAT no presentó modificaciones. El Cloruro de Berberina manifestó una LD 50/24 horas de 640 mg/kg.; también acción hipoglicémica y a nivel de SNC hubo acción depresora. La evaluación histológica de hígado y piel para cada una de las presentaciones permitió establecer normalidad.

  12. Estudio preliminar de la toxicidad aguda del sulfato y del cloruro de berberina

    OpenAIRE

    Edward J Acero M; Amador Avila T.; Luis Granobles P.; Stella Torres de Young

    2010-01-01

    Se realizaron ensayos para determinar la Toxicidad Aguda (LD50) del Sulfato de Berberina en Hámster dorado administrado tópicamente, y del Cloruro de Berberina administrado vía subcutánea. No se halló LD 50 para el Sulfato de Berberina, y la evaluación hemática de Colesterol, Urea y transaminasas ALAT y ASAT no presentó modificaciones. El Cloruro de Berberina manifestó una LD 50/24 horas de 640 mg/kg.; también acción hipoglicémica y a nivel de SNC hubo acción depresora. La evaluación histo...

  13. Insuficiência renal aguda em paciente tratada com ATRA e anfotericina B: relato de caso

    OpenAIRE

    2011-01-01

    O presente relato apresenta o caso clínico de uma paciente com leucemia promie-locítica aguda tratada com ácido todo-transretinoico (ATRA), que apresentou suspeita de síndrome do ácido transreti-noico (síndrome de ATRA). Com a ocor-rência de leucopenia febril inespecífica, foram associados ao tratamento antimi-crobianos e antifúngicos. A diminuição da função renal, observada inicialmente, contribuiu para a suspeita de síndrome de ATRA, que foi agravada pelos antifúngi-cos. Assim, o uso de ATR...

  14. The improbable transmission of Trypanosoma cruzi to human: the missing link in the dynamics and control of Chagas disease.

    Directory of Open Access Journals (Sweden)

    Pierre Nouvellet

    2013-11-01

    Full Text Available Chagas disease has a major impact on human health in Latin America and is becoming of global concern due to international migrations. Trypanosoma cruzi, the etiological agent of the disease, is one of the rare human parasites transmitted by the feces of its vector, as it is unable to reach the salivary gland of the insect. This stercorarian transmission is notoriously poorly understood, despite its crucial role in the ecology and evolution of the pathogen and the disease. The objective of this study was to quantify the probability of T. cruzi vectorial transmission to humans, and to use such an estimate to predict human prevalence from entomological data. We developed several models of T. cruzi transmission to estimate the probability of transmission from vector to host. Using datasets from the literature, we estimated the probability of transmission per contact with an infected triatomine to be 5.8 × 10(-4 (95%CI: [2.6 ; 11.0] × 10(-4. This estimate was consistent across triatomine species, robust to variations in other parameters, and corresponded to 900-4,000 contacts per case. Our models subsequently allowed predicting human prevalence from vector abundance and infection rate in 7/10 independent datasets covering various triatomine species and epidemiological situations. This low probability of T. cruzi transmission reflected well the complex and unlikely mechanism of transmission via insect feces, and allowed predicting human prevalence from basic entomological data. Although a proof of principle study would now be valuable to validate our models' predictive ability in an even broader range of entomological and ecological settings, our quantitative estimate could allow switching the evaluation of disease risk and vector control program from purely entomological indexes to parasitological measures, as commonly done for other major vector borne diseases. This might lead to different quantitative perspectives as these indexes are well known

  15. Contributions of Toxicology to the Problem of Chagas' Disease (American Trypanosomiasis)——A Year 2000 Update

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Toxicology is a science that studies the deleterious interactions between chemicals and living organisms. This definition covers living organisms related to the problem to be analyzed: man, insects and trypanosomes. Chagas' disease, also known as American trypanosomiasis, is an endemic parasitic disease limited to the tropical and subtropical countries of Latin America (Pinto Díaz, 1984; WHO, 1981, 1985; Schirmer, Muller, and Krauthsiegel, 1995; Castro and Toranzo, 1988; Docampo and Moreno, 1985; Fairlamb, 1982). It is estimated that at least 20 million persons are infected with the etiologic agent of the disease, Trypanosoma cruzi (Pinto Díaz, 1984; WHO, 1981, 1985; Schirmer, Muller, and Krauthsiegel, 1995; Castro and Toranzo, 1988; Docampo and Moreno, 1985; Fairlamb, 1982). Further, more than 40 million are living under conditions where they may be bitten by the vector insect infected with the parasite (Pinto Díaz, 1984; WHO, 1981, 1985; Schirmer, Muller, and Krauthsiegel, 1995; Castro and Toranzo, 1988; Docampo and Moreno, 1985; Fairlamb, 1982). About 120 000 new cases per year were reported (Pinto Díaz, 1984; WHO, 1981, 1985; Schirmer, Muller, and Krauthsiegel, 1995; Castro and Toranzo, 1988; Docampo and Moreno, 1985; Fairlamb, 1982). The infection results because the vector insects (a Reduvii bug) have hematophagous habits, and because these blood sucking organisms, usually defecate immediately after having their meal. As a result, the infected feces find their way into the host bloodstream through a bite wound in the skin or via intact mucous membrane or the conjunctiva (Pinto Díaz, 1984; WHO, 1981, 1985; Schirmer, Muller, and Krauthsiegel, 1995; Castro and Toranzo, 1988; Docampo and Moreno, 1985; Fairlamb, 1982).

  16. Crisis aguda de Asma Bronquial. Diagnóstico y tratamiento estandarizado

    Directory of Open Access Journals (Sweden)

    Anelia de la Caridad Rojas-Pérez

    2013-01-01

    Full Text Available Se realizó un estudio prospectivo de intervención en 150 pacientes con diagnóstico de Asma Bronquial que acudieron con crisis aguda al Servicio de Urgencias del Hospital Pediátrico de Holguín, de Enero del 2009 hasta Diciembre del 2010; para evaluar la evolución de los mismos después de la aplicación de Guías de Buenas Prácticas. Se aplicó tratamiento a los pacientes según lo establecido, observando su respuesta. Predominó el grupo de 4 a 8 años del sexo masculino, el 52 % de los pacientes presentaron crisis ligeras, buena respuesta al uso de broncodilatadores en aerosol, se aplicó la Prednisona por vía oral en la mayoría de los casos que lo requirieron, el 68,7 % realizó tratamiento domiciliario con respuestas controladas y solo en el 31,3 % se decidió ingreso hospitalario lo que permitió arribar a la siguiente conclusión: Con la aplicación de Guías de Buenas Prácticas Clínicas par a el manejo de la exacerbación aguda del Asma Bronquial se logró una clasificación adecuada de la severidad de la misma, buena respuesta a los tratamientos utilizados y disminución de los ingresos hospitalarios.

  17. Mielitis aguda necrotizante en un paciente con Sida Acute necrotizing myelitis in an AIDS patient

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    M. Corti

    2003-04-01

    Full Text Available Como consecuencia de la infección por el virus de la inmunodeficiencia humana tipo-1 (HIV-1, otros patógenos como citomegalovirus (CMV y herpes simple tipo 1-2 (HSV 1-2 pueden comprometer tanto el sistema nervioso central como el periférico. Estos agentes pueden involucrar también a la médula espinal y causar una mielitis aguda necrotizante. Esta complicación ocurre por lo general en pacientes con enfermedad HIV/sida avanzada y marcada inmunodeficiencia, con recuentos de linfocitos T CD4+ de menos de 50 cél/µL. El cuadro clínico, los cambios en el LCR y las neuroimágenes generan una importante sospecha diagnóstica. Es fundamental el inicio precoz de la terapia antiviral específica. Se presenta un paciente con enfermedad avanzada debida al HIV-1 y mielitis aguda necrotizante por CMV y HSV bajo la forma clínica de síndrome de la cola de caballo.In the setting of HIV infection, cytomegalovirus (CMV and herpes simplex virus type 1-2 (HSV 1-2 can affect both the central and peripheral nervous systems. These agents can involve the spinal cord and produce a necrotizing transverse myelitis. This usually occurs in AIDS patients with severe immunodeficiency: CD4 + lymphocyte counts typically are less than 50 cell/µL. The clinical presentation, CSF and imaging studies can provide a high level of suspicion diagnosis. Prompt initiation of antiviral specific drugs is essential. We report a patient with an acute necrotizing myelitis (cauda equina syndrome secondary to CMV and HSV infections.

  18. Colecistite aguda não-complicada: colecistectomia laparoscópica precoce ou tardia?

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    Ajith Sankarankutty

    2012-10-01

    Full Text Available Metanálises recentes sugerem que a colecistectomia laparoscópica precoce (dentro de uma semana do início dos sintomas para a doença aguda, não complicada, da vesícula biliar é segura e viável. No entanto, enquetes sobre as práticas cirúrgicas indicam que a colecistectomia laparoscópica precoce é realizada por apenas uma minoria dos cirurgiões. Além disso, o melhor momento para realização deste procedimento, bem como sua relação custo-eficácia continuam sendo uma questão de debate. A reunião de revista TBE - CiTE realizou uma avaliação crítica dos artigos mais relevantes, publicados recentemente, sobre o momento da colecistectomia laparoscópica e sua relação custo-eficácia para o tratamento da colecistite aguda não complicada e fornece recomendações baseadas em evidências sobre o tema. A literatura engloba pequenos ensaios com alto risco para vieses. Ela sugere que colecistectomia laparoscópica precoce é segura e encurta o período de internação. Há uma escassez de estudos bem desenhados e de grandes séries analisando custo-utilidade. As seguintes recomendações foram geradas: (1 a colecistectomia laparoscópica precoce deve ser tentada como o tratamento de primeira linha dentro de uma semana do início dos sintomas, e (2 O custo-efetividade da colecistectomia laparoscópica precoce deve ser avaliada em cada local, levando-se em consideração os recursos, tais como a disponibilidade de pessoal treinado e de equipamentos laparoscópicos.

  19. Diagnóstico laboratorial das leucemias linfóides agudas

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    Farias Mariela Granero

    2004-01-01

    Full Text Available A leucemia linfóide aguda (LLA é a forma mais comum de câncer na infância, compreendendo 70% dos casos; em adultos a incidência é de apenas 20%. A abordagem inicial do diagnóstico consiste no exame citomorfológico do sangue periférico e da medula óssea. O estudo imunofenotípico eleva para 99% o percentual de casos corretamente classificados, permitindo identificar a linhagem celular (T ou B e os diferentes estágios de maturação da célula. Aproximadamente 20% dos casos são de origem de célula T; 75%, precursores de célula B; e 5%, de célula B madura. As técnicas citogenéticas têm contribuído de maneira fundamental para a compreensão da biologia molecular e do tratamento da LLA. As anormalidades cromossômicas, quando associadas ao painel de imunofenotipagem, constituem o parâmetro mais importante para a classificação das leucemias, e, juntamente com outros fatores clínicos e laboratoriais, possibilitam a estratificação dos pacientes em diferentes grupos de risco, tendo importância fundamental para determinar o prognóstico e estabelecer o tratamento adequado. O objetivo deste trabalho é fazer uma revisão bibliográfica dos métodos laboratoriais através dos critérios morfológicos, citoquímicos, imunológicos, citogenéticos e de genética molecular, que são úteis para a classificação e o diagnóstico das leucemias linfóides agudas.

  20. Nutritional support in patients with severe acute pancreatitis Soporte nutricional en pacientes con pancreatitis aguda grave

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    Mónica Marcela Peláez Hernández

    2007-04-01

    Full Text Available Severe acute pancreatitis is associated with a systemic inflammatory response leading to a hypermetabolic, hypercatabolic condition; for those reasons, patients suffering from this disease require an excellent artificial nutritional support in order to maintain the structural integrity and the function of vital organs with minimal pancreatic secretion. Total parenteral nutrition has been the standard practice in the treatment of patients with severe acute pancreatitis because of the favorable outcomes of early nutritional support while avoiding pancreatic stimulation; however, recent evidence suggests there are potentially greater benefits with enteral as compared with parenteral nutrition, including fewer septic and metabolic complications and lesser costs. That is why present guidelines for the management of acute pancreatitis recommend that enteral instead of parenteral nutrition be used in patients with severe acute pancreatitis. La pancreatitis aguda, especialmente en su forma grave, está asociada con una respuesta inflamatoria sistémica que lleva a un estado de hipermetabolismo e hipercatabolismo, en el que se requiere un excelente soporte nutricional que permita mantener la integridad estructural y la función de los órganos vitales con un estímulo mínimo de la secreción pancreática. La nutrición parenteral total era el soporte de elección, que permitía obtener todos los beneficios de la nutrición temprana sin estimular la secreción pancreática; pero la evidencia actual muestra mayores beneficios con la nutrición enteral, porque se asocia con menos complicaciones infecciosas y metabólicas y con disminución en los costos. Por ello las guías actuales de tratamiento de la pancreatitis aguda grave recomiendan como primera elección el soporte nutricional enteral.

  1. O mosaico patogênico da pancreatite aguda grave The pathogenic mosaic of severe acute pancreatitis

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    Márcio Cavalcante Carneiro

    2004-12-01

    Full Text Available A pancreatite aguda tem sido alvo de grandes discussões que vão desde o entendimento de sua fisiopatologia até a investigação de novas modalidades terapêuticas. Reconhece-se que a necrose pancreática e a falência orgânica múltipla - mormente associadas à infecção - representam os principais fatores determinantes da evolução para o óbito, mas, apesar dos grandes avanços em seu estudo, a doença permanece como um desafio para o clínico e o cirurgião. Deste modo, um melhor conhecimento dos mecanismos envolvidos em sua fisiopatologia pode ser a chave para um tratamento mais eficaz, principalmente em relação às formas graves, cuja letalidade ainda encontra-se substancialmente elevada. Baseado nestas considerações, o presente trabalho tem por objetivo a revisão bibliográfica da fisiopatologia, dos fatores patogênicos envolvidos na história natural da pancreatite aguda grave e dos eventos associados à síndrome da resposta inflamatória sistêmica e à sepse, esboçando-se assim o mosaico patogênico desta importante condição.Acute pancreatitis has been the objective of discussion, principally regarding its physiopathology and treatment. It is recognized that pancreatic necrosis, infections and multiple organ dysfunction are associated with high mortality. This disease remains a challenge for physicians and surgeons. However, a better understanding of evolved mechanisms may be the key for an appropriated treatment, principally for severe forms of disease in which mortality remains elevated. This study reviews the physiopathology and natural history of severe acute pancreatitis, and its association to SIRS and sepsis.

  2. Intoxicaciones agudas en pacientes mayores de 65 años

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    P. Miranda Arto

    2014-04-01

    Full Text Available Fundamento. Los estudios sobre la intoxicación aguda en sujetos de edad avanzada en nuestro país son escasos, a pesar de los riesgos asociados que presenta este grupo de pacientes. Material y métodos. Estudio descriptivo retrospectivo de las intoxicaciones agudas atendidas en el servicio de Urgencias del Hospital Clínico Universitario de Zaragoza entre 1995 y 2009, en pacientes con edad igual o mayor a 65 años. Resultados. Se registraron 762 casos, el 4,74% del total de intoxicados, con una edad media de 74,16 (SD ± 6 años. La vía oral fue la más frecuente (85% y por tipo de intoxicación, la sobredosis de alcohol (28,7%. Junto a éste, las benzodiacepinas (14,3% y los productos cáusticos (11% fueron los principales tóxicos involucrados. El 21% de los pacientes recibieron tratamiento específico antitóxico, no precisando ingreso el 82,4%. Se observó en la evolución temporal una tendencia que apuntaba a la disminución del tratamiento emético y del lavado gástrico y un aumento del carbón activado. La mortalidad de la serie fue del 1,04%. Conclusiones. Las intoxicaciones en pacientes mayores presentan una mayor morbimortalidad, precisando más ingresos y más tentativas autolíticas con resultado de muerte.

  3. Seroprevalence and sociocultural conditionants of Chagas disease in school aged children of marginal zones of Asunción

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    Vera Ninfa I.

    1998-01-01

    Full Text Available Chagas disease is becoming a public health problem in Latin America due to the wide distribution, the high prevalence, the magnitude of the damage caused and the difficulties to control it. In Paraguay, the disease is mainly distributed in the departments of Paraguari, Cordillera and Central. Prevalence in marginal zones, where migrations from rural populations and endemic areas make possible the urbanization of the disease, has no been studied yet. This is a descriptive study with a cross-sectional sampling and a probabilistic system recruitment carried out in school aged children from marginal zones of Asuncion to determine the prevalence of Chagas' disease. Serological methods, parasite isolation and questionnaires were used to achieve the goals. Nine hundred and fifty three children were studied to determine the prevalence of Chagas' disease in marginal zones which was 1.4%.

  4. Prioridades de intervención para la fase aguda de las emergencias complejas formuladas por nueve agencias de ayuda humanitaria

    OpenAIRE

    2004-01-01

    Las Emergencias Complejas son un problema de Salud Pública internacional de frecuencia y magnitud crecientes que producen una importante mortalidad y morbilidad especialmente durante su fase aguda. El objetivo de este estudio es identificar y analizar las áreas prioritarias de intervención en la fase aguda de una emergencia compleja formuladas en los manuales operativos de las principales agencias de ayuda, así como el nivel de desarrollo y estructuración de las actividad...

  5. Participación de las moléculas de superficie de Trypanosoma cruzi en la enfermedad de Chagas por vía oral

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    Liliana Andrea Morales Laverde

    2016-06-01

    localizaron 101 estudios experimentales, epidemiológicos y/o revisiones sistemáticas, que describían los mecanismos de invasión y las moléculas  involucradas  de forma específica como Gp82 y Gp90. Se compararon los análisis de la expresión de dichas moléculas en  diferentes  cepas y DTUs del parásito. 81 de estos artículos fueron relevantes en la discusión y elaboración del trabajo. Conclusiones: La enfermedad de Chagas aguda con transmisión oral pone en evidencia la capacidad invasiva de las formas infectantes de T. cruzi a través de la mucosa gástrica. Glicoproteínas como Gp82 y Gp90 están involucradas en el establecimiento de la infección y se expresan diferencialmente en tripomastigotes. Estas diferencias de expresión también se observan entre cepas, por lo tanto este hecho plantea diferencias en la capacidad infectiva por vía oral de las distintas cepas de T. cruzi.

  6. Evaluation of the Chagas Disease Control Program in Açucena Municipality, Rio Doce Valley, State of Minas Gerais, Brazil

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    Adriana dos Santos

    2014-04-01

    Full Text Available Introduction Açucena Municipality, Rio Doce Valley, State of Minas Gerais, Brazil temporarily (2001-2005 interrupted epidemiological surveillance for Chagas disease. The objective of this work was to evaluate the Chagas Disease Control Program (CDCP in Açucena and to offer suggestions for improving local epidemiological surveillance. Methods This study was conducted in three phases: I a serological investigation of schoolchildren aged 5 to 15 years using an enzyme-linked immunosorbent assay (ELISA test performed on blood collected on filter paper followed by ELISA, indirect immunofluorescence (IIF and indirect hemaglutination (IHA on venous blood for borderline cases and those in the gray zone of reactivity; II vector evaluation using the data obtained by local health agents during 2006-2010; and III examination by ELISA, IIF and IHA of serum samples from the inhabitants of houses where infected Triatoma vitticeps was found and evaluation of their knowledge about Chagas disease. Results Five individuals had inconclusive results in the ELISA screening but were seronegative for Chagas disease. The triatomine evaluation revealed the presence of three species: Triatoma vitticeps, Panstrongylus megistus and Panstrongylus diasi. Triatoma vitticeps was the most prevalent and widespread, with a higher (67% index of Trypanosoma cruzi flagellates and evidence of colonization. Most of the inhabitants of the infested houses recognized triatomines and had basic knowledge about Chagas disease. Conclusions Although T. vitticeps is not clearly associated with Chagas disease transmission, these results highlight the importance of maintaining CDCP in endemic areas and the need for greater emphasis on epidemiological surveillance, especially in areas with important vectorial changes or that have been modified by human intervention.

  7. Impact of Helminth Infection on the Clinical and Microbiological Presentation of Chagas Diseases in Chronically Infected Patients.

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    Fernando Salvador

    2016-04-01

    Full Text Available Helminth infections are highly prevalent in tropical and subtropical countries, coexisting in Chagas disease endemic areas. Helminth infections in humans may modulate the host immune system, changing the Th1/Th2 polarization. This immunological disturbance could modify the immune response to other infections. The aim of this study is to evaluate the relationship between clinical, microbiological and epidemiological characteristics of Chagas disease patients, with the presence of helminth infection.A prospective observational study was conducted at Vall d'Hebron University Hospital (Barcelona, Spain. Inclusion criteria were: age over 18 years, diagnosis of Chagas disease, and not having received specific treatment for Chagas disease previously to the inclusion. The study protocol included Chagas disease assessment (cardiac and digestive evaluation, detection of T. cruzi DNA measured by PCR in peripheral blood, and helminth infection diagnosis (detection of IgG anti-Strongyloides stercoralis by ELISA, microscopic examination of stool samples from three different days, and specific faecal culture for S. stercoralis larvae.Overall, 65 patients were included, median age was 38 years, 75.4% were women and most of them came from Bolivia. Cardiac and digestive involvement was present in 18.5% and 27.7% of patients respectively. T. cruzi PCR was positive in 28 (43.1% patients. Helminth infection was diagnosed in 12 (18.5% patients. No differences were observed in clinical and epidemiological characteristics between patients with and without helminth infection. Nevertheless, the proportion of patients with positive T. cruzi PCR was higher among patients with helminth infection compared with patients without helminth infection (75% vs 35.8%, p = 0.021.We observed a high prevalence of S. stercoralis infection among chronic Chagas disease patients attended in our tropical medicine unit. Strongyloidiasis was associated with significantly higher proportion of

  8. Protective human leucocyte antigen haplotype, HLA-DRB1*01-B*14, against chronic Chagas disease in Bolivia.

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    Florencia del Puerto

    Full Text Available BACKGROUND: Chagas disease, caused by the flagellate parasite Trypanosoma cruzi affects 8-10 million people in Latin America. The mechanisms that underlie the development of complications of chronic Chagas disease, characterized primarily by pathology of the heart and digestive system, are not currently understood. To identify possible host genetic factors that may influence the clinical course of Chagas disease, Human Leucocyte Antigen (HLA regional gene polymorphism was analyzed in patients presenting with differing clinical symptoms. METHODOLOGY: Two hundred and twenty nine chronic Chagas disease patients in Santa Cruz, Bolivia, were examined by serological tests, electrocardiogram (ECG, and Barium enema colon X-ray. 31.4% of the examinees showed ECG alterations, 15.7% megacolon and 58.1% showed neither of them. A further 62 seropositive megacolon patients who had undergone colonectomy due to acute abdomen were recruited. We analyzed their HLA genetic polymorphisms (HLA-A, HLA-B, MICA, MICB, DRB1 and TNF-alpha promoter region mainly through Sequence based and LABType SSO typing test using LUMINEX Technology. PRINCIPAL FINDINGS: The frequencies of HLA-DRB1*01 and HLA-B*14:02 were significantly lower in patients suffering from megacolon as well as in those with ECG alteration and/or megacolon compared with a group of patients with indeterminate symptoms. The DRB1*0102, B*1402 and MICA*011 alleles were in strong Linkage Disequilibrium (LD, and the HLA-DRB1*01-B*14-MICA*011 haplotype was associated with resistance against chronic Chagas disease. CONCLUSIONS: This is the first report of HLA haplotype association with resistance to chronic Chagas disease.

  9. Edema pulmonar assimétrico por pressão negativa pós-obstrução de via aérea superior: relato de caso Edema pulmonar asimétrico por presión negativa pós-obstrucción aguda de vía aérea superior: relato de caso Asymmetric negative pressure pulmonary edema after acute upper airway obstruction: case report

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    Aldo José Peixoto

    2002-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Edema pulmonar por pressão negativa pós-obstrução de via aérea é atualmente uma entidade bem descrita, porém, provavelmente pouco diagnosticada e os casos pouco publicados. O objetivo deste relato é apresentar um caso de edema pulmonar por pressão negativa pós-obstrução de via aérea superior, cuja principal característica foi a assimetria do edema pulmonar, sendo muito mais acentuado no pulmão direito. RELATO DO CASO: Menino de 4 anos, 17 kg, estado físico ASA I, foi submetido a adenoamigdalectomia e cauterização de cornetos, sob anestesia geral com sevoflurano/óxido nitroso/O2. A cirurgia durou 1 hora e 30 minutos sem qualquer intercorrência. Com a superficialização da anestesia o paciente, ventilando espontaneamente, reagiu ao tubo traqueal, que foi retirado. Após isto, os esforços ventilatórios resultaram em retração da parede torácica, sem aparente movimento de ar, sendo impossível ventilá-lo com máscara facial, ocorrendo hipoxemia grave (SpO2 de 50%, necessitando ser reintubado. Neste momento foi verificado que o pulmão se encontrava mais duro e havia estertores bilateralmente, caracterizando edema pulmonar. Uma radiografia de tórax mostrou infiltrado pulmonar difuso bilateralmente, porém, com atelectasia do lobo superior direito, mostrando acentuada assimetria do edema pulmonar. O paciente teve que ser ventilado mecanicamente com PEEP durante 20 horas, quando foi extubado. Houve melhora progressiva do edema pulmonar, recebendo alta em 48 horas. CONCLUSÕES: O edema pulmonar por pressão negativa é uma entidade rara com alto grau de morbidade, pouco diagnosticada e exige do anestesiologista conhecimento atualizado e tratamento adequado. Costuma ser bilateral, raramente unilateral e excepcionalmente com expressiva assimetria como no nosso relato. A maioria dos casos é tratada com suporte ventilatório com PEEP ou CPAP, não necessitando de qualquer outra terapia. O prognóstico

  10. Serological survey for Chagas' disease in school children in the Rio de Janeiro State, Brazil

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    Walter B. Petana

    1976-04-01

    Full Text Available A serological survey for Chagas' disease was carried out in school children in the Rio de Janeiro State, a zone considered as non-endemic for the infection. A total of 168 schools in 20 municipalities have been visited and 13,254 blood samples were obtained. The blood eluates were screened by the indirect fluorescence test (IFT, and all positive samples were checked and confirmed in sera by the complement fixation test (CFT. AH serologically positive children were subject to a clinical scrutiny, and the houses where the children lived have been searched for triatomine bugs. Only in two municipalities, Magé and Araruama, there was a significant number of children found positive. The total number of reactive samples by IFT and CFT from 13,004 blood samples screened was 143 (1.00 per cent. No serious clinicai symptoms suggestive of Chagas' disease have been found in any of the positive children, and no triatomine bugs were discovered in the dwellings where the children lived. The overall small percentage of children with positive serology postulates that the infection is not a serious health problem in the area investigated. It is recommended, however, to carry out a more detailed study in Magé and Araruama to find the reason for the relatively high percentage of serologically positive children encountered in these two municipalities.Um inquérito sorológico pela reação de imunofluorescência indireta para doença de Chagas, foi realizado, incluindo 13.254 crianças de 168 escolas primárias sorteadas em 20 municípios do Estado do Rio de Janeiro. Os casos positivos pela imunofluorescência eram confirmados pela reação de fixação do complemento e submetidos a exame clínico, investigando-se em seguida suas residências quanto à existência ou não de triatomíneos. Somente nos municípios de Magé e Araruama houve um número significativo de crianças com sorologia positiva. Do total de amostras estudadas somente 143 (1% foram positivas

  11. When a Diplomat goes into politics because of war. The case of João Chagas (1910-1914

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    Luís Alves de Fraga

    2012-01-01

    Full Text Available Analysis of the case of a Portuguese diplomat, João Chagas, who, during the First Republic, and by resorting to the conditions available to him as representative of his country, surpassed the mere negotiating role attributed to diplomacy to conduct national politics, succeeding in changing the international statute of Portugal in the Great War. The article describes the internal and external situation of Portugal in political, geopolitical and geostrategic terms, the conflict between Portuguese and British interests, the activity of Portuguese diplomats in London, Berlin and Paris, and, finally, the work of João Chagas.

  12. Estudo radiológico do megacólon em área endêmica de doença de Chagas Radiological study on megacolon cases in an endemic area for Chagas disease

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    Cleudson Castro

    2010-10-01

    Full Text Available INTRODUÇÃO: Foi realizado estudo radiológico do cólon em pacientes de zona endêmica da doença de Chagas usando-se a técnica do enema opaco simplificado de Ximenes e cols. MÉTODOS: Participaram 291 pacientes, com idade media de 48,8 (±12,5 anos, sendo 222 soropositivos para doença de Chagas. Fizeram radiografias na posição ântero-posterior, póstero-anterior e perfil lateral esquerdo, que foram analisadas por inspeção visual e medida do maior diâmetro em centímetros do reto e sigmoide. RESULTADOS: À inspeção visual, foi possível diagnosticar megacólon em 14 (6,3% pacientes chagásicos. A média do diâmetro da ampola retal dos chagásicos 6,3 (±1,0cm foi semelhante a dos não-chagásicos 6,2 (±1,0cm (p=0,391 e o diâmetro médio da alça sigmoide dos chagásicos 5 (±1,6cm foi maior que o dos não chagásicos 4,4 (±0,8 cm, (p=0,001. CONCLUSÕES: Excluindo-se os casos de megacólon evidente e de provável megacólon, a população chagásica continuou com o diâmetro médio do sigmoide significantemente maior (p=0,003 que a não chagásica.INTRODUCTION: A radiological study on the colon of patients from an endemic Chagas disease zone was conducted using the simplified opaque enema technique of Ximenes et al. METHODS: The study involved 291 individuals with a mean age of 48.8(±12.5 years-old, of whom 222 were seropositive for Chagas disease. Anteroposterior, posteroanterior and left lateral view radiographs were analyzed by visual inspection and measurement of the largest rectal and sigmoid diameters. RESULTS: From the visual inspection, megacolon was diagnosed in 14 (6.3% Chagas disease patients. The mean diameter of the rectal ampulla among the Chagas patients was 6.3 (±1.0cm, similar to the measurement in non-Chagas individuals: 6.2 (±1.0 cm (p= 0.391. The mean sigmoid loop diameter in the Chagas patients was 5 (±1.6cm, which was larger than among the non-Chagas individuals: 4.4 (±0.8cm (p= 0.001. CONCLUSIONS

  13. Cultivation-Independent Methods Reveal Differences among Bacterial Gut Microbiota in Triatomine Vectors of Chagas Disease

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    da Mota, Fabio Faria; Marinho, Lourena Pinheiro; Moreira, Carlos José de Carvalho; Lima, Marli Maria; Mello, Cícero Brasileiro; Garcia, Eloi Souza; Carels, Nicolas; Azambuja, Patricia

    2012-01-01

    Background Chagas disease is a trypanosomiasis whose agent is the protozoan parasite Trypanosoma cruzi, which is transmitted to humans by hematophagous bugs known as triatomines. Even though insecticide treatments allow effective control of these bugs in most Latin American countries where Chagas disease is endemic, the disease still affects a large proportion of the population of South America. The features of the disease in humans have been extensively studied, and the genome of the parasite has been sequenced, but no effective drug is yet available to treat Chagas disease. The digestive tract of the insect vectors in which T. cruzi develops has been much less well investigated than blood from its human hosts and constitutes a dynamic environment with very different conditions. Thus, we investigated the composition of the predominant bacterial species of the microbiota in insect vectors from Rhodnius, Triatoma, Panstrongylus and Dipetalogaster genera. Methodology/Principal Findings Microbiota of triatomine guts were investigated using cultivation-independent methods, i.e., phylogenetic analysis of 16s rDNA using denaturing gradient gel electrophoresis (DGGE) and cloned-based sequencing. The Chao index showed that the diversity of bacterial species in triatomine guts is low, comprising fewer than 20 predominant species, and that these species vary between insect species. The analyses showed that Serratia predominates in Rhodnius, Arsenophonus predominates in Triatoma and Panstrongylus, while Candidatus Rohrkolberia predominates in Dipetalogaster. Conclusions/Significance The microbiota of triatomine guts represents one of the factors that may interfere with T. cruzi transmission and virulence in humans. The knowledge of its composition according to insect species is important for designing measures of biological control for T. cruzi. We found that the predominant species of the bacterial microbiota in triatomines form a group of low complexity whose structure

  14. Relationship between Fibrosis and Ventricular Arrhythmias in Chagas Heart Disease Without Ventricular Dysfunction

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    Tassi, Eduardo Marinho, E-mail: etassi@ibest.com.br [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Continentino, Marcelo Abramoff [Hospital Frei Galvão, Guaratinguetá, SP (Brazil); Nascimento, Emília Matos do; Pereira, Basílio de Bragança [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Coppe - Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia - UFRJ, Rio de Janeiro, RJ (Brazil); Pedrosa, Roberto Coury [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

    2014-05-15

    Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. To quantify fibrosis by using late gadolinium enhancement CMR in patients with Chagas disease and preserved or minimally impaired ventricular function (> 45%), and to detect patterns of dependence between fibrosis, SWMA and LVEF in the presence of ventricular arrhythmia. Electrocardiogram, treadmill exercise test, Holter and CMR were carried out in 61 patients, who were divided into three groups as follows: (1) normal electrocardiogram and CMR without SWMA; (2) abnormal electrocardiogram and CMR without SWMA; (3) CMR with SWMA independently of electrocardiogram. The number of patients with ventricular arrhythmia in relation to the total of patients, the percentage of fibrosis, and the LVEF were, respectively: Group 1, 4/26, 0.74% and 74.34%; Group 2, 4/16, 3.96% and 68.5%; and Group 3, 11/19, 14.07% and 55.59%. Ventricular arrhythmia was found in 31.1% of the patients. Those with and without ventricular arrhythmia had mean LVEF of 59.87% and 70.18%, respectively, and fibrosis percentage of 11.03% and 3.01%, respectively. Of the variables SWMA, groups, age, LVEF and fibrosis, only the latter was significant for the presence of ventricular arrhythmia, with a cutoff point of 11.78% for fibrosis mass (p < 0.001). Even in patients with Chagas disease and preserved or minimally impaired ventricular function, electrical instability can be present. Regarding the presence of ventricular arrhythmia, fibrosis is the most important variable, its amount being proportional to the complexity of the groups.

  15. Design or screening of drugs for the treatment of Chagas disease: what shows the most promise?

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    Lepesheva, Galina I.

    2013-01-01

    Introduction Endemic in Latin America, Chagas disease is now becoming a serious global health problem, and yet has no financial viability for the pharmaceutical industry and remains incurable. In 2012, two antimycotic drugs inhibitors of fungal sterol 14α-demethylase (CYP51) – posaconazole and ravuconazole – entered clinical trials. Availability of the X-ray structure of the orthologous enzyme from the causative agent of the disease, protozoan parasite Trypanosoma cruzi, determined in complexes with posaconazole as well as with several experimental protozoa-specific CYP51 inhibitors opens an excellent opportunity to improve the situation. Areas covered This article summarizes the information available in PubMed and Google on the outcomes of treatment of the chronic Chagas disease. It also outlines the major features of the T. cruzi CYP51 structure and the possible structure-based strategies for rational design of novel T. cruzi specific drugs. Expert opinion There is no doubt that screenings for alternative drug-like molecules as well as mining the T. cruzi genome for novel drug targets are of great value and might eventually lead to groundbreaking discoveries. However, all newly identified molecules must proceed through the long, expensive and low-yielding drug optimization process, and all novel potential drug targets must be validated in terms of their essentiality and druggability. CYP51 is already a well-validated and highly successful target for clinical and agricultural antifungals. With minimal investments into the final stages of their development/trials, T. cruzi-specific CYP51 inhibitors can provide an immediate treatment for Chagas disease, either on their own or in combination with the currently available drugs. PMID:24079515

  16. Amazonian Triatomine Biodiversity and the Transmission of Chagas Disease in French Guiana: In Medio Stat Sanitas.

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    Péneau, Julie; Nguyen, Anne; Flores-Ferrer, Alheli; Blanchet, Denis; Gourbière, Sébastien

    2016-02-01

    The effects of biodiversity on the transmission of infectious diseases now stand as a cornerstone of many public health policies. The upper Amazonia and Guyana shield are hot-spots of biodiversity that offer genuine opportunities to explore the relationship between the risk of transmission of Chagas disease and the diversity of its triatomine vectors. Over 730 triatomines were light-trapped in four geomorphological landscapes shaping French-Guiana, and we determined their taxonomic status and infection by Trypanosoma cruzi. We used a model selection approach to unravel the spatial and temporal variations in species abundance, diversity and infection. The vector community in French-Guiana is typically made of one key species (Panstrongylus geniculatus) that is more abundant than three secondary species combined (Rhodnius pictipes, Panstrongylus lignarius and Eratyrus mucronatus), and four other species that complete the assemblage. Although the overall abundance of adult triatomines does not vary across French-Guiana, their diversity increases along a coastal-inland gradient. These variations unravelled a non-monotonic relationship between vector biodiversity and the risk of transmission of Chagas disease, so that intermediate biodiversity levels are associated with the lowest risks. We also observed biannual variations in triatomine abundance, representing the first report of a biannual pattern in the risk of Chagas disease transmission. Those variations were highly and negatively correlated with the average monthly rainfall. We discuss the implications of these patterns for the transmission of T. cruzi by assemblages of triatomine species, and for the dual challenge of controlling Amazonian vector communities that are made of both highly diverse and mostly intrusive species.

  17. Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease

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    Patrícia M. Guimarães

    2014-05-01

    Full Text Available Objective: To evaluate psychiatric comorbidities in outpatients receiving care for HIV and Chagas disease at Instituto de Pesquisa Clínica Evandro Chagas (IPEC, Fundação Oswaldo Cruz (Fiocruz, Rio de Janeiro, Brazil. Methods: Cross-sectional study with a consecutive sample of 125 patients referred to an outpatient psychiatric clinic from February to December 2010. The Mini International Neuropsychiatric Interview (MINI was used. Factors associated with more frequent mental disorders were estimated by odds ratios (OR with 95% confidence intervals (95%CI by multiple logistic regression. Results: Seventy-six (60.8% patients with HIV, 40 (32% patients with Chagas disease, and nine (7.2% patients with human T-lymphotropic virus were interviewed. The majority were women (64%, with up to 8 years of formal education (56%, and unemployed (81.6%. The median age was 49 years. Suicide risk (n=71 (56%, agoraphobia (n=65 (52%, major depressive episode (n=56 (44.8%, and alcohol/drug abuse (n=43 (34.4% predominated, the latter being directly associated with lower family income (OR = 2.64; 95%CI 1.03-6.75 and HIV infection (OR = 5.24; 95%CI 1.56-17.61. Suicide risk was associated with non-white skin color (OR = 2.21; 95%CI 1.03-4.75, unemployment (OR = 2.72; 95%CI 1.01-7.34, and diagnosis of major depression (OR = 3.34; 95%CI 1.54-7.44. Conclusion: Measures targeting adverse socioeconomic conditions and psychiatric and psychological monitoring and care should be encouraged in this population, considering the association with abuse of alcohol/other psychoactive drugs and suicide risk.

  18. Pharmacophore modeling for anti-Chagas drug design using the fragment molecular orbital method.

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    Ryunosuke Yoshino

    Full Text Available Chagas disease, caused by the parasite Trypanosoma cruzi, is a neglected tropical disease that causes severe human health problems. To develop a new chemotherapeutic agent for the treatment of Chagas disease, we predicted a pharmacophore model for T. cruzi dihydroorotate dehydrogenase (TcDHODH by fragment molecular orbital (FMO calculation for orotate, oxonate, and 43 orotate derivatives.Intermolecular interactions in the complexes of TcDHODH with orotate, oxonate, and 43 orotate derivatives were analyzed by FMO calculation at the MP2/6-31G level. The results indicated that the orotate moiety, which is the base fragment of these compounds, interacts with the Lys43, Asn67, and Asn194 residues of TcDHODH and the cofactor flavin mononucleotide (FMN, whereas functional groups introduced at the orotate 5-position strongly interact with the Lys214 residue.FMO-based interaction energy analyses revealed a pharmacophore model for TcDHODH inhibitor. Hydrogen bond acceptor pharmacophores correspond to Lys43 and Lys214, hydrogen bond donor and acceptor pharmacophores correspond to Asn67 and Asn194, and the aromatic ring pharmacophore corresponds to FMN, which shows important characteristics of compounds that inhibit TcDHODH. In addition, the Lys214 residue is not conserved between TcDHODH and human DHODH. Our analysis suggests that these orotate derivatives should preferentially bind to TcDHODH, increasing their selectivity. Our results obtained by pharmacophore modeling provides insight into the structural requirements for the design of TcDHODH inhibitors and their development as new anti-Chagas drugs.

  19. Stairway to Heaven or Hell? Perspectives and Limitations of Chagas Disease Chemotherapy.

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    Salomao, Kelly; Menna-Barreto, Rubem Figueiredo Sadok; de Castro, Solange Lisboa

    2016-01-01

    In this review, we intend to provide a general view of the evolution of experimental studies in the area of chemotherapy for Chagas disease. We can follow the process of drug development through three phases. The first phase began almost at the same time as the discovery made by Carlos Chagas and proceeds to 1970, during which time an extensive list of compounds was subjected to preclinical and clinical trials. The second phase began with the introduction of nifurtimox and benznidazole into the clinical setting, followed with the search for alternative drugs. In this phase, a dichotomy existed between rational and empirical approaches in preclinical studies. The third phase began with the unravelling of the T. cruzi genome. The development of transgenic parasites has allowed the development of solid HTS protocols, and the establishment of bioluminescent T. cruzi has allowed in vivo drug evaluations using a reduced number of animals. Among the wide variety of compounds subjected to preclinical studies, we have discovered azolic and non-azolic inhibitors of sterol C14α-demethylase (CYP51) and nitro compounds. Two compounds evaluated during the second phase, namely, MK-436 and allopurinol, could be revisited. Clinical studies of posaconazole and E1224 yielded disappointing results, and it is critical to understand the reason for their failure as a monotherapy. Currently, the combination and repositioning of drugs with different mechanisms of action are complementary approaches. The use of drug combinations, particularly those of nitro compounds with CYP51 inhibitors, is considered a real alternative for the treatment of Chagas disease.

  20. Cultivation-independent methods reveal differences among bacterial gut microbiota in triatomine vectors of Chagas disease.

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    Fabio Faria da Mota

    Full Text Available BACKGROUND: Chagas disease is a trypanosomiasis whose agent is the protozoan parasite Trypanosoma cruzi, which is transmitted to humans by hematophagous bugs known as triatomines. Even though insecticide treatments allow effective control of these bugs in most Latin American countries where Chagas disease is endemic, the disease still affects a large proportion of the population of South America. The features of the disease in humans have been extensively studied, and the genome of the parasite has been sequenced, but no effective drug is yet available to treat Chagas disease. The digestive tract of the insect vectors in which T. cruzi develops has been much less well investigated than blood from its human hosts and constitutes a dynamic environment with very different conditions. Thus, we investigated the composition of the predominant bacterial species of the microbiota in insect vectors from Rhodnius, Triatoma, Panstrongylus and Dipetalogaster genera. METHODOLOGY/PRINCIPAL FINDINGS: Microbiota of triatomine guts were investigated using cultivation-independent methods, i.e., phylogenetic analysis of 16s rDNA using denaturing gradient gel electrophoresis (DGGE and cloned-based sequencing. The Chao index showed that the diversity of bacterial species in triatomine guts is low, comprising fewer than 20 predominant species, and that these species vary between insect species. The analyses showed that Serratia predominates in Rhodnius, Arsenophonus predominates in Triatoma and Panstrongylus, while Candidatus Rohrkolberia predominates in Dipetalogaster. CONCLUSIONS/SIGNIFICANCE: The microbiota of triatomine guts represents one of the factors that may interfere with T. cruzi transmission and virulence in humans. The knowledge of its composition according to insect species is important for designing measures of biological control for T. cruzi. We found that the predominant species of the bacterial microbiota in triatomines form a group of low

  1. Chagas disease: morbidity profile in an endemic area of Northeastern Brazil

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    Cléber de Mesquita Andrade

    2015-12-01

    Full Text Available Abstract: INTRODUCTION : This study evaluated the clinical forms and manifestation severities of Chagas disease among serologically reactive individuals from Western Rio Grande do Norte (Northeastern Brazil. METHODS : This cross-sectional study included 186 adults who were evaluated using electrocardiography, echocardiography, chest radiography, and contrast radiography of the esophagus and colon. A clinical-epidemiological questionnaire was also used. RESULTS : The indeterminate, cardiac, digestive, and cardiodigestive clinical forms of Chagas disease were diagnosed in 51.6% (96/186, 32.2% (60/186, 8.1% (15/186 and 8.1% (15/186 of the participants, respectively. Heart failure (functional classes I-IV was detected in 7.5% (14/186 of the participants, and 36.4% (24/66, 30.3% (20/66, 15.2% (10/66, 13.6% (9/66, and 4.5% (3/66 of the patients were at stage A, B1, B2, C, and D, respectively. Dilated cardiomyopathy and electrocardiographic changes were detected in 10.2% (19/186 and 48.1% (91/186 of the participants, respectively. Apical aneurysm was diagnosed in 10.8% (20/186 of the participants, and other changes in the segmental myocardial contractility of the left ventricle were diagnosed in 33.9% (63/186 of the participants. Megaesophagus (groups I-IV was observed in 7% (13/186 of the participants, megacolon (grades 1-3 was detected in12.9% (24/186 of the participants, and both organs were affected in 29.2% (7/24 of the megacolon cases. CONCLUSIONS : We detected various clinical forms of Chagas disease (including the digestive form. Our findings indicate that clinical symptoms alone may not be sufficient to exclude or confirm cardiac and/or digestive damage, and the number of patients with symptomatic clinical forms may be underestimated.

  2. Antitrypanosomal Treatment with Benznidazole Is Superior to Posaconazole Regimens in Mouse Models of Chagas Disease.

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    Khare, Shilpi; Liu, Xianzhong; Stinson, Monique; Rivera, Ianne; Groessl, Todd; Tuntland, Tove; Yeh, Vince; Wen, Ben; Molteni, Valentina; Glynne, Richard; Supek, Frantisek

    2015-10-01

    Two CYP51 inhibitors, posaconazole and the ravuconazole prodrug E1224, were recently tested in clinical trials for efficacy in indeterminate Chagas disease. The results from these studies show that both drugs cleared parasites from the blood of infected patients at the end of the treatment but that parasitemia rebounded over the following months. In the current study, we sought to identify a dosing regimen of posaconazole that could permanently clear Trypanosoma cruzi from mice with experimental Chagas disease. Infected mice were treated with posaconazole or benznidazole, an established Chagas disease drug, and parasitological cure was defined as an absence of parasitemia recrudescence after immunosuppression. Twenty-day therapy with benznidazole (10 to 100 mg/kg of body weight/day) resulted in a dose-dependent increase in antiparasitic activity, and the 100-mg/kg regimen effected parasitological cure in all treated mice. In contrast, all mice remained infected after a 25-day treatment with posaconazole at all tested doses (10 to 100 mg/kg/day). Further extension of posaconazole therapy to 40 days resulted in only a marginal improvement of treatment outcome. We also observed similar differences in antiparasitic activity between benznidazole and posaconazole in acute T. cruzi heart infections. While benznidazole induced rapid, dose-dependent reductions in heart parasite burdens, the antiparasitic activity of posaconazole plateaued at low doses (3 to 10 mg/kg/day) despite increasing drug exposure in plasma. These observations are in good agreement with the outcomes of recent phase 2 trials with posaconazole and suggest that the efficacy models combined with the pharmacokinetic analysis employed here will be useful in predicting clinical outcomes of new drug candidates.

  3. Utilizing Chemical Genomics to Identify Cytochrome b as a Novel Drug Target for Chagas Disease.

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    Shilpi Khare

    2015-07-01

    Full Text Available Unbiased phenotypic screens enable identification of small molecules that inhibit pathogen growth by unanticipated mechanisms. These small molecules can be used as starting points for drug discovery programs that target such mechanisms. A major challenge of the approach is the identification of the cellular targets. Here we report GNF7686, a small molecule inhibitor of Trypanosoma cruzi, the causative agent of Chagas disease, and identification of cytochrome b as its target. Following discovery of GNF7686 in a parasite growth inhibition high throughput screen, we were able to evolve a GNF7686-resistant culture of T. cruzi epimastigotes. Clones from this culture bore a mutation coding for a substitution of leucine by phenylalanine at amino acid position 197 in cytochrome b. Cytochrome b is a component of complex III (cytochrome bc1 in the mitochondrial electron transport chain and catalyzes the transfer of electrons from ubiquinol to cytochrome c by a mechanism that utilizes two distinct catalytic sites, QN and QP. The L197F mutation is located in the QN site and confers resistance to GNF7686 in both parasite cell growth and biochemical cytochrome b assays. Additionally, the mutant cytochrome b confers resistance to antimycin A, another QN site inhibitor, but not to strobilurin or myxothiazol, which target the QP site. GNF7686 represents a promising starting point for Chagas disease drug discovery as it potently inhibits growth of intracellular T. cruzi amastigotes with a half maximal effective concentration (EC50 of 0.15 µM, and is highly specific for T. cruzi cytochrome b. No effect on the mammalian respiratory chain or mammalian cell proliferation was observed with up to 25 µM of GNF7686. Our approach, which combines T. cruzi chemical genetics with biochemical target validation, can be broadly applied to the discovery of additional novel drug targets and drug leads for Chagas disease.

  4. Epidemiología de la enfermedad de Chagas en el estado de Veracruz

    OpenAIRE

    Grupo de Estudio sobre la Enfermedad de Chagas; Segura,Elsa L; Alejandro Escobar-Mesa

    2005-01-01

    Objetivo. Identificar la seroprevalencia de enfermedad de Chagas, los factores de riesgo de la vivienda e índices entomológicos, para proponer medidas de control en 11 jurisdicciones sanitarias del estado de Veracruz. Material y métodos. Entre 1997 y 2001 se hizo un estudio transversal cuya muestra quedó integrada por 281 localidades, 2 526 viviendas y 9 782 individuos. Se aplicó un cuestionario sobre factores de riesgo, se tomó sangre en papel filtro y se buscaron triatominos en el intra y p...

  5. PREVALENCE OF CHAGAS DISEASE IN A RURAL AREA IN THE STATE OF CEARA, BRAZIL

    Science.gov (United States)

    FREITAS, Erlane Chaves; OLIVEIRA, Maria de Fátima; ANDRADE, Mônica Coelho; VASCONCELOS, Arduina Sofia Ortet de Barros; da SILVA, José Damião; CÂNDIDO, Darlan da Silva; PEREIRA, Laíse dos Santos; CORREIA, João Paulo Ramalho; da CRUZ, José Napoleão Monte; CAVALCANTI, Luciano Pamplona de Góes

    2015-01-01

    SUMMARY Chagas disease is caused by Trypanosoma cruzi and affects about two to three million people in Brazil, still figuring as an important public health problem. A study was conducted in a rural area of the municipality of Limoeiro do Norte - CE, northeastern Brazil, aiming to determine the prevalence of T. cruzi infection. Of the inhabitants, 52% were examined, among whom 2.6% (4/154) were seropositive in at least two serological tests. All seropositive individuals were older than 50 years, farmers, with a low education and a family income of less than three minimum wages. Active surveillance may be an alternative for early detection of this disease. PMID:26603232

  6. Soro-epidemiologia da doença de Chagas em Santa Catarina

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    BR Schlemper Jr

    1983-12-01

    Full Text Available Em Santa Catarina, o Inquérito Sorológico Nacional para doença de Chagas (CNPq-SUCAM revelou positividade de 1,3% em cerca de 74.000 amostras de soro processadas pela reação de imunofluorescência indireta em papel de filtro, com 15 municípios apresentando prevalências de 5,4% a 41,3%. Na presente investigação, em 9 dos municípios com alta prevalência, foram obtidas amostras de sangue, por punção venosa, de 222 indivíduos dos quais 140 haviam sido sorologicamente positivos e 58 negativos no Inquérito Nacional. Em 24 outros indivíduos a reação foi executada pela primeira vez. Os testes sorológicos (imunofluorescência indireta, hemaglutinação indireta, aglutinação direta com e sem 2-mercaptoetanol e fixação do complemento realizados em 3 diferentes laboratórios evidenciaram 220 soros negativos e apenas 2 positivos. Dados epidenúológicos obtidos nas áreas trabalhadas confirmaram estes resultados negativos. Os resultados discordam daqueles encontrados pelo Inquérito Sorológico Nacional e confirmam a inexistência de focos domiciliares de transmissão da doença de Chagas em Santa Catarina.The National Serologic Survey (CNPq - SUCAM for Chagfis'disease in Santa Catarina revealed 1,3% of positive results in 74.000 serum samples. The method employed was indirect immunofluorescence in filter paper. Fifteen cities have shown high prevalence (5,4% to 41,3%. In the present investigation the blood samples were obtained in 9 cities by venous punction of 222 persons: 140 from people serologicaly positive, 58 negative in the National Survey as well as 24 other persons in which the reaction was performed for the first time The serologic test (indirect immunofluorescence, indirect hemagglutination, direct agghxtination with and without 2-ME and complement fíxation carried out in three diferent laboratories detected 220 negative and only 2 positive sera. This result was confirmed by specific epidemiological aspects related to

  7. ELISA versus PCR for diagnosis of chronic Chagas disease: systematic review and meta-analysis

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    Hasslocher-Moreno Alejandro M

    2010-11-01

    Full Text Available Abstract Background Most current guidelines recommend two serological tests to diagnose chronic Chagas disease. When serological tests are persistently inconclusive, some guidelines recommend molecular tests. The aim of this investigation was to review chronic Chagas disease diagnosis literature and to summarize results of ELISA and PCR performance. Methods A systematic review was conducted searching remote databases (MEDLINE, LILACS, EMBASE, SCOPUS and ISIWeb and full texts bibliography for relevant abstracts. In addition, manufacturers of commercial tests were contacted. Original investigations were eligible if they estimated sensitivity and specificity, or reliability -or if their calculation was possible - of ELISA or PCR tests, for chronic Chagas disease. Results Heterogeneity was high within each test (ELISA and PCR and threshold effect was detected only in a particular subgroup. Reference standard blinding partially explained heterogeneity in ELISA studies, and pooled sensitivity and specificity were 97.7% [96.7%-98.5%] and 96.3% [94.6%-97.6%] respectively. Commercial ELISA with recombinant antigens studied in phase three investigations partially explained heterogeneity, and pooled sensitivity and specificity were 99.3% [97.9%-99.9%] and 97.5% [88.5%-99.5%] respectively. ELISA's reliability was seldom studied but was considered acceptable. PCR heterogeneity was not explained, but a threshold effect was detected in three groups created by using guanidine and boiling the sample before DNA extraction. PCR sensitivity is likely to be between 50% and 90%, while its specificity is close to 100%. PCR reliability was never studied. Conclusions Both conventional and recombinant based ELISA give useful information, however there are commercial tests without technical reports and therefore were not included in this review. Physicians need to have access to technical reports to understand if these serological tests are similar to those included in

  8. Triatominae species of Suriname (Heteroptera: Reduviidae and their role as vectors of Chagas disease

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    Hélène Hiwat

    2014-07-01

    Full Text Available Nine species of Triatominae, representing three tribes and five genera, are currently known in Suriname. An annotated list of the species based on the collections of the Bureau of Public Health (Suriname, the National Zoological Collection Suriname and the National History Museum Leiden (the Netherlands is provided. Additionally, the results of several years of opportunistic collection in two domestic environments are presented. The most common species are Rhodnius pictipes Stål, 1972, Rhodnius robustus Larrouse, 1972 and Panstrongylus geniculatus (Latreille, 1811. The significance of the species as vectors of Chagas disease in Suriname is discussed.

  9. A inserção institucional do controle da doença de Chagas

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    Antônio Carlos Silveira

    2011-01-01

    Full Text Available Em 1943, a partir da criação do "Centro de Estudos e Profilaxia da Moléstia de Chagas" da Fundação Oswaldo Cruz de Bambuí em Minas Gerais, são concebidas as bases tecnológicas e metodológicas para o controle extensivo da enfermidade. Para isso foi decisivo o advento de um novo inseticida (o gammexane, P 530 e a demonstração de sua eficácia no controle dos vetores da doença de Chagas. Como resultado prático desses acontecimentos em "maio de 1950 foi oficialmente inaugurada, em Uberaba, a primeira campanha de profilaxia da doença de Chagas, no Brasil". Mesmo que se dispusesse desde então de meios para fazer o controle da transmissão vetorial da endemia chagásica, não se dispunha dos recursos financeiros exigidos para fazê-lo de forma abrangente e regular. O baixo nível de prioridade conferida a essa atividade se expressava em sua inserção institucional. Em 1941, foram criados os Serviços Nacionais, de malária, peste, varíola, entre outros, enquanto a doença de Chagas fazia parte da Divisão de Organização Sanitária (DOS, que reunia enfermidades consideradas de menor importância. Em 1956 o Departamento Nacional de Endemias Rurais (DNERu incorporou todas as chamadas grandes endemias em uma única instituição, mas na prática isso não significou a implementação das ações de controle da doença de Chagas. Com a reestruturação do Ministério da Saúde em 1970, a Superintendência de Campanhas de Saúde Pública (SUCAM abarcou todas as endemias rurais, e a doença de Chagas passou a ter o status de Divisão Nacional, na mesma posição hierárquica daquelas outras doenças transmitidas por vetores antes consideradas prioritárias. Essa condição determinou a possibilidade de uma repartição de recursos mais equilibrada, o que efetivamente ocorreu, com a realocação de pessoal e insumos do programa de malária para o controle vetorial da doença de Chagas. Em 1991, a Fundação Nacional de Saúde sucedeu a SUCAM

  10. Triatominae species of Suriname (Heteroptera: Reduviidae) and their role as vectors of Chagas disease.

    Science.gov (United States)

    Hiwat, Hélène

    2014-07-01

    Nine species of Triatominae, representing three tribes and five genera, are currently known in Suriname. An annotated list of the species based on the collections of the Bureau of Public Health (Suriname), the National Zoological Collection Suriname and the National History Museum Leiden (the Netherlands) is provided. Additionally, the results of several years of opportunistic collection in two domestic environments are presented. The most common species are Rhodnius pictipes Stål, 1972, Rhodnius robustus Larrouse, 1972 and Panstrongylus geniculatus (Latreille, 1811). The significance of the species as vectors of Chagas disease in Suriname is discussed.

  11. Distantiae transmission of Trypanosoma cruzi: a new epidemiological feature of acute Chagas disease in Brazil.

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    Samanta Cristina das Chagas Xavier

    2014-05-01

    Full Text Available BACKGROUND: The new epidemiological scenario of orally transmitted Chagas disease that has emerged in Brazil, and mainly in the Amazon region, needs to be addressed with a new and systematic focus. Belém, the capital of Pará state, reports the highest number of acute Chagas disease (ACD cases associated with the consumption of açaí juice. METHODOLOGY/PRINCIPAL FINDINGS: The wild and domestic enzootic transmission cycles of Trypanosoma cruzi were evaluated in the two locations (Jurunas and Val-de Cães that report the majority of the autochthonous cases of ACD in Belém city. Moreover, we evaluated the enzootic cycle on the three islands that provide most of the açaí fruit that is consumed in these localities. We employed parasitological and serological tests throughout to evaluate infectivity competence and exposure to T. cruzi. In Val-de-Cães, no wild mammal presented positive parasitological tests, and 56% seroprevalence was observed, with low serological titers. Three of 14 triatomines were found to be infected (TcI. This unexpected epidemiological picture does not explain the high number of autochthonous ACD cases. In Jurunas, the cases of ACD could not be autochthonous because of the absence of any enzootic cycle of T. cruzi. In contrast, in the 3 island areas from which the açaí fruit originates, 66.7% of wild mammals and two dogs displayed positive hemocultures, and 15.6% of triatomines were found to be infected by T. cruzi. Genotyping by mini-exon gene and PCR-RFLP (1f8/Akw21I targeting revealed that the mammals and triatomines from the islands harbored TcI and Trypanosoma rangeli in single and mixed infections. CONCLUSION/SIGNIFICANCE: These findings show that cases of Chagas disease in the urban area of Belém may be derived from infected triatomines coming together with the açaí fruits from distant islands. We term this new epidemiological feature of Chagas disease as "Distantiae transmission".

  12. Prevalence of Chagas disease in Brazil: a systematic review and meta-analysis.

    Science.gov (United States)

    Martins-Melo, Francisco Rogerlândio; Ramos, Alberto Novaes; Alencar, Carlos Henrique; Heukelbach, Jorg

    2014-02-01

    Chagas disease is a major public health problem in Brazil and Latin America. During the last years, it has become an emerging problem in North America and Europe due to increasing international migration. Here we describe the prevalence of Chagas disease in Brazil through a systematic review. We searched national and international electronic databases, grey literature and reference lists of selected articles for population-based studies on Chagas disease prevalence in Brazil, performed from 1980 until September 2012. Forty-two articles with relevant prevalence data were identified from a total of 4985 references. Prevalence ranged from 0% to 25.1%. Most surveys were performed in the Northeast region, especially in the state of Piauí. We observed a high degree of heterogeneity in most pooled estimates (I(2)>75%; pdisease prevalence across studies for the entire period was 4.2% (95% CI: 3.1-5.7), ranging from 4.4% (95% CI: 2.3-8.3) in the 1980s to 2.4% (95% CI: 1.5-3.8) after 2000. Females (4.2%; 95% CI: 2.6-6.8), >60 year-olds (17.7%; 95% CI: 11.4-26.5), Northeast (5.0%; 95% CI: 3.1-8.1) and Southeast (5.0%; CI: 2.4-9.9) regions and mixed (urban/rural) areas (6.4%; 95% CI: 4.2-9.4) had the highest pooled prevalence. About 4.6 million (95% CI: 2.9-7.2 million) of people are estimated to be infected with Trypanosoma cruzi. The small number of studies and small-scale samples of the general population in some areas limit interpretation, and findings of this review do not necessarily reflect the situation of the entire country. Systematic population-based studies at regional and national level are recommended to provide more accurate estimates and better define the epidemiology and risk areas of Chagas disease in Brazil.

  13. Training Systems Modelers through the Development of a Multi-scale Chagas Disease Risk Model

    Science.gov (United States)

    Hanley, J.; Stevens-Goodnight, S.; Kulkarni, S.; Bustamante, D.; Fytilis, N.; Goff, P.; Monroy, C.; Morrissey, L. A.; Orantes, L.; Stevens, L.; Dorn, P.; Lucero, D.; Rios, J.; Rizzo, D. M.

    2012-12-01

    The goal of our NSF-sponsored Division of Behavioral and Cognitive Sciences grant is to create a multidisciplinary approach to develop spatially explicit models of vector-borne disease risk using Chagas disease as our model. Chagas disease is a parasitic disease endemic to Latin America that afflicts an estimated 10 million people. The causative agent (Trypanosoma cruzi) is most commonly transmitted to humans by blood feeding triatomine insect vectors. Our objectives are: (1) advance knowledge on the multiple interacting factors affecting the transmission of Chagas disease, and (2) provide next generation genomic and spatial analysis tools applicable to the study of other vector-borne diseases worldwide. This funding is a collaborative effort between the RSENR (UVM), the School of Engineering (UVM), the Department of Biology (UVM), the Department of Biological Sciences (Loyola (New Orleans)) and the Laboratory of Applied Entomology and Parasitology (Universidad de San Carlos). Throughout this five-year study, multi-educational groups (i.e., high school, undergraduate, graduate, and postdoctoral) will be trained in systems modeling. This systems approach challenges students to incorporate environmental, social, and economic as well as technical aspects and enables modelers to simulate and visualize topics that would either be too expensive, complex or difficult to study directly (Yasar and Landau 2003). We launch this research by developing a set of multi-scale, epidemiological models of Chagas disease risk using STELLA® software v.9.1.3 (isee systems, inc., Lebanon, NH). We use this particular system dynamics software as a starting point because of its simple graphical user interface (e.g., behavior-over-time graphs, stock/flow diagrams, and causal loops). To date, high school and undergraduate students have created a set of multi-scale (i.e., homestead, village, and regional) disease models. Modeling the system at multiple spatial scales forces recognition that

  14. Carvedilol Enhances the Antioxidant Effect of Vitamins E and C in Chronic Chagas Heart Disease

    Energy Technology Data Exchange (ETDEWEB)

    Budni, Patrícia, E-mail: budnip@gmail.com [Universidade Federal de Santa Catarina, Florianópolis, SC (Brazil); Pedrosa, Roberto Coury [Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil); Dalmarco, Eduardo Monguilhott; Dalmarco, Juliana Bastos; Frode, Tânia Sílvia; Wilhelm, Danilo Filho [Universidade Federal de Santa Catarina, Florianópolis, SC (Brazil)

    2013-10-15

    Chagas disease is still an important endemic disease in Brazil, and the cardiac involvement is its more severe manifestation. To verify whether the concomitant use of carvedilol will enhance the antioxidant effect of vitamins E and C in reducing the systemic oxidative stress in chronic Chagas heart disease. A total of 42 patients with Chagas heart disease were studied. They were divided into four groups according to the modified Los Andes classification: 10 patients in group IA (normal electrocardiogram and echocardiogram; no cardiac involvement); 20 patients in group IB (normal electrocardiogram and abnormal echocardiogram; mild cardiac involvement); eight patients in group II (abnormal electrocardiogram and echocardiogram; no heart failure; moderate cardiac involvement); and four patients in group III (abnormal electrocardiogram and echocardiogram with heart failure; severe cardiac involvement). Blood levels of markers of oxidative stress were determined before and after a six-month period of treatment with carvedilol, and six months after combined therapy of carvedilol with vitamins E and C. The markers analyzed were as follows: activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase and reductase, myeloperoxidade and adenosine deaminase; and the levels of reduced glutathione, thiobarbituric-acid reactive substances, protein carbonyls, vitamin E, and nitric oxide. After treatment with carvedilol, all groups showed significant decrease in protein carbonyls and reduced glutathione levels, whereas nitric oxide levels and adenosine activity increased significantly only in the less severely affected group (IA). In addition, the activity of most of the antioxidant enzymes was decreased in the less severely affected groups (IA and IB). By combining the vitamins with carvedilol, a reduction in protein damage, in glutathione levels, and in the activity of most of the antioxidant enzymes were observed. The decrease in oxidative

  15. Exposição aguda a derivados imidazolínicos em crianças

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    Bucaretchi Fábio

    2003-01-01

    Full Text Available OBJETIVOS: Estudar a exposição aguda a derivados imidazolínicos em crianças com idade inferior a 15 anos, atendidas no período de janeiro de 1994 a dezembro de 1999. MÉTODOS: Neste estudo retrospectivo foram avaliadas 72 crianças com idades entre dois meses e 13 anos, mediana de dois anos (25% a 75%; um a três anos, expostas a nafazolina (n = 48, fenoxazolina (n = 18, oximetazolina (n = 5 e tetrizolina (n = 1; por via oral (n = 46, nasal (n = 24 ou desconhecida (n = 2. RESULTADOS: No total, 57 crianças desenvolveram manifestações clínicas: sonolência (n = 34, sudorese (n = 20, palidez (n = 17, hipotermia (n = 16, bradicardia (n = 13, extremidades frias (n = 9, agitação (n = 7, taquicardia (n = 6, vômitos (n = 34, respiração irregular e apnéia (n = 5, miose/midríase (n = 4, sendo a nafazolina (n = 47, a fenoxazolina (n = 5 e a oximetazolina (n = 4 os princípios ativos mais envolvidos. O início das manifestações clínicas foi rápido, iniciando-se, em 32/57 crianças, até duas horas após a exposição. Somente medidas de suporte foram empregadas, com uma criança necessitando de ventilação mecânica após exposição à nafazolina. Na maioria dos pacientes, o quadro clínico remitiu até 24 horas após a exposição (n = 39/57. Não houve evolução letal. Pacientes expostos à nafazolina (n = 47/48 apresentaram maior freqüência de manifestações clínicas de intoxicação em comparação com aqueles expostos à fenoxazolina (n = 5/18 (p < 0,001. Comparando-se a freqüência de pacientes que desenvolveram manifestações clínicas de acordo com a via de exposição (oral, n = 34/46; nasal, n = 21/24, não foi encontrada uma diferença estatisticamente significante (p = 0,31. CONCLUSÕES: Na maioria dos casos de exposição a derivados imidazolínicos, principalmente à nafazolina e em crianças com menos de três anos de idade, ocorreu, independentemente da via (oral ou nasal, o aparecimento precoce de manifesta

  16. Apendicitis aguda sin enfermedad de Crohn en un paciente con inflamación intestinal. Informe de un caso

    OpenAIRE

    Ernesto Sierra-Montenegro; Eduardo Villanueva-Sáenz; José Luis Rocha-Ramírez; Javier Pérez-Aguirre; José Manuel Fernández-Rivero; René Soto-Quirino

    2008-01-01

    Introducción: La enfermedad de Crohn fue descrita por primera ocasión en 1932; la asociación de apendicitis aguda con esta enfermedad es muy rara y ante afectación del ciego el riesgo de fístula es muy alto. El objetivo fue informar un caso de apendicitis aguda en un paciente con diagnóstico de enfermedad de Crohn. Caso clínico: Mujer de 48 años de edad, con diagnóstico reciente de enfermedad de Crohn quien presentó cuadro clínico de dolor abdominal intenso en fosa iliaca derecha con tratamie...

  17. Incidencia y factores de riesgo para adquirir diarrea aguda en una comunidad rural de la selva peruana.

    OpenAIRE

    HENRÍQUEZ CAMACHO, César; GUILLÉN ASTETE, Carlos; BENAVENTE, LUIS; GOTUZZO HERENCIA, Eduardo; ECHEVARRIA ZARATE, JUAN; SEAS RAMOS, Carlos

    2013-01-01

    Objetivo: Determinar la incidencia y factores de riesgo para adquirir diarrea aguda en una comunidad rural localizada en la selva del departamento de San Martín, Perú. Material y métodos: Una cohorte de 119 personas fue seleccionada al azar entre la población de 446 habitantes y seguida diariamente por un mes entre enero y febrero de 1999, buscando casos de diarrea aguda, definida como tres ó más cámaras de deposiciones al día por no más de 3 días. Un estudio caso control pareado fue diseñado...

  18. Cardiac Repolarization Abnormalities and Potential Evidence for Loss of Cardiac Sodium Currents on ECGs of Patients with Chagas' Heart Disease

    Science.gov (United States)

    Schlegel, T. T.; Medina, R.; Jugo, D.; Nunez, T. J.; Borrego, A.; Arellano, E.; Arenare, B.; DePalma, J. L.; Greco, E. C.; Starc, V.

    2007-01-01

    Some individuals with Chagas disease develop right precordial lead ST segment elevation in response to an ajmaline challenge test, and the prevalence of right bundle branch block (RBBB) is also high in Chagas disease. Because these same electrocardiographic abnormalities occur in the Brugada syndrome, which involves genetically defective cardiac sodium channels, acquired damage to cardiac sodium channels may also occur in Chagas disease. We studied several conventional and advanced resting 12-lead/derived Frank-lead ECG parameters in 34 patients with Chagas -related heart disease (mean age 39 14 years) and in 34 age-/gender-matched healthy controls. All ECG recordings were of 5-10 min duration, obtained in the supine position using high fidelity hardware/software (CardioSoft, Houston, TX). Even after excluding those Chagas patients who had resting BBBs, tachycardia and/or pathologic arrhythmia (n=8), significant differences remained in multiple conventional and advanced ECG parameters between the Chagas and control groups (n=26/group), especially in their respective QT interval variability indices, maximal spatial QRS-T angles and low frequency HRV powers (p=0.0006, p=0.0015 and p=0.0314 respectively). In relation to the issue of potential damage to cardiac sodium channels, the Chagas patients had: 1) greater than or equal to twice the incidence of resting ST segment elevation in leads V1-V3 (n=10/26 vs. n=5/26) and of both leftward (n=5/26 versus n=0/26) and rightward (n=7/26 versus n=3/26) QRS axis deviation than controls; 2) significantly increased filtered (40-250 Hz) QRS interval durations (92.1 8.5 versus 85.3 plus or minus 9.0 ms, p=0.022) versus controls; and 3) significantly decreased QT and especially JT interval durations versus controls (QT interval: 387.5 plus or minus 26.4 versus 408.9 plus or minus 34.6 ms, p=0.013; JT interval: 290.5 plus or minus 26.3 versus 314.8 plus or minus 31.3 ms; p=0.0029). Heart rates and Bazett-corrected QTc/JTc intervals

  19. Chronic Chagas cardiomyopathy: a review of the main pathogenic mechanisms and the efficacy of aetiological treatment following the BENznidazole Evaluation for Interrupting Trypanosomiasis (BENEFIT) trial

    Science.gov (United States)

    Rassi, Anis; Marin, José Antonio; Rassi, Anis

    2017-01-01

    Chagas cardiomyopathy is the most frequent and most severe manifestation of chronic Chagas disease, and is one of the leading causes of morbidity and death in Latin America. Although the pathogenesis of Chagas cardiomyopathy is incompletely understood, it may involve several mechanisms, including parasite-dependent myocardial damage, immune-mediated myocardial injury (induced by the parasite itself and by self-antigens), and microvascular and neurogenic disturbances. In the past three decades, a consensus has emerged that parasite persistence is crucial to the development and progression of Chagas cardiomyopathy. In this context, antiparasitic treatment in the chronic phase of Chagas disease could prevent complications related to the disease. However, according to the results of the BENEFIT trial, benznidazole seems to have no benefit for arresting disease progression in patients with chronic Chagas cardiomyopathy. In this review, we give an update on the main pathogenic mechanisms of Chagas disease, and re-examine and discuss the results of the BENEFIT trial, together with its limitations and implications. PMID:28225900

  20. Budesonida inalatória em crianças com asma aguda Nebulized budesonide to treat acute asthma in children

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    Geórgia K. M. Milani

    2004-04-01

    Full Text Available OBJETIVO: Avaliar a eficácia de budesonida na forma de suspensão, em dose única para inalação, como tratamento adjunto ao b2 inalatório, comparada com dose única de prednisona por via oral, em pacientes com crise aguda de asma. MÉTODO: Estudo prospectivo, randômico, paralelo, duplo-cego, duplo-placebo. Foram selecionadas 49 crianças, com idade entre 2 e 7 anos, em crise aguda de asma, que, após inalação com salbutamol (0,15 mg/kg, foram divididas em três grupos. O grupo I foi tratado com placebo via oral e inalatório; o grupo II, com prednisona via oral (1 mg/kg e placebo inalatório; e o grupo III, budesonida inalatória (2 mg e placebo via oral. As avaliações foram realizadas pela aplicação de um escore clínico e medida da saturação transcutânea da hemoglobina, seqüencialmente até 72 horas. Caso o escore clínico fosse igual ou superior ao da avaliação inicial, e a saturação inferior à primeira avaliação, a inalação com b2 adrenérgico era repetida. RESULTADOS: A melhora do escore clínico foi progressiva a partir de 30 minutos, e não houve diferença significativa nos três grupos estudados. Ocorreu aumento significativo da saturação da hemoglobina em relação ao valor inicial, com 2 horas no grupo prednisona, 4 horas no grupo budesonida e 24 horas no grupo placebo. CONCLUSÃO: O número de inalações com broncodilatador foi semelhante nos três grupos, com uma média de 2,9 no grupo placebo; 2,7 no grupo prednisona; e 2,5 no grupo budesonida. Em geral, as drogas estudadas foram bem toleradas, com efeitos colaterais semelhantes ao placebo. A administração de dose única de budesonida inalatória associada ao salbutamol, na crise moderada de asma, promoveu melhora clínica comparável à da prednisona oral. A recuperação da saturação transcutânea da hemoglobina foi mais rápida com prednisona.OBJECTIVE: To investigate the efficacy of a single dose of inhaled budesonide as compared to oral

  1. Asma aguda em adultos na sala de emergência: o manejo clínico na primeira hora

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    DALCIN PAULO DE TARSO ROTH

    2000-01-01

    Full Text Available Asma é doença com alta prevalência em nosso meio e ao redor do mundo. Embora novas opções terapêuticas tenham sido recentemente desenvolvidas, parece haver aumento mundial na sua morbidade e mortalidade. Em muitas instituições, as exacerbações asmáticas ainda constituem emergência médica muito comum. As evidências têm demonstrado que a primeira hora no manejo da asma aguda na sala de emergência concentra decisões cruciais que podem determinar o desfecho desta situação clínica. Nesta revisão não-sistemática, os autores enfocaram a primeira hora da avaliação e tratamento do paciente com asma aguda na sala de emergência, descrevendo uma estratégia apropriada para o seu manejo. São consideradas as seguintes etapas: diagnóstico, avaliação da gravidade, tratamento farmacológico, avaliação das complicações e decisão sobre onde se realizará o tratamento adicional. Espera-se que estas recomendações contribuam para que o médico clínico tome a decisão apropriada na primeira hora do manejo da asma aguda.

  2. Características clínicas da fase aguda da infecção experimental de felinos pelo vírus da imunodeficiência felina

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    M.S. Zanutto

    2011-03-01

    Full Text Available A infecção dos felinos pelo Vírus da Imunodeficiência Felina (FIV resulta no desenvolvimento da síndrome de imunodeficiência dos felinos. Gengivite, perda de peso, linfadenomegalia generalizada, anemia, insuficiência renal crônica, complicações neurológicas, diarréia crônica e infecções bacterianas são encontradas frequentemente. A fase aguda da infecção pode ser assintomática, retardando o estabelecimento do diagnóstico e a implantação de medidas profiláticas para restringir o contágio e a transmissão do agente aos felinos suscetíveis. Com a finalidade de estudar as características clínicas da fase aguda da infecção, dez felinos jovens, sem definição racial, com oito meses de idade foram inoculados por via endovenosa com 1mL de sangue venoso de um gato portador do FIV subtipo B. A confirmação da infecção foi obtida através de teste sorológico em quatro e oito semanas pós-inoculação (p.i. e por nested-PCR. Foram realizados hemogramas semanais, exame ultrassonográfico do abdômen quinzenais e exame oftalmológico mensal, durante doze semanas p.i. Discreta tendência a linfopenia na segunda semana p.i. e a neutropenia entre a quinta e sétima semana p.i., febre intermitente em alguns gatos, linfadenomegalia e hepato-esplenomegalia entre a quarta e a 12ª semana p.i. foram as alterações clínicas observadas. Apenas um gato apresentou uveíte unilateral direita. A fase aguda da infecção transcorreu com alterações clínicas inespecíficas. A linfadenomegalia e a hepato-esplenomegalia observadas no decorrer da infecção, refletindo hiperplasia linfóide, sugerem a necessidade de se realizar o teste sorológico para o FIV, em todos os gatos que se apresentarem com essas alterações, o que permitirá o diagnóstico precoce da infecção e a adoção de medidas profiláticas no sentido de minimizar a propagação da infecção.

  3. Soporte nutricional en la pancreatitis aguda Artificial nutrition in acute pancreatitis

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    J. Garnacho Montero

    2005-06-01

    Full Text Available Los cambios metabólicos que tienen lugar en la pancreatitis aguda originan, como en otros pacientes graves, una situación de estrés metabólico que, en muchas ocasiones, requiere la aplicación de soporte nutricional especializado. Los pacientes que presentan mayores niveles de gravedad (definida como un índice de Ranson = 3 o un APACHE II = 10 son los candidatos a recibir apoyo nutricional. La nutrición enteral debe ser la primera vía de aporte de nutrientes a considerar y debe mantenerse salvo que los pacientes presenten intolerancia o desarrollen dolor, ascitis, o incremento de las cifras de amilasa sérica. La nutrición enteral transpilórica, a través de una sonda naso-yeyunal o mediante yeyunostomía por catéter, es una vía de acceso segura en la pancreatitis aguda grave e incluso puede acompañarse de ventajas evolutivas para los pacientes en comparación con la nutrición parenteral. La indicación de nutrición parenteral estaría condicionada por la imposibilidad de obtener un abordaje enteral adecuado (yeyunal, la intolerancia a la nutrición enteral o la reagudización del proceso tras el inicio del soporte nutricional enteral. Con los datos actuales, no pueden establecerse recomendaciones acerca de las características idóneas que debe reunir la composición de nutrientes que deben recibir los pacientes con pancreatitis aguda.Metabolic changes that occur in acute pancreatitis result, as with other critically ill patients, in a metabolic stress situation that many times requires the application of a specialized nutritional support. Patients presenting the highest severity indexes (defined as Ranson's index = 3 or an APACHE II = 10 are candidates to receive nutritional support. Enteral nutrition must be the first route to consider for nutrients supply and must be maintained except for patients that have intolerance or develop pain, ascites, or increased serum amylase levels. Transpyloric enteral nutrition, through a naso

  4. Do Brazilian scientific journals promote the adherence of Chagas disease researchers to internacional ethical principals?

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    Guilherme Malafaia

    2013-06-01

    Full Text Available The ethical aspects of the Brazilian publications about human Chagas disease (CD developed between 1996 and 2010 and the policy adopted by Brazilian medical journals were analyzed. Articles were selected on the SciELO Brazil data basis, and the evaluation of ethical aspects was based on the normative contents about ethics in research involving human experimentation according to the Brazilian resolution of the National Health Council no. 196/1996. The editorial policies of the section "Instructions to authors" were analyzed. In the period of 1996-2012, 58.9% of articles involving human Chagas disease did not refer to the fulfillment of the ethical aspects concerning research with human beings. In 80% of the journals, the requirements and confirmation of the information about ethical aspects in the studies of human CD were not observed. Although a failure in this type of service is still observed, awareness has been raised in federal agencies, educational institutions/research and publishing groups to standardize the procedures and ethical requirements for the Brazilian journals, reinforcing the fulfillment of the ethical parameters, according to the resolution of NHC no. 196/1996.

  5. [Chagas disease in chronic phase outside the endemic area. The diagnostic tools].

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    Paris, L; Touafek, F; Elghouzzi, M H; Chérif, S; Mazier, D

    2009-12-01

    The diagnosis of Chagas disease during the chronic phase is based on serology. Outside South America the use of two methods is recommended by WHO. A third method must be available for inconclusive results but there is no gold standard. A pilot study of screening in 254 Bolivian people living in the Paris area (France) was made. Serological study was performed using IIF and three Elisa, Elisa Cruzi (BioMérieux Brésil), BioElisa Chagas (Bio-kit), and Chagatest Elisa recombinante v. 3.0 (Wiener Lab). 165 patients were negative, 69 positive and 20 inconclusive. PCR-based assays appear to have a better sensitivity than parasitological methods, but not more than 70% that do not justify their use for primary testing. There are no standardized and commercial assays. The primer pairs based on the nuclear sequence TCZ1-TCZ2 seems to be the more specific (no cross reaction with others Trypanosomatidae) and the most sensitive with the strains of the two lineage of Trypanosoma cruzi. PCR would have a role in inconclusive serological cases or in the evaluation of treatment failure.

  6. Entomological factors affecting the low endemicity of Chagas disease in Nazca, Southwestern Peru.

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    Paredes-Esquivel, Claudia; Lecaros, Emilio; Aguliar-Rosales, Mauro; Acosta, Hilda Solis; Castellanos, Pedro

    2010-05-01

    Chagas disease is prevalent in Peru. The province of Nazca, in the southwestern region of the country, shows a high intradomiciliary infestation rate of Triatoma infestans bugs. Although the vector is present, the number of Chagas disease cases appears to be much lower than those reported in the neighboring region of Arequipa. We examined 624 T. infestans from Nazca to determine the current Trypanosoma cruzi infection rates, and found that no bugs were infected with this parasite. These results contrast with those found in Arequipa, where 19-30% triatomines have been reported infected. To compare their vectorial capacity, we infected 30 T. infestans specimens, selected both from Nazca and Arequipa, by feeding bugs on T. cruzi-infected mice. The parasites developed all stages expected in the vector; furthermore, the infective stage, metacyclic trypomastigote, was found in both insect populations from the second week after infection. In addition, those insects that accepted to be fed with mice blood defecated immediately after finishing blood meal, indicating that they might be efficient vectors. We maintain that differences observed in infection rates between vectors from Nazca and Arequipa may be explained by differences in host availability. In Arequipa hosts are mainly small animals, whereas in Nazca the main blood source comes from birds, which are refractory to the infection.

  7. Gas exchange during exercise in different evolutional stages of chronic Chagas' heart disease

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    Fátima Palha de Oliveira

    2000-12-01

    Full Text Available OBJECTIVE: To compare gas exchange at rest and during exercise in patients with chronic Chagas' heart disease grouped according to the Los Andes clinical/hemodynamic classification. METHODS: We studied 15 healthy volunteers and 52 patients grouped according to the Los Andes clinical/hemodynamic classification as follows: 17 patients in group IA (normal electrocardiogram/echocardiogram, 9 patients in group IB (normal electrocardiogram and abnormal echocardiogram, 14 patients in group II (abnormal electrocardiogram/echocardiogram, without congestive heart failure, and 12 patients in group III (abnormal electrocardiogram/echocardiogram with congestive heart failure. The following variables were analyzed: oxygen consumption (V O2, carbon dioxide production (V CO2, gas exchange rate (R, inspiratory current volume (V IC, expiratory current volume (V EC, respiratory frequency, minute volume (V E, heart rate (HR, maximum load, O2 pulse, and ventilatory anaerobic threshold (AT. RESULTS: When compared with the healthy group, patients in groups II and III showed significant changes in the following variables: V O2peak, V CO2peak, V ICpeak, V ECpeak, E, HR, and maximum load. Group IA showed significantly better results for these same variables as compared with group III. CONCLUSION: The functional capacity of patients in the initial phase of chronic Chagas' heart disease is higher than that of patients in an advanced phase and shows a decrease that follows the loss in cardiac-hemodynamic performance.

  8. Diagnostic electrocardiography in epidemiological studies of Chagas' disease: multicenter evaluation of a standardized method.

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    Lázzari, J O; Pereira, M; Antunes, C M; Guimarães, A; Moncayo, A; Chávez Domínguez, R; Hernández Pieretti, O; Macedo, V; Rassi, A; Maguire, J; Romero, A

    1998-11-01

    An electrocardiographic recording method with an associated reading guide, designed for epidemiological studies on Chagas' disease, was tested to assess its diagnostic reproducibility. Six cardiologists from five countries each read 100 electrocardiographic (ECG) tracings, including 30 from chronic chagasic patients, then reread them after an interval of 6 months. The readings were blind, with the tracings numbered randomly for the first reading and renumbered randomly for the second reading. The physicians, all experienced in interpreting ECGs from chagasic patients, followed printed instructions for reading the tracings. Reproducibility of the readings was evaluated using the kappa (kappa) index for concordance. The results showed a high degree of interobserver concordance with respect to the diagnosis of normal vs. abnormal tracings (kappa = 0.66; SE 0.02). While the interpretations of some categories of ECG abnormalities were highly reproducible, others, especially those having a low prevalence, showed lower levels of concordance. Intraobserver concordance was uniformly higher than interobserver concordance. The findings of this study justify the use by specialists of the recording of readings method proposed for epidemiological studies on Chagas' disease, but warrant caution in the interpretation of some categories of electrocardiographic alterations.

  9. Chagas disease in Mexico: an analysis of geographical distribution during the past 76 years - A review

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    Alejandro Cruz-Reyes

    2006-06-01

    Full Text Available Literature from 1928 through 2004 was compiled from different document sources published in Mexico or elsewhere. From these 907 publications, we found 19 different topics of Chagas disease study in Mexico. The publications were arranged by decade and also by state. This information was used to construct maps describing the distribution of Chagas disease according to different criteria: the disease, vectors, reservoirs, and strains. One of the major problems confronting study of this zoonotic disease is the great biodiversity of the vector species; there are 30 different species, with at least 10 playing a major role in human infection. The high variability of climates and biogeographic regions further complicate study and understanding of the dynamics of this disease in each region of the country. We used a desktop Genetic Algorithm for Rule-Set Prediction procedure to provide ecological models of organism niches, offering improved flexibility for choosing predictive environmental and ecological data. This approach may help to identify regions at risk of disease, plan vector-control programs, and explore parasitic reservoir association. With this collected information, we have constructed a data base: CHAGMEX, available online in html format.

  10. Impact of Chagas Disease in Bolivian Immigrants Living in Europe and the Risk of Stigmatization

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    Rafael M. Ortí-Lucas

    2014-01-01

    Full Text Available Background. The prevalence of Chagas disease in endemic countries varies with the kind of vector involved and the socioeconomic conditions of the population of origin. Due to recent immigration it is an emerging public health problem in Europe, especially in those countries which receive immigrant populations with a high prevalence of carriers. The study reviews the impact of the disease on Bolivian immigrants living in Europe, the preventive measures and regulations applied in European countries, and their repercussion on possible stigmatization of certain population groups. Methods. The Bolivian immigrant population resident in 2012 was estimated and the affected population in different European countries was calculated with data on carrier prevalence that were recently published. The preventive measures and regulations available in Europe were also reviewed. MEDLINE-PubMed, GoPubMed, and Embase were consulted for the literature review. Results. The Bolivian immigrant population has the highest prevalence of Chagas carriers (6.7%–25% compared to the overall Latin American population (1.3%–2.4%. Only in Spain, France, Belgium, UK, Portugal, Italy, Switzerland, The Netherlands, and Germany, preventive measures are applied to this population. The established regulations are insufficient and completely different criteria are applied in the different countries and this could reflect a certain degree of stigmatization.

  11. Trypanocide treatment of women infected with Trypanosoma cruzi and its effect on preventing congenital Chagas.

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    Fabbro, Diana L; Danesi, Emmaria; Olivera, Veronica; Codebó, Maria Olenka; Denner, Susana; Heredia, Cecilia; Streiger, Mirtha; Sosa-Estani, Sergio

    2014-11-01

    With the control of the vectorial and transfusional routes of infection with Trypanosoma cruzi, congenital transmission has become an important source of new cases. This study evaluated the efficacy of trypanocidal therapy to prevent congenital Chagas disease and compared the clinical and serological evolution between treated and untreated infected mothers. We conducted a multicenter, observational study on a cohort of mothers infected with T. cruzi, with and without trypanocidal treatment before pregnancy. Their children were studied to detect congenital infection. Among 354 "chronically infected mother-biological child" pairs, 132 were treated women and 222 were untreated women. Among the children born to untreated women, we detected 34 infected with T. cruzi (15.3%), whose only antecedent was maternal infection. Among the 132 children of previously treated women, no infection with T. cruzi was found (0.0%) (pChagas infection was effective in preventing the congenital transmission of Trypanosoma cruzi to their children; it had also a protective effect on the women's clinical evolution and deparasitation could be demonstrated in many treated women after over 10 years of follow up.

  12. Usefulness of serology for the evaluation of Trypanosoma cruzi transmission in endemic areas of Chagas' disease

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    Roberto Chuit

    1989-09-01

    Full Text Available Thirteen communities from 7 Argentinian provinces were selected for the evaluation of serology as an indicator of transmission of Chagas disease. Of the communities appraised, 6 did not have a history of previous treatment with insecticides and 7 had received sporadic or continuous insecticide treatment. The inhabitants of 20% of the houses of each locality were studied by serology. The samples were obtained byfinger pricking and 50 fil of blood were mixed with 150μl of 50% glycerine solution in tissue culture media to be assayed by Indirect Hemagglutination and Indirect Immunofluorescence tests. In untreated areas, the prevalence of infection in infants 0-4 years old was 17.5%, reaching to over 22% for the 5-9 year old group, and to 33.3% in 10-14 year old individuals. The prevalence in treated and surveyed areas was 2.6% in 0-4 year old children, 5.4% in 5-9 year old and 6,2% in 10-14 year old youngsters. The differences between both areas were statistically significant (p < 0.005. This study favors serology as a valid indicator for the evaluation of transmission of Chagas disease in rural areas.

  13. Parasite prolyl oligopeptidases and the challenge of designing chemotherapeuticals for Chagas disease, leishmaniasis and African trypanosomiasis.

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    Bastos, I M D; Motta, F N; Grellier, P; Santana, J M

    2013-01-01

    The trypanosomatids Trypanosoma cruzi, Leishmania spp. and Trypanosoma brucei spp. cause Chagas disease, leishmaniasis and human African trypanosomiasis, respectively. It is estimated that over 10 million people worldwide suffer from these neglected diseases, posing enormous social and economic problems in endemic areas. There are no vaccines to prevent these infections and chemotherapies are not adequate. This picture indicates that new chemotherapeutic agents must be developed to treat these illnesses. For this purpose, understanding the biology of the pathogenic trypanosomatid- host cell interface is fundamental for molecular and functional characterization of virulence factors that may be used as targets for the development of inhibitors to be used for effective chemotherapy. In this context, it is well known that proteases have crucial functions for both metabolism and infectivity of pathogens and are thus potential drug targets. In this regard, prolyl oligopeptidase and oligopeptidase B, both members of the S9 serine protease family, have been shown to play important roles in the interactions of pathogenic protozoa with their mammalian hosts and may thus be considered targets for drug design. This review aims to discuss structural and functional properties of these intriguing enzymes and their potential as targets for the development of drugs against Chagas disease, leishmaniasis and African trypanosomiasis.

  14. Mitigating social and health inequities: community participation and Chagas disease in rural Argentina.

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    Llovet, Ignacio; Dinardi, Graciela; De Maio, Fernando G

    2011-01-01

    Chagas disease (CD) causes 12,500 deaths annually in Latin America. As a neglected disease primarily associated with poverty, it is a major driver of health inequity. Argentina's efforts to control vector transmission have been unsuccessful. Using new survey data (n=400 households), we compare the social patterning of the burden of CD by examining socio-demographic predictors of self-reported CD and the presence of vinchucas in two areas of rural northern Argentina known to have experienced different interventions in surveillance and control. Our analyses suggest that Avellaneda, an area known for horizontal intervention strategies which nurture community participation is quite distinct from Silipica, an area which has experienced a vertical intervention strategy since 1990. Avellaneda has higher level of self-reported Chagas infection and lower level of vinchuca presence; Silipica has pronounced and statistically significant differences patterned by the head of household's level of educational attainment. A greater awareness of the disease and its transmission, along with community mobilisation and spraying, may bring about more self-reported CD and less vinchuca presence in Avellaneda than in Silipica. This suggests that strategies based on community participation may be effective in reducing the social patterning of the burden of disease, even in poor places.

  15. Impact of Chagas Disease in Bolivian Immigrants Living in Europe and the Risk of Stigmatization

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    Ortí-Lucas, Rafael M.; Parada-Barba, María C.; de la Rubia-Ortí, José E.; Carrillo-Ruiz, Alejandra; Beso-Delgado, María; Boone, An L. D.

    2014-01-01

    Background. The prevalence of Chagas disease in endemic countries varies with the kind of vector involved and the socioeconomic conditions of the population of origin. Due to recent immigration it is an emerging public health problem in Europe, especially in those countries which receive immigrant populations with a high prevalence of carriers. The study reviews the impact of the disease on Bolivian immigrants living in Europe, the preventive measures and regulations applied in European countries, and their repercussion on possible stigmatization of certain population groups. Methods. The Bolivian immigrant population resident in 2012 was estimated and the affected population in different European countries was calculated with data on carrier prevalence that were recently published. The preventive measures and regulations available in Europe were also reviewed. MEDLINE-PubMed, GoPubMed, and Embase were consulted for the literature review. Results. The Bolivian immigrant population has the highest prevalence of Chagas carriers (6.7%–25%) compared to the overall Latin American population (1.3%–2.4%). Only in Spain, France, Belgium, UK, Portugal, Italy, Switzerland, The Netherlands, and Germany, preventive measures are applied to this population. The established regulations are insufficient and completely different criteria are applied in the different countries and this could reflect a certain degree of stigmatization. PMID:24719753

  16. Aptamer-based detection of disease biomarkers in mouse models for chagas drug discovery.

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    Fernanda Fortes de Araujo

    2015-01-01

    Full Text Available Drug discovery initiatives, aimed at Chagas treatment, have been hampered by the lack of standardized drug screening protocols and the absence of simple pre-clinical assays to evaluate treatment efficacy in animal models. In this study, we used a simple Enzyme Linked Aptamer (ELA assay to detect T. cruzi biomarker in blood and validate murine drug discovery models of Chagas disease. In two mice models, Apt-29 ELA assay demonstrated that biomarker levels were significantly higher in the infected group compared to the control group, and upon Benznidazole treatment, their levels reduced. However, biomarker levels in the infected treated group did not reduce to those seen in the non-infected treated group, with 100% of the mice above the assay cutoff, suggesting that parasitemia was reduced but cure was not achieved. The ELA assay was capable of detecting circulating biomarkers in mice infected with various strains of T. cruzi parasites. Our results showed that the ELA assay could detect residual parasitemia in treated mice by providing an overall picture of the infection in the host. They suggest that the ELA assay can be used in drug discovery applications to assess treatment efficacy in-vivo.

  17. Aptamer-based detection of disease biomarkers in mouse models for chagas drug discovery.

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    de Araujo, Fernanda Fortes; Nagarkatti, Rana; Gupta, Charu; Marino, Ana Paula; Debrabant, Alain

    2015-01-01

    Drug discovery initiatives, aimed at Chagas treatment, have been hampered by the lack of standardized drug screening protocols and the absence of simple pre-clinical assays to evaluate treatment efficacy in animal models. In this study, we used a simple Enzyme Linked Aptamer (ELA) assay to detect T. cruzi biomarker in blood and validate murine drug discovery models of Chagas disease. In two mice models, Apt-29 ELA assay demonstrated that biomarker levels were significantly higher in the infected group compared to the control group, and upon Benznidazole treatment, their levels reduced. However, biomarker levels in the infected treated group did not reduce to those seen in the non-infected treated group, with 100% of the mice above the assay cutoff, suggesting that parasitemia was reduced but cure was not achieved. The ELA assay was capable of detecting circulating biomarkers in mice infected with various strains of T. cruzi parasites. Our results showed that the ELA assay could detect residual parasitemia in treated mice by providing an overall picture of the infection in the host. They suggest that the ELA assay can be used in drug discovery applications to assess treatment efficacy in-vivo.

  18. Bibliometric assessment of the contributions of literature on Chagas disease in Latin America and the Caribbean.

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    Delgado-Osorio, Nathalia; Vera-Polania, Felipe; Lopez-Isaza, Andres F; Martinez-Pulgarin, Dayron F; Murillo-Abadia, Jonathan; Munoz-Urbano, Marcela; Cardona-Ospina, Jaime A; Bello, Ricardo; Lagos-Grisales, Guillermo J; Villegas-Rojas, Soraya; Rodriguez-Morales, Alfonso J

    2014-01-01

    Chagas disease, considered a parasitic neglected disease, is endemic in Latin America. Although, its mortality rate has decreased over time, it still represents a public health problem in the region. A bibliometric evaluation of the Latin American contributions on this disease was done. This study used SCI (1980-2013), MEDLINE/GOPUBMED (1802-2013), Scopus (1959-2013), SCIELO (2004-2013), and LILACS (1980-2013). Different study types have been characterized by years, origin city/country, journals and most productive authors, by country, cites and H-index. 2988 articles were retrieved from SCI (30.85% of total). Brazil was found to be the highest producer (31.22%), followed by Argentina (18.14%) and México (9.57%); the region received 47241 citations, 28.60% for Brazil (H-index=52), 18.26% of Argentina (Hindex= 43), 11.40% Bolivia (H-index=37). 4484 were retrieved from Scopus (30.20% of the total), 38.58% of which were from Brazil, 12.40% from Argentina and 8.90% from Mexico. From Medline, 6647 records were retrieved (45.58% Brazil). From SciELO, 917 articles (47.66% Brazil). From LILACS, 2165 articles (60.05% Brazil). Brazil has the highest output in the region. Despite advances in controlling Chagas disease, scientific production is low, particularly for regional bibliographic databases, which calls for more research on this disease.

  19. Rational spatio-temporal strategies for controlling a Chagas disease vector in urban environments.

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    Levy, Michael Z; Malaga Chavez, Fernando S; Cornejo Del Carpio, Juan G; Vilhena, Daril A; McKenzie, F Ellis; Plotkin, Joshua B

    2010-07-06

    The rational design of interventions is critical to controlling communicable diseases, especially in urban environments. In the case of the Chagas disease vector Triatoma infestans, successful control is stymied by the return of the insect after the effectiveness of the insecticide wanes. Here, we adapt a genetic algorithm, originally developed for the travelling salesman problem, to improve the spatio-temporal design of insecticide campaigns against T. infestans, in a complex urban environment. We find a strategy that reduces the expected instances of vector return 34-fold compared with the current strategy of sequential insecticide application to spatially contiguous communities. The relative success of alternative control strategies depends upon the duration of the effectiveness of the insecticide, and it shows chaotic fluctuations in response to unforeseen delays in a control campaign. We use simplified models to analyse the outcomes of qualitatively different spatio-temporal strategies. Our results provide a detailed procedure to improve control efforts for an urban Chagas disease vector, as well as general guidelines for improving the design of interventions against other disease agents in complex environments.

  20. Chronic Chagas cardiopathy in Chile. Importance of Trypanosoma cruzi burden and clinical evaluation.

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    Apt, Werner; Arribada, Arturo; Zulantay, Inés; Saavedra, Miguel; Muñoz, Catalina; Toro, Bruno; Vega, Bastián; Rodríguez, Jorge

    2016-10-01

    Currently there are no biological markers to indicate which individuals with chronic indeterminate period of Chagas disease develop heart disease and who will remain all his life in this phase. The aim of this survey was to determine if Trypanosoma cruzi burden is related to the presence of heart disease in patients with chronic Chagas disease. 200 patients who had not been treated, 100 with cardiopathy and 100 without, groups A and B respectively, were submitted to clinical study and electrocardiogram, Echo-Doppler was performed for group A in which all important known causes of cardiopathy were discarded. In both groups xenodiagnosis, conventional PCR and quantitative PCR were undertaken. The 100 cardiopaths had 133 electrocardiographic alterations most of them in grade II of the New York Heart Association classification. 98 cardiopaths were classified in grade I by Echo-Doppler and only 2 cases were in grade III due to low ejection fraction. The difference in average parasitemia in patients of group A and B was not significant and no statistically differences were observed between average parasitemia of cardiopaths grade II versus grade I of NYHA. This results allow to characterize same clinical, electrocardiographical and parasitological features in chagasic cardiopaths of Chile.

  1. EFFECTS OF VITAMIN C SUPPLEMENTATION ON THE CHRONIC PHASE OF CHAGAS DISEASE

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    Ricardo Guimarães MARIM

    2015-06-01

    Full Text Available Introduction: In order to examine the effectiveness of vitamin C (ascorbic acid in combating the oxidative insult caused by Trypanosoma cruzi during the development of the chronic phase of Chagas disease, Swiss mice were infected intraperitoneally with 5.0 × 104 trypomastigotes of T. cruzi QM1strain. Methods: Mice were given supplements of two different doses of vitamin C for 180 days. Levels of lipid oxidation (as indicated by thiobarbituric acid reactive substances-TBARS, total peroxide, vitamin C, and reduced glutathione were measured in the plasma, TBARS, total peroxide and vitamin C were measured in the myocardium and histopathologic analysis was undertaken in heart, colon and skeletal muscle. Results: Animals that received a dose equivalent to 500 mg of vitamin C daily showed increased production of ROS in plasma and myocardium and a greater degree of inflammation and necrosis in skeletal muscles than those that received a lower dose or no vitamin C whatsoever. Conclusion: Although some research has shown the antioxidant effect of vitamin C, the results showed that animals subject to a 500 mg dose of vitamin C showed greater tissue damage in the chronic phase of Chagas disease, probably due to the paradoxical actions of the substance, which in this pathology, will have acted as a pro-oxidant or pro-inflammatory.

  2. Soro-epidemiologia da doença de Chagas em Santa Catarina

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    BR Schlemper Jr

    1983-12-01

    Full Text Available Em Santa Catarina, o Inquérito Sorológico Nacional para doença de Chagas (CNPq-SUCAM revelou positividade de 1,3% em cerca de 74.000 amostras de soro processadas pela reação de imunofluorescência indireta em papel de filtro, com 15 municípios apresentando prevalências de 5,4% a 41,3%. Na presente investigação, em 9 dos municípios com alta prevalência, foram obtidas amostras de sangue, por punção venosa, de 222 indivíduos dos quais 140 haviam sido sorologicamente positivos e 58 negativos no Inquérito Nacional. Em 24 outros indivíduos a reação foi executada pela primeira vez. Os testes sorológicos (imunofluorescência indireta, hemaglutinação indireta, aglutinação direta com e sem 2-mercaptoetanol e fixação do complemento realizados em 3 diferentes laboratórios evidenciaram 220 soros negativos e apenas 2 positivos. Dados epidenúológicos obtidos nas áreas trabalhadas confirmaram estes resultados negativos. Os resultados discordam daqueles encontrados pelo Inquérito Sorológico Nacional e confirmam a inexistência de focos domiciliares de transmissão da doença de Chagas em Santa Catarina.

  3. Morphological and Genetic Differentiation within the Southernmost Vector of Chagas Disease: Triatoma patagonica (Hemiptera – Reduviidae)

    Science.gov (United States)

    Pita, Sebastián; Calleros, Lucía; Crocco, Liliana; Panzera, Yanina; Rodríguez, Claudia S.; Panzera, Francisco

    2016-01-01

    The epidemiological importance of Chagas disease vectors largely depends on their spreading ability and adaptation to domestic habitats. Triatoma patagonica is a secondary vector of Chagas disease endemic of Argentina, and it has been found colonizing domiciles and most commonly peridomiciliary structures in several Argentine provinces and morphological variation along its distribution range have been described. To asses if population differentiation represents geographic variants or true biological species, multiple genetic and phenotypic approaches and laboratory cross-breeding were performed in T. patagonica peridomestic populations. Analyses of chromatic variation of forewings, their size and the content of C-heterochromatin on chromosomes revealed that populations are structured following a North-South latitudinal variation. Cytochrome c oxidase I mitochondrial gene (COI) nucleotide analysis showed a mean genetic distance of 5.2% between the most distant populations. The cross-breeding experiments suggest a partial reproductive isolation between some populations with 40% of couples not laying eggs and low hatching efficiency. Our findings reveal phenotypic and genetic variations that suggest an incipient differentiation processes among T. patagonica populations with a pronounced phenotypic and genetic divergence between the most distant populations. The population differentiation here reported is probably related to differential environmental conditions and it could reflect the occurrence of an incipient speciation process in T. patagonica. PMID:28005972

  4. Morphological and Genetic Differentiation within the Southernmost Vector of Chagas Disease: Triatoma patagonica (Hemiptera - Reduviidae).

    Science.gov (United States)

    Nattero, Julieta; Pita, Sebastián; Calleros, Lucía; Crocco, Liliana; Panzera, Yanina; Rodríguez, Claudia S; Panzera, Francisco

    2016-01-01

    The epidemiological importance of Chagas disease vectors largely depends on their spreading ability and adaptation to domestic habitats. Triatoma patagonica is a secondary vector of Chagas disease endemic of Argentina, and it has been found colonizing domiciles and most commonly peridomiciliary structures in several Argentine provinces and morphological variation along its distribution range have been described. To asses if population differentiation represents geographic variants or true biological species, multiple genetic and phenotypic approaches and laboratory cross-breeding were performed in T. patagonica peridomestic populations. Analyses of chromatic variation of forewings, their size and the content of C-heterochromatin on chromosomes revealed that populations are structured following a North-South latitudinal variation. Cytochrome c oxidase I mitochondrial gene (COI) nucleotide analysis showed a mean genetic distance of 5.2% between the most distant populations. The cross-breeding experiments suggest a partial reproductive isolation between some populations with 40% of couples not laying eggs and low hatching efficiency. Our findings reveal phenotypic and genetic variations that suggest an incipient differentiation processes among T. patagonica populations with a pronounced phenotypic and genetic divergence between the most distant populations. The population differentiation here reported is probably related to differential environmental conditions and it could reflect the occurrence of an incipient speciation process in T. patagonica.

  5. [Epidemiological status of Chagas disease in the endemic area from Region II of Antofagasta].

    Science.gov (United States)

    Cáceres, J; Burchard, L; Bahamonde, M I; Contreras, M C; García, A; Rojas, A; Schenone, H; Lorca, M

    1999-01-01

    During 1997 a seroepidemiological study on Chagas' disease was carried out in 18 localities of three provinces (Tocopilla, El Loa and Antofagasta) of Region II (20 degrees 56'-26 degrees South Lat.; 70 degrees 38'-67 degrees West Long.), in order to assess the impact of the control program against Triatoma infestans launched in 1988, based on insecticide spraying of dwellings. By means of ELISA and an indirect hemagglutination test for Chagas' disease blood samples from 1,034 children under 10 years of age were examined, arising a 0.5% (3 cases) positivity. Test resulted positive in 2 (0.9%) children from the locality of San Pedro de Atacama and 1 (0.4%) from Calama city, all in the age group 6-10 year-old. However, none of their dwellings were found infested with T. infestants. These results indicate that the control program has a good possibility to prevent new human infections. It is advisable to continue the seroepidemiological and entomological vigilance and remark the necessity of increasing the effort in the study of transmission through other routes, to adopt or reinforce the pertinent preventive measures.

  6. Do Brazilian scientific journals promote the adherence of Chagas disease researchers to international ethical principles?

    Science.gov (United States)

    Malafaia, Guilherme; Guilhem, Dirce; Talvani, André

    2013-01-01

    The ethical aspects of the Brazilian publications about human Chagas disease (CD) developed between 1996 and 2010 and the policy adopted by Brazilian medical journals were analyzed. Articles were selected on the SciELO Brazil data basis, and the evaluation of ethical aspects was based on the normative contents about ethics in research involving human experimentation according to the Brazilian resolution of the National Health Council no. 196/1996. The editorial policies of the section "Instructions to authors" were analyzed. In the period of 1996-2012, 58.9% of articles involving human Chagas disease did not refer to the fulfillment of the ethical aspects concerning research with human beings. In 80% of the journals, the requirements and confirmation of the information about ethical aspects in the studies of human CD were not observed. Although a failure in this type of service is still observed, awareness has been raised in federal agencies, educational institutions/research and publishing groups to standardize the procedures and ethical requirements for the Brazilian journals, reinforcing the fulfillment of the ethical parameters, according to the resolution of NHC no. 196/1996.

  7. Genetic variants in the chemokines and chemokine receptors in Chagas disease.

    Science.gov (United States)

    Flórez, Oscar; Martín, Javier; González, Clara Isabel

    2012-08-01

    Clinical symptoms of Chagas' disease occur in 30% of the individuals infected with Trypanosoma cruzi and are characterised by heart inflammation and dysfunction. Chemokines and chemokine receptors control the migration of leukocytes during the inflammatory process and are involved in the modulation of Th1 or Th2 responses. To determine their influence, we investigated the possible role of CCL5/RANTES and CXCL8/IL8 chemokines, and CCR2 and CCR5 chemokines receptors cluster gene polymorphisms with the development of chagasic cardiomyopathy. Our study included 260 Chagas seropositive individuals (asymptomatic, n=130; cardiomyopathic, n=130) from an endemic area of Colombia. Genotyping was performed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) and TaqMan SNP genotyping assay. We found statistically significant differences in the distribution of the CCR5 human haplogroup (HH)-A (p=0.027; OR=3.78, 95% CI=1.04-13.72). Moreover, we found that the CCR5-2733 G and CCR5-2554 T alleles are associated, respectively, with a reduced risk of susceptibility and severity to develop chagasic cardiomyopathy. No other associations were found to be significant for the other polymorphisms analysed in the CCR5, CCR2, CCL5/RANTES and CXCL8/IL8 genes. Our data suggest that the analysed chemokines and chemokine receptor genetic variants have a weak but important association with the development of chagasic cardiomyopathy in the population under study.

  8. Arylimidamide DB766, a Potential Chemotherapeutic Candidate for Chagas' Disease Treatment ▿

    Science.gov (United States)

    Batista, Denise da Gama Jaén; Batista, Marcos Meuser; Oliveira, Gabriel Melo de; Amaral, Patrícia Borges do; Lannes-Vieira, Joseli; Britto, Constança Carvalho; Junqueira, Angela; Lima, Marli Maria; Romanha, Alvaro José; Sales Junior, Policarpo Ademar; Stephens, Chad E.; Boykin, David W.; Soeiro, Maria de Nazaré Correia

    2010-01-01

    Chagas' disease, a neglected tropical illness for which current therapy is unsatisfactory, is caused by the intracellular parasite Trypanosoma cruzi. The goal of this work is to investigate the in vitro and in vivo effects of the arylimidamide (AIA) DB766 against T. cruzi. This arylimidamide exhibits strong trypanocidal activity and excellent selectivity for bloodstream trypomastigotes and intracellular amastigotes (Y strain), giving IC50s (drug concentrations that reduce 50% of the number of the treated parasites) of 60 and 25 nM, respectively. DB766 also exerts striking effects upon different parasite stocks, including those naturally resistant to benznidazole, and displays higher activity in vitro than the reference drugs. By fluorescent and transmission electron microscopy analyses, we found that this AIA localizes in DNA-enriched compartments and induces considerable damage to the mitochondria. DB766 effectively reduces the parasite load in the blood and cardiac tissue and presents efficacy similar to that of benznidazole in mouse models of T. cruzi infection employing the Y and Colombian strains, using oral and intraperitoneal doses of up to 100 mg/kg/day that were given after the establishment of parasite infection. This AIA ameliorates electrocardiographic alterations, reduces hepatic and heart lesions induced by the infection, and provides 90 to 100% protection against mortality, which is similar to that provided by benznidazole. Our data clearly show the trypanocidal efficacy of DB766, suggesting that this AIA may represent a new lead compound candidate to Chagas' disease treatment. PMID:20457822

  9. Serological survey for Chagas' disease in school children in the Rio de Janeiro State, Brazil

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    Walter B. Petana

    1976-04-01

    Full Text Available A serological survey for Chagas' disease was carried out in school children in the Rio de Janeiro State, a zone considered as non-endemic for the infection. A total of 168 schools in 20 municipalities have been visited and 13,254 blood samples were obtained. The blood eluates were screened by the indirect fluorescence test (IFT, and all positive samples were checked and confirmed in sera by the complement fixation test (CFT. AH serologically positive children were subject to a clinical scrutiny, and the houses where the children lived have been searched for triatomine bugs. Only in two municipalities, Magé and Araruama, there was a significant number of children found positive. The total number of reactive samples by IFT and CFT from 13,004 blood samples screened was 143 (1.00 per cent. No serious clinicai symptoms suggestive of Chagas' disease have been found in any of the positive children, and no triatomine bugs were discovered in the dwellings where the children lived. The overall small percentage of children with positive serology postulates that the infection is not a serious health problem in the area investigated. It is recommended, however, to carry out a more detailed study in Magé and Araruama to find the reason for the relatively high percentage of serologically positive children encountered in these two municipalities.

  10. The effect of Ageratum fastigiatum extract on Rhodnius nasutus, vector of Chagas disease

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    Bethânia A. Avelar-Freitas

    2013-04-01

    Full Text Available Control of Chagas disease is based on insecticide spraying in domiciles in order to exterminate triatomine populations. However, since the vectors differ in susceptibility to currently used insecticides, the screening of the toxic potential of Brazilian flora may identify new molecules lethal to triatomines. This study evaluated the toxicity of ethanolic extract of Ageratum fastigiatum (Gardner R.M. King & H. Rob., Asteraceae, on Rhodnius nasutus, a known vector of Chagas disease. Ethanolic extracts of the aerial parts of A. fastigiatum were prepared at 25 and 50 mg/mL concentrations, and 5 µL was applied to fifth-instar nymphs of R. nasutus (n=30. Controls included nymphs that were treated with 5 µL ethanol (n=30 or left untreated (n=30. The percentage of dead insects in each group was observed at 24, 48, 72, 96 and 120 h after application. The extracts of A. fastigiatum showed a mortality rate of about 37% and 77% after 120 h, at concentrations of 25 and 50 mg/mL, respectively. In control groups, the mortality rate remained under 7%. The extract of A. fastigiatum contains a coumarin, a molecule with recognized toxicity in insects, and which may be responsible for killing the triatomines.

  11. Sorologia positiva para sífilis, toxoplasmose e doença de Chagas em gestantes de primeira consulta em centros de saúde de área metropolitana, Brasil Positive sorology of syphilis, toxoplasmosis and Chagas' disease in pregnant women on their first visit to State Health Centes in a metropolitan area, Brazil

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    Adelaide José Vaz

    1990-10-01

    Full Text Available Alguns testes sorológicos têm sido utilizados para detectar, indiretamente, a presença de possíveis agentes etiológicos infecciosos durante a gestação, que sendo transmitidos ao feto, por via placentária, causam infecções congênitas com seqüelas leves ou graves e até morte fetal. Foram estudadas 481 gestantes, com idade média de 24,5 anos (de 14 a 46 anos, atendidas em primeira consulta nos Centros de Saúde, na Cidade de São Paulo, SP (Brasil no período de abril a outubro de 1988. Segundo o trimestre gestacional, 230 pacientes (47,8% estavam no primeiro trimestre; 203 (42,2% no 2º e 48 (10,0% no 3º. Das 474 pacientes que declararam algum tipo de renda mensal, 309 (65,2% pertenciam a familias com renda até 1 SMPC (salário mínimo per capita e somente 15 (3,2% pertenciam a famílias com renda superior a 3 SMPC, caracterizando o baixo nível econômico das gestantes. Das 481 pacientes 159 (33,1% eram nascidas no Estado de São Paulo e as 322 (66,9% restantes eram imigrantes procedentes de outros Estados, destacando-se Bahia (23,1%; Minas Gerais (11,4%; Paraná (7,5%; Paraíba (5,4% e Pernambuco(5,4%. Foram realizados testes imunodiagnósticos para sífilis, toxoplasmose e doença de Chagas. Foram observados resultados positivos para sífilis em 25 gestantes (5,2%. Para toxoplasmose, 157 (32,4% não tinham anticorpos em nível detectável e 67 (13,9% apresentaram títulos elevados, indicativos de infecção ativa, das quais em 6 (10,3% foram detectados anticorpos da classe IgM. Para doença de Chagas foram encontrados anticorpos específicos em 14 (2,9% gestantes, sendo que destas, 10 (71,4% eram procedentes da Bahia e Minas Gerais.The diagnosis of some infectious diseases contracted during pregnancy is very important, as these diseases can be transmitted to the fetus. Four hundred and eighty-one pregnant women were studied, of an average 24.5 years of age (from 14 to 46, during their first prenatal visit to the State of S

  12. Opportunities for improved chagas disease vector control based on knowledge, attitudes and practices of communities in the yucatan peninsula, Mexico.

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    Kathryn Rosecrans

    2014-03-01

    Full Text Available BACKGROUND: Chagas disease is a vector-borne parasitic disease of major public health importance. Current prevention efforts are based on triatomine vector control to reduce transmission to humans. Success of vector control interventions depends on their acceptability and value to affected communities. We aimed to identify opportunities for and barriers to improved vector control strategies in the Yucatan peninsula, Mexico. METHODOLOGY/PRINCIPAL FINDINGS: We employed a sequence of qualitative and quantitative research methods to investigate knowledge, attitudes and practices surrounding Chagas disease, triatomines and vector control in three rural communities. Our combined data show that community members are well aware of triatomines and are knowledgeable about their habits. However, most have a limited understanding of the transmission dynamics and clinical manifestations of Chagas disease. While triatomine control is not a priority for community members, they frequently use domestic insecticide products including insecticide spray, mosquito coils and plug-in repellents. Families spend about $32 US per year on these products. Alternative methods such as yard cleaning and window screens are perceived as desirable and potentially more effective. Screens are nonetheless described as unaffordable, in spite of a cost comparable to the average annual spending on insecticide products. CONCLUSION/SIGNIFICANCE: Further education campaigns and possibly financing schemes may lead families to redirect their current vector control spending from insecticide products to window screens. Also, synergism with mosquito control efforts should be further explored to motivate community involvement and ensure sustainability of Chagas disease vector control.

  13. SINDROME INTERMEDIO: UN PATRÓN TÍPICO DE INSUFICIENCIA RENAL AGUDA EN EL ANCIANO

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    Algranati L

    2004-01-01

    Full Text Available Acute renal failure is a frequent entity in the elderly. This is due on one hand to the structural and physiological changes of the aged kidney, and on the other hand to the exposure of this population to polypharmacy and their reduced capability to metabolize drugs. In the present report we present a case of a seventy year-old woman who developed acute renal failure secondary to severe dehydration with a clinical and laboratory pattern of intermediate syndrome: laboratory results compatible with parenchymal renal insufficiency (elevated urinary sodium, plasma urea and creatinine, but with a positive response to hydration. The main characteristics of the aged kidney that predispose to the development of an intermediate syndrome are: the vascular dysautonomy and reduced capability of sodium and water reabsorption. The intermediate syndrome is a typical pattern of pre-renal insufficiency in the elderly. RESUMEN: La insuficiencia renal aguda es frecuente en el anciano. Esto se debe por un lado a los cambios estructurales y funcionales propios del riñón senil, y por otro a la gran exposición que esta población tiene a la polifarmacia, y su reducida capacidad para metabolizar los medicamentos. En este reporte presentamos el caso de una mujer de 70 años que desarrolló una insuficiencia renal aguda secundaria a severa deshidratación, mostrando un patrón clínico y de laboratorio propio de un sindrome intermedio: laboratorios compatibles con una insuficiencia renal parenquimatosa (sodio urinario, uremia y creatininemia elevadas, pero con una respuesta favorable a la hidratación. Las principales características del riñón senil que predisponen al desarrollo del sindrome intermedio: son la disautonomía vascular y la reducida capacidad en la recuperación de sodio y agua El sindrome intermedio es un patrón típico de insuficiencia prerrenal en el anciano.

  14. Apendicite aguda: modelo experimental em coelhos Acute appendicitis: model experimental in rabbits

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    João EBRAM-NETO

    2000-04-01

    Full Text Available Com objetivo de estudar experimentalmente as diversas fases evolutivas da apendicite aguda, foram utilizados 60 coelhos (Oryctogalus cuniculus, fêmeas, da linhagem Nova Zelândia, com peso variando de 2510 a 3040 gramas. Os animais foram divididos em dois grupos denominados controle e experimento, e estes subdivididos em três subgrupos com períodos de observação de 12, 24 e 48 horas. No grupo experimento foi realizada a oclusão do lume apendicular por meio de sutura seromuscular circular a 8 cm da extremidade distal do apêndice cecal, com fio de polipropileno 4-0. No controle foi feita somente a simulação da cirurgia. Os aspectos macroscópicos (aumento do tamanho, necrose, perfuração, aderência e secreção na cavidade abdominal bem como os microscópicos do grupo experimento, evidenciaram uma progressão das alterações anatomopatológicas mostrando haver uma relação entre a intensidade dos achados histopatológicos e o tempo de observação. Conclui-se que o método utilizado causa apendicite aguda com alterações anatomopatológicas distintas, de acordo com a fase evolutiva da doença.The evolving phases of acute appendicitis were studied experimentally. Sixty female rabbits (Oryctogalus cuniculus of New Zealand lineage weighing about 2510 to 3040 g were divided in two groups: a control group and experimental group. The experimental group was divided into three subgroups for observation after 12, 24 and 48 hours of the operation, that consisted on a 4-0 polypropylene circular suture at 8 cm from the distal part of the cecal appendix. The control group was sham operated. The macroscopic exam (increase of the appendix volume, necrosis, perfuration, adherence and secretion in the abdominal cavity and the microscopic finding showed a progression in the anatomopathological alterations. There was a close relationship between the histopathological findings and time after the appendiceal obstruction. We conclude that the method

  15. Plasmaférese como modalidade terapêutica na pancreatite aguda por hipertrigliceridemia

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    Felipe Soares Castelliano Lucena de Castro

    2012-09-01

    Full Text Available Pancreatite aguda é uma condição inflamatória manifestada clinicamente por dor abdominal e níveis séricos elevados das enzimas pancreáticas. A hipertrigliceridemia é sua terceira causa mais comum. O presente relato teve por objetivo descrever um caso de pancreatite aguda por hipertrigliceridemia, cuja modalidade terapêutica utilizada foi a plasmaférese. Paciente, gênero feminino, 48 anos, apresentou-se ao hospital com queixa de "dor muito forte na barriga". Relatou início do quadro com náuseas, vômitos e dor abdominal do tipo queimação, iniciada em região epigástrica. Negou febre. Ao exame: obesa, orientada, taquipneica, normotensa, taquicárdica, normocorada, desidratada, afebril, anictérica, acianótica; abdome: distendido, ruídos hidroaéreos presentes, timpânico, doloroso difusamente, porém, principalmente em andar supramesocólico. Aos exames de admissão: triglicerídeo 10.932 mg/dL, colesterol 1.548 mg/dL, amilase 226 mg/dL, lípase 899 mg/dL. A tomografia computadorizada de abdome evidenciou pâncreas aumentado de volume (Balthazar E. Evoluiu com piora do estado geral, sendo encaminhada para o centro de terapia intensiva. Foi realizada plasmaférese sem intercorrências. No 14º dia, teve alta do centro de terapia intensiva indo para enfermaria de gastrenterologia, onde foi reiniciada dieta oral, com boa aceitação. Evoluiu bem, com alta hospitalar no 25º de internação. São necessários níveis elevados de triglicerídeos para causar pancreatite, sendo importante excluir causas mais comuns. A abordagem terapêutica utilizada foi importante para reduzir, rapidamente, a h