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Sample records for chagas heart disease

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

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    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.

  2. 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

  3. 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

    2016-07-01

    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

  4. Resveratrol Reverses Functional Chagas Heart Disease in Mice

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    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

  5. Chagas heart disease: pathophysiologic mechanisms, prognostic factors and risk stratification

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    Anis Rassi Jr

    2009-07-01

    Full Text Available Chagas heart disease (CHD results from infection with the protozoan parasite Trypanosoma cruzi and is the leading cause of infectious myocarditis worldwide. It poses a substantial public health burden due to high morbidity and mortality. CHD is also the most serious and frequent manifestation of chronic Chagas disease and appears in 20-40% of infected individuals between 10-30 years after the original acute infection. In recent decades, numerous clinical and experimental investigations have shown that a low-grade but incessant parasitism, along with an accompanying immunological response [either parasite-driven (most likely or autoimmune-mediated], plays an important role in producing myocardial damage in CHD. At the same time, primary neuronal damage and microvascular dysfunction have been described as ancillary pathogenic mechanisms. Conduction system disturbances, atrial and ventricular arrhythmias, congestive heart failure, systemic and pulmonary thromboembolism and sudden cardiac death are the most common clinical manifestations of chronic Chagas cardiomyopathy. Management of CHD aims to relieve symptoms, identify markers of unfavourable prognosis and treat those individuals at increased risk of disease progression or death. This article reviews the pathophysiology of myocardial damage, discusses the value of current risk stratification models and proposes an algorithm to guide mortality risk assessment and therapeutic decision-making in patients with CHD.

  6. Chagas Disease

    Science.gov (United States)

    Chagas disease is caused by a parasite. It is common in Latin America but not in the United States. ... nose, the bite wound or a cut. The disease can also spread through contaminated food, a blood ...

  7. Association of the Functional MICA-129 Polymorphism With the Severity of Chronic Chagas Heart Disease.

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    Ayo, Christiane Maria; Oliveira, Amanda Priscila de; Camargo, Ana Vitória da Silveira; Mattos, Cinara Cássia Brandão de; Bestetti, Reinaldo Bulgarelli; Mattos, Luiz Carlos de

    2015-10-15

    MICA-129 polymorphism affects the binding affinity of MICA molecules with the NKG2D receptor and influences effector cell function. The genotype met/met was associated with the severity of left ventricular systolic dysfunction (LVSD) in patients with chronic Chagas heart disease, while the val/val genotype was associated with the absence of LVSD.

  8. 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.

  9. 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.

  10. 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.

  11. Effects of Exercise Training on Heart Rate Variability in Chagas Heart Disease

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    Bruno Ramos Nascimento

    2014-09-01

    Full Text Available Background: Heart rate variability (HRV is a marker of autonomic dysfunction severity. The effects of physical training on HRV indexes in Chagas heart disease (CHD are not well established. Objective: To evaluate the changes in HRV indexes in response to physical training in CHD. Methods: Patients with CHD and left ventricular (LV dysfunction, physically inactive, were randomized either to the intervention (IG, N = 18 or control group (CG, N = 19. The IG participated in a 12-week exercise program consisting of 3 sessions/week. Results: Mean age was 49.5 ± 8 years, 59% males, mean LVEF was 36.3 ± 7.8%. Baseline HRV indexes were similar between groups. From baseline to follow-up, total power (TP: 1653 (IQ 625 - 3418 to 2794 (1617 - 4452 ms, p = 0.02 and very low frequency power: 586 (290 - 1565 to 815 (610 - 1425 ms, p = 0.047 increased in the IG, but not in the CG. The delta (post - pre HRV indexes were similar: SDNN 11.5 ± 30.0 vs. 3.7 ± 25.1 ms. p = 0.10; rMSSD 2 (6 - 17 vs. 1 (21 - 9 ms. p = 0.43; TP 943 (731 - 3130 vs. 1780 (921 - 2743 Hz. p = 0.46; low frequency power (LFP 1.0 (150 - 197 vs. 60 (111 - 146 Hz. p = 0.85; except for high frequency power, which tended to increase in the IG: 42 (133 - 92 vs. 79 (61 - 328 Hz. p = 0.08. Conclusion: In the studied population, the variation of HRV indexes was similar between the active and inactive groups. Clinical improvement with physical activity seems to be independent from autonomic dysfunction markers in CHD.

  12. Case-control study of factors associated with chronic Chagas heart disease in patients over 50 years of age

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    Silvana de Araújo Silva

    2007-11-01

    Full Text Available A case-control study on chronic Chagas heart disease (CCHD was carried out between 1997 and 2005. Ninety patients over 50 years of age were examined for factors related to (CCHD. Fourty-six patients (51.1% with Chagas heart disease (anomalous ECG were assigned to the case group and 44 (48.9% were included in the control group as carriers of undetermined forms of chronic disease. Social, demographic (age, gender, skin color, area of origin, epidemiological (permanence within an endemic zone, family history of Chagas heart disease or sudden death, physical strain, alcoholism, and smoking, and clinical (systemic hypertension variables were analyzed. The data set was assessed through single-variable and multivariate analysis. The two factors independently associated with heart disease were age - presence of heart disease being three times higher in patients over 60 years of age (odds ratio, OR: 2.89; confidence interval of 95%: 1.09-7.61 - and family history of Chagas heart disease (OR: 2.833, CI 95%: 1.11-7.23. Systemic hypertension and gender did not prove to hold any association with heart disease, as neither did skin color, but this variable showed low statistical power due to reduced sample size.

  13. Carvedilol Enhances the Antioxidant Effect of Vitamins E and C in Chronic Chagas Heart Disease

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    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

  14. Carvedilol Enhances the Antioxidant Effect of Vitamins E and C in Chronic Chagas Heart Disease

    International Nuclear Information System (INIS)

    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. Echocardiographic Parameters and Survival in Chagas Heart Disease with Severe Systolic Dysfunction

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    Rassi, Daniela do Carmo, E-mail: dani.rassi@hotmail.com [Faculdade de Medicina e Hospital das Clínicas da Universidade Federal de Goiás (UFG), Goiânia, GO (Brazil); Vieira, Marcelo Luiz Campos [Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP (Brazil); Arruda, Ana Lúcia Martins [Instituto de Radiologia da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP (Brazil); Hotta, Viviane Tiemi [Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP (Brazil); Furtado, Rogério Gomes; Rassi, Danilo Teixeira; Rassi, Salvador [Faculdade de Medicina e Hospital das Clínicas da Universidade Federal de Goiás (UFG), Goiânia, GO (Brazil)

    2014-03-15

    Echocardiography provides important information on the cardiac evaluation of patients with heart failure. The identification of echocardiographic parameters in severe Chagas heart disease would help implement treatment and assess prognosis. To correlate echocardiographic parameters with the endpoint cardiovascular mortality in patients with ejection fraction < 35%. Study with retrospective analysis of pre-specified echocardiographic parameters prospectively collected from 60 patients included in the Multicenter Randomized Trial of Cell Therapy in Patients with Heart Diseases (Estudo Multicêntrico Randomizado de Terapia Celular em Cardiopatias) - Chagas heart disease arm. The following parameters were collected: left ventricular systolic and diastolic diameters and volumes; ejection fraction; left atrial diameter; left atrial volume; indexed left atrial volume; systolic pulmonary artery pressure; integral of the aortic flow velocity; myocardial performance index; rate of increase of left ventricular pressure; isovolumic relaxation time; E, A, Em, Am and Sm wave velocities; E wave deceleration time; E/A and E/Em ratios; and mitral regurgitation. In the mean 24.18-month follow-up, 27 patients died. The mean ejection fraction was 26.6 ± 5.34%. In the multivariate analysis, the parameters ejection fraction (HR = 1.114; p = 0.3704), indexed left atrial volume (HR = 1.033; p < 0.0001) and E/Em ratio (HR = 0.95; p = 0.1261) were excluded. The indexed left atrial volume was an independent predictor in relation to the endpoint, and values > 70.71 mL/m{sup 2} were associated with a significant increase in mortality (log rank p < 0.0001). The indexed left atrial volume was the only independent predictor of mortality in this population of Chagasic patients with severe systolic dysfunction.

  16. Inhibition of autoimmune Chagas-like heart disease by bone marrow transplantation.

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    Maria C Guimaro

    2014-12-01

    Full Text Available Infection with the protozoan Trypanosoma cruzi manifests in mammals as Chagas heart disease. The treatment available for chagasic cardiomyopathy is unsatisfactory.To study the disease pathology and its inhibition, we employed a syngeneic chicken model refractory to T. cruzi in which chickens hatched from T. cruzi inoculated eggs retained parasite kDNA (1.4 kb minicircles. Southern blotting with EcoRI genomic DNA digests revealed main 18 and 20 kb bands by hybridization with a radiolabeled minicircle sequence. Breeding these chickens generated kDNA-mutated F1, F2, and F3 progeny. A targeted-primer TAIL-PCR (tpTAIL-PCR technique was employed to detect the kDNA integrations. Histocompatible reporter heart grafts were used to detect ongoing inflammatory cardiomyopathy in kDNA-mutated chickens. Fluorochromes were used to label bone marrow CD3+, CD28+, and CD45+ precursors of the thymus-dependent CD8α+ and CD8β+ effector cells that expressed TCRγδ, vβ1 and vβ2 receptors, which infiltrated the adult hearts and the reporter heart grafts.Genome modifications in kDNA-mutated chickens can be associated with disruption of immune tolerance to compatible heart grafts and with rejection of the adult host's heart and reporter graft, as well as tissue destruction by effector lymphocytes. Autoimmune heart rejection was largely observed in chickens with kDNA mutations in retrotransposons and in coding genes with roles in cell structure, metabolism, growth, and differentiation. Moreover, killing the sick kDNA-mutated bone marrow cells with cytostatic and anti-folate drugs and transplanting healthy marrow cells inhibited heart rejection. We report here for the first time that healthy bone marrow cells inhibited heart pathology in kDNA+ chickens and thus prevented the genetically driven clinical manifestations of the disease.

  17. Chronic Chagas' heart disease: a disease on its way to becoming a worldwide health problem: epidemiology, etiopathology, treatment, pathogenesis and laboratory medicine.

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    Muñoz-Saravia, Silvia Gilka; Haberland, Annekathrin; Wallukat, Gerd; Schimke, Ingolf

    2012-01-01

    Chagas' disease, caused by Trypanosoma cruzi infection, is ranked as the most serious parasitic disease in Latin America. Nearly 30% of infected patients develop life-threatening complications, and with a latency of 10-30 years, mostly Chagas' heart disease which is currently the major cause of morbidity and mortality in Latin America, enormously burdening economic resources and dramatically affecting patients' social and labor situations. Because of increasing migration, international tourism and parasite transfer by blood contact, intrauterine transfer and organ transplantation, Chagas' heart disease could potentially become a worldwide problem. To raise awareness of this problem, we reflect on the epidemiology and etiopathology of Chagas' disease, particularly Chagas' heart disease. To counteract Chagas' heart disease, in addition to the general interruption of the infection cycle and chemotherapeutic elimination of the infection agent, early and effective causal or symptomatic therapies would be indispensable. Prerequisites for this are improved knowledge of the pathogenesis and optimized patient management. From economic and logistics viewpoints, this last prerequisite should be performed using laboratory medicine tools. Consequently, we first summarize the mechanisms that have been suggested as driving Chagas' heart disease, mainly those associated with the presence of autoantibodies against G-protein-coupled receptors; secondly, we indicate new treatment strategies involving autoantibody apheresis and in vivo autoantibody neutralization; thirdly, we present laboratory medicine tools such as autoantibody estimation and heart marker measurement, proposed for diagnosis, risk assessment and patient guidance and lastly, we critically reflect upon the increase in inflammation and oxidative stress markers in Chagas' heart disease.

  18. The potential influence of atherogenic dyslipidemia on the severity of chronic Chagas heart disease

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    Luz Peverengo

    2016-02-01

    Full Text Available SUMMARY Introduction: chronic Chagas heart disease (CCHD is the most common manifestation of American Trypanosomiasis, causing about 50,000 deaths annually. Several factors bear correlation with the severity of CCHD. However, to our knowledge, the assessment on the contribution of major cardiovascular risk factors (CRF, such as hypertension and atherogenic dyslipidemia (AD to CCHD severity is scarce, despite their well-established role in coronary artery disease, heart failure and stroke. Objective: to explore the potential relationship of blood pressure and AD with the clinical profile of patients with CCHD. Methods: we performed a cross-sectional study in T. cruziseropositive patients categorized according to a standard CCHD classification. All individuals were subjected to complete clinical examination. Autoantibodies induced by T. cruzi were assessed by ELISA. Results: we observed that Atherogenic index (AI levels rose significantly in relation to the severity of the CCHD stage, with CCHD III cases showing the highest values of AI. Furthermore, those patients with globally dilated cardiomyopathy with reduced ejection fraction showed higher levels of AI. In regard to autoantibodies, anti-B13 also showed relation with the severity of the disease. Conclusion: we observed that AI correlated with CCHD stages and contributed, in association with anti-B13 antibodies and age, to the prediction of systolic heart failure.

  19. 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.

  20. Chagas disease

    Science.gov (United States)

    Insect control with insecticides and houses that are less likely to have high insect populations will help control the spread of the disease. Blood banks in Central and South America screen donors for ...

  1. Prevalence of Cardiac Arrhythmias During and After Pregnancy in Women with Chagas' Disease without Apparent Heart Disease

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    Achá Renato Enrique Sologuren

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate cardiac arrhythmias during and after pregnancy in women with Chagas' disease without apparent heart disease using dynamic electrocardiography. METHODS: Twenty pregnant women with Chagas' disease without apparent heart disease aged 19 to 42 years (26.96 ± 3.6 and a control group of 20 non-chagasic pregnant patients aged 16 to 34 years (22.5 ± 4.8. The patients were submitted to passive hemagglutination and indirect immunofluorescence for the detection of Trypanosoma cruzi evaluation, and electrocardiography, echocardiography and 24-h dynamic electrocardiography. RESULTS: Supraventricular premature depolarizations were observed in 18 (90% patients and ventricular premature depolarization in 11 (55% patients of both groups during pregnancy. After delivery, supraventricular premature depolarizations were present in 13 (60% chagasic patients and in 16 (89.4% control patients (P<=0.05. Ventricular premature depolarization were observed in 9 (45% chagasic patients and 11 (57.8% control patients. CONCLUSION: The prevalence of ventricular premature depolarization was similar for the chagasic and control groups during and after pregnancy. The incidence of supraventricular premature depolarizations was similar in the two groups during pregnancy, while after delivery a predominance was observed in the control group compared to the chagasic group.

  2. Cardiac Repolarization Abnormalities and Potential Evidence for Loss of Cardiac Sodium Currents on ECGs of Patients with Chagas' Heart Disease

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    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

  3. 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.

  4. Chagas disease in prehistory

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    Luiz F. Ferreira

    2011-09-01

    Full Text Available The classical hypothesis proposes that Chagas disease has been originated in the Andean region among prehistoric people when they started domesticating animals, changing to sedentary habits, and adopting agriculture. These changes in their way of life happened nearly 6,000 years ago. However, paleoparasitological data based on molecular tools showed that Trypanosoma cruzi infection and Chagas disease were commonly found both in South and North American prehistoric populations long before that time, suggesting that Chagas disease may be as old as the human presence in the American continent. The study of the origin and dispersion of Trypanosoma cruzi infection among prehistoric human populations may help in the comprehension of the clinical and epidemiological questions on Chagas disease that still remain unanswered.A hipótese clássica sobre a origem da doença de Chagas propõe que tenha surgido entre as populações pré-históricas dos Andes quando começaram a domesticar animais, mudaram para hábitos sedentários e adotaram a agricultura. Estas mudanças em seus hábitos de vida aconteceram há aproximadamente 6.000 anos. Entretanto, os dados da paleoparasitologia, baseados na biologia molecular, mostraram que a infecção por Trypanosoma cruzi e a doença de Chagas eram comuns tanto em populações pré-históricas da América do Sul e América do Norte muito antes deste período. De acordo com os dados paleoparasitológicos, a doença de Chagas pode ser tão antiga quanto a presença humana no continente americano. O estudo sobre a origem e dispersão da infecção por Trypanosoma cruzi entre populações humanas pré-históricas pode auxiliar na compreensão de questões clínicas e epidemiológicas sobre a doença de Chagas que ainda permanecem sem resposta.

  5. Chagas Disease, France

    OpenAIRE

    Lescure, François-Xavier; Canestri, Ana; Melliez, Hugues; Jauréguiberry, Stéphane; Develoux, Michel; Dorent, Richard; Guiard-Schmid, Jean-Baptiste; Bonnard, Philippe; Ajana, Faïza; Rolla, Valeria; Carlier, Yves; Gay, Frederick; Elghouzzi, Marie-Hélène; Danis, Martin; Pialoux, Gilles

    2008-01-01

    Chagas disease (CD) is endemic to Latin America; its prevalence is highest in Bolivia. CD is sometimes seen in the United States and Canada among migrants from Latin America, whereas it is rare in Europe. We report 9 cases of imported CD in France from 2004 to 2006.

  6. Treatment Patterns and their Relation to the Diagnosis of Chagas Disease in Patients with Heart Failure, 2001-2011: Bogotá, Colombia

    Directory of Open Access Journals (Sweden)

    Micah Rae Pepper

    2013-03-01

    Full Text Available Introduction Chagas (CH disease, found throughout Latin America, is caused by the parasite Trypanosoma cruzi. Heart failure is a common (i.e. 10-30% late outcome for people who develop symptomatic Chagas disease. Studies show that patients with Chagasic heart failure have a worse prognosis than patients with heart failure from other aetiologies. As most people living with CH are from lower socioeconomic backgrounds where access to quality medical care can be limited, the study investigated the equality of patient care between Chagas and non-Chagas heart failure patients in La Fundación Cardioinfantil (FCI, Bogotá, Colombia. Methods The study was a retrospective cohort study, compiling data from medical files of patients hospitalized for heart failure between 2001-2011. Each CH patient (n=41 was matched with 1-2 comparable non-Chagas (no-CH patients (n=77. Results/Projected Outcomes At the FCI, no differences were observed between care given to CH and no-CH patients, concluding that patients with CH receive a similar standard of care to patients with no-CH. Because this report is not inclusive of other health institutions in Colombia, the FCI is recommended as a model institution for equal patient treatment.

  7. Relationship between Fibrosis and Ventricular Arrhythmias in Chagas Heart Disease Without Ventricular Dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    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.

  8. Cell Therapy in Chagas Disease

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    Antonio C. Campos de Carvalho

    2009-01-01

    Full Text Available Chagas disease which is caused by the parasite Trypanosoma cruzi is an important cause of cardiomyopathy in Latin America. In later stages chagasic cardiomyopathy is associated with congestive heart failure which is often refractory to medical therapy. In these individuals heart transplantation has been attempted. However, this procedure is fraught with many problems attributable to the surgery and the postsurgical administration of immunosuppressive drugs. Studies in mice suggest that the transplantation of bone-marrow-derived cells ameliorates the inflammation and fibrosis in the heart associated with this infection. Cardiac magnetic resonance imaging reveals that bone marrow transplantation ameliorates the infection induced right ventricular enlargement. On the basis of these animal studies the safety of autologous bone marrow transplantation has been assessed in patients with chagasic end-stage heart disease. The initial results are encouraging and more studies need to be performed.

  9. 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.

  10. Chagas' disease and AIDS

    OpenAIRE

    Vaidian, Anil K; Louis M Weiss; Tanowitz, Herbert B.

    2004-01-01

    Chagas' disease caused by Trypanosoma cruzi is an opportunistic infection in the setting of HIV/AIDS. Some individuals with HIV and chronic T. cruzi infection may experience a reactivation, which is most commonly manifested by meningoencephalitis. A reactivation myocarditis is the second most common manifestation. These presentations may be difficult to distinguish from toxoplasmosis in individuals with HIV/AIDS. The overlap of HIV and Trypanosoma cruzi infection occurs not only in endemic ar...

  11. Chagas Disease Cardiomyopathy: Immunopathology and Genetics

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    Edecio Cunha-Neto

    2014-01-01

    Full Text Available Chagas disease, caused by the protozoan Trypanosoma cruzi, is endemic in Latin America and affects ca. 10 million people worldwide. About 30% of Chagas disease patients develop chronic Chagas disease cardiomyopathy (CCC, a particularly lethal inflammatory cardiomyopathy that occurs decades after the initial infection, while most patients remain asymptomatic. Mortality rate is higher than that of noninflammatory cardiomyopathy. CCC heart lesions present a Th1 T-cell-rich myocarditis, with cardiomyocyte hypertrophy and prominent fibrosis. Data suggest that the myocarditis plays a major pathogenetic role in disease progression. Major unmet goals include the thorough understanding of disease pathogenesis and therapeutic targets and identification of prognostic genetic factors. Chagas disease thus remains a neglected disease, with no vaccines or antiparasitic drugs proven efficient in chronically infected adults, when most patients are diagnosed. Both familial aggregation of CCC cases and the fact that only 30% of infected patients develop CCC suggest there might be a genetic component to disease susceptibility. Moreover, previous case-control studies have identified some genes associated to human susceptibility to CCC. In this paper, we will review the immunopathogenesis and genetics of Chagas disease, highlighting studies that shed light on the differential progression of Chagas disease patients to CCC.

  12. Control of Chagas disease vectors

    OpenAIRE

    JM Ramsey; CJ Schofield

    2003-01-01

    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 di...

  13. Morbidity of Chagas heart disease in the microregion of Rio Negro, Amazonian Brazil: a case-control study

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    Jose Rodrigues Coura

    2013-12-01

    Full Text Available A case-control study on the morbidity of Chagas heart disease was carried out in the municipality of Barcelos in the microregion of the Rio Negro, state of Amazonas. One hundred and six individuals, who were serologically positive for Trypanosoma cruzi infection, as confirmed by at least two techniques with different principles, were matched according to age and sex with an equal number of seronegative individuals. The cases and controls were evaluated using an epidemiological questionnaire and clinical, electrocardiograph and echocardiograph examinations. In the seroepidemiological evaluation, 62% of the interviewees recognised triatomines and most of them confirmed that they had seen these insects in the piassava plantations of the riverside communities of the Negro River tributaries. Of the seropositive patients, 25.8% affirmed that they had been stung by the triatomines and 11.7% denied having been stung. The principal clinical manifestations of the seropositive individuals were palpitations, chest pain and dyspnoea upon effort. Cardiac auscultation revealed extrasystoles, bradycardia and systolic murmurs. The electrocardiographic alterations were ventricular extrasystoles, left and right bundle branch block, atrioventricular block and primary T wave alterations. The echocardiogram was altered in 22.6% of the seropositive individuals and in 8.5% of the seronegative individuals.

  14. Control of Chagas disease vectors

    Directory of Open Access Journals (Sweden)

    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.

  15. 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.

  16. Prophylactic and therapeutic DNA vaccines against Chagas disease

    OpenAIRE

    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-lik...

  17. Disfunção endotelial venosa em pacientes com doença de Chagas sem insuficiência cardíaca Venous endothelial dysfunction in Chagas' disease patients without heart failure

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    Rodrigo Della Méa Plentz

    2006-06-01

    Full Text Available OBJETIVO: Analisar a função endotelial venosa em pacientes chagásicos sem insuficiência cardíaca. MÉTODOS: O grupo Chagas (G1 foi composto por quatorze mulheres e dois homens com idade de 46 ± 2,7 anos, e o grupo controle (G0, por sete mulheres e um homem, pareados em idade, peso, altura. A Técnica de Complacência da Veia Dorsal da Mão foi utilizada para avaliação da função endotelial venosa. Foram infundidas doses crescentes de fenilefrina para se obter pré-constrição de 70% do basal; a seguir, foram administradas acetilcolina e nitroprussiato de sódio para avaliar as respostas de venodilatação, respectivamente, dependentes e independentes do endotélio. RESULTADOS: Não houve variação entre os valores hemodinâmicos nos grupos durante o experimento. A dose média de fenilefrina necessária para pré-constrição da veia foi significativamente maior no G1 (1116 ± 668,2 ng/ml, comparada à do G0 (103 ± 28 ng/ml p = 0,05. A resposta de venodilatação máxima dependente do endotélio foi significativamente menor no grupo G1 (65,5 ± 8%, comparada à do G0 (137 ± 20 % p = 0,009. Não houve diferença nas respostas de venodilatação independente do endotélio entre os grupos. CONCLUSÃO: Pacientes com doença de Chagas sem insuficiência cardíaca apresentam disfunção endotelial venosa.OBJECTIVE: To analyze the venous endothelial function in Chagas' disease patients without heart failure. METHODS: The Chagas' disease Group (G1 was composed by 14 women and 2 men aged 46 ± 2,7 and the Control Group (G0 by 7 women and 1 man matched by age, weight and height. Dorsal Hand Vein Compliance Technique was used to evaluate the venous endothelial function. Crescent doses of phenylephrine were infused to get a 70% pre-constriction of the vein; after that, acetylcholine and sodium nitroprusside were respectively administrated to analyze the endothelium-dependent and -independent venodilation. RESULTS: No significant systemic

  18. 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.

  19. Update on Chagas' disease in Mexico

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    Dumonteil Eric

    1999-01-01

    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.

  20. Transplante cardíaco (TC: a experiência do portador da doença de Chagas Trasplante cardíaco (TC: la experiencia del portador de la enfermedad de Chagas Heart transplantation: the experience of patients with Chagas disease

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    Maria Lúcia Araújo Sadala

    2009-09-01

    ógicos abarcaron: la selección de los pacientes; las entrevistas; el análisis de los datos, indicando las unidades de significado y el análisis individual; la búsqueda de convergencias de los discursos; el análisis hermenéutico de las convergencias. Del análisis de los datos emergieron los siguientes temas: el tiempo vivido por el receptor, portador de la Enfermedad de Chagas; la concepción del TC que tiene el portador de Chagas; el cuidado en la trayectoria del TC.Successful heart transplantation in patients with Chagas disease depends on special care to be provided during all phases of the transplantation process, and requires specific and rigorous follow-up by the health care team. Recipients must be aware of the permanence of the trypanosome in their organisms as well as of the possibility of infection reactivation after transplantation. Therefore, the patient's knowledge regarding this condition and his active participation in his own treatment are of utmost importance. This study aimed at investigating heart transplantation as experienced by patients with Chagas disease, seeking to understand the meanings that they attribute to such an experience. The methodological procedures included: patient selection; interviews; data analysis, indication of the meaning units and individual analysis; search for discourse convergence; and hermeneutic analysis of convergences. From the data analysis, the following themes emerged: the time lived by recipients with Chagas Disease; the conception of heart transplantation presented by patients with Chagas Disease; and care in the course of heart transplantation.

  1. Heart Disease

    Science.gov (United States)

    ... Got Homework? Here's Help White House Lunch Recipes Heart Disease KidsHealth > For Kids > Heart Disease Print A A ... chest pain, heart attacks, and strokes . What Is Heart Disease? The heart is the center of the cardiovascular ...

  2. Inhibitory Receptors Are Expressed by Trypanosoma cruzi-Specific Effector T Cells and in Hearts of Subjects with Chronic Chagas Disease

    Science.gov (United States)

    Argüello, Rafael J.; Albareda, María C.; Alvarez, María G.; Bertocchi, Graciela; Armenti, Alejandro H.; Vigliano, Carlos; Meckert, Patricia C.; Tarleton, Rick L.; Laucella, Susana A.

    2012-01-01

    We had formerly demonstrated that subjects chronically infected with Trypanosoma cruzi show impaired T cell responses closely linked with a process of T cell exhaustion. Recently, the expression of several inhibitory receptors has been associated with T cell dysfunction and exhaustion. In this study, we have examined the expression of the cytotoxic T lymphocyte antigen 4 (CTLA-4) and the leukocyte immunoglobulin like receptor 1 (LIR-1) by peripheral T. cruzi antigen-responsive IFN-gamma (IFN-γ)-producing and total T cells from chronically T. cruzi-infected subjects with different clinical forms of the disease. CTAL-4 expression was also evaluated in heart tissue sections from subjects with severe myocarditis. The majority of IFN-γ-producing CD4+ T cells responsive to a parasite lysate preparation were found to express CTLA-4 but considerably lower frequencies express LIR-1, irrespective of the clinical status of the donor. Conversely, few IFN-γ-producing T cells responsive to tetanus and diphtheria toxoids expressed CTLA-4 and LIR-1. Polyclonal stimulation with anti-CD3 antibodies induced higher frequencies of CD4+CTAL-4+ T cells in patients with severe heart disease than in asymptomatic subjects. Ligation of CTLA-4 and LIR-1 with their agonistic antibodies, in vitro, reduces IFN-γ production. Conversely, CTLA-4 blockade did not improved IFN-γ production in response to T. cruzi antigens. Subjects with chronic T. cruzi infection had increased numbers of CD4+LIR-1+ among total peripheral blood mononuclear cells, relative to uninfected individuals and these numbers decreased after treatment with benznidazole. CTLA-4 was also expressed by CD3+ T lymphocytes infiltrating heart tissues from chronically infected subjects with severe myocarditis. These findings support the conclusion that persistent infection with T. cruzi leads to the upregulation of inhibitory receptors which could alter parasite specific T cell responses in the chronic phase of Chagas disease. PMID

  3. Inhibitory receptors are expressed by Trypanosoma cruzi-specific effector T cells and in hearts of subjects with chronic Chagas disease.

    Directory of Open Access Journals (Sweden)

    Rafael J Argüello

    Full Text Available We had formerly demonstrated that subjects chronically infected with Trypanosoma cruzi show impaired T cell responses closely linked with a process of T cell exhaustion. Recently, the expression of several inhibitory receptors has been associated with T cell dysfunction and exhaustion. In this study, we have examined the expression of the cytotoxic T lymphocyte antigen 4 (CTLA-4 and the leukocyte immunoglobulin like receptor 1 (LIR-1 by peripheral T. cruzi antigen-responsive IFN-gamma (IFN-γ-producing and total T cells from chronically T. cruzi-infected subjects with different clinical forms of the disease. CTAL-4 expression was also evaluated in heart tissue sections from subjects with severe myocarditis. The majority of IFN-γ-producing CD4(+ T cells responsive to a parasite lysate preparation were found to express CTLA-4 but considerably lower frequencies express LIR-1, irrespective of the clinical status of the donor. Conversely, few IFN-γ-producing T cells responsive to tetanus and diphtheria toxoids expressed CTLA-4 and LIR-1. Polyclonal stimulation with anti-CD3 antibodies induced higher frequencies of CD4(+CTAL-4(+ T cells in patients with severe heart disease than in asymptomatic subjects. Ligation of CTLA-4 and LIR-1 with their agonistic antibodies, in vitro, reduces IFN-γ production. Conversely, CTLA-4 blockade did not improved IFN-γ production in response to T. cruzi antigens. Subjects with chronic T. cruzi infection had increased numbers of CD4(+LIR-1(+ among total peripheral blood mononuclear cells, relative to uninfected individuals and these numbers decreased after treatment with benznidazole. CTLA-4 was also expressed by CD3(+ T lymphocytes infiltrating heart tissues from chronically infected subjects with severe myocarditis. These findings support the conclusion that persistent infection with T. cruzi leads to the upregulation of inhibitory receptors which could alter parasite specific T cell responses in the chronic phase

  4. Immunosuppression and Chagas disease: a management challenge.

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    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

  5. 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.

  6. Current drug therapy and pharmaceutical challenges for Chagas disease.

    Science.gov (United States)

    Bermudez, José; Davies, Carolina; Simonazzi, Analía; Real, Juan Pablo; Palma, Santiago

    2016-04-01

    One of the most significant health problems in the American continent in terms of human health, and socioeconomic impact is Chagas disease, caused by the protozoan parasite Trypanosoma cruzi. Infection was originally transmitted by reduviid insects, congenitally from mother to fetus, and by oral ingestion in sylvatic/rural environments, but blood transfusions, organ transplants, laboratory accidents, and sharing of contaminated syringes also contribute to modern day transmission. Likewise, Chagas disease used to be endemic from Northern Mexico to Argentina, but migrations have earned it global. The parasite has a complex life cycle, infecting different species, and invading a variety of cells - including muscle and nerve cells of the heart and gastrointestinal tract - in the mammalian host. Human infection outcome is a potentially fatal cardiomyopathy, and gastrointestinal tract lesions. In absence of a vaccine, vector control and treatment of patients are the only tools to control the disease. Unfortunately, the only drugs now available for Chagas' disease, Nifurtimox and Benznidazole, are relatively toxic for adult patients, and require prolonged administration. Benznidazole is the first choice for Chagas disease treatment due to its lower side effects than Nifurtimox. However, different strategies are being sought to overcome Benznidazole's toxicity including shorter or intermittent administration schedules-either alone or in combination with other drugs. In addition, a long list of compounds has shown trypanocidal activity, ranging from natural products to specially designed molecules, re-purposing drugs commercialized to treat other maladies, and homeopathy. In the present review, we will briefly summarize the upturns of current treatment of Chagas disease, discuss the increment on research and scientific publications about this topic, and give an overview of the state-of-the-art research aiming to produce an alternative medication to treat T. cruzi infection

  7. Chagas disease in a Texan horse with neurologic deficits.

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    Bryan, Laura K; Hamer, Sarah A; Shaw, Sarah; Curtis-Robles, Rachel; Auckland, Lisa D; Hodo, Carolyn L; Chaffin, Keith; Rech, Raquel R

    2016-01-30

    A 10-year-old Quarter Horse gelding presented to the Texas A&M University Veterinary Teaching Hospital with a six month-history of ataxia and lameness in the hind limbs. The horse was treated presumptively for equine protozoal myeloencephalitis (EPM) based on clinical signs but was ultimately euthanized after its condition worsened. Gross lesions were limited to a small area of reddening in the gray matter of the thoracic spinal cord. Histologically, trypanosome amastigotes morphologically similar to Trypanosoma cruzi, the agent of Chagas disease in humans and dogs, were sporadically detected within segments of the thoracic spinal cord surrounded by mild lymphoplasmacytic inflammation. Ancillary testing for Sarcocystis neurona, Neospora spp., Toxoplasma gondii and Leishmania spp. was negative. Conventional and real time polymerase chain reaction (PCR) of affected paraffin embedded spinal cord were positive for T. cruzi, and sequencing of the amplified T. cruzi satellite DNA PCR fragment from the horse was homologous with various clones of T. cruzi in GenBank. While canine Chagas disease cases have been widely reported in southern Texas, this is the first report of clinical T. cruzi infection in an equid with demonstrable amastigotes in the spinal cord. In contrast to previous instances of Chagas disease in the central nervous system (CNS) of dogs and humans, no inflammation or T. cruzi amastigotes were detected in the heart of the horse. Based on clinical signs, there is a potential for misdiagnosis of Chagas disease with other infectious diseases that affect the equine CNS. T. cruzi should be considered as a differential diagnosis in horses with neurologic clinical signs and histologic evidence of meningomyelitis that originate in areas where Chagas disease is present. The prevalence of T. cruzi in horses and the role of equids in the parasite life cycle require further study. PMID:26801589

  8. Heart Diseases

    Science.gov (United States)

    ... re like most people, you think that heart disease is a problem for others. But heart disease is the number one killer in the U.S. ... disability. There are many different forms of heart disease. The most common cause of heart disease is ...

  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. Chagas disease in the Amazon Region

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    Hugo Marcelo Aguilar

    2007-10-01

    Full Text Available The risk that Chagas disease becomes established as a major endemic threat in Amazonia (the world's largest tropical biome, today inhabited by over 30 million people relates to a complex set of interacting biological and social determinants. These include intense immigration from endemic areas (possibly introducing parasites and vectors, extensive landscape transformation with uncontrolled deforestation, and the great diversity of wild Trypanosoma cruzi reservoir hosts and vectors (25 species in nine genera, which maintain intense sylvatic transmission cycles. Invasion of houses by adventitious vectors (with infection rates > 60% is common, and focal adaptation of native triatomines to artificial structures has been reported. Both acute (~ 500 and chronic cases of autochthonous human Chagas disease have been documented beyond doubt in the region. Continuous, low-intensity transmission seems to occur throughout the Amazon, and generates a hypoendemic pattern with seropositivity rates of ~ 1-3%. Discrete foci also exist in which transmission is more intense (e.g., in localized outbreaks probably linked to oral transmission and prevalence rates higher. Early detection-treatment of acute cases is crucial for avoiding further dispersion of endemic transmission of Chagas disease in Amazonia, and will require the involvement of malaria control and primary health care systems. Comprehensive eco-epidemiological research, including prevalence surveys or the characterization of transmission dynamics in different ecological settings, is still needed. The International Initiative for Chagas Disesae Surveillance and Prevention in the Amazon provides the framework for building up the political and scientific cooperation networks required to confront the challenge of preventing Chagas disease in Amazonia.

  11. 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.

  12. 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.

  13. Chagas disease and globalization of the Amazon.

    Science.gov (United States)

    Briceño-León, Roberto

    2007-01-01

    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. PMID:17308715

  14. 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.

  15. Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

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    Luiz Fernando Junqueira Junior

    2012-04-01

    Full Text Available INTRODUCTION: Exclusive or associated lesions in various structures of the autonomic nervous system occur in the chronic forms of Chagas disease. In the indeterminate form, the lesions are absent or mild, whereas in the exclusive or combined heart and digestive disease forms, they are often more pronounced. Depending on their severity these lesions can result mainly in cardiac parasympathetic dysfunction but also in sympathetic dysfunction of variable degrees. Despite the key autonomic effect on cardiovascular functioning, the pathophysiological and clinical significance of the cardiac autonomic dysfunction in Chagas disease remains unknown. METHODS: Review of data on the cardiac autonomic dysfunction in Chagas disease and their potential consequences, and considerations supporting the possible relationship between this disturbance and general or cardiovascular clinical and functional adverse outcomes. RESULTS: We hypothesise that possible consequences that cardiac dysautonomia might variably occasion or predispose in Chagas disease include: transient or sustained arrhythmias, sudden cardiac death, adverse overall and cardiovascular prognosis with enhanced morbidity and mortality, an inability of the cardiovascular system to adjust to functional demands and/or respond to internal or external stimuli by adjusting heart rate and other hemodynamic variables, and immunomodulatory and cognitive disturbances. CONCLUSIONS: Impaired cardiac autonomic modulation in Chagas disease might not be a mere epiphenomenon without significance. Indirect evidences point for a likely important role of this alteration as a primary predisposing or triggering cause or mediator favouring the development of subtle or evident secondary cardiovascular functional disturbances and clinical consequences, and influencing adverse outcomes.

  16. Heart Disease

    Science.gov (United States)

    ... Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults, examines the relationship between consuming too much added sugar and the risk of heart disease death. When it Comes to Blood Pressure, Make Control ...

  17. Caracterização clínico-laboratorial de chagásicos hipertensos sem insuficiência cardíaca manifesta Clinical and laboratory characterization of hypertensive Chagas' disease patients without evident heart failure

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    Laura Bertanha

    2008-04-01

    Full Text Available Este estudo avaliou as características de 125 chagásicos, > 25 anos, atendidos no Hospital de Clínicas da Universidade Estadual de Campinas, SP, considerando-se: pressão arterial, idade, gênero, cor, cardiopatia, índice de massa corporal, perfil lipídico, glicemia, etilismo, tabagismo, dislipidemia, diabetes, distúrbio de ansiedade e obesidade. Apresentavam hipertensão arterial 69 (55,2% pacientes. Verificou-se que os chagásicos hipertensos eram mais idosos que os não hipertensos (p = 0,028. Entre os hipertensos havia: mais mulheres (p = 0,015; níveis mais elevados de glicemia, LDL-colesterol e colesterol total (p = 0,005; p = 0,024; p = 0,017; mais diabéticos (p = 0,006, dano cardíaco (p = 0,04 e sobrecarga ventricular esquerda (p = 0,003. Apenas a idade mostrou-se mais elevada nos pacientes com dano cardíaco (p = 0,003. Os chagásicos hipertensos apresentaram características clínico-laboratoriais semelhantes à população hipertensa, em geral. Dessa associação pode haver somatória de efeitos deletérios para o aparelho cardiovascular.This study evaluated the characteristics of 125 Chagas disease patients aged > 25 years or over who were attended at the Clinical Hospital of the State University of Campinas, State of São Paulo. Arterial pressure, age, gender, skin color, heart disease, body mass index, lipid profile, blood glucose level, alcohol and tobacco dependence, dyslipidemia, diabetes, anxiety disorders and obesity were investigated. It was found that the hypertensive Chagas disease patients were older than the non-hypertensive ones (p = 0.028. Among the hypertensive patients, there were more women (p = 0.015; higher blood glucose, LDL cholesterol and total cholesterol levels (p = 0.005, p = 0.024 and p = 0.017; more diabetics (p = 0.006; and more cardiac damage (p = 0.04 and left ventricular hypertrophy (p = 0.003. Only the age of patients with cardiac damage was shown to be higher (p = 0.003. The hypertensive

  18. Panorama epidemiológico y clínico de la cardiopatía chagásica crónica en México Epidemiological and clinical outlook of chronic Chagas' heart disease in Mexico

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    Justo Sierra-Johnson

    2005-10-01

    Full Text Available OBJECTIVO: Comparar las características epidemiológicas y clínicas de la cardiopatía chagásica crónica con otras miocardiopatías dilatadas. MÉTODOS: Se incluyeron a 128 pacientes consecutivos en un hospital de espcialidad, de 1993 a 2003 con miocardiopatías dilatadas, donde 51 (40% con anti Tripanosoma cruzi. Se recopiló información epidemiológica por entrevista directa, y datos clínicos en los servicios asistenciales. Se utilizaron la prueba de la Chi-cuadrado o prueba exacta de Fischer, prueba t de Student ó la prueba de U de Mann Whitney y análisis multivariado. RESULTADOS: Los pacientes con cardiopatía chagásica crónica, eran más viejos (55±10 años que los pacientes con miocardiopatías (42±17 años, nacieron en zonas rurales (90% vs 68%, en viviendas precarias (75% vs 16%, con hacinamiento (45% vs 20%, convivencia con animales domésticos (71% vs 61% y conocían al vector (73% vs 25%. Los trastornos del ritmo y de la conducción, así como la colocación de marcapaso definitivo fueron frecuentes en los pacientes con cardiopatía chagásica crónica (84% vs 55%, 78% vs 64% Y 24% vs 10% respectivamente. La insuficiencia cardiaca congestiva venosa fue más frecuente en los pacientes con miocardiopatía seronegativa (88% vs 71% y la perfusión miocárdic anormal con arterias epicárdicas normales fue igual en ambos grupos. Con respecto a co-morbilidad, los pacientes con cardiopatía chagásica crónica tenían sólo dos padecimientos, mientras que en el otro grupo era más amplia. CONCLUSIÓNES: La enfermedad de Chagas causa la miocardiopatía dilatada específica más común. Debido a su distribución regional en la República Mexicana, merece atención y se recomienda a nivel público adoptar medidas de prevención que ya probaron eficacia en otros países.OBJECTIVE: To compare the epidemiological and clinical characteristics of chronic Chagas' heart disease to other dilated cardiomyopathies. METHODS: A study comprising

  19. Invasive and noninvasive correlations of B-type natriuretic peptide in patients with heart failure due to Chagas cardiomyopathy.

    Science.gov (United States)

    Vilas-Boas, Fábio; Feitosa, Gilson Soares; Soares, Milena B P; Pinho-Filho, Joel Alves; Nascimento, Thais; Barojas, Marcos M; Andrade, Marcus V S; Ribeiro-Dos-Santos, Ricardo; Bocchi, Edimar

    2008-01-01

    Heart failure due to Chagas cardiomyopathy (HFCC) differs from failure with other etiologies because of the occurrence of intense inflammatory infiltrate and right ventricle compromise. This article investigates correlations of B-type natriuretic peptide (BNP) levels with parameters of severity in HFCC. Twenty-eight patients and 8 normal controls underwent heart catheterization and clinical and laboratory analyses. BNP levels were higher in patients with HFCC (PHFCC, irrespective of NYHA class, and that the occurrence of HFCC correlates with severity of disease.

  20. Coronary heart disease

    Science.gov (United States)

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... Coronary heart disease is the leading cause of death in the United States for men and women. Coronary heart ...

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Biologic and Genetics Aspects of Chagas Disease at Endemic Areas

    OpenAIRE

    Marilanda Ferreira Bellini; Rosana Silistino-Souza; Marileila Varella-Garcia; Maria Tercília Vilela Azeredo-Oliveira; Ana Elizabete Silva

    2012-01-01

    The etiologic agent of Chagas Disease is the Trypanosoma cruzi, transmitted through blood-sucking insect vectors of the Triatominae subfamily, representing one of the most serious public health concerns in Latin America. There are geographic variations in the prevalence of clinical forms and morbidity of Chagas disease, likely due to genetic variation of the T. cruzi and the host genetic and environmental features. Increasing evidence has supported that inflammatory cytokines and chemokines a...

  3. 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.

  4. A new era for chagas disease drug discovery?

    Science.gov (United States)

    Keenan, Martine; Chaplin, Jason H

    2015-01-01

    Recent clinical trials investigating treatment of chronic indeterminate Chagas disease with two re-purposed azole anti-fungal drugs, posaconazole and ravuconazole, revealed their inferiority to the current standard-of-care benznidazole and highlighted the inadequacy of the existing pre-clinical testing paradigm for this disease. A very limited number of controlled clinical trials for Chagas disease have been conducted to date. The selection of these compounds for clinical evaluation relied heavily on pre-clinical data obtained from in vitro screens and animal studies. This chapter reviews the evolution of CYP51 as a target for Trypanosoma cruzi growth inhibition and also explores the impact of clinical trial data on contemporary Chagas disease drug discovery. Advances in pre-clinical profiling assays, the current compound landscape and progress towards the identification of new drug targets to re-invigorate research are reviewed. PMID:25727705

  5. 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.

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

    Science.gov (United States)

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

    2014-08-26

    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. PMID:25228957

  7. 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

  8. 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.

  9. Heart disease - resources

    Science.gov (United States)

    Resources - heart disease ... The following organizations are good resources for information on heart disease: American Heart Association -- www.heart.org Centers for Disease Control and Prevention -- www.cdc.gov/heartdisease

  10. Heart Diseases and Disorders

    Science.gov (United States)

    ... Resources Heart Diseases & Disorders Back to Patient Resources Heart Diseases & Disorders Millions of people experience irregular heartbeats, called ... harmless and happen in healthy people free of heart disease. However, some abnormal heart rhythms can be serious ...

  11. Heart disease and diet

    Science.gov (United States)

    Diet - heart disease ... diet and lifestyle can reduce your risk of: Heart disease, heart attacks, and stroke Conditions that lead to heart disease, including high cholesterol , high blood pressure, and obesity ...

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

    Directory of Open Access Journals (Sweden)

    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

  13. Assessment and epidemiology of Chagas' disease in patients treated in Araguaina - Tocantins

    International Nuclear Information System (INIS)

    Chagas disease (AD) was described by Carlos Chagas in 1909. It is caused by a parasite T. cruzi, transmitted by bugs, by blood transfusion, vertical and orally. The DC has two phases: acute and chronic. The evolution to the cardiac form occurs in about 30% of chronic cases and is the largest cause of mortality in chronic Chagas disease. The aim of this study was to Chagas' disease in patients of Tocantins, compared with other heart patients and asymptomatic from the standpoint of non-invasive exams using radiant energies such as echocardiography and ECG and RX. The descriptive study included 80 patients, 20 chronic form of Chagas disease, 20 indeterminate, 20 with other heart diseases, and 20 controls. There was a prevalence of 9.5% of chagasic patients treated in outpatient cardiology at Araguaina Tocantins, and 7.3% in chronic and 2.21% in the indeterminate. Of the chronic patients in the study 50% had mega esophagus and megacolon 4 (20%). Most patients had no family history of AD, nor was a smoker or drinker. Major electrocardiographic abnormalities found refer to driving. The evaluation of ICT, the chronic chagasic showed that increased by 40% of patients, 40% had esophageal changes and 20% of patients had megacolon s. The echocardiogram was abnormal in 42%). 27% of patients had EF below 55% changed. Changes in segmental contractility and Asynchrony septum were found in 80% of chronic Chagas disease. In 80% of the patients was observed diastolic dysfunction. The valvular changes occurred in 75%. Electrocardiographic abnormalities occurred in 80% of patients with CCC, while the other heart had ECG changes. Arterial hypertension had an incidence of 45% in patients with CCC and 40% in FCI. The systolic and diastolic ventricular dysfunction was more prevalent in groups that had an abnormal ECG and arrhythmia. Observed that the group of chagasic decreased ejection fraction is correlated to a higher incidence of arrhythmias besides diastolic dysfunction and related

  14. 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.

  15. 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

  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. 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. PMID:26090490

  18. Heart Disease

    Science.gov (United States)

    ... occurs when the heart is not able to pump blood through the body as well as it should. ... arteries. The pressure is highest when your heart pumps blood into your arteries – when it beats. It is ...

  19. Padrão circadiano dos episódios de taquicardia ventricular em portadores de cardiopatia chagásica Circadian pattern of ventricular tachycardia episodes in patients with chagas heart disease

    Directory of Open Access Journals (Sweden)

    Mauricio Abello

    2007-02-01

    Full Text Available Cardiomiopatia chagásica crônica (CCC causa arritmias ventriculares e morte súbita, sendo a mais freqüente causa de óbito em muitas áreas endêmicas1,2. A variação circadiana na incidência de arritmias ventriculares e morte súbita difere de acordo com o substrato (p. ex: picos matinais e noturnos na cardiopatia isquêmica e na cardiomiopatia dilatada não-chagásica. Cardioversores-desfibriladores implantáveis de terceira geração (CDI conseguem registrar o dia e a hora de cada episódio de taquicardia ventricular (TV, permitindo uma análise dos padrões de ocorrência de taquiarritmias. O objetivo deste estudo foi avaliar a variação circadiana da TV espontânea em portadores de CCC tratados com CDI.Chronic Chagas' cardiomyopathy (CCM causes ventricular arrhythmias and sudden death, and constitutes the most frequent cause of death in many endemic areas1,2. The circadian variation in the incidence of ventricular arrhythmias and sudden death differs according to the substrate (e.g., morning and evening peaks in ischemic heart disease and non-Chagasic dilated cardiomyopathy. Third generation implantable cardioverter defibrillators (ICDs have the ability to store the time and date of each ventricular tachycardia (VT episode, enabling the patterns of ventricular tachyarrhythmia occurrence to be analyzed. The aim of our study was to evaluate the circadian variation of spontaneous VT in recipients of an ICD with CCM.

  20. Accurate real-time PCR strategy for monitoring bloodstream parasitic loads in chagas disease patients.

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    Tomas Duffy

    Full Text Available BACKGROUND: This report describes a real-time PCR (Q-PCR strategy to quantify Trypanosoma cruzi (T. cruzi DNA in peripheral blood samples from Chagas disease patients targeted to conserved motifs within the repetitive satellite sequence. METHODOLOGY/PRINCIPAL FINDINGS: The Q-PCR has a detection limit of 0.1 and 0.01 parasites/mL, with a dynamic range of 10(6 and 10(7 for Silvio X10 cl1 (T. cruzi I and Cl Brener stocks (T. cruzi IIe, respectively, an efficiency of 99%, and a coefficient of determination (R(2 of 0.998. In order to express accurately the parasitic loads: (1 we adapted a commercial kit based on silica-membrane technology to enable efficient processing of Guanidine Hydrochloride-EDTA treated blood samples and minimize PCR inhibition; (2 results were normalized incorporating a linearized plasmid as an internal standard of the whole procedure; and (3 a correction factor according to the representativity of satellite sequences in each parasite lineage group was determined using a modified real-time PCR protocol (Lg-PCR. The Q-PCR strategy was applied (1 to estimate basal parasite loads in 43 pediatric Chagas disease patients, (2 to follow-up 38 of them receiving treatment with benznidazole, and (3 to monitor three chronic Chagas heart disease patients who underwent heart-transplantation and displayed events of clinical reactivation due to immunosupression. CONCLUSION/SIGNIFICANCE: All together, the high analytical sensitivity of the Q-PCR strategy, the low levels of intra- and inter-assay variations, as well as the accuracy provided by the Lg-PCR based correction factor support this methodology as a key laboratory tool for monitoring clinical reactivation and etiological treatment outcome in Chagas disease patients.

  1. Hypothyroidism and Heart Disease

    Science.gov (United States)

    ... Hypothyroidism and Heart Disease Fact Sheet Hypothyroidism and Heart Disease January 2014 Download PDFs English Espanol Editors Alan ... hormone. Why does hypothyroidism increase your risk for heart disease? Both thyroid hormones (T4 and T3) are related ...

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Interactive Media on Chagas Disease: Development and Content

    Directory of Open Access Journals (Sweden)

    Claudinei Caetano de Souza

    2013-10-01

    Full Text Available An interactive media on Chagas disease was developed as an educational tool, on the context of the scientific research and dissemination actions of the National Institute of Structural Biotechnology and Medicinal Chemistry in Infectious Diseases (INBEQMeDI. Different computational resources were used either in terms of hardware and software. The media contains 13 videos that range from 30 seconds to 4 minutes, all with information about Chagas disease, showing the social and economic aspects; the research made by the INBEQMeDI group; different aspects of the disease illustrated by slides arranged in a mobile carousel, and radio programs, with funny skits. The target audience for use of this feature is students aged 10 to 17 years. Teachers of areas of science and biology, through a partnership with the Agency of Education of the State of São Paulo, will be invited to plan a strategy for media use with their students.

  4. Distribution and characterization of canine Chagas disease in Texas.

    Science.gov (United States)

    Kjos, S A; Snowden, K F; Craig, T M; Lewis, B; Ronald, N; Olson, J K

    2008-04-15

    Although acute and chronic cases of canine Chagas disease have been reported from multiple areas in the southern region of the United States, little data are available on current disease occurrence patterns in endemic areas. Therefore, a study to assess frequency, geographic distribution, signalment, and clinical spectrum of Chagas disease in domestic dogs from Texas was conducted. Serology, histopathology, and clinical case records from multiple institutions for the time period 1993-2007 were analyzed. A total of 537 serologically and/or histopathologically confirmed cases were documented. Cases were reported from 48 of 254 counties within Texas, covering all major geographic regions. Forty-eight dog breeds were represented among the cases, primarily in the sporting and working groups. In histopathologically confirmed cases, acute death occurred in 42%, approximately half of which were ecoregions of Texas, affecting a broad range of dog breeds and age groups. PMID:18255233

  5. 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

  6. The Role of Haptoglobin Genotypes in Chagas Disease

    Directory of Open Access Journals (Sweden)

    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.

  7. Treatment with Benznidazole during the Chronic Phase of Experimental Chagas' Disease Decreases Cardiac Alterations

    Science.gov (United States)

    Garcia, Simone; Ramos, Carolina O.; Senra, Juliana F. V.; Vilas-Boas, Fabio; Rodrigues, Maurício M.; Campos-de-Carvalho, Antonio C.; Ribeiro-dos-Santos, Ricardo; Soares, Milena B. P.

    2005-01-01

    Chagas' disease, caused by Trypanosoma cruzi infection, is one of the main causes of death due to heart failure in Latin American countries. Benznidazole, the chemotherapeutic agent most often used for the treatment of chagasic patients, is highly toxic and has limited efficacy, especially in the chronic phase of the disease. In the present study we used a mouse model of chronic Chagas' disease to investigate the effects of benznidazole treatment during the chronic phase on disease progression. The hearts of benznidazole-treated mice had decreased parasitism and myocarditis compared to the hearts of untreated chagasic mice. Both groups of Trypanosoma cruzi-infected mice had significant alterations in their electrocardiograms compared to those of the healthy mice. However, untreated mice had significantly higher cardiac conduction disturbances than benznidazole-treated mice, including intraventricular conduction disturbances, atrioventricular blocks, and extrasystoles. The levels of antibodies against T. cruzi antigens (epimastigote extract, P2β, and trans-sialidase) as well as antibodies against peptides of the second extracellular loops of β1-adrenergic and M2-muscarinic cardiac receptors were also lower in the sera from benznidazole-treated mice than in the sera from untreated mice. These results demonstrate that treatment with benznidazole in the chronic phase of infection prevents the development of severe chronic cardiomyopathy, despite the lack of complete parasite eradication. In addition, our data highlight the role of parasite persistence in the development of chronic Chagas' disease and reinforce the importance of T. cruzi elimination in order to decrease or prevent the development of severe chagasic cardiomyopathy. PMID:15793134

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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

  10. A Paratransgenic Strategy for the Control of Chagas Disease

    Directory of Open Access Journals (Sweden)

    Ivy Hurwitz

    2012-01-01

    Full Text Available Chagas disease results from infection with the parasite Trypanosoma cruzi. This disease remains a significant cause of morbidity and mortality in central and south America. Chagas disease now exists and is detected worldwide because of human migration. Control of Chagas disease has relied mainly on vector eradication however, the development of insect resistance to pesticides, coupled with cost and adverse health effects of insecticide treatments, has prompted our group to investigate novel methods of transmission control. Our laboratory has been instrumental in the development of the paratransgenic strategy to control vectorial transmission of T. cruzi. In this paper, we discuss various components of the paratransgenic approach. Specifically, we describe classes of molecules that can serve as effectors, including antimicrobial peptides, endoglucanases, and highly specific single chain antibodies that target surface glycoprotein tags on the surface of T. cruzi. Furthermore, we address evolving concepts related to field dispersal of engineered bacteria as part of the paratransgenic control strategy and attendant risk assessment evaluation.

  11. Heart disease and women

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007188.htm Heart disease and women To use the sharing features on ... please enable JavaScript. People often do not consider heart disease a woman's disease. Yet cardiovascular disease is the ...

  12. What Causes Heart Disease?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. What Causes Heart Disease? Research suggests that coronary heart disease (CHD) begins with damage to the lining and ... causing coronary microvascular disease (MVD). Coronary MVD is heart disease that affects the heart's tiny arteries. The cause ...

  13. Does my patient have chronic Chagas disease? Development and temporal validation of a diagnostic risk score

    OpenAIRE

    Pedro Emmanuel Alvarenga Americano do Brasil; Sergio Salles Xavier; Marcelo Teixeira Holanda; Alejandro Marcel Hasslocher-Moreno; José Ueleres Braga

    2016-01-01

    Abstract: INTRODUCTION With the globalization of Chagas disease, unexperienced health care providers may have difficulties in identifying which patients should be examined for this condition. This study aimed to develop and validate a diagnostic clinical prediction model for chronic Chagas disease. METHODS This diagnostic cohort study included consecutive volunteers suspected to have chronic Chagas disease. The clinical information was blindly compared to serological tests results, and a ...

  14. Protective human leucocyte antigen haplotype, HLA-DRB1*01-B*14, against chronic Chagas disease in Bolivia.

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  16. Heart Disease in Women

    Science.gov (United States)

    ... United States, 1 in 4 women dies from heart disease. The most common cause of heart disease in both men and women is narrowing or ... It's the major reason people have heart attacks. Heart diseases that affect women more than men include Coronary ...

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

    Directory of Open Access Journals (Sweden)

    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

  18. Doença de Chagas no Brasil Chagas disease in Brazil

    Directory of Open Access Journals (Sweden)

    Márcio C. Vinhaes

    2000-01-01

    Full Text Available Sumariam-se os dados da Fundação Nacional de Saúde (FNS sobre o estado atual dos vetores da doença de Chagas no Brasil, verificando-se que após vinte anos de controle químico continuado houve franca redução dos índices triatomínico-tripanosômicos, particularmente para esp��cies como Triatoma infestans e Panstrongylus megistus. Em paralelo, dados de sorologia escolar, de internações e de mortalidade pela doença indicam descenso nas taxas de incidência e impacto médico social da protozoose, restando áreas mais preocupantes, como o Nordeste e resíduos de T. infestans. Impõe-se urgente uma vigilância epidemiológica efetiva, a ser realizada por estados e municípios ante o processo de descentralização da FNS.This article presents the current situation for Chagas disease vectors in Brazil, based on data from the Brazilian National Health Foundation (FNS. Over the course of the last 20 years, continuous chemical control has resulted in a clear reduction of triatomine densities and Trypanosoma cruzi in Brazilian dwellings. Results have been particularly promising in relation to Triatoma infestans and Panstrongylus megistus, considered the most important species in the past. In parallel, data from school serological surveys, hospitalized patients, and mortality records show an important decrease in the disease. Nevertheless, some areas of the Brazilian Northeast and some residual foci of Triatoma infestans and Panstrongylus megistus remain as major challenges for public health authorities, requiring effective epidemiological surveillance. States and municipalities are required to assume this task at present, as the traditional Brazilian National Health Foundation is undergoing decentralization.

  19. Antitrypanosomal Treatment with Benznidazole Is Superior to Posaconazole Regimens in Mouse Models of Chagas Disease.

    Science.gov (United States)

    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. PMID:26239982

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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

    presence of T. cruzi in blood, explored in fresh smears by serial micro-hematocrite and/or by xenodiagnosis, was the only criterion to define infection in NB. All NB were followed up by direct agglutination (DA with or without 2 mercaptoethanol (DA-w2ME, DA-wo2ME and IIF in order to establish the specific antibody kinetics. Clinical studies on NB with T. cruzi infection include routine laboratory tests. Benznidazole (3 to 7 mg/kg/day and, in 1 case, nifurtimox (15 mg/kg/day were employed as therapeutic agents. T. cruzi infection was confirmed in 149 PW (15.9%, table I. These chagasic mothers delivered 6 chagasic NB (CCHD-NB, (4%. Diagnosis of congenital Chagas' disease accounted for a total of 12 NB out of the 968 studied. 4 out of them were positive by both micro-hematocrite and blood smears and 7 by micro-hematocrite alone. Xenodiagnosis was performed in 2 NB resulting positive in both cases, table II. The most usual clinical findings included hepatomegaly (present in all cases, splenomegaly 8/12, jaundice 10/12 and prematurity 5/12, table 3. Laboratory findings showed anemia to be of hypochromic microcytic type in all cases. Other laboratory findings included lymphocytosis, normal erythrosedimentation, slight to moderate increase of transaminases in all cases, and elevated indirect bilirrubin in cases with jaundice, table 4. Analysis of cerebro spinal fluid in 6 CCh-NB revealed the presence of T. cruzi in 2 cases, plus abnormal cytochemical content in one of them, table 4. The serological reactions of infected and treated NB became negative between 4th and 8th month in all but 1 case that remained positive until 14th, fig. 1. A close correlation was found between DA and IIF. DA-w2ME liter showed a significant drop during the initial phase of the controls. Benznidazole was successful in 11 out of the 12 CCh-NB. The remaining NB was effectively treated with nifurtimox. Therapeutic tolerance was satisfactory for both agents. These observations showed that congenital Chagas

  2. Aspirin and heart disease

    Science.gov (United States)

    ... the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology ... NE, et al. Antithrombotic and thrombolytic therapy for ischemic ... of coronary heart disease. In: Mann DL, Zipes DP, Libby P, et ...

  3. Heart disease - risk factors

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000106.htm Heart disease - risk factors To use the sharing features on ... a certain health condition. Some risk factors for heart disease you cannot change, but some you can. Changing ...

  4. 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.

  5. Chagas' disease and Duffy antigen/receptor for chemokine (DARC: a mini-review

    Directory of Open Access Journals (Sweden)

    AP Oliveira

    2011-01-01

    Full Text Available Duffy gene (FY codifies the transmembrane glycoprotein Duffy (gp-Fy of 35 to 43 kDa which is moderately immunogenic. This glycoprotein is polymorphic, and constitutes the antigens of the Duffy histo-blood system which were designated receptors for chemokines and denominated DARC (Duffy antigen/receptor for chemokine. This receptor has an important role in the regulation of chemokine levels in the circulation, as it binds and adsorbs them on the surface of red cells as a reservoir. It plays a "sink" role, which can contribute to homeostasis by removing inflammatory chemokines from circulation as well as maintaining them in plasmatic levels. Chronic Chagas' cardiopathy (CCC is the most frequent form of the disease. It is an inflammatory disease, in which infiltrated inflammatory cells play an important role in the development and progress of the infection. High chemokine levels in the plasma have been associated with the disease severity in patients with heart failure. In this context, the profile of DARC expression could play an important function as a receptor for chemokines in Chagas' disease, in patients with CCC, as it can modulate damage from this inflammatory disease.

  6. Heart Disease in Women

    Science.gov (United States)

    ... States, 1 in 4 women dies from heart disease. The most common cause of heart disease in both men and women is narrowing or ... the heart itself. This is called coronary artery disease, and it happens slowly over time. It's the ...

  7. Menopause and Heart Disease

    Science.gov (United States)

    ... Blood Pressure Tools & Resources Stroke More Menopause and Heart Disease Updated:Apr 18,2016 Heart disease risk rises for everyone as they age, but ... women is seen about 10 years after menopause. Heart disease is the leading killer of women . Estrogen Levels ...

  8. Living with Heart Disease

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Living With Heart Disease If you have coronary heart disease (CHD), you can take steps to control its ... the section of this article titled "How Is Heart Disease Treated?" You also can visit the Health Topics ...

  9. Heart Disease in Women

    Science.gov (United States)

    ... heart disease risk factors causes coronary MVD. Although death rates from heart disease have dropped in the last 30 years, they ... stopped her "dead in her tracks." Jennifer reminds us how heart disease takes too many of our moms, sisters, and ...

  10. Heart Disease Risk Factors

    Science.gov (United States)

    ... Hearts® WISEWOMAN Program Other Chronic Disease Topics Diabetes Nutrition Obesity Physical Activity Stroke Heart Disease Risk Factors Recommend ... Hearts® WISEWOMAN Program Other Chronic Disease Topics Diabetes Nutrition Obesity Physical Activity Stroke File Formats Help: How do ...

  11. Aspectos neurológicos da doença de chagas: sistema nervoso central Neurological aspects of Chagas' disease: central nervous system

    Directory of Open Access Journals (Sweden)

    Sylvio de Vergueiro Forjaz

    1967-09-01

    several organs and with nervous symptoms (especially mental disturbances it has not been possible to get positive results from the complement fixation test (Machado-Guerreiro's reaction when performed using cerebrospinal fluid, yet this test is positive in about 97% of the cases when blood is used instead. Recently, Köberle and coworkers have shown a great diminution in the number of nerve cells in the intramural plexuses of hollow viscera and in the cerebellum and spinal cord of men and experimental animals with Chagas' disease. It is hoped this approach using neuronal countings will in a near future show which are the true cases of chronic Chagas nervous disease. Regarding the embolic phenomena of Chagas heart disease, they do not have particular symptomatological aspects, except the high degree of mortality. Theoretically, cerebral thrombotic phenomena may also develop under the same etiology, but they have not been demonstrated through a pathological study.

  12. 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.

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

    OpenAIRE

    Roberto Briceño-León

    2007-01-01

    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 mod...

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

    Science.gov (United States)

    Moncayo, Alvaro

    2003-07-01

    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 of the autonomous nervous system in the heart, esophagus, colon and the peripheral nervous system. Data on the prevalence and distribution of Chagas disease improved in quality during the 1980's as a result of the demographically representative cross-sectional studies carried out in countries where accurate information was not available. A group of experts met in Bras lia 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 program in the Southern Cone countries the transmission of Chagas disease by vectors and by blood transfusion has been interrupted in Uruguay in1997, in Chile in 1999, and in 8 of the 12 endemic states of Brazil in 2000 and so the incidence of new infections by T. cruzi in the whole continent has decreased by 70%. Similar control multi-country initiatives have been launched in the Andean countries and in Central America and rapid progress has been recorded to ensure the interruption of the transmission of Chagas disease by 2005 as requested by a Resolution of the World Health Assembly approved in 1998. The cost-benefit analysis of the investments of the vector control program in Brazil indicate that there are savings of US$17 in medical care and disabilities for each dollar spent on prevention, showing that the program is a health investment with good return. Since the inception in 1979 of the Steering Committee on Chagas Disease

  15. Travelers' Health: Trypanosomiasis, American (Chagas Disease)

    Science.gov (United States)

    ... Guide Learn About Destination See a Doctor Pre-Travel Appointment Your Health Status How Diseases Spread Pack Smart Plan Ahead ... During Trip After Your Trip CDC-TV Videos Travel to the Olympics ... Presentations for Health Professionals Yellow Fever Vaccine Course About the Yellow ...

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Travel and Heart Disease

    Science.gov (United States)

    ... Privacy Policy Cardiovascular Conditions • Conditions Home • Arrhythmia and Atrial Fibrillation • Cardiac Arrest • Cardiac Rehab • Cardiomyopathy • Cardiovascular Conditions of Childhood • Cholesterol • Congenital Heart Defects • Diabetes • Heart Attack • Heart Failure (HF) • Heart Valve Problems and Disease • High Blood ...

  18. Genetic Susceptibility to Cardiac and Digestive Clinical Forms of Chronic Chagas Disease: Involvement of the CCR5 59029 A/G Polymorphism.

    Science.gov (United States)

    de Oliveira, Amanda Priscila; Bernardo, Cássia Rubia; Camargo, Ana Vitória da Silveira; Ronchi, Luiz Sérgio; Borim, Aldenis Albaneze; de Mattos, Cinara Cássia Brandão; de Campos Júnior, Eumildo; Castiglioni, Lílian; Netinho, João Gomes; Cavasini, Carlos Eugênio; Bestetti, Reinaldo Bulgarelli; de Mattos, Luiz Carlos

    2015-01-01

    The clinical manifestations of chronic Chagas disease include the cardiac form of the disease and the digestive form. Not all the factors that act in the variable clinical course of this disease are known. This study investigated whether the CCR5Δ32 (rs333) and CCR5 59029 A/G (promoter region--rs1799987) polymorphisms of the CCR5 gene are associated with different clinical forms of chronic Chagas disease and with the severity of left ventricular systolic dysfunction in patients with chronic Chagas heart disease (CCHD). The antibodies anti-T. cruzi were identified by ELISA. PCR and PCR-RFLP were used to identify the CCR5Δ32 and CCR5 59029 A/G polymorphisms. The chi-square test was used to compare variables between groups. There was a higher frequency of the AA genotype in patients with CCHD compared with patients with the digestive form of the disease and the control group. The results also showed a high frequency of the AG genotype in patients with the digestive form of the disease compared to the other groups. The results of this study show that the CCR5Δ32 polymorphism does not seem to influence the different clinical manifestations of Chagas disease but there is involvement of the CCR5 59029 A/G polymorphism in susceptibility to the different forms of chronic Chagas disease. Besides, these polymorphisms do not influence left ventricular systolic dysfunction in patients with CCHD.

  19. Genetic Susceptibility to Cardiac and Digestive Clinical Forms of Chronic Chagas Disease: Involvement of the CCR5 59029 A/G Polymorphism.

    Directory of Open Access Journals (Sweden)

    Amanda Priscila de Oliveira

    Full Text Available The clinical manifestations of chronic Chagas disease include the cardiac form of the disease and the digestive form. Not all the factors that act in the variable clinical course of this disease are known. This study investigated whether the CCR5Δ32 (rs333 and CCR5 59029 A/G (promoter region--rs1799987 polymorphisms of the CCR5 gene are associated with different clinical forms of chronic Chagas disease and with the severity of left ventricular systolic dysfunction in patients with chronic Chagas heart disease (CCHD. The antibodies anti-T. cruzi were identified by ELISA. PCR and PCR-RFLP were used to identify the CCR5Δ32 and CCR5 59029 A/G polymorphisms. The chi-square test was used to compare variables between groups. There was a higher frequency of the AA genotype in patients with CCHD compared with patients with the digestive form of the disease and the control group. The results also showed a high frequency of the AG genotype in patients with the digestive form of the disease compared to the other groups. The results of this study show that the CCR5Δ32 polymorphism does not seem to influence the different clinical manifestations of Chagas disease but there is involvement of the CCR5 59029 A/G polymorphism in susceptibility to the different forms of chronic Chagas disease. Besides, these polymorphisms do not influence left ventricular systolic dysfunction in patients with CCHD.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Urban transmission of Chagas disease in Cochabamba, Bolivia

    Directory of Open Access Journals (Sweden)

    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.

  3. A vital role for complement in heart disease

    DEFF Research Database (Denmark)

    Lappegård, Knut T; Garred, Peter; Jonasson, Lena;

    2014-01-01

    , emerging evidence points to an association between the complement system and heart diseases. Thus, complement seems to be important in coronary heart disease as well as in heart failure, where several studies underscore the prognostic importance of complement activation. Furthermore, patients with atrial...... fibrillation often share risk factors both with coronary heart disease and heart failure, and there is some evidence implicating complement activation in atrial fibrillation. Moreover, Chagas heart disease, a protozoal infection, is an important cause of heart failure in Latin America, and the complement...... system is crucial for the protozoa-host interaction. Thus, complement activation appears to be involved in the pathophysiology of a diverse range of cardiac conditions. Determination of the exact role of complement in the various heart diseases will hopefully help to identify patients that might benefit...

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

    Directory of Open Access Journals (Sweden)

    José Rodrigues Coura

    2012-03-01

    Full Text Available 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.

  5. 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.

  6. Women and Heart Disease

    Institute of Scientific and Technical Information of China (English)

    邹国如

    2005-01-01

    Heart disease is the leading killer of Americans. But it kills more women than men. The American Heart Association says heart disease and other cardiovascular (心血管的) disorders kill about five hundred thousand women a year. That is more than the next seven causes of death combined.

  7. Heart disease and depression

    Science.gov (United States)

    Heart disease and depression often go hand-in-hand. You are are more likely to feel sad or depressed after a heart attack ... heart disease. The good news is that treating depression may help improve both your mental and physical ...

  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. Increased type 1 chemokine expression in experimental Chagas disease correlates with cardiac pathology in beagle dogs.

    Science.gov (United States)

    Guedes, Paulo M M; Veloso, Vanja M; Talvani, André; Diniz, Livia F; Caldas, Ivo S; Do-Valle-Matta, Maria A; Santiago-Silva, Juliana; Chiari, Egler; Galvão, Lucia M C; Silva, João S; Bahia, Maria T

    2010-11-15

    Chemokines and chemokine receptors interaction have presented important role in leukocyte migration to specific immune reaction sites. Recently, it has been reported that chemokine receptors CXC (CXCR3) and CC (CCR5) were preferentially expressed on Th1 cells while CCR3 and CCR4 were preferentially expressed on Th2 cells. This study evaluated the mRNA expression of type 1 and type 2 chemokine and chemokine receptors in the cardiac tissue of Beagle dogs infected with distinct genetic groups of Trypanosoma cruzi (Y, Berenice-78 and ABC strains) during acute and chronic phases. To analyze the correlation between chemokine and chemokine receptors expression and the development of heart pathology, the chronic infected animals were divided into groups, according to the parasite strain and based on the degree of heart damage: cardiac and indeterminate form of Chagas disease. Our results indicated that cardiac type1/2 chemokines and their receptors were partially dependent on the genetic diversity of parasites as well as the polarization of clinical forms. Also, dogs presenting cardiac form showed lower heart tissue mRNA expression of CCL24 (type 2) and higher expression of CCL5, CCL4 and CXCR3 (type 1) when compared with those with indeterminate form of disease. Together, these data reinforce a close-relation between T. cruzi genetic population and the host specific type 1 immune response and, for the first time, we show the distribution of type 1/2 chemokines associated with the development of cardiac pathology using dogs, a well similar model to study human Chagas disease.

  10. Integrate Study of a Bolivian Population Infected by Trypanosoma cruzi, the Agent of Chagas Disease

    Directory of Open Access Journals (Sweden)

    Simone Frédérique Brenière

    2002-04-01

    Full Text Available A cross section of a human population (501 individuals selected at random, and living in a Bolivian community, highly endemic for Chagas disease, was investigated combining together clinical, parasitological and molecular approaches. Conventional serology and polymerase chain reaction (PCR indicated an active transmission of the infection, a high seroprevalence (43.3% ranging from around 12% in 45 years, and a high sensitivity (83.8% and specificity of PCR. Abnormal ECG tracing was predominant in chagasic patients and was already present among individuals younger than 13 years. SAPA (shed acute phase antigen recombinant protein and the synthetic peptide R-13 were used as antigens in ELISA tests. The reactivity of SAPA was strongly associated to Trypanosoma cruzi infection and independent of the age of the patients but was not suitable neither for universal serodiagnosis nor for discrimination of specific phases of Chagas infection. Anti-R-13 response was observed in 27.5% only in chagasic patients. Moreover, anti-R13 reactivity was associated with early infection and not to cardiac pathology. This result questioned previous studies, which considered the anti-R-13 response as a marker of chronic Chagas heart disease. The major clonets 20 and 39 (belonging to Trypanosoma cruzi I and T. cruzi II respectively which circulate in equal proportions in vectors of the studied area, were identified in patients' blood by PCR. Clonet 39 was selected over clonet 20 in the circulation whatever the age of the patient. The only factor related to strain detected in patients' blood, was the anti-R-13 reactivity: 37% of the patients infected by clonet 39 (94 cases had anti-R13 antibodies contrasting with only 6% of the patients without clonet 39 (16 cases.

  11. 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

    2016-03-01

    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

  12. SIRT1-PGC1α-NFκB Pathway of Oxidative and Inflammatory Stress during Trypanosoma cruzi Infection: Benefits of SIRT1-Targeted Therapy in Improving Heart Function in Chagas Disease

    Science.gov (United States)

    Wen, Jian-jun; Liang, Lisa Yi

    2016-01-01

    Chronic chagasic cardiomyopathy (CCM) is presented by increased oxidative/inflammatory stress and decreased mitochondrial bioenergetics. SIRT1 senses the redox changes and integrates mitochondrial metabolism and inflammation; and SIRT1 deficiency may be a major determinant in CCM. To test this, C57BL/6 mice were infected with Trypanosoma cruzi (Tc), treated with SIRT1 agonists (resveratrol or SRT1720), and monitored during chronic phase (~150 days post-infection). Resveratrol treatment was partially beneficial in controlling the pathologic processes in Chagas disease. The 3-weeks SRT1720 therapy provided significant benefits in restoring the left ventricular (LV) function (stroke volume, cardiac output, ejection fraction etc.) in chagasic mice, though cardiac hypertrophy presented by increased thickness of the interventricular septum and LV posterior wall, increased LV mass, and disproportionate synthesis of collagens was not controlled. SRT1720 treatment preserved the myocardial SIRT1 activity and PGC1α deacetylation (active-form) that were decreased by 53% and 9-fold respectively, in chagasic mice. Yet, SIRT1/PGC1α-dependent mitochondrial biogenesis (i.e., mitochondrial DNA content, and expression of subunits of the respiratory complexes and mtDNA replication machinery) was not improved in chronically-infected/SRT1720-treated mice. Instead, SRT1720 therapy resulted in 2-10-fold inhibition of Tc-induced oxidative (H2O2 and advanced oxidation protein products), nitrosative (inducible nitric oxide synthase, 4-hydroxynonenal, 3-nitrotyrosine), and inflammatory (IFNγ, IL1β, IL6 and TNFα) stress and inflammatory infiltrate in chagasic myocardium. These benefits were delivered through SIRT1-dependent inhibition of NFκB transcriptional activity. We conclude that Tc inhibition of SIRT1/PGC1α activity was not a key mechanism in mitochondrial biogenesis defects during Chagas disease. SRT1720-dependent SIRT1 activation led to suppression of NFκB transcriptional

  13. 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

  14. Chagas disease: serological and electrocardiographic studies in Wichi and Creole communities of Misión Nueva Pompeya, Chaco, Argentina

    Directory of Open Access Journals (Sweden)

    Edgardo Moretti

    2010-08-01

    Full Text Available Chagas disease, which is caused by Trypanosoma cruzi, affects nearly 16 million people in Latin America and causes 75-90 million people to be at risk of infection. The disease is urbanizing and globalizing due to frequent migrations. There are regions of high prevalence of infection, including the north-eastern provinces of Argentina and the entire phytogeographic region known as the Gran Chaco. In the province of Chaco, Argentina, there are places inhabited by native populations such as the Wichi and Toba communities, among others. Many Creole populations resulting from miscegenation with European colonists and immigrants coexist within these communities. It has been widely accepted that in the chronic phase of the disease, between 25-30% of individuals develop some form of cardiac disease, with the right bundle-branch block being the most typical condition described so far. The aim of this work was to study the prevalence of Chagas infection and its electrocardiographic profile in the Wichi and Creole populations of Misión Nueva Pompeya, in the area known as Monte Impenetrable in Chaco, to determine the prevalence and the pattern of heart diseases produced by Chagas disease in this region.

  15. Adult congenital heart disease

    OpenAIRE

    Morphet, John AM

    2006-01-01

    One million people over the age of 20 suffer from congenital heart disease in the United States. These adult patients can slip through the cracks of our medical system; many are too old to be cared for in most pediatric institutions by pediatric cardiologists and, unfortunately, most adult cardiologists are not trained in congenital heart disease. Therefore, it is important to identify the common lesions in adult congenital heart disease and how they should be managed. Acyanotic congenital he...

  16. Radioisotopic exploration of patients suffering from chronic Chagas' disease

    International Nuclear Information System (INIS)

    The importance of Chagas' disease - a histic and haematic parasitosis endemic in extensive areas of Latin America, with 60 million people exposed to it and 20 million infected - stems from the high sickness and mortality rates affecting mainly rural and fringe populations. Nevertheless, progressive urbanization of the disease due to population migration and blood transfusion is being observed. The authors studied 56 cases of patients with Chagas' disease, 45 of whom were detected asymptomatically when donating blood by immunoserological reactions involving complement fixation and haemagglutination. Radiotracers were used to explore ventricular function in 56 cases; oesophageal transit in 29 cases; the upper urinary tract in 25 cases; and bladder function in 22 cases. All four procedures were applied to 19 patients. In 40 patients a study was made of the left and right ventricular function, the left being found altered in 17% of the cases, the right ventricular function in 22% and both in 25%. In 26 cases (65%) anomalies were encountered in at least one of the two ventricles. Oesophageal transit was altered in 20 patients, 16 of them asymptomatically. In 6 of them it was prolonged, in 4 it was adynamic and in 10 cases uncoordinated. The upper urinary tract showed abnormalities (pyelic dilation, pyelo-ureteral dyskinesia, ureteral dyskinesia, ureteral dilation and/or vesico-ureteral reflux) in 22 patients, in all cases asymptomatically. Bladder function was abnormal in 18 asymptomatic patients, basically represented by a residual decompensated cystopathy with a hypotonicity of different degrees. Of the 45 patients without symptoms detected when donating blood, there was alteration of ventricular function in 49%, of oesophageal transit in 68%, of the upper urinary tract in 90%, and of bladder function in 78%, with an overall figure of 66% abnormal examinations from 106 radioisotopic studies

  17. Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

  18. Mesenchymal bone marrow cell therapy in a mouse model of chagas disease. Where do the cells go?

    Directory of Open Access Journals (Sweden)

    Jasmin

    Full Text Available BACKGROUND: Chagas disease, resulting from infection with the parasite Trypanosoma cruzi (T. cruzi, is a major cause of cardiomyopathy in Latin America. Drug therapy for acute and chronic disease is limited. Stem cell therapy with bone marrow mesenchymal cells (MSCs has emerged as a novel therapeutic option for cell death-related heart diseases, but efficacy of MSC has not been tested in Chagas disease. METHODS AND RESULTS: We now report the use of cell-tracking strategies with nanoparticle labeled MSC to investigate migration of transplanted MSC in a murine model of Chagas disease, and correlate MSC biodistribution with glucose metabolism and morphology of heart in chagasic mice by small animal positron emission tomography (microPET. Mice were infected intraperitoneally with trypomastigotes of the Brazil strain of T. cruzi and treated by tail vein injection with MSC one month after infection. MSCs were labeled with near infrared fluorescent nanoparticles and tracked by an in vivo imaging system (IVIS. Our IVIS results two days after transplant revealed that a small, but significant, number of cells migrated to chagasic hearts when compared with control animals, whereas the vast majority of labeled MSC migrated to liver, lungs and spleen. Additionally, the microPET technique demonstrated that therapy with MSC reduced right ventricular dilation, a phenotype of the chagasic mouse model. CONCLUSIONS: We conclude that the beneficial effects of MSC therapy in chagasic mice arise from an indirect action of the cells in the heart rather than a direct action due to incorporation of large numbers of transplanted MSC into working myocardium.

  19. The potential for emergence of Chagas disease in the United States

    Directory of Open Access Journals (Sweden)

    Rebecca Click Lambert

    2008-05-01

    Full Text Available To determine the risk for Chagas disease (American trypanosomiasis in the United States, the characteristics that make the triatomine vector effective and the areas most at risk for transmission were delineated. In addition, the status of Chagas disease awareness among physicians in areas with a potential risk for the disease was determined. A geographical information system (GIS was used to analyze three triatomine species within the United States known to harbor Trypanosoma cruzi and that exhibit qualities of domesticity. An analysis of the minimum temperature threshold for increased triatomine activity delineates the current population at increased risk, and by incorporating temperature predictions for 2030, the population at risk under a future climate scenario was also delineated. Considering both environmental and social factors, a vignette-based physician survey, based on the results of the GIS analysis, was used to gauge the level of awareness of Chagas disease within the delineated higher risk range. The current area at increased risk for Chagas disease includes much of the southern United States, and the higher risk range is expected to expand into the central United States based upon the 1°C (1.8°F increase in temperature predicted by the Intergovernmental Panel on Climate Change (IPCC by the year 2030. Survey results indicate a limited consideration of Chagas disease during differential diagnosis, illustrating that the low number of Chagas disease cases discovered in the United States may be attributable to a lack of disease awareness as opposed to a lack of disease threat. This study combines GIS and survey analyses to evaluate the role that temperature variability and disease awareness among physicians play in the potential emergence of Chagas disease in the United States. This approach indicates that there is a potential for Chagas disease to emerge in the United States.

  20. [Association of encephalic vascular accidents and Chagas disease].

    Science.gov (United States)

    Lopes, E R; Marquez, J O; da Costa Neto, B; Menezes, A A; Chapadeiro, M E

    1991-01-01

    The frequency of strokes was studied in chronic chagasic and years of age, non-chagasic patients, older than 15 coming to necropsy in Uberaba, from 1979 than 1988. The study consisted of paired sex and age matched controls. Two hundred and eight pairs were analysed. Either ischemic or hemorrhagic strokes were found in 41 (19.7%) of the chagasics and in 55 (26.4%) of the non-chagasic, a difference not significant at the level of 5%. Twelve (75%) of the former had infarcts and 4 (25%) had brain hemorrhage; five (31.3%) of the non-chagasics had ischemic strokes and 11 (68.7%) had hemorrhagic strokes. The differences were significant to the level of 5%. The results indicate a high frequency of ischemic strokes in human Chagas' disease and demonstrate a lesser frequency of hemorrhagic stroke in chagasics when compared with non-chagasics. PMID:1841424

  1. Cerebral evoked potentials in human chronic Chagas' disease

    Directory of Open Access Journals (Sweden)

    O. M. Genovese

    1989-09-01

    Full Text Available Seventy five patients with the diagnosis of chronic Chagas' disease were studied by employing EPs techniques. Two of them had delayed arrival of the signal to the Erb's point and one to the spinal cord when looking at SEPs. TWo patients had increment of the time interval between waves 1st and IIIrd, when studying PEATs. These findings were interpreted as due to peripheral nerve fibers damage, a feature described in previous papers. The, most striking finding was the prolonged time interval between waves N13 and N20 (SEPs found in two patients and between waves IIIrd and Vth (PEAT seen in 7 affected subjects. These observations suggested the development of some sort of CNS involvement, perhaps related to myelin damage, in patients who reached the chronic state of the infection.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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.

  4. 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.

  5. Ischaemic heart disease

    DEFF Research Database (Denmark)

    Hansen, Louise Houlberg; Mikkelsen, Søren

    2013-01-01

    Purpose. Correct prehospital diagnosis of ischaemic heart disease (IHD) may accelerate and improve the treatment. We sought to evaluate the accuracy of prehospital diagnoses of ischemic heart diseases assigned by physicians. Methods. The Mobile Emergency Care Unit (MECU) in Odense, Denmark...

  6. Health-related quality of life in patients with Chagas disease: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Giovane Rodrigo Sousa

    2015-04-01

    Full Text Available Chagas disease (ChD, a neglected tropical disease caused by infection with the parasite Trypanosoma cruzi (T. cruzi, remains a serious public health issue in Latin America and is an emerging disease in several non-endemic countries, where knowledge of the condition and experience with its clinical management are limited. Regionally, the disease is the major cause of disability secondary to tropical diseases in young adults. Health-related quality of life (HRQoL impairment is common in patients with ChD, especially in those with Chagas dilated cardiomyopathy, the most severe manifestation of the disease, which frequently leads to heart failure. The aim of this review was to conduct a literature search for studies that have evaluated the determining factors of HRQoL in ChD patients. We included cross-sectional, case-control, cohort, and experimental studies, as well as clinical trials that evaluated the HRQoL in ChD patients aged 18 to 60 years and are presenting an explicit description of statistical analysis. Using a combination of keywords based on Descriptors in Health Sciences (DeCS and Medical Subject Headings (MeSH for searches in PubMed and the Scientific Electronic Library Online (SciELO, 148 studies were found. After exclusions, 12 studies were selected for analysis. Three main findings were extracted from these studies: 1 cardiac involvement is associated with a worse HRQoL in ChD patients; 2 HRQoL is associated with the patients' functional capacity; and 3 simple and inexpensive therapeutic measures are effective for improving HRQoL in ChD patients. Hence, ChD patients' functional capacity, the effectiveness of non-surgical conservative treatment, and cardiac involvement are important determining factors for the HRQoL in ChD patients.

  7. 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.

  8. Inflammation Enhances the Risks of Stroke and Death in Chronic Chagas Disease Patients

    OpenAIRE

    Guedes, Paulo Marcos Matta; de Andrade, Cléber Mesquita; Nunes, Daniela Ferreira; de Sena Pereira, Nathalie; Queiroga, Tamyres Bernadete Dantas; Machado-Coelho, George Luiz Lins; Nascimento, Manuela Sales Lima; Do-Valle-Matta, Maria Adelaide; da Câmara, Antônia Cláudia Jácome; Chiari, Egler; Galvão, Lúcia Maria da Cunha

    2016-01-01

    Ischemic strokes have been implicated as a cause of death in Chagas disease patients. Inflammation has been recognized as a key component in all ischemic processes, including the intravascular events triggered by vessel interruption, brain damage and repair. In this study, we evaluated the association between inflammatory markers and the death risk (DR) and stroke risk (SR) of patients with different clinical forms of chronic Chagas disease. The mRNA expression levels of cytokines, transcript...

  9. Chagas disease: What is known and what should be improved: a systemic review

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    José Rodrigues Coura

    2012-06-01

    Full Text Available This study consists of a broad review on what is known and what should be improved regarding knowledge of Chagas disease, not only through analysis on the main studies published on the topics discussed, but to a large extent based on experience of this subject, acquired over the past 50 years (1961-2011. Among the subjects covered, we highlight the pathogenesis and evolution of infection by Trypanosoma cruzi, drugs in use and new strategies for treating Chagas disease; the serological tests for the diagnosis and the controls of cure the infection; the regional variations in prevalence, morbidity and response to treatment of the disease; the importance of metacyclogenesis of T. cruzi in different species of triatomines and its capacity to transmit Chagas infection; the risks of adaptation of wild triatomines to human dwellings; the morbidity and need for a surveillance and control program for Chagas disease in the Amazon region and the need to prioritize initiatives for controlling Chagas disease in Latin America and Mexico and in non-endemic countries, which is today a major international dilemma. Finally, we raise the need for to create a new initiative for controlling Chagas disease in the Gran Chaco, which involves parts of Argentina, Bolivia and Paraguay.

  10. Does my patient have chronic Chagas disease? Development and temporal validation of a diagnostic risk score

    Directory of Open Access Journals (Sweden)

    Pedro Emmanuel Alvarenga Americano do Brasil

    2016-06-01

    Full Text Available Abstract: INTRODUCTION With the globalization of Chagas disease, unexperienced health care providers may have difficulties in identifying which patients should be examined for this condition. This study aimed to develop and validate a diagnostic clinical prediction model for chronic Chagas disease. METHODS This diagnostic cohort study included consecutive volunteers suspected to have chronic Chagas disease. The clinical information was blindly compared to serological tests results, and a logistic regression model was fit and validated. RESULTS The development cohort included 602 patients, and the validation cohort included 138 patients. The Chagas disease prevalence was 19.9%. Sex, age, referral from blood bank, history of living in a rural area, recognizing the kissing bug, systemic hypertension, number of siblings with Chagas disease, number of relatives with a history of stroke, ECG with low voltage, anterosuperior divisional block, pathologic Q wave, right bundle branch block, and any kind of extrasystole were included in the final model. Calibration and discrimination in the development and validation cohorts (ROC AUC 0.904 and 0.912, respectively were good. Sensitivity and specificity analyses showed that specificity reaches at least 95% above the predicted 43% risk, while sensitivity is at least 95% below the predicted 7% risk. Net benefit decision curves favor the model across all thresholds. CONCLUSIONS: A nomogram and an online calculator (available at http://shiny.ipec.fiocruz.br:3838/pedrobrasil/chronic_chagas_disease_prediction/ were developed to aid in individual risk estimation.

  11. Ruthenium Complex with Benznidazole and Nitric Oxide as a New Candidate for the Treatment of Chagas Disease

    Science.gov (United States)

    Sesti-Costa, Renata; Carneiro, Zumira A.; Silva, Maria C.; Santos, Maíta; Silva, Grace K.; Milanezi, Cristiane; da Silva, Roberto S.; Silva, João S.

    2014-01-01

    Background Chagas disease remains a serious medical and social problem in Latin America and is an emerging concern in nonendemic countries as a result of population movement, transfusion of infected blood or organs and congenital transmission. The current treatment of infected patients is unsatisfactory due to strain-specific drug resistance and the side effects of the current medications. For this reason, the discovery of safer and more effective chemotherapy is mandatory for the successful treatment and future eradication of Chagas disease. Methods and Findings We investigated the effect of a ruthenium complex with benznidazole and nitric oxide (RuBzNO2) against Trypanosoma cruzi both in vitro and in vivo. Our results demonstrated that RuBzNO2 was more effective than the same concentrations of benznidazole (Bz) in eliminating both the extracellular trypomastigote and the intracellular amastigote forms of the parasite, with no cytotoxic effect in mouse cells. In vivo treatment with the compound improved the survival of infected mice, inhibiting heart damage more efficiently than Bz alone. Accordingly, tissue inflammation and parasitism was significantly diminished after treatment with RuBzNO2 in a more effective manner than that with the same concentrations of Bz. Conclusions The complexation of Bz with ruthenium and nitric oxide (RuBzNO2) increases its effectiveness against T. cruzi and enables treatment with lower concentrations of the compound, which may reduce the side effects of Bz. Our findings provide a new potential candidate for the treatment of Chagas disease. PMID:25275456

  12. Ruthenium complex with benznidazole and nitric oxide as a new candidate for the treatment of chagas disease.

    Directory of Open Access Journals (Sweden)

    Renata Sesti-Costa

    2014-10-01

    Full Text Available Chagas disease remains a serious medical and social problem in Latin America and is an emerging concern in nonendemic countries as a result of population movement, transfusion of infected blood or organs and congenital transmission. The current treatment of infected patients is unsatisfactory due to strain-specific drug resistance and the side effects of the current medications. For this reason, the discovery of safer and more effective chemotherapy is mandatory for the successful treatment and future eradication of Chagas disease.We investigated the effect of a ruthenium complex with benznidazole and nitric oxide (RuBzNO2 against Trypanosoma cruzi both in vitro and in vivo. Our results demonstrated that RuBzNO2 was more effective than the same concentrations of benznidazole (Bz in eliminating both the extracellular trypomastigote and the intracellular amastigote forms of the parasite, with no cytotoxic effect in mouse cells. In vivo treatment with the compound improved the survival of infected mice, inhibiting heart damage more efficiently than Bz alone. Accordingly, tissue inflammation and parasitism was significantly diminished after treatment with RuBzNO2 in a more effective manner than that with the same concentrations of Bz.The complexation of Bz with ruthenium and nitric oxide (RuBzNO2 increases its effectiveness against T. cruzi and enables treatment with lower concentrations of the compound, which may reduce the side effects of Bz. Our findings provide a new potential candidate for the treatment of Chagas disease.

  13. 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

  14. Heart Disease and Stroke Prevention

    Science.gov (United States)

    ... disease and stroke prevention Heart Health and Stroke Heart disease and stroke prevention Related information Learn more about ... well-being. Does menopausal hormone therapy (MHT) prevent heart disease? Once you reach menopause, your ovaries stop making ...

  15. Living with Coronary Heart Disease

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Coronary Heart Disease Coronary heart disease (CHD) can cause serious complications. However, if you ... changes and medicines, go to "How Is Coronary Heart Disease Treated?" Work closely with your doctor to control ...

  16. Living with Diabetic Heart Disease

    Science.gov (United States)

    ... from the NHLBI on Twitter. Living With Diabetic Heart Disease Diabetic heart disease (DHD) increases the likelihood of earlier and more ... also tend to have less success from certain heart disease treatments, such as coronary artery bypass grafting and ...

  17. Heart Disease and African Americans

    Science.gov (United States)

    ... Minority Population Profiles > Black/African American > Heart Disease Heart Disease and African Americans Although African American adults are ... were 30 percent more likely to die from heart disease than non-Hispanic whites. African American women are ...

  18. Evaluation of Parasiticide Treatment with Benznidazol in the Electrocardiographic, Clinical, and Serological Evolution of Chagas Disease.

    Directory of Open Access Journals (Sweden)

    Abilio Augusto Fragata-Filho

    2016-03-01

    Full Text Available Chagas disease is one of the most important endemic parasitic diseases in Latin America. In its chronic phase, progression to cardiomyopathy has high morbidity and mortality. The persistence of a normal electrocardiogram (ECG provides a similar prognosis to that of a non-diseased population. Benznidazole (BNZ is the only drug with trypanocidal action available in Brazil.A group of 310 patients with chronic Chagas disease who had normal ECGs at the first medical visit performed before 2002 were included. There were 263 patients treated with BNZ and 47 untreated. The follow-up period was 19.59 years. Univariate analyses showed that those treated were younger and predominantly male. As many as 79.08% of those treated and 46.81% of those untreated continued with normal electrocardiograms (p <0.0001. The occurrence of electrocardiographic abnormalities and relevant clinical events (heart failure, stroke, total mortality, and cardiovascular death was less prevalent in treated patients (p <0.001, p: 0.022, p: 0.047 respectively. In multivariate analyses, the parasiticide treatment was an independent variable for persistence of a normal ECG pattern, which was an independent variable in the prevention of significant clinical events. The immunofluorescence titers decreased with the parasitological treatment. However, the small number of tests in untreated patients did not allow the correlation of the decrease of these titers with electrocardiographic alterations.These data suggest that treatment with benznidazole prevents the occurrence of electrocardiographic alterations. On the other hand, patients who develop ECG abnormalities present with more significant clinical events.

  19. Viability study of a multiplex diagnostic platform for Chagas disease

    Directory of Open Access Journals (Sweden)

    Leonardo Foti

    2009-07-01

    Full Text Available A new multiplex assay platform was evaluated to detect Trypanosoma cruzi infection using the recombinant antigens CRA, FRA, CRAFRA fusion and parasite lysate. The antigens presented different sensitivity and specificity in a singleplex test when compared to a serial dilution of two pools comprising 10 positive serum samples and one pool of 10 negative samples. The recombinant protein CRA presented lower sensitivity (55% in contrast to the 100% specificity and sensitivity of FRA, CRAFRA and T. cruzi lysate. These antigens also showed good results in a duplex test and the duplex test with CRAFRA/T. cruzi lysate showed better performance with 100% specificity and sensitivity, as well as a lower cut-off value in comparison to the other duplex test, FRA/T. cruzi lysate. Hence, when the antigens were used in duplex format, both tests showed decreased cut-off values and no interference between different bead sets, resulting in increasing sensitivity and specificity. The results of these multiplex tests show that they could be an alternative to singleplex detection for Chagas disease, and also indicate the necessity of using multiplex diagnostic tools to increase the sensitivity and specificity for diagnostic tests. Emerging data from the T. cruzi genome and from its ORFeome project will also allow the identification of new antigens for this disease detection application.

  20. Viability study of a multiplex diagnostic platform for Chagas disease.

    Science.gov (United States)

    Foti, Leonardo; Fonseca, Bruna de Paula Fonseca e; Nascimento, Lilian Dias; Marques, Christiane de Fatima Silva; da Silva, Edmilson Domingos; Duarte, Cesar Augusto Barros; Probst, Christian M; Goldenberg, Samuel; Pinto, Antônio Gomes; Krieger, Marco Aurélio

    2009-07-01

    A new multiplex assay platform was evaluated to detect Trypanosoma cruzi infection using the recombinant antigens CRA, FRA, CRAFRA fusion and parasite lysate. The antigens presented different sensitivity and specificity in a singleplex test when compared to a serial dilution of two pools comprising 10 positive serum samples and one pool of 10 negative samples. The recombinant protein CRA presented lower sensitivity (55%) in contrast to the 100% specificity and sensitivity of FRA, CRAFRA and T. cruzi lysate. These antigens also showed good results in a duplex test and the duplex test with CRAFRA/T. cruzi lysate showed better performance with 100% specificity and sensitivity, as well as a lower cut-off value in comparison to the other duplex test, FRA/T. cruzi lysate. Hence, when the antigens were used in duplex format, both tests showed decreased cut-off values and no interference between different bead sets, resulting in increasing sensitivity and specificity. The results of these multiplex tests show that they could be an alternative to singleplex detection for Chagas disease, and also indicate the necessity of using multiplex diagnostic tools to increase the sensitivity and specificity for diagnostic tests. Emerging data from the T. cruzi genome and from its ORFeome project will also allow the identification of new antigens for this disease detection application. PMID:19753468

  1. Coronary Heart Disease

    Science.gov (United States)

    ... by Mail Close www.diabetes.org > Living With Diabetes > Treatment and Care > Women Share: Print Page Text Size: A A ... heart-and-circulation, In this section Living With Diabetes Treatment and Care Women Coronary Heart Disease Sexual Health Women and ...

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

    Science.gov (United States)

    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

  3. Congenital heart disease

    Science.gov (United States)

    ... blood sugar level. Certain genes may play a role in congenital heart disease. Many family members may be affected. Talk to your provider about genetic counseling and screening if you have a family history ...

  4. Inflammation and Heart Disease

    Science.gov (United States)

    ... Pressure High Blood Pressure Tools & Resources Stroke More Inflammation and Heart Disease Updated:Apr 18,2016 Understand the risks of inflammation. Although it is not proven that inflammation causes ...

  5. Chagas Disease Vector Control in Tupiza, Southern Bolivia

    Directory of Open Access Journals (Sweden)

    G Guillen

    1997-01-01

    Full Text Available Heavy domestic and peridomestic infestations of Triatoma infestans were controlled in two villages in southern Bolivia by the application of deltamethrin SC25 (2.5% suspension concentrate at a target dose of 25 mg a.i./m². Actual applied dose was monitored by HPLC analysis of filter papers placed at various heights on the house walls, and was shown to range from 0 to 59.6 about a mean of 28.5 mg a.i./m². Wall bioassays showed high mortality of T. infestans during the first month after the application of deltamethrin. Mortality declined to zero as summer temperatures increased, but reappeared with the onset of the following winter. In contrast, knockdown was apparent throughout the trial, showing no discernible temperature dependence. House infestation rates, measured by manual sampling and use of paper sheets to collect bug faeces, declined from 79% at the beginning of the trial to zero at the 6 month evaluation. All but one of the houses were still free of T. infestans at the final evaluation 12 months after spraying, although a small number of bugs were found at this time in 5 of 355 peridomestic dependencies. Comparative cost studies endorse the recommendation of large-scale application of deltamethrin, or pyrethroid of similar cost-effectiveness, as a means to eliminate domestic T. infestans populations in order to interrupt transmission of Chagas disease

  6. [José Lima Pedreira de Freitas and the redefinition and control of Chagas disease].

    Science.gov (United States)

    Rocha, Juan Stuardo Yazlle

    2016-08-01

    A brief overview of the evolution of knowledge about Chagas disease since its discovery by Carlos Chagas in 1909 until the mid-1940s is presented. The trajectory of physician Pedreira de Freitas and his growing involvement in research in the area led to his contributions to laboratory diagnosis - which lent consistency and security to epidemiological surveys of Chagas disease - and the redefinition of the scale of the disease in Brazil and the Americas with its terrible social and economic impact. His proposal for the disease prevention model - based on selective purging in the application of insecticide - was adopted nationally and internationally and made it possible to bring the disease under control in Brazil and other countries. He devoted himself with equal intensity to enhancing the teaching of medical practices in the community and was a pioneer in the implementation of preventive medicine in medical education in Brazil. PMID:27557035

  7. 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)

  8. Socio-cultural aspects of Chagas disease: a systematic review of qualitative research.

    Directory of Open Access Journals (Sweden)

    Laia Ventura-Garcia

    Full Text Available BACKGROUND: Globally, more than 10 million people are infected with Trypanosoma cruzi, which causes about 20 000 annual deaths. Although Chagas disease is endemic to certain regions of Latin America, migratory flows have enabled its expansion into areas where it was previously unknown. Economic, social and cultural factors play a significant role in its presence and perpetuation. This systematic review aims to provide a comprehensive overview of qualitative research on Chagas disease, both in endemic and non-endemic countries. METHODOLOGY/PRINCIPAL FINDINGS: Searches were carried out in ten databases, and the bibliographies of retrieved studies were examined. Data from thirty-three identified studies were extracted, and findings were analyzed and synthesized along key themes. Themes identified for endemic countries included: socio-structural determinants of Chagas disease; health practices; biomedical conceptions of Chagas disease; patient's experience; and institutional strategies adopted. Concerning non-endemic countries, identified issues related to access to health services and health seeking. CONCLUSIONS: The emergence and perpetuation of Chagas disease depends largely on socio-cultural aspects influencing health. As most interventions do not address the clinical, environmental, social and cultural aspects jointly, an explicitly multidimensional approach, incorporating the experiences of those affected is a potential tool for the development of long-term successful programs. Further research is needed to evaluate this approach.

  9. Barriers to treatment access for Chagas disease in Mexico.

    Directory of Open Access Journals (Sweden)

    Jennifer M Manne

    Full Text Available BACKGROUND: According to World Health Organization (WHO prevalence estimates, 1.1 million people in Mexico are infected with Trypanosoma cruzi, the etiologic agent of Chagas disease (CD. However, limited information is available about access to antitrypanosomal treatment. This study assesses the extent of access in Mexico, analyzes the barriers to access, and suggests strategies to overcome them. METHODS AND FINDINGS: Semi-structured in-depth interviews were conducted with 18 key informants and policymakers at the national level in Mexico. Data on CD cases, relevant policy documents and interview data were analyzed using the Flagship Framework for Pharmaceutical Policy Reform policy interventions: regulation, financing, payment, organization, and persuasion. Data showed that 3,013 cases were registered nationally from 2007-2011, representing 0.41% of total expected cases based on Mexico's national prevalence estimate. In four of five years, new registered cases were below national targets by 11-36%. Of 1,329 cases registered nationally in 2010-2011, 834 received treatment, 120 were pending treatment as of January 2012, and the treatment status of 375 was unknown. The analysis revealed that the national program mainly coordinated donation of nifurtimox and that important obstacles to access include the exclusion of antitrypanosomal medicines from the national formulary (regulation, historical exclusion of CD from the social insurance package (organization, absence of national clinical guidelines (organization, and limited provider awareness (persuasion. CONCLUSIONS: Efforts to treat CD in Mexico indicate an increased commitment to addressing this disease. Access to treatment could be advanced by improving the importation process for antitrypanosomal medicines and adding them to the national formulary, increasing education for healthcare providers, and strengthening clinical guidelines. These recommendations have important implications for other

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Heart Disease and Stroke

    Centers for Disease Control (CDC) Podcasts

    2013-09-03

    In this podcast, Dr. Tom Frieden, CDC Director, discusses the number one killer in the United States - heart disease and stroke.  Created: 9/3/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/6/2014.

  13. Anthocyanins and heart disease

    Science.gov (United States)

    Anthocyanins are red, blue, and purple pigments distributed throughout nature, and in our diet. One potential health benefit of dietary anthocyanins is protection against cardiovascular disease (CVD). Evidence for beneficial effects of anthocyanins with respect to heart disease comes from epidemio...

  14. Study of the hypothalamic - hypophyseal - thyroid axis by the administration of TRH to Chagas' disease patients

    International Nuclear Information System (INIS)

    The TSH and T3 response to synthetic TRH was evaluated in two groups of patients: normal and with Chagas' disease, from the urban area of Sao Paulo (Brazil). Plasma T4, PBI and TSH values were within the normal range, when compared with those found in the controls: So were the thyroid uptakes of 2 and 24 hours; the basal levels of T3 where within the normal range except in three subjects whose values were higher than normal. After TRH administration the amount of TSH secretion in patients with Chagas' disease was increased when compared to normal ones, while T3 secretion was unaltered. It is suggested that in the Chagas' disease there is an increase in the pituitary TSH, while the thyroid reserve is preserved. This increase could be due to a difference in the regulation rate of TRH, which is determined by the neuronal degeneration caused by the disease itself. (author)

  15. Proteins involved on TGF-β pathway are up-regulated during the acute phase of experimental Chagas disease.

    Science.gov (United States)

    Ferreira, Roberto Rodrigues; de Souza, Elen Mello; de Oliveira, Fabiane Loiola; Ferrão, Patrícia Mello; Gomes, Leonardo Henrique Ferreira; Mendonça-Lima, Leila; Meuser-Batista, Marcelo; Bailly, Sabine; Feige, Jean Jacques; de Araujo-Jorge, Tania Cremonini; Waghabi, Mariana Caldas

    2016-05-01

    Studies developed by our group in the last years have shown the involvement of TGF-β in acute and chronic Chagas heart disease, with elevated plasma levels and activated TGF-β cell signaling pathway as remarkable features of patients in the advanced stages of this disease, when high levels of cardiac fibrosis is present. Imbalance in synthesis and degradation of extracellular matrix components is the basis of pathological fibrosis and TGF-β is considered as one of the key regulators of this process. In the present study, we investigated the activity of the TGF-β signaling pathway, including receptors and signaling proteins activation in the heart of animals experimentally infected with Trypanosoma cruzi during the period that mimics the acute phase of Chagas disease. We observed that T. cruzi-infected animals presented increased expression of TGF-β receptors. Overexpression of receptors was followed by an increased phosphorylation of Smad2/3, p38 and ERK. Furthermore, we correlated these activities with cellular factors involved in the fibrotic process induced by TGF-β. We observed that the expression of collagen I, fibronectin and CTGF were increased in the heart of infected animals on day 15 post-infection. Correlated with the increased TGF-β activity in the heart, we found that serum levels of total TGF-β were significantly higher during acute infection. Taken together, our data suggest that the commitment of the heart associates with increased activity of TGF-β pathway and expression of its main components. Our results, confirm the importance of this cytokine in the development and maintenance of cardiac damage caused by T. cruzi infection.

  16. 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...

  17. Antigenicity and Diagnostic Potential of Vaccine Candidates in Human Chagas Disease

    OpenAIRE

    Shivali Gupta; Xianxiu Wan; Zago, Maria P.; Martinez Sellers, Valena C.; Silva, Trevor S.; Dadjah Assiah; Monisha Dhiman; Sonia Nuñez; Petersen, John R; Vázquez-Chagoyán, Juan C.; Jose G Estrada-Franco; Nisha Jain Garg

    2013-01-01

    BACKGROUND: Chagas disease, caused by Trypanosoma cruzi, is endemic in Latin America and an emerging infectious disease in the US and Europe. We have shown TcG1, TcG2, and TcG4 antigens elicit protective immunity to T. cruzi in mice and dogs. Herein, we investigated antigenicity of the recombinant proteins in humans to determine their potential utility for the development of next generation diagnostics for screening of T. cruzi infection and Chagas disease. METHODS AND RESULTS: Sera samples f...

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

    Directory of Open Access Journals (Sweden)

    Moncayo Alvaro

    2003-01-01

    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, 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 of the autonomous nervous system in the heart, esophagus, colon and the peripheral nervous system. Data on the prevalence and distribution of Chagas disease improved in quality during the 1980's as a result of the demographically representative cross-sectional studies carried out in countries where accurate information was not available. A group of experts met in Brasília 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 program in the Southern Cone countries the transmission of Chagas disease by vectors and by blood transfusion has been interrupted in Uruguay in1997, in Chile in 1999, and in 8 of the 12 endemic states of Brazil in 2000 and so the incidence of new infections by T. cruzi in the whole continent has decreased by 70%. Similar control multi-country initiatives have been launched in the Andean countries and in Central America and rapid progress has been recorded to ensure the interruption of the transmission of Chagas disease by 2005 as requested by a Resolution of the World Health Assembly approved in 1998. The cost-benefit analysis of the investments of the vector control program in Brazil indicate that there are savings of US$17 in medical care and disabilities for each dollar spent on prevention, showing that the program is a health investment with good return. Since the inception in 1979 of the Steering

  19. A vital role for complement in heart disease.

    Science.gov (United States)

    Lappegård, Knut T; Garred, Peter; Jonasson, Lena; Espevik, Terje; Aukrust, Pål; Yndestad, Arne; Mollnes, Tom E; Hovland, Anders

    2014-10-01

    Heart diseases are common and significant contributors to worldwide mortality and morbidity. During recent years complement mediated inflammation has been shown to be an important player in a variety of heart diseases. Despite some negative results from clinical trials using complement inhibitors, emerging evidence points to an association between the complement system and heart diseases. Thus, complement seems to be important in coronary heart disease as well as in heart failure, where several studies underscore the prognostic importance of complement activation. Furthermore, patients with atrial fibrillation often share risk factors both with coronary heart disease and heart failure, and there is some evidence implicating complement activation in atrial fibrillation. Moreover, Chagas heart disease, a protozoal infection, is an important cause of heart failure in Latin America, and the complement system is crucial for the protozoa-host interaction. Thus, complement activation appears to be involved in the pathophysiology of a diverse range of cardiac conditions. Determination of the exact role of complement in the various heart diseases will hopefully help to identify patients that might benefit from therapeutic complement intervention.

  20. Congenital Chagas disease of second generation in Santiago, Chile. Report of two cases

    Directory of Open Access Journals (Sweden)

    SCHENONE Hugo

    2001-01-01

    Full Text Available Congenital Chagas disease (CChD has been reported in different countries, mostly in Latin America. In 1987 a fatal case of CChD of second generation (CChDSG was published. Within a period of six months - 1989-1990 - two cases of CChDSG were diagnosed and studied in the city of Santiago. Two premature newborns, sons of two sisters, with moderate liver and spleen enlargement, were found to have positive serology for Chagas disease and xenodiagnoses. The mothers, urban residents all their lives, without antecedents of triatomine bugs contact or blood transfusions, showed positive serology and xenodiagnoses. Their mother (grandmother of the infants, lived 20 years in a Northern rural Chagas disease endemic locality, in a triatomine infested house. Afterwards, she moved to Santiago, where she married and has resided up to now. Serology and xenodiagnoses were also positive. All the Trypanosoma cruzi infected individuals were successfully treated with nifurtimox.

  1. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... of Diabetes Educators JDRF American Heart Association MedlinePlus Diabetes Disease Organizations Many organizations provide support to patients ... Disease Organizations (PDF, 293 KB). Alternate Language URL Diabetes, Heart Disease, and Stroke Page Content On this ...

  2. Lyme Disease and the Heart

    Science.gov (United States)

    ... of the American Heart Association Cardiology Patient Page Lyme Disease and the Heart Peter J. Krause and Linda ... in a few cases. Diagnosis and Treatment of Lyme Disease The Centers for Disease Control and Prevention has ...

  3. Irradiated T. cruzi and resistant consomic animals can be useful in Chagas disease studies

    International Nuclear Information System (INIS)

    Human Chagas disease is considered the most significant parasitic disease in Latin America. It is estimated that 16-18 million people are infected by T. cruzi. As a consequence, approximately 50,000 deaths occur every year. The acute infection usually goes unrecognized and enters into a chronic stage that persists throughout the host's life span. However, roughly 30% of infected individuals eventually will develop disease with an array of possible manifestations affecting the heart, the digestive tract, and/or the peripheral nervous system. This disease is commonly modeled in inbred mice even though mouse strains used to simulate experimental infection vary considerably. In this way, Wrightsman and Trischmann showed that chromosome 17 was directly involved in a T. cruzi resistance, showing the influence of host's genetic constitution on disease severity. Additionally, in 2003, Passos and Graefe, working separately, quantified parasite burdens in resistant and susceptible strains and applied a backcross strategy to map the genomic loci linked to susceptibility and resistance in inbred mice. The genomes of the animals were scanned with microsatellite markers and the results found by these authors showed that the resistance mechanism is polygenic and is under the control of a complex network. In the particular case of Y strain, in vivo assays indicated that survival was related to the chromosomes 7,11,14,17 and 19. In order to evaluate the influence of each isolated chromosome as well as their interactions, we employed susceptible isogenic mice to construct consomic lineages for each one of those chromosomes. The consomic strains were injected with irradiated and native forms of Y strain T. cruzi, and the infectivity parameters were evaluated by quantitative methods. Radiation caused inability of trypanosomes to infect and kill mice, when these parasites were irradiated with 1 kGy of gamma rays from a 60Co source. In this experiment we used 101, 102, 103, 104 and 105

  4. Integrated control of Chagas disease for its elimination as public health problem - A Review

    Science.gov (United States)

    Sosa-Estani, Sergio; Segura, Elsa Leonor

    2015-01-01

    Chagas disease or American trypanosomiasis is, together with geohelminths, the neglected disease that causes more loss of years of healthy life due to disability in Latin America. Chagas disease, as determined by the factors and determinants, shows that different contexts require different actions, preventing new cases or reducing the burden of disease. Control strategies must combine two general courses of action including prevention of transmission to prevent the occurrence of new cases (these measures are cost effective), as well as opportune diagnosis and treatment of infected individuals in order to prevent the clinical evolution of the disease and to allow them to recuperate their health. All actions should be implemented as fully as possible and with an integrated way, to maximise the impact. Chagas disease cannot be eradicated due because of the demonstrated existence of infected wild triatomines in permanent contact with domestic cycles and it contributes to the occurrence of at least few new cases. However, it is possible to interrupt the transmission of Trypanosoma cruzi in a large territory and to eliminate Chagas disease as a public health problem with a dramatic reduction of burden of the disease. PMID:25993503

  5. Trypanosoma cruzi, causal agent of Chagas disease: The borderline between wild and domestic cycles in Venezuela.

    Directory of Open Access Journals (Sweden)

    Leidi eHerrera

    2014-11-01

    Full Text Available American trypanosomiasis or Chagas disease, caused by Trypanosoma cruzi, occurs between triatomine vectors and mammals, including man. T. cruzi has 150 Ma in America with almost 10 million of infected people today. The overlapping of its wild and domestic ecotopes is increasing. The host-parasite imbrications has been discerned by the study of infection patterns, transmissibility and transmission cycles in natural and laboratory models, through to parasitological and molecular tests. This article describes specific parasite niches, as plant biocenosis or biological corridors between domestic and wild ecotopes and helps distinguish Chagas disease risks and the borderline between wild and domestic transmission cycles, with emphasis on Venezuelan studies.

  6. Distantiae transmission of Trypanosoma cruzi: a new epidemiological feature of acute Chagas disease in Brazil.

    OpenAIRE

    Samanta Cristina das Chagas Xavier; André Luiz Rodrigues Roque; Daniele Bilac; Vitor Antônio Louzada de Araújo; Sócrates Fraga da Costa da Costa Neto; Elias Seixas Lorosa; Luiz Felipe Coutinho Ferreira da Silva; Ana Maria Jansen

    2014-01-01

    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 Va...

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

    Science.gov (United States)

    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.

  8. Hypertensive Heart Disease

    DEFF Research Database (Denmark)

    Wachtell, Kristian

    2011-01-01

    Abstract Hypertensive heart disease is prevalent and during the last decade it has been determined that patients with left ventricular (LV) hypertrophy have increased cardiovascular morbidity and mortality. However, many have doubted the effectiveness of LV mass assessment because it is difficult...

  9. Congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    970296 Evaluating the degree of pulmonary vascularlesions in congenital heart disease with selective pul-monary angiography. PAN Shiwei(潘世伟), et al.Fuwai Hosp, CAMS & PUMC, Beijing, 100037. Chin JCardiol 1997; 25(1): 39-41. Objective: To evaluate the degree of pulmonary vas-

  10. Coronary Artery Disease - Coronary Heart Disease

    Science.gov (United States)

    ... Tools & Resources Stroke More Coronary Artery Disease - Coronary Heart Disease Updated:May 20,2016 View an animation of ... call 9-1-1. Risk Factors and Coronary Heart Disease Major risk factors that can't be changed ...

  11. Assessment and epidemiology of Chagas' disease in patients treated in Araguaina - Tocantins; Avaliacao e epidemiologia da cardiopatia chagasica em pacientes atendidos em Araguaina - Tocantins

    Energy Technology Data Exchange (ETDEWEB)

    Correa, Valeria Rita

    2010-07-01

    Chagas disease (AD) was described by Carlos Chagas in 1909. It is caused by a parasite T. cruzi, transmitted by bugs, by blood transfusion, vertical and orally. The DC has two phases: acute and chronic. The evolution to the cardiac form occurs in about 30% of chronic cases and is the largest cause of mortality in chronic Chagas disease. The aim of this study was to Chagas' disease in patients of Tocantins, compared with other heart patients and asymptomatic from the standpoint of non-invasive exams using radiant energies such as echocardiography and ECG and RX. The descriptive study included 80 patients, 20 chronic form of Chagas disease, 20 indeterminate, 20 with other heart diseases, and 20 controls. There was a prevalence of 9.5% of chagasic patients treated in outpatient cardiology at Araguaina Tocantins, and 7.3% in chronic and 2.21% in the indeterminate. Of the chronic patients in the study 50% had mega esophagus and megacolon 4 (20%). Most patients had no family history of AD, nor was a smoker or drinker. Major electrocardiographic abnormalities found refer to driving. The evaluation of ICT, the chronic chagasic showed that increased by 40% of patients, 40% had esophageal changes and 20% of patients had megacolon s. The echocardiogram was abnormal in 42%). 27% of patients had EF below 55% changed. Changes in segmental contractility and Asynchrony septum were found in 80% of chronic Chagas disease. In 80% of the patients was observed diastolic dysfunction. The valvular changes occurred in 75%. Electrocardiographic abnormalities occurred in 80% of patients with CCC, while the other heart had ECG changes. Arterial hypertension had an incidence of 45% in patients with CCC and 40% in FCI. The systolic and diastolic ventricular dysfunction was more prevalent in groups that had an abnormal ECG and arrhythmia. Observed that the group of chagasic decreased ejection fraction is correlated to a higher incidence of arrhythmias besides diastolic dysfunction and

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

    Directory of Open Access Journals (Sweden)

    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

  13. Baroreflex Sensitivity and its Association with Arrhythmic Events in Chagas Disease

    Directory of Open Access Journals (Sweden)

    Astrid Meireles Santos

    2014-07-01

    Full Text Available Background: Sudden death is the leading cause of death in Chagas disease (CD, even in patients with preserved ejection fraction (EF, suggesting that destabilizing factors of the arrhythmogenic substrate (autonomic modulation contribute to its occurrence. Objective: To determine baroreflex sensitivity (BRS in patients with undetermined CD (GI, arrhythmogenic CD with nonsustained ventricular tachycardia (NSVT (GII and CD with spontaneous sustained ventricular tachycardia (STV (GIII, to evaluate its association with the occurrence and complexity of arrhythmias. Method: Forty-two patients with CD underwent ECG and continuous and noninvasive BP monitoring (TASK force monitor. The following were determined: BRS (phenylephrine method; heart rate variability (HRV on 24-h Holter; and EF (echocardiogram. Results: GIII had lower BRS (6.09 ms/mm Hg as compared to GII (11.84 and GI (15.23. The difference was significant between GI and GIII (p = 0.01. Correlating BRS with the density of ventricular extrasystoles (VE, low VE density ( 10/h had preserved BRS (p = 0.003. Patients with depressed BRS had higher VE density (p = 0.01, regardless of the EF. The BRS was the only variable related to the occurrence of SVT (p = 0.028. Conclusion: The BRS is preserved in undetermined CD. The BRS impairment increases as disease progresses, being more severe in patients with more complex ventricular arrhythmias. The degree of autonomic dysfunction did not correlate with EF, but with the density and complexity of ventricular arrhythmias.

  14. Genetically Determined MBL Deficiency Is Associated with Protection against Chronic Cardiomyopathy in Chagas Disease.

    Science.gov (United States)

    Luz, Paola Rosa; Miyazaki, Márcia I; Chiminacio Neto, Nelson; Padeski, Marcela C; Barros, Ana Cláudia M; Boldt, Angelica B W; Messias-Reason, Iara J

    2016-01-01

    Chagas disease (CD) is caused by Trypanosoma cruzi, whose sugar moieties are recognized by mannan binding lectin (MBL), a soluble pattern-recognition molecule that activates the lectin pathway of complement. MBL levels and protein activity are affected by polymorphisms in the MBL2 gene. We sequenced the MBL2 promoter and exon 1 in 196 chronic CD patients and 202 controls. The MBL2*C allele, which causes MBL deficiency, was associated with protection against CD (P = 0.007, OR = 0.32). Compared with controls, genotypes with this allele were completely absent in patients with the cardiac form of the disease (P = 0.003). Furthermore, cardiac patients with genotypes causing MBL deficiency presented less heart damage (P = 0.003, OR = 0.23), compared with cardiac patients having the XA haplotype causing low MBL levels, but fully capable of activating complement (P = 0.005, OR = 7.07). Among the patients, those with alleles causing MBL deficiency presented lower levels of cytokines and chemokines possibly implicated in symptom development (IL9, p = 0.013; PDGFB, p = 0.036 and RANTES, p = 0.031). These findings suggest a protective effect of genetically determined MBL deficiency against the development and progression of chronic CD cardiomyopathy.

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

    Science.gov (United States)

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

    2015-01-01

    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. PMID:25946155

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

    Science.gov (United States)

    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.

  17. Transplante de células da medula óssea na insuficiência cardíaca chagásica: relato da primeira experiência humana Transplante de células de la médula ósea en la insuficiencia cardíaca de la enfermedad de chagas: relato de la Primera Experiencia Humana Bone marrow cell transplantation in chagas' disease heart failure: report of the first human experience

    Directory of Open Access Journals (Sweden)

    Fábio Vilas-Boas

    2011-04-01

    , arritmias y parámetros bioquímicos, inmunológicos y neurohumorales. RESULTADOS:No se registraron complicaciones relacionadas directamente con el procedimiento. La FEVI pasó de 20,1 ± 6,8% para 28,3 ± 7,9%, p BACKGROUND: Heart failure due to Chagas' disease (HFCD is a progressive inflammatory cardiomyopathy that affects millions of individuals in Latin America. Studies using mice models of HFCD indicate that bone marrow mononuclear cell transplantation (BMCT may reduce inflammation, fibrosis, and improve myocardial function. OBJECTIVE: The purpose of this study was to evaluate, for the first time in humans, the safety and efficacy of BMCT to the myocardium of patients with HFCD. METHODS: A total of 28 HFCD patients (mean age 52.2 ± 9.9 years with NYHA class III and IV were submitted to BMCT through intracoronary injection. Effects on the left ventricle ejection fraction (LVEF, functional capacity, quality-of-life, arrhythmias, biochemical, immunological, and neuro-humoral parameters, were evaluated. RESULTS: There were no complications directly related to the procedure. LVEF was 20.1 ± 6.8% and 28.3 ± 7.9%, p < 0.03 at baseline and 180 days after the procedure, respectively. In the same period, significant improvements were observed in the NYHA class (3.1 ± 0.3 to 1.8 ± 0.5; p < 0.001, quality-of-life (50.9 ± 11.7 to 25.1 ± 15.9; p < 0.001, and in the six-minute walking test (355 ± 136 m to 437 ± 94 m; p < 0,01. There were no changes in markers of immune or neurohormonal activation. No complications were registered. CONCLUSION: Our data suggest that the intracoronary injection of BMCT is safe and potentially effective in patients with HFCD. The extent of the benefit, however, appears to be small and needs to be confirmed in a larger randomized, double blind, placebo controlled clinical trial.

  18. 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…

  19. A doença de Chagas em Minas Gerais: esbôco crítico dos trabalhos publicados até 1951 Chagas' disease in Minas Geraes: a critical sudy of the papers published up to 1951

    Directory of Open Access Journals (Sweden)

    J. Pellegrino

    1953-12-01

    Lassance were carried out by Chagas and its co-workers of the Oswaldo Cruz Institute. During this period they described the various clinical features of the new disease, made a detailed study of its agent and the biology of the transmitting insects, and experiments and studies on the pathogeny and pathology of the disease; they developed diagnostic methods, analysed the role of domiciliary and wild reservoirs, and insistently showed the social significance of this sanitary problem. 2 The research work made on Chagas' disease in Bambuí contributed decisively for the growing interest on the study of this disease during the last few years. Although the work in Bambuí was carried out continuously since its beginning in 1940, the researches may be divided into two groups, namely the preliminary made before the installation in the mentioned city of the Center for the Study and Prophylaxis of Chagas' Disease in November 1943, and the work done after the installation of the Center. The first group represents the first contribution after the researches carried out in Lassance, towards a formal study of acute cases of Chagas' disease in the State .The finding of numerous acute cases at Bambuí led the direction of the Oswaldo Cruz Institute to create a Center of Studies in that city. An outstanding contribution on the clinical, epidemiological and prophylactic fields was brought about by investigators of Manguinhos with the abundant material supplied by the Bambuí Center. The chief contributions from Bambuí were of three kinds: a The individualization of the chronic Chagas' heart disease on clinical, anatomo-pathological, electrocardiographic and experimental basis; the demonstration of its great frequency in infected individuals and the verification that in certain rural areas schizotrypanosis is one of the most important etiological factors of heart disease. b The experience acquired with the use of the complement fixation reaction with antigens of cultures of Schizotripanum

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Heart Disease: Know Your Risk

    Science.gov (United States)

    ... and Stroke This information in Spanish ( en español ) Heart disease: Know your risk Are you at risk for ... risk factors Return to top More information on Heart disease and stroke prevention Read more from womenshealth.gov ...

  2. FastStats: Heart Disease

    Science.gov (United States)

    ... this? Submit What's this? Submit Button NCHS Home Heart Disease Recommend on Facebook Tweet Share Compartir Data are ... the U.S. Morbidity Number of adults with diagnosed heart disease: 27.6 million Percent of adults with diagnosed ...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Socio-Cultural Aspects of Chagas Disease: a Systematic Review of Qualitative Research

    NARCIS (Netherlands)

    L. Ventura-Garcia; M. Roura; C. Pell; E. Posada; J. Gascón; E. Aldasoro; J. Muñoz; R. Pool

    2013-01-01

    Background: Globally, more than 10 million people are infected with Trypanosoma cruzi, which causes about 20 000 annual deaths. Although Chagas disease is endemic to certain regions of Latin America, migratory flows have enabled its expansion into areas where it was previously unknown. Economic, soc

  6. Oral Transmission of Chagas Disease by Consumption of Açaí Palm Fruit, Brazil

    OpenAIRE

    Nóbrega, Aglaêr A.; Garcia, Marcio H.; Tatto, Erica; Marcos T Obara; Costa, Elenild; Sobel, Jeremy; Araujo, Wildo N.

    2009-01-01

    In 2006, a total of 178 cases of acute Chagas disease were reported from the Amazonian state of Pará, Brazil. Eleven occurred in Barcarena and were confirmed by visualization of parasites on blood smears. Using cohort and case–control studies, we implicated oral transmission by consumption of açaí palm fruit.

  7. In vitro and in vivo experimental models for drug screening and development for Chagas disease

    Directory of Open Access Journals (Sweden)

    Alvaro José Romanha

    2010-03-01

    Full Text Available Chagas disease, a neglected illness, affects nearly 12-14 million people in endemic areas of Latin America. Although the occurrence of acute cases sharply has declined due to Southern Cone Initiative efforts to control vector transmission, there still remain serious challenges, including the maintenance of sustainable public policies for Chagas disease control and the urgent need for better drugs to treat chagasic patients. Since the introduction of benznidazole and nifurtimox approximately 40 years ago, many natural and synthetic compounds have been assayed against Trypanosoma cruzi, yet only a few compounds have advanced to clinical trials. This reflects, at least in part, the lack of consensus regarding appropriate in vitro and in vivo screening protocols as well as the lack of biomarkers for treating parasitaemia. The development of more effective drugs requires (i the identification and validation of parasite targets, (ii compounds to be screened against the targets or the whole parasite and (iii a panel of minimum standardised procedures to advance leading compounds to clinical trials. This third aim was the topic of the workshop entitled Experimental Models in Drug Screening and Development for Chagas Disease, held in Rio de Janeiro, Brazil, on the 25th and 26th of November 2008 by the Fiocruz Program for Research and Technological Development on Chagas Disease and Drugs for Neglected Diseases Initiative. During the meeting, the minimum steps, requirements and decision gates for the determination of the efficacy of novel drugs for T. cruzi control were evaluated by interdisciplinary experts and an in vitro and in vivo flowchart was designed to serve as a general and standardised protocol for screening potential drugs for the treatment of Chagas disease.

  8. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008277 Relationship between pulse wave velocity and the NYHA classification of coronary insufficiency.SUN Weiping(孙卫平),et al.Dept Cardiol,Tongji Hosp Tongji Univ,Shanghai 200065.Chin J Intern Med 2008;47(5):382-384.Objective To investigate the relationship between brachial-ankle pulse wave velocity(baPWV)and different stage of cardiac dysfunction.Methods 253 consecutive patients with coronary atherosclerotic heart disease

  9. Cardiac rehabilitation program in patients with Chagas heart failure: a single-arm pilot study

    Directory of Open Access Journals (Sweden)

    Mauro Felippe Felix Mediano

    2016-06-01

    Full Text Available Abstract: INTRODUCTION: The benefit of a cardiac rehabilitation (CR program for patients with Chagas heart failure (CHF remains unclear. Therefore, we aimed to investigate the effects of CR for CHF patients. METHODS: A single-arm pilot study, including 12 patients with CHF, was performed. Patients participated in an 8-month physical exercise intervention, comprising aerobic, strength, and stretching exercises (3 times per week, 60 minutes per session. Nutritional and pharmaceutical counseling were also performed. Functional capacity (cardiopulmonary exercise test, muscle respiratory strength (manovacuometry, and body composition (anthropometry and skinfolds were evaluated at baseline, and after 4 and 8 months of intervention. Cardiac function (echocardiography, biomarkers (lipid profile, glucose, and glycated hemoglobin and quality of life (Minnesota Living with Heart Failure Questionnaire were assessed at baseline and at the end of the intervention. RESULTS: Seven of 12 patients included in the study completed the 8-month follow-up period. Only 2 moderate adverse events occurred during the exercise training. Functional capacity improved after 4 months of CR, while left ventricular ejection fraction (LVEF and respiratory strength improved after 8 months. Patients with right ventricular (RV dysfunction at baseline exhibited an improvement in functional capacity after 4 months, and improvements in left ventricular (LV diastolic pressure, respiratory strength, and quality of life at the end of follow-up. Conversely, those with normal baseline RV function demonstrated LVEF increases that were not observed in patients with RV dysfunction. CONCLUSIONS: CR was feasible, safe, and has important clinical benefits for patients with CHF, specifically for cardiac function and muscle respiratory strength.

  10. Development of a Novel Multiplex Immunoassay Multi-cruzi for the Serological Confirmation of Chagas Disease

    OpenAIRE

    Granjon, Elodie; Dichtel-Danjoy, Marie-Laure; Saba, Esber; Sabino, Ester; Campos de Oliveira, Lea; Zrein, Maan

    2016-01-01

    Background Chagas disease is due to the parasite Trypanosoma cruzi, a protist disseminated by a Triatome vector. This disease is endemic to Latin America and considered by WHO as one of the 17 world’s neglected diseases. In Europe and in North America, imported cases are also detected, due to migration of population outside of the endemic region. Diagnosis of T. cruzi infection is usually made indirectly by the detection of specific antibodies to T. cruzi antigens. Following initial diagnosti...

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

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    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.

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

    Science.gov (United States)

    Carbajal-de-la-Fuente, Ana Laura; Yadón, Zaida E

    2013-11-01

    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. PMID:24244761

  13. Resultados iniciais do transplante de células de medula óssea para o miocárdio de pacientes com insuficiência cardíaca de etiologia chagásica Early results of bone marrow cell transplantation to the myocardium of patients with heart failure due to chagas disease

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    Fábio Vilas-Boas

    2006-08-01

    Full Text Available OBJETIVO: Avaliar efeitos precoces do transplante de células de medula óssea para o miocárdio de pacientes com insuficiência cardíaca (IC de etiologia chagásica. MÉTODOS: A amostra consistiu de 28 pacientes, idade média 52,2±9,9 anos, 24 masculinos, 25 em classe NYHA III e 3 em NYHA IV, apesar de tratamento otimizado. O procedimento consistiu na aspiração de 50ml de medula óssea, separação da fração mononuclear e injeção intracoronariana. Foram avaliados os efeitos sobre a fração de ejeção ventricular esquerda (FEVE, distância no teste de 6 minutos, qualidade de vida, classe NYHA, efeitos arritmogênicos e bioquímicos. RESULTADOS: Não houve complicações relacionadas diretamente ao procedimento. A fração de ejeção ventricular esquerda em repouso antes do transplante era 20,1±6,8% e, após 60 dias, aumentou para 23,0±9,0%, p = 0,02. Houve melhora da classe NYHA (3,1±0,3 para 1,8±0,5; pOBJECTIVE: To evaluate early effects of bone marrow cell transplantation to the myocardium of patients with heart failure (CHF due to Chagas disease. METHODS: We studied 28 patients (mean age 52.2 ± 9.9, of whom 24 were male. Despite optimized treatment, 25 patients were in NYHA class III and three patients, in NYHA class IV. The procedure consisted of aspiration of 50 mL of bone marrow, separation of the mononuclear fraction, and intracoronary injection. Effects on left ventricle ejection fraction (LVEF, distance walked in the six-minute walking test, quality-of-life, NYHA class, arrhythmogenic and biochemical parameters, were all evaluated. RESULTS: There were no complications directly related to the procedure. Baseline left ventricular ejection fraction was 20.1 ± 6.8%, and 60 days after transplantation it increased to 23.0 ± 9.0%, p = 0.02. Significant improvements were observed in the NYHA class (3.1 ± 0.3 to 1.8 ± 0.5; p < 0.0001; quality-of-life (50.9 ± 11.7 to 21.8 ± 13.4; p < 0.0001; and distance walked in six

  14. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... Disease, and Other Dental Problems Diabetic Eye Disease Diabetes, Heart Disease, and Stroke Having diabetes or prediabetes ... can help prevent future health problems. What is diabetes? Diabetes is a disorder of metabolismthe way our ...

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

    OpenAIRE

    José Rodrigues Coura; Angela Cristina Verissimo Junqueira; Cristina Maria Giordano; Ilra Renata Komoda Funatsu

    1994-01-01

    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 betwe...

  16. Chemokine receptor CCR5 polymorphisms and Chagas' disease cardiomyopathy.

    Science.gov (United States)

    Calzada, J E; Nieto, A; Beraún, Y; Martín, J

    2001-09-01

    In this study we investigated the possible role of two CCR5 gene polymorphisms, CCR5Delta32 deletion and CCR5 59029 A-->G promoter point mutation, in determining the susceptibility to Trypanosoma cruzi infection as well as in the development of chagasic heart disease. These CCR5 polymorphisms were assessed in 85 seropositive (asymptomatic, n=53; cardiomyopathic, n=32) and 87 seronegative individuals. The extremely low frequency (0.009) of the CCR5Delta32 allele in our population did not allow us to analyse its possible influence on T. cruzi infection. We found no differences in the distribution of CCR5 59029 promoter genotype or phenotype frequencies between total chagasic patients and controls. However, we observed that the CCR5 59029-A/G genotype was significantly increased in asymptomatic with respect to cardiomyopathic patients (P=0.02; OR=0.33, 95% CI 0.10-0.94). In addition, the presence of the CCR5 59029-G allele was also increased in asymptomatics when compared with cardiomyopathics (P=0.02; OR=0.35, 95% CI 0.12-0.96). Our data suggest that the CCR5 59029 promoter polymorphism may be involved in a differential susceptibility to chagasic cardiomyopathy.

  17. Outbreak of acute Chagas disease associated with oral transmission in the Rio Negro region, Brazilian Amazon

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    Rita de Cássia de Souza-Lima

    2013-10-01

    Full Text Available Introduction Chagas disease is considered as emerging in the Brazilian Amazon, usually occurring in acute outbreaks. Methods We describe 17 cases of acute Chagas disease in Rio Negro, Amazonas. Results There were 15 males (average age, 31.3 years, all positive for Trypanosoma cruzi in fresh blood smear examination, and 14 positive by xenodiagnosis and PCR. The top clinical manifestations were fever, asthenia, abdominal pain, and palpitations. Electrocardiograms featured low-voltage QRS, anterosuperior divisional block, and right bundle branch block associated with anterosuperior divisional block. Conclusions All patients had consumed açaí products from Monte Alegre in the rural area around Santa Izabel do Rio Negro, Brazil.

  18. Outbreak of acute Chagas disease associated with oral transmission in the Rio Negro region, Brazilian Amazon

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    Rita de Cassia de Souza-Lima

    2013-07-01

    Full Text Available Introduction Chagas disease is considered as emerging in the Brazilian Amazon, usually occurring in acute outbreaks. Methods We describe 17 cases of acute Chagas disease in Rio Negro, Amazonas. Results There were 15 males (average age, 31.3 years, all positive for Trypanosoma cruzi in fresh blood smear examination, and 14 positive by xenodiagnosis and PCR. The top clinical manifestations were fever, asthenia, abdominal pain, and palpitations. Electrocardiograms featured low-voltage QRS, anterosuperior divisional block, and right bundle branch block associated with anterosuperior divisional block. Conclusions All patients had consumed açaí products from Monte Alegre in the rural area around Santa Izabel do Rio Negro, Brazil.

  19. Chagas disease: from bush to huts and houses. Is it the case of the Brazilian amazon?

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    José Rodrigues Coura

    1999-09-01

    Full Text Available Two of the major problems facing the Amazon - human migration from the other areas and uncontrolled deforestation - constitute the greatest risk for the establishment of endemic Chagas disease in this part of Brazil. At least 18 species of triatomines had been found in the Brazilian Amazon, 10 of them infected with Trypanosoma cruzi, associated with numerous wild reservoirs. With wide-range deforestation, wild animals will perforce be driven into other areas, with tendency for triatomines to become adapted to alternative food sources in peri and intradomicilies. Serological surveys and cross-sectional studies for Chagas disease, carried out in rural areas of the Rio Negro, in the Brazilian Amazon, showed a high level of seropositivity for T. cruzi antibodies. A strong correlation of seroreactivity with the contact of gatherers of piaçava fibers with wild triatomines could be evidenced.

  20. 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. PMID:27232127

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

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    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. [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. PMID:2501847

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

    OpenAIRE

    C. I. Abramson; E. Aldana; E. Sulbaran

    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.

  4. Assessment of Autonomic Function by Phase Rectification of RRInterval Histogram Analysis in Chagas Disease

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    Olivassé Nasari Junior

    2015-06-01

    Full Text Available Background: In chronic Chagas disease (ChD, impairment of cardiac autonomic function bears prognostic implications. Phase‑rectification of RR-interval series isolates the sympathetic, acceleration phase (AC and parasympathetic, deceleration phase (DC influences on cardiac autonomic modulation. Objective: This study investigated heart rate variability (HRV as a function of RR-interval to assess autonomic function in healthy and ChD subjects. Methods: Control (n = 20 and ChD (n = 20 groups were studied. All underwent 60-min head-up tilt table test under ECG recording. Histogram of RR-interval series was calculated, with 100 ms class, ranging from 600–1100 ms. In each class, mean RR-intervals (MNN and root-mean-squared difference (RMSNN of consecutive normal RR-intervals that suited a particular class were calculated. Average of all RMSNN values in each class was analyzed as function of MNN, in the whole series (RMSNNT, and in AC (RMSNNAC and DC (RMSNNDC phases. Slopes of linear regression lines were compared between groups using Student t-test. Correlation coefficients were tested before comparisons. RMSNN was log-transformed. (α < 0.05. Results: Correlation coefficient was significant in all regressions (p < 0.05. In the control group, RMSNNT, RMSNNAC, and RMSNNDC significantly increased linearly with MNN (p < 0.05. In ChD, only RMSNNAC showed significant increase as a function of MNN, whereas RMSNNT and RMSNNDC did not. Conclusion: HRV increases in proportion with the RR-interval in healthy subjects. This behavior is lost in ChD, particularly in the DC phase, indicating cardiac vagal incompetence.

  5. Right Ventricular Doppler Echocardiographic Study of Indeterminate Form of Chagas Disease

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    Rogério Gomes Furtado

    2015-03-01

    Full Text Available Background: Patients with indeterminate form of Chagas disease/cardiac normality (ICD/CN exhibited normal electrocardiograms and chest X-rays; however, more sophisticated tests detected some degree of morphological and functional changes in the heart. Objective: To assess the prevalence of systolic and diastolic dysfunction of the right ventricle (RV in patients with ICD/CN. Methods: This was a case–control and prevalence study. Using Doppler two-dimensional echocardiography (2D, 92 patients were assessed and divided into two groups: group I (normal, n = 31 and group II (ICD/CN, n = 61. Results: The prevalence of RV systolic dysfunction in patients in groups I and II was as follows: fractional area change (0.0% versus 0.6%, mobility of the tricuspid annulus (0.0% versus 0.0%, and S-wave tissue Doppler (6.4% versus 26.0%, p = 0.016. The prevalence of global disorders such as the right myocardial performance index using tissue Doppler (16.1% versus 27.8%, p = 0.099 and pulsed Doppler (61.3% versus 68%, p = 0.141 and diastolic disorders such as abnormal relaxation (0.0% versus 6.0%, pseudonormal pattern (0.0% versus 0.0%, and restrictive pattern (0.0% versus 0.0% was not statistically different between groups. Conclusion: The prevalence of RV systolic dysfunction was estimated to be 26% (S wave velocity compared with other variables, suggesting incipient changes in RV systolic function in the ICD/CN group.

  6. Health-related quality of life in patients with Chagas disease

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    Bruna Guimarães Oliveira

    2011-04-01

    Full Text Available INTRODUCTION: Chagas disease (ChD is a chronic illness related to significant morbidity and mortality that can affect the quality of life (QoL of infected patients. However, there are few studies regarding QoL in ChD. The objectives of this study are to construct a health-related QoL (HRQoL profile of ChD patients and compare this with a non-ChD (NChD group to identify factors associated with the worst HRQoL scores in ChD patients. METHODS: HRQoL was investigated in 125 patients with ChD and 21 NChD individuals using the Medical Outcomes Study 36-item Short-Form (SF-36 and the Minnesota Living with Heart Failure Questionnaire (MLWHFQ. Patients were submitted to a standard protocol that included clinical examination, ECG, Holter monitoring, Doppler echocardiogram and autonomic function tests. RESULTS: HRQoL scores were significantly worse among the ChD group compared to the NChD group in the SF-36 domains of physical functioning and role-emotional and in the MLWHFQ scale. For the ChD group, univariate analysis showed that HRQoL score quartiles were associated with level of education, sex, marital status, use of medication, functional classification and cardiovascular and gastrointestinal symptoms. In the multivariate analysis, female sex, fewer years of education, single status, worst functional classification, presence of cardiovascular and gastrointestinal symptoms, associated illnesses, Doppler echocardiographic abnormalities and ventricular arrhythmia detected during Holter monitoring were predictors of lower HRQoL scores. CONCLUSIONS: ChD patients showed worse HRQoL scores compared to NChD. For the ChD group, sociodemographic and clinical variables were associated with worst scores.

  7. Type 1 chemokine receptor expression in Chagas' disease correlates with morbidity in cardiac patients.

    Science.gov (United States)

    Gomes, Juliana A S; Bahia-Oliveira, Lilian M G; Rocha, Manoel Otávio C; Busek, Solange C U; Teixeira, Mauro M; Silva, João Santana; Correa-Oliveira, Rodrigo

    2005-12-01

    Chemokines and chemokine receptors (CKRs) control the migration of leukocytes during the inflammatory process and are important immunological markers of type 1 (CCR5 and CXCR3) and type 2 (CCR3 and CCR4) responses. The coexpression of CKRs (CCR2, CCR3, CCR5, CXCR3, and CXCR4) and intracellular cytokines (interleukin-10 [IL-10], IL-4, tumor necrosis factor alpha [TNF-alpha], and gamma interferon [IFN-gamma]) on T CD4+ and CD8+ peripheral cells from individuals with indeterminate (IND) or cardiac (CARD) clinical forms of Chagas' disease after in vitro stimulation with Trypanosoma cruzi antigens, were evaluated in this study. The percentage of T CD4+ and CD8+ cells coexpressing CCR5 and IFN-gamma, CXCR3 and IFN-gamma, and CXCR3 and TNF-alpha were higher in CARD than in IND individuals; on the other hand, the percentage of T CD4+ or CD8+ cells coexpressing CCR3 and IL-10 or coexpressing CCR3 and IL-4 were lower in CARD individuals than in IND individuals. In addition, a significant positive correlation between the expression of CCR5 or CXCR3 and IFN-gamma was observed in CARD individuals contrasting with a significant positive correlation between the expression of CCR3 and IL-4 and of CCR3 and IL-10 in IND patients. These results reinforce the hypothesis that a T. cruzi-exacerbated specific type 1 immune response developed by CARD chagasic patients is associated with the development of heart pathology.

  8. Women's Heart Disease: Join the Heart Truth Community

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    ... this page please turn JavaScript on. Feature: Women's Heart Disease Join The Heart Truth Community Past Issues / Winter ... introduced as the national symbol for women and heart disease awareness in 2002 by the NHLBI. The Red ...

  9. Women and Heart Disease: Sharing Advice from the Heart

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    ... page please turn JavaScript on. Feature: Women and Heart Disease Sharing Advice From The Heart Past Issues / Spring ... gowns in an effort to raise awareness that heart disease is the leading cause of death among women. ...

  10. 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.

  11. Working conditions of Chagas' disease patients in a large Brazilian city

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    Maria Elena Guariento

    1999-04-01

    Full Text Available This study evaluated the working conditions of Chagas' disease patients in the city of Campinas, São Paulo, focusing on two-hundred-fifty patients with steady employment and treated at the University Hospital (HC-FCM/Unicamp: 98% were working-age and 77.6% were men. The origin of the patients reflected the migratory process occurring among this population. Most of the patients had limited professional skills, while 63.6% had not finished primary school and 21.6% were illiterate. However, 63.6% were regularly employed under duly processed work contracts. Their jobs were mainly in general services (21.6% and heavy industry (21.2%. Some 55% of the patients reported a monthly income less than or equal to U$100.00, and 40.4% reported having been fired at least once during the last ten years, in 8.9% of the cases because of a diagnosis of Chagas' disease. Of the patients undergoing pre-hiring physical examinations (57.2%, 9.1% were refused, 92.3% of whom due to positive serology for T. cruzi. Finally, 78.4% reported not belonging to a labor union. The study demonstrated the precarious working conditions and discrimination experienced by workers with Chagas' disease.

  12. 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.

  13. Living with heart disease and angina

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    ... medlineplus.gov/ency/patientinstructions/000576.htm Living with heart disease and angina To use the sharing features on ... please enable JavaScript. Coronary artery disease - living with Heart Disease and Angina Coronary heart disease (CHD) is a ...

  14. Other Possible Heart Disease Risk Factors

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    ... your risk Heart Health and Stroke Other possible heart disease risk factors Related information Depression fact sheet Stress ... Return to top More information on Other possible heart disease risk factors Read more from womenshealth.gov Heart ...

  15. Heart Disease Affects Women of All Ages

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    Skip Navigation Bar Home Current Issue Past Issues Heart Disease Affects Women of All Ages Past Issues / Winter ... weeks of a heart attack. For Women with Heart Disease: About 6 million American women have coronary heart ...

  16. Heart Valve Diseases

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    Your heart has four valves. Normally, these valves open to let blood flow through or out of your heart, and then shut to keep it from flowing ... close tightly. It's one of the most common heart valve conditions. Sometimes it causes regurgitation. Stenosis - when ...

  17. 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.

  18. Epidemiology of rheumatic heart disease.

    OpenAIRE

    Imamoglu, A.; Ozen, S

    1988-01-01

    We compared the incidence of rheumatic heart disease in elementary schoolchildren from low and high socioeconomic groups; children from one of the schools were rescreened 10 years later. The results showed that the incidence of rheumatic heart disease was significantly higher in low socioeconomic group but it is gradually declining.

  19. What Causes Heart Valve Disease?

    Science.gov (United States)

    ... other infections with strep bacteria that progress to rheumatic fever can cause heart valve disease. When the body tries to fight the strep ... you feel better before the medicine is gone. Heart valve disease caused by rheumatic fever mainly affects older adults who had strep ...

  20. A Case of Vertical Transmission of Chagas Disease Contracted via Blood Transfusion in Canada

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    Margaret A Fearon

    2013-01-01

    Full Text Available Chagas disease is caused by the protozoan parasite Trypanosoma cruzi and is endemic in many countries in Latin America, where infected bugs of the Triatominea subfamily carry the parasite in the gut and transmit it to humans through fecal contamination of a bite. However, vertical transmission and transmission through blood transfusion and organ transplantation is well documented. Increasing immigration from endemic countries to North America has prompted blood operators, including Canadian Blood Services and Hema Quebec, to initiate blood donor testing for Chagas antibody. In the present report, an unusual case of vertical transmission from a mother, most likely infected through blood transfusion, and detected as part of a concurrent seroprevalence study in blood donors is described.

  1. New approach towards the synthesis of selenosemicarbazones, useful compounds for Chagas' disease.

    Science.gov (United States)

    Pizzo, Chiara; Faral-Tello, Paula; Yaluff, Gloria; Serna, Elva; Torres, Susana; Vera, Ninfa; Saiz, Cecilia; Robello, Carlos; Mahler, Graciela

    2016-02-15

    Herein, we describe a new approach towards the synthesis of selenosemicarbazones. The reaction involves an O-Se exchange of semicarbazones using Ishihara reagent. Eleven selenosemicarbazones were prepared using this methodology, with low to moderate yields. Among the prepared compounds the m-bromo phenyl methyl derivative 1b was selected to be evaluated in vivo, in a murine model of acute Chagas' disease. Compound 1b 10 mg/kg bw/day reduced 50% of parasitaemia profile compared with the control group, but was less effective than Benznidazole (50 mg/kg bw/day reduced 90%) and toxic. These studies are important to guide future Chagas drug design. PMID:26774036

  2. Valvular heart disease

    International Nuclear Information System (INIS)

    The predicts of the patients with valvular heart disease it has improved substantially in the last 15 years.A better understanding of the appropriate programming of the surgery it is one of the key reasons .In general the surgery for the illness valvular stenosis it can take a long time until the appearance of the symptoms. Probably that in the future it progresses toward a conservation of the native valves in the patient.It will be beneficial because the valves modern prosthetic even have inherent risks .The aortic stenosis acquired it will follow requiring a valve prosthetic substitution .But the valvular disease it will be treated every time but by means of procedures that keep the native valves.They include the lung autograft for the aortic stenosis ,The balloonla commissurectomy with ball for the mitral stenosis ,the aortic valvular repair for aortic inadequacy .This procedures will make that the surgery is but attractive eliminating the risks associated with the prosthetics.The continuous advances in the valuation non invasive of the aortic and mitral valves, the of the appropriate selection moment for the derivation for surgical treatment, the improves of the surgical techniques for the valvular substitution and reconstruction and the very recent advances in less aggressive surgical focuses they should combine to improve the patients' perspectives with cardiopatia valvular

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

  6. Chagas Disease: Challenges in Developing New Trypanocidal Lead Compounds [Doença de Chagas: Desafios no Desenvolvimento de Novas Substâncias Líderes Tripanomicidas

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    Fernando de C. da Silva

    2012-03-01

    Full Text Available Chagas disease cycle was fully elucidated by Carlos Chagas in 1909, when he reported his discovery to the scientific community in two seminal papers. Today remains innumerous factors that limit its therapeutic treatment. One of them is the lack of new drugs in the market since is well known that the existing drugs are poorly active with low efficacy and considerable side effects. Nowadays, many efforts have been done in combinatorial chemistry and synthesis of new compounds searching for new lead compounds. The present review intends to show that a wide variety of synthetic strategies are being used for the preparation of pharmaceutically active compounds against several strains of T. cruzi with a range of potential clinical applications.

  7. 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

  8. Inquérito sôbre a Doença de Chagas em candidatos a doadores de sangue Survey on the incidence of Chaga's Disease among prospective blood donors

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    J. Pellegrino

    1951-03-01

    Full Text Available Em 576 indivíduos que se apresentaram ao Banco de Sangue do Hospital do Pronto Socorro de Belo Horizonte, para a prova de seleção de doadores de sangue, foi feita a reação de fixação do complemento (antígeno de cultura do S. cruzi para o diagnóstico da doença de CHAGAS. Em 14 casos a reação foi positiva. Sete candidatos a doador, com reação positiva, foram estudados clìnicamente, e nêles foi praticado xenodiagnóstico, eletrocardiograma e tele-radiografia do coração e vasos da base. Em todos os 7 casos estudados apurou-se que já haviam habitado casas infestadas por triatomíneos em zonas endêmicas e 3 deles apresentaram sinais de comprometimento miocárdico, revelando o eletrocardiograma, em dois, bloqueio do ramo direito, e, em um, bloqueio A-V total. Em 3 candidatos conseguiu-se a comprovação parasitológica da infecção chagásica pela positividade do xenodiagnóstico. Foram feitas considerações sobre o problema da transmissibilidade da doença de CHAGAS pela transfusão de sangue e da necessidade de se tornar obrigatória a inclusão da reação de fixação do complemento para esquizotripanose entre as provas de rotina exigidas na seleção de doadores de sangue.In the "Blood Bank" of the Hospital do Pronto Socorro in Belo Horizonte, Minas Gerais, Brazil, 576 individuals were submitted to the routine medical examination which is required before applicants are accepted as regular blood donors. Among the blood tests which were performed, it was included, this time, the complement-fixation test for CHAGAS' disease, the antigen being prepared from cultures of S. cruzi. Fourteen individuals showed positive reaction for CHAGAS' disease. Of these, 7 were submitted to xenodiagnosis, to electrocardiographic examination and to X-rays examination of the heart and of the basal vessels. All of the 7 individuals have lived in huts which harbored triatomid-bugs, in regions where CHAGAS' disease is endemic. The electrocardiograms

  9. What Are Coronary Heart Disease Risk Factors?

    Science.gov (United States)

    ... from the NHLBI on Twitter. What Are Coronary Heart Disease Risk Factors? Coronary heart disease risk factors are ... high blood pressure, overweight and obesity, and others. Heart Disease Risk Factors 09/30/2011 This video—presented ...

  10. How Is Diabetic Heart Disease Treated?

    Science.gov (United States)

    ... from the NHLBI on Twitter. How Is Diabetic Heart Disease Treated? Diabetic heart disease (DHD) is treated with lifestyle changes, medicines, and ... treating DHD include: Controlling diabetes and any other heart disease risk factors you have, such as unhealthy blood ...

  11. Heart Disease Risk Factors You Can Control

    Science.gov (United States)

    ... disease: Know your risk Heart Health and Stroke Heart disease risk factors you can control Did you know? ... overall health. Return to top More information on Heart disease risk factors you can control Read more from ...

  12. Genetics Home Reference: critical congenital heart disease

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    ... Home Health Conditions critical congenital heart disease critical congenital heart disease Enable Javascript to view the expand/collapse boxes. Print All Open All Close All Description Critical congenital heart disease (CCHD) is a term that refers to a ...

  13. 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%.

  14. Inositol metabolism in Trypanosoma cruzi: potential target for chemotherapy against Chagas' disease

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    MECIA M. OLIVEIRA

    2000-09-01

    Full Text Available Chagas' disease is a debilitating and often fatal disease caused by the protozoan parasite Trypanosoma cruzi. The great majority of surface molecules in trypanosomes are either inositol-containing phospholipids or glycoproteins that are anchored into the plasma membrane by glycosylphosphatidylinositol anchors. The polyalcohol myo-inositol is the precursor for the biosynthesis of these molecules. In this brief review, recent findings on some aspects of the molecular and cellular fate of inositol in T. cruzi life cycle are discussed and identified some points that could be targets for the development of parasite-specific therapeutic agents.

  15. Serum-Mediated Activation of Macrophages Reflects TcVac2 Vaccine Efficacy against Chagas Disease

    OpenAIRE

    Gupta, Shivali; Silva, Trevor S.; Osizugbo, Jessica E.; Tucker, Laura; Spratt, Heidi M.; Garg, Nisha J.

    2014-01-01

    Chagas disease is endemic in Latin America and an emerging infectious disease in the United States. No effective treatments are available. The TcG1, TcG2, and TcG4 antigens are highly conserved in clinically relevant Trypanosoma cruzi isolates and are recognized by B and T cells in infected hosts. Delivery of these antigens as a DNA prime/protein boost vaccine (TcVac2) elicited lytic antibodies and type 1 CD8+ T cells that expanded upon challenge infection and provided >90% control of parasit...

  16. 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

  17. 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.

  18. Combining Public Health Education and Disease Ecology Research: Using Citizen Science to Assess Chagas Disease Entomological Risk in Texas.

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    Rachel Curtis-Robles

    2015-12-01

    Full Text Available Chagas disease is a zoonotic parasitic disease well-documented throughout the Americas and transmitted primarily by triatomine 'kissing bug' vectors. In acknowledgment of the successful history of vector control programs based on community participation across Latin America, we used a citizen science approach to gain novel insight into the geographic distribution, seasonal activity, and Trypanosoma cruzi infection prevalence of kissing bugs in Texas while empowering the public with information about Chagas disease.We accepted submissions of kissing bugs encountered by the public in Texas and other states from 2013-2014 while providing educational literature about Chagas disease. In the laboratory, kissing bugs were identified to species, dissected, and tested for T. cruzi infection. A total of 1,980 triatomines were submitted to the program comprised of at least seven species, of which T. gerstaeckeri and T. sanguisuga were the most abundant (85.7% of submissions. Triatomines were most commonly collected from dog kennels and outdoor patios; Overall, 10.5% of triatomines were collected from inside the home. Triatomines were submitted from across Texas, including many counties which were not previously known to harbor kissing bugs. Kissing bugs were captured primarily throughout April-October, and peak activity occurred in June-July. Emails to our dedicated account regarding kissing bugs were more frequent in the summer months (June-August than the rest of the year. We detected T. cruzi in 63.3% of tested bugs.Citizen science is an efficient approach for generating data on the distribution, phenology, and infection prevalence of kissing bugs-vectors of the Chagas disease parasite-while educating the public and medical community.

  19. Design or screening of drugs for the treatment of Chagas disease: what shows the most promise?

    Science.gov (United States)

    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

  20. Amazonian Triatomine Biodiversity and the Transmission of Chagas Disease in French Guiana: In Medio Stat Sanitas.

    Science.gov (United States)

    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.

  1. Cyanotic heart disease

    Science.gov (United States)

    ... checking it through the skin with a pulse oximeter Complete blood count (CBC) ECG (electrocardiogram) Looking at ... the groin ( cardiac catheterization ) Transcutaneous oxygen monitor (pulse oximeter) Echo-Doppler Testing the heart's electrical system

  2. Bibliometric assessment of the contributions of literature on Chagas disease in Latin America and the Caribbean.

    Science.gov (United States)

    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.

  3. Chagas disease as a mechanistic model for testing a novel hypothesis A doença de Chagas como um modelo mecanicista para testar uma nova hipótese

    Directory of Open Access Journals (Sweden)

    Serge A. Mosovich

    2008-02-01

    Full Text Available The association between depression and cardiovascular disease is well documented. Nevertheless, the process through which they are linked remains unknown, as does the direction of this relationship. Studies have suggested both that depression is a risk factor for heart disease and that heart disease is a risk factor for depression. A number of studies have established that a relationship exists between depression and inflammation, with alterations in the levels of inflammatory markers (IL-1, IL-6, TNF-alpha and others. Depressive symptoms have also been identified in many diseases characterized by inflammatory processes e.g. rheumatoid arthritis, bronchial asthma, diabetes, tuberculosis and cardiovascular diseases. In this brief viewpoint, we explain and propose how to use Chagas disease, a disorder characterized by inflammatory processes and leading to cardiovascular and autonomic problems, as a model for studying the directionality of the relationship between heart disease and depression.A associação entre depressão e doença cardiovascular está bem documentada. Não obstante, o processo pelo qual está associada permanece desconhecido, assim como o sentido desta associação. Estudos têm sugerido que tanto a depressão é um fator de risco para a doença cardiovascular quanto esta o é para a depressão. Uma série de trabalhos tem estabelecido que uma relação existe entre depressão e inflamação, com alterações evidenciadas por marcadores de inflamação (IL-1, IL-6, TNF alfa e outros. Sintomas de depressão também têm sido identificados em diversas doenças caracterizadas por processos inflamatórios, tais como artrite reumatoide, asma brônquica, diabete, tuberculose e doenças cardiovasculares. Nesta breve opinião é explicitado e proposto como empregar a doença de Chagas, um agravo caracterizado por processos inflamatórios e indutor de problemas cardiovasculares e autonômicos, como um modelo de estudo da direcionalidade

  4. 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.

  5. Value of the Qrs-T Angle in Predicting the Induction of Ventricular Tachyarrhythmias in Patients with Chagas Disease

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    Hugo Bizetto Zampa

    2014-12-01

    Full Text Available Background: The QRS-T angle correlates with prognosis in patients with heart failure and coronary artery disease, reflected by an increase in mortality proportional to an increase in the difference between the axes of the QRS complex and T wave in the frontal plane. The value of this correlation in patients with Chagas heart disease is currently unknown. Objective: Determine the correlation of the QRS-T angle and the risk of induction of ventricular tachycardia / ventricular fibrillation (VT / VF during electrophysiological study (EPS in patients with Chagas disease. Methods: Case-control study at a tertiary center. Patients without induction of VT / VF on EPS were used as controls. The QRS-T angle was categorized as normal (0-105º, borderline (105-135º or abnormal (135-180º. Differences between groups for continuous variables were analyzed with the t test or Mann-Whitney test, and for categorical variables with Fisher's exact test. P values < 0.05 were considered significant. Results: Of 116 patients undergoing EPS, 37.9% were excluded due to incomplete information / inactive records or due to the impossibility to correctly calculate the QRS-T angle (presence of left bundle branch block and atrial fibrillation. Of 72 patients included in the study, 31 induced VT / VF on EPS. Of these, the QRS-T angle was normal in 41.9%, borderline in 12.9% and abnormal in 45.2%. Among patients without induction of VT / VF on EPS, the QRS-T angle was normal in 63.4%, borderline in 14.6% and abnormal in 17.1% (p = 0.04. When compared with patients with normal QRS-T angle, those with abnormal angle had a fourfold higher risk of inducing ventricular tachycardia / ventricular fibrillation on EPS [odds ratio (OR 4; confidence interval (CI 1.298-12.325; p = 0.028]. After adjustment for other variables such as age, ejection fraction (EF and QRS size, there was a trend for the abnormal QRS-T angle to identify patients with increased risk of inducing VT / VF during

  6. Exercise-induced ventricular arrhythmias and vagal dysfunction in Chagas disease patients with no apparent cardiac involvement

    Directory of Open Access Journals (Sweden)

    Henrique Silveira Costa

    2015-04-01

    Full Text Available INTRODUCTION : Exercise-induced ventricular arrhythmia (EIVA and autonomic imbalance are considered as early markers of heart disease in Chagas disease (ChD patients. The objective of the present study was to verify the differences in the occurrence of EIVA and autonomic maneuver indexes between healthy individuals and ChD patients with no apparent cardiac involvement. METHODS : A total of 75 ChD patients with no apparent cardiac involvement, aged 44.7 (8.5 years, and 38 healthy individuals, aged 44.0 (9.2 years, were evaluated using echocardiography, symptom-limited treadmill exercise testing and autonomic function tests. RESULTS : The occurrence of EIVA was higher in the chagasic group (48% than in the control group (23.7% during both the effort and the recovery phases. Frequent ventricular contractions occurred only in the patient group. Additionally, the respiratory sinus arrhythmia index was significantly lower in the chagasic individuals compared with the control group. CONCLUSIONS : ChD patients with no apparent cardiac involvement had a higher frequency of EIVA as well as more vagal dysfunction by respiratory sinus arrhythmia. These results suggest that even when asymptomatic, ChD patients possess important arrhythmogenic substrates and subclinical disease.

  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. Health-related quality of life in patients with Chagas disease

    OpenAIRE

    Bruna Guimarães Oliveira; Mery Natali Silva Abreu; Claudia Drummond Guimarães Abreu; Manoel Otavio da Costa Rocha; Antonio Luiz Ribeiro

    2011-01-01

    INTRODUCTION: Chagas disease (ChD) is a chronic illness related to significant morbidity and mortality that can affect the quality of life (QoL) of infected patients. However, there are few studies regarding QoL in ChD. The objectives of this study are to construct a health-related QoL (HRQoL) profile of ChD patients and compare this with a non-ChD (NChD) group to identify factors associated with the worst HRQoL scores in ChD patients. METHODS: HRQoL was investigated in 125 patients with ChD ...

  9. What Are Heart Disease and Stroke?

    Science.gov (United States)

    ... Blood Pressure Tools & Resources Stroke More What Are Heart Disease and Stroke? Updated:Dec 8,2015 There are ... include: High blood pressure Smoking Diabetes High cholesterol Heart disease Atrial fibrillation (Abnormal heart rhythm) Call 9-1- ...

  10. Being active when you have heart disease

    Science.gov (United States)

    Heart disease - activity ... Getting regular exercise when you have heart disease is important. Exercise can make your heart muscle stronger. It may also help you be more active without chest pain or other ...

  11. 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.

  12. Prevalence, clinical staging and risk for blood-borne transmission of Chagas disease among Latin American migrants in Geneva, Switzerland.

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    Yves Jackson

    Full Text Available BACKGROUND: Migration of Latin Americans to the USA, Canada and Europe has modified Chagas disease distribution, but data on imported cases and on risks of local transmission remain scarce. We assessed the prevalence and risk factors for Chagas disease, staged the disease and evaluated attitudes towards blood transfusion and organ transplant among Latin American migrants in Geneva, Switzerland. METHODOLOGY/PRINCIPAL FINDINGS: This cross-sectional study included all consecutive Latin American migrants seeking medical care at a primary care facility or attending two Latino churches. After completing a questionnaire, they were screened for Chagas disease with two serological tests (Biomérieux ELISA cruzi; Biokit Bioelisa Chagas. Infected subjects underwent a complete medical work-up. Predictive factors for infection were assessed by univariate and multivariate logistic regression analysis.1012 persons (females: 83%; mean age: 37.2 [SD 11.3] years, Bolivians: 48% [n = 485] were recruited. 96% had no residency permit. Chagas disease was diagnosed with two positive serological tests in 130 patients (12.8%; 95%CI 10.8%-14.9%, including 127 Bolivians (26.2%; 95%CI 22.3%-30.1%. All patients were in the chronic phase, including 11.3% with cardiac and 0.8% with digestive complications. Predictive factors for infection were Bolivian origin (OR 33.2; 95%CI 7.5-147.5, reported maternal infection with T. cruzi (OR 6.9; 95%CI 1.9-24.3, and age older than 35 years (OR 6.7; 95%CI 2.4-18.8. While 22 (16.9% infected subjects had already donated blood, 24 (18.5% and 34 (26.2% considered donating blood and organs outside Latin America, respectively. CONCLUSIONS: Chagas disease is highly prevalent among Bolivian migrants in Switzerland. Chronic cardiac and digestive complications were substantial. Screening of individuals at risk should be implemented in nonendemic countries and must include undocumented migrants.

  13. Prevalência da doença de Chagas em gestantes da região sul do Rio Grande do Sul Prevalence of Chagas disease among pregnant women in the southern region of Rio Grande do Sul

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    Anelise Bergmann Araújo

    2009-12-01

    Full Text Available Anticorpos antiTrypanosoma cruzi no cordão umbilical de 351 parturientes da Cidade de Pelotas, RS foram pesquisados a fim de investigar a prevalência da doença de Chagas em gestantes. Um (0,3% caso foi identificado, não sendo detectada transmissão congênita. Salienta-se a importância da investigação da doença de Chagas em gestantes de zonas endêmicas ou provenientes destas.Anti-Trypanosoma cruzi antibodies in the umbilical cord of 351 parturients in the city of Pelotas, Rio Grande do Sul were investigated to determine the prevalence of Chagas disease among pregnant women. One case was identified (0.3%, without detection of congenital transmission. This highlights the importance of investigating Chagas disease among pregnant women living in or originating from endemic areas.

  14. Stairway to Heaven or Hell? Perspectives and Limitations of Chagas Disease Chemotherapy.

    Science.gov (United States)

    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.

  15. Stairway to Heaven or Hell? Perspectives and Limitations of Chagas Disease Chemotherapy.

    Science.gov (United States)

    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. PMID:27072716

  16. 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.

  17. Caffeine and Heart Disease

    Science.gov (United States)

    ... American Heart area Search by State SELECT YOUR LANGUAGE Español (Spanish) 简体中文 (Traditional Chinese) 繁体中文 (Simplified Chinese) ... Smoking Tips for Friends and Family of Quitters Workplace Health Employer Resources Workplace Health Index Recognition & Awards ...

  18. 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

  19. Diabetes and ischemic heart disease

    DEFF Research Database (Denmark)

    Bergmann, Natasha; Ballegaard, Søren; Holmager, Pernille;

    2014-01-01

    The aim of this study was to test i) whether patients having diabetes and ischemic heart disease (IHD), i.e., patients suffering from two chronic diseases, demonstrate a higher degree of chronic stress when compared with patients suffering from IHD alone, and ii) whether suffering from the two...

  20. 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

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

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    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

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

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    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

  3. 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.

  4. 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.

  5. Entomological factors affecting the low endemicity of Chagas disease in Nazca, Southwestern Peru.

    Science.gov (United States)

    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.

  6. [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.

  7. [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. PMID:10488587

  8. Diagnostic electrocardiography in epidemiological studies of Chagas' disease: multicenter evaluation of a standardized method.

    Science.gov (United States)

    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. 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. Conventional serological performance in diagnosis of Chagas' disease in southern Brazil

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    Anelise Bergmann Araújo

    2013-04-01

    Full Text Available Results of Chagas' disease diagnosis show disagreement. The aim of this study was to compare commercial tests for Chagas' disease serodiagnosis in southern Brazil. A total of 161 samples were evaluated. Three enzyme-linked immunosorbent assays, one indirect hemagglutination and one indirect immunofluorescence were assessed. Trypomastigote excreted-secreted antigen-blot was a confirmatory method. From 161 samples, 65.84% were positive in all tests, while 34.16% presents mismatch result in at least one of the tests. All techniques tested presented false-positive and/or false-negative results as follows: Enzyme-linked immunosorbent assay 1 had more false-positive results (lower specificity, indirect immunofluorescence had the highest rate of false-negative results (lower sen sitivity, enzyme-linked immunosorbent assays had fewer false-negative results (higher sensitivity, while indirect hemagglutination showed no false-positive result (higher specificity. Knowing the characteristics of techniques make it possible to combine them and obtain more reliable diagnosis. Therefore, it seems useful to combine techniques for diagnosing this infection.

  11. Correlation between infection rate of triatominies and Chagas Disease in Southwest of Bahia, Brazil: a warning sign?

    Science.gov (United States)

    Silveira, Eliezer A DA; Ribeiro, Israel S; Amorim, Miguel S; Rocha, Dalva V; Coutinho, Helder S; Freitas, Leandro M DE; Tomazi, Laize; Silva, Robson A A DA

    2016-07-11

    Chagas disease, caused by the Trypanosoma cruzi, has a wide distribution in South America, and its main method of control is the elimination of triatomines. It is presented here the geographic distribution and the rate of natural infection by T. cruzi of triatomines collected and evaluated from 2008 to 2013 in southwest of Bahia. Triatomines were captured in the intradomiciliary and peridomiciliary areas of five cities located in the southwest of Bahia state, identified, and analyzed for the presence of trypanosomatids in their feces. During the study period the number of patients suspected for acute Chagas disease was recovered from the Notifiable Diseases Information System (SINAN). 8966 triatomines were captured and identified as belonging to eight species. Twenty-six presented themselves infected, being Triatoma sordida the most abundant and with the highest percentage of infection by T. cruzi. Tremedal was the city with the highest number of cases of acute Chagas' disease reported to SINAN. All cities showed triatomines infected with T. cruzi, so there is considerable risk of vectorial transmission of Chagas disease in the southwestern Bahia state, evidencing the need for vector transmission control programs and preventive surveillance measures. PMID:27411071

  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. Polymorphic sites at the immunoregulatory CTLA-4 gene are associated with chronic chagas disease and its clinical manifestations.

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    Fabrício C Dias

    Full Text Available BACKGROUND: Chagas disease affects approximately 10 million people mainly in Latin America. The immune regulation by the host seems to be an essential factor for disease evolution, and immune system inhibitory molecules such as CTLA-4 and PD-1 favor the maintenance of peripheral tolerance. Considering that polymorphisms at the immunoregulatory CTLA-4 and PDCD1 genes may alter their inhibitory function, we investigated the association of alleles, genotypes and haplotypes of polymorphic sites observed at the CTLA-4 and PDCD1 genes with different clinical manifestations of chronic Chagas disease (indeterminate, cardiac, digestive and mixed. METHODS: The polymorphisms at the CTLA-4 (-1722T/C, -318C/T and +49A/G and PDCD1 (PD-1.3G/A genes were typed using TaqMan methodology in 277 chronic Chagas disease patients classified into four groups, according to clinical characteristics, and 326 non-infected controls. RESULTS: Our results showed that CTLA-4 -1722CC genotype (22%, -1722C allele (27% and CTLA-4 TCG (8.6%, TCA (26% and CCA (15% haplotypes were strongly associated with the indeterminate form, while the CTLA-4-318CT genotype (82% and CTLA-4-318T allele (47% were found mainly in patients with the mixed form of the disease. The CTLA-4 TCG haplotype (10.2% was associated with the digestive form. On the other hand, the PD-1.3G/A polymorphism was not associated with chronic Chagas disease and its clinical manifestations. CONCLUSIONS: Here, we showed that alleles, genotypes and haplotypes reported to increase the expression of the regulatory molecule CTLA-4 were associated with the indeterminate form of the disease. Taken together, our data support the idea that polymorphic sites at immunoregulatory genes may influence the development of Chagas disease variants.

  14. Regulatory T Cells Phenotype in Different Clinical Forms of Chagas' Disease

    Science.gov (United States)

    Teixeira-Carvalho, Andréa; Renato Zuquim Antas, Paulo; Assis Silva Gomes, Juliana; Sathler-Avelar, Renato; Otávio Costa Rocha, Manoel; Elói-Santos, Silvana Maria; Pinho, Rosa Teixeira; Correa-Oliveira, Rodrigo; Martins-Filho, Olindo Assis

    2011-01-01

    CD25High CD4+ regulatory T cells (Treg cells) have been described as key players in immune regulation, preventing infection-induced immune pathology and limiting collateral tissue damage caused by vigorous anti-parasite immune response. In this review, we summarize data obtained by the investigation of Treg cells in different clinical forms of Chagas' disease. Ex vivo immunophenotyping of whole blood, as well as after stimulation with Trypanosoma cruzi antigens, demonstrated that individuals in the indeterminate (IND) clinical form of the disease have a higher frequency of Treg cells, suggesting that an expansion of those cells could be beneficial, possibly by limiting strong cytotoxic activity and tissue damage. Additional analysis demonstrated an activated status of Treg cells based on low expression of CD62L and high expression of CD40L, CD69, and CD54 by cells from all chagasic patients after T. cruzi antigenic stimulation. Moreover, there was an increase in the frequency of the population of Foxp3+ CD25HighCD4+ cells that was also IL-10+ in the IND group, whereas in the cardiac (CARD) group, there was an increase in the percentage of Foxp3+ CD25High CD4+ cells that expressed CTLA-4. These data suggest that IL-10 produced by Treg cells is effective in controlling disease development in IND patients. However, in CARD patients, the same regulatory mechanism, mediated by IL-10 and CTLA-4 expression is unlikely to be sufficient to control the progression of the disease. These data suggest that Treg cells may play an important role in controlling the immune response in Chagas' disease and the balance between regulatory and effector T cells may be important for the progression and development of the disease. Additional detailed analysis of the mechanisms on how these cells are activated and exert their function will certainly give insights for the rational design of procedure to achieve the appropriate balance between protection and pathology during parasite

  15. Homocysteine and coronary heart disease

    DEFF Research Database (Denmark)

    Clarke, Robert; Bennett, Derrick A; Parish, Sarah;

    2012-01-01

    Moderately elevated blood levels of homocysteine are weakly correlated with coronary heart disease (CHD) risk, but causality remains uncertain. When folate levels are low, the TT genotype of the common C677T polymorphism (rs1801133) of the methylene tetrahydrofolate reductase gene (MTHFR) appreci......Moderately elevated blood levels of homocysteine are weakly correlated with coronary heart disease (CHD) risk, but causality remains uncertain. When folate levels are low, the TT genotype of the common C677T polymorphism (rs1801133) of the methylene tetrahydrofolate reductase gene (MTHFR...

  16. [Risk of Chagas disease through transfusions in the Americans].

    Science.gov (United States)

    Schmuñis, G A

    1999-01-01

    . In absolute numbers, the highest potential for occurrence of cases of T. cruzi infection were present in Bolivia, the greatest number of HVC cases in Colombia, and the most cases of HVB in Nicaragua. Only in two countries, Bolivia and Colombia, HIV could be potentially transmitted by blood transfusion. Although the situation has improved since 1993, and 100% of donors are being screened for T. cruzi in Argentina, Colombia, Ecuador, El Salvador, Honduras, Paraguay, Uruguay and Venezuela, success will only be assured by: total enforcement of the law by governments; implementation of altruistic and volunteer blood donations, exclusively; 100% of donors are screened for communicable diseases; the collection, processing and use of blood strictly follow quality control norms; reagents used in diagnosis are adequate, and the use of blood and blood derivatives is limited to cases where it is only absolutely necessary. PMID:10668254

  17. Geographic Distribution of Chagas Disease Vectors in Brazil Based on Ecological Niche Modeling

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    Rodrigo Gurgel-Gonçalves

    2012-01-01

    Full Text Available Although Brazil was declared free from Chagas disease transmission by the domestic vector Triatoma infestans, human acute cases are still being registered based on transmission by native triatomine species. For a better understanding of transmission risk, the geographic distribution of Brazilian triatomines was analyzed. Sixteen out of 62 Brazilian species that both occur in >20 municipalities and present synanthropic tendencies were modeled based on their ecological niches. Panstrongylus geniculatus and P. megistus showed broad ecological ranges, but most of the species sort out by the biome in which they are distributed: Rhodnius pictipes and R. robustus in the Amazon; R. neglectus, Triatoma sordida, and T. costalimai in the Cerrado; R. nasutus, P. lutzi, T. brasiliensis, T. pseudomaculata, T. melanocephala, and T. petrocchiae in the Caatinga; T. rubrovaria in the southern pampas; T. tibiamaculata and T. vitticeps in the Atlantic Forest. Although most occurrences were recorded in open areas (Cerrado and Caatinga, our results show that all environmental conditions in the country are favorable to one or more of the species analyzed, such that almost nowhere is Chagas transmission risk negligible.

  18. Diabetic Heart Disease

    Science.gov (United States)

    ... Lifestyle changes also help. These include a healthy diet, maintaining a healthy weight, being physically active, and quitting smoking. NIH: National Institute of Diabetes and Digestive and Kidney Diseases

  19. A field trial of alternative targeted screening strategies for Chagas disease in Arequipa, Peru.

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    Gabrielle C Hunter

    2012-01-01

    Full Text Available BACKGROUND: Chagas disease is endemic in the rural areas of southern Peru and a growing urban problem in the regional capital of Arequipa, population ∼860,000. It is unclear how to implement cost-effective screening programs across a large urban and periurban environment. METHODS: We compared four alternative screening strategies in 18 periurban communities, testing individuals in houses with 1 infected vectors; 2 high vector densities; 3 low vector densities; and 4 no vectors. Vector data were obtained from routine Ministry of Health insecticide application campaigns. We performed ring case detection (radius of 15 m around seropositive individuals, and collected data on costs of implementation for each strategy. RESULTS: Infection was detected in 21 of 923 (2.28% participants. Cases had lived more time on average in rural places than non-cases (7.20 years versus 3.31 years, respectively. Significant risk factors on univariate logistic regression for infection were age (OR 1.02; p = 0.041, time lived in a rural location (OR 1.04; p = 0.022, and time lived in an infested area (OR 1.04; p = 0.008. No multivariate model with these variables fit the data better than a simple model including only the time lived in an area with triatomine bugs. There was no significant difference in prevalence across the screening strategies; however a self-assessment of disease risk may have biased participation, inflating prevalence among residents of houses where no infestation was detected. Testing houses with infected-vectors was least expensive. Ring case detection yielded four secondary cases in only one community, possibly due to vector-borne transmission in this community, apparently absent in the others. CONCLUSIONS: Targeted screening for urban Chagas disease is promising in areas with ongoing vector-borne transmission; however, these pockets of epidemic transmission remain difficult to detect a priori. The flexibility to adapt to the

  20. Antigenicity and diagnostic potential of vaccine candidates in human Chagas disease.

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    Shivali Gupta

    Full Text Available BACKGROUND: Chagas disease, caused by Trypanosoma cruzi, is endemic in Latin America and an emerging infectious disease in the US and Europe. We have shown TcG1, TcG2, and TcG4 antigens elicit protective immunity to T. cruzi in mice and dogs. Herein, we investigated antigenicity of the recombinant proteins in humans to determine their potential utility for the development of next generation diagnostics for screening of T. cruzi infection and Chagas disease. METHODS AND RESULTS: Sera samples from inhabitants of the endemic areas of Argentina-Bolivia and Mexico-Guatemala were analyzed in 1(st-phase for anti-T. cruzi antibody response by traditional serology tests; and in 2(nd-phase for antibody response to the recombinant antigens (individually or mixed by an ELISA. We noted similar antibody response to candidate antigens in sera samples from inhabitants of Argentina and Mexico (n=175. The IgG antibodies to TcG1, TcG2, and TcG4 (individually and TcG(mix were present in 62-71%, 65-78% and 72-82%, and 89-93% of the subjects, respectively, identified to be seropositive by traditional serology. Recombinant TcG1- (93.6%, TcG2- (96%, TcG4- (94.6% and TcG(mix- (98% based ELISA exhibited significantly higher specificity compared to that noted for T. cruzi trypomastigote-based ELISA (77.8% in diagnosing T. cruzi-infection and avoiding cross-reactivity to Leishmania spp. No significant correlation was noted in the sera levels of antibody response and clinical severity of Chagas disease in seropositive subjects. CONCLUSIONS: Three candidate antigens were recognized by antibody response in chagasic patients from two distinct study sites and expressed in diverse strains of the circulating parasites. A multiplex ELISA detecting antibody response to three antigens was highly sensitive and specific in diagnosing T. cruzi infection in humans, suggesting that a diagnostic kit based on TcG1, TcG2 and TcG4 recombinant proteins will be useful in diverse situations.

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

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    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.La enfermedad de Chagas es un problema grave de salud en América Latina, causando cerca de 50 000 muertes al año y unos 18 millones de infectados. Alrededor del 25-30% de los pacientes infectados con Trypanosoma cruzi desarrollan la forma crónica de la enfermedad. La respuesta de defensa ante el T. cruzi depende de la inmunidad innata y adquirida con la participación de macrófagos, células “natural killer”, linfocitos T y B, y la producción de citoquinas proinflamatorias de tipo Th-1. Además, el aumento en la producción de óxido nítrico (NO en los macrófagos lleva a una acci

  2. 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.

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

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    Fernanda Machado Fonseca

    2014-12-01

    Full Text Available 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. Methods Gastric biopsy samples were taken from patients who underwent endoscopy for histological analysis according to the Updated Sydney System. H. pylori infection was assessed by histology, 16S ribosomal ribonucleic acid (rRNA polymerase chain reaction (PCR, serology and the 13C-urea breath test. Patients were considered H. pylori-negative when all of these diagnostic tests were negative. Clinical and socio-demographic data were obtained by reviewing medical records and using a questionnaire. Results The prevalence of H. pylori infection (70.3% versus 71.7% and chronic gastritis (92.2% versus 85% was similar in the chagasic and non-chagasic groups, respectively; such as peptic ulcer, atrophy and intestinal metaplasia. Gastritis was associated with H. pylori infection independent of Chagas disease in a log-binomial regression model. However, the chagasic H. pylori-negative patients showed a significantly higher grade of mononuclear (in the corpus and polymorphonuclear (PMN (in the antrum cell infiltration. Additionally, the patients with the digestive form of Chagas disease showed a significantly lower prevalence of corpus atrophy than those with other clinical forms. Conclusions The prevalence of H. pylori infection and of gastric histological and endoscopic features was similar among the chagasic and non-chagasic patients. Additionally, this is the first controlled study to demonstrate that H. pylori is the major cause of gastritis in patients with Chagas disease.

  4. Miocárdio não compactado, Doença de Chagas e disfunção: relato de caso Miocardio no compactado, Enfermedad de Chagas y disfunción: caso clínico Noncompaction of the myocardium, Chagas' disease and dysfunction: a case report

    Directory of Open Access Journals (Sweden)

    Ronaldo Peixoto de Mello

    2010-07-01

    Full Text Available Relatamos a associação entre a cardiopatia associada ao miocárdio não compactado do ventrículo esquerdo (MNCVE à cardiopatia chagásica crônica (CCC em paciente com clínica de insuficiência cardíaca, acidente vascular cerebral isquêmico e arritmia cardíaca. As imagens típicas de MNCVE e CCC foram documentadas pela ressonância magnética cardíaca (RMC.Relatamos la asociación entre la cardiopatía asociada al miocardio no compactado del ventrículo izquierdo (MNCVI con la cardiopatía chagásica crónica (CCC en paciente con clínica de insuficiencia cardíaca, accidente vascular cerebral isquémico y arritmia cardíaca. Las imágenes típicas de MNCVI y CCC fueron documentadas por resonancia magnética cardíaca (RMC.We report the association between heart disease associated with noncompaction of the left ventricular myocardium (NCLVM and chronic Chagas' heart disease (CCHD in a patient with heart failure, ischemic stroke and cardiac arrhythmia. Images typical of NCLVM and CCHD were documented by cardiac magnetic resonance imaging (CMRI.

  5. Monocytes in ischemic heart disease

    NARCIS (Netherlands)

    A.M. van der Laan

    2013-01-01

    The link between the immune system and ischemic heart disease has been recognized for years and great improvements have been made in understanding the role of immune cells in the context of infarct healing, atherosclerosis and arteriogenesis, using experimental and in vitro models. However, the role

  6. Men and Heart Disease

    Science.gov (United States)

    ... Paul Coverdell National Acute Stroke Program Funded States History of PCNASP PCNASP Metrics/Data Elements PCNASP Logic Model 2015 PCNASP FOA DP15-1514 WISEWOMAN Sodium Reduction in Communities Building GIS Capacity for Chronic Disease Surveillance Highlights Reports Chronic ...

  7. Predicting coronary heart disease

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Fuster, Valentin

    2012-01-01

    Atherosclerosis is the leading cause of death and disabling disease. Whereas risk factors are well known and constitute therapeutic targets, they are not useful for prediction of risk of future myocardial infarction, stroke, or death. Therefore, methods to identify atherosclerosis itself have bee...

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

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    Albarracin-Veizaga Hugo

    1999-01-01

    Full Text Available 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 selected by systematic sampling. Concerning each subject age, gender, birthplace, occupation, duration of residence and building materials used in their houses were recorded. Vectors were captured both in domestic and peridomestic environments. RESULTS: Seropositive, 12.5% (16/128: females, 15.1% (11/73; males, 9.1% (5/55. Average time of residence: 6.1 years for the whole population sample and 7.4 years for the seropositive subjects. Most houses had adobe walls (76.7% , n= 30, galvanized iron rooves (86.7% and earthen floors (53.4% 80% of the walls had crevices. One hundred forty seven specimens of Triatoma infestans were captured, of which 104 (70.7% were domestic, and 1 peridomestic Triatoma sordida. Precipitin host identification: birds, 67.5%; humans, 27.8%; rodents, 11.9%; dogs, 8.7%; cats, 1.6%. House infestation and density indices were 53.3 and 493.0 respectively. We found 21 (14.3% specimens of T. infestans infected with trypanosomes, 18 (85.7% of which in domestic environments. DISCUSSION: The elements for the vector transmission of Chagas disease are present in Avaroa/Primer de Mayo and the ancient custom of keeping guinea pigs indoors adds to the risk of human infection. In neighboring Cochabamba, due to substandard quality control, contaminated blood transfusions are not infrequent, which further aggravates the spread of Chagas disease. Prompt action to check the transmission of this infection, involving additionally the congenital and transfusional

  9. Modeling horizontal gene transfer (HGT in the gut of the Chagas disease vector Rhodnius prolixus

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    Durvasula Ravi V

    2011-05-01

    Full Text Available Abstract Background Paratransgenesis is an approach to reducing arthropod vector competence using genetically modified symbionts. When applied to control of Chagas disease, the symbiont bacterium Rhodococcus rhodnii, resident in the gut lumen of the triatomine vector Rhodnius prolixus (Hemiptera: Reduviidae, is transformed to export cecropin A, an insect immune peptide. Cecropin A is active against Trypanosoma cruzi, the causative agent of Chagas disease. While proof of concept has been achieved in laboratory studies, a rigorous and comprehensive risk assessment is required prior to consideration of field release. An important part of this assessment involves estimating probability of transgene horizontal transfer to environmental organisms (HGT. This article presents a two-part risk assessment methodology: a theoretical model predicting HGT in the gut of R. prolixus from the genetically transformed symbiont R. rhodnii to a closely related non-target bacterium, Gordona rubropertinctus, in the absence of selection pressure, and a series of laboratory trials designed to test the model. Results The model predicted an HGT frequency of less than 1.14 × 10-16 per 100,000 generations at the 99% certainty level. The model was iterated twenty times, with the mean of the ten highest outputs evaluated at the 99% certainty level. Laboratory trials indicated no horizontal gene transfer, supporting the conclusions of the model. Conclusions The model treats HGT as a composite event, the probability of which is determined by the joint probability of three independent events: gene transfer through the modalities of transformation, transduction, and conjugation. Genes are represented in matrices and Monte Carlo method and Markov chain analysis are used to simulate and evaluate environmental conditions. The model is intended as a risk assessment instrument and predicts HGT frequency of less than 1.14 × 10-16 per 100,000 generations. With laboratory studies that

  10. Analysis of Children's Perception of Triatomine Vectors of Chagas Disease through Drawings: Opportunities for Targeted Health Education

    OpenAIRE

    Yevstigneyeva, Violetta; Camara-Mejia, Javier; Dumonteil, Eric

    2014-01-01

    Background Chagas disease is a tropical parasitic disease affecting about 10 million people, mostly in the Americas, and transmitted mainly by triatomine bugs. Insect vector control with indoor residual insecticides and the promotion of housing improvement is the main control intervention. The success of such interventions relies on their acceptance and appropriation by communities, which depends on their knowledge and perceptions of both the disease and the vector. In this study, we investig...

  11. Analysis of children's perception of triatomine vectors of chagas disease through drawings: opportunities for targeted health education.

    OpenAIRE

    Violetta Yevstigneyeva; Javier Camara-Mejia; Eric Dumonteil

    2014-01-01

    Chagas disease is a tropical parasitic disease affecting about 10 million people, mostly in the Americas, and transmitted mainly by triatomine bugs. Insect vector control with indoor residual insecticides and the promotion of housing improvement is the main control intervention. The success of such interventions relies on their acceptance and appropriation by communities, which depends on their knowledge and perceptions of both the disease and the vector. In this study, we investigated school...

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

    Directory of Open Access Journals (Sweden)

    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

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

    OpenAIRE

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

    2015-01-01

    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 (posaco...

  15. Coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950286 Percutaneous transluminal coronary angio-plasty for unstable angina.LIU Meilin(刘梅林),et.al.1st Teach Hosp,Beijing Med Univ,Beijing,100034.Chin J Intern Med 1995;34(3):169-172.Percutaneous transluminal coronary angioplasty(PTCA) was performed in 190 patients with 250 dis-eased vessels and 278 lesions from Dec.1987 to Feb.1994.All the patients had unstable angina (UA).There were 52(18.7%) type A lesions,175(62.9%)type B lesions and 51(18.3%) type C lesions.Of the

  16. In vivo studies of 5-arylethenylbenzofuroxans in acute murine models of Chagas' disease.

    Science.gov (United States)

    Boiani, Lucía; Davies, Carolina; Arredondo, Carolina; Porcal, Williams; Merlino, Alicia; Gerpe, Alejandra; Boiani, Mariana; Pacheco, José Pedro; Basombrío, Miguel Angel; Cerecetto, Hugo; González, Mercedes

    2008-10-01

    5-arylethenylbenzofuroxan derivatives with high in vitro anti-Trypanosoma cruzi activity were studied in vivo using acute murine models of Chagas' disease. The selected compounds, as pure isomeric forms, 1, 2, 3 and 4, or as equimolecular mixture of geometric isomers, 1:2, 3:4, 5:6 were studied against different T. cruzi strains. Consequently, Tulahuen 2 strain, Colombiana strain (resistant to Nifurtimox and Benznidazole), and two different wild strains, one isolated from the wild reservoir Didelphis marsupialis and another one from Uruguayan patients, were selected. No relevant signs of in vivo toxicity were observed with the benzofuroxans orally administered. Compound 1 and the mixture of isomers 1:2 were the best for treating infection against the four studied strains. PMID:18255195

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

    Directory of Open Access Journals (Sweden)

    Fabíola Adriane Souza Oliveira

    2010-11-01

    Full Text Available

    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 people in the local health unit (Programa Saúde da Família, Tancredo Neves. The information about Chagas Disease was obtaining from ‘A’ files, this present in virtual information program. Take a part in the study only patients with the confirmed diagnostic of Chagas Disease in two diagnostic methods different. Results: The prevalence of Chagas Disease were 1% (86 patients, 60% of cases belong of female gender. The middle age at the men was 47,5 years and the woman was 48,6 years. The main occupation were: retired 9,3%, general services 51,1%, house-wife 17,4%, unemployment 18,5%, students 1,1% and autonomous 1,1%. The analysis of schooling demonstrates: 27,9% was illiterate, 68,6% does not have completely the primary school and 2,3% has completely the second school. The co morbid more seen were the Systemic Hypertension Arterial (SHA. Conclusion: The epidemiological profile in the study site is of the an adult patient with the age between 40-50 years, female gender, with schooling low, working in general services and with SHA were the co morbid.

    A Doença de Chagas (DC é uma infecção causada pelo Trypanosoma cruzi, transmitida por um inseto hematófago, adquirida por transfusão sanguínea ou congenitamente, com evolução dividida em fase aguda e crônica. Objetivo: Analisar as seguintes variáveis dos pacientes portadores da Doença de Chagas (DC: idade, sexo, escolaridade, prevalência, comorbidades associadas e ocupação. Metodologia: A região do

  18. Warning signs and symptoms of heart disease

    Science.gov (United States)

    ... patientinstructions/000775.htm Warning signs and symptoms of heart disease To use the sharing features on this page, please enable JavaScript. Heart disease often develops over time. You may have early ...

  19. Flu and Heart Disease and Stroke

    Science.gov (United States)

    ... What's this? Submit Button Past Newsletters Flu and Heart Disease & Stroke Language: English Español Recommend on Facebook Tweet Share Compartir People with Heart Disease* and Those Who Have Had a Stroke Are ...

  20. How Can Heart Disease be Prevented?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Can Heart Disease Be Prevented? Taking action to control your risk factors can help prevent or delay coronary heart disease (CHD). Your risk for CHD increases with the ...

  1. Exercise echocardiography for structural heart disease.

    Science.gov (United States)

    Izumo, Masaki; Akashi, Yoshihiro J

    2016-03-01

    Since the introduction of transcatheter structural heart intervention, the term "structural heart disease" has been widely used in the field of cardiology. Structural heart disease refers to congenital heart disease, valvular heart disease, and cardiomyopathy. In structural heart disease, valvular heart disease is frequently identified in the elderly. Of note, the number of patients who suffer from aortic stenosis (AS) and mitral regurgitation (MR) is increasing in developed countries because of the aging of the populations. Transcatheter aortic valve replacement and percutaneous mitral valve repair has been widely used for AS and MR, individually. Echocardiography is the gold standard modality for initial diagnosis and subsequent evaluation of AS and MR, although the difficulties in assessing patients with these diseases still remain. Here, we review the clinical usefulness and prognostic impact of exercise echocardiography on structural heart disease, particularly on AS and MR.

  2. Gallstones Linked to Higher Heart Disease Risk

    Science.gov (United States)

    ... news/fullstory_160497.html Gallstones Linked to Higher Heart Disease Risk Researcher says study highlights a connection between ... may have a slightly increased risk of developing heart disease down the road, a large new study suggests. ...

  3. Heart Disease and Asians and Pacific Islanders

    Science.gov (United States)

    ... HIV/AIDS Immunizations Infant Heath & Mortality Mental Health Obesity Organ and ... heart disease and they are less likely to die from heart disease. In general, Asian American adults have lower rates of being overweight or obese, lower rates of ...

  4. Lineage analysis of circulating Trypanosoma cruzi parasites and their association with clinical forms of Chagas disease in Bolivia.

    Directory of Open Access Journals (Sweden)

    Ramona del Puerto

    Full Text Available BACKGROUND: The causative agent of Chagas disease, Trypanosoma cruzi, is divided into 6 Discrete Typing Units (DTU: Tc I, IIa, IIb, IIc, IId and IIe. In order to assess the relative pathogenicities of different DTUs, blood samples from three different clinical groups of chronic Chagas disease patients (indeterminate, cardiac, megacolon from Bolivia were analyzed for their circulating parasites lineages using minicircle kinetoplast DNA polymorphism. METHODS AND FINDINGS: Between 2000 and 2007, patients sent to the Centro Nacional de Enfermedades Tropicales for diagnosis of Chagas from clinics and hospitals in Santa Cruz, Bolivia, were assessed by serology, cardiology and gastro-intestinal examinations. Additionally, patients who underwent colonectomies due to Chagasic magacolon at the Hospital Universitario Japonés were also included. A total of 306 chronic Chagas patients were defined by their clinical types (81 with cardiopathy, 150 without cardiopathy, 100 with megacolon, 144 without megacolon, 164 with cardiopathy or megacolon, 73 indeterminate and 17 cases with both cardiopathy and megacolon. DNA was extracted from 10 ml of peripheral venous blood for PCR analysis. The kinetoplast minicircle DNA (kDNA was amplified from 196 out of 306 samples (64.1%, of which 104 (53.3% were Tc IId, 4 (2.0% Tc I, 7 (3.6% Tc IIb, 1 (0.5% Tc IIe, 26 (13.3% Tc I/IId, 1 (0.5% Tc I/IIb/IId, 2 (1.0% Tc IIb/d and 51 (25.9% were unidentified. Of the 133 Tc IId samples, three different kDNA hypervariable region patterns were detected; Mn (49.6%, TPK like (48.9% and Bug-like (1.5%. There was no significant association between Tc types and clinical manifestations of disease. CONCLUSIONS: None of the identified lineages or sublineages was significantly associated with any particular clinical manifestations in the chronic Chagas patients in Bolivia.

  5. Plasma cytokine expression is associated with cardiac morbidity in chagas disease.

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    Giovane Rodrigo Sousa

    Full Text Available The expression of immune response appears to be associated with morbidity in Chagas disease. However, the studies in this field have usually employed small samples of patients and statistical analyses that do not consider the wide dispersion of cytokine production observed in these patients. The aim of this study was to evaluate the plasma cytokine levels in well-defined clinical polar groups of chagasic patients divided into categories that better reflect the wide cytokine profile and its relationship with morbidity. Patients infected with Trypanosoma cruzi (T. cruzi were grouped as indeterminate (IND and cardiac (CARD forms ranging from 23 to 69 years of age (mean of 45.6±11.25. The IND group included 82 individuals, ranging from 24 to 66 years of age (mean of 39.6±10.3. The CARD group included 94 patients ranging from 23 to 69 years of age (mean of 48±12.52 presenting dilated cardiomyopathy. None of the patients have undergone chemotherapeutic treatment, nor had been previously treated for T. cruzi infection. Healthy non-chagasic individuals, ranging from 29 to 55 years of age (mean of 42.6±8.8 were included as a control group (NI. IND patients have a higher intensity of interleukin 10 (IL-10 expression when compared with individuals in the other groups. By contrast, inflammatory cytokine expression, such as interferon gamma (IFN-γ, tumor necrosis factor alpha (TNF-α, interleukin 6 (IL-6, and interleukin 1 beta (IL-1β, proved to be the highest in the CARD group. Correlation analysis showed that higher IL-10 expression was associated with better cardiac function, as determined by left ventricular ejection fraction and left ventricular diastolic diameter values. Altogether, these findings reinforce the concept that a fine balance between regulatory and inflammatory cytokines represents a key element in the establishment of distinct forms of chronic Chagas disease.

  6. Epidemiology of and impact of insecticide spraying on Chagas disease in communities in the Bolivian Chaco.

    Directory of Open Access Journals (Sweden)

    Aaron M Samuels

    Full Text Available BACKGROUND: Chagas disease control campaigns relying upon residual insecticide spraying have been successful in many Southern American countries. However, in some areas, rapid reinfestation and recrudescence of transmission have occurred. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a cross-sectional survey in the Bolivian Chaco to evaluate prevalence of and risk factors for T. cruzi infection 11 years after two rounds of blanket insecticide application. We used a cubic B-spline model to estimate change in force of infection over time based on age-specific seroprevalence data. Overall T. cruzi seroprevalence was 51.7%. The prevalence was 19.8% among children 2-15, 72.7% among those 15-30 and 97.1% among participants older than 30 years. Based on the model, the estimated annual force of infection was 4.3% over the two years before the first blanket spray in 2000 and fell to 0.4% for 2001-2002. The estimated annual force of infection for 2004-2005, the 2 year period following the second blanket spray, was 4.6%. However, the 95% bootstrap confidence intervals overlap for all of these estimates. In a multivariable model, only sleeping in a structure with cracks in the walls (aOR = 2.35; 95% CI = 1.15-4.78, age and village of residence were associated with infection. CONCLUSIONS/SIGNIFICANCE: As in other areas in the Chaco, we found an extremely high prevalence of Chagas disease. Despite evidence that blanket insecticide application in 2000 may have decreased the force of infection, active transmission is ongoing. Continued spraying vigilance, infestation surveillance, and systematic household improvements are necessary to disrupt and sustain interruption of infection transmission.

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

    Directory of Open Access Journals (Sweden)

    Paula Melo de Abreu Vieira

    Full Text Available 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 parasitemia during all the acute phase of infection. Moreover, the infection with either MT or BT forms resulted in increased levels of total leukocytes, monocytes and lymphocytes, specifically later for MT and earlier for BT. The infection with BT forms presented earlier production of proinflammatory cytokine TNF-α and later of IFN-γ by both T cells subpopulations. This event was accompanied by an early cardiac inflammation with an exacerbation of this process at the end of the acute phase. On the other hand, infection with MT forms result in an early production of IFN-γ, with subsequent control in the production of this cytokine by IL-10, which provided to these animals an immunomodulatory profile in the end of the acute phase. These results are in agreement with what was found for cardiac inflammation where animals infected with MT forms showed intense cardiac inflammation later at infection, with a decrease in the same at the end of this phase. In summary, our findings emphasize the importance of taking into account the inoculums source of T. cruzi, since vectorial or transfusional routes of T. cruzi infection may trigger distinct parasite-host interactions during the acute phase that may influence relevant biological aspects of chronic Chagas disease.

  8. Different Infective Forms Trigger Distinct Immune Response in Experimental Chagas Disease

    Science.gov (United States)

    Vieira, Paula Melo de Abreu; Francisco, Amanda Fortes; Machado, Evandro Marques de Meneses; Nogueira, Nívia Carolina; Fonseca, Kátia da Silva; Reis, Alexandre Barbosa; Teixeira-Carvalho, Andrea; Martins-Filho, Olindo Assis; Tafuri, Washington Luiz; Carneiro, Cláudia Martins

    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 parasitemia during all the acute phase of infection. Moreover, the infection with either MT or BT forms resulted in increased levels of total leukocytes, monocytes and lymphocytes, specifically later for MT and earlier for BT. The infection with BT forms presented earlier production of proinflammatory cytokine TNF-α and later of IFN-γ by both T cells subpopulations. This event was accompanied by an early cardiac inflammation with an exacerbation of this process at the end of the acute phase. On the other hand, infection with MT forms result in an early production of IFN-γ, with subsequent control in the production of this cytokine by IL-10, which provided to these animals an immunomodulatory profile in the end of the acute phase. These results are in agreement with what was found for cardiac inflammation where animals infected with MT forms showed intense cardiac inflammation later at infection, with a decrease in the same at the end of this phase. In summary, our findings emphasize the importance of taking into account the inoculums source of T. cruzi, since vectorial or transfusional routes of T. cruzi infection may trigger distinct parasite-host interactions during the acute phase that may influence relevant biological aspects of chronic Chagas disease. PMID:22412949

  9. Screening Tests for Women Who Have Heart Disease

    Science.gov (United States)

    ... Heart Handbook for Women FOR WOMEN WHO HAVE HEART DISEASE If you have heart disease, it is extremely ... flow and any blockages. COULD YOU HAVE HIDDEN HEART DISEASE? Many women have undiagnosed heart disease—even after ...

  10. Analysis of children's perception of triatomine vectors of chagas disease through drawings: opportunities for targeted health education.

    Directory of Open Access Journals (Sweden)

    Violetta Yevstigneyeva

    2014-10-01

    Full Text Available Chagas disease is a tropical parasitic disease affecting about 10 million people, mostly in the Americas, and transmitted mainly by triatomine bugs. Insect vector control with indoor residual insecticides and the promotion of housing improvement is the main control intervention. The success of such interventions relies on their acceptance and appropriation by communities, which depends on their knowledge and perceptions of both the disease and the vector. In this study, we investigated school-aged children's knowledge and perception on triatomine vectors and Chagas disease to further understand how communities view this vector and the disease in Yucatan, Mexico.We performed an analysis of children's drawings on the theme of triatomines and their house in several rural villages, to explore in an open-ended manner their views, understanding and misconceptions. A total of 261 drawings were collected from children ages 6-12 from four villages. We found that children are very familiar with triatomine vectors, and know very well many aspects of their biology and ecology, and in particular their blood-feeding habits. On the other hand, their drawings suggest that the role of triatomines as vectors of a chronic and severe cardiac disease is less understood, and the main perceived health threat appears limited to the bite itself, as previously observed in adults.These results have important implications for the specific design of future education materials and campaigns, and for the promotion of the inclusion of children in raising Chagas disease awareness in these endemic communities.

  11. Opportunities for Improved Chagas Disease Vector Control Based on Knowledge, Attitudes and Practices of Communities in the Yucatan Peninsula, Mexico

    OpenAIRE

    Kathryn Rosecrans; Gabriela Cruz-Martin; Ashley King; Eric Dumonteil

    2014-01-01

    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...

  12. Treatment of Chagas Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    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.

  13. Polymerase chain reaction and blood culture in blood donors screened by ELISA test for Chagas' disease

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    Andréa Tieko Kinoshita-Yanaga

    2011-03-01

    Full Text Available The objective of this study was to evaluate, through blood culture and PCR, the results of the ELISA for Chagas' disease in the screening of blood donors in the public blood-supply network of the state of Paraná, Brazil, and to map the epidemiological profile of the donors with respect to their risk of infection by Trypanosoma cruzi. The negative and positive results of the ELISA were confirmed by blood culture and PCR for 190/191 individuals (99.5%. For one individual (0.5%, the ELISA was inconclusive, blood culture and IIF were negative, and IHA and PCR positive. Three individuals (1.6% were positive for T. cruzi on all the tests. Donors were predominantly female, and natives of Paraná, of rural origin, had observed or been informed of the presence of the vector in the municipalities where they resided, had never received a blood transfusion, had donated blood 1 to 4 times, and reported no cases of Chagas' disease in their families. We concluded that PCR and blood culturing have excellent potential for confirming the results of the ELISA, and that candidate blood donors with negative or positive tests have a similar risk of infection by T. cruzi, indicating that the ELISA test is sufficiently safe for screening blood prior to use.O objetivo deste estudo foi avaliar, pela hemocultura e PCR, os resultados do teste ELISA utilizado para doença de Chagas na triagem de doadores de sangue na rede pública do Estado do Paraná, Brasil, e traçar o perfil epidemiológico dos doadores quanto ao risco de infecção pelo Trypanosoma cruzi. Os resultados negativos e positivos do ELISA foram confirmados pela hemocultura e PCR em 190/191 indivíduos (99,5%. Para um indivíduo (0,5%, o teste de ELISA foi inconclusivo, hemocultura e IFI foram negativas, HAI e PCR foram positivas. Três indivíduos (1,6% foram positivos para T. cruzi em todos os testes. A maioria dos doadores era do sexo feminino, oriundos do Estado do Paraná, de origem rural, tinham

  14. The importance of the multidisciplinary approach to deal with the new epidemiological scenario of Chagas disease (global health).

    Science.gov (United States)

    Pinazo, Maria-Jesus; Gascon, Joaquim

    2015-11-01

    There are currently two major factors that have modified the epidemiology of Chagas disease in the last decades: climate change and migration flows. In this new scenario, there are new challenges to control and prevent Trypanosoma cruzi infection in endemic countries, such as the control of a wider distribution of triatomine vectors or the reinforcement of vertical transmission programs. In non-endemic areas, few countries are aware of the emergence of this new disease and have established changes in their health systems. To address this new public health challenge, the priorities should be control programs to avoid new cases of T. cruzi infection acquired through vertical transmission, blood transfusion or organ transplant. In both, endemic and non-endemic areas, the international community and all the actors involved in Chagas disease must join efforts mainly in two directions: better management of the infection in affected individuals and more research to cover the knowledge gap mainly in physiopathology, diagnosis and treatment. PMID:26187358

  15. Experimental chemotherapy for Chagas disease: 15 years of research contributions from in vivo and in vitro studies

    Directory of Open Access Journals (Sweden)

    Maria de Nazaré C Soeiro

    2009-07-01

    Full Text Available Chagas disease, which is caused by the intracellular parasite Trypanosoma cruzi, is a neglected illness with 12-14 million reported cases in endemic geographic regions of Latin America. While the disease still represents an important public health problem in these affected areas, the available therapy, which was introduced more than four decades ago, is far from ideal due to its substantial toxicity, its limited effects on different parasite stocks, and its poor activity during the chronic phase of the disease. For the past 15 years, our group, in collaboration with research groups focused on medicinal chemistry, has been working on experimental chemotherapies for Chagas disease, investigating the biological activity, toxicity, selectivity and cellular targets of different classes of compounds on T. cruzi. In this report, we present an overview of these in vitro and in vivo studies, focusing on the most promising classes of compounds with the aim of contributing to the current knowledge of the treatment of Chagas disease and aiding in the development of a new arsenal of candidates with anti-T. cruzi efficacy.

  16. Scientific authorships and collaboration network analysis on Chagas disease: papers indexed in PubMed (1940-2009

    Directory of Open Access Journals (Sweden)

    Gregorio González-Alcaide

    2012-08-01

    Full Text Available Chagas disease is a chronic, tropical, parasitic disease, endemic throughout Latin America. The large-scale migration of populations has increased the geographic distribution of the disease and cases have been observed in many other countries around the world. To strengthen the critical mass of knowledge generated in different countries, it is essential to promote cooperative and translational research initiatives. We analyzed authorship of scientific documents on Chagas disease indexed in the Medline database from 1940 to 2009. Bibliometrics was used to analyze the evolution of collaboration patterns. A Social Network Analysis was carried out to identify the main research groups in the area by applying clustering methods. We then analyzed 13,989 papers produced by 21,350 authors. Collaboration among authors dramatically increased over the study period, reaching an average of 6.2 authors per paper in the last five-year period. Applying a threshold of collaboration of five or more papers signed in co-authorship, we identified 148 consolidated research groups made up of 1,750 authors. The Chagas disease network identified constitutes a "small world," characterized by a high degree of clustering and a notably high number of Brazilian researchers.

  17. Value of the Qrs-T Angle in Predicting the Induction of Ventricular Tachyarrhythmias in Patients with Chagas Disease.

    Science.gov (United States)

    Zampa, Hugo Bizetto; Moreira, Dalmo Ar; Ferreira Filho, Carlos Alberto Brandão; Souza, Charles Rios; Menezes, Camila Caldas; Hirata, Henrique Seichii; Armaganijan, Luciana Vidal

    2014-10-28

    Background: The QRS-T angle correlates with prognosis in patients with heart failure and coronary artery disease, reflected by an increase in mortality proportional to an increase in the difference between the axes of the QRS complex and T wave in the frontal plane. The value of this correlation in patients with Chagas heart disease is currently unknown. Objective: Determine the correlation of the QRS-T angle and the risk of induction of ventricular tachycardia / ventricular fibrillation (VT / VF) during electrophysiological study (EPS) in patients with Chagas disease. Methods: Case-control study at a tertiary center. Patients without induction of VT / VF on EPS were used as controls. The QRS-T angle was categorized as normal (0-105º), borderline (105-135º) or abnormal (135-180º). Differences between groups for continuous variables were analyzed with the t test or Mann-Whitney test, and for categorical variables with Fisher's exact test. P values ventricular tachycardia / ventricular fibrillation on EPS [odds ratio (OR) 4; confidence interval (CI) 1.298-12.325; p = 0.028]. After adjustment for other variables such as age, ejection fraction (EF) and QRS size, there was a trend for the abnormal QRS-T angle to identify patients with increased risk of inducing VT / VF during EPS (OR 3.95; CI 0.99-15.82; p = 0.052). The EF also emerged as a predictor of induction of VT / VF: for each point increase in EF, there was a 4% reduction in the rate of sustained ventricular arrhythmia on EPS. Conclusions: Changes in the QRS-T angle and decreases in EF were associated with an increased risk of induction of VT / VF on EPS.Fundamento: O ângulo QRS-T mostra correlação com prognóstico em pacientes com insuficiência cardíaca e doença coronariana, traduzido por um aumento na mortalidade proporcional ao aumento na diferença entre os eixos do complexo QRS e da onda T no plano frontal. Até hoje, nenhuma informação a este respeito foi obtida em pacientes com cardiopatia chag

  18. Environmental and socio-economic risk modelling for Chagas disease in Bolivia.

    Science.gov (United States)

    Mischler, Paula; Kearney, Michael; McCarroll, Jennifer C; Scholte, Ronaldo G C; Vounatsou, Penelope; Malone, John B

    2012-09-01

    Accurately defining disease distributions and calculating disease risk is an important step in the control and prevention of diseases. Geographical information systems (GIS) and remote sensing technologies, with maximum entropy (Maxent) ecological niche modelling computer software, were used to create predictive risk maps for Chagas disease in Bolivia. Prevalence rates were calculated from 2007 to 2009 household infection survey data for Bolivia, while environmental data were compiled from the Worldclim database and MODIS satellite imagery. Socio-economic data were obtained from the Bolivian National Institute of Statistics. Disease models identified altitudes at 500-3,500 m above the mean sea level (MSL), low annual precipitation (45-250 mm), and higher diurnal range of temperature (10-19 °C; peak 16 °C) as compatible with the biological requirements of the insect vectors. Socio-economic analyses demonstrated the importance of improved housing materials and water source. Home adobe wall materials and having to fetch drinking water from rivers or wells without pump were found to be highly related to distribution of the disease by the receiver operator characteristic (ROC) area under the curve (AUC) (0.69 AUC, 0.67 AUC and 0.62 AUC, respectively), while areas with hardwood floors demonstrated a direct negative relationship (-0.71 AUC). This study demonstrates that Maxent modelling can be used in disease prevalence and incidence studies to provide governmental agencies with an easily learned, understandable method to define areas as either high, moderate or low risk for the disease. This information may be used in resource planning, targeting and implementation. However, access to high-resolution, sub-municipality socio-economic data (e.g. census tracts) would facilitate elucidation of the relative influence of poverty-related factors on regional disease dynamics.

  19. Environmental and socio-economic risk modelling for Chagas disease in Bolivia

    Directory of Open Access Journals (Sweden)

    Paula Mischler

    2012-09-01

    Full Text Available Accurately defining disease distributions and calculating disease risk is an important step in the control and prevention of diseases. Geographical information systems (GIS and remote sensing technologies, with maximum entropy (Maxent ecological niche modelling computer software, were used to create predictive risk maps for Chagas disease in Bolivia. Prevalence rates were calculated from 2007 to 2009 household infection survey data for Bolivia, while environmental data were compiled from the Worldclim database and MODIS satellite imagery. Socio-economic data were obtained from the Bolivian National Institute of Statistics. Disease models identified altitudes at 500-3,500 m above the mean sea level (MSL, low annual precipitation (45-250 mm, and higher diurnal range of temperature (10-19 °C; peak 16 °C as compatible with the biological requirements of the insect vectors. Socio-economic analyses demonstrated the importance of improved housing materials and water source. Home adobe wall materials and having to fetch drinking water from rivers or wells without pump were found to be highly related to distribution of the disease by the receiver operator characteristic (ROC area under the curve (AUC (0.69 AUC, 0.67 AUC and 0.62 AUC, respectively, while areas with hardwood floors demonstrated a direct negative relationship (-0.71 AUC. This study demonstrates that Maxent modelling can be used in disease prevalence and incidence studies to provide governmental agencies with an easily learned, understandable method to define areas as either high, moderate or low risk for the disease. This information may be used in resource planning, targeting and implementation. However, access to high-resolution, sub-municipality socio-economic data (e.g. census tracts would facilitate elucidation of the relative influence of poverty-related factors on regional disease dynamics.

  20. What Are the Signs and Symptoms of Diabetic Heart Disease?

    Science.gov (United States)

    ... What Are the Signs and Symptoms of Diabetic Heart Disease? Some people who have diabetic heart disease (DHD) ... when it's given right after symptoms occur. Coronary Heart Disease A common symptom of coronary heart disease (CHD) ...

  1. Chagas disease among the Latin American adult population attending in a primary care center in Barcelona, Spain.

    Directory of Open Access Journals (Sweden)

    Carme Roca

    Full Text Available BACKGROUND/AIMS: The epidemiology of Chagas disease, until recently confined to areas of continental Latin America, has undergone considerable changes in recent decades due to migration to other parts of the world, including Spain. We studied the prevalence of Chagas disease in Latin American patients treated at a health center in Barcelona and evaluated its clinical phase. We make some recommendations for screening for the disease. METHODOLOGY/PRINCIPAL FINDINGS: We performed an observational, cross-sectional prevalence study by means of an immunochromatographic test screening of all continental Latin American patients over the age of 14 years visiting the health centre from October 2007 to October 2009. The diagnosis was confirmed by serological methods: conventional in-house ELISA (cELISA, a commercial kit (rELISA and ELISA using T cruzi lysate (Ortho-Clinical Diagnostics (oELISA. Of 766 patients studied, 22 were diagnosed with T. cruzi infection, showing a prevalence of 2.87% (95% CI, 1.6-4.12%. Of the infected patients, 45.45% men and 54.55% women, 21 were from Bolivia, showing a prevalence in the Bolivian subgroup (n=127 of 16.53% (95% CI, 9.6-23.39%. ALL THE INFECTED PATIENTS WERE IN A CHRONIC PHASE OF CHAGAS DISEASE: 81% with the indeterminate form, 9.5% with the cardiac form and 9.5% with the cardiodigestive form. All patients infected with T. cruzi had heard of Chagas disease in their country of origin, 82% knew someone affected, and 77% had a significant history of living in adobe houses in rural areas. CONCLUSIONS: We found a high prevalence of T. cruzi infection in immigrants from Bolivia. Detection of T. cruzi-infected persons by screening programs in non-endemic countries would control non-vectorial transmission and would benefit the persons affected, public health and national health systems.

  2. Evasion and Immuno-Endocrine Regulation in Parasite Infection: Two Sides of the Same Coin in Chagas Disease?

    Science.gov (United States)

    Morrot, Alexandre; Villar, Silvina R.; González, Florencia B.; Pérez, Ana R.

    2016-01-01

    Chagas disease is a serious illness caused by the protozoan parasite Trypanosoma cruzi. Nearly 30% of chronically infected people develop cardiac, digestive, or mixed alterations, suggesting a broad range of host-parasite interactions that finally impact upon chronic disease outcome. The ability of T. cruzi to persist and cause pathology seems to depend on diverse factors like T. cruzi strains, the infective load and the route of infection, presence of virulence factors, the parasite capacity to avoid protective immune response, the strength and type of host defense mechanisms and the genetic background of the host. The host-parasite interaction is subject to a constant neuro-endocrine regulation that is thought to influence the adaptive immune system, and as the infection proceeds it can lead to a broad range of outcomes, ranging from pathogen elimination to its continued persistence in the host. In this context, T. cruzi evasion strategies and host defense mechanisms can be envisioned as two sides of the same coin, influencing parasite persistence and different outcomes observed in Chagas disease. Understanding how T. cruzi evade host's innate and adaptive immune response will provide important clues to better dissect mechanisms underlying the pathophysiology of Chagas disease. PMID:27242726

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

    Directory of Open Access Journals (Sweden)

    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

  4. Biomarkers of therapeutic responses in chronic Chagas disease: state of the art and future perspectives

    Directory of Open Access Journals (Sweden)

    Maria-Jesus Pinazo

    2015-05-01

    Full Text Available The definition of a biomarker provided by the World Health Organization is any substance, structure, or process that can be measured in the body, or its products and influence, or predict the incidence or outcome of disease. Currently, the lack of prognosis and progression markers for chronic Chagas disease has posed limitations for testing new drugs to treat this neglected disease. Several molecules and techniques to detect biomarkers in Trypanosoma cruzi-infected patients have been proposed to assess whether specific treatment with benznidazole or nifurtimox is effective. Isolated proteins or protein groups from different T. cruzi stages and parasite-derived glycoproteins and synthetic neoglycoconjugates have been demonstrated to be useful for this purpose, as have nucleic acid amplification techniques. The amplification of T. cruzi DNA using the real-time polymerase chain reaction method is the leading test for assessing responses to treatment in a short period of time. Biochemical biomarkers have been tested early after specific treatment. Cytokines and surface markers represent promising molecules for the characterisation of host cellular responses, but need to be further assessed.

  5. Population Structure of the Chagas Disease Vector Triatoma infestans in an Urban Environment

    Science.gov (United States)

    Khatchikian, Camilo E.; Foley, Erica A.; Barbu, Corentin M.; Hwang, Josephine; Ancca-Juárez, Jenny; Borrini-Mayori, Katty; Quıspe-Machaca, Victor R.; Naquira, Cesar; Brisson, Dustin; Levy, Michael Z.

    2015-01-01

    Chagas disease is a vector-borne disease endemic in Latin America. Triatoma infestans, a common vector of this disease, has recently expanded its range into rapidly developing cities of Latin America. We aim to identify the environmental features that affect the colonization and dispersal of T. infestans in an urban environment. We amplified 13 commonly used microsatellites from 180 T. infestans samples collected from a sampled transect in the city of Arequipa, Peru, in 2007 and 2011. We assessed the clustering of subpopulations and the effect of distance, sampling year, and city block location on genetic distance among pairs of insects. Despite evidence of genetic similarity, the majority of city blocks are characterized by one dominant insect genotype, suggesting the existence of barriers to dispersal. Our analyses show that streets represent an important barrier to the colonization and dispersion of T. infestans in Arequipa. The genetic data describe a T. infestans infestation history characterized by persistent local dispersal and occasional long-distance migration events that partially parallels the history of urban development. PMID:25646757

  6. Bats, Trypanosomes, and Triatomines in Ecuador: New Insights into the Diversity, Transmission, and Origins of Trypanosoma cruzi and Chagas Disease

    OpenAIRE

    C. Miguel Pinto; Sofía Ocaña-Mayorga; Tapia, Elicio E.; Lobos, Simón E.; Zurita, Alejandra P.; Fernanda Aguirre-Villacís; Amber MacDonald; Anita G Villacís; Luciana Lima; Teixeira, Marta M. G.; Mario J Grijalva; Perkins, Susan L.

    2015-01-01

    The generalist parasite Trypanosoma cruzi has two phylogenetic lineages associated almost exclusively with bats-Trypanosoma cruzi Tcbat and the subspecies T. c. marinkellei. We present new information on the genetic variation, geographic distribution, host associations, and potential vectors of these lineages. We conducted field surveys of bats and triatomines in southern Ecuador, a country endemic for Chagas disease, and screened for trypanosomes by microscopy and PCR. We identified parasite...

  7. Usefulness of real time PCR to quantify parasite load in serum samples from chronic Chagas disease patients

    OpenAIRE

    Melo, Myllena F; Moreira, Otacilio C.; Tenório, Priscila; Lorena, Virginia; Lorena-Rezende, Izaura; Júnior, Wilson Oliveira; Gomes, Yara; Britto, Constança

    2015-01-01

    Background Inconclusive results of serological diagnosis in Chagas disease have an important impact on blood banks worldwide, reflecting in the high number of discarded bags or in an increased transmission by blood transfusion. Molecular techniques such as qPCR have been used for diagnosis and to monitor Trypanosoma cruzi load in peripheral blood samples. A promising perspective refers to the possibility of parasite DNA detection in serum, taking advantage in using the same samples collected ...

  8. Extraction of Trypanosoma cruzi DNA from food: a contribution to the elucidation of acute Chagas disease outbreaks

    OpenAIRE

    Renata Trotta Barroso Ferreira; Aline Martins Melandre; Maria Luiza Cabral; Maria Regina Branquinho; Paola Cardarelli-Leite

    2016-01-01

    Abstract: INTRODUCTION: Before 2004, the occurrence of acute Chagas disease (ACD) by oral transmission associated with food was scarcely known or investigated. Originally sporadic and circumstantial, ACD occurrences have now become frequent in the Amazon region, with recently related outbreaks spreading to several Brazilian states. These cases are associated with the consumption of açai juice by waste reservoir animals or insect vectors infected with Trypanosoma cruzi in endemic areas. Altho...

  9. Health in adults with congenital heart disease.

    Science.gov (United States)

    Cuypers, Judith A A E; Utens, Elisabeth M W J; Roos-Hesselink, Jolien W

    2016-09-01

    Since the introduction of cardiac surgery, the prospects for children born with a cardiac defect have improved spectacularly. Many reach adulthood and the population of adults with congenital heart disease is increasing and ageing. However, repair of congenital heart disease does not mean cure. Many adults with congenital heart disease encounter late complications. Late morbidity can be related to the congenital heart defect itself, but may also be the consequence of the surgical or medical treatment or longstanding alterations in hemodynamics, neurodevelopment and psychosocial development. This narrative review describes the cardiac and non-cardiac long-term morbidity in the adult population with congenital heart disease. PMID:27451323

  10. Feeding sources and trypanosome infection index of Rhodnius pallescens in a Chagas disease endemic area of Amador County, Panama.

    Science.gov (United States)

    Pineda, Vanessa; Montalvo, Edilma; Alvarez, Dayra; Santamaría, Ana María; Calzada, Jose Eduardo; Saldaña, Azael

    2008-01-01

    The sylvatic triatomine Rhodnius pallescens is considered to be the most important and widespread vector of Trypanosoma cruzi and Trypanosoma rangeli in Panama. However, its behavior and biological characteristics have only been partially investigated. Thus, to achieve sustainable and efficient control over Chagas disease in Panama, a better understanding of the ecology and biology of R. pallescens is essential. In this study we evaluated R. pallescens host feeding sources using a dot-blot assay, and the trypanosome infection index by PCR analysis in a Chagas disease endemic area of central Panama. It was found that in peridomestic palm trees, 20.3% of the examined bugs had fed on opossums (Didelphis marsupialis). However, we observed an increased anthropophagy (25.4%) for those bugs collected inside houses. Considering the domestic and peridomestic habitats as a whole, the proportion of collected R. pallescens infected with trypanosomes was 87.4%. In the two habitats the predominant infection was with T. cruzi (80-90%). Between 47-51% of the analyzed triatomines were infected with T. rangeli. Mixed infections (40-51%) were also detected. These findings provide a better basis for the implementation of a rational control and surveillance program for Chagas disease in regions where R. pallescens is endemic. PMID:18488091

  11. Heart rate reduction in coronary artery disease and heart failure.

    Science.gov (United States)

    Ferrari, Roberto; Fox, Kim

    2016-08-01

    Elevated heart rate is known to induce myocardial ischaemia in patients with coronary artery disease (CAD), and heart rate reduction is a recognized strategy to prevent ischaemic episodes. In addition, clinical evidence shows that slowing the heart rate reduces the symptoms of angina by improving microcirculation and coronary flow. Elevated heart rate is an established risk factor for cardiovascular events in patients with CAD and in those with chronic heart failure (HF). Accordingly, reducing heart rate improves prognosis in patients with HF, as demonstrated in SHIFT. By contrast, data from SIGNIFY indicate that heart rate is not a modifiable risk factor in patients with CAD who do not also have HF. Heart rate is also an important determinant of cardiac arrhythmias; low heart rate can be associated with atrial fibrillation, and high heart rate after exercise can be associated with sudden cardiac death. In this Review, we critically assess these clinical findings, and propose hypotheses for the variable effect of heart rate reduction in cardiovascular disease. PMID:27226153

  12. Heart rate reduction in coronary artery disease and heart failure.

    Science.gov (United States)

    Ferrari, Roberto; Fox, Kim

    2016-08-01

    Elevated heart rate is known to induce myocardial ischaemia in patients with coronary artery disease (CAD), and heart rate reduction is a recognized strategy to prevent ischaemic episodes. In addition, clinical evidence shows that slowing the heart rate reduces the symptoms of angina by improving microcirculation and coronary flow. Elevated heart rate is an established risk factor for cardiovascular events in patients with CAD and in those with chronic heart failure (HF). Accordingly, reducing heart rate improves prognosis in patients with HF, as demonstrated in SHIFT. By contrast, data from SIGNIFY indicate that heart rate is not a modifiable risk factor in patients with CAD who do not also have HF. Heart rate is also an important determinant of cardiac arrhythmias; low heart rate can be associated with atrial fibrillation, and high heart rate after exercise can be associated with sudden cardiac death. In this Review, we critically assess these clinical findings, and propose hypotheses for the variable effect of heart rate reduction in cardiovascular disease.

  13. Data and Statistics: Women and Heart Disease

    Science.gov (United States)

    ... Program Funded States History of PCNASP PCNASP Metrics/Data Elements PCNASP Logic Model 2015 PCNASP FOA DP15- ... Insurance Million Hearts® Clinical Quality Measures (CQM) Dashboard Data Trends & Maps Printed Atlases Heart Disease Hospitalizations Among ...

  14. Brain and heart disease studies

    International Nuclear Information System (INIS)

    Highlights of important studies completed during the past year using the Donner 280-crystal positron ring tomograph are summarized in this article. Using rubidium-82, images of a brain tumor and an arteriovenous malformation are described. An image demonstrating methionine uptake in a patient with schizophrenia and an image reflecting sugar metabolism in the brain of a man with Alzheimer's disease are also included. Uptake of rubidium-82 in subjects before and after exercise is being investigated. The synthesis of new radiopharmaceuticals and the development of a new synthesis for C-taurine for use in the study of metabolism in the human heart are also being studied

  15. First report of a family outbreak of Chagas disease in French Guiana and posttreatment follow-up.

    Science.gov (United States)

    Blanchet, Denis; Brenière, Simone Frédérique; Schijman, Alejandro G; Bisio, Margarita; Simon, Stéphane; Véron, Vincent; Mayence, Claire; Demar-Pierre, Magalie; Djossou, Félix; Aznar, Christine

    2014-12-01

    The outbreak of acute Chagas disease due to oral transmission of the parasite is a well-known phenomenon mainly occurring in the Amazon. Such an event is described here for the first time in French Guiana. Eight patients of the same family, presenting epidemiological and clinical histories compatible with recent Trypanosoma cruzi infection of Chagas disease due to the ingestion of palm Oenocarpus bacaba juice were, rather late after the putative date of infection, underwent four parasitological and two serological specific tests for confirmation of the diagnosis. Real-time PCR results were positive for all the patients; strains were isolated by hemoculture from four patients, PCR identification of TcI DTU was made for six patients, while parasites were not detected in any of the patients by direct microscopic examination. The results of two serologic tests were positive. All patients were treated with benznidazole, and two patients were additionally given nifurtimox. A 6-year follow-up was possible for six patients. Real-time PCR was negative for these patients after 1 year, while the antibody rates decreased slowly and serology results were negative only after several years (1-5 years). Our findings confirm the occurrence of an outbreak of Chagas infection in members of the same family, with the oral mode of infection being the most likely hypothesis to explain this group of cases. Our results show the successful treatment of patients infected by TcI and the usefulness of real-time PCR for the emergency diagnosis of recent Chagas disease cases and in posttreatment follow-up.

  16. Atlas of Mexican Triatominae (Reduviidae: Hemiptera and vector transmission of Chagas disease

    Directory of Open Access Journals (Sweden)

    Janine M Ramsey

    2015-05-01

    Full Text Available Chagas disease is one of the most important yet neglected parasitic diseases in Mexico and is transmitted by Triatominae. Nineteen of the 31 Mexican triatomine species have been consistently found to invade human houses and all have been found to be naturally infected with Trypanosoma cruzi. The present paper aims to produce a state-of-knowledge atlas of Mexican triatomines and analyse their geographic associations with T. cruzi, human demographics and landscape modification. Ecological niche models (ENMs were constructed for the 19 species with more than 10 records in North America, as well as for T. cruzi. The 2010 Mexican national census and the 2007 National Forestry Inventory were used to analyse overlap patterns with ENMs. Niche breadth was greatest in species from the semiarid Nearctic Region, whereas species richness was associated with topographic heterogeneity in the Neotropical Region, particularly along the Pacific Coast. Three species, Triatoma longipennis, Triatoma mexicana and Triatoma barberi, overlapped with the greatest numbers of human communities, but these communities had the lowest rural/urban population ratios. Triatomine vectors have urbanised in most regions, demonstrating a high tolerance to human-modified habitats and broadened historical ranges, exposing more than 88% of the Mexican population and leaving few areas in Mexico without the potential for T. cruzi transmission.

  17. Atlas of Mexican Triatominae (Reduviidae: Hemiptera) and vector transmission of Chagas disease.

    Science.gov (United States)

    Ramsey, Janine M; Peterson, A Townsend; Carmona-Castro, Oscar; Moo-Llanes, David A; Nakazawa, Yoshinori; Butrick, Morgan; Tun-Ku, Ezequiel; la Cruz-Félix, Keynes de; Ibarra-Cerdeña, Carlos N

    2015-05-01

    Chagas disease is one of the most important yet neglected parasitic diseases in Mexico and is transmitted by Triatominae. Nineteen of the 31 Mexican triatomine species have been consistently found to invade human houses and all have been found to be naturally infected with Trypanosoma cruzi. The present paper aims to produce a state-of-knowledge atlas of Mexican triatomines and analyse their geographic associations with T. cruzi, human demographics and landscape modification. Ecological niche models (ENMs) were constructed for the 19 species with more than 10 records in North America, as well as for T. cruzi. The 2010 Mexican national census and the 2007 National Forestry Inventory were used to analyse overlap patterns with ENMs. Niche breadth was greatest in species from the semiarid Nearctic Region, whereas species richness was associated with topographic heterogeneity in the Neotropical Region, particularly along the Pacific Coast. Three species, Triatoma longipennis, Triatoma mexicana and Triatoma barberi, overlapped with the greatest numbers of human communities, but these communities had the lowest rural/urban population ratios. Triatomine vectors have urbanised in most regions, demonstrating a high tolerance to human-modified habitats and broadened historical ranges, exposing more than 88% of the Mexican population and leaving few areas in Mexico without the potential for T. cruzi transmission. PMID:25993505

  18. Increase of reactive oxygen species by desferrioxamine during experimental Chagas' disease

    Science.gov (United States)

    Francisco, Amanda Fortes; de Abreu Vieira, Paula Melo; Arantes, Jerusa Marilda; Silva, Maisa; Pedrosa, Maria Lúcia; Elói-Santos, Silvana Maria; Martins-Filho, Olindo Assis; Teixeira-Carvalho, Andréa; Araújo, Márcio Sobreira Silva; Tafuri, Washington Luiz; Carneiro, Cláudia Martins

    2010-01-01

    Oxidative stress is common in inflammatory processes associated with many diseases including Chagas' disease. The aim of the present study was to evaluate, in a murine model, biomarkers of oxidative stress together with components of the antioxidant system in order to provide an overview of the mechanism of action of the iron chelator desferrioxamine (DFO). The study population comprised 48 male Swiss mice, half of which were treated daily by intraperitoneal injection of DFO over a 35-day period, while half were administered sterile water in a similar manner. On the 14th day of the experiment, 12 DFO-treated mice and an equal number of untreated mice were experimentally infected with Trypanosoma cruzi. Serum concentrations of nitric oxide and superoxide dismutase and hepatic levels of total glutathione, thiobarbituric acid reactive species and protein carbonyl, were determined on days 0, 7, 14 and 21 post-infection. The results obtained revealed that DFO enhances antioxidant activity in the host but also increases oxidative stress, indicating that the mode of action of the drug involves a positive contribution to the host together with an effect that is not beneficial to the parasite. PMID:20663295

  19. Globalização, iniqüidade e doença de Chagas Globalization, inequity and Chagas disease

    Directory of Open Access Journals (Sweden)

    João Carlos Pinto Dias

    2007-01-01

    Full Text Available A doença de Chagas (tripanossomíase americana, apresenta múltiplos aspectos sócio-culturais e político-econômicos que envolvem questões de iniqüidade e globalização. São relações presentes tanto nos processos de produção da doença como nas possibilidades de sua prevenção e manejo. Apesar da pobreza da região, envolvendo questões de iniqüidade e globalização, a doença tem sido controlada em várias áreas, o que reforça a auto-estima dos países. Para o futuro, problemas e desafios podem ser esperados, principalmente em termos da assistência médica para os indivíduos já infectados e da sustentação de uma vigilância epidemiológica permanente. Ambos estes pontos dependem de um melhor desempenho dos sistemas nacionais de saúde, principalmente em termos de sua competência e da superação de situações de iniqüidade. Particularmente, tem cabido à comunidade científica e acadêmica latino-americana um papel de grande destaque na implementação e sustentação de políticas de controle da doença, que hoje evoluíram para estratégias de ação compartida entre países, o que pode significar importante avanço no contexto político da região.Chagas disease (American trypanosomiasis bears a close relationship to multiple social and political aspects involving issues of globalization and inequity. Such relations concern the process of disease production and control in parallel with medical management. Despite the poverty in Latin America and various problems related to inequities and globalization, Chagas disease has been controlled in several areas, a fact that reinforces the countries' self-reliance. Several problems and challenges related to the disease can be expected in the future, mainly concerning medical care for already infected individuals and the sustainability of effective epidemiological surveillance. Both points depend heavily on improved performance by the national health systems, principally in

  20. What Are the Signs and Symptoms of Coronary Heart Disease?

    Science.gov (United States)

    ... What Are the Signs and Symptoms of Coronary Heart Disease? A common symptom of coronary heart disease (CHD) ... and Symptoms of Heart Problems Related to Coronary Heart Disease Some people who have CHD have no signs ...

  1. Trypanosoma cruzi (Chagas' disease agent reduces HIV-1 replication in human placenta

    Directory of Open Access Journals (Sweden)

    Cappa Stella

    2008-07-01

    Full Text Available Abstract Background Several factors determine the risk of HIV mother-to-child transmission (MTCT, such as coinfections in placentas from HIV-1 positive mothers with other pathogens. Chagas' disease is one of the most endemic zoonoses in Latin America, caused by the protozoan Trypanosoma cruzi. The purpose of the study was to determine whether T. cruzi modifies HIV infection of the placenta at the tissue or cellular level. Results Simple and double infections were carried out on a placental histoculture system (chorionic villi isolated from term placentas from HIV and Chagas negative mothers and on the choriocarcinoma BeWo cell line. Trypomastigotes of T. cruzi (VD lethal strain, either purified from mouse blood or from Vero cell cultures, 24 h-supernatants of blood and cellular trypomastigotes, and the VSV-G pseudotyped HIV-1 reporter virus were used for the coinfections. Viral transduction was evaluated by quantification of luciferase activity. Coinfection with whole trypomastigotes, either from mouse blood or from cell cultures, decreased viral pseudotype luciferase activity in placental histocultures. Similar results were obtained from BeWo cells. Supernatants of stimulated histocultures were used for the simultaneous determination of 29 cytokines and chemokines with the Luminex technology. In histocultures infected with trypomastigotes, as well as in coinfected tissues, IL-6, IL-8, IP-10 and MCP-1 production was significantly lower than in controls or HIV-1 transducted tissue. A similar decrease was observed in histocultures treated with 24 h-supernatants of blood trypomastigotes, but not in coinfected tissues. Conclusion Our results demonstrated that the presence of an intracellular pathogen, such as T. cruzi, is able to impair HIV-1 transduction in an in vitro system of human placental histoculture. Direct effects of the parasite on cellular structures as well as on cellular/viral proteins essential for HIV-1 replication might influence

  2. Epidemiology of Chagas disease in non endemic countries: the role of international migration

    Directory of Open Access Journals (Sweden)

    Gabriel A Schmunis

    2007-10-01

    Chagas disease.

  3. 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

  4. Contribuciones de la genética y la proteómica al estudio de la enfermedad de Chagas Genomic and proteomic contributions for Chagas disease control

    Directory of Open Access Journals (Sweden)

    Teresa López-Ordóñez

    2009-01-01

    Full Text Available La enfermedad de Chagas representa uno de los problemas más importantes de salud pública en el continente americano. El conocimiento sobre el genoma y el proteoma de los agentes de esta infección es esencial para desarrollar herramientas precisas y eficaces a corto y largo plazo y prevenir la transmisión. En el presente documento se destacan los aportes que han permitido mejorar el diseño, la implementación y la eficacia de las actividades de vigilancia y control de la enfermedad. Se revisan la contribución de la información genómica o proteómica sobre la distribución geográfica de los vectores, y la diversidad y la dinámica poblacional, además de la identificación de poblaciones y especies blanco para control. Por otra parte, se analiza la forma en que el conocimiento del genoma del parásito ha contribuido al diagnóstico de la infección, el estudio de las poblaciones de Trypanosoma cruzi, el tratamiento farmacológico y la interacción del parásito con sus hospederos. Una revisión de estas contribuciones incluye los temas de investigación básica y aplicada más destacados para el futuro inmediato.Chagas disease represents one of the more significant public health problems in the Americas. Information regarding the genome and proteome of vectors and parasite, as well as their interactions, will be essential to develop specific and effective diagnostic and preventive tools. Advances that have contributed to the design, implementation, and efficacy of disease surveillance and control activities are reviewed. Genomic and proteomic information has contributed to a better understanding of vector distributions and dispersion, diversity, population dynamics, and control targets (populations and species. In addition, genomic and proteomic studies have impacted parasite diagnostics, Trypanosoma cruzi population dynamics, pharmacological treatment and knowledge of parasite-host interactions. Discussion of these contributions includes

  5. Changes in Proteome Profile of Peripheral Blood Mononuclear Cells in Chronic Chagas Disease.

    Science.gov (United States)

    Garg, Nisha Jain; Soman, Kizhake V; Zago, Maria P; Koo, Sue-Jie; Spratt, Heidi; Stafford, Susan; Blell, Zinzi N; Gupta, Shivali; Nuñez Burgos, Julio; Barrientos, Natalia; Brasier, Allan R; Wiktorowicz, John E

    2016-02-01

    Trypanosoma cruzi (Tc) infection causes chagasic cardiomyopathy; however, why 30-40% of the patients develop clinical disease is not known. To discover the pathomechanisms in disease progression, we obtained the proteome signature of peripheral blood mononuclear cells (PBMCs) of normal healthy controls (N/H, n = 30) and subjects that were seropositive for Tc-specific antibodies, but were clinically asymptomatic (C/A, n = 25) or clinically symptomatic (C/S, n = 28) with cardiac involvement and left ventricular dysfunction. Protein samples were labeled with BODIPY FL-maleimide (dynamic range: > 4 orders of magnitude, detection limit: 5 f-mol) and resolved by two-dimensional gel electrophoresis (2D-GE). After normalizing the gel images, protein spots that exhibited differential abundance in any of the two groups were analyzed by mass spectrometry, and searched against UniProt human database for protein identification. We found 213 and 199 protein spots (fold change: |≥ 1.5|, psurvival and free radical scavenging capacity in C/S (but not C/A) subjects. The MYC/SP1 transcription factors that regulate hypoxia and oxidative/inflammatory stress were predicted to be key targets in the context of control of Chagas disease severity. Further, MARS-modeling identified a panel of proteins that had >93% prediction success in classifying infected individuals with no disease and those with cardiac involvement and LV dysfunction. In conclusion, we have identified molecular pathways and a panel of proteins that could aid in detecting seropositive individuals at risk of developing cardiomyopathy. PMID:26919708

  6. Heart Valve Disease among Patients with Hyperprolactinaemia

    DEFF Research Database (Denmark)

    Steffensen, Charlotte; Maegbaek, Merete Lund; Laurberg, Peter;

    2012-01-01

    Increased risk of heart valve disease during treatment with certain dopamine agonists, such as cabergoline, has been observed in patients with Parkinson's disease. The same compound is used to treat hyperprolactinemia, but it is unknown whether this also associates with heart valve disease....

  7. Invasion speeds of Triatoma dimidiata, vector of Chagas disease: An application of orthogonal polynomials method.

    Science.gov (United States)

    Mesk, Mohammed; Mahdjoub, Tewfik; Gourbière, Sébastien; Rabinovich, Jorge E; Menu, Frédéric

    2016-04-21

    Demographic processes and spatial dispersal of Triatoma dimidiata, a triatomine species vector of Chagas disease, are modeled by integrodifference equations to estimate invasion capacity of this species under different ecological conditions. The application of the theory of orthogonal polynomials and the steepest descent method applied to these equations, allow a good approximation of the abundance of the adult female population and the invasion speed. We show that: (1) under the same mean conditions of demography and dispersal, periodic spatial dispersal results in an invasion speed 2.5 times larger than the invasion speed when spatial dispersal is continuous; (2) when the invasion speed of periodic spatial dispersal is correlated to adverse demographic conditions, it is 34.7% higher as compared to a periodic dispersal that is correlated to good demographic conditions. From our results we conclude, in terms of triatomine population control, that the invasive success of T. dimidiata may be most sensitive to the probability of transition from juvenile to adult stage. We discuss our main theoretical predictions in the light of observed data in different triatomines species found in the literature. PMID:26807809

  8. An innovative ecohealth intervention for Chagas disease vector control in Yucatan, Mexico

    Science.gov (United States)

    Waleckx, Etienne; Camara-Mejia, Javier; Ramirez-Sierra, Maria Jesus; Cruz-Chan, Vladimir; Rosado-Vallado, Miguel; Vazquez-Narvaez, Santos; Najera-Vazquez, Rosario; Gourbière, Sébastien; Dumonteil, Eric

    2015-01-01

    Background Non-domiciliated (intrusive) triatomine vectors remain a challenge for the sustainability of Chagas disease vector control as these triatomines are able to transiently (re-)infest houses. One of the best-characterized examples is Triatoma dimidiata from the Yucatan peninsula, Mexico, where adult insects seasonally infest houses between March and July. Methods We focused our study on three rural villages in the state of Yucatan, Mexico, in which we performed a situation analysis as a first step before the implementation of an ecohealth (ecosystem approach to health) vector control intervention. Results The identification of the key determinants affecting the transient invasion of human dwellings by T. dimidiata was performed by exploring associations between bug presence and qualitative and quantitative variables describing the ecological, biological and social context of the communities. We then used a participatory action research approach for implementation and evaluation of a control strategy based on window insect screens to reduce house infestation by T. dimidiata. Conclusions This ecohealth approach may represent a valuable alternative to vertically-organized insecticide spraying. Further evaluation may confirm that it is sustainable and provides effective control (in the sense of limiting infestation of human dwellings and vector/human contacts) of intrusive triatomines in the region. PMID:25604765

  9. Two approaches to discovering and developing new drugs for Chagas disease

    Directory of Open Access Journals (Sweden)

    JH McKerrow

    2009-07-01

    Full Text Available This review will focus on two general approaches carried out at the Sandler Center, University of California, San Francisco, to address the challenge of developing new drugs for the treatment of Chagas disease. The first approach is target-based drug discovery, and two specific targets, cytochrome P450 CYP51 and cruzain (aka cruzipain, are discussed. A "proof of concept" molecule, the vinyl sulfone inhibitor K777, is now a clinical candidate. The preclinical assessment compliance for filing as an Investigational New Drug with the United States Food and Drug Administration (FDA is presented, and an outline of potential clinical trials is given. The second approach to identifying new drug leads is parasite phenotypic screens in culture. The development of an assay allowing high throughput screening of Trypanosoma cruzi amastigotes in skeletal muscle cells is presented. This screen has the advantage of not requiring specific strains of parasites, so it could be used with field isolates, drug resistant strains or laboratory strains. It is optimized for robotic liquid handling and has been validated through a screen of a library of FDA-approved drugs identifying 65 hits.

  10. Intrusive versus domiciliated triatomines and the challenge of adapting vector control practices against Chagas disease

    Science.gov (United States)

    Waleckx, Etienne; Gourbière, Sébastien; Dumonteil, Eric

    2015-01-01

    Chagas disease prevention remains mostly based on triatomine vector control to reduce or eliminate house infestation with these bugs. The level of adaptation of triatomines to human housing is a key part of vector competence and needs to be precisely evaluated to allow for the design of effective vector control strategies. In this review, we examine how the domiciliation/intrusion level of different triatomine species/populations has been defined and measured and discuss how these concepts may be improved for a better understanding of their ecology and evolution, as well as for the design of more effective control strategies against a large variety of triatomine species. We suggest that a major limitation of current criteria for classifying triatomines into sylvatic, intrusive, domiciliary and domestic species is that these are essentially qualitative and do not rely on quantitative variables measuring population sustainability and fitness in their different habitats. However, such assessments may be derived from further analysis and modelling of field data. Such approaches can shed new light on the domiciliation process of triatomines and may represent a key tool for decision-making and the design of vector control interventions. PMID:25993504

  11. Delay in maturation of the submandibular gland in Chagas disease correlates with lower DNA synthesis

    Directory of Open Access Journals (Sweden)

    José B Alves

    2008-09-01

    Full Text Available It has been demonstrated that the acute phase of Trypanosoma cruzi infection promotes several changes in the oral glands. The present study examined whether T. cruzi modulates the expression of host cell apoptotic or mitotic pathway genes. Rats were infected with T. cruzi then sacrificed after 18, 32, 64 or 97 days, after which the submandibular glands were analyzed by immunohistochemistry. Immunohistochemical analyses using an anti-bromodeoxyuridine antibody showed that, during acute T. cruzi infection, DNA synthesizing cells in rat submandibular glands were lower than in non-infected animals (p < 0.05. However, after 64 days of infection (chronic phase, the number of immunolabeled cells are similar in both groups. However, immunohistochemical analysis of Fas and Bcl-2 expression did not find any difference between infected and non-infected animals in both the acute and chronic stages. These findings suggest that the delay in ductal maturation observed at the acute phase of Chagas disease is correlated with lower expression of DNA synthesis genes, but not apoptotic genes.

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Gender differences in adult congenital heart disease

    NARCIS (Netherlands)

    P. Engelfriet; B.J.M. Mulder

    2009-01-01

    Objective. To assess gender differences in morbidity, mortality and patient management among adults born with a heart defect. Methods and results. The database of the European Heart Survey on adult congenital heart disease was explored. This contains data on 4110 patients with one of eight congenita

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

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    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.

  16. Epidemiología de la enfermedad de Chagas en el estado de Veracruz Epidemiology of Chagas disease in the state of Veracruz

    Directory of Open Access Journals (Sweden)

    Elsa L Segura

    2005-06-01

    quantify exposure to risk factors and seropositivity. Odds ratios with 95% confidence intervals and Mantel-Haenszel chi-squared tests were obtained. Multivariate analysis was performed with unconditional logistic regression, variables included in the model were those that had a p-value up to 0.20 in the bivariate analysis. The etiologic fraction in the exposed was also obtained. RESULTS: The prevalence of Chagas disease was between 0 and 2.8%. Jurisdictions at a higher risk were Tuxpan, Panuco and Cordoba; Orizaba showed no risk. The main household risk factors were palma/zacate (palmtree, grass leaves roof and walls, dirt floor, the presence of the vector, and ventilation. CONCLUSIONS: Epidemiological surveillance should emphasize health education, housing improvement, and use of insecticides.

  17. Innovative community-based ecosystem management for dengue and Chagas disease prevention in low and middle income countries in Latin America and the Caribbean.

    Science.gov (United States)

    Finkelman, Jacobo

    2015-02-01

    In 2009, the WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the International Development Research Centre (IDRC) launched a call for innovative community-based ecosystem management research projects for dengue and Chagas disease prevention in low and middle income countries in Latin America and the Caribbean. Eight research institutions were selected. The outputs of these projects led to a better understanding of the interaction between ecological, biological, social and economic (eco-bio-social) determinants of dengue and Chagas disease in Latin America and the Caribbean. Both diseases are considered highly relevant in the regional health agendas.

  18. Interactions Between Trypanosoma cruzi the Chagas Disease Parasite and Naturally Infected Wild Mepraia Vectors of Chile.

    Science.gov (United States)

    Campos-Soto, Ricardo; Ortiz, Sylvia; Cordova, Ivan; Bruneau, Nicole; Botto-Mahan, Carezza; Solari, Aldo

    2016-03-01

    Chagas disease, which ranks among the world's most neglected diseases, is a chronic, systemic, parasitic infection caused by the protozoan Trypanosoma cruzi. Mepraia species are the wild vectors of this parasite in Chile. Host-parasite interactions can occur at several levels, such as co-speciation and ecological host fitting, among others. Thus, we are exploring the interactions between T. cruzi circulating in naturally infected Mepraia species in all areas endemic of Chile. We evaluated T. cruzi infection rates of 27 different haplotypes of the wild Mepraia species and identified their parasite genotypes using minicircle PCR amplification and hybridization tests with genotype-specific DNA probes. Infection rates were lower in northern Chile where Mepraia gajardoi circulates (10-35%); in central Chile, Mepraia spinolai is most abundant, and infection rates varied in space and time (0-55%). T. cruzi discrete typing units (DTUs) TcI, TcII, TcV, and Tc VI were detected. Mixed infections with two or more DTUs are frequently found in highly infected insects. T. cruzi DTUs have distinct, but not exclusive, ecological and epidemiological associations with their hosts. T. cruzi infection rates of M. spinolai were higher than in M. gajardoi, but the presence of mixed infection with more than one T. cruzi DTU was the same. The same T. cruzi DTUs (TcI, TcII, TcV, and TcVI) were found circulating in both vector species, even though TcI was not equally distributed. These results suggest that T. cruzi DTUs are not associated with any of the two genetically related vector species nor with the geographic area. The T. cruzi vectors interactions are discussed in terms of old and recent events. By exploring T. cruzi DTUs present in Mepraia haplotypes and species from northern to central Chile, we open the analysis on these invertebrate host-parasite interactions. PMID:26771702

  19. Public street lights increase house infestation by the Chagas disease vector Triatoma dimidiata.

    Science.gov (United States)

    Pacheco-Tucuch, Freddy Santiago; Ramirez-Sierra, Maria Jesus; Gourbière, Sébastien; Dumonteil, Eric

    2012-01-01

    Triatoma dimidiata is one of the primary vectors of Chagas disease. We previously documented the spatio-temporal infestation of houses by this species in the Yucatan peninsula, Mexico, and found that non-domiciliated triatomines were specifically attracted to houses. However, the factors mediating this attraction remained unclear. Artificial light has been known for a long time to attract many insect species, and therefore may contribute to the spread of different vector-borne diseases. Also, based on the collection of different species of triatomines with light traps, several authors have suggested that light might attract triatomines to houses, but the role of artificial light in house infestation has never been clearly demonstrated and quantified. Here we performed a spatial analysis of house infestation pattern by T. dimidiata in relation to the distribution of artificial light sources in three different villages from the Yucatan peninsula, Mexico. In all three villages, infested houses were significantly closer to public street light sources than non-infested houses (18.0 ± 0.6 vs 22.6 ± 0.4 m), and street lights rather than domestic lights were associated with house infestation. Accordingly, houses closer to a public street lights were 1.64 times more likely to be infested than houses further away (OR, CI95% 1.23-2.18). Behavioral experiments using a dual-choice chamber further confirmed that adult male and females were attracted to white light during their nocturnal activity. Attraction was also dependent on light color and decreased with increasing wavelength. While public lighting is usually associated with increased development, these data clearly show that it also directly contributes to house infestation by non-domiciliated T. dimidiata. PMID:22558384

  20. Heart disease in patients with osteogenesis imperfecta

    DEFF Research Database (Denmark)

    Ashournia, Hamoun; Johansen, Frank Ted; Folkestad, Lars;

    2015-01-01

    described, less is known about the effects of decreased collagen on other organs. In the heart, collagen type 1 is present in the heart valves, chordae tendineae, annuli fibrosi and the interventricular septum. It is thus likely that the heart is affected in OI. OBJECTIVES: The aim of this systematic...... commonly reported heart diseases amongst the patients with OI were valvulopathies and increased aortic diameter. Findings in the large case series and the cross-sectional studies were broadly similar to each other. CONCLUSION: The findings support the hypothesis that patients with OI have increased risk of...... heart disease compared to healthy controls. It is biologically plausible that patients with OI may have an increased risk of developing heart disease, and valve disease in particular....

  1. What Are the Signs and Symptoms of Heart Disease?

    Science.gov (United States)

    ... Twitter. What Are the Signs and Symptoms of Heart Disease? The signs and symptoms of coronary heart disease ( ... will have signs and symptoms of the disease. Heart Disease Signs and Symptoms The illustration shows the major ...

  2. What Is Heart Valve Disease?

    Science.gov (United States)

    ... heart work harder and affect its ability to pump blood. Overview How the Heart Valves Work At the ... into the atria. As the ventricles contract, they pump blood through the pulmonary and aortic valves. The pulmonary ...

  3. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... or higher or Taking medication for elevated blood glucose levels Source: Grundy SM, et al. Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung,and Blood Institute Scientific Statement. Circulation. 2005;112: ...

  4. Paratransgenic triatomines for the control of Chagas Disease transmission: Perspectives from the field

    International Nuclear Information System (INIS)

    Full text: Chagas disease remains a leading public health concern throughout much of Central and South America. Over 16 million people were infected with Trypanosoma cruzi, the causative agent of Chagas Disease, and further 100 million were at risk, prior to the initiation of the regional vector control initiatives. With neither a cure nor vaccine available, control relies heavily on strategies that eliminate the domestic triatomine vectors of T. cruzi. Insecticide-based strategies have had initial success but are limited by problems of cost, sustainability, and the inability to control non-domiciliated bug populations. Extra-domiciliary bug populations present the risk of re-invading human dwellings in the absence of continued use of chemicals. For the past 10 years, our group has developed a novel strategy to render bugs incapable of T. cruzi transmission. This approach, termed paratransgenesis, involves genetic manipulation of symbiotic bacteria resident in the gut lumen of the bug, to export molecules that are toxic to T. cruzi. Triatomines disperse the symbiotic bacteria to their progeny via fecal contamination. Nymphs that probe feces of adult bugs rapidly establish gut infections with the symbiont. We have exploited the biology of bacterial transfer amongst triatomines to create a synthetic paste termed CRUZIGARD for field delivery of engineered bacteria. Viewed as an integrated control strategy, this method would complement and ensure the sustainability of the ongoing insecticide-based initiatives. The strategy is designed to completely block transmission by targeting bug populations that prove resilient to conventional methods. The novel concept of the auto-propagation of a transmission-blocking agent is based on the natural and efficient dispersal of genetically altered bacteria through lateral spread of fecal material in bug colonies, making it cost-effective and sustainable. Significant barriers still exist to field use of this technology. The efficacy

  5. African-Americans and Heart Disease, Stroke

    Science.gov (United States)

    ... Pressure High Blood Pressure Tools & Resources Stroke More African-Americans and Heart Disease, Stroke Updated:Apr 18, ... of getting those diseases are even higher for African-Americans. The good news is, African-Americans can ...

  6. Psychosocial factors in coronary heart disease

    Science.gov (United States)

    French, J. R. P., Jr.; Chaplan, R. D.

    1969-01-01

    The relationship between job satisfaction and coronary heart disease is explored for blue and white collar groups, different personalities and physiological risk factors. Differences found among administrators, engineers and scientists with regard to variables associated with heart disease are in terms of physiology, personality, reported job stress, and smoking.

  7. Smoking, Stress, and Coronary Heart Disease.

    Science.gov (United States)

    Epstein, Leonard H.; Perkins, Kenneth A.

    1988-01-01

    Focuses on the interrelation between stressors and smoking, and on its potential impact on coronary heart disease risk beyond that due to stressors or to smoking alone. Reviews evidence supporting the stress-smoking interrelationship, its relevance to the risk of heart disease, and mechanisms explaining why smokers smoke more during stress and why…

  8. Surveillance, health promotion and control of Chagas disease in the Amazon Region--Medical attention in the Brazilian Amazon Region: a proposal.

    Science.gov (United States)

    Coura, José Rodrigues; Junqueira, Angela C V

    2015-11-01

    We refer to Oswaldo Cruz's reports dating from 1913 about the necessities of a healthcare system for the Brazilian Amazon Region and about the journey of Carlos Chagas to 27 locations in this region and the measures that would need to be adopted. We discuss the risks of endemicity of Chagas disease in the Amazon Region. We recommend that epidemiological surveillance of Chagas disease in the Brazilian Amazon Region and Pan-Amazon region should be implemented through continuous monitoring of the human population that lives in the area, their housing, the environment and the presence of triatomines. The monitoring should be performed with periodic seroepidemiological surveys, semi-annual visits to homes by health agents and the training of malaria microscopists and healthcare technicians to identify Trypanosoma cruzi from patients' samples and T. cruzi infection rates among the triatomines caught. We recommend health promotion and control of Chagas disease through public health policies, especially through sanitary education regarding the risk factors for Chagas disease. Finally, we propose a healthcare system through base hospitals, intermediate-level units in the areas of the Brazilian Amazon Region and air transportation, considering the distances to be covered for medical care.

  9. Surveillance, health promotion and control of Chagas disease in the Amazon Region - Medical attention in the Brazilian Amazon Region: a proposal

    Science.gov (United States)

    Coura, José Rodrigues; Junqueira, Angela CV

    2015-01-01

    We refer to Oswaldo Cruz's reports dating from 1913 about the necessities of a healthcare system for the Brazilian Amazon Region and about the journey of Carlos Chagas to 27 locations in this region and the measures that would need to be adopted. We discuss the risks of endemicity of Chagas disease in the Amazon Region. We recommend that epidemiological surveillance of Chagas disease in the Brazilian Amazon Region and Pan-Amazon region should be implemented through continuous monitoring of the human population that lives in the area, their housing, the environment and the presence of triatomines. The monitoring should be performed with periodic seroepidemiological surveys, semi-annual visits to homes by health agents and the training of malaria microscopists and healthcare technicians to identify Trypanosoma cruzi from patients' samples and T. cruzi infection rates among the triatomines caught. We recommend health promotion and control of Chagas disease through public health policies, especially through sanitary education regarding the risk factors for Chagas disease. Finally, we propose a healthcare system through base hospitals, intermediate-level units in the areas of the Brazilian Amazon Region and air transportation, considering the distances to be covered for medical care. PMID:26560976

  10. Resilience in Patients with Ischemic Heart Disease

    OpenAIRE

    Conceição Maria Martins de Lemos; David William Moraes; Lucia Campos Pellanda

    2016-01-01

    Background: Resilience is a psychosocial factor associated with clinical outcomes in chronic diseases. The relationship between this protective factor and certain diseases, such heart diseases, is still under-explored. Objective: The present study sought to investigate the frequency of resilience in individuals with ischemic heart disease. Method: This was a cross-sectional study with 133 patients of both genders, aged between 35 and 65 years, treated at Rio Grande do Sul Cardiology Institu...

  11. Social Representations and Practices Towards Triatomines and Chagas Disease in Calakmul, México.

    Science.gov (United States)

    Valdez-Tah, Alba; Huicochea-Gómez, Laura; Ortega-Canto, Judith; Nazar-Beutelspacher, Austreberta; Ramsey, Janine M

    2015-01-01

    Vector-borne transmission of Trypanosoma cruzi (VBTTc) is dependent on the concomitant interaction between biological and environmental hazard over the entire landscape, and human vulnerability. Representations and practices of health-disease-care-seeking and territorial appropriation and use were analyzed for VBTTc in a qualitative ethnographic study in the Zoh-Laguna landscape, Campeche, Mexico. In-depth interviews and participatory observation explored representations and practices regarding ethno-ecological knowledge related to vector-transmission, health-disease-care-seeking, and land use processes. The population has a broad knowledge of biting insects, which they believe are all most abundant in the rainy season; the community´s proximity to natural areas is perceived as a barrier to control their abundance. Triatomines are mostly recognized by men, who have detailed knowledge regarding their occurrence and association with mammals in non-domestic fragments, where they report being bitten. Women emphasize the dermal consequences of triatomine bites, but have little knowledge about the disease. Triatomine bites and the chinchoma are "normalized" events which are treated using home remedies, if at all. The neglected condition of Chagas disease in Mexican public health policies, livelihoods which are dependent on primary production, and gender-related knowledge (or lack thereof) are structural circumstances which influence the environment and inhabitants´ living conditions; in turn, these trigger triatomine-human contact. The most important landscape practices producing vulnerability are the activities and mobility within and between landscape fragments causing greater exposure of inhabitants primarily in the dry season. A landscape approach to understanding vulnerability components of VBTTc from health-disease-care-seeking perspectives and based on territorial appropriation and use, is essential where there is continuous movement of vectors between and

  12. Social Representations and Practices Towards Triatomines and Chagas Disease in Calakmul, Mexico.

    Directory of Open Access Journals (Sweden)

    Alba Valdez-Tah

    Full Text Available Vector-borne transmission of Trypanosoma cruzi (VBTTc is dependent on the concomitant interaction between biological and environmental hazard over the entire landscape, and human vulnerability. Representations and practices of health-disease-care-seeking and territorial appropriation and use were analyzed for VBTTc in a qualitative ethnographic study in the Zoh-Laguna landscape, Campeche, Mexico. In-depth interviews and participatory observation explored representations and practices regarding ethno-ecological knowledge related to vector-transmission, health-disease-care-seeking, and land use processes. The population has a broad knowledge of biting insects, which they believe are all most abundant in the rainy season; the community´s proximity to natural areas is perceived as a barrier to control their abundance. Triatomines are mostly recognized by men, who have detailed knowledge regarding their occurrence and association with mammals in non-domestic fragments, where they report being bitten. Women emphasize the dermal consequences of triatomine bites, but have little knowledge about the disease. Triatomine bites and the chinchoma are "normalized" events which are treated using home remedies, if at all. The neglected condition of Chagas disease in Mexican public health policies, livelihoods which are dependent on primary production, and gender-related knowledge (or lack thereof are structural circumstances which influence the environment and inhabitants´ living conditions; in turn, these trigger triatomine-human contact. The most important landscape practices producing vulnerability are the activities and mobility within and between landscape fragments causing greater exposure of inhabitants primarily in the dry season. A landscape approach to understanding vulnerability components of VBTTc from health-disease-care-seeking perspectives and based on territorial appropriation and use, is essential where there is continuous movement of vectors

  13. Marital stability and congenital heart disease.

    Science.gov (United States)

    Silbert, A R; Newburger, J W; Fyler, D C

    1982-06-01

    The incidence of divorce or legal separation was studied in 438 families of children born with heart disease who entered the New England Regional Infant Cardiac Program between 1968 and 1973. The parents were interviewed when the children were 5 1/2 years old. The rate of divorce in 438 families of children with critical congenital heart disease was not significantly different from the rate in two comparison groups: (1) 25 families of children whose cardiac defect was spontaneously cured, and (2) 26 families of children catheterized in infancy for suspected cardiac defect but who were found to be free of heart disease. Rates of divorce or legal separation for the three groups were: critical congenital heart disease, 12.1%, spontaneously cured, 4.2% free of heart disease, 11.5% these rates were not significantly different. The average national divorce rate was 20.3% for the same period.

  14. Chemokine receptor expression on the surface of peripheral blood mononuclear cells in Chagas disease.

    Science.gov (United States)

    Talvani, Andre; Rocha, Manoel O C; Ribeiro, Antonio L; Correa-Oliveira, Rodrigo; Teixeira, Mauro M

    2004-01-15

    We evaluated the expression of chemokine receptors (CCR1, CCR2, CCR5, and CXCR4) on the surface of peripheral blood mononuclear cells obtained from patients with chronic chagasic cardiomyopathy (CCC) and noninfected individuals. Only CCR5 and CXCR4 expression was different on the surface of the subsets (CD4, CD8, and CD14) evaluated. Patients with mild CCC had elevated leukocyte expression of CCR5, compared with noninfected individuals or those with severe disease. CXCR4 expression was lower on leukocytes from patients with severe CCC. The differential expression of both receptors on leukocytes of patients with CCC was consistent and clearly correlated with the degree of heart function such that the lower the heart function, the lower the expression of either CCR5 or CXCR4. These results highlight the possible participation of the chemokine system in early forms of chagasic cardiomyopathy and the relevance of heart failure-induced remodeling in modifying immune parameters in infected individuals.

  15. Antennal phenotype of Mexican haplogroups of the Triatoma dimidiata complex, vectors of Chagas disease.

    Science.gov (United States)

    May-Concha, Irving; Guerenstein, Pablo G; Ramsey, Janine M; Rojas, Julio C; Catalá, Silvia

    2016-06-01

    Triatoma dimidiata (Latreille) is a species complex that spans North, Central, and South America and which is a key vector of all known discrete typing units (DTU) of Trypanosoma cruzi, the etiologic agent of Chagas disease. Morphological and genetic studies indicate that T. dimidiata is a species complex with three principal haplogroups (hg) in Mexico. Different markers and traits are still inconclusive regarding if other morphological differentiation may indicate probable behavioral and vectorial divergences within this complex. In this paper we compared the antennae of three Mexican haplogroups (previously verified by molecular markers ND4 and ITS-2) and discussed possible relationships with their capacity to disperse and colonized new habitats. The abundance of each type of sensillum (bristles, basiconics, thick- and thin-walled trichoids) on the antennae of the three haplogroups, were measured under light microscopy and compared using Kruskal-Wallis non-parametric and multivariate non-parametric analyses. Discriminant analyses indicate significant differences among the antennal phenotype of haplogroups either for adults and some nymphal stages, indicating consistency of the character to analyze intraspecific variability within the complex. The present study shows that the adult antennal pedicel of the T. dimidiata complex have abundant chemosensory sensilla, according with good capacity for dispersal and invasion of different habitats also related to their high capacity to adapt to conserved as well as modified habitats. However, the numerical differences among the haplogroups are suggesting variations in that capacity. The results here presented support the evidence of T. dimidiata as a species complex but show females and males in a different way. Given the close link between the bug's sensory system and its habitat and host-seeking behavior, AP characterization could be useful to complement genetic, neurological and ethological studies of the closely

  16. Triatomines in dwellings and outbuildings in an endemic area of Chagas disease in northeastern Brazil

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    Antonio Fernando Rodrigues Lima

    2012-12-01

    Full Text Available INTRODUCTION: The present study identified the triatomines collected in intra and peri-domestic environments, observed the occurrence of Trypanosoma cruzi infection in triatomines and correlated this information with housing conditions and the fauna associated with the rural areas of the City of Itabaianinha, located in the State of Sergipe, Brazil. METHODS: Quarterly visits were conducted between March 2009 and March 2010, and the homes to be visited for the active search of insects were determined by random selection. In each housing unit, the insects were collected by a manual search with a metal clip and flashlight to inspect openings and cavities, with a collection time of one hour/home/individual. The Pirisa® dislodge chemical was used to force the insects to leave their ecotopes. Analysis of the intestinal contents of triatomines was performed in the laboratory to establish the presence of Trypanosomatidae. RESULTS: Of the 103 dwellings surveyed, 17.5% were infested with Panstrongylus megistus. The village of Mutuca exhibited the highest infestation rate (38.1%. All the villages with relevant infestation rates were situated in the northern area of the city. The highest percentage of vector infection was found in the village of Água Boa (56.5%. The rural dwellings were found to be primarily brick or wooden house with or without roughcast or plastered walls, and the outbuilding most frequently associated with triatomines was the chicken run. CONCLUSIONS: These results emphasise the need for broader vector control and surveillance and for educational campaigns in the context of the Chagas Disease Control Program.

  17. Genetically modifying the insect gut microbiota to control Chagas disease vectors through systemic RNAi.

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    Mabel L Taracena

    2015-02-01

    Full Text Available Technologies based on RNA interference may be used for insect control. Sustainable strategies are needed to control vectors of Chagas disease such as Rhodnius prolixus. The insect microbiota can be modified to deliver molecules to the gut. Here, Escherichia coli HT115(DE3 expressing dsRNA for the Rhodnius heme-binding protein (RHBP and for catalase (CAT were fed to nymphs and adult triatomine stages. RHBP is an egg protein and CAT is an antioxidant enzyme expressed in all tissues by all developmental stages. The RNA interference effect was systemic and temporal. Concentrations of E. coli HT115(DE3 above 3.35 × 10(7 CFU/mL produced a significant RHBP and CAT gene knockdown in nymphs and adults. RHBP expression in the fat body was reduced by 99% three days after feeding, returning to normal levels 10 days after feeding. CAT expression was reduced by 99% and 96% in the ovary and the posterior midgut, respectively, five days after ingestion. Mortality rates increased by 24-30% in first instars fed RHBP and CAT bacteria. Molting rates were reduced by 100% in first instars and 80% in third instars fed bacteria producing RHBP or CAT dsRNA. Oviposition was reduced by 43% (RHBP and 84% (CAT. Embryogenesis was arrested in 16% (RHBP and 20% (CAT of laid eggs. Feeding females 105 CFU/mL of the natural symbiont, Rhodococcus rhodnii, transformed to express RHBP-specific hairpin RNA reduced RHBP expression by 89% and reduced oviposition. Modifying the insect microbiota to induce systemic RNAi in R. prolixus may result in a paratransgenic strategy for sustainable vector control.

  18. High similarity of Trypanosoma cruzi kDNA genetic profiles detected by LSSP-PCR within family groups in an endemic area of Chagas disease in Brazil

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    Sandra Maria Alkmim-Oliveira

    2014-10-01

    Full Text Available Introduction Determining the genetic similarities among Trypanosoma cruzi populations isolated from different hosts and vectors is very important to clarify the epidemiology of Chagas disease. Methods An epidemiological study was conducted in a Brazilian endemic area for Chagas disease, including 76 chronic chagasic individuals (96.1% with an indeterminate form; 46.1% with positive hemoculture. Results T. cruzi I (TcI was isolated from one child and TcII was found in the remaining (97.1% subjects. Low-stringency single-specific-primer-polymerase chain reaction (LSSP-PCR showed high heterogeneity among TcII populations (46% of shared bands; however, high similarities (80-100% among pairs of mothers/children, siblings, or cousins were detected. Conclusions LSSP-PCR showed potential for identifying similar parasite populations among individuals with close kinship in epidemiological studies of Chagas disease.

  19. Trypanosoma cruzi III from armadillos (Dasypus novemcinctus novemcinctus) from Northeastern Venezuela and its biological behavior in murine model. Risk of emergency of Chagas' disease.

    Science.gov (United States)

    Morocoima, Antonio; Carrasco, Hernán J; Boadas, Johanna; Chique, José David; Herrera, Leidi; Urdaneta-Morales, Servio

    2012-11-01

    Trypanosoma cruzi, etiological agent of Chagas' disease, was isolated from armadillos (Dasypus novemcinctus novemcinctus) captured in rural communities Northeastern Venezuela from Nueva Esparta State (no endemic for Chagas' disease), Monagas and Anzoátegui States (endemics). The isolates, genetically typed by PCR-RFLP as belonging to the TcIII DTU, have demonstrated in murine model heterogenic parasitemia, mortality and histotropism with marked parasitism in cardiac, skeletal, and smooth myocytes that showed correlation with lymphobasophilic inflammatory infiltrates. Our finding of T. cruzi infected armadillos in Isla Margarita (Nueva Esparta State), together with reports of triatomine vectors in this region, the accentuated synanthropy of armadillos, intense economic activity, migration due to tourism and the lack of environmental education programs all of them represent risks that could cause the emergence of Chagas' disease in this area. This is the first report of the TcIII DTU in Northeastern Venezuela, thus widening the geographic distribution of this DTU. PMID:22902748

  20. Ecological connectivity of Trypanosoma cruzi reservoirs and Triatoma pallidipennis hosts in an anthropogenic landscape with endemic Chagas disease.

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    Janine M Ramsey

    Full Text Available Traditional methods for Chagas disease prevention are targeted at domestic vector reduction, as well as control of transfusion and maternal-fetal transmission. Population connectivity of Trypanosoma cruzi-infected vectors and hosts, among sylvatic, ecotone and domestic habitats could jeopardize targeted efforts to reduce human exposure. This connectivity was evaluated in a Mexican community with reports of high vector infestation, human infection, and Chagas disease, surrounded by agricultural and natural areas. We surveyed bats, rodents, and triatomines in dry and rainy seasons in three adjacent habitats (domestic, ecotone, sylvatic, and measured T. cruzi prevalence, and host feeding sources of triatomines. Of 12 bat and 7 rodent species, no bat tested positive for T. cruzi, but all rodent species tested positive in at least one season or habitat. Highest T. cruzi infection prevalence was found in the rodents, Baiomys musculus and Neotoma mexicana. In general, parasite prevalence was not related to habitat or season, although the sylvatic habitat had higher infection prevalence than by chance, during the dry season. Wild and domestic mammals were identified as bloodmeals of T. pallidipennis, with 9% of individuals having mixed human (4.8% single human and other mammal species in bloodmeals, especially in the dry season; these vectors tested >50% positive for T. cruzi. Overall, ecological connectivity is broad across this matrix, based on high rodent community similarity, vector and T. cruzi presence. Cost-effective T. cruzi, vector control strategies and Chagas disease transmission prevention will need to consider continuous potential for parasite movement over the entire landscape. This study provides clear evidence that these strategies will need to include reservoir/host species in at least ecotones, in addition to domestic habitats.

  1. Genome-wide screening and identification of new Trypanosoma cruzi antigens with potential application for chronic Chagas disease diagnosis.

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    João Luís Reis-Cunha

    Full Text Available The protozoan Trypanosoma cruzi is the etiologic agent of Chagas disease, an infection that afflicts approximately 8 million people in Latin America. Diagnosis of chronic Chagas disease is currently based on serological tests because this condition is usually characterized by high anti-T. cruzi IgG titers and low parasitemia. The antigens used in these assays may have low specificity due to cross reactivity with antigens from related parasite infections, such as leishmaniasis, and low sensitivity caused by the high polymorphism among T. cruzi strains. Therefore, the identification of new T. cruzi-specific antigens that are conserved among the various parasite discrete typing units (DTUs is still required. In the present study, we have explored the hybrid nature of the T. cruzi CL Brener strain using a broad genome screening approach to select new T. cruzi antigens that are conserved among the different parasite DTUs and that are absent in other trypanosomatid species. Peptide arrays containing the conserved antigens with the highest epitope prediction scores were synthesized, and the reactivity of the peptides were tested by immunoblot using sera from C57BL/6 mice chronically infected with T. cruzi strains from the TcI, TcII or TcVI DTU. The two T. cruzi proteins that contained the most promising peptides were expressed as recombinant proteins and tested in ELISA experiments with sera from chagasic patients with distinct clinical manifestations: those infected with T. cruzi from different DTUs and those with cutaneous or visceral leishmaniasis. These proteins, named rTc_11623.20 and rTc_N_10421.310, exhibited 94.83 and 89.66% sensitivity, 98.2 and 94.6% specificity, respectively, and a pool of these 2 proteins exhibited 96.55% sensitivity and 98.18% specificity. This work led to the identification of two new antigens with great potential application in the diagnosis of chronic Chagas disease.

  2. Eritema nodoso como forma de reativação da doença de Chagas em transplantado cardíaco Erythema nodoso in reactivation of Chagas' disease after cardiac transplantation

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    Solange Corrêa Garcia Pires d'Ávila

    2005-02-01

    Full Text Available O presente caso ilustra uma forma de eritema nodoso, cujo agente foi o Trypanosoma cruzi em paciente chagásica submetida a transplante cardíaco. O diagnóstico foi firmado através do exame histopatológico de biópsia da lesão cutânea e estudo imunohistoquímico. O tratamento com nifurtimox promoveu regressão total das lesões.We report a patient with Chagas' disease that presented Trypanosoma cruzi reactivation after cardiac transplantation and immunodepression, characterized by skin lesions of erythema nodosum. This is an unusual presentation of Chagas' disease.

  3. Who Is at Risk for Coronary Heart Disease?

    Science.gov (United States)

    ... on Twitter. Who Is at Risk for Coronary Heart Disease? In the United States, coronary heart disease (CHD) ... type of fat. Other Risks Related to Coronary Heart Disease Other conditions and factors also may contribute to ...

  4. Behavior patterns and coronary heart disease

    Science.gov (United States)

    Townsend, J. C.; Cronin, J. P.

    1975-01-01

    The relationships between two behavioral patterns, cardiac risk factors, and coronary heart disease are investigated. Risk factors used in the analysis were family history of coronary disease, smoking, cholesterol, obesity, systotic blood pressure, diastolic blood pressure, blood sugar, uric acid, erythrocyte sedimentation rate, and white blood unit. It was found that conventional, non-behavioral pattern risk factors alone were not significantly related to coronary heart disease.

  5. An entomoepidemiological investigation of Chagas disease in the state of Ceará, Northeast Region of Brazil.

    Science.gov (United States)

    Coutinho, Carolina Fausto de Souza; Souza-Santos, Reinaldo; Teixeira, Natalia Faria Daflon; Georg, Ingebourg; Gomes, Taís Ferreira; Boia, Marcio Neves; dos Reis, Neilane Bertoni; Maia, Alexander de Oliveira; Lima, Marli Maria

    2014-04-01

    The seroprevalence of Chagas disease in humans and the presence of triatomines were investigated in a rural locality in the State of Ceará, Brazil, an historically endemic region. Approximately 80% of the surveyed residents agreed to undergo serological tests. Intradomestic and peridomestic environments were searched for triatomines in both the dry and rainy seasons. The prevalence rate of Chagas disease was 1.2% and the majority of individuals confirmed with the disease over 50 years of age. A total of 761 specimens of triatomines were captured, most of which were from colonies composed of nymphs and adult bugs, and the majority of specimens were obtained in the dry season. Triatoma brasiliensis was the predominant species. Analysis using light microscopy revealed that 28.6% of the insects were Trypanosoma cruzi positive. Results suggest that peridomestic man-made structures, such as animal shelters, improper storage of timber and uninhabited dwellings contribute to the high rate of triatomine infestation in the area. PMID:24896053

  6. An entomoepidemiological investigation of Chagas disease in the state of Ceará, Northeast Region of Brazil

    Directory of Open Access Journals (Sweden)

    Carolina Fausto de Souza Coutinho

    2014-04-01

    Full Text Available The seroprevalence of Chagas disease in humans and the presence of triatomines were investigated in a rural locality in the State of Ceará, Brazil, an historically endemic region. Approximately 80% of the surveyed residents agreed to undergo serological tests. Intradomestic and peridomestic environments were searched for triatomines in both the dry and rainy seasons. The prevalence rate of Chagas disease was 1.2% and the majority of individuals confirmed with the disease over 50 years of age. A total of 761 specimens of triatomines were captured, most of which were from colonies composed of nymphs and adult bugs, and the majority of specimens were obtained in the dry season. Triatoma brasiliensis was the predominant species. Analysis using light microscopy revealed that 28.6% of the insects were Trypanosoma cruzi positive. Results suggest that peridomestic man-made structures, such as animal shelters, improper storage of timber and uninhabited dwellings contribute to the high rate of triatomine infestation in the area.

  7. Evaluation of spatially targeted strategies to control non-domiciliated Triatoma dimidiata vector of Chagas disease.

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    Corentin Barbu

    2011-05-01

    Full Text Available BACKGROUND: Chagas disease is a major neglected tropical disease with deep socio-economical effects throughout Central and South America. Vector control programs have consistently reduced domestic populations of triatomine vectors, but non-domiciliated vectors still have to be controlled efficiently. Designing control strategies targeting these vectors is challenging, as it requires a quantitative description of the spatio-temporal dynamics of village infestation, which can only be gained from combinations of extensive field studies and spatial population dynamic modelling. METHODOLOGY/PRINCIPAL FINDINGS: A spatially explicit population dynamic model was combined with a two-year field study of T. dimidiata infestation dynamics in the village of Teya, Mexico. The parameterized model fitted and predicted accurately both intra-annual variation and the spatial gradient in vector abundance. Five different control strategies were then applied in concentric rings to mimic spatial design targeting the periphery of the village, where vectors were most abundant. Indoor insecticide spraying and insect screens reduced vector abundance by up to 80% (when applied to the whole village, and half of this effect was obtained when control was applied only to the 33% of households closest to the village periphery. Peri-domicile cleaning was able to eliminate up to 60% of the vectors, but at the periphery of the village it has a low effect, as it is ineffective against sylvatic insects. The use of lethal traps and the management of house attractiveness provided similar levels of control. However this required either house attractiveness to be null, or ≥ 5 lethal traps, at least as attractive as houses, to be installed in each household. CONCLUSION/SIGNIFICANCE: Insecticide and insect screens used in houses at the periphery of the village can contribute to reduce house infestation in more central untreated zones. However, this beneficial effect remains insufficient

  8. The changing epidemiology of congenital heart disease

    NARCIS (Netherlands)

    T. van der Bom; A.C. Zomer; A.H. Zwinderman; F.J. Meijboom; B.J. Bouma; B.J.M. Mulder

    2011-01-01

    Congenital heart disease is the most common congenital disorder in newborns. Advances in cardiovascular medicine and surgery have enabled most patients to reach adulthood. Unfortunately, prolonged survival has been achieved at a cost, as many patients suffer late complications, of which heart failur

  9. Bats, Trypanosomes, and Triatomines in Ecuador: New Insights into the Diversity, Transmission, and Origins of Trypanosoma cruzi and Chagas Disease.

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    C Miguel Pinto

    Full Text Available The generalist parasite Trypanosoma cruzi has two phylogenetic lineages associated almost exclusively with bats-Trypanosoma cruzi Tcbat and the subspecies T. c. marinkellei. We present new information on the genetic variation, geographic distribution, host associations, and potential vectors of these lineages. We conducted field surveys of bats and triatomines in southern Ecuador, a country endemic for Chagas disease, and screened for trypanosomes by microscopy and PCR. We identified parasites at species and genotype levels through phylogenetic approaches based on 18S ribosomal RNA (18S rRNA and cytochrome b (cytb genes and conducted a comparison of nucleotide diversity of the cytb gene. We document for the first time T. cruzi Tcbat and T. c. marinkellei in Ecuador, expanding their distribution in South America to the western side of the Andes. In addition, we found the triatomines Cavernicola pilosa and Triatoma dispar sharing shelters with bats. The comparisons of nucleotide diversity revealed a higher diversity for T. c. marinkellei than any of the T. c. cruzi genotypes associated with Chagas disease. Findings from this study increased both the number of host species and known geographical ranges of both parasites and suggest potential vectors for these two trypanosomes associated with bats in rural areas of southern Ecuador. The higher nucleotide diversity of T. c. marinkellei supports a long evolutionary relationship between T. cruzi and bats, implying that bats are the original hosts of this important parasite.

  10. 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; Cudischevitch, Cecília de Oliveira; Carneiro, Alan Brito; Macedo, Gustavo Bartholomeu; Lannes, Denise; Silva-Neto, Mário Alberto Cardoso da

    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 seven distinguished contemporary Brazilian researchers working with Triatominaes. Students (22) in the seventh grade of a public elementary school received the comic book. The study was then followed up by the use of Concept Maps elaborated by the students. Six Concept Maps elaborated by the students before the introduction of the comic book received an average score of 7. Scores rose to an average of 45 after the introduction of the comic book. This result suggests that a more attractive content can greatly improve the knowledge and conceptual understanding among students not previously exposed to insect biochemistry. In conclusion, this study illustrates an alternative to current strategies of teaching about the transmission of neglected diseases. It also promotes the diffusion of the scientific knowledge produced by Brazilian researchers that may stimulate students to choose a scientific career.

  11. Global Climate Change Effects on Venezuela's Vulnerability to Chagas Disease is Linked to the Geographic Distribution of Five Triatomine Species.

    Science.gov (United States)

    Ceccarelli, Soledad; Rabinovich, Jorge E

    2015-11-01

    We analyzed the possible effects of global climate change on the potential geographic distribution in Venezuela of five species of triatomines (Eratyrus mucronatus (Stal, 1859), Panstrongylus geniculatus (Latreille, 1811), Rhodnius prolixus (Stål, 1859), Rhodnius robustus (Larrousse, 1927), and Triatoma maculata (Erichson, 1848)), vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. To obtain the future potential geographic distributions, expressed as climatic niche suitability, we modeled the presences of these species using two IPCC (Intergovernmental Panel on Climate Change) future emission scenarios of global climate change (A1B and B1), the Global Climate model CSIRO Mark 3.0, and three periods of future projections (years 2020, 2060, and 2080). After estimating with the MaxEnt software the future climatic niche suitability for each species, scenario, and period of future projections, we estimated a series of indexes of Venezuela's vulnerability at the county, state, and country level, measured as the number of people exposed due to the changes in the geographical distribution of the five triatomine species analyzed. Despite that this is not a measure of the risk of Chagas disease transmission, we conclude that possible future effects of global climate change on the Venezuelan population vulnerability show a slightly decreasing trend, even taking into account future population growth; we can expect fewer locations in Venezuela where an average Venezuelan citizen would be exposed to triatomines in the next 50-70 yr. PMID:26336258

  12. VFV as a New Effective CYP51 Structure-Derived Drug Candidate for Chagas Disease and Visceral Leishmaniasis.

    Science.gov (United States)

    Lepesheva, Galina I; Hargrove, Tatiana Y; Rachakonda, Girish; Wawrzak, Zdzislaw; Pomel, Sébastien; Cojean, Sandrine; Nde, Pius N; Nes, W David; Locuson, Charles W; Calcutt, M Wade; Waterman, Michael R; Daniels, J Scott; Loiseau, Philippe M; Villalta, Fernando

    2015-11-01

    Sterol 14α-demethylases (CYP51) are the enzymes essential for sterol biosynthesis. They serve as clinical targets for antifungal azoles and are considered as targets for treatment of human Trypanosomatidae infections. Recently, we have shown that VNI, a potent and selective inhibitor of trypanosomal CYP51 that we identified and structurally characterized in complex with the enzyme, can cure the acute and chronic forms of Chagas disease. The purpose of this work was to apply the CYP51 structure/function for further development of the VNI scaffold. As anticipated, VFV (R)-N-(1-(3,4'-difluorobiphenyl-4-yl)-2-(1H-imidazol-1-yl)ethyl)-4-(5-phenyl-1,3,4-oxadiazol-2-yl)benzamide, the derivative designed to fill the deepest portion of the CYP51 substrate-binding cavity, reveals a broader antiprotozoan spectrum of action. It has stronger antiparasitic activity in cellular experiments, cures the experimental Chagas disease with 100% efficacy, and suppresses visceral leishmaniasis by 89% (vs 60% for VNI). Oral bioavailability, low off-target activity, favorable pharmacokinetics and tissue distribution characterize VFV as a promising new drug candidate. PMID:25883390

  13. Mitochondrial dysfunction in Trypanosoma cruzi: the role of Serratia marcescens prodigiosin in the alternative treatment of Chagas disease

    Directory of Open Access Journals (Sweden)

    Triana Omar

    2011-05-01

    Full Text Available Abstract Background Chagas disease is a health threat for many people, mostly those living in Latin America. One of the most important problems in treatment is the limitation of existing drugs. Prodigiosin, produced by Serratia marcescens (Rhodnius prolixus endosymbiont, belongs to the red-pigmented bacterial prodiginine family, which displays numerous biological activities, including antibacterial, antifungal, antiprotozoal, antimalarial, immunosuppressive, and anticancer properties. Here we describe its effects on Trypanosoma cruzi mitochondria belonging to Tc I and Tc II. Results Parasites exposed to prodigiosin altered the mitochondrial function and oxidative phosphorylation could not have a normal course, probably by inhibition of complex III. Prodigiosin did not produce cytotoxic effects in lymphocytes and Vero cells and has better effects than benznidazole. Our data suggest that the action of prodigiosin on the parasites is mediated by mitochondrial structural and functional disruptions that could lead the parasites to an apoptotic-like cell death process. Conclusions Here, we propose a potentially useful trypanocidal agent derived from knowledge of an important aspect of the natural life cycle of the parasite: the vector-parasite interaction. Our results indicate that prodigiosin could be a good candidate for the treatment of Chagas disease.

  14. Global Climate Change Effects on Venezuela's Vulnerability to Chagas Disease is Linked to the Geographic Distribution of Five Triatomine Species.

    Science.gov (United States)

    Ceccarelli, Soledad; Rabinovich, Jorge E

    2015-11-01

    We analyzed the possible effects of global climate change on the potential geographic distribution in Venezuela of five species of triatomines (Eratyrus mucronatus (Stal, 1859), Panstrongylus geniculatus (Latreille, 1811), Rhodnius prolixus (Stål, 1859), Rhodnius robustus (Larrousse, 1927), and Triatoma maculata (Erichson, 1848)), vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. To obtain the future potential geographic distributions, expressed as climatic niche suitability, we modeled the presences of these species using two IPCC (Intergovernmental Panel on Climate Change) future emission scenarios of global climate change (A1B and B1), the Global Climate model CSIRO Mark 3.0, and three periods of future projections (years 2020, 2060, and 2080). After estimating with the MaxEnt software the future climatic niche suitability for each species, scenario, and period of future projections, we estimated a series of indexes of Venezuela's vulnerability at the county, state, and country level, measured as the number of people exposed due to the changes in the geographical distribution of the five triatomine species analyzed. Despite that this is not a measure of the risk of Chagas disease transmission, we conclude that possible future effects of global climate change on the Venezuelan population vulnerability show a slightly decreasing trend, even taking into account future population growth; we can expect fewer locations in Venezuela where an average Venezuelan citizen would be exposed to triatomines in the next 50-70 yr.

  15. How Is Heart Disease Treated?

    Science.gov (United States)

    ... for a Healthy Weight Web site. Stress and Depression Research shows that getting upset or angry can ... health. Share your story with other women on Facebook . The Heart Truth campaign offers a variety of ...

  16. Experimental Chagas' disease in rhesus monkeys. I. Clinical, parasitological, hematological and anatomo-pathological studies in the acute and indeterminate phase of the disease.

    Science.gov (United States)

    Bonecini-Almeida, M da G; Galvão-Castro, B; Pessoa, M H; Pirmez, C; Laranja, F

    1990-01-01

    Rhesus monkeys (Macaca mulatta) were infected subcutaneously with 1.0 x 10(4) to 1.5 x 10(4) metacyclic trypomastigotes of Trypanosoma cruzi (Colombian strain). Parasitological and immunological parameters were evaluated in these animals for periods of 1 month to over 3 years. A chagoma was observed between the 3rd and the 13th day after infection (a.i.) and patent parasitaemia between the 13th and 59th day a.i.. Thereafter, parasites were demonstrated only by haemoculture and/or xenodiagnosis. Circulating specific IgM and IgG antibodies were observed as early as in the 2nd week a.i. IgG levels persisted until the end of the experiment, but IgM antibodies were detectable nine months a.i. Haematological alterations comprised leucocytosis and lymphocytosis. Electrocardiographic alterations were minor and transient, similar to those observed in non-lethal human acute Chagas' myocarditis. Myocarditis and myositis, characterized by multiple foci of lympho-histiocyte inflammatory infiltrate, were present in monkeys sacrificed on the 41st, 70th and 76th day but not in the animal sacrificed 3 years and 3 months a. i.. The results suggest that Chagas' disease in rhesus monkeys reproduces the acute and indeterminate phases of human Chagas' disease. PMID:2128360

  17. Experimental chagas' disease in rhesus monkeys. I. Clinical parasitological, hematological and anatomo-pathological studies in the acute and indeterminate phase of the disease

    Directory of Open Access Journals (Sweden)

    Maria da Glória Bonecine-Almeida

    1990-06-01

    Full Text Available Rhesus monkeys (macaca mulatta were infected subcutaneously with 1.0 x 10**4 to 1.5 x 10**4 metacyclic trypomastigotes of Trypanosoma cruzi (Colombian strain. Parasitological and immunological parameters were evaluated in these animals for periods of 1 month to over 3 years. a chagona was observed between the 3 rd and the 13th day after infection (a.i and patent parasitaemia between the 13th and 59th day a.i.. Thereafter, parasites were demonstrated only by haemoculture and/or xenodiagnosis. Circulating specifc IgM and IgC antibodies were observed as early as in the 2nd week a. i. IgG levels persisted until the end of the expriment, but IgM antibodies were detectable nine months a. i. Haematological alterations comprised leucocytosis and lymphocytosis. Eletrocardiographic alterations were minor and transient, similar to those observe in non-lethal human acute Chagas' myocarditis. Myocarditis and myositis, characterized by multiple foci of lympho-histiocyte inflammatory infiltrate, were present in monkeys sacrificed on the 41 th, 70th and 76 th day but not in the animal sacrificed 3 years and 3 months a. i.. The results suggest that Chagas' disease in rhesus monkeys reproduces the acute and indeterminate phases of human Chagas' disease.

  18. How Is Coronary Heart Disease Diagnosed?

    Science.gov (United States)

    ... groin (upper thigh), or neck. The tube is threaded into your coronary arteries, and the dye is ... awards at five academic institutions to identify genetic connections to heart, lung, and blood diseases. Individual studies ...

  19. Magnetic resonance imaging of valvular heart disease

    DEFF Research Database (Denmark)

    Søndergaard, Lise; Ståhlberg, F; Thomsen, C

    1999-01-01

    The optimum management of patients with valvular heart diseases requires accurate and reproducible assessment of the valvular lesion and its hemodynamic consequences. Magnetic resonance imaging (MRI) techniques, such as volume measurements, signal-void phenomena, and velocity mapping, can be used...... in an integrated approach to gain qualitative and quantitative information on valvular heart disease as well as ventricular dimensions and functions. Thus, MRI may be advantageous to the established diagnostic tools in assessing the severity of valvular heart disease as well as monitoring the lesion and predicting...... the optimal timing for valvular surgery. This paper reviews the validation of these MRI techniques in assessing valvular heart disease and discusses some typical pitfalls of the techniques, including suggestions for solutions.J. Magn. Reson. Imaging 1999;10:627-638....

  20. Sleep Apnea and Heart Disease, Stroke

    Science.gov (United States)

    ... Pressure High Blood Pressure Tools & Resources Stroke More Sleep Apnea and Heart Disease, Stroke Updated:Sep 16, ... be life-threatening. It’s a condition known as sleep apnea, in which the person may experience pauses ...

  1. Job Dissatisfaction and Coronary Heart Disease

    Science.gov (United States)

    Friis, Robert

    1976-01-01

    Based on the psychosocial factor that life dissatisfactions may be associated with physical illnesses, this research examines the relationship between job dissatisfaction and its causal link to premature death from heart disease. (Author/RK)

  2. Heart Disease Down Among Over-40 Americans

    Science.gov (United States)

    ... risk factors is likely why the rates of heart disease are coming down. These factors include high blood pressure, abnormal cholesterol, smoking, diabetes, overweight and obesity. The rates of high blood pressure and abnormal cholesterol haven' ...

  3. Air Pollution and Heart Disease, Stroke

    Science.gov (United States)

    ... High Blood Pressure Tools & Resources Stroke More Air Pollution and Heart Disease, Stroke Updated:Aug 30,2016 ... routine or in a less populated place, tiny pollution particles in the air can lead to big ...

  4. Evaluation of oral mucosal transudate for immunodiagnosis of Chagas´ disease

    Directory of Open Access Journals (Sweden)

    BARROS Maria das Neves D. S.

    1999-01-01

    Full Text Available Anticorpos anti-Trypanosoma cruzi (isotipo IgG foram detectados no transudato da mucosa oral (TMO através de um ensaio imunoenzimático. Foram estudados 21 indivíduos com doença de Chagas crônica comprovada através de diagnóstico clínico, eletrocardiográfico, epidemiológico e sorológico: 10 com forma cardíaca, 2 com forma digestiva, 6 com forma mista e 3 com forma assintomática. Sete indivíduos de área endêmica, com sorologia negativa, constituiram o grupo controle. O soro destes grupos foi armazenado a -20 oC. A coleta de TMO de ambos os grupos foi realizada com o dispositivo OraSureâ seguindo orientação do fabricante (OraSureâ , Epitope Inc., Beaverton, OR, USA. As amostras de TMO foram diluídas (1:2 e testadas em duplicata através de um ensaio imunoenzimático da Abbott Laboratories para detectar anticorpos IgG contra doença de Chagas. Vinte dos vinte e um pacientes chagásicos apresentaram densidade óptica acima do limiar de reatividade e foram considerados positivos para doença de Chagas. Nenhuma das amostras provenientes de indivíduos soronegativos foi positiva. A sensibilidade e especificidade foram de 95% e 100%, respectivamente. Estes resultados indicam que TMO poderá ser utilizado como um fluido biológico alternativo para o diagnóstico da doença de Chagas. Nós estamos aumentando o número de indivíduos para validar estes resultados incluindo a análise comparativa entre amostras de TMO e soro.

  5. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... Research Training & Career Development Grant programs for students, postdocs, and faculty Research at NIDDK Labs, faculty, and ... diabetes, digestive and liver diseases, kidney diseases, weight control and nutrition, urologic diseases, endocrine and metabolic diseases, ...

  6. 10.8.Rheumatic heart disease

    Institute of Scientific and Technical Information of China (English)

    1992-01-01

    920083 A preliminary study of cell immunefunction in rheumatic heart disease.YANG Qi(杨奇),et al.Res Lab Cardiovasc Dis,Luzhou MedColl Hosp,Sichuan.Chin Cir J 1991; 6 (5): 392-394.Cell immune function of forty one patients withrheumatic heart disease (RHD),forty four withRHD and rheumatic fever (RF) and fifty normal

  7. Energy expenditure in congenital heart disease.

    OpenAIRE

    Barton, J S; Hindmarsh, P C; Scrimgeour, C M; Rennie, M J; Preece, M A

    1994-01-01

    Growth failure is a well recognised consequence of severe congenital heart disease. Total daily energy expenditure (TDEE) was investigated in eight infants with severe congenital heart disease to determine whether an increase in this parameter is an important factor in their failure to thrive, and to estimate the energy intake that would be required to allow normal growth. The infants were studied over a seven day period before surgery using the doubly labelled water method. Growth failure wa...

  8. Rheumatic heart disease with triple valve involvement

    OpenAIRE

    BRAMBATI, MATTEO; LAURENZI, PIER FRANCESCO; MARLETTA, FIORANGELA; MANINA, GIORGIA; COMINA, DENISE PROVVIDENZA; PRESTON, NGAMBE MANDI; CASSETTI, GIUSEPPINA; MERLO, CHIARA; Volpi, Michele; MUSSO, ROBERTA; LA ROCCA, ROBERTO

    2013-01-01

    Acute rheumatic fever (ARF) is a postinfectious, nonsuppurative sequela of pharyngeal infection caused by Streptococcus pyogenes, or Group A β hemolytic Streptococcus (GABHS). Of the associated symptoms, only damage to the heart’s valvular tissue, or rheumatic heart disease (RHD), can become a chronic condition leading to congestive heart failure, stroke, endocarditis, and death. ARF is the most common cause of cardiac disease in children in developing countries. A joint meeting o...

  9. Biomarkers in kidney and heart disease

    NARCIS (Netherlands)

    Maisel, Alan S.; Katz, Nevin; Hillege, Hans L.; Shaw, Andrew; Zanco, Pierluigi; Bellomo, Rinaldo; Anand, Inder; Anker, Stefan D.; Aspromonte, Nadia; Bagshaw, Sean M.; Berl, Tomas; Bobek, Ilona; Cruz, Dinna N.; Daliento, Luciano; Davenport, Andrew; Haapio, Mikko; House, Andrew A.; Mankad, Sunil; McCullough, Peter; Mebazaa, Alexandre; Palazzuoli, Alberto; Ponikowski, Piotr; Ronco, Federico; Sheinfeld, Geoff; Soni, Sachin; Vescovo, Giorgio; Zamperetti, Nereo; Ronco, Claudio

    2011-01-01

    There is much symptomatic similarity between acute kidney disease and acute heart disease. Both may present with shortness of breath and chest discomfort, and thus it is not surprising that biomarkers of acute myocardial and renal disease often coexist in many physicians' diagnostic work-up schedule

  10. Radiation-induced valvular heart disease.

    Science.gov (United States)

    Gujral, Dorothy M; Lloyd, Guy; Bhattacharyya, Sanjeev

    2016-02-15

    Radiation to the mediastinum is a key component of treatment with curative intent for a range of cancers including Hodgkin's lymphoma and breast cancer. Exposure to radiation is associated with a risk of radiation-induced heart valve damage characterised by valve fibrosis and calcification. There is a latent interval of 10-20 years between radiation exposure and development of clinically significant heart valve disease. Risk is related to radiation dose received, interval from exposure and use of concomitant chemotherapy. Long-term outlook and the risk of valve surgery are related to the effects of radiation on mediastinal structures including pulmonary fibrosis and pericardial constriction. Dose prediction models to predict the risk of heart valve disease in the future and newer radiation techniques to reduce the radiation dose to the heart are being developed. Surveillance strategies for this cohort of cancer survivors at risk of developing significant heart valve complications are required.

  11. Ivabradine, heart failure and chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Luca Di Lullo

    2015-12-01

    Full Text Available The incidence and prevalence of congestive heart failure are actually increasing worldwide, especially in Western countries. In Europe and the United States, congestive heart failure represents a disabling clinical disease, accountable for increased hospitalization and health care costs. European guidelines have underlined the importance of pharmacological treatment to improve both patients’ outcomes and quality of life. The latest clinical trials to evaluate ivabradine’s efficacy have underlined its usefulness as a stand-alone medication and in combination with conventional congestive heart failure therapy, including in chronic kidney disease patients.

  12. Ecoepidemiology, short history and control of Chagas disease in the endemic countries and the new challenge for non-endemic countries.

    Science.gov (United States)

    Coura, José Rodrigues; Viñas, Pedro Albajar; Junqueira, Angela Cv

    2014-11-01

    Chagas disease is maintained in nature through the interchange of three cycles: the wild, peridomestic and domestic cycles. The wild cycle, which is enzootic, has existed for millions of years maintained between triatomines and wild mammals. Human infection was only detected in mummies from 4,000-9,000 years ago, before the discovery of the disease by Carlos Chagas in 1909. With the beginning of deforestation in the Americas, two-three centuries ago for the expansion of agriculture and livestock rearing, wild mammals, which had been the food source for triatomines, were removed and new food sources started to appear in peridomestic areas: chicken coops, corrals and pigsties. Some accidental human cases could also have occurred prior to the triatomines in peridomestic areas. Thus, triatomines progressively penetrated households and formed the domestic cycle of Chagas disease. A new epidemiological, economic and social problem has been created through the globalisation of Chagas disease, due to legal and illegal migration of individuals infected by Trypanosoma cruzi or presenting Chagas disease in its varied clinical forms, from endemic countries in Latin America to non-endemic countries in North America, Europe, Asia and Oceania, particularly to the United States of America and Spain. The main objective of the present paper was to present a general view of the interchanges between the wild, peridomestic and domestic cycles of the disease, the development of T. cruzi among triatomine, their domiciliation and control initiatives, the characteristics of the disease in countries in the Americas and the problem of migration to non-endemic countries. PMID:25410988

  13. Ecoepidemiology, short history and control of Chagas disease in the endemic countries and the new challenge for non-endemic countries

    Directory of Open Access Journals (Sweden)

    José Rodrigues Coura

    2014-11-01

    Full Text Available Chagas disease is maintained in nature through the interchange of three cycles: the wild, peridomestic and domestic cycles. The wild cycle, which is enzootic, has existed for millions of years maintained between triatomines and wild mammals. Human infection was only detected in mummies from 4,000-9,000 years ago, before the discovery of the disease by Carlos Chagas in 1909. With the beginning of deforestation in the Americas, two-three centuries ago for the expansion of agriculture and livestock rearing, wild mammals, which had been the food source for triatomines, were removed and new food sources started to appear in peridomestic areas: chicken coops, corrals and pigsties. Some accidental human cases could also have occurred prior to the triatomines in peridomestic areas. Thus, triatomines progressively penetrated households and formed the domestic cycle of Chagas disease. A new epidemiological, economic and social problem has been created through the globalisation of Chagas disease, due to legal and illegal migration of individuals infected by Trypanosoma cruzi or presenting Chagas disease in its varied clinical forms, from endemic countries in Latin America to non-endemic countries in North America, Europe, Asia and Oceania, particularly to the United States of America and Spain. The main objective of the present paper was to present a general view of the interchanges between the wild, peridomestic and domestic cycles of the disease, the development of T. cruzi among triatomine, their domiciliation and control initiatives, the characteristics of the disease in countries in the Americas and the problem of migration to non-endemic countries.

  14. Ecoepidemiology, short history and control of Chagas disease in the endemic countries and the new challenge for non-endemic countries.

    Science.gov (United States)

    Coura, José Rodrigues; Viñas, Pedro Albajar; Junqueira, Angela Cv

    2014-11-01

    Chagas disease is maintained in nature through the interchange of three cycles: the wild, peridomestic and domestic cycles. The wild cycle, which is enzootic, has existed for millions of years maintained between triatomines and wild mammals. Human infection was only detected in mummies from 4,000-9,000 years ago, before the discovery of the disease by Carlos Chagas in 1909. With the beginning of deforestation in the Americas, two-three centuries ago for the expansion of agriculture and livestock rearing, wild mammals, which had been the food source for triatomines, were removed and new food sources started to appear in peridomestic areas: chicken coops, corrals and pigsties. Some accidental human cases could also have occurred prior to the triatomines in peridomestic areas. Thus, triatomines progressively penetrated households and formed the domestic cycle of Chagas disease. A new epidemiological, economic and social problem has been created through the globalisation of Chagas disease, due to legal and illegal migration of individuals infected by Trypanosoma cruzi or presenting Chagas disease in its varied clinical forms, from endemic countries in Latin America to non-endemic countries in North America, Europe, Asia and Oceania, particularly to the United States of America and Spain. The main objective of the present paper was to present a general view of the interchanges between the wild, peridomestic and domestic cycles of the disease, the development of T. cruzi among triatomine, their domiciliation and control initiatives, the characteristics of the disease in countries in the Americas and the problem of migration to non-endemic countries.

  15. Commonly Asked Questions about Children and Heart Disease

    Science.gov (United States)

    ... routine ultrasound heart rhythm abnormality family history of congenital heart disease a problem in another organ of the fetus ... important that a cardiologist who is knowledgeable about congenital heart disease be involved in your child’s care indefinitely. Specialized ...

  16. Major Risk Factors for Heart Disease: High Blood Cholesterol

    Science.gov (United States)

    ... Major Risk Factors for Heart Disease High Blood Cholesterol High blood cholesterol is another major risk factor for heart disease ... can do something about. The higher your blood cholesterol level, the greater your risk for developing heart ...

  17. A therapeutic nanoparticle vaccine against Trypanosoma cruzi in a BALB/c mouse model of Chagas disease.

    Science.gov (United States)

    Barry, Meagan A; Wang, Qian; Jones, Kathryn M; Heffernan, Michael J; Buhaya, Munir H; Beaumier, Coreen M; Keegan, Brian P; Zhan, Bin; Dumonteil, Eric; Bottazzi, Maria Elena; Hotez, Peter J

    2016-04-01

    Chagas disease, caused by Trypanosoma cruzi, results in an acute febrile illness that progresses to chronic chagasic cardiomyopathy in 30% of patients. Current treatments have significant side effects and poor efficacy during the chronic phase; therefore, there is an urgent need for new treatment modalities. A robust TH1-mediated immune response correlates with favorable clinical outcomes. A therapeutic vaccine administered to infected individuals could bolster the immune response, thereby slowing or stopping the progression of chagasic cardiomyopathy. Prior work in mice has identified an efficacious T. cruzi DNA vaccine encoding Tc24. To elicit a similar protective cell-mediated immune response to a Tc24 recombinant protein, we utilized a poly(lactic-co-glycolic acid) nanoparticle delivery system in conjunction with CpG motif-containing oligodeoxynucleotides as an immunomodulatory adjuvant. In a BALB/c mouse model, the vaccine produced a TH1-biased immune response, as demonstrated by a significant increase in antigen-specific IFNγ-producing splenocytes, IgG2a titers, and proliferative capacity of CD8(+) T cells. When tested for therapeutic efficacy, significantly reduced systemic parasitemia was seen during peak parasitemia. Additionally, there was a significant reduction in cardiac parasite burden and inflammatory cell infiltrate. This is the first study demonstrating immunogenicity and efficacy of a therapeutic Chagas vaccine using a nanoparticle delivery system. PMID:26890466

  18. An entomological and seroepidemiological study of the vectorial-transmission risk of Chagas disease in the coast of northern Chile.

    Science.gov (United States)

    González, C R; Reyes, C; Canals, A; Parra, A; Muñoz, X; Rodríguez, K

    2015-12-01

    Four species of triatomines are known from Chile: Triatoma infestans Klug, Mepraia spinolai Porter, M. gajardoi Frías, Henry & González, and M. parapatrica Frías (Hemiptera: Reduviidae), the last three are endemic. The geographical distribution of M. gajardoi includes the coastal areas in the north of Chile between 18° and 21°S, an area with both a resident workforce and summer-season visitors. A study was developed to assess the risk of vectorial transmission of Chagas disease by M. gajardoi in hut settlements on the coast of the Tarapacá Region, in particular in Caleta San Marcos and Caleta Río Seco. The study comprised fingerstick sampling of 95 persons, venous samples from 29 domestic dogs and capture of 52 triatomines, from both fishing coves. The samples were analysed by enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) techniques. The results show that, of the total number of persons studied, 100% were negative for Trypanosoma cruzi Chagas (Trypanosomatida: Trypanosomatidae) antibodies, 10.34% of canids were positive for the antibody and 5.8% of M. gajardoi were infected to the PCR technique. The presence of this species in areas close to human settlements constitutes a risk to human populations established on the coast of northern Chile.

  19. Deficient regulatory T cell activity and low frequency of IL-17-producing T cells correlate with the extent of cardiomyopathy in human Chagas' disease.

    Directory of Open Access Journals (Sweden)

    Paulo Marcos Matta Guedes

    Full Text Available BACKGROUND: Myocardium damage during Chagas' disease results from the immunological imbalance between pro- and production of anti-inflammatory cytokines and has been explained based on the Th1-Th2 dichotomy and regulatory T cell activity. Recently, we demonstrated that IL-17 produced during experimental T. cruzi infection regulates Th1 cells differentiation and parasite induced myocarditis. Here, we investigated the role of IL-17 and regulatory T cell during human Chagas' disease. METHODOLOGY/PRINCIPAL FINDINGS: First, we observed CD4(+IL-17(+ T cells in culture of peripheral blood mononuclear cells (PBMC from Chagas' disease patients and we evaluated Th1, Th2, Th17 cytokine profile production in the PBMC cells from Chagas' disease patients (cardiomyopathy-free, and with mild, moderate or severe cardiomyopathy cultured with T. cruzi antigen. Cultures of PBMC from patients with moderate and severe cardiomyopathy produced high levels of TNF-α, IFN-γ and low levels of IL-10, when compared to mild cardiomyopathy or cardiomyopathy-free patients. Flow cytometry analysis showed higher CD4(+IL-17(+ cells in PBMC cultured from patients without or with mild cardiomyopathy, in comparison to patients with moderate or severe cardiomyopathy. We then analyzed the presence and function of regulatory T cells in all patients. All groups of Chagas' disease patients presented the same frequency of CD4(+CD25(+ regulatory T cells. However, CD4(+CD25(+ T cells from patients with mild cardiomyopathy or cardiomyopathy-free showed higher suppressive activity than those with moderate and severe cardiomyopathy. IFN-γ levels during chronic Chagas' disease are inversely correlated to the LVEF (P = 0.007, r = -0.614, while regulatory T cell activity is directly correlated with LVEF (P = 0.022, r = 0.500. CONCLUSION/SIGNIFICANCE: These results indicate that reduced production of the cytokines IL-10 and IL-17 in association with high levels of IFN-γ and TNF

  20. Perspectivas da evolução clínica de pacientes com cardiomiopatia chagásica listados em prioridade para o transplante cardíaco Clinical perspectives of patients with Chagas cardiomyopathy listed as high priority for heart transplantation

    Directory of Open Access Journals (Sweden)

    Luiz Felipe P. Moreira

    2005-09-01

    Full Text Available INTRODUÇÃO: O choque cardiogênico é responsável por elevados índices de mortalidade na fila de espera para o transplante cardíaco. Na cardiomiopatia chagásica, a alta incidência de disfunção biventricular pode contribuir com a gravidade desta complicação. MÉTODO: Foram estudados 141 pacientes indicados em caráter de prioridade para o transplante. Destes pacientes, 46 eram portadores de cardiomiopatia chagásica e 95 de outras cardiomiopatias. O choque cardiogênico foi tratado farmacologicamente e com o implante ocasional do balão intra-aórtico. Em cinco pacientes chagásicos, foi realizado o implante de dispositivo paracorpóreo de assistência ventricular esquerda. RESULTADOS: Num período médio de 2,8 meses, 58 (41,1% dos 141 pacientes foram transplantados, 73 (51,7% faleceram e 10 foram retirados da fila. A mortalidade entre os pacientes chagásicos e não chagásicos foi de 45,6% e 54,7%, respectivamente. No entanto, a expectativa média de vida, sem a realização do transplante cardíaco, dos pacientes chagásicos foi de apenas 1,5 meses, sendo observado risco relativo de mortalidade de 1,6 para estes pacientes em relação aos não chagásicos (pINTRODUCTION: Heart failure is responsible for high mortality rates of patients on heart transplantation waiting lists. In Chagas cardiomyopathy, the presence of biventricular dysfunction increases the severity of this situation. METHOD: One hundred and forty-one patients suffering from cardiogenic shock, listed as high priority for heart transplantation, were studied. Forty-six patients presented with Chagas cardiomyopathy and 95 with other cardiomyopathies. Heart failure was treated using intravenous inotropic drugs and intra-aortic balloon pump implantation. Five patients with Chagas disease underwent paracorporeal left ventricular assist device implantation. RESULTS: During a mean follow-up of 2.8 months, 58 (41.1% of the 141 patients were transplanted, while 73 (53.7% died

  1. Multi Parametric Approach Using Fuzzification on Heart Disease Analysis

    OpenAIRE

    Upasana Juneja*1; Deepti Dhingra2

    2014-01-01

    The aim of this study is to define a fuzzy based prediction system that will accept the patient basic information as well as the symptoms as input and identify the chances of heart disease. Heart Disease Prediction System is the system that helps to predict the heart disease mainly cardiovascular. The importance of heart disease prediction system can be visualized from the fact that heart disease is one of the diseases that causes highest mortality rate. The present system hel...

  2. Cintilografia para detecção de comprometimento miocárdico na forma indeterminada da doença de Chagas Gammagrafía para detección de compromiso miocárdico en la forma indeterminada de la enfermedad de Chagas Scintigraphy for the detection of myocardial damage in the indeterminate form of Chagas disease

    Directory of Open Access Journals (Sweden)

    Ivana Moura Abuhid

    2010-07-01

    ón ventricular en los pacientes en la fase indeterminada de la Enfermedad de Chagas y en los controles normales, excepto en un paciente que presentó signos de disfunción ventricular en el análisis funcional en la gammagrafía miocárdica de perfusión sincronizada con el electrocardiograma (ECG. CONCLUSIÓN: Los resultados de este estudio, en el cual, pese al pequeño número de pacientes, mostraron que la gammagrafía miocárdica de reposo y esfuerzo con sestamibi-99mTc no es un método eficaz para detectar precozmente alteraciones miocárdicas en la forma indeterminada del Mal de Chagas.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.

  3. Hispanics and Heart Disease, Stroke

    Science.gov (United States)

    ... of transportation and lack of health insurance. Those factors can make early diagnoses and management of risks difficult, said Martha L. Daviglus, M.D., Ph.D., a cardiovascular epidemiologist at Northwestern University and University of Illinois and an American Heart ...

  4. Perturbed T cell IL7 receptor-signaling in chronic Chagas disease

    Science.gov (United States)

    Albareda, M. Cecilia; Perez-Mazliah, Damián; Natale, M. Ailén; Castro-Eiro, Melisa; Alvarez, María G.; Viotti, Rodolfo; Bertocchi, Graciela; Lococo, Bruno; Tarleton, Rick L; Laucella, Susana A.

    2015-01-01

    We have previously demonstrated that immune responses in subjects with chronic Trypanosoma cruzi infection display features common to other persistent infections with signs of T cell exhaustion. Alterations in cytokine receptor signal transduction have emerged as one of the cell-intrinsic mechanisms of T cell exhaustion. Herein, we performed an analysis of the expression of IL-7R components (CD127 and CD132) on CD4+ and CD8+ T cells, and evaluated IL-7-dependent signaling events in patients at different clinical stages of chronic chagasic heart disease. Subjects with no signs of cardiac disease showed a decrease in CD127+CD132+ cells and a reciprocal gain of CD127-CD132+ in CD8+ and CD4+ T cells compared to either patients exhibiting heart enlargement or uninfected controls. T. cruzi infection, in vitro, was able to stimulate the downregulation of CD127 and the upregulation of CD132 on T cells. IL-7-induced phosphorylation of STAT5 as well as Bcl-2 and CD25 expression were lower in T. cruzi-infected subjects compared with uninfected controls. The serum levels of IL-7 was also increased in chronic chagasic patients. The present study highlights perturbed IL-7/IL-7R T cell signaling through STAT5 as a potential mechanism of T cell exhaustion in chronic T. cruzi infection. PMID:25769928

  5. Pregnancy outcomes in women with heart disease

    Institute of Scientific and Technical Information of China (English)

    LIU Hua; XU Ji-wen; ZHAO Xu-dong; YE Tai-yang; LIN Jian-hua; LIN Qi-de

    2010-01-01

    Background As the Shanghai Obstetrical Cardiology Intensive Care Center, our hospital has accumulated a large number of clinical data of pregnant women with heart disease. This paper is a retrospective analysis of 1142 pregnancies in women with heart disease so as to evaluate the maternal and fetal outcomes of these patients.Methods A retrospective analysis was carried out for pregnancies in 1142 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between 1993 and 2007.Results In this study, main heart diseases in pregnancy were arrhythmia (n=359, 31.4%), congenital heart disease (CHD; n=291,25.5%), and myocarditis and its sequelae (n=284, 24.9%); based on the functional classification criteria of New York Heart Association (NYHA), more than half (n=678, 59.4%) of patients were classified NYHA Class Ⅰ; pregnant women in NHYA Class Ⅰ-Ⅱ (n=951, 83.3%) commonly had arrhythmia, myocarditis and its sequelae, while those in NHYA Class Ⅲ-Ⅳ (n=191, 16.7%) mainly had CHD, rheumatic heart disease (RHD), cardiopathy induced by hypertensive disorders complicating pregnancy, and peripartum cardiomyopathy (PPCM). Cardiac failure occurred in 97 (8.5%)patients, and 8 (0.7%) maternal deaths and 12 (1.1%) perinatal deaths were reported in this study. Compared with those in NHYA Class Ⅰ-Ⅱ, women in NHYA Class Ⅲ-Ⅳ had a significantly lower gestational age at birth (P <0.05), lower birth weight (P <0.01), and higher incidence of preterm delivery, small for gestational age and perinatal death (P <0.01). The incidence of cardiac failure in pregnant women with cardiopathy induced by hypertensive disorders complicating pregnancy and PPCM was relatively high, with a rate of 80% and 52.2%, respectively. After cardiac operation, 131(90.3%) women were in classified NHYA Class Ⅰ-Ⅱ and 14 (9.7%) in NHYA Class Ⅲ-Ⅳ.Conclusions Arrhythmia is the type of heart disease that has a highest incidence in patients with heart

  6. Heart Disease in Women | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Heart Disease in Women Past Issues / Winter 2014 Table of ... United States, 1 in 4 women dies from heart disease. In fact, coronary heart disease (CHD)—the most ...

  7. Trypanosoma cruzi IV causing outbreaks of acute Chagas disease and infections by different haplotypes in the Western Brazilian Amazonia.

    Directory of Open Access Journals (Sweden)

    Wuelton Marcelo Monteiro

    Full Text Available BACKGROUND: Chagas disease is an emergent tropical disease in the Brazilian Amazon Region, with an increasing number of cases in recent decades. In this region, the sylvatic cycle of Trypanosoma cruzi transmission, which constitutes a reservoir of parasites that might be associated with specific molecular, epidemiological and clinical traits, has been little explored. The objective of this work is to genetically characterize stocks of T. cruzi from human cases, triatomines and reservoir mammals in the State of Amazonas, in the Western Brazilian Amazon. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed 96 T. cruzi samples from four municipalities in distant locations of the State of Amazonas. Molecular characterization of isolated parasites from cultures in LIT medium or directly from vectors or whole human blood was performed by PCR of the non-transcribed spacer of the mini-exon and of the 24 S alfa ribosomal RNA gene, RFLP and sequencing of the mitochondrial cytochrome c oxidase subunit II (COII gene, and by sequencing of the glucose-phosphate isomerase gene. The T. cruzi parasites from two outbreaks of acute disease were all typed as TcIV. One of the outbreaks was triggered by several haplotypes of the same DTU. TcIV also occurred in isolated cases and in Rhodnius robustus. Incongruence between mitochondrial and nuclear phylogenies is likely to be indicative of historical genetic exchange events resulting in mitochondrial introgression between TcIII and TcIV DTUs from Western Brazilian Amazon. TcI predominated among triatomines and was the unique DTU infecting marsupials. CONCLUSION/SIGNIFICANCE: DTU TcIV, rarely associated with human Chagas disease in other areas of the Amazon basin, is the major strain responsible for the human infections in the Western Brazilian Amazon, occurring in outbreaks as single or mixed infections by different haplotypes.

  8. Here, There and Everywhere: The Ubiquitous Distribution of the Immunosignaling Molecule Lysophosphatidylcholine and its Role on Chagas Disease

    Directory of Open Access Journals (Sweden)

    Mario Alberto Cardoso Silva-Neto

    2016-02-01

    Full Text Available Chagas disease is a severe illness, which can lead to death if the patients are not promptly treated. The disease is caused by the protozoan parasite Trypanosoma cruzi, which is mostly transmitted by a triatomine insect vector. There are 8-10 million people infected with T. cruzi in the world, but the vector-borne transmission occurs only in the Americas, especially Latin America. About 30 % of chronically infected people develop cardiac diseases and up to 10 % develop digestive, neurological or mixed disorders. Lysophosphatydilcholine (LPC is the major phospholipid component of oxidized low-density lipoproteins associated with atherosclerosis-related tissue damage. Insect-derived LPC is a powerful chemoattractant for inflammatory cells at the site of the insect bite, enhances parasite invasion, and inhibits the production of nitric oxide (NO by T. cruzi-stimulated macrophages. The recognition of the ubiquitous presence of LPC on the vector saliva, its production by the parasite itself and its presence both on patient plasma as well as its role on diverse host x parasite interaction systems lead us to compare its distribution in nature with the title of the famous Beatles song Here, There and Everywhere recorded exactly 50 years ago in 1966. Here, we review the major findings pointing out the role of such molecule as an immunosignaling modulator of Chagas disease transmission. Also, we believe that future investigation of the connection of this ubiquity and the immune role of such molecule may lead in the future to novel methods to control parasite transmission, infection and pathogenesis.

  9. A new endemic focus of Chagas disease in the northern region of Veraguas Province, Western Half Panama, Central America.

    Directory of Open Access Journals (Sweden)

    Azael Saldaña

    Full Text Available BACKGROUND: Chagas disease was originally reported in Panama in 1931. Currently, the best knowledge of this zoonosis is restricted to studies done in historically endemic regions. However, little is known about the distribution and epidemiology of Chagas disease in other rural areas of the country. METHODS AND FINDINGS: A cross-sectional descriptive study was carried out between May 2005 - July 2008 in four rural communities of the Santa Fe District, Veraguas Province. The study included an entomologic search to collect triatomines, bloodmeal type identification and infection rate with trypanosomes in collected vectors using a dot- blot and PCR analysis, genotyping of circulating Trypanosoma cruzi (mini-exon gene PCR analysis and the detection of chagasic antibodies among inhabitants. The vector Rhodnius pallescens was more frequently found in La Culaca and El Pantano communities (788 specimens, where it was a sporadic household visitor. These triatomines presented darker coloration and larger sizescompared with typical specimens collected in Central Panama. Triatoma dimidiata was more common in Sabaneta de El Macho (162 specimens. In one small sub-region (El Macho, 60% of the houses were colonized by this vector. Of the examined R. pallescens, 54.7.0% (88/161 had fed on Didelphis marsupialis, and 24.6% (34/138 of T. dimidiata specimens collected inside houses were positive for human blood. R. pallescens presented an infection index with T. cruzi of 17.7% (24/136, with T. rangeli of 12.5% (17/136 and 50.7% (69/136 were mixed infections. In 117 T. dimidiata domestic specimens the infection index with T. cruzi was 21.4%. Lineage I of T. cruzi was confirmed circulating in these vectors. A T. cruzi infection seroprevalence of 2.3% (24/1,056 was found in this population. CONCLUSIONS: This is the first report of Chagas disease endemicity in Santa Fe District, and it should be considered a neglected public health problem in this area of Panama.

  10. Carcinoid heart disease: Diagnosis and management.

    Science.gov (United States)

    Luis, Sushil A; Pellikka, Patricia A

    2016-01-01

    Hedinger syndrome refers to carcinoid valvular heart disease. The disease is believed to be triggered by vasoactive substances that result in valvular fibrosis. It classically occurs in patients with metastatic carcinoid and preferentially involves the right sided cardiac valves. Affected valves become thickened and retracted, exhibiting regurgitation and sometimes, stenosis. Echocardiography is recommended in patients with carcinoid syndrome and a follow up study is advisable in those who develop a murmur or other symptoms or signs of valvular heart disease. For appropriately selected patients, valve replacement surgery appears to improve outcomes.

  11. Heart Disease and Stroke in Women

    Centers for Disease Control (CDC) Podcasts

    2009-05-11

    This women's health podcast focuses on the impact of heart disease and stroke in women and includes steps to prevent these conditions.  Created: 5/11/2009 by Office of Women’s Health (OWH) and National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/11/2009.

  12. Reducing cholesterol to prevent coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    Matthew J. Sorrentino

    2005-01-01

    @@ Coronary heart disease (CHD) remains the number one killer of men and women in the United States of America despite major advances in interventional technologies for the treatment of coronary artery disease. CHD is rapidly becoming a major cause of morbidity and mortality in developing nations as well and is now recognized as the leading cause of death worldwide.

  13. Host-Seeking Behavior and Dispersal of Triatoma infestans, a Vector of Chagas Disease, under Semi-field Conditions

    Science.gov (United States)

    Castillo-Neyra, Ricardo; Barbu, Corentin M.; Salazar, Renzo; Borrini, Katty; Naquira, Cesar; Levy, Michael Z.

    2015-01-01

    Chagas disease affects millions of people in Latin America. The control of this vector-borne disease focuses on halting transmission by reducing or eliminating insect vector populations. Most transmission of Trypanosoma cruzi, the causative agent of Chagas disease, involves insects living within or very close to households and feeding mostly on domestic animals. As animal hosts can be intermittently present it is important to understand how host availability can modify transmission risk to humans and to characterize the host-seeking dispersal of triatomine vectors on a very fine scale. We used a semi-field system with motion-detection cameras to characterize the dispersal of Triatoma infestans, and compare the behavior of vector populations in the constant presence of hosts (guinea pigs), and after the removal of the hosts. The emigration rate – net insect population decline in original refuge – following host removal was on average 19.7% of insects per 10 days compared to 10.2% in constant host populations (p = 0.029). However, dispersal of T. infestans occurred in both directions, towards and away from the initial location of the hosts. The majority of insects that moved towards the original location of guinea pigs remained there for 4 weeks. Oviposition and mortality were observed and analyzed in the context of insect dispersal, but only mortality was higher in the group where animal hosts were removed (p-value vector control. Removing domestic animals in infested areas increases vector dispersal from the first day of host removal. The implications of these patterns of vector dispersal in a field setting are not yet known but could result in movement towards human rooms. PMID:25569228

  14. Genome of Rhodnius prolixus, an insect vector of Chagas disease, reveals unique adaptations to hematophagy and parasite infection.

    Science.gov (United States)

    Mesquita, Rafael D; Vionette-Amaral, Raquel J; Lowenberger, Carl; Rivera-Pomar, Rolando; Monteiro, Fernando A; Minx, Patrick; Spieth, John; Carvalho, A Bernardo; Panzera, Francisco; Lawson, Daniel; Torres, André Q; Ribeiro, Jose M C; Sorgine, Marcos H F; Waterhouse, Robert M; Montague, Michael J; Abad-Franch, Fernando; Alves-Bezerra, Michele; Amaral, Laurence R; Araujo, Helena M; Araujo, Ricardo N; Aravind, L; Atella, Georgia C; Azambuja, Patricia; Berni, Mateus; Bittencourt-Cunha, Paula R; Braz, Gloria R C; Calderón-Fernández, Gustavo; Carareto, Claudia M A; Christensen, Mikkel B; Costa, Igor R; Costa, Samara G; Dansa, Marilvia; Daumas-Filho, Carlos R O; De-Paula, Iron F; Dias, Felipe A; Dimopoulos, George; Emrich, Scott J; Esponda-Behrens, Natalia; Fampa, Patricia; Fernandez-Medina, Rita D; da Fonseca, Rodrigo N; Fontenele, Marcio; Fronick, Catrina; Fulton, Lucinda A; Gandara, Ana Caroline; Garcia, Eloi S; Genta, Fernando A; Giraldo-Calderón, Gloria I; Gomes, Bruno; Gondim, Katia C; Granzotto, Adriana; Guarneri, Alessandra A; Guigó, Roderic; Harry, Myriam; Hughes, Daniel S T; Jablonka, Willy; Jacquin-Joly, Emmanuelle; Juárez, M Patricia; Koerich, Leonardo B; Lange, Angela B; Latorre-Estivalis, José Manuel; Lavore, Andrés; Lawrence, Gena G; Lazoski, Cristiano; Lazzari, Claudio R; Lopes, Raphael R; Lorenzo, Marcelo G; Lugon, Magda D; Majerowicz, David; Marcet, Paula L; Mariotti, Marco; Masuda, Hatisaburo; Megy, Karine; Melo, Ana C A; Missirlis, Fanis; Mota, Theo; Noriega, Fernando G; Nouzova, Marcela; Nunes, Rodrigo D; Oliveira, Raquel L L; Oliveira-Silveira, Gilbert; Ons, Sheila; Orchard, Ian; Pagola, Lucia; Paiva-Silva, Gabriela O; Pascual, Agustina; Pavan, Marcio G; Pedrini, Nicolás; Peixoto, Alexandre A; Pereira, Marcos H; Pike, Andrew; Polycarpo, Carla; Prosdocimi, Francisco; Ribeiro-Rodrigues, Rodrigo; Robertson, Hugh M; Salerno, Ana Paula; Salmon, Didier; Santesmasses, Didac; Schama, Renata; Seabra-Junior, Eloy S; Silva-Cardoso, Livia; Silva-Neto, Mario A C; Souza-Gomes, Matheus; Sterkel, Marcos; Taracena, Mabel L; Tojo, Marta; Tu, Zhijian Jake; Tubio, Jose M C; Ursic-Bedoya, Raul; Venancio, Thiago M; Walter-Nuno, Ana Beatriz; Wilson, Derek; Warren, Wesley C; Wilson, Richard K; Huebner, Erwin; Dotson, Ellen M; Oliveira, Pedro L

    2015-12-01

    Rhodnius prolixus not only has served as a model organism for the study of insect physiology, but also is a major vector of Chagas disease, an illness that affects approximately seven million people worldwide. We sequenced the genome of R. prolixus, generated assembled sequences covering 95% of the genome (∼ 702 Mb), including 15,456 putative protein-coding genes, and completed comprehensive genomic analyses of this obligate blood-feeding insect. Although immune-deficiency (IMD)-mediated immune responses were observed, R. prolixus putatively lacks key components of the IMD pathway, suggesting a reorganization of the canonical immune signaling network. Although both Toll and IMD effectors controlled intestinal microbiota, neither affected Trypanosoma cruzi, the causal agent of Chagas disease, implying the existence of evasion or tolerance mechanisms. R. prolixus has experienced an extensive loss of selenoprotein genes, with its repertoire reduced to only two proteins, one of which is a selenocysteine-based glutathione peroxidase, the first found in insects. The genome contained actively transcribed, horizontally transferred genes from Wolbachia sp., which showed evidence of codon use evolution toward the insect use pattern. Comparative protein analyses revealed many lineage-specific expansions and putative gene absences in R. prolixus, including tandem expansions of genes related to chemoreception, feeding, and digestion that possibly contributed to the evolution of a blood-feeding lifestyle. The genome assembly and these associated analyses provide critical information on the physiology and evolution of this important vector species and should be instrumental for the development of innovative disease control methods. PMID:26627243

  15. Interrupting Chagas disease transmission in Venezuela A interrupção da transmissão da doença de Chagas na Venezuela

    Directory of Open Access Journals (Sweden)

    Alberto ACHÉ

    2001-02-01

    Full Text Available The interruption of vectorial transmission of Chagas disease in Venezuela is attributed to the combined effects of ongoing entomoepidemiological surveillance, ongoing house spraying with residual insecticides and the concurrent building and modification of rural houses in endemic areas during almost five decades. The original endemic areas which totaled 750,000 km², have been reduced to 365,000 km². During 1958-1968, initial entomological evaluations carried out showed that the house infestation index ranged between 60-80%, the house infection index at 8-11% and a house density index of 30-50 triatomine bugs per house. By 1990-98, these indexes were further reduced to 1.6-4.0%, 0.01-0.6% and 3-4 bugs per house respectively. The overall rural population seroprevalence has declined from 44.5% (95% C.I.: 43.4-45.3% to 9.2% (95% C.I.: 9.0-9.4% for successive grouped periods from 1958 to 1998. The annual blood donor prevalence is firmly established below 1%. The population at risk of infection has been estimated to be less than four million. Given that prevalence rates are stable and appropriate for public health programmes, consideration has been given to potential biases that may distort results such as: a geographical differences in illness or longevity of patients; b variations in levels of ascertainment; c variations in diagnostic criteria; and d variations in population structure, mainly due to appreciable population migration. The endemic areas with continuous transmission are now mainly confined to piedmonts, as well as patchy foci in higher mountainous ranges, where the exclusive vector is Rhodnius prolixus. There is also an unstable area, of which landscapes are made up of grasslands with scattered broad-leaved evergreen trees and costal plains, where transmission is very low and occasional outbreaks are reported.A interrupção da transmissão da doença de Chagas é atribuida aos efeitos conjuntos da vigilância soroepidemiol

  16. Emmanuel Dias: o principal artífice do combate à doença de Chagas nas Américas Emmanuel Dias: the principal architect of the fight against Chagas disease in the Americas

    Directory of Open Access Journals (Sweden)

    João Carlos Pinto Dias

    2008-10-01

    Full Text Available Comemora-se em 2008 o centenário de nascimento do Dr. Emmanuel Dias, cuja vida foi intensamente dedicada ao estudo, reconhecimento e controle da doença de Chagas. Esta súmula se incorpora às diversas homenagens feitas no Brasil e no Exterior, resgatando alguns elementos históricos na trajetória do cientista e o enorme impacto social resultante direta e indiretamente de seu trabalho. Afilhado e assistente de Carlos Chagas, Emmanuel foi considerado por Chagas Filho como o mais profícuo dos seguidores de seu pai. Em trinta anos de atividades, Dias iniciou-se como brilhante protozoologista depois passando ao enfrentamento da doença humana. Trabalhou intensivamente em diagnóstico, epidemiologia, clinica e controle. Idealizou estratégias de prospecção, mapeou a doença nas Américas, participou diretamente da sistematização da cardiopatia crônica e descreveu o primeiro inseticida eficaz contra os triatomíneos, também formatando a estratégia de seu controle. Mais ainda, estendeu suas atividades para toda a área endêmica, divulgando a doença e seu controle, de um lado, e impulsionando autoridades sanitárias e centros de decisão com vistas a implantação de ações, de outro. De seu trabalho resultaram programas nacionais e regionais que reduziram significativamente a transmissão da doença humana em todo o Continente. Foi recentemente considerado como o cientista que teve o maior impacto no enfrentamento desta tripanossomíase, em todos os tempos.In 2008, the centenary of the birth of Emmanuel Dias, whose life was intensely dedicated to the study, recognition and control of Chagas disease, is being celebrated. This summary of his life joins with the various homages paid in Brazil and abroad, to recall some of the key historical points in this scientist's career and the enormous social impact that resulted directly and indirectly from his work. Dias, who was Carlos Chagas' protégée and assistant, was considered by Chagas Filho

  17. Anticoagulation in adults with congenital heart disease

    DEFF Research Database (Denmark)

    Jensen, A S; Idorn, L; Nørager, B;

    2015-01-01

    Adults with congenital heart disease are a growing population. One of the major challenges in the care of these patients is to prevent thromboembolic episodes. Despite relative young age and no typical cardiovascular risk factors, this cohort has a high prevalence of thrombotic events. It is diff......Adults with congenital heart disease are a growing population. One of the major challenges in the care of these patients is to prevent thromboembolic episodes. Despite relative young age and no typical cardiovascular risk factors, this cohort has a high prevalence of thrombotic events....... It is difficult to use treatment algorithms from the general adult population with acquired heart disease in this heterogeneous population due to special conditions such as myocardial scarring after previous surgery, atypical atrial flutter, prothrombotic conditions and the presence of interatrial shunts....... Furthermore, there is a lack of scientific evidence regarding how to prevent thromboembolic events with anticoagulation in adults with congenital heart disease. The aim of this paper is to review the current literature pertaining to anticoagulation in adults with congenital heart disease and hence enable...

  18. A model for intra-familial distribution of an infectious disease (Chagas' disease

    Directory of Open Access Journals (Sweden)

    M. F. Feitosa

    1993-06-01

    Full Text Available A probabilistic model for intra-familial distribution of infectous disease is proposed and applied to the prevalence of positive serology for Trypanosoma cruzi infection in Northeastern Brazilian sample. This double with one tail excess model fits satisfactorily to the data and its interpretation says that around 51% of these 982 families are free of infection risk; among those that are at risk, 3% have a high risk (0.66, probably due to high domestic infestation of the vector bug; while 97% show a small risk (0.11, probably due to accidental, non-domestic transmission.

  19. Assessment of esophageal dynamics by radionuclide scintigraphy a potential method for early diagnosis of aperistalsis in patients with Chagas disease

    International Nuclear Information System (INIS)

    The esophageal transit time of a sup(99m) Tc labelled test drink (swallow to arrival at the cardia) - TTE - and the time elapsed from swallow to opening of the cardia - TDAC - were assessed by scintigraphy in 40 healthy volunteers (Group I) and in 106 patients with Chagas disease. Sequential images of tracer esophageal transit were obtained by scintigraphy chamber. A time/activity curve in the region of the cardia was obtained by a multichannel analyzer, from which the 2 parameters were calculated. The assessment of TTE and TDAC by scintigraphic technique is proposed as a screening test for early recognition of esophageal motor disorders as well as for follow-up studies after treatment. (M.A.C.)

  20. Anatomia patológica de corações de chagásicos assintomáticos falecidos de modo violento Anatomo-pathology of heart of asymptomatic chagas' patients who had a violent death

    Directory of Open Access Journals (Sweden)

    Edison Reis Lopes

    1981-06-01

    Full Text Available Com finalidade de melhor conhecimento da forma indeterminada da doença de Chagas os autores realizaram estudo anatomopatólogico sistematizado de trinta corações de chagásicos assintomáticos falecidos de modo violento. Demonstram que nos portadores da forma em questão da tripanossomiase cruzi o coração e acometido por lesões da mesma natureza, porém de intensidade muito menor do que as observadas em chagásicos crônicos que falecem subitamente ou após periodo variável de insuficiência cardíaca. Baseados em seus achados e em outros dados da literatura, concluem que a infecção chagásica, sem inflamação do coração, se ocorre, é rara. Tecem ainda considerações a respeito do significado das lesões observadas no sistema nervoso autônomo intracardíaco no sistema de condução e sobre a gênese formal da cardite chagásica crônica humana.With the purpose of better knowledge of the indeterminate form of Chagas's disease the authors carried out a systematized anatomopathological study of thirty hearts from symptomatic chagasics who had a violent death. In this specific form of the trypanosomiasis cruzi the hearts show lesions of the same nature but much less intense as those observed in chronic chagasics who had a sudden death or died after cardiac failure. Based on theses findings and on data from literature, we conclude that chagasic infection without a cardiac inflammatory process, if it occurs, is very rarely only. Also some comments are made upon the meaning of the lesions observed in the intra-cardiac autonomic nervous system, in the conduction system and on the formal origin of the human chronic chagasic carditis.

  1. 2013 update on congenital heart disease, clinical cardiology, heart failure, and heart transplant.

    Science.gov (United States)

    Subirana, M Teresa; Barón-Esquivias, Gonzalo; Manito, Nicolás; Oliver, José M; Ripoll, Tomás; Lambert, Jose Luis; Zunzunegui, José L; Bover, Ramon; García-Pinilla, José Manuel

    2014-03-01

    This article presents the most relevant developments in 2013 in 3 key areas of cardiology: congenital heart disease, clinical cardiology, and heart failure and transplant. Within the area of congenital heart disease, we reviewed contributions related to sudden death in adult congenital heart disease, the importance of specific echocardiographic parameters in assessing the systemic right ventricle, problems in patients with repaired tetralogy of Fallot and indication for pulmonary valve replacement, and confirmation of the role of specific factors in the selection of candidates for Fontan surgery. The most recent publications in clinical cardiology include a study by a European working group on correct diagnostic work-up in cardiomyopathies, studies on the cost-effectiveness of percutaneous aortic valve implantation, a consensus document on the management of type B aortic dissection, and guidelines on aortic valve and ascending aortic disease. The most noteworthy developments in heart failure and transplantation include new American guidelines on heart failure, therapeutic advances in acute heart failure (serelaxin), the management of comorbidities such as iron deficiency, risk assessment using new biomarkers, and advances in ventricular assist devices.

  2. Genetic risk profiles for coronary heart disease

    OpenAIRE

    Tikkanen, Emmi

    2013-01-01

    Coronary heart disease (CHD) is a major burden for public health worldwide. Several factors are known to be associated with the disease risk, including high levels of low-density lipoprotein (LDL) cholesterol and blood pressure. The established risk factors do not, however, fully predict an individual s risk for the disease. In recent years, new candidate risk factors, including genetic markers, have been extensively studied. Genome-wide association studies (GWASs) have mapped over 40 genetic...

  3. Aptamer based, non-PCR, non-serological detection of Chagas disease biomarkers in Trypanosoma cruzi infected mice.

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    Rana Nagarkatti

    Full Text Available Chagas disease affects about 5 million people across the world. The etiological agent, the intracellular parasite Trypanosoma cruzi (T. cruzi, can be diagnosed using microscopy, serology or PCR based assays. However, each of these methods has their limitations regarding sensitivity and specificity, and thus to complement these existing diagnostic methods, alternate assays need to be developed. It is well documented that several parasite proteins called T. cruzi Excreted Secreted Antigens (TESA, are released into the blood of an infected host. These circulating parasite antigens could thus be used as highly specific biomarkers of T. cruzi infection. In this study, we have demonstrated that, using a SELEx based approach, parasite specific ligands called aptamers, can be used to detect TESA in the plasma of T. cruzi infected mice. An Enzyme Linked Aptamer (ELA assay, similar to ELISA, was developed using biotinylated aptamers to demonstrate that these RNA ligands could interact with parasite targets. Aptamer L44 (Apt-L44 showed significant and specific binding to TESA as well as T. cruzi trypomastigote extract and not to host proteins or proteins of Leishmania donovani, a related trypanosomatid parasite. Our result also demonstrated that the target of Apt-L44 is conserved in three different strains of T. cruzi. In mice infected with T. cruzi, Apt-L44 demonstrated a significantly higher level of binding compared to non-infected mice suggesting that it could detect a biomarker of T. cruzi infection. Additionally, Apt-L44 could detect these circulating biomarkers in both the acute phase, from 7 to 28 days post infection, and in the chronic phase, from 55 to 230 days post infection. Our results show that Apt-L44 could thus be used in a qualitative ELA assay to detect biomarkers of Chagas disease.

  4. Determinants of Health Service Responsiveness in Community-Based Vector Surveillance for Chagas Disease in Guatemala, El Salvador, and Honduras.

    Directory of Open Access Journals (Sweden)

    Ken Hashimoto

    Full Text Available Central American countries face a major challenge in the control of Triatoma dimidiata, a widespread vector of Chagas disease that cannot be eliminated. The key to maintaining the risk of transmission of Trypanosoma cruzi at lowest levels is to sustain surveillance throughout endemic areas. Guatemala, El Salvador, and Honduras integrated community-based vector surveillance into local health systems. Community participation was effective in detection of the vector, but some health services had difficulty sustaining their response to reports of vectors from the population. To date, no research has investigated how best to maintain and reinforce health service responsiveness, especially in resource-limited settings.We reviewed surveillance and response records of 12 health centers in Guatemala, El Salvador, and Honduras from 2008 to 2012 and analyzed the data in relation to the volume of reports of vector infestation, local geography, demography, human resources, managerial approach, and results of interviews with health workers. Health service responsiveness was defined as the percentage of households that reported vector infestation for which the local health service provided indoor residual spraying of insecticide or educational advice. Eight potential determinants of responsiveness were evaluated by linear and mixed-effects multi-linear regression. Health service responsiveness (overall 77.4% was significantly associated with quarterly monitoring by departmental health offices. Other potential determinants of responsiveness were not found to be significant, partly because of short- and long-term strategies, such as temporary adjustments in manpower and redistribution of tasks among local participants in the effort.Consistent monitoring within the local health system contributes to sustainability of health service responsiveness in community-based vector surveillance of Chagas disease. Even with limited resources, countries can improve health

  5. Neglect of a Neglected Disease in Italy: The Challenge of Access-to-Care for Chagas Disease in Bergamo Area.

    Directory of Open Access Journals (Sweden)

    Ernestina Carla Repetto

    2015-09-01

    Full Text Available Chagas disease (CD represents a growing problem in Europe; Italy is one of the most affected countries but there is no national framework for CD and access-to-care is challenging. In 2012 Médecins Sans Frontières (MSF started an intervention in Bergamo province, where many people of Latin American origin (PLAO are resident. A new model-of-care for CD, initiated by Centre for Tropical Diseases of Sacro Cuore Hospital, Negrar (CTD, the NGO OIKOS and the Bolivian community since 2009 in the same area, was endorsed. Hereby, we aim to describe the prevalence of CD and the treatment management outcomes among PLAO screened from 1st June 2012 to 30th June 2013.Retrospective cohort study using routine program data. Screening sessions were done in Bergamo at OIKOS outpatient service and serological confirmation, staging and treatment for CD was offered at the CTD. MSF provided health education on CD, awareness generation prior to screening days, pre-test and post-test counselling through cultural mediators of Latin American origin.Of 1305 PLAO screened, 223(17% had CD. Among 210 patients eligible for treatment, 102(49% were lost-to-follow-up before treatment. The median delay from diagnosis to treatment was 4 months (range 0.7-16.6 months. Among 108 started on treatment, 63(58% completed treatment, 36(33% interrupted treatment, (33 for drug side-effects, two for patients decision and one due to pregnancy, 6(6% were lost-to-follow-up and 3(3% were on treatment at study censuring.In this first study focusing on process of care for CD in Italy, less than 30% of patients completed treatment with drop-outs along the cascade of care. There is an urgent need to involve affected communities and local regional health authorities to take part to this model-of-care, adapting it to the local epidemiology. The Italian health authorities should take steps in advocating for a change in the current paradigm.

  6. Virtual Surgery in Congenital Heart Disease

    DEFF Research Database (Denmark)

    Sørensen, Thomas Sangild; Mosegaard, Jesper; Kislinskiy, Stefan;

    2014-01-01

     Teaching, diagnosing, and planning of therapy in patients with complex structural cardiovascular heart disease require profound understanding of the three-dimensional (3D) nature of cardiovascular structures in these patients. To obtain such understanding, modern imaging modalities provide high...... et al., Cardiol Young 13:451–460, 2003). In combination with the availability of virtual models of congenital heart disease (CHD), techniques for computer- based simulation of cardiac interventions have enabled early clinical exploration of the emerging concept of virtual surgery (Sorensen et al...

  7. Genetic research in coronary heart disease.

    Science.gov (United States)

    Motulsky, A G

    1984-01-01

    Coronary heart disease research along genetic lines is difficult. Studies in molecular genetics of apolipoprotein and receptor variability appear most promising in the near future. However, unexpected discoveries and methodology may turn up that may completely change the field. Exclusive concentration on lipid research therefore should be avoided. It is likely that most advances will come from carefully designed studies that ask specific questions. Such research design is appropriate not only for laboratory studies but also for clinical and epidemiological investigations. The collaboration of clinicians, biochemists, geneticists, epidemiologists, and statisticians is likely to lead to better understanding of coronary heart disease.

  8. A genetic marker for rheumatic heart disease.

    OpenAIRE

    Rajapakse, C N; Halim, K; Al-Orainey, I; Al-Nozha, M; al-Aska, A K

    1987-01-01

    The frequency of antigen types (A, B, C, and DR) in an unselected group of 25 patients with chronic rheumatic heart disease and an unselected group of 15 patients with acute rheumatic fever was compared with that in a group of 100 healthy volunteers. All patients and controls were Arabs of Saudi origin. Only the frequency of HLA-DR4 was significantly different in the controls and the patient groups--controls 12%, chronic rheumatic heart disease 72%, acute rheumatic fever 53%, both patient gro...

  9. Problems and perspectives for Chagas disease control: in search of a realistic analysis Problemas e perspectivas para o controle da doença de Chagas: a busca de uma análise realística

    Directory of Open Access Journals (Sweden)

    João Carlos Pinto Dias

    2008-04-01

    Full Text Available Chagas disease was an important medical and social problem in almost all of Latin America throughout the twentieth century. It has been combated over a broad swath of this continent over recent decades, with very satisfactory results in terms of vector and transfusional transmission. Today, a surveillance stage still remains to be consolidated, in parallel with appropriate care required for some millions of infected individuals who are today living in endemic and non-endemic areas. Contradictorily, the good results attained have generated excessive optimism and even disregard among health authorities, in relation to this disease and its control. The loss of visibility and priority may be a logical consequence, particularly in Latin American healthcare systems that are still disorganized and overburdened due to insufficiencies of financial and human resources. Consolidation of the victories against Chagas disease is attainable but depends on political will and continual attention from the most consequential protagonists in this struggle, especially the Latin American scientific community.Constituindo um importante problema medico e social de quase toda a América Latina por todo o século XX, a doença de Chagas tem sido combatida em ampla extensão do Continente nas últimas décadas, logrando-se resultados muito satisfatórios em termos de sua transmissão vetorial e transfusional. Atualmente há ainda uma etapa de vigilância a ser consolidada, em paralelo com a atenção adequada e necessária para alguns milhões de infectados que hoje vivem em áreas endêmicas e não endêmicas. Contraditoriamente, os logros alcançados têm gerado excesso de otimismo e mesmo descaso para com a doença e seu controle entre autoridades sanitárias. A perda de visibilidade e prioridade pode ser uma conseqüência lógica, principalmente nos sistemas de saúde latino americanos, ainda desarticulados e assoberbados por poucos recursos financeiros e humanos. A

  10. 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

  11. The renin–angiotensin–aldosterone-system and right heart failure in congenital heart disease

    OpenAIRE

    Stine Andersen; Asger Andersen; Jens Erik Nielsen-Kudsk

    2016-01-01

    Adults with congenital heart disease represent a rapidly growing patient group. Dysfunction of the right ventricle is often present, and right heart failure constitutes the main cause of death. Heart failure therapies used in acquired left heart failure are often initiated in adults with right heart failure due to congenital heart disease, but the right ventricle differs substantially from the left ventricle, and the clinical evidence for this treatment strategy is lacking. In this review,...

  12. Antioxidant vitamins and coronary heart disease risk

    DEFF Research Database (Denmark)

    Knekt, Paul; Ritz, John; Pereira, Mark A;

    2004-01-01

    BACKGROUND: Epidemiologic studies have suggested a lower risk of coronary heart disease (CHD) at higher intakes of fruit, vegetables, and whole grain. Whether this association is due to antioxidant vitamins or some other factors remains unclear. OBJECTIVE: We studied the relation between the intake...

  13. Remnant cholesterol and ischemic heart disease

    DEFF Research Database (Denmark)

    Varbo, Anette; Nordestgaard, Børge G

    2014-01-01

    PURPOSE OF REVIEW: To review recent advances in the field of remnant cholesterol as a contributor to the development of ischemic heart disease (IHD). RECENT FINDINGS: Epidemiologic, mechanistic, and genetic studies all support a role for elevated remnant cholesterol (=cholesterol in triglyceride...

  14. The Counselor and Coronary Heart Disease

    Science.gov (United States)

    Ottens, Allen J.

    1977-01-01

    It is clear that steps can be taken for heart disease prevention and that counselors must give thought to adapting existing ideas and techniques and to developing and experimenting with new and innovative preventive tactics. Of utmost importance is the belief that behavioral intervention is both warranted and worthwhile. (Author)

  15. Pneumonia lipoídica associada à forma digestiva da doença de Chagas Digestive Chagas disease with concomitant lipoid pneumonia

    OpenAIRE

    Marcelo Fernando Ranzani; Nilson Sebastião Miranda; Ulisses Frederigue Junior; Sérgio Marrone Ribeiro; Jussara Marcondes Machado

    2004-01-01

    Mulher de 50 anos com megaesôfago e megacólon chagásico apresentou quadro clínico de tosse seca, dor torácica e dispnéia leves. O raio X de tórax mostrou opacidade do tipo alveolar bilateral sugestivo de pneumonia. Após biópsia a céu aberto chegou-se ao diagnóstico de pneumonia lipoídica. A doença foi causada pelo uso crônico de laxantes à base de óleo mineral, utilizados nos últimos três anos. Os autores discutem a associação da forma digestiva da doença de Chagas com pneumonia lipoídica, e ...

  16. The impact of climate change on the geographical distribution of two vectors of Chagas disease: implications for the force of infection.

    Science.gov (United States)

    Medone, Paula; Ceccarelli, Soledad; Parham, Paul E; Figuera, Andreína; Rabinovich, Jorge E

    2015-04-01

    Chagas disease, caused by the parasite Trypanosoma cruzi, is the most important vector-borne disease in Latin America. The vectors are insects belonging to the Triatominae (Hemiptera, Reduviidae), and are widely distributed in the Americas. Here, we assess the implications of climatic projections for 2050 on the geographical footprint of two of the main Chagas disease vectors: Rhodnius prolixus (tropical species) and Triatoma infestans (temperate species). We estimated the epidemiological implications of current to future transitions in the climatic niche in terms of changes in the force of infection (FOI) on the rural population of two countries: Venezuela (tropical) and Argentina (temperate). The climatic projections for 2050 showed heterogeneous impact on the climatic niches of both vector species, with a decreasing trend of suitability of areas that are currently at high-to-moderate transmission risk. Consequently, climatic projections affected differently the FOI for Chagas disease in Venezuela and Argentina. Despite the heterogeneous results, our main conclusions point out a decreasing trend in the number of new cases of Tr. cruzi human infections per year between current and future conditions using a climatic niche approach. PMID:25688019

  17. Multimodality Imaging of Heart Valve Disease

    Energy Technology Data Exchange (ETDEWEB)

    Rajani, Ronak, E-mail: Dr.R.Rajani@gmail.com [Department of Cardiology, St. Thomas’ Hospital, London (United Kingdom); Khattar, Rajdeep [Department of Cardiology, Royal Brompton Hospital, London (United Kingdom); Chiribiri, Amedeo [Divisions of Imaging Sciences, The Rayne Institute, St. Thomas' Hospital, London (United Kingdom); Victor, Kelly; Chambers, John [Department of Cardiology, St. Thomas’ Hospital, London (United Kingdom)

    2014-09-15

    Unidentified heart valve disease is associated with a significant morbidity and mortality. It has therefore become important to accurately identify, assess and monitor patients with this condition in order that appropriate and timely intervention can occur. Although echocardiography has emerged as the predominant imaging modality for this purpose, recent advances in cardiac magnetic resonance and cardiac computed tomography indicate that they may have an important contribution to make. The current review describes the assessment of regurgitant and stenotic heart valves by multimodality imaging (echocardiography, cardiac computed tomography and cardiac magnetic resonance) and discusses their relative strengths and weaknesses.

  18. Pharmacogenomics of hypertension and heart disease.

    Science.gov (United States)

    Arwood, Meghan J; Cavallari, Larisa H; Duarte, Julio D

    2015-09-01

    Heart disease is a leading cause of death in the United States, and hypertension is a predominant risk factor. Thus, effective blood pressure control is important to prevent adverse sequelae of hypertension, including heart failure, coronary artery disease, atrial fibrillation, and ischemic stroke. Over half of Americans have uncontrolled blood pressure, which may in part be explained by interpatient variability in drug response secondary to genetic polymorphism. As such, pharmacogenetic testing may be a supplementary tool to guide treatment. This review highlights the pharmacogenetics of antihypertensive response and response to drugs that treat adverse hypertension-related sequelae, particularly coronary artery disease and atrial fibrillation. While pharmacogenetic evidence may be more robust for the latter with respect to clinical implementation, there is increasing evidence of genetic variants that may help predict antihypertensive response. However, additional research and validation are needed before clinical implementation guidelines for antihypertensive therapy can become a reality.

  19. CDC Vital Signs: Preventable Deaths from Heart Disease and Stroke

    Science.gov (United States)

    ... Read the MMWR Science Clips Preventable Deaths from Heart Disease & Stroke Improving care can save more lives Recommend ... death among all ages. Problem Many deaths from heart disease and stroke can be prevented. What do we ...

  20. "Keep the Beat": Healthy Blood Pressure Helps Prevent Heart Disease

    Science.gov (United States)

    ... Keep the Beat": Healthy Blood Pressure Helps Prevent Heart Disease Past Issues / Winter 2010 Table of Contents Your ... a condition that also increases the chance of heart disease and stroke. High blood pressure is especially common ...

  1. Women's Heart Disease: Cindy Parsons and Follow the Fifty

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Cindy Parsons and Follow the Fifty Past Issues / ... Program, knowing that her personal risk factors for heart disease, including family history, were high. She watched her ...

  2. The changing state of surgery for adult congenital heart disease

    OpenAIRE

    Monro, J

    2005-01-01

    The number of patients with adult congenital heart disease is expected to increase by 25% during this decade, so that by 2010 there will be more patients undergoing surgery for congenital heart disease over 16 years of age than under

  3. Phase-contrast MRI and applications in congenital heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Goldberg, A., E-mail: adgoldberg@geisinger.edu [Department of Radiology, Geisinger Health System, Danville, PA (United States); Jha, S. [Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA (United States)

    2012-05-15

    A review of phase-contrast magnetic resonance imaging techniques, with specific application to congenital heart disease, is presented. Theory, pitfalls, advantages, and specific examples of multiple, well-described congenital heart disease presentations are discussed.

  4. The educational gradient in coronary heart disease

    DEFF Research Database (Denmark)

    Ariansen, Inger; Mortensen, Laust Hvas; Igland, Jannicke;

    2015-01-01

    BACKGROUND: Independently of cardiovascular disease (CVD) risk factors, cognitive ability may account for some of the excess risk of coronary heart disease (CHD) associated with lower education. We aimed to assess how late adolescence cognitive ability and midlife CVD risk factors are associated...... with the educational gradient in CHD in Norway. METHODS: In a cohort of 57 279 men born during 1949-1959, health survey information was linked to military conscription records of cognitive ability, to national educational data, to hospitalisation records from the Cardiovascular Disease in Norway (CVDNOR) project...

  5. Defective production of interleukin 2 in patients with Chagas' disease: purified IL-2 augments in vitro response in patients with chagasic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Luis Briceno

    1996-10-01

    Full Text Available The production of interleukin 2 (IL-2 by peripheral blood mononuclear cells, from patients with different clinical forms of Chagas disease and healthy controls, was evaluated after stimulation with Trypanosoma cruzi antigen, PPD and PHA. PHA induced higher production of IL-2 in infected patients than healthy controls. No diferences were found between infected groups. With PPD the trend was similar, the only difference was that asymptomatic infected patients (INF showed higher levels of IL-2 production than patients with cardiomyopathy (CDM. With T. cruzi antigen, most patients showed little or no IL-2 production at 24 hr, a peak at 48 hr and an abrupt fall at 72 hr. A similar pattern of IL- 2 production was observed in INF and CDM. To evaluate the physiologic relevance of the deficit in IL-2 production, we studied the effect of non-mitogenic concentratios of IL-2 in the proliferative response to specific antigens. The addition of IL-2 only enhanced the proliferative response of CDM patients. These observations suggest that patients suffering Chagas' disease, particularly CDM, have a significant reduction in the capacity to produce IL-2. These findings could be of importance in the pathogenesis of Chagas' disease.

  6. Contemporary treatment of amyloid heart disease.

    Science.gov (United States)

    Palecek, Tomas; Fikrle, Michal; Nemecek, Eduard; Bauerova, Lenka; Kuchynka, Petr; Louch, William E; Spicka, Ivan; Rysava, Romana

    2015-01-01

    The amyloidoses represent a group of diseases characterized by extracellular deposition of abnormal protein, amyloid, which is formed by insoluble extracellular fibrils in β-pleated sheets. Although cardiac involvement may occur in all types of amyloidoses, clinically relevant amyloid cardiomyopathy is a typical feature of AL amyloidosis and transthyretin-related amyloidoses. Congestive heart failure represents the commonest manifestation of amyloid heart disease. Noninvasive imaging techniques, especially echocardiography and cardiac magnetic resonance, play a major role in the diagnosis of amyloid cardiomyopathy; however, histological confirmation and exact typing of amyloid deposits is necessary whether in extracardiac location or directly in the myocardium. Early diagnosis of amyloid heart disease is of utmost importance as the presence and especially the severity of cardiac involvement generally drives the prognosis of affected subjects and plays a major role in determining the intensity of specific treatment, namely in AL amyloidosis. The management of patients with amyloid heart disease is complex. Loop diuretics together with aldosterone antagonists represent the basis for influencing signs of congestion. In AL amyloidosis, high-dose chemotherapy followed by autologous stem cell transplantation is generally considered to be a front-line treatment option, if the disease is diagnosed at its early stage. The combination of mephalan with dexamethasone has been the standard therapy for severely affected individuals; however, the combinations with several novel agents including immunomodulatory drugs and bortezomibe have been tested in clinical trials with promising results. New therapeutic substances with the potential to slow or even stop the progression of transthyretin-related amyloidosis are also extensively studied. PMID:25483951

  7. A Family Cluster of Chagas Disease Detected through Selective Screening of Blood Donors: A Case Report and Brief Review

    Directory of Open Access Journals (Sweden)

    Guillaume Mongeau-Martin

    2015-01-01

    Full Text Available Chagas disease (CD is a protozoan infection caused by Trypanosoma cruzi, which is transmitted by triatomine insect vectors in parts of Latin America. In a nonendemic country, such as Canada, spread can still occur via vertical transmission, and infected blood or organ donations. The Canadian Blood Services and Héma-Québec have both implemented selective screening of blood donors for CD based on risk factors. In 2011, Héma-Québec identified two seropositive ‘at-risk’ Chilean siblings who had donated blood in Montreal, Quebec. They were referred to the JD MacLean Centre for Tropical Diseases (Montreal, Quebec for confirmatory testing (T cruzi excreted-secreted antigen ELISA, polymerase chain reaction and/or radioimmunoprecipitation assay and follow-up. Screening of the rest of the family revealed two other seropositive family members (the mother and sister. While their geographical history in Chile suggests vectorial transmission, this family cluster of CD raises the possibility of vertical transmission. Congenital infection should always be considered among CD-positive mothers and pregnant women. With blood donor screening, Canadian physicians will increasingly see patients with CD and should know how to manage them appropriately. In addition to the case presentation, the authors review the transmission, screening and clinical management of CD in a nonendemic context.

  8. A family cluster of Chagas disease detected through selective screening of blood donors: A case report and brief review.

    Science.gov (United States)

    Mongeau-Martin, Guillaume; Ndao, Momar; Libman, Michael; Delage, Gilles; Ward, Brian J

    2015-01-01

    Chagas disease (CD) is a protozoan infection caused by Trypanosoma cruzi, which is transmitted by triatomine insect vectors in parts of Latin America. In a nonendemic country, such as Canada, spread can still occur via vertical transmission, and infected blood or organ donations. The Canadian Blood Services and Héma-Québec have both implemented selective screening of blood donors for CD based on risk factors. In 2011, Héma-Québec identified two seropositive 'at-risk' Chilean siblings who had donated blood in Montreal, Quebec. They were referred to the JD MacLean Centre for Tropical Diseases (Montreal, Quebec) for confirmatory testing (T cruzi excreted-secreted antigen ELISA, polymerase chain reaction and/or radioimmunoprecipitation assay) and follow-up. Screening of the rest of the family revealed two other seropositive family members (the mother and sister). While their geographical history in Chile suggests vectorial transmission, this family cluster of CD raises the possibility of vertical transmission. Congenital infection should always be considered among CD-positive mothers and pregnant women. With blood donor screening, Canadian physicians will increasingly see patients with CD and should know how to manage them appropriately. In addition to the case presentation, the authors review the transmission, screening and clinical management of CD in a nonendemic context. PMID:26236358

  9. Effectiveness of Large-Scale Chagas Disease Vector Control Program in Nicaragua by Residual Insecticide Spraying Against Triatoma dimidiata.

    Science.gov (United States)

    Yoshioka, Kota; Nakamura, Jiro; Pérez, Byron; Tercero, Doribel; Pérez, Lenin; Tabaru, Yuichiro

    2015-12-01

    Chagas disease is one of the most serious health problems in Latin America. Because the disease is transmitted mainly by triatomine vectors, a three-phase vector control strategy was used to reduce its vector-borne transmission. In Nicaragua, we implemented an indoor insecticide spraying program in five northern departments to reduce house infestation by Triatoma dimidiata. The spraying program was performed in two rounds. After each round, we conducted entomological evaluation to compare the vector infestation level before and after spraying. A total of 66,200 and 44,683 houses were sprayed in the first and second spraying rounds, respectively. The entomological evaluation showed that the proportion of houses infested by T. dimidiata was reduced from 17.0% to 3.0% after the first spraying, which was statistically significant (P < 0.0001). However, the second spraying round did not demonstrate clear effectiveness. Space-time analysis revealed that reinfestation of T. dimidiata is more likely to occur in clusters where the pre-spray infestation level is high. Here we discuss how large-scale insecticide spraying is neither effective nor affordable when T. dimidiata is widely distributed at low infestation levels. Further challenges involve research on T. dimidiata reinfestation, diversification of vector control strategies, and implementation of sustainable vector surveillance. PMID:26416118

  10. Potential for entomopathogenic fungi to control Triatoma dimidiata (Hemiptera: Reduviidae, a vector of Chagas disease in Mexico

    Directory of Open Access Journals (Sweden)

    María Guadalupe Vázquez-Martínez

    2014-12-01

    Full Text Available Introduction The use of entomopathogenic fungi to control disease vectors has become relevant because traditional chemical control methods have caused damage to the environment and led to the development of resistance among vectors. Thus, this study assessed the pathogenicity of entomopathogenic fungi in Triatoma dimidiata. Methods Preparations of 108 conidia/ml of Gliocladium virens, Talaromyces flavus, Beauveria bassiana and Metarhizium anisopliae were applied topically on T. dimidiata nymphs and adults. Controls were treated with the 0.0001% Tween-80 vehicle. Mortality was evaluated and recorded daily for 30 days. The concentration required to kill 50% of T. dimidiata (LC50 was then calculated for the most pathogenic isolate. Results Pathogenicity in adults was similar among B. bassiana, G. virens and T. flavus (p>0.05 and differed from that in triatomine nymphs (p=0.009. The most entomopathogenic strains in adult triatomines were B. bassiana and G. virens, which both caused 100% mortality. In nymphs, the most entomopathogenic strain was B. bassiana, followed by G. virens. The native strain with the highest pathogenicity was G. virens, for which the LC50 for T. dimidiata nymphs was 1.98 x108 conidia/ml at 13 days after inoculation. Conclusions Beauveria bassiana and G. virens showed entomopathogenic potential in T. dimidiata nymphs and adults. However, the native G. virens strain presents a higher probability of success in the field, and G. virens should thus be considered a potential candidate for the biological control of triatomine Chagas disease vectors.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Reorganization of Extracellular Matrix in Placentas from Women with Asymptomatic Chagas Disease: Mechanism of Parasite Invasion or Local Placental Defense?

    Directory of Open Access Journals (Sweden)

    Juan Duaso

    2012-01-01

    Full Text Available Chagas disease, produced by the protozoan Trypanosoma cruzi (T. cruzi, is one of the most frequent endemic diseases in Latin America. In spite the fact that in the past few years T. cruzi congenital transmission has become of epidemiological importance, studies about this mechanism of infection are scarce. In order to explore some morphological aspects of this infection in the placenta, we analyzed placentas from T. cruzi-infected mothers by immunohistochemical and histochemical methods. Infection in mothers, newborns, and placentas was confirmed by PCR and by immunofluorescence in the placenta. T. cruzi-infected placentas present destruction of the syncytiotrophoblast and villous stroma, selective disorganization of the basal lamina, and disorganization of collagen I in villous stroma. Our results suggest that the parasite induces reorganization of this tissue component and in this way may regulate both inflammatory and immune responses in the host. Changes in the ECM of placental tissues, together with the immunological status of mother and fetus, and parasite load may determine the probability of congenital transmission of T. cruzi.

  13. Search for a platelet-activating factor receptor in the Trypanosoma cruzi proteome: a potential target for Chagas disease chemotherapy

    Directory of Open Access Journals (Sweden)

    Daniel Fábio Kawano

    2011-12-01

    Full Text Available Chagas disease (CD causes the highest burden of parasitic diseases in the Western Hemisphere and is therefore a priority for drug research and development. Platelet-activating factor (PAF causes the CD parasite Trypanosoma cruzi to differentiate, which suggests that the parasite may express PAF receptors. Here, we explored the T. cruzi proteome for PAF receptor-like proteins. From a total of 23,000 protein sequences, we identified 29 hypothetical proteins that are predicted to have seven transmembrane domains (TMDs, which is the main characteristic of the G protein-coupled receptors (GPCRs, including the PAF receptor. The TMDs of these sequences were independently aligned with domains from 25 animal PAF receptors and the sequences were analysed for conserved residues. The conservation score mean values for the TMDs of the hypothetical proteins ranged from 31.7-44.1%, which suggests that if the putative T. cruzi PAF receptor is among the sequences identified, the TMDs are not highly conserved. These results suggest that T. cruzi contains several GPCR-like proteins and that one of these GPCRs may be a PAF receptor. Future studies may further validate the PAF receptor as a target for CD chemotherapy.

  14. Additional data on the epidemiology of chagas disease in the municipality of Caxias, Rio de Janeiro state, Brazil

    Directory of Open Access Journals (Sweden)

    J. Rodrigues Coura

    1975-04-01

    Full Text Available An area believed to be an autochthonous focus for Chagas' disease was investigated in the municipality of Caxias, Rio de Janeiro State. The study included search for domestic triatomine bugs, serological test (IFT and CFT in persons in whose house infested bugs were discovered, detailed clinicai examination and xenodiagnosis test of ali serologicall/ yy positive persons, and xenodiagnosis test on dogs from households in which infected triatomine bugs have been found. Only in one of the locatities (Piranema domestic Triatoma infestans have been discovered. some of which were infected with T. cruzi. A small number of persons (mostly children had a positive serologicál test for Chagas’ disease, but in all of them the infection was clinically asymptomatic. From two dogs, belonging to a household in which serologically positive children and infected T. infestans were discovered, T. cruzi was isolated by xenodiagnosis. The importunt epidemiological information obtained from this investigation was the discovery of domestic adaptation of T. infestans in an area with dense population .and with very low social and sanitary conditions, in a locality considered as non-endemic for the infection.

  15. Development of a Comprehensive Heart Disease Knowledge Questionnaire

    Science.gov (United States)

    Bergman, Hannah E.; Reeve, Bryce B.; Moser, Richard P.; Scholl, Sarah; Klein, William M. P.

    2011-01-01

    Background: Heart disease is the number one killer of both men and women in the United States, yet a comprehensive and evidence-based heart disease knowledge assessment is currently not available. Purpose: This paper describes the two-phase development of a novel heart disease knowledge questionnaire. Methods: After review and critique of the…

  16. Psychological Perspectives on the Development of Coronary Heart Disease

    Science.gov (United States)

    Matthews, Karen A.

    2005-01-01

    Psychological science has new opportunities to have major input into the understanding of the development of coronary heart disease. This article provides an overview of advances in understanding the etiology of heart disease, recently applied technologies for measuring early stages of heart disease, and an accumulating base of evidence on the…

  17. Phylogeographic Pattern and Extensive Mitochondrial DNA Divergence Disclose a Species Complex within the Chagas Disease Vector Triatoma dimidiata

    Science.gov (United States)

    Monteiro, Fernando A.; Peretolchina, Tatiana; Lazoski, Cristiano; Harris, Kecia; Dotson, Ellen M.; Abad-Franch, Fernando; Tamayo, Elsa; Pennington, Pamela M.; Monroy, Carlota; Cordon-Rosales, Celia; Salazar-Schettino, Paz Maria; Gómez-Palacio, Andrés; Grijalva, Mario J.; Beard, Charles B.; Marcet, Paula L.

    2013-01-01

    Background Triatoma dimidiata is among the main vectors of Chagas disease in Latin America. However, and despite important advances, there is no consensus about the taxonomic status of phenotypically divergent T. dimidiata populations, which in most recent papers are regarded as subspecies. Methodology and Findings A total of 126 cyt b sequences (621 bp long) were produced for specimens from across the species range. Forty-seven selected specimens representing the main cyt b clades observed (after a preliminary phylogenetic analysis) were also sequenced for an ND4 fragment (554 bp long) and concatenated with their respective cyt b sequences to produce a combined data set totalling 1175 bp/individual. Bayesian and Maximum-Likelihood phylogenetic analyses of both data sets (cyt b, and cyt b+ND4) disclosed four strongly divergent (all pairwise Kimura 2-parameter distances >0.08), monophyletic groups: Group I occurs from Southern Mexico through Central America into Colombia, with Ecuadorian specimens resembling Nicaraguan material; Group II includes samples from Western-Southwestern Mexico; Group III comprises specimens from the Yucatán peninsula; and Group IV consists of sylvatic samples from Belize. The closely-related, yet formally recognized species T. hegneri from the island of Cozumel falls within the divergence range of the T. dimidiata populations studied. Conclusions We propose that Groups I–IV, as well as T. hegneri, should be regarded as separate species. In the Petén of Guatemala, representatives of Groups I, II, and III occur in sympatry; the absence of haplotypes with intermediate genetic distances, as shown by multimodal mismatch distribution plots, clearly indicates that reproductive barriers actively promote within-group cohesion. Some sylvatic specimens from Belize belong to a different species – likely the basal lineage of the T. dimidiata complex, originated ∼8.25 Mya. The evidence presented here strongly supports the proposition that T

  18. Phylogeographic pattern and extensive mitochondrial DNA divergence disclose a species complex within the Chagas disease vector Triatoma dimidiata.

    Directory of Open Access Journals (Sweden)

    Fernando A Monteiro

    Full Text Available BACKGROUND: Triatoma dimidiata is among the main vectors of Chagas disease in Latin America. However, and despite important advances, there is no consensus about the taxonomic status of phenotypically divergent T. dimidiata populations, which in most recent papers are regarded as subspecies. METHODOLOGY AND FINDINGS: A total of 126 cyt b sequences (621 bp long were produced for specimens from across the species range. Forty-seven selected specimens representing the main cyt b clades observed (after a preliminary phylogenetic analysis were also sequenced for an ND4 fragment (554 bp long and concatenated with their respective cyt b sequences to produce a combined data set totalling 1175 bp/individual. Bayesian and Maximum-Likelihood phylogenetic analyses of both data sets (cyt b, and cyt b+ND4 disclosed four strongly divergent (all pairwise Kimura 2-parameter distances >0.08, monophyletic groups: Group I occurs from Southern Mexico through Central America into Colombia, with Ecuadorian specimens resembling Nicaraguan material; Group II includes samples from Western-Southwestern Mexico; Group III comprises specimens from the Yucatán peninsula; and Group IV consists of sylvatic samples from Belize. The closely-related, yet formally recognized species T. hegneri from the island of Cozumel falls within the divergence range of the T. dimidiata populations studied. CONCLUSIONS: We propose that Groups I-IV, as well as T. hegneri, should be regarded as separate species. In the Petén of Guatemala, representatives of Groups I, II, and III occur in sympatry; the absence of haplotypes with intermediate genetic distances, as shown by multimodal mismatch distribution plots, clearly indicates that reproductive barriers actively promote within-group cohesion. Some sylvatic specimens from Belize belong to a different species - likely the basal lineage of the T. dimidiata complex, originated ~8.25 Mya. The evidence presented here strongly supports the proposition

  19. Reações adversas em pacientes com doença de Chagas tratados com benzonidazol, no Estado do Ceará Adverse reactions in Chagas disease patients treated with benznidazole, in the State of Ceará

    Directory of Open Access Journals (Sweden)

    Vânia Maria Oliveira de Pontes

    2010-04-01

    Full Text Available INTRODUÇÃO: A doença de Chagas, causada pelo Trypanosoma cruzi, é tratada com benzonidazol, tendo o inconveniente de apresentar efetividade parcial e alta toxicidade, que varia desde reações de hipersensibilidade a aplasia medular. O objetivo foi descrever e avaliar a ocorrência de reações adversas em pacientes chagásicos em tratamento com benzonidazol em Fortaleza, Ceará. MÉTODOS: Estudo descritivo prospectivo envolvendo 32 pacientes chagásicos crônicos tratados com benzonidazol entre janeiro de 2005 e abril de 2006. Dados sociodemográficos e clínicos foram coletados de questionários, entrevistas e exames laboratoriais. As amostras de sangue foram coletadas antes, com 30 e 60 dias de tratamento. RESULTADOS: Reações adversas foram relatadas em 28 (87,5% pacientes tratados, tendo sido as mais frequentes: prurido (50%, formigamento (43,8%, fraqueza muscular (37,5% e rash cutânea (31,3%. Dos 28 pacientes com reações adversas, oito (28,57% interromperam o tratamento. Reações adversas que culminaram com a suspensão do tratamento foram formigamento sete (87,5% ou erupção cutânea cinco (62,5%. Observou-se aumento discreto dos níveis de aminotransferases durante o tratamento em (9,4% pacientes. CONCLUSÕES: Concluindo, o acompanhamento farmacoterapêutico dos pacientes chagásicos é de grande relevância na prevenção e detecção precoce das reações adversas a medicamentos.INTRODUCTION: Chagas disease is caused by Trypanosoma cruzi and treated with benznidazole (BNZ. This drug has the troublesome features of presenting partial effectiveness and high toxicity ranging from hypersensitivity reactions to medullary aplasia. The objective here was to describe and evaluate the occurrence of adverse reactions in Chagas disease patients treated with benznidazole in Fortaleza, Ceará. METHODS: This was a prospective descriptive study involving 32 chronic Chagas patients treated with benznidazole between January 2005 and April

  20. 10.7.Congenital heart disease

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930270 Clinical analysis of rupture of aorticsinus aneurysm in 30 cases.ZHANG Yuwei (张玉威),et al.Instit Cardiovasc Dis,Dept Med,Shenyang Milit General Hosp,PLA.Chin Cir J1993;8(1):30—31.Rupture of aortic sinus aneurysm is a rarecongenital heart disease.It is sometimes misdi-agnosed and treated because of no typical symp-toms and signs.30 cases with rupture of a-neurysm of aortic sinus were studied.Clinicaldata suggested that the disease could be firstlynoticed when the healthy male aged 20~40years developed suddenly chest pain or extreme-ly uncomfortable feeling with gradually increas-ing heart dysfunction low—frequency harsh andsuperficial continuous precordial murmurs.Chest X-ray exhibited enlargement of heartand asymmetry of pulmonary plethora.ECG