Chagas disease, a risk factor for high blood pressure.

Science.gov (United States)

Vicco, Miguel Hernán; Rodeles, Luz; Yódice, Agustina; Marcipar, Iván

2014-12-01

Chagas disease is a parasite infection caused by the protozoan Trypanosoma cruzi. Its most common complications is chronic Chagas heart disease but impairments of the systemic vasculature also has been observed. Although the different mechanisms that regulate blood pressure are disrupted, to our knowledge data on the association of hypertension and chronic Chagas disease are scarce. In this regard we evaluate whether Chagas disease constitutes a high blood pressure risk factor. We recruited 200 individuals, half of them with positive serology for T. cruzi. They were subjected to a complete clinical examination. The mean age of sampled individuals was 46.7 ± 12.3, and the mean of systolic and diastolic blood pressure were 124 ± 12 mmHg and 82 ± 10 mmHg, respectively. There were no between-group differences regarding age, sex distribution or body mass index. Chagas disease contributed significantly to high blood pressure (OR = 4, 95% CI 1.8323-7.0864, p = 0.0002). Our results reveal an important association between Chagas disease and high blood pressure, which should be contemplated by physicians in order to promote preventive cardiovascular actions in patients with Chagas disease.

A Multi-disciplinary Overview of Chagas in Periurban Peru

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Sarah McCune

2010-04-01

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

How universal is coverage and access to diagnosis and treatment for Chagas disease in Colombia? A health systems analysis.

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Cucunubá, Zulma M; Manne-Goehler, Jennifer M; Díaz, Diana; Nouvellet, Pierre; Bernal, Oscar; Marchiol, Andrea; Basáñez, María-Gloria; Conteh, Lesong

2017-02-01

Limited access to Chagas disease diagnosis and treatment is a major obstacle to reaching the 2020 World Health Organization milestones of delivering care to all infected and ill patients. Colombia has been identified as a health system in transition, reporting one of the highest levels of health insurance coverage in Latin America. We explore if and how this high level of coverage extends to those with Chagas disease, a traditionally marginalised population. Using a mixed methods approach, we calculate coverage for screening, diagnosis and treatment of Chagas. We then identify supply-side constraints both quantitatively and qualitatively. A review of official registries of tests and treatments for Chagas disease delivered between 2008 and 2014 is compared to estimates of infected people. Using the Flagship Framework, we explore barriers limiting access to care. Screening coverage is estimated at 1.2% of the population at risk. Aetiological treatment with either benznidazol or nifurtimox covered 0.3-0.4% of the infected population. Barriers to accessing screening, diagnosis and treatment are identified for each of the Flagship Framework's five dimensions of interest: financing, payment, regulation, organization and persuasion. The main challenges identified were: a lack of clarity in terms of financial responsibilities in a segmented health system, claims of limited resources for undertaking activities particularly in primary care, non-inclusion of confirmatory test(s) in the basic package of diagnosis and care, poor logistics in the distribution and supply chain of medicines, and lack of awareness of medical personnel. Very low screening coverage emerges as a key obstacle hindering access to care for Chagas disease. Findings suggest serious shortcomings in this health system for Chagas disease, despite the success of universal health insurance scale-up in Colombia. Whether these shortcomings exist in relation to other neglected tropical diseases needs investigating

Evaluation of strategies to communicate harmful and potentially harmful constituent (HPHC) information through cigarette package inserts: a discrete choice experiment.

Science.gov (United States)

Salloum, Ramzi G; Louviere, Jordan J; Getz, Kayla R; Islam, Farahnaz; Anshari, Dien; Cho, Yoojin; O'Connor, Richard J; Hammond, David; Thrasher, James F

2017-07-13

The US Food and Drug Administration (FDA) has regulatory authority to use inserts to communicate with consumers about harmful and potentially harmful constituents (HPHCs) in tobacco products; however, little is known about the most effective manner for presenting HPHC information. In a discrete choice experiment, participants evaluated eight choice sets, each of which showed two cigarette packages from four different brands and tar levels (high vs low), accompanied by an insert that included between-subject manipulations (ie, listing of HPHCs vs grouping by disease outcome and numeric values ascribed to HPHCs vs no numbers) and within-subject manipulations (ie, 1 of 4 warning topics; statement linking an HPHC with disease vs statement with no HPHC link). For each choice set, participants were asked: (1) which package is more harmful and (2) which motivates them to not smoke; each with a 'no difference' option. Alternative-specific logit models regressed choice on attribute levels. 1212 participants were recruited from an online consumer panel (725 18-29-year-old smokers and susceptible non-smokers and 487 30-64-year-old smokers). Participants were more likely to endorse high-tar products as more harmful than low-tar products, with a greater effect when numeric HPHC information was present. Compared with a simple warning statement, the statement linking HPHCs with disease encouraged quit motivation. Numeric HPHC information on inserts appears to produce misunderstandings that some cigarettes are less harmful than others. Furthermore, brief narratives that link HPHCs to smoking-related disease may promote cessation versus communications that do not explicitly link HPHCs to disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Watermarking spot colors in packaging

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Reed, Alastair; Filler, TomáÅ.¡; Falkenstern, Kristyn; Bai, Yang

2015-03-01

In January 2014, Digimarc announced Digimarc® Barcode for the packaging industry to improve the check-out efficiency and customer experience for retailers. Digimarc Barcode is a machine readable code that carries the same information as a traditional Universal Product Code (UPC) and is introduced by adding a robust digital watermark to the package design. It is imperceptible to the human eye but can be read by a modern barcode scanner at the Point of Sale (POS) station. Compared to a traditional linear barcode, Digimarc Barcode covers the whole package with minimal impact on the graphic design. This significantly improves the Items per Minute (IPM) metric, which retailers use to track the checkout efficiency since it closely relates to their profitability. Increasing IPM by a few percent could lead to potential savings of millions of dollars for retailers, giving them a strong incentive to add the Digimarc Barcode to their packages. Testing performed by Digimarc showed increases in IPM of at least 33% using the Digimarc Barcode, compared to using a traditional barcode. A method of watermarking print ready image data used in the commercial packaging industry is described. A significant proportion of packages are printed using spot colors, therefore spot colors needs to be supported by an embedder for Digimarc Barcode. Digimarc Barcode supports the PANTONE spot color system, which is commonly used in the packaging industry. The Digimarc Barcode embedder allows a user to insert the UPC code in an image while minimizing perceptibility to the Human Visual System (HVS). The Digimarc Barcode is inserted in the printing ink domain, using an Adobe Photoshop plug-in as the last step before printing. Since Photoshop is an industry standard widely used by pre-press shops in the packaging industry, a Digimarc Barcode can be easily inserted and proofed.

Chagas disease. A new pathophysiological assessment

International Nuclear Information System (INIS)

Redruello, M.; Masoli, O.; Hasson, I.; Cragnolino, D.; Traverso, S.; Perez Balino, N.; Sarmiento, R.; Lazzari, J.; Luluaga, E.

2002-01-01

Background: There is scarce information on myocardial perfusion abnormalities and on the coronary vasomotor condition in Chagas disease patients. Aims: To assess regional perfusion abnormalities and the coronary vasomotor response of patients in the chronic phase of Chagas disease. Methods: With the use of 99mTc-sestamibi SPECT imaging and cold pressor test and intracoronary acetylcoline (ACH) perfusion, we studied 9 patients aged 42,6±12 years, 4 males, in the chronic stage of Chagas disease (5 with the indeterminate form and 4 with heart lesion) with normal coronary arteries. Vasomotor responses to intracoronary increasing doses of ACH and to a single dose of nitroglycerine (NTG) were assessed with digital quantitative angiography. Regional myocardial perfusion was evaluated at rest and after cold pressor test by a semi quantitative score analysis in an 18-segment model with 99mTc-sestamibi SPECT images. Results were expressed as mean ± 2SD. Differences between continuous variables were measured by two tails Student's t test for paired variables and the significance level was set at 5 %. Results: All patients had regional perfusion defects and abnormal vasomotor response. The diameter of the left anterior descending artery decreased 34% from a basal diameter of 3.66∫0.95 mm down to 2.42±0.74 mm after maximal response to ACH (p<0.002). NTG infusion augmented its diameter to 3.86±0.77 mm (p<0.0002) that is a 60% increase from post ACH diameter. Myocardial perfusion score was 1∫2.66 at rest and 6.22±3.6 after cold pressor test (p<0.0001). Conclusions: This group of patients in the chronic phase of Chagas disease showed an abnormal vasoconstrictive response to intracoronary ACH and cold-induced perfusion defects suggesting that endothelial dysfunction plays a role in the pathophysiology of chronic Chagas heart disease

American Trypanosomiasis (Also Known as Chagas Disease) Detailed FAQs

Science.gov (United States)

... I prevent infection? What is Chagas disease? Chagas disease is caused by the parasite Trypanosoma cruzi , which is transmitted to animals and people by insect vectors that are found only in the Americas (mainly, ...

Evaluation of package inserts of Ayurveda drug formulations from Mumbai city.

Science.gov (United States)

Shirolkar, Sudatta; Tripathi, Raakhi K; Potey, Anirudha V

2015-01-01

Package insert (PI) is a vital document accompanying a prescribed medication to provide information to the prescriber and end-user at a glance. Studies regarding PIs of Ayurvedic medicines in accordance with standard guidelines are lacking. Present study was undertaken to evaluate PI of Ayurveda drugs. PIs of Ayurveda drugs were obtained from five randomly selected Ayurveda medical shops located in three main zones of Mumbai. From each medical shop, a range of 15-20 PI was planned to be collected for different formulations. It was decided to collect a minimum fifty PIs/group for equitable distribution of various formulations in period of January-June2013. Checklist was prepared, and content validity was achieved. Final validated checklist contained a total of 13 items, and the presence or absence of information pertaining to these items on the PI was evaluated. Any other additional information present on PI was also noted. Each item was analyzed and expressed as percentages. The information on 258 PIs included: Name of ingredients (67%), quantity of ingredients (47.27%), route of administration (86.8%), dosage form (86.8%), indications (18%), dose (18%), contraindications (18%), side effects (9%), shelf life (5.81%), storage conditions (11%), and manufacturers name with contact details (34%). PIs accompanying Ayurveda medicinal products in India are deficient in information required to be furnished by them.

New evidence of spontaneous cure in human Chagas' disease Novas evidências da cura espontânea da doença de Chagas humana

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Sonia S. Francolino

2003-01-01

Full Text Available A new case of spontaneous cure of human Chagas' disease is described in Uruguay. An 87-year-old man who had a typical acute phase of Trypanosoma cruzi infection in 1947 and never received specific treatment against the disease, when examined in 1998 revealed several completely negative parasitological and serological tests, including traditional serology, PCR and flow cytometry. As a whole, such findings fulfill the current criteria to define the cure of Chagas' disease. Clinical data suggest the possibility of a benign evolution of Chagas' disease in this case, but the basic findings (slight cardiac and esophageal impairment could also be due to the advanced age of the patient.Um novo caso de cura espontânea da doença de Chagas humana é descrito no Uruguai. Um homem de 87 anos de idade que teve um quadro típico de doença de Chagas aguda em 1947 e nunca recebeu tratamento específico, revelou-se em 1998 completamente negativo para exames sorológicos e parasitológicos, inclusive por PCR e citometria de fluxo. Estes achados, no conjunto, preenchem os critérios correntes para a definição de cura da doença de Chagas. O quadro clínico atual sugere a possiblidade de uma evolução benigna da doença de Chagas, mas os achados principais (comprometimento leve do coração e do esôfago poderiam também dever-se à avançada idade do paciente.

Honduras stands out in fight against chagas disease | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2011-01-25

Jan 25, 2011 ... The model is based on community involvement to both treat and prevent Chagas. ... treat children with Chagas and educate the population on how to control ... parents, children, and community leaders—monitored homes and ...

Enfermedad de Chagas en Nicaragua

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Carlos N. Talavera - López

2008-04-01

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

Do package inserts reflect symptoms experienced in practice?: assessment using an automated phone pharmacovigilance system with varenicline and zolpidem in a primary care setting.

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Haas, Jennifer S; Amato, Mary; Marinacci, Lucas; Orav, E John; Schiff, Gordon D; Bates, David W

2012-08-01

While the US FDA maintains a voluntary reporting system, postmarketing adverse drug events (ADEs) are underreported, and this case report-based system does not allow accurate determination of incidence. The aim of the study was to assess the usefulness of an automated phone pharmacovigilance system for ambulatory patients by comparing systematically collected, patient-reported symptoms to reflect possible ADEs with those reported on the package inserts of two drugs with postmarketing safety concerns, varenicline and zolpidem. English-speaking adults who received a prescription for zolpidem (n = 370) or varenicline (n = 107) from a primary care physician at one of 11 participating clinics, and who participated in the pharmacovigilance system during 2008-2010, were included in the study. Patients were called approximately 4 weeks following their visit and asked to complete a standard script that asked about adherence and pre-specified symptoms. The main outcome measures were elicited rates of pre-specified symptoms or possible ADEs. Compared with the package insert, patients taking zolpidem were significantly (p zolpidem were not detected. These data highlight the potential value of, and innovative ways of collecting, information about possible ADEs directly from patients.

Chagas disease risk in Texas.

Science.gov (United States)

Sarkar, Sahotra; Strutz, Stavana E; Frank, David M; Rivaldi, Chissa-Louise; Sissel, Blake; Sánchez-Cordero, Victor

2010-10-05

Chagas disease, caused by Trypanosoma cruzi, remains a serious public health concern in many areas of Latin America, including México. It is also endemic in Texas with an autochthonous canine cycle, abundant vectors (Triatoma species) in many counties, and established domestic and peridomestic cycles which make competent reservoirs available throughout the state. Yet, Chagas disease is not reportable in Texas, blood donor screening is not mandatory, and the serological profiles of human and canine populations remain unknown. The purpose of this analysis was to provide a formal risk assessment, including risk maps, which recommends the removal of these lacunae. The spatial relative risk of the establishment of autochthonous Chagas disease cycles in Texas was assessed using a five-stage analysis. 1. Ecological risk for Chagas disease was established at a fine spatial resolution using a maximum entropy algorithm that takes as input occurrence points of vectors and environmental layers. The analysis was restricted to triatomine vector species for which new data were generated through field collection and through collation of post-1960 museum records in both México and the United States with sufficiently low georeferenced error to be admissible given the spatial resolution of the analysis (1 arc-minute). The new data extended the distribution of vector species to 10 new Texas counties. The models predicted that Triatoma gerstaeckeri has a large region of contiguous suitable habitat in the southern United States and México, T. lecticularia has a diffuse suitable habitat distribution along both coasts of the same region, and T. sanguisuga has a disjoint suitable habitat distribution along the coasts of the United States. The ecological risk is highest in south Texas. 2. Incidence-based relative risk was computed at the county level using the Bayesian Besag-York-Mollié model and post-1960 T. cruzi incidence data. This risk is concentrated in south Texas. 3. The

Chagas disease risk in Texas.

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Sahotra Sarkar

Full Text Available BACKGROUND: Chagas disease, caused by Trypanosoma cruzi, remains a serious public health concern in many areas of Latin America, including México. It is also endemic in Texas with an autochthonous canine cycle, abundant vectors (Triatoma species in many counties, and established domestic and peridomestic cycles which make competent reservoirs available throughout the state. Yet, Chagas disease is not reportable in Texas, blood donor screening is not mandatory, and the serological profiles of human and canine populations remain unknown. The purpose of this analysis was to provide a formal risk assessment, including risk maps, which recommends the removal of these lacunae. METHODS AND FINDINGS: The spatial relative risk of the establishment of autochthonous Chagas disease cycles in Texas was assessed using a five-stage analysis. 1. Ecological risk for Chagas disease was established at a fine spatial resolution using a maximum entropy algorithm that takes as input occurrence points of vectors and environmental layers. The analysis was restricted to triatomine vector species for which new data were generated through field collection and through collation of post-1960 museum records in both México and the United States with sufficiently low georeferenced error to be admissible given the spatial resolution of the analysis (1 arc-minute. The new data extended the distribution of vector species to 10 new Texas counties. The models predicted that Triatoma gerstaeckeri has a large region of contiguous suitable habitat in the southern United States and México, T. lecticularia has a diffuse suitable habitat distribution along both coasts of the same region, and T. sanguisuga has a disjoint suitable habitat distribution along the coasts of the United States. The ecological risk is highest in south Texas. 2. Incidence-based relative risk was computed at the county level using the Bayesian Besag-York-Mollié model and post-1960 T. cruzi incidence data. This

Comprehensive Die Shear Test of Silicon Packages Bonded by Thermocompression of Al Layers with Thin Sn Capping or Insertions

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Shiro Satoh

2018-04-01

Full Text Available Thermocompression bonding for wafer-level hermetic packaging was demonstrated at the lowest temperature of 370 to 390 °C ever reported using Al films with thin Sn capping or insertions as bonding layer. For shrinking the chip size of MEMS (micro electro mechanical systems, a smaller size of wafer-level packaging and MEMS–ASIC (application specific integrated circuit integration are of great importance. Metal-based bonding under the temperature of CMOS (complementary metal-oxide-semiconductor backend process is a key technology, and Al is one of the best candidates for bonding metal in terms of CMOS compatibility. In this study, after the thermocompression bonding of two substrates, the shear fracture strength of dies was measured by a bonding tester, and the shear-fractured surfaces were observed by SEM (scanning electron microscope, EDX (energy dispersive X-ray spectrometry, and a surface profiler to clarify where the shear fracture took place. We confirmed two kinds of fracture mode. One mode is Si bulk fracture mode, where the die shear strength is 41.6 to 209 MPa, proportionally depending on the area of Si fracture. The other mode is bonding interface fracture mode, where the die shear strength is 32.8 to 97.4 MPa. Regardless of the fracture modes, the minimum die shear strength is practical for wafer-level MEMS packaging.

Fungi & Health: can polysaccharides from the fungus inonotus obliquus (CHAGA) inhibit tumor growth?

DEFF Research Database (Denmark)

Wold, C. W.; Corthay, A.; Kjeldsen, Christian

Inonotus obliquus (Chaga) – a white rot fungus found on birch trees in the northern hemisphere –has been used in traditional medicine in Europe and Asia for centuries. Native peoples have made use of Chaga by brewing it as a tea to treat gastro-intestinal problems, to heal wounds and even to treat...... cancer. The last few decades, studies have found Chaga to contain biologically active substances such as polysaccharides, triterpenoids, polyphenols and melanin. In vivo effects such as tumor growth inhibition have been observed in mice receiving various Chaga extracts. The main hypothesis behind...... the tumor inhibiting effect is two-fold: i) fungal polysaccharides may inhibit tumor growth indirectly by activating certain immune cells such as macrophages and ii) triterpenoids and other steroids from Chaga may give a direct cytotoxic effect against cancer cells. While triterpenoids from Chaga have been...

Challenges in the management of Chagas disease in Latin-American migrants in Europe.

Science.gov (United States)

Monge-Maillo, B; López-Vélez, R

2017-05-01

Chagas disease is endemic in Latin America. Due to migration the infection has crossed borders and it is estimated that 68,000-120,000 people with Chagas disease are currently living in Europe and 30% of them may develop visceral involvement. However, up to 90% of Chagas disease cases in Europe remain undiagnosed. The challenges which have to be overcome in Chagas disease in non-endemic countries are focused on related downing barriers to health care access, and related to screening, diagnostic tools and therapeutic management. The aim of this review is to highlight how healthcare management for Latin American migrants with Chagas disease in Europe may be improved. Medical literature was searched using PubMed. No limits were placed with respect to the language or date of publication although most of the articles selected were articles published in the last five years. Chosen search terms were "Chagas disease" AND ("migrants" OR "screening" OR "transmission" OR "treatment"; OR "knowledge" OR "non-endemic countries"); migrants AND ("Public health" OR "Health Service Accessibility" OR "Delivery of Health care"); and "Congenital Chagas disease". Healthcare management of migrant populations with Chagas disease in Europe has to be improved: -Surveillance programmes are needed to measure the burden of the disease; -screening programmes are needed; -administrative and cultural barriers in the access to health care for migrants should be reduced; -education programmes on Chagas disease should be performed -research on new diagnostic tools and therapeutic options are required. This review highlights the needs of profound changes in the health care of Latin American migrants with Chagas disease in Europe. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Risk factors for Chagas disease among pregnant women in El Salvador.

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Sasagawa, Emi; Aiga, Hirotsugu; Corado, Edith Y; Cuyuch, Blanca L; Hernández, Marta A; Guevara, Ana V; Romero, José E; Ramos, Hector M; Cedillos, Rafael A; Misago, Chizuru; Kita, Kiyoshi

2015-03-01

To determine the seroprevalence of Chagas disease among pregnant women and estimate the risk factors for Chagas disease during pregnancies. Community-based serological tests on Trypanosoma cruzi and structured interviews on socio-demographic and socio-economic status were conducted with pregnant women registered at three health centres in Sonsonate province, El Salvador. Of 797 pregnant women participating in the study, 29 (3.6%) were infected with Chagas disease. None had clinical symptoms. The results of bivariate analyses showed the significant association between seropositivity and maternal age ≥35 years, anaemia, illiteracy, having no formal school education and having knowledge on Chagas disease (P < 0.05). The results of multivariate analysis indicate that age ≥35 years and anaemia were significantly associated with being infected with Chagas disease among pregnant women (OR = 3.541 and 5.197, respectively). We recommend that the national Chagas disease control programme be better coordinated with the national maternal and child health programme to introduce blood screening for T. cruzi during antenatal visits. If financial constraint allows systematic blood screening to be only partially implemented, resources should be focused on pregnant women ≥35 years and women who have anaemia. © 2014 John Wiley & Sons Ltd.

Attitudes of consumers and healthcare professionals towards the patient package inserts - a study in Palestine

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Al-Ramahi R

2012-03-01

Full Text Available Reading the patient package inserts (PPIs is a key source of information about medications for patients. They should be clear and understandable to the general population. Objectives: The aims of this study were to obtain base-line data on the extent of reading PPIs by consumers and possible factors that might affect this; to explore the attitude of the Palestinian public and healthcare professionals towards the patient package inserts (PPIs; and to review a random sample of PPIs for the availability of different information.Methods: The first part of the study was a cross-sectional self-administered questionnaire. The questionnaire for consumers included 15 items. The questionnaire for healthcare professionals included 10 items and it was very similar to that of consumers with some modifications. In the second part, a random sample of PPIs was reviewed. In our community pharmacies, where medications are arranged according to their producing company, a researcher was asked to choose randomly 10-15 medications for every company to check for the availability of pharmacological, pharmaceutical and clinical information. Results: A total of 304 healthcare professionals out of 320 (95.0% and 223 consumers out of 240 (92.9% accepted to answer the survey. Forty five percent consumers reported that they always read the PPIs, and 29.3% said that they read the PPIs most of the times. Increased rate of reading the leaflet was found among females (P = 0.047. The preferred language for the PPIs was Arabic for most of the consumers (89.6% while it was English for most of the healthcare professionals (80.8%. 35.9% of the consumers and 43.6% of the healthcare professionals found the font size suitable. 42.3% of the consumers and 25.5% of the healthcare professionals said that they found the information in the PPIs useful and enough. The PPIs of 135 randomly sampled medications were reviewed. Many important sections were not found in the PPIs' sample. Conclusion

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

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Roberto Briceño-León

2009-01-01

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

Chagas Parasite Detection in Blood Images Using AdaBoost

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Víctor Uc-Cetina

2015-01-01

Full Text Available The Chagas disease is a potentially life-threatening illness caused by the protozoan parasite, Trypanosoma cruzi. Visual detection of such parasite through microscopic inspection is a tedious and time-consuming task. In this paper, we provide an AdaBoost learning solution to the task of Chagas parasite detection in blood images. We give details of the algorithm and our experimental setup. With this method, we get 100% and 93.25% of sensitivity and specificity, respectively. A ROC comparison with the method most commonly used for the detection of malaria parasites based on support vector machines (SVM is also provided. Our experimental work shows mainly two things: (1 Chagas parasites can be detected automatically using machine learning methods with high accuracy and (2 AdaBoost + SVM provides better overall detection performance than AdaBoost or SVMs alone. Such results are the best ones known so far for the problem of automatic detection of Chagas parasites through the use of machine learning, computer vision, and image processing methods.

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.

[Seroepidemiology of Chagas disease in Mexico].

Science.gov (United States)

Velasco-Castrejón, O; Valdespino, J L; Tapia-Conyer, R; Salvatierra, B; Guzmán-Bracho, C; Magos, C; Llausás, A; Gutiérrez, G; Sepúlveda, J

1992-01-01

The lack of information about Chagas disease in Mexico, as well as the controversy concerning its importance, was the basis for the seroprevalence study of Trypanosoma cruzi in the National Seroepidemiology Survey (NSS). This information was representative of the national situation with regard to disease prevalences and other factors related to the nation's health. Unfortunately the NSS was not a very good information source for the study of trypanosomiasis americana, because its coverage in the disperse rural areas was poor. Nevertheless, the results of the NSS indicated that Chagas disease has an irregular distribution in Mexico with seroprevalences of 1.6, 0.5 and 0.2 for the different dilution levels used in the evaluation. The survey data showed Chagas disease to be less important than that mentioned by other authors. The NSS data confirmed the areas of disease transmission already reported and identified some new ones in Hidalgo, Chiapas and Veracruz. The survey also detected migratory workers with Chagas antibodies in Baja California border cities, a situation which indicates a risk for blood transfusion in areas of the country presumed to be free of the disease. Three quarters (74.5%) of the seropositive population were less than 39 years old. Moreover, the fact that children of less than four years were infected suggests that natural transmission is still very important in some areas. Although the seroprevalences were greater in the lower socio-economic groups, some persons of the higher socio-economic level were also affected. This situation may be explained by the fact that many of these persons own vacation homes in tropical areas.

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.

Dobutamine Stress Echocardiography Safety in Chagas Disease Patients.

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

2017-02-01

A few decades ago, patients with Chagas disease were predominantly rural workers, with a low risk profile for obstructive coronary artery disease (CAD). As urbanization has increased, they became exposed to the same risk factors for CAD of uninfected individuals. Dobutamine stress echocardiography (DSE) has proven to be an important tool in CAD diagnosis. Despite being a potentially arrhythmogenic method, it is safe for coronary patients without Chagas disease. For Chagas disease patients, however, the indication of DSE in clinical practice is uncertain, because of the arrhythmogenic potential of that heart disease. To assess DSE safety in Chagas disease patients with clinical suspicion of CAD, as well as the incidence of arrhythmias and adverse events during the exam. Retrospective analysis of a database of patients referred for DSE from May/2012 to February/2015. This study assessed 205 consecutive patients with Chagas disease suspected of having CAD. All of them had their serology for Chagas disease confirmed. Their mean age was 64±10 years and most patients were females (65.4%). No patient had significant adverse events, such as acute myocardial infarction, ventricular fibrillation, asystole, stroke, cardiac rupture and death. Regarding arrhythmias, ventricular extrasystoles occurred in 48% of patients, and non-sustained ventricular tachycardia in 7.3%. DSE proved to be safe in this population of Chagas disease patients, in which no potentially life-threatening outcome was found. Até poucas décadas atrás, os pacientes chagásicos eram predominantemente trabalhadores rurais, com baixo perfil de risco para doença obstrutiva coronária. Com a crescente urbanização, passaram a ter os mesmos fatores de risco para doença aterosclerótica que indivíduos não infectados. O ecocardiograma sob estresse com dobutamina (EED) é uma importante ferramenta no diagnóstico de coronariopatia. É referido, porém, como um método potencialmente arritmogênico, mas

Technical note: Computer-manufactured inserts for prosthetic sockets.

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Sanders, Joan E; McLean, Jake B; Cagle, John C; Gardner, David W; Allyn, Katheryn J

2016-08-01

The objective of this research was to use computer-aided design software and a tabletop 3-D additive manufacturing system to design and fabricate custom plastic inserts for trans-tibial prosthesis users. Shape quality of inserts was tested right after they were inserted into participant's test sockets and again after four weeks of wear. Inserts remained properly positioned and intact throughout testing. Right after insertion the inserts caused the socket to be slightly under-sized, by a mean of 0.11mm, approximately 55% of the thickness of a nylon sheath. After four weeks of wear the under-sizing was less, averaging 0.03mm, approximately 15% of the thickness of a nylon sheath. Thus the inserts settled into the sockets over time. If existing prosthetic design software packages were enhanced to conduct insert design and to automatically generate fabrication files for manufacturing, then computer manufactured inserts may offer advantages over traditional methods in terms of speed of fabrication, ease of design, modification, and record keeping. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

Aspectos neurológicos da moléstia de chagas

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Fritz Köberle

1967-09-01

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

Chagas Disease Infection among Migrants at the Mexico/Guatemala Border.

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Conners, Erin E; Ordoñez, Teresa López; Cordon-Rosales, Celia; Casanueva, Carmen Fernández; Miranda, Sonia Morales; Brouwer, Kimberly C

2017-10-01

Chagas disease results in the largest burden, in terms of disability-adjusted-life-years, of any parasitic disease in the Americas. Monitoring Chagas disease among migrants is critical to controlling its spread and to serving the needs of the migrant community. Therefore, we determined the prevalence and correlates of Chagas disease in regional and international migrant populations at the Mexico/Guatemala border. Data were collected as part of a larger study of human immunodeficiency virus (HIV) and migration. Participants were a sample of recent regional and international migrants who used an illicit substance or had recent problem drinking. Trypanosoma cruzi infection was classified as testing positive on two different enzyme-linked immunosorbent assays (ELISAs). Interviewer-administered surveys captured sociodemographics, migration history, Chagas disease knowledge, and access to care. We enrolled 389 recent migrants, and the prevalence of Chagas disease was 3.1%. Only 19% of the participants reported having ever heard of the disease and less than 1% had been previously tested. Trypanosoma cruzi -positive participants were more likely to have been born in a rural area or town than a city (92% yes versus 59% no, P = 0.02) and have recently lived in a house with a makeshift roof (33% yes versus 8% no, P < 0.01), walls (42% yes versus 13% no, P < 0.01), or floor (50% yes versus 21% no, P < 0.02), or cinderblock walls (92% yes versus 63% no, P = 0.04). With migration rapidly changing the distribution of Chagas disease, more work needs to be done to create targeted surveillance programs and provide access to affordable treatment among Latin American migrants.

Chagas Disease (American trypanosomiasis)

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... sheets/detail/chagas-disease-(american-trypanosomiasis)","@context":"http://schema.org","@type":"Article"}; العربية 中文 français русский español ... capacities, focusing on: strengthening world epidemiological surveillance and information systems; preventing transmission by blood transfusion and organ ...

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

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Emi Sasagawa

2014-04-01

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

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

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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

Molecular Epidemiologic Source Tracking of Orally Transmitted Chagas Disease, Venezuela

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Segovia, Maikell; Martínez, Clara E.; Messenger, Louisa A.; Nessi, Anaibeth; Londoño, Juan C.; Espinosa, Raul; Martínez, Cinda; Alfredo, Mijares; Bonfante-Cabarcas, Rafael; Lewis, Michael D.; de Noya, Belkisyolé A.; Miles, Michael A.; Llewellyn, Martin S.

2013-01-01

Oral outbreaks of Chagas disease are increasingly reported in Latin America. The transitory presence of Trypanosoma cruzi parasites within contaminated foods, and the rapid consumption of those foods, precludes precise identification of outbreak origin. We report source attribution for 2 peri-urban oral outbreaks of Chagas disease in Venezuela via high resolution microsatellite typing. PMID:23768982

Seroprevalencia de la enfermedad de Chagas en el cantón Aguarico, Amazonía ecuatoriana Seroprevalence of Chagas disease in Aguarico canton in the Ecuadorian Amazon

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Manuel Amunárriz

2010-07-01

Full Text Available OBJETIVO: Determinar el estado actual de la seroprevalencia de la enfermedad de Chagas en la población del cantón Aguarico, y comparar los resultados obtenidos con datos provenientes de otros estudios epidemiológicos. MÉTODOS: Desde septiembre de 2008 hasta octubre de 2009 se recogieron 2 033 sueros correspondientes a 36,6% de la población total del cantón Aguarico. Se empleó la técnica CHAGATEST/ELISA recombinante v.3.0 para determinar positividad a la enfermedad de Chagas. Los casos positivos se confirmaron con pruebas de hemoaglutinación indirecta y ELISA. RESULTADOS: De las 2 033 muestras de suero obtenidas, 73 fueron positivas para Chagas (3,6%. El rango de variación de seroprevalencia en las comunidades con casos positivos osciló entre 1,4% y 13,3%. Un 60,3% de los casos positivos se encontraron en el sexo femenino. Estos hallazgos son similares a los de estudios previos de comparación realizados en 1990. CONCLUSIONES: Los datos obtenidos confirman la existencia de un foco autóctono de la enfermedad de Chagas en la Amazonía ecuatoriana, con un porcentaje superior a la media de la región amazónica. No se detectaron cuadros clínicos agudos ni patologías crónicas. Es perentorio implementar un programa de control de la enfermedad culturalmente adaptado a la región.OBJECTIVE: Determine the current seroprevalence of Chagas disease in the population of Aguarico canton, and compare the findings with data from other epidemiological studies. METHODS: From September 2008 to October 2009, 2 033 serum samples were collected from 36.6% of the total population in Aguarico canton. The Chagatest recombinant ELISA v.3.0 was used to determine positivity to Chagas disease. Cases that tested positive were confirmed by indirect hemagglutination and ELISA. RESULTS: Of the 2 033 serum samples obtained, 73 tested positive for Chagas disease (3.6%. Seroprevalence in communities with positive cases ranged from 1.4% to 13.3%, with 60.3% of the

Experimental Chagas disease-induced perturbations of the fecal microbiome and metabolome.

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McCall, Laura-Isobel; Tripathi, Anupriya; Vargas, Fernando; Knight, Rob; Dorrestein, Pieter C; Siqueira-Neto, Jair L

2018-03-01

Trypanosoma cruzi parasites are the causative agents of Chagas disease. These parasites infect cardiac and gastrointestinal tissues, leading to local inflammation and tissue damage. Digestive Chagas disease is associated with perturbations in food absorption, intestinal traffic and defecation. However, the impact of T. cruzi infection on the gut microbiota and metabolome have yet to be characterized. In this study, we applied mass spectrometry-based metabolomics and 16S rRNA sequencing to profile infection-associated alterations in fecal bacterial composition and fecal metabolome through the acute-stage and into the chronic stage of infection, in a murine model of Chagas disease. We observed joint microbial and chemical perturbations associated with T. cruzi infection. These included alterations in conjugated linoleic acid (CLA) derivatives and in specific members of families Ruminococcaceae and Lachnospiraceae, as well as alterations in secondary bile acids and members of order Clostridiales. These results highlight the importance of multi-'omics' and poly-microbial studies in understanding parasitic diseases in general, and Chagas disease in particular.

Chagas. From Exotic Tropical Disease to Pathology Globalized

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Beatriz BASSO

2016-09-01

Full Text Available Chagas disease, whose aetiological agent is Trypanosoma cruzi, is one of the main endemic diseases in Latin America, ranking fourth regarding the number of lost life years due to death or disability in the area; nevertheless, it is among the so-called “neglected diseases”. Despite its rural origin, where it is transmitted through vector insects belonging to the Reduviidae family, it has nowadays also become a problem in urbanized areas and is becoming globalized through inter-human transmission, above all congenital, but also through transfusions and transplants. Chagas, a Hidden Affliction (Chagas, Un mal escondido, a documentary by Ricardo Preve, focuses on both aspects of the disease: the rural and the global one, including interviews with North American doctors and European researchers. A significant part of the film takes place in the USA, showing the worst consequence of the evolution of the disease, which is death by chagasic cardiopathy which, being a reality that takes place during filming, increases the sense of drama. In this paper we approach specific topics related to Chagas disease from a biomedical point of view, including comments related to the highlights of the film that are connected with such aspects. Towards the end, there is mention of the film Houses of Fire (Casas de fuego and of certain illustrative aspects concerning the life of Dr Salvador Mazza and the Argentine Mission of Regional Pathology Studies (MEPRA, topics that have already been dealt with in this. 

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.

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

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M. A. Miles

1983-12-01

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

Prevention of congenital Chagas disease by Benznidazole treatment in reproductive-age women. An observational study.

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Álvarez, María G; Vigliano, Carlos; Lococo, Bruno; Bertocchi, Graciela; Viotti, Rodolfo

2017-10-01

Since the decline in new cases of infection by insect/vector, congenital Chagas disease has become more relevant in the transmission of Chagas disease. Treatment with benznidazole significantly reduces the parasitemia, which constitutes an important factor linked to vertical transmission. The objective of this study was to evaluate whether treatment with benznidazole previously administered to women of childbearing age can prevent or reduce the incidence of new cases of congenital Chagas disease. An historical cohort study that included all women in reproductive age (15-45 years) assisted in our center was designed. We included 67 mothers with chronic Chagas disease; 35 women had not been treated prior to pregnancy, 15 had been treated prior to pregnancy and 17 gave birth prior and after treatment with benznidazole. Eight mothers gave birth to 16 children with congenital Chagas disease (8/67, 12%). The prevalence of congenital Chagas was 16/114 (14%) children born to untreated mothers and 0/42 (0%) children born to benznidazole- treated mothers, p=0.01. No significant differences were observed in clinical, serologic, epidemiological or socioeconomic baseline variables between mothers with and without children born with congenital Chagas. A 32% conversion rate to negative serology was observed in benznidazole-treated women after long-term follow up. Antiparasitic treatment administered to women in reproductive age can prevent the occurrence of congenital Chagas disease. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

Chagas disease: 100 years after its discovery. A systemic review.

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Coura, José Rodrigues; Borges-Pereira, José

2010-01-01

Although Chagas disease was only discovered in 1909, it began millions of years ago as an enzootic disease among wild animals. Its transmission to man began accidentally as an anthropozoonosis when mankind invaded wild ecotopes. Endemic Chagas disease became established as a zoonosis over the last 200-300 years through deforestation for agriculture and livestock rearing and adaptation of triatomines to dwellings and to humans and domestic animals as food sources. When T. cruzi is transmitted to man, it invades the bloodstream and lymphatic system and lodges in muscle and heart tissue, the digestive system and phagocytic cells. Through this, it causes inflammatory lesions and an immune response, particularly mediated by CD4(+), CD8(+), IL2 and IL4, with cell and neuron destruction and fibrosis. These processes lead to blockage of the heart's conductive system, arrhythmias, heart failure, aperistalsis and dilatation of hollow viscera, especially the esophagus and colons. Chagas disease is characterized by an acute phase with or without symptoms, with (or more often without) T. cruzi penetration signs (inoculation chagoma or Romaña's sign), fever, adenomegaly, hepatosplenomegaly and patent parasitemia; and a chronic phase: indeterminate (asymptomatic, with normal electrocardiogram and heart, esophagus and colon X-rays) or cardiac, digestive or cardiac/digestive forms. There is great regional variation in the morbidity caused by Chagas disease: severe cardiac or digestive forms may occur in 10-50%, and indeterminate forms in the remaining, asymptomatic cases. The epidemiological and control characteristics of Chagas disease vary according to each country's ecological conditions and health policies. 2010. Published by Elsevier B.V.

48 CFR 1852.211-70 - Packaging, handling, and transportation.

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2010-10-01

... transportation. 1852.211-70 Section 1852.211-70 Federal Acquisition Regulations System NATIONAL AERONAUTICS AND... and Clauses 1852.211-70 Packaging, handling, and transportation. As prescribed in 1811.404-70, insert the following clause: Packaging, Handling, and Transportation (SEPT 2005) (a) The Contractor shall...

Chagas Disease Knowledge and Risk Behaviors of the Homeless Population in Houston, TX.

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Ingber, Alexandra; Garcia, Melissa N; Leon, Juan; Murray, Kristy O

2018-04-01

Chagas disease is a parasitic infection, caused by Trypanosoma cruzi, endemic in Latin America. Sylvatic T. cruzi-infected triatomine vectors are present in rural and urban areas in the southern USA and may transmit T. cruzi infection to at-risk populations, such as homeless individuals. Our study aimed to evaluate Chagas disease knowledge and behaviors potentially associated with transmission risk of Chagas disease among Houston, Texas' homeless population by performing interviews with 212 homeless individuals. The majority of the 212 surveyed homeless individuals were male (79%), African-American (43%), American-born individuals (96%). About 30% of the individuals reported having seen triatomines in Houston, and 25% had evidence of blood-borne transmission risk (IV drug use and/or unregulated tattoos). The median total time homeless was significantly associated with recognition of the triatomine vector. Our survey responses indicate that the homeless populations may exhibit potential risks for Chagas disease, due to increased vector exposure, and participation in blood-borne pathogen risk behaviors. Our findings warrant additional research to quantify the prevalence of Chagas disease among homeless populations.

Chagas disease, migration and community settlement patterns in Arequipa, Peru.

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Angela M Bayer

2009-12-01

Full Text Available Chagas disease is one of the most important neglected tropical diseases in the Americas. Vectorborne transmission of Chagas disease has been historically rare in urban settings. However, in marginal communities near the city of Arequipa, Peru, urban transmission cycles have become established. We examined the history of migration and settlement patterns in these communities, and their connections to Chagas disease transmission.This was a qualitative study that employed focus group discussions and in-depth interviews. Five focus groups and 50 in-depth interviews were carried out with 94 community members from three shantytowns and two traditional towns near Arequipa, Peru. Focus groups utilized participatory methodologies to explore the community's mobility patterns and the historical and current presence of triatomine vectors. In-depth interviews based on event history calendars explored participants' migration patterns and experience with Chagas disease and vectors. Focus group data were analyzed using participatory analysis methodologies, and interview data were coded and analyzed using a grounded theory approach. Entomologic data were provided by an ongoing vector control campaign. We found that migrants to shantytowns in Arequipa were unlikely to have brought triatomines to the city upon arrival. Frequent seasonal moves, however, took shantytown residents to valleys surrounding Arequipa where vectors are prevalent. In addition, the pattern of settlement of shantytowns and the practice of raising domestic animals by residents creates a favorable environment for vector proliferation and dispersal. Finally, we uncovered a phenomenon of population loss and replacement by low-income migrants in one traditional town, which created the human settlement pattern of a new shantytown within this traditional community.The pattern of human migration is therefore an important underlying determinant of Chagas disease risk in and around Arequipa. Frequent

The costs of preventing and treating chagas disease in Colombia.

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Marianela Castillo-Riquelme

Full Text Available The objective of this study is to report the costs of Chagas disease in Colombia, in terms of vector disease control programmes and the costs of providing care to chronic Chagas disease patients with cardiomyopathy.Data were collected from Colombia in 2004. A retrospective review of costs for vector control programmes carried out in rural areas included 3,084 houses surveyed for infestation with triatomine bugs and 3,305 houses sprayed with insecticide. A total of 63 patient records from 3 different hospitals were selected for a retrospective review of resource use. Consensus methodology with local experts was used to estimate care seeking behaviour and to complement observed data on utilisation.The mean cost per house per entomological survey was $4.4 (in US$ of 2004, whereas the mean cost of spraying a house with insecticide was $27. The main cost driver of spraying was the price of the insecticide, which varied greatly. Treatment of a chronic Chagas disease patient costs between $46.4 and $7,981 per year in Colombia, depending on severity and the level of care used. Combining cost and utilisation estimates the expected cost of treatment per patient-year is $1,028, whereas lifetime costs averaged $11,619 per patient. Chronic Chagas disease patients have limited access to healthcare, with an estimated 22% of patients never seeking care.Chagas disease is a preventable condition that affects mostly poor populations living in rural areas. The mean costs of surveying houses for infestation and spraying infested houses were low in comparison to other studies and in line with treatment costs. Care seeking behaviour and the type of insurance affiliation seem to play a role in the facilities and type of care that patients use, thus raising concerns about equitable access to care. Preventing Chagas disease in Colombia would be cost-effective and could contribute to prevent inequalities in health and healthcare.

A mathematical model of Chagas disease transmission

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Hidayat, Dayat; Nugraha, Edwin Setiawan; Nuraini, Nuning

2018-03-01

Chagas disease is a parasitic infection caused by protozoan Trypanosoma cruzi which is transmitted to human by insects of the subfamily Triatominae, including Rhodnius prolixus. This disease is a major problem in several countries of Latin America. A mathematical model of Chagas disease with separate vector reservoir and a neighboring human resident is constructed. The basic reproductive ratio is obtained and stability analysis of the equilibria is shown. We also performed sensitivity populations dynamics of infected humans and infected insects based on migration rate, carrying capacity, and infection rate parameters. Our findings showed that the dynamics of the infected human and insect is mostly affected by carrying capacity insect in the settlement.

Survey of Pediatric Infectious Diseases Society Members About Congenital Chagas Disease.

Science.gov (United States)

Edwards, Morven S; Abanyie, Francisca A; Montgomery, Susan P

2018-01-01

Participants in a survey about congenital Chagas disease, distributed electronically to Pediatric Infectious Diseases Society members, perceived having limited knowledge about congenital Trypanosoma cruzi infection. Most rarely or never consider the diagnosis in infants born to parents from Latin America. Improved awareness of congenital Chagas disease and assessment of at-risk infants is needed.

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

International Nuclear Information System (INIS)

Pedroso, Enio Roberto Pietra; Rezende, Nilton Alves de

2010-01-01

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)

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)

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

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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.

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.

A Paratransgenic Strategy for the Control of Chagas Disease

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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.

A Highly Sensitive Rapid Diagnostic Test for Chagas Disease That Utilizes a Recombinant Trypanosoma cruzi Antigen

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Barfield, C. A.; Barney, R. S.; Crudder, C. H.; Wilmoth, J. L.; Stevens, D. S.; Mora-Garcia, S.; Yanovsky, M. J.; Weigl, B. H.; Yanovsky, J.

2011-01-01

Improved diagnostic tests for Chagas disease are urgently needed. A new lateral flow rapid test for Chagas disease is under development at PATH, in collaboration with Laboratorio Lemos of Argentina, which utilizes a recombinant antigen for detection of antibodies to Trypanosoma cruzi. To evaluate the performance of this test, 375 earlier characterized serum specimens from a region where Chagas is endemic were tested using a reference test (the Ortho T. cruzi ELISA, Johnson & Johnson), a commercially available rapid test (Chagas STAT-PAK, Chembio), and the PATH–Lemos rapid test. Compared to the composite reference tests, the PATH–Lemos rapid test demonstrated an optimal sensitivity of 99.5% and specificity of 96.8%, while the Chagas STAT-PAK demonstrated a sensitivity of 95.3% and specificity of 99.5%. These results indicate that the PATH–Lemos rapid test shows promise as an improved and reliable tool for screening and diagnosis of Chagas disease. PMID:21342808

21 CFR 310.501 - Patient package inserts for oral contraceptives.

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2010-04-01

... dispenser may provide the insert to the parent or legal guardian of a legally incompetent patient (or to the... the effectiveness of oral contraceptives in preventing pregnancy, the contraindications to the drug's... concerning the increased risks associated with cigarette smoking and oral contraceptive use. (5) A discussion...

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

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Karl Reinhard

2003-01-01

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

Evaluation of the Chagas Stat-Paktm Assay for Detection of Trypanosoma cruzi Antibodies in Wildlife Reservoirs

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Yabsley, Michael J.; Brown, Emily L.; Roellig, Dawn M.

2010-01-01

An immunochromatographic assay (Chagas Stat-Pak™) was evaluated for the detection of Trypanosoma cruzi antibodies in 4 species of wildlife reservoirs. Antibodies to T. cruzi were detected in raccoons (Procyon lotor) (naturally and experimentally infected) and degus (Octodon degu) (experimentally-infected) using the Chagas Stat-Pak. In naturally exposed wild raccoons, the Chagas Stat-Pak had a sensitivity and specificity of 66.7–80.0% and 96.3%, respectively. Compared with indirect immunofluorescent antibody assay results, serocon-version as determined by Chagas Stat-Pak was delayed for experimentally infected raccoons, but occurred sooner in experimentally infected degus. The Chagas Stat-Pak did not detect antibodies in naturally or experimentally infected Virginia opossums (Didelphis virginiana) or in experimentally infected short-tailed opossums (Monodelphis domestica). These data suggest that the Chagas Stat-Pak might be useful in field studies of raccoons and degus when samples would not be available for more-conventional serologic assays. Because this assay did not work on either species of marsupial, the applicability of the assay should be examined before it is used in other wild species. PMID:19016578

Using PATIMDB to create bacterial transposon insertion mutant libraries.

Science.gov (United States)

Urbach, Jonathan M; Wei, Tao; Liberati, Nicole; Grenfell-Lee, Daniel; Villanueva, Jacinto; Wu, Gang; Ausubel, Frederick M

2009-04-01

PATIMDB is a software package for facilitating the generation of transposon mutant insertion libraries. The software has two main functions: process tracking and automated sequence analysis. The process tracking function specifically includes recording the status and fates of multiwell plates and samples in various stages of library construction. Automated sequence analysis refers specifically to the pipeline of sequence analysis starting with ABI files from a sequencing facility and ending with insertion location identifications. The protocols in this unit describe installation and use of PATIMDB software.

Antioxidant effect of Morus nigra on Chagas disease progression.

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Montenote, Michelly Cristina; Wajsman, Vithor Zuccaro; Konno, Yoichi Takaki; Ferreira, Paulo César; Silva, Regildo Márcio Gonçalves; Therezo, Altino Luiz Silva; Silva, Luciana Pereira; Martins, Luciamáre Perinetti Alves

2017-11-06

Considering the widespread popular use of Morus nigra and the amount of scientific information on its antioxidant and anti-inflammatory activity, the effectiveness of this phytotherapeutic compound in the parasitemia progression during the acute phase of Chagas disease and its role in the development of the inflammatory process as well as its effects on the oxidative damage in the chronic phase of infection were evaluated. Thus, 96 male Swiss mice were randomly divided into eight groups, four groups were uninfected controls, and four groups were intraperitoneally infected with 5.0 x 104 blood trypomastigotes forms of T. cruzi QM2 strain. Four batches composed of one uninfected and one infected group were respectively treated with 70% alcohol solution and 25 μL, 50 μL and 75 μL of the phytotherapeutic compound. Levels of antioxidant elements (TBARS, FRAP, GSH and Sulfhydryl groups) were measured in plasma samples. The phytotherapeutic compound's antioxidant activity was measured by polyphenol and total flavonoid quantification, DPPH, NO, and FRAP method. Our results showed that the vehicle influenced some of the results that may have physiological relevance in Chagas disease. However, an important action of M. nigra tincture was observed in the progression of Chagas disease, since our results demonstrated a reduction in parasitemia of treated groups when compared to controls, especially in the group receiving 25 µL. However, in the chronic phase, the 50-µL dosage presented a better activity on some antioxidant defenses and minimized the tissue inflammatory process. Results indicated an important action of M. nigra tincture on the Chagas disease progression.

Prevalence of Chagas' Disease in Mulungu do Morro Northeastern Brazil

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Roque Aras

2002-05-01

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

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

OpenAIRE

Fernando de C. da Silva; Sabrina B. Ferreira; David R. da Rocha; Vitor F. Ferreira

2012-01-01

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 ...

Morphologic and morphometric evaluation of pancreatic islets in chronic Chagas' disease

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Saldanha João Carlos

2001-01-01

Full Text Available PURPOSE: Hyperglycemia and abnormal glucose tolerance tests observed in some patients with chronic Chagas' disease suggest the possibility of morphological changes in pancreatic islets and/or denervation. The purpose of this study was to describe the morphology and morphometry of pancreatic islets in chronic Chagas' disease. METHODS: Morphologic and computerized morphometric studies were performed in fragments of the head, body, and tail regions of the pancreas obtained at necropsies of 8 normal controls and 17 patients with chronic Chagas' disease: 8 with the digestive form (Megas and 9 with the congestive heart failure form. RESULTS: The Megas group had a larger (p < 0.05 pancreatic islet area in the tail of the pancreas (10649.3 ± 4408.8 µm² than the normal control (9481.8 ± 3242.4 µm² and congestive heart failure (9475.1 ± 2104.9 µm² groups; likewise, the density of the pancreatic islets (PI was greater (1.2 ± 0.7 vs. 0.9 ± 0.6 vs. 1.9 ± 1.0 PI/mm², respectively. In the tail region of the pancreas of patients with the Megas form, there was a significant and positive correlation (r = +0.73 between the area and density of pancreatic islets. Discrete fibrosis and leukocytic infiltrates were found in pancreatic ganglia and pancreatic islets of the patients with Chagas' disease. Trypanosoma cruzi nests were not observed in the examined sections. Individuals with the Megas form of Chagas' disease showed increased area and density of pancreatic islets in the tail of the pancreas. CONCLUSION: The observed morphometric and morphologic alterations are consistent with functional changes in the pancreas, including glycemia and insulin disturbances.

Evolução tardia do transplante cardíaco na doença de Chagas: long-term evolution in cardiac transplantation Chagas' Disease

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Alfredo I Fiorelli

1990-08-01

Full Text Available Nas formas cardíacas da doença de Chagas que evoluem com insuficiência cardíaca refratária ao tratamento clínico, o transplante é a única alternativa, ao lado da cardiomioplastia. Os autores apresentam a evolução tardia de seis pacientes com miocardiopatia chagásica terminal submetidos a transplante cardíaco ortotópico. O período médio de observação foi de 25,2 meses. O diagnóstico de reativação da doença de Chagas apoiou-se na observação clínica, na investigação laboratorial do parasita, nas biópsias endomiocárdicas e dos nódulos de subcutâneo. A análise dos resultados demonstra que: 1 os testes laboratoriais mostraram-se ineficazes no diagnóstico da reativação da doença, sendo que as biópsias mostraram maior índice de positividade; 2 a pulsoterapia com corticóide predispõe à reativação; 3 a doença linfoproliferativa apresenta alta incidência na doença de Chagas, sendo a principal complicação tardia. Possivelmente, o benzonidazol apresente seu efeito oncogênico potencializado. Tendo em vista o caráter endêmico da doença e a falta de alternativa terapêutica, tornou-se obrigatória a analise do esquema imunossupressor, do tratamento da reativação e a maior experiência clínica, para posições mais definidas.In the cardiac forms of Chagas' Disease that develop with refractory cardiac failure under clinical treatment, the transplant is the only alternative along with the cardiomyoplasty. The authors present the six patient late evolution with terminal chagasic myocardiopathy submitted under on orthopic heart transplantation. The average period of observation was of 25.2 months. The diagnosis of Chagas' Disease reativation relies on the clinical observation, laboratory investigation of parasito, endomyocardial biopsy and subcutaneous nodules. The analyses of the results show that: 1 the laboratory exams were useless in the diagnosis of the disease reativation, but the biopsy presented hight

Technological innovation strategies for the specific treatment of Chagas disease based on Benznidazole.

Science.gov (United States)

Ferraz, Leslie Raphael de Moura; Alves, Alinne Élida Gonçalves; Nascimento, Débora Dolores Souza da Silva; Amariz, Isabela Araújo E; Ferreira, Aline Silva; Costa, Salvana Priscylla Manso; Rolim, Larissa Araújo; Lima, Ádley Antonini Neves de; Rolim Neto, Pedro José

2018-02-13

Caused by Trypanosoma cruzi, Chagas disease is responsible for public health problems greater in magnitude than those attributed to malaria, schistosomiasis, or leishmaniasis. A factor in the socioeconomic development of poor countries, Chagas disease can cause death due to a high parasitic burden during its acute phase due and irreversible damage in organs such as the heart, esophagus, and colon during its chronic phase, even when the number of parasites is minimal. For treating Chagas disease, benznidazole (BNZ) remains the drug of choice and, in Latin America, the only drug on the market for treating the disease. However, BNZ has exhibited insufficient activity in the chronic phase of Chagas disease, required administration in large doses, prolonged treatment, and shown a high incidence of adverse reactions (vomiting, rash, peripheral neuropathy, and spinal cord depression), toxicity, and low solubility in water. As an antidote, pharmaceutical technologies have been introduced that can improve BNZ's solubility and dissolution, as well as reduce side effects in light of its bioavailability, all of which can enhance therapy for Chagas disease. In response to that trend, by conducting a literature review, we sought to identify current pharmaceutical technologies used in tandem with BNZ to improve therapy for Chagas disease. Documented techniques include emulsion and microemulsion formation, solutions, parenteral formulas, micronization, and drug delivery systems supported by the development of nanoparticles and cyclodextrins, solid dispersions, and the use of metal-organic frameworks as innovative excipients. Such technologies increase the water solubility of BNZ by 4-25-fold on dissolution and an 85% release with efficacy in only a few minutes, as recorded during a viability experiment with nanoparticle suspensions. That experiment demonstrated the need for a lower concentration of BNZ to kill 50% of trypomastigote forms of T. cruzi, described in terms of the

[Costs of Chagas' disease screening test in blood donors in two Colombian blood banks, 2015].

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Alvis, Nelson José; Díaz, Diana Patricia; Castillo, Liliana; Alvis, Nelson Rafael; Bermúdez, María Isabel; Berrío, Olga Maritza; Beltrán, Mauricio; Castañeda-Orjuela, Carlos Andrés

2018-03-15

Transfusion is a mechanism of transmission of Chagas' disease. There are no studies on the costs of the screening test in Colombian blood banks. To estimate the costs of the screening test for Chagas' disease among blood donors in two Colombian blood banks, 2015. We conducted a micro-costing study from the perspective of the health care provider to estimate the cost of Chagas' disease testing in two blood banks, Banco de Sangre de la Cruz Roja, Seccional Bolívar, and Banco de Sangre del Hospital de Yopal, Casanare, taking into account four cost categories: 1) Administrative costs: public services and insurance costs were calculated based on the blood bank area in square meters; 2) capital costs: building and equipment costs that were annualized using a 3% discount rate and a lifespan of 20 years for building and five for equipment; 3) costs of Chagas' disease test materials and reagents adjusted by blood bank production level, and 4) costs of staff in charge of Chagas' disease test processing. The costs of transfusion bagsand immunohematology tests are also reported. The cost of Chagas' disease test in the blood bank of Seccional Bolívar was COP$ 37,804 (USD$ 12), and the blood bag and immunohematology test costs were COP$ 25,941 (USD$ 8.2) and COP$ 6,800 (USD$ 2.2), respectively. In the blood bank of Yopal, Casanare, the costs were COP$ 77,384 (USD$ 24.6), COP$ 30,141 (USD$ 9.6) and COP$ 12,627 (USD$ 4), respectively. Personnel cost accounted for the highest percentage of the total cost for both blood banks (47.5% in Seccional Bolívar, and 55.7% in Yopal, Casanare). Our results are an important input for the planning of services and cost-effectiveness studies for screening tests for Chagas' disease in Colombian blood banks.

Controlled but not cured: Structural processes and explanatory models of Chagas disease in tropical Bolivia.

Science.gov (United States)

Forsyth, Colin

2015-11-01

Dressler (2001:456) characterizes medical anthropology as divided between two poles: the constructivist, which focuses on the "meaning and significance that events have for people," and the structuralist, which emphasizes socioeconomic processes and relationships. This study synthesizes structuralist and constructivist perspectives by investigating how structural processes impact explanatory models of Chagas disease in a highly endemic area. The research took place from March-June 2013 through the Centro Medico Humberto Parra, a non-profit clinic servicing low income populations in Palacios, Bolivia and surrounding communities. Semistructured interviews (n = 68) and consensus analysis questionnaires (n = 48) were administered to people dealing with Chagas disease. In the interview narratives, respondents link Chagas disease with experiences of marginalization and rural poverty, and describe multilayered impediments to accessing treatment. They often view the disease as incurable, but this reflects inconsistent messages from the biomedical system. The consensus analysis results show strong agreement on knowledge of the vector, ethnomedical treatment, and structural factors related to Chagas disease. In interpreting Chagas disease, respondents account for the structural factors which place them at risk and impede access to care. Copyright © 2015 Elsevier Ltd. All rights reserved.

[What is not searched, it is difficult to find: Chagas' disease].

Science.gov (United States)

Briceno, Luis; Mosca, Walter

2016-05-01

A conservative estimation indicates that more than 400 000 Latin American immigrants are living in Italy. Several studies have shown that among these, the prevalence of Chagas disease is between 3.9% and 17%, so it is not unlikely to find a patient with this disease during a cardiology visit. How many patients from Latin America are diagnosed with heart failure in Italy and no one has ever thought about a possible Chagas disease? This brief review describes the situation of the disease in Italy, its characteristics, the etiology of this disease and its treatment. The latter aspect will be discussed considering the recent published results of the BENEFIT study, where it was found that treatment with benznidazole in patients with Chagas' cardiomyopathy is able to reduce significantly the detection of parasites in the blood, but it is not able to prevent clinical deterioration during 5 years of follow-up. The possible implications of these results will be discussed.

The impact of Chagas disease control in Latin America: a review.

Science.gov (United States)

Dias, J C P; Silveira, A C; Schofield, C J

2002-07-01

Discovered in 1909, Chagas disease was progressively shown to be widespread throughout Latin America, affecting millions of rural people with a high impact on morbidity and mortality. With no vaccine or specific treatment available for large-scale public health interventions, the main control strategy relies on prevention of transmission, principally by eliminating the domestic insect vectors and control of transmission by blood transfusion. Vector control activities began in the 1940s, initially by means of housing improvement and then through insecticide spraying following successful field trials in Brazil (Bambui Research Centre), with similar results soon reproduced in São Paulo, Argentina, Venezuela and Chile. But national control programmes only began to be implemented after the 1970s, when technical questions were overcome and the scientific demonstration of the high social impact of Chagas disease was used to encourage political determination in favour of national campaigns (mainly in Brazil). Similarly, large-scale screening of infected blood donors in Latin America only began in the 1980s following the emergence of AIDS. By the end of the last century it became clear that continuous control in contiguous endemic areas could lead to the elimination of the most highly domestic vector populations - especially Triatoma infestans and Rhodnius prolixus - as well as substantial reductions of other widespread species such as T. brasiliensis, T. sordida, and T. dimidiata, leading in turn to interruption of disease transmission to rural people. The social impact of Chagas disease control can now be readily demonstrated by the disappearance of acute cases and of new infections in younger age groups, as well as progressive reductions of mortality and morbidity rates in controlled areas. In economic terms, the cost-benefit relationship between intervention (insecticide spraying, serology in blood banks) and the reduction of Chagas disease (in terms of medical and

The impact of Chagas disease control in Latin America: a review

Directory of Open Access Journals (Sweden)

JCP Dias

2002-07-01

Full Text Available Discovered in 1909, Chagas disease was progressively shown to be widespread throughout Latin America, affecting millions of rural people with a high impact on morbidity and mortality. With no vaccine or specific treatment available for large-scale public health interventions, the main control strategy relies on prevention of transmission, principally by eliminating the domestic insect vectors and control of transmission by blood transfusion. Vector control activities began in the 1940s, initially by means of housing improvement and then through insecticide spraying following successful field trials in Brazil (Bambui Research Centre, with similar results soon reproduced in São Paulo, Argentina, Venezuela and Chile. But national control programmes only began to be implemented after the 1970s, when technical questions were overcome and the scientific demonstration of the high social impact of Chagas disease was used to encourage political determination in favour of national campaigns (mainly in Brazil. Similarly, large-scale screening of infected blood donors in Latin America only began in the 1980s following the emergence of AIDS. By the end of the last century it became clear that continuous control in contiguous endemic areas could lead to the elimination of the most highly domestic vector populations - especially Triatoma infestans and Rhodnius prolixus - as well as substantial reductions of other widespread species such as T. brasiliensis, T. sordida, and T. dimidiata, leading in turn to interruption of disease transmission to rural people. The social impact of Chagas disease control can now be readily demonstrated by the disappearance of acute cases and of new infections in younger age groups, as well as progressive reductions of mortality and morbidity rates in controlled areas. In economic terms, the cost-benefit relationship between intervention (insecticide spraying, serology in blood banks and the reduction of Chagas disease (in terms

Esophageal striated muscle contractions in patients with Chagas' disease and idiopathic achalasia

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R.O. Dantas

2002-06-01

Full Text Available Chagas' disease causes degeneration and reduction of the number of intrinsic neurons of the esophageal myenteric plexus, with consequent absent or partial lower esophageal sphincter relaxation and loss of peristalsis in the esophageal body. The impairment of esophageal motility is seen mainly in the distal smooth muscle region. There is no study about esophageal striated muscle contractions in the disease. In 81 patients with heartburn (44 with esophagitis taken as controls, 51 patients with Chagas' disease (21 with esophageal dilatation and 18 patients with idiopathic achalasia (11 with esophageal dilatation we studied the amplitude, duration and area under the curve of esophageal proximal contractions. Using the manometric method and a continuous perfusion system we measured the esophageal striated muscle contractions 2 to 3 cm below the upper esophageal sphincter after swallows of a 5-ml bolus of water. There was no significant difference in striated muscle contractions between patients with heartburn and esophagitis and patients with heartburn without esophagitis. There was also no significant difference between patients with heartburn younger or older than 50 years or between men and women or in esophageal striated muscle contractions between patients with heartburn and Chagas' disease. The esophageal proximal amplitude of contractions was lower in patients with idiopathic achalasia than in patients with heartburn. In patients with Chagas' disease there was no significant difference between patients with esophageal dilatation and patients with normal esophageal diameter. Esophageal striated muscle contractions in patients with Chagas' disease have the same amplitude and duration as seen in patients with heartburn. Patients with idiopathic achalasia have a lower amplitude of contraction than patients with heartburn.

Behavioural alterations are independent of sickness behaviour in chronic experimental Chagas disease.

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Vilar-Pereira, Glaucia; Ruivo, Leonardo Alexandre de Souza; Lannes-Vieira, Joseli

2015-12-01

The existence of the nervous form of Chagas disease is a matter of discussion since Carlos Chagas described neurological disorders, learning and behavioural alterations in Trypanosoma cruzi-infected individuals. In most patients, the clinical manifestations of the acute phase, including neurological abnormalities, resolve spontaneously without apparent consequence in the chronic phase of infection. However, chronic Chagas disease patients have behavioural changes such as psychomotor alterations, attention and memory deficits, and depression. In the present study, we tested whether or not behavioural alterations are reproducible in experimental models. We show that C57BL/6 mice chronically infected with the Colombian strain of T. cruzi (150 days post-infection) exhibit behavioural changes as (i) depression in the tail suspension and forced swim tests, (ii) anxiety analysed by elevated plus maze and open field test sand and (iii) motor coordination in the rotarod test. These alterations are neither associated with neuromuscular disorders assessed by the grip strength test nor with sickness behaviour analysed by temperature variation sand weight loss. Therefore, chronically T. cruzi-infected mice replicate behavioural alterations (depression and anxiety) detected in Chagas disease patients opening an opportunity to study the interconnection and the physiopathology of these two biological processes in an infectious scenario.

[Control of Chagas disease in pregnant Latin-American women and her children].

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Merino, Francisco J; Martínez-Ruiz, Rocío; Olabarrieta, Iciar; Merino, Paloma; García-Bujalance, Silvia; Gastañaga, Teresa; Flores-Chavez, María

2013-09-01

Chagas disease is a chronic and systemic infection caused by Trypanosoma cruzi. According to estimates from WHO, 10 million people are affected by this parasite. In the last years, birthrate among the immigrant women from Latin America settled in the Comunidad Autónoma de Madrid has been increasing, and as T. cruzi can be transmitted from mother to child, in fact 11 cases of congenital Chagas disease have been confirmed. Therefore, the aim of this paper is encouraging improvements in the coverage of the anti-T. cruzi antibodies detection in pregnant women from endemic areas. By this strategy, an active search for infected pregnant women and early detection of her infected newborns could be conducted, and then an early specific treatment could be administrated. Thus, there could be an important contribution to the control of Chagas disease in non-endemic area.

Histopathologic identification of Trypanosoma cruzi (Chagas' encephalitis in an AIDS patient

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Dimath Alyemni

2017-03-01

Full Text Available Trypanosoma cruzi (Chagas' encephalitis is an uncommon manifestation of T. cruzi infection, typically seen in immunocompromised patients. Encephalitis results from the reactivation of chronic infection predominately in individuals from endemic areas. Increased awareness of this complication is essential especially with increased migration of patients from endemic areas with concomitant HIV infection. Here we report a case of Chagas' encephalitis in an AIDS patient from Mexico in which there was no evidence of acute serologic, CSF, or blood infection by T. cruzi trypomastigotes.

Packaging of microwave integrated circuits operating beyond 100 GHz

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Samoska, L.; Daniel, E.; Sokolov, V.; Sommerfeldt, S.; Bublitz, J.; Olson, K.; Gilbert, B.; Chow, D.

2002-01-01

Several methods of packaging high speed (75-330 GHz) InP HEMT MMIC devices are discussed. Coplanar wirebonding is presented with measured insertion loss of less than 0.5dB and return loss better than -17 dB from DC to 110 GHz. A motherboard/daughterboard packaging scheme is presented which supports minimum loss chains of MMICs using this coplanar wirebonding method. Split waveguide block packaging approaches are presented in G-band (140-220 GHz) with two types of MMIC-waveguide transitions: E-plane probe andantipodal finline.

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.

Comprehensive analysis of three TYK2 gene variants in the susceptibility to Chagas disease infection and cardiomyopathy

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Carmona, F. David; Dolade, Nuria; Vargas, Sofia; Echeverría, Luis Eduardo; González, Clara Isabel; Martin, Javier

2018-01-01

Tyrosine kinase 2 (TYK2) is a member of the Janus kinases family implicated in the signal transduction of type I interferons and several interleukins. It has been described that genetic mutations within TYK2 lead to multiple deleterious effects in the immune response. In this work, we have analyzed three functional independent variants from the frequency spectrum on the TYK2 gene (common and low-frequency variants) suggested to reduce the function of the gene in mediating cytokine signaling and the susceptibility to infections by Trypanosoma cruzi and/or the development of Chagas cardiomyopathy in the Colombian population. A total of 1,323 individuals from a Colombian endemic region for Chagas disease were enrolled in the study. They were classified as seronegative (n = 445), seropositive asymptomatic (n = 336), and chronic Chagas Cardiomyopathy subjects (n = 542). DNA samples were genotyped using TaqMan probes. Our results showed no statistically significant differences between the allelic frequencies of the three analyzed variants when seropositive and seronegative individuals were compared, therefore these variants were not associated with susceptibility to Chagas disease. Moreover, when Chagas cardiomyopathy patients were compared to asymptomatic patients, no significant associations were found. Previous reports highlighted the association of this gene in immune-related disorders under an autoimmunity context, but not predisposing patients to infectious diseases, which is consistent with our findings. Therefore, according to our results, TYK2 gene variants do not seem to play an important role in Chagas disease susceptibility and/or chronic Chagas cardiomyopathy. PMID:29304122

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

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NANCY ORELLANA-HALKYER

2010-12-01

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

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

International Nuclear Information System (INIS)

Correa, Valeria Rita

2010-01-01

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 related

Quality assurance of the serologic diagnosis of Chagas' disease Garantía de calidad en el diagnóstico serológico de la enfermedad de Chagas

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Estela N. Cura

1998-04-01

Full Text Available A quality assurance program of the Chagas' disease laboratory network of Argentina has been conducted by the National Reference Center since 1988, with the aim of assessing the reliability of serologic test results. Chagas' disease is endemic in Argentina, but the prevalence of seropositivity for Trypanosoma cruzi among 18- to 20-year-old men decreased from 5.8% in 1981 to 1.8% in 1994. About 600 laboratories form the Chagas' disease laboratory network, with main central laboratories in each of the 24 provinces in Argentina. The quality assurance program promotes regular use of good laboratory practice and internal and external quality control to improve performance of the participants; it also provides technical assistance and guidelines. Eventual corrective measures are discussed in workshops. Results of the first external evaluation by proficiency testing of serum panels and confirmation of results for 58 of the main laboratories reveal that from 1988 to 1994 the rate of agreement has increased.El Centro Nacional de Referencia ha llevado a cabo desde 1988 un programa de garantía de calidad en la red de laboratorios para el diagnóstico de la enfermedad de Chagas en Argentina. El propósito ha sido evaluar la confiabilidad de los resultados de la prueba serológica. La enfermedad de Chagas es endémica en Argentina, pero la prevalencia de seropositividad a Trypanosoma cruzi en hombres de 18 a 24 años bajó de 5,8% en 1981 a 1,8% en 1994. Alrededor de 600 laboratorios forman la red para el diagnóstico de la enfermedad de Chagas, que cuenta con un laboratorio central en cada una de las 24 provincias argentinas. El programa para la garantía de la calidad promueve la aplicación continua de las buenas prácticas de laboratorio y se vale de controles de calidad internos y externos para mejorar el rendimiento de los participantes. También provee asistencia técnica y sienta parámetros normativos. Cualquier enmienda que resulte necesaria se

Enfermedad de Chagas o Tripanosomiasis Americana.

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Felipe Guhl

2000-08-01

Full Text Available

Situación Actual de Colombia.

La enfermedad de Chagas o tripanosomiasis americana es una enfermedad parasitaria crónica causada por un protozoario flagelado el Trypanosoma cruzi, descrito por primera vez por Carlos Chagas, médico brasileño, a comienzos de este siglo y en su honor se denominó la enfermedad que lleva su nombre.

Este parásito normalmente se transmite al ser humano a través de insectos triatomíneos estrictamente hematófagos de la familia Reduviidae, en el momento en que perforan la piel para succionar la sangre que los alimenta.

Sin embargo, no se inocula directamente por intermedio de las estructuras bucales del insecto en el momento de la picadura como en el caso de las tripanosomiasis africanas, si no que se deposita pasivamente en la piel a través de las heces del insecto, penetrando en el cuerpo por la herida que causa la picadura u otras abrasiones de la piel o de la mucosa. El T. cruzi, también puede transmitirse por infección congénita, por transfusión de sangre contaminada o por el transplante de órganos contaminados. El ciclo vital del parásito es largo y complejo y su desarrollo tiene varias etapas, tanto en el vector triatomineo como en el huésped vertebrado .

La Enfermedad de Chagas constituye una amenaza permanente para casi la cuarta parte de toda la población de América Latina. Si bien la enfermedad se encuentra presente en toda América Central y del Sur, sus manifestaciones y características epidemiológicas son altamente variables entre una y otra zona endémica. Existe una gran diversidad en las tasas de prevalencia, formas de transmisión, características parasitarias, patología clínica, vectores y reservorios.

Más que cualquier otra enfermedad parasitaria, la enfermedad de Chagas se relaciona con el desarrollo económico y social de la población: los insectos triatomineos y las enfermedades que ellos transmiten existirán mientras en

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.

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

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Rangel, José Antonio Santana; Monreal, Luz Arenas; Ramsey, Janine M

2016-08-04

To explore the pillars of community resilience in a region where Chagas disease is endemic, with the aim of promoting participatory processes to deal with this condition from the resilience of the population. Qualitative study using ethnographic record and six interviews of focus groups with young people, women and men. The research was carried out in a rural area of the state of Morelos, Mexico, between 2006 and 2007. We carried out educational sessions with the population in general, so that residents could identify the relationship between the vector Triatoma pallidipennis, the parasite (Trypanosoma cruzi), symptoms, and preventive actions for Chagas disease. The ethnographic record and groups were analyzed based on Taylor and Bogdan's modification, and the focus was to understand the socio-cultural meanings that guide the speeches and activities of residents in relation to the pillars of community resilience. The population felt proud of belonging to that location and three pillars of community resilience were clearly identified: collective self-esteem, cultural identity, and social honesty. Having these pillars as bases, we promoted the participation of the population concerning Chagas disease, and a Community Action Group was formed with young people, adult men and women, and social leaders. This Group initiated actions of epidemiological and entomological surveillance in the community to deal with this problem. It is necessary to create more experiences that deepen the understanding of the pillars of community resilience, and how they contribute to enhance participation in health to deal with Chagas disease. Explorar los pilares de la resiliencia comunitaria en una región en la que la enfermedad de Chagas es endémica, con la finalidad de partir de la resiliencia de la población para impulsar procesos participativos para enfrentar este padecimiento. Estudio cualitativo que utilizó registro etnográfico y seis entrevistas de grupos focales con j

Post-mortem diagnosis of chronic Chagas's disease comparative evaluation of three serological tests on pericardial fluid.

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Lopes, E R; Chapadeiro, E; Batista, S M; Cunha, J G; Rocha, A; Miziara, L; Ribeiro, J U; Patto, R J

1978-01-01

In an attempt to improve the post-mortem diagnosis of Chagas's disease the authors performed haemagglutination tests (HAT), fluorescent Trypanosoma cruzi antibody tests (FAT), and complement fixation tests (CFT) on the pericardial fluid obtained at autopsy of 50 individuals with Chagas's heart disease, and 93 patients in whom this disease was not thought to be present. The results demonstrate that all three tests are efficient for the post-mortem diagnosis of Chagas's disease but suggest that their combined use would detect more cases than would one isolated reaction only.

Challenges and opportunities for primary, secondary, and tertiary prevention of Chagas' disease.

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Rassi, A; Dias, J C P; Marin-Neto, J A; Rassi, A

2009-04-01

A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas' disease have now been detected in non-endemic areas, such as North America and some European countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.

Association of caspase-1 polymorphisms with Chagas cardiomyopathy among individuals in Santa Cruz, Bolivia.

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Fu, Katherine Yih-Jia; Zamudio, Roxana; Henderson-Frost, Jo; Almuedo, Alex; Steinberg, Hannah; Clipman, Steven Joseph; Duran, Gustavo; Marcus, Rachel; Crawford, Thomas; Alyesh, Daniel; Colanzi, Rony; Flores, Jorge; Gilman, Robert Hugh; Bern, Caryn

2017-01-01

Trypanosoma cruzi (Tc) infection is usually acquired in childhood in endemic areas, leading to Chagas disease, which progresses to Chagas cardiomyopathy in 20-30% of infected individuals over decades. The pathogenesis of Chagas cardiomyopathy involves the host inflammatory response to T. cruzi, in which upstream caspase-1 activation prompts the cascade of inflammatory chemokines/cytokines, cardiac remodeling, and myocardial dysfunction. The aim of the present study was to examine the association of two caspase-1 single nucleotide polymorphisms (SNPs) with cardiomyopathy. We recruited infected (Tc+, n = 149) and uninfected (Tc-, n = 87) participants in a hospital in Santa Cruz, Bolivia. Cardiac status was classified (I, II, III, IV) based on Chagas cardiomyopathy-associated electrocardiogram findings and ejection fractions on echocardiogram. Genotypes were determined using Taqman probes via reverse transcription-polymerase chain reaction of peripheral blood DNA. Genotype frequencies were analyzed according to three inheritance patterns (dominant, recessive, additive) using logistic regression adjusted for age and sex. The AA allele for the caspase-1 SNP rs501192 was more frequent in Tc+ cardiomyopathy (classes II, III, IV) patients compared to those with a normal cardiac status (class I) [odds ratio (OR) = -2.18, p = 0.117]. This trend approached statistical significant considering only Tc+ patients in class I and II (OR = -2.64, p = 0.064). Caspase-1 polymorphisms may play a role in Chagas cardiomyopathy development and could serve as markers to identify individuals at higher risk for priority treatment.

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

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Prata Aluízio

1999-01-01

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

Follow up Evaluation of Air Force Blood Donors Screening Positive for Chagas Disease

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2017-10-05

59 MDW/SGVU SUBJECT: Professional Presentation Approval 31 JULY2017 Your paper, entitled Follow-up Evaluation of Air Force Blood Donors Screening...PUBLISHED OR PRESENTED: Follow-up Evaluation of Air Force Blood Donors Screening Positive for Chagas Disease 7. FUNDING RECEIVED FOR THIS STUDY? 0...PREVIOUS EDITIONS ARE OBSOLETE 50. DATE Page 3 of 3 Pages Follow-up Evaluation of Air Force Blood Donors Screening Positive for Chagas Disease

Total Artificial Heart as Bridge to Heart Transplantation in Chagas Cardiomyopathy: Case Report.

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Ruzza, A; Czer, L S C; De Robertis, M; Luthringer, D; Moriguchi, J; Kobashigawa, J; Trento, A; Arabia, F

2016-01-01

Chagas disease (CD) is becoming an increasingly recognized cause of dilated cardiomyopathy outside of Latin America, where it is endemic, due to population shifts and migration. Heart transplantation (HTx) is a therapeutic option for end-stage cardiomyopathy due to CD, but may be considered a relative contraindication due to potential reactivation of the causative organism with immunosuppression therapy. The total artificial heart (TAH) can provide mechanical circulatory support in decompensated patients with severe biventricular dysfunction until the time of HTx, while avoiding immunosuppressive therapy and removing the organ most affected by the causative organism. We report herein a patient with CD and severe biventricular dysfunction, who had mechanical circulatory support with a TAH for more than 6 months, followed by successful orthotopic HTx and treatment with benznidazole for 3 months. The patient had no evidence of recurrent disease in the transplanted heart based on endomyocardial biopsy up to 1 year post-transplantation, and remains alive more than 30 months after insertion of a TAH and 24 months after HTx. Copyright © 2016 Elsevier Inc. All rights reserved.

Chagas disease as a cause of heart failure and ventricular arrhythmias in patients long removed from endemic areas: an emerging problem in Europe.

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Vannucchi, Vieri; Tomberli, Benedetta; Zammarchi, Lorenzo; Fornaro, Alessandra; Castelli, Gabriele; Pieralli, Filippo; Berni, Andrea; Yacoub, Sophie; Bartoloni, Alessandro; Olivotto, Iacopo

2015-12-01

Chagas disease is a parasitic disease caused by the protozoan Trypanosoma cruzi. In endemic areas (South and Central America), Chagas disease represents a relevant public health issue, and is the most frequent cause of cardiomyopathy. In nonendemic areas, such as Europe, Chagas disease represents an emerging problem following the establishment of sizeable communities from Brazil and Bolivia. Chagas cardiomyopathy represents the most frequent and serious complication of chronic Chagas disease, affecting about 20-30% of patients, potentially leading to heart failure, arrhythmias, thromboembolism, stroke and sudden death. Because late complications of Chagas disease may develop several years or even decades after the acute infection, it may be extremely challenging to reach the correct diagnosis in patients long removed from the countries of origin. We report two examples of Chagas cardiomyopathy in South American women permanently residing in Italy for more than 20 years, presenting with cardiac manifestations ranging from left ventricular dysfunction and heart failure to isolated ventricular arrhythmias. The present review emphasizes that Chagas disease should be considered as a potential diagnosis in patients from endemic areas presenting with 'idiopathic' cardiac manifestations, even when long removed from their country of origin, with potential implications for treatment and control of Chagas disease transmission.

Development of packagings for 'MONJU' blanket fuel assemblies

International Nuclear Information System (INIS)

Shibata, Kan; Ouchi, Yuichiro; Matsuzaki, Masaaki; Okuda, Yoshihisa

1995-01-01

Blanket assemblies for prototype Fast Breeder Reactor 'MONJU' are made at commercial fuel fabrication plants capable of handling deplete Uranium in Japan. For the purpose of transport the assemblies are inserted into a packaging that is set horizontally at the fabrication plants because of compatibility with equipment installed at the plants. On the other hand, the assemblies must be taken out from the packaging set vertically at 'MONJU' due to compatibility. For this reason development of a new packaging, which makes it possible to take assemblies in and out both horizontally and vertically, is needed to carry out transport of assemblies for reload. The development and fabrication of the packagings, taking about two years, were completed in March 1995. The packagings were used in transport of assemblies in June 1995 for the first change. This report introduces the outline of the packaging and confirmation tests done in the process of development. (author)

Doença de Chagas no Brasil Chagas disease in Brazil

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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.

Community resilience and Chagas disease in a rural region of Mexico

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José Antonio Santana Rangel

2016-01-01

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

Necroscopic study of a Chagas' disease chronic case with normal electrocardiograms

International Nuclear Information System (INIS)

Lopes, E.R.; Rocha, A.; Adad, S.J.; Fernandes, E.L.; Chapadeiro, E.

1988-01-01

The morphological changes in the postmortem study of a man probably with the indeterminate form of Chagas' disease are described. The heart exhibited lesions of the epicardium, myocardium and endocardium, as well as of the conduction system, primarily small inflammatory foci. There was mild fibrosis of the myocardium, atrioventricular node, and left bundle branch (at its origin). These alterations, although mild, were similar, in quality, to those described in the other chronic forms of Chagas' disease, and suggest active lesions, with a potential for further development. In the esophagus, among other features, a striking reduction of the number of neurons was observed. (author)

Drug discovery for Chagas disease should consider Trypanosoma cruzi strain diversity

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Bianca Zingales

2014-09-01

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

[Chagas's disease and deep ecology: the anti-vectorial fight in question].

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Siqueira-Batista, Rodrigo; Gomes, Andréia Patrícia; Rôças, Giselle; Cotta, Rosângela Minardi Mitre; Rubião, Eduardo Cárdenas Nogueira; Pissinatti, Alcides

2011-02-01

The inter-relations between man and the environment are among the main themes currently debated by the Brazilian public health. On such horizon, the questions concerning Chagas's disease are found to remain specially in the scope of the directed actions of control to the triatomine, the anti-vectorial fight , though already a century since its first description by Carlos Chagas, a major epidemiological problem in Latin America. Based on these considerations the present article will seek to discuss the main ecological aspects related to the American trypanosomiasis, emphasizing the control of the vectorial transmission in the context of the deep ecology.

Dual Use of Packaging on the Moon: Logistics-2-Living

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Howe, A. Scott; Howard, Robert

2010-01-01

This paper describes a modular packaging system for logistics that can be reconfigured into internal outfitting for a lunar outpost, including desks, chairs, partitions, cabinets, and radiation shielding. Logistics include clothes, equipment, food, and other consumables needed to sustain the crew for the duration of the mission. A significant mass penalty is required for the packaging and handling of logistics for re-supply of short to long-term space missions that must be brought out of the gravity well on a launch vehicle. Once the supplies have been exhausted, the packaging material is typically of no further use and is discarded. If a scheme can be developed that reuses the logistics packaging, the mass penalty can be reduced. In this research, a modular packaging system has been devised as a kit-of-parts that can be used for both handling logistics supplies, and then reconfigured into desks, chairs, partitions, cabinets, and radiation shielding. The system is derived from a standard International Space Station (ISS)-type Cargo Transfer Bag (CTB), using soft, unfoldable box-like containers with stiff metal inserts. The empty hydrogen-impregnated CTBs can be used as-is for cabinets, opened up for use as partitions, or draped over the habitat as layers of radiation shielding. Stiff metal inserts can be reconfigured into desks and other useful outfitting.

Integrated control of Chagas disease for its elimination as public health problem--a review.

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Sosa-Estani, Sergio; Segura, Elsa Leonor

2015-05-01

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.

Role of T. cruzi exposure in the pattern of T cell cytokines among chronically infected HIV and Chagas disease patients

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Tania Regina Tozetto-Mendoza

Full Text Available OBJECTIVES: The impact of Chagas disease (CD in HIV-infected patients is relevant throughout the world. In fact, the characterization of the adaptive immune response in the context of co-infection is important for predicting the need for interventions in areas in which HIV and Chagas disease co-exist. METHODS: We described and compared the frequency of cytokine-producing T cells stimulated with soluble antigen of Trypanosoma cruzi (T. cruzi using a cytometric assay for the following groups: individuals with chronic Chagas disease (CHR, n=10, those with Chagas disease and HIV infection (CO, n=11, those with only HIV (HIV, n=14 and healthy individuals (C, n=15. RESULTS: We found 1 a constitutively lower frequency of IL-2+ and IFN-γ+ T cells in the CHR group compared with the HIV, CO and healthy groups; 2 a suppressive activity of soluble T. cruzi antigen, which down-regulated IL-2+CD4+ and IFN-γ+CD4+ phenotypes, notably in the healthy group; 3 a down-regulation of inflammatory cytokines on CD8+ T cells in the indeterminate form of Chagas disease; and 4 a significant increase in IL-10+CD8+ cells distinguishing the indeterminate form from the cardiac/digestive form of Chagas disease, even in the presence of HIV infection. CONCLUSIONS: Taken together, our data suggest the presence of an immunoregulatory response in chronic Chagas disease, which seems to be driven by T. cruzi antigens. Our findings provide new insights into immunotherapeutic strategies for people living with HIV/AIDS and Chagas disease.

Chagas disease in Switzerland: history and challenges.

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Jackson, Y; Chappuis, F

2011-09-15

Chagas disease, endemic in Latin America, is an emerging health problem in Europe affecting an estimated 80,000 persons. Around 60,000 Latin American migrants live in Switzerland, and cases of Chagas disease have been reported since 1979. As of June 2011, 258 cases have been diagnosed, mostly adults in the indeterminate phase of the chronic stage of the disease. Vertical transmission has been identified and there is a high potential for blood- and organ-borne transmission in the absence of systematic screening. Major challenges include (i) raising awareness among migrants and healthcare professionals, (ii) developing national protocols for screening and treatment targeting high-risk groups such as pregnant woman, newborns, migrants from highly endemic areas (e.g. Bolivia), and immunocompromised migrants, (iii) preventing blood- and organ-borne transmission by appropriate screening strategies, (iv) taking into account the social vulnerability of individuals at risk in the design and implementation of public health programmes, and (v) facilitating contacts with the communities at risk through outreach programmes, for example in churches and cultural groups.

Perfil clínico de pacientes chagásicos e não-chagásicos portadores de marca-passo cardíaco artificial Clinical profile of Chagas and non-Chagas' disease patients with cardiac pacemaker

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Leonor Garcia Rincon

2006-06-01

Full Text Available O objetivo do estudo foi comparar pacientes chagásicos e não-chagásicos com marca-passo cardíaco artificial uni ou bicameral quanto à fração de ejeção do ventrículo esquerdo, o limiar de estimulação ventricular e a incidência de arritmias cardíacas. Entre janeiro/2001 e novembro/2002 foram avaliados 45 pacientes chagásicos e 35 não-chagásicos portadores de marca-passo quanto à história clínica, radiografia do tórax, ecocardiograma, Holter 24h e análise telemétrica do marca-passo. Embora os chagásicos fossem mais jovens, os dois grupos foram semelhantes quanto a variáveis radiológicas e o limiar de estimulação ventricular direito. Os chagásicos apresentaram menor fração de ejeção do ventrículo esquerdo ao ecocardiograma e maior incidência de arritmia ventricular ao Holter 24h. Observou-se correlação positiva entre a baixa fração de ejeção do ventrículo esquerdo e a intensidade da arritmia ventricular ao Holter 24h. Em pacientes com marca-passo, a doença de Chagas está associada a marcadores cardíacos de prognóstico adverso.The aim of this study was to compare Chagas and non-Chagas' disease patients using single or dual-chamber pacemaker in relation to the ejection fraction of the left ventricle, the ventricular stimulation threshold and the occurrence of ventricular arrhythmia. From January, 2001 to November, 2002, 45 Chagas' disease patients and 35 non-Chagas' disease patients, all pacemaker users, were evaluated considering clinical history, echocardiographic study, Holter monitoring and analysis of the pacemaker telemetry data. Chagas' disease patients were significantly younger, but both groups were similar when chest X-Ray variables and right ventricular stimulation threshold were analyzed. Chagas' disease patients had a lower left ventricular ejection fraction and more frequent ventricular arrhythmia during Holter monitoring. A positive correlation between the low ejection fraction of the left

Towards Chagas disease elimination: Neonatal screening for congenital transmission in rural communities.

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Pennington, Pamela Marie; Juárez, José Guillermo; Arrivillaga, Margarita Rivera; De Urioste-Stone, Sandra María; Doktor, Katherine; Bryan, Joe P; Escobar, Clara Yaseli; Cordón-Rosales, Celia

2017-09-01

Chagas disease is a neglected tropical disease that continues to affect populations living in extreme poverty in Latin America. After successful vector control programs, congenital transmission remains as a challenge to disease elimination. We used the PRECEDE-PROCEED planning model to develop strategies for neonatal screening of congenital Chagas disease in rural communities of Guatemala. These communities have persistent high triatomine infestations and low access to healthcare. We used mixed methods with multiple stakeholders to identify and address maternal-infant health behaviors through semi-structured interviews, participatory group meetings, archival reviews and a cross-sectional survey in high risk communities. From December 2015 to April 2016, we jointly developed a strategy to illustratively advertise newborn screening at the Health Center. The strategy included socioculturally appropriate promotional and educational material, in collaboration with midwives, nurses and nongovernmental organizations. By March 2016, eight of 228 (3.9%) pregnant women had been diagnosed with T. cruzi at the Health Center. Up to this date, no neonatal screening had been performed. By August 2016, seven of eight newborns born to Chagas seropositive women had been parasitologically screened at the Health Center, according to international standards. Thus, we implemented a successful community-based neonatal screening strategy to promote congenital Chagas disease healthcare in a rural setting. The success of the health promotion strategies developed will depend on local access to maternal-infant services, integration with detection of other congenital diseases and reliance on community participation in problem and solution definition.

Chagas disease vector blood meal sources identified by protein mass spectrometry.

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Judith I Keller

Full Text Available Chagas disease is a complex vector borne parasitic disease involving blood feeding Triatominae (Hemiptera: Reduviidae insects, also known as kissing bugs, and the vertebrates they feed on. This disease has tremendous impacts on millions of people and is a global health problem. The etiological agent of Chagas disease, Trypanosoma cruzi (Kinetoplastea: Trypanosomatida: Trypanosomatidae, is deposited on the mammalian host in the insect's feces during a blood meal, and enters the host's blood stream through mucous membranes or a break in the skin. Identifying the blood meal sources of triatomine vectors is critical in understanding Chagas disease transmission dynamics, can lead to identification of other vertebrates important in the transmission cycle, and aids management decisions. The latter is particularly important as there is little in the way of effective therapeutics for Chagas disease. Several techniques, mostly DNA-based, are available for blood meal identification. However, further methods are needed, particularly when sample conditions lead to low-quality DNA or to assess the risk of human cross-contamination. We demonstrate a proteomics-based approach, using liquid chromatography tandem mass spectrometry (LC-MS/MS to identify host-specific hemoglobin peptides for blood meal identification in mouse blood control samples and apply LC-MS/MS for the first time to Triatoma dimidiata insect vectors, tracing blood sources to species. In contrast to most proteins, hemoglobin, stabilized by iron, is incredibly stable even being preserved through geologic time. We compared blood stored with and without an anticoagulant and examined field-collected insect specimens stored in suboptimal conditions such as at room temperature for long periods of time. To our knowledge, this is the first study using LC-MS/MS on field-collected arthropod disease vectors to identify blood meal composition, and where blood meal identification was confirmed with more

Interactive Media on Chagas Disease: Development and Content

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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.

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

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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

Brain Chagas'disease: increasing differential diagnosis of brain mass in immunosuppressed patients - a case report and literature revision

International Nuclear Information System (INIS)

Batista, Laercio Leitao; centola, Crescencio A.P.; Kakudate, Milton Y.

1995-01-01

The authors present a case of Chagas'disease as tumor-like lesion of the brain, in a patient with Aids, simulating the lesions most frequently found in these patients, as toxoplasmosis, lymphoma and cryptococcosis. Furthermore, the case reported have peculiarity to be the only with lesion documented in cerebellum, and unusual due to be secondary by reactivation of chronic Chagas disease. Moreover, emphasize analysis of cerebrospinal fluid with realization of sorologic tests to Chagas's disease, as simple as effective method, to make use of biopsy with stereotaxia in unfinished cases and bad evolution. Finally, after a wide world literature review about Chagas'disease as a tumor-like lesion of the brain, emphasizing this publication as the first written in a radiology journal of specialty. (author). 40 refs., 3 figs., 1 tab

CHARITY: Chagas cardiomyopathy bisoprolol intervention study: a randomized double-blind placebo force-titration controlled study with Bisoprolol in patients with chronic heart failure secondary to Chagas cardiomyopathy [NCT00323973

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Casas Juan P

2006-06-01

Full Text Available Abstract Background Chagas' disease is the major cause of disability secondary to tropical diseases in young adults from Latin America, and around 20 million people are currently infected by T. cruzi. Heart failure due to Chagas cardiomyopathy is the main clinical presenation in Colombia. Heart failure due to Chagas' disease may respond to digoxin, diuretics and vasodilator therapy. Beta-adrenoreceptor antagonism seems to protect against the increased risk of cardiac arrhythmia and sudden death due to chronic sympathetic stimulation. The aim of this study is to evaluate the effects of the selective beta-adrenergic receptor blocker Bisoprolol on cardiovascular mortality, hospital readmission due to progressive heart failure and functional status in patients with heart failure secondary to Chagas' cardiomyopathy. Methods/design A cohort of 500 T. cruzi seropositive patients (250 per arm will be selected from several institutions in Colombia. During the pretreatment period an initial evaluation visit will be scheduled in which participants will sign consent forms and baseline measurements and tests will be conducted including blood pressure measurements, twelve-lead ECG and left ventricular ejection fraction assessment by 2D echocardiography. Quality of life questionnaire will be performed two weeks apart during baseline examination using the "Minnesota living with heart failure" questionnaire. A minimum of two 6 minutes corridor walk test once a week over a two-week period will be performed to measure functional class. During the treatment period patients will be randomly assigned to receive Bisoprolol or placebo, initially taking a total daily dose of 2.5 mgrs qd. The dose will be increased every two weeks to 5, 7.5 and 10 mgrs qd (maximum maintenance dose. Follow-up assessment will include clinical check-up, and blood collection for future measurements of inflammatory reactants and markers. Quality of life measurements will be obtained at six

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

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Florencia del Puerto

Full Text Available BACKGROUND: Chagas disease, caused by the flagellate parasite Trypanosoma cruzi affects 8-10 million people in Latin America. The mechanisms that underlie the development of complications of chronic Chagas disease, characterized primarily by pathology of the heart and digestive system, are not currently understood. To identify possible host genetic factors that may influence the clinical course of Chagas disease, Human Leucocyte Antigen (HLA regional gene polymorphism was analyzed in patients presenting with differing clinical symptoms. METHODOLOGY: Two hundred and twenty nine chronic Chagas disease patients in Santa Cruz, Bolivia, were examined by serological tests, electrocardiogram (ECG, and Barium enema colon X-ray. 31.4% of the examinees showed ECG alterations, 15.7% megacolon and 58.1% showed neither of them. A further 62 seropositive megacolon patients who had undergone colonectomy due to acute abdomen were recruited. We analyzed their HLA genetic polymorphisms (HLA-A, HLA-B, MICA, MICB, DRB1 and TNF-alpha promoter region mainly through Sequence based and LABType SSO typing test using LUMINEX Technology. PRINCIPAL FINDINGS: The frequencies of HLA-DRB1*01 and HLA-B*14:02 were significantly lower in patients suffering from megacolon as well as in those with ECG alteration and/or megacolon compared with a group of patients with indeterminate symptoms. The DRB1*0102, B*1402 and MICA*011 alleles were in strong Linkage Disequilibrium (LD, and the HLA-DRB1*01-B*14-MICA*011 haplotype was associated with resistance against chronic Chagas disease. CONCLUSIONS: This is the first report of HLA haplotype association with resistance to chronic Chagas disease.

Is endothelial microvascular function equally impaired among patients with chronic Chagas and ischemic cardiomyopathy?

Science.gov (United States)

Borges, Juliana Pereira; Mendes, Fernanda de Souza Nogueira Sardinha; Lopes, Gabriella de Oliveira; Sousa, Andréa Silvestre de; Mediano, Mauro Felippe Felix; Tibiriçá, Eduardo

2018-08-15

Chronic Chagas cardiomyopathy (CCC) and cardiomyopathies due to other etiologies involve differences in pathophysiological pathways that are still unclear. Systemic microvascular abnormalities are associated with the pathogenesis of ischemic heart disease. However, systemic microvascular endothelial function in CCC remains to be elucidated. Thus, we compared the microvascular endothelial function of patients presenting with CCC to those with ischemic cardiomyopathy disease. Microvascular reactivity was assessed in 21 patients with cardiomyopathy secondary to Chagas disease, 21 patients with cardiomyopathy secondary to ischemic disease and 21 healthy controls. Microvascular blood flow was assessed in the skin of the forearm using laser speckle contrast imaging coupled with iontophoresis of acetylcholine (ACh). Peak increase in forearm blood flow with ACh iontophoresis in relation to baseline was greater in healthy controls than in patients with heart disease (controls: 162.7 ± 58.4% vs. ischemic heart disease: 74.1 ± 48.3% and Chagas: 85.1 ± 68.1%; p < 0.0001). Patients with Chagas and ischemic cardiomyopathy presented similar ACh-induced changes from baseline in skin blood flow (p = 0.55). Endothelial microvascular function was equally impaired among patients with CCC and ischemic cardiomyopathy. Copyright © 2018 Elsevier B.V. All rights reserved.

Towards Chagas disease elimination: Neonatal screening for congenital transmission in rural communities.

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Pamela Marie Pennington

2017-09-01

Full Text Available Chagas disease is a neglected tropical disease that continues to affect populations living in extreme poverty in Latin America. After successful vector control programs, congenital transmission remains as a challenge to disease elimination. We used the PRECEDE-PROCEED planning model to develop strategies for neonatal screening of congenital Chagas disease in rural communities of Guatemala. These communities have persistent high triatomine infestations and low access to healthcare. We used mixed methods with multiple stakeholders to identify and address maternal-infant health behaviors through semi-structured interviews, participatory group meetings, archival reviews and a cross-sectional survey in high risk communities. From December 2015 to April 2016, we jointly developed a strategy to illustratively advertise newborn screening at the Health Center. The strategy included socioculturally appropriate promotional and educational material, in collaboration with midwives, nurses and nongovernmental organizations. By March 2016, eight of 228 (3.9% pregnant women had been diagnosed with T. cruzi at the Health Center. Up to this date, no neonatal screening had been performed. By August 2016, seven of eight newborns born to Chagas seropositive women had been parasitologically screened at the Health Center, according to international standards. Thus, we implemented a successful community-based neonatal screening strategy to promote congenital Chagas disease healthcare in a rural setting. The success of the health promotion strategies developed will depend on local access to maternal-infant services, integration with detection of other congenital diseases and reliance on community participation in problem and solution definition.

Use of a Chagas Urine Nanoparticle Test (Chunap) to Correlate with Parasitemia Levels in T. cruzi/HIV Co-infected Patients

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Castro-Sesquen, Yagahira E.; Gilman, Robert H.; Mejia, Carolina; Clark, Daniel E.; Choi, Jeong; Reimer-McAtee, Melissa J.; Castro, Rosario; Valencia-Ayala, Edward; Flores, Jorge; Bowman, Natalie; Castillo-Neyra, Ricardo; Torrico, Faustino; Liotta, Lance; Bern, Caryn; Luchini, Alessandra

2016-01-01

Background Early diagnosis of reactivated Chagas disease in HIV patients could be lifesaving. In Latin America, the diagnosis is made by microscopical detection of the T. cruzi parasite in the blood; a diagnostic test that lacks sensitivity. This study evaluates if levels of T. cruzi antigens in urine, determined by Chunap (Chagas urine nanoparticle test), are correlated with parasitemia levels in T. cruzi/HIV co-infected patients. Methodology/Principal Findings T. cruzi antigens in urine of HIV patients (N = 55: 31 T. cruzi infected and 24 T. cruzi serology negative) were concentrated using hydrogel particles and quantified by Western Blot and a calibration curve. Reactivation of Chagas disease was defined by the observation of parasites in blood by microscopy. Parasitemia levels in patients with serology positive for Chagas disease were classified as follows: High parasitemia or reactivation of Chagas disease (detectable parasitemia by microscopy), moderate parasitemia (undetectable by microscopy but detectable by qPCR), and negative parasitemia (undetectable by microscopy and qPCR). The percentage of positive results detected by Chunap was: 100% (7/7) in cases of reactivation, 91.7% (11/12) in cases of moderate parasitemia, and 41.7% (5/12) in cases of negative parasitemia. Chunap specificity was found to be 91.7%. Linear regression analysis demonstrated a direct relationship between parasitemia levels and urine T. cruzi antigen concentrations (p 105 pg was chosen to determine patients with reactivation of Chagas disease (7/7). Antigenuria levels were 36.08 times (95% CI: 7.28 to 64.88) higher in patients with CD4+ lymphocyte counts below 200/mL (p = 0.016). No significant differences were found in HIV loads and CD8+ lymphocyte counts. Conclusion Chunap shows potential for early detection of Chagas reactivation. With appropriate adaptation, this diagnostic test can be used to monitor Chagas disease status in T. cruzi/HIV co-infected patients. PMID:26919324

A inserção institucional do controle da doença de Chagas

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Antônio Carlos Silveira

2011-01-01

Full Text Available Em 1943, a partir da criação do "Centro de Estudos e Profilaxia da Moléstia de Chagas" da Fundação Oswaldo Cruz de Bambuí em Minas Gerais, são concebidas as bases tecnológicas e metodológicas para o controle extensivo da enfermidade. Para isso foi decisivo o advento de um novo inseticida (o gammexane, P 530 e a demonstração de sua eficácia no controle dos vetores da doença de Chagas. Como resultado prático desses acontecimentos em "maio de 1950 foi oficialmente inaugurada, em Uberaba, a primeira campanha de profilaxia da doença de Chagas, no Brasil". Mesmo que se dispusesse desde então de meios para fazer o controle da transmissão vetorial da endemia chagásica, não se dispunha dos recursos financeiros exigidos para fazê-lo de forma abrangente e regular. O baixo nível de prioridade conferida a essa atividade se expressava em sua inserção institucional. Em 1941, foram criados os Serviços Nacionais, de malária, peste, varíola, entre outros, enquanto a doença de Chagas fazia parte da Divisão de Organização Sanitária (DOS, que reunia enfermidades consideradas de menor importância. Em 1956 o Departamento Nacional de Endemias Rurais (DNERu incorporou todas as chamadas grandes endemias em uma única instituição, mas na prática isso não significou a implementação das ações de controle da doença de Chagas. Com a reestruturação do Ministério da Saúde em 1970, a Superintendência de Campanhas de Saúde Pública (SUCAM abarcou todas as endemias rurais, e a doença de Chagas passou a ter o status de Divisão Nacional, na mesma posição hierárquica daquelas outras doenças transmitidas por vetores antes consideradas prioritárias. Essa condição determinou a possibilidade de uma repartição de recursos mais equilibrada, o que efetivamente ocorreu, com a realocação de pessoal e insumos do programa de malária para o controle vetorial da doença de Chagas. Em 1991, a Fundação Nacional de Saúde sucedeu a SUCAM

Pacemaker Implants in Children and Adolescents with Chagas Disease in Brazil: 18-Year Incidence.

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Mizzaci, Carolina Christianini; Souza, Thiago Gonçalves Schroder E; Targueta, Gabriel Pelegrineti; Tótora, Ana Paula Frederico; Mateos, Juan Carlos Pachón; Mateos, José Carlos Pachon

2017-06-01

Chagas disease continues to be a serious public health problem, and accounts for 25-30% of the indications for cardiac stimulation in Brazil. To assess clinical and epidemiological characteristics of patients with Chagas disease, younger than 18 years, who had undergone pacemaker implantation in Brazil between 1994 and 2011, and its temporal trend. This was a cross-sectional analysis of data from the Brazilian Pacemaker Registry database. The following variables were analyzed: year when pacemaker was implanted, location, age, sex, ethnic group, functional class and the main electrocardiographic findings at baseline. In a total of 183,123 implants performed between 1994 and 2011, 214 implants of cardiac stimulation device in Chagas disease patients aged younger than 18 years were identified. Mean age at implantation was 5.6 ± 6.2 years. Second- and third-degree atrioventricular blocks corresponded to 71% of indications for pacemaker implantation. Fifty-six percent of the procedures were performed in the southeast region. Regarding the total number of pacemaker implants per year, there was a remarkable increase in the implants for all causes. However, time series analysis of the implants in Chagas disease patients younger than 18 years revealed a significant reduction in the annual number of implants. There has been an important reduction in the number of pacemaker implantations among children and adolescents with Chagas disease, suggesting a reduction in the vertical transmission of the parasite. A doença de Chagas mantém-se como sério problema de saúde pública e tem sido responsável por aproximadamente 25% a 30% das indicações de estimulação cardíaca no Brasil. Estudar as características clínicas e epidemiológicas dos pacientes menores de 18 anos portadores de doença de Chagas submetidos a implante de marca-passo no território brasileiro entre 1994 e 2011, e sua tendência temporal. Trata-se de um estudo retrospectivo que utilizou informa

Area-wide control of Chagas disease vectors in Latin America

International Nuclear Information System (INIS)

Schofield, C.J.

2000-01-01

Chagas disease (American trypanosomiasis) is now ranked by the World Bank as the most serious parasitic disease of the Americas, with a medical and economic impact far outranking even the combined effects of other parasitic diseases such as malaria and schistosomiasis (World Bank 1993). The infection is virtually impossible to cure and the disease is difficult and costly to treat. In contrast, transmission can be halted by eliminating the domestic insect vectors - large blood sucking reduviids of the subfamily Triatominae - and by improved screening of blood donors to minimise the risk of transfusional transmission (WHO 1991). Improved screening of blood banks requires appropriate legislation backed by a well-developed system of reference laboratories and standardised procedures, although to a large extent, this can be implemented in a progressive way from local to national levels (Schmunis 1991). By contrast, the key to success in Chagas disease vector control lies in the implementation of large-scale regional or international programmes coupled with long-term community-based vigilance. This is a classic intervention model beginning with a vertical intervention, the attack phase, in which all infested houses are sprayed by trained professionals, progressively backed by a more horizontal community-based system where householders themselves can report the presence of any residual infestations for retreatment where necessary. Elimination of domestic vectors of Chagas disease is facilitated by their slow reproductive rates and limited genetic variability, but is hampered by the ease of passive transport of the insects from one house to another, even across state and international boundaries (Schofield 1994). For this reason, international collaboration is particularly important in Chagas disease vector control. Since early trials in the 1940s, there have been many local and regional campaigns designed to control domestic populations of Triatominae, especially in

Urban outbreak of acute orally acquired Chagas disease in Táchira, Venezuela

OpenAIRE

Benítez, Jesús A.; Araujo, Benjamín; Contreras, Krisell; Rivas, Marianela; Ramírez, Pedro; Guerra, Watermo; Calderón, Noél; Terren, Carlo Ascaso; Barrera, Reggie; Rodríguez Morales, Alfonso Javier

2013-01-01

Aguda por vía oral adquirió la enfermedad de Chagas (AOACD) se ha convertido en una amenaza importante en algunos países de América del Sur [1,2]. Hasta marzo de 2013, al menos cuatro han reportado brotes de la enfermedad de Chagas aguda adquirida por vía oral, en concreto Brasil [3], Venezuela [4], Colombia [5] y Bolivia [6]. Los brotes también se están produciendo probablemente en Argentina y Ecuador, según algunos informes antiguos [2]. En Venezuela, ha habido por lo menos tres informes ep...

Opportunity cost for early treatment of Chagas disease in Mexico.

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Janine M Ramsey

2014-04-01

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

Opportunity cost for early treatment of Chagas disease in Mexico.

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Ramsey, Janine M; Elizondo-Cano, Miguel; Sanchez-González, Gilberto; Peña-Nieves, Adriana; Figueroa-Lara, Alejandro

2014-04-01

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. 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. 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.

Consumer and health literacy: The need to better design tobacco-cessation product packaging, labels, and inserts.

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Weiss, Stephanie M; Smith-Simone, Stephanie Y

2010-03-01

Tobacco-cessation product packaging and instruction materials may not be appropriate for some smokers and may contribute to the underuse and misuse of evidence-based treatments. The dual goals of this project are to analyze literacy levels of Food and Drug Administration (FDA)-approved and non-approved tobacco-cessation product packaging, directions, and claims, and to identify and categorize claims found on product packaging. The Campaign for Tobacco Free Kids (CTFK) maintains the Quitting and Reducing Tobacco Use Inventory of Products (QuiTIP) database, which catalogs products marketed and sold to consumers to reduce or quit use of tobacco products. It also includes all medications approved by the FDA for tobacco cessation as well as a sample of non-approved products such as homeopathic, herbal, nutritional, or dietary supplements commonly marketed as either cessation aids or alternative tobacco/nicotine products. This paper assesses the reading levels required to understand product packaging, labeling, and instructions using the Simple Measure of Gobbledygook (SMOG) and identifies claims on the product package labels using standard qualitative methods. Key findings show that the average reading levels needed to understand instructions for both FDA-approved and non-approved cessation products are above the reading levels recommended to ensure maximum comprehension. Improving the packaging and directions of evidence-based tobacco-cessation products so that they are preferably at or below a fifth-grade reading level, along with using consumer-based design principles to develop packaging, may help smokers take advantage of and correctly use products that will greatly increase their chances of successful quitting. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Evaluation of oral mucosal transudate for immunodiagnosis of Chagas´ disease

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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.

Current and developing therapeutic agents in the treatment of Chagas disease

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Werner Apt

2010-09-01

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

Microbial viability in preparations packaged for single use.

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Obayashi, Akiko; Oie, Shigeharu; Kamiya, Akira

2003-05-01

We evaluated microbial viability in preparations packaged for single use only which mandate that residual solution be discarded such as albumin and globulin preparations as blood products, preparations containing albumin (such as urokinase and interferon), fat emulsions, and a preparation containing fat emulsions (propofol). In most preparations, Serratia marcescens and Burkholderia cepacia proliferated rapidly at 30 degrees C. However, in globulin preparations containing 1-2.25% glycine to prevent protein degradation (Gamma-Venin P, Venilon-I, Globulin Injection, and Ahlbulin), no growth of S. marcescens and B. cepacia was detected over 24 h at 30 degrees C. For globulin preparations containing 1-2.25% glycine, the injunction to "Discard residual solution after the package has been used" in the package inserts can be revised to "It is possible to use residual solution within 24 h after the package has been used with storage in a cool place."

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

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Mario Zaidenberg

1993-02-01

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

Antagonistic Effect of Atorvastatin on High Fat Diet Induced Survival during Acute Chagas Disease

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Zhao, Dazhi; Lizardo, Kezia; Cui, Min Hui; Ambadipudi, Kamalakar; Lora, Jose; Jelicks, Linda A; Nagajyothi, Jyothi F

2016-01-01

Chagasic cardiomyopathy, which is seen in Chagas Disease, is the most severe and life-threatening manifestation of infection by the kinetoplastid Trypanosoma cruzi. Adipose tissue and diet play a major role in maintaining lipid homeostasis and regulating cardiac pathogenesis during the development of Chagas cardiomyopathy. We have previously reported that T. cruzi has a high affinity for lipoproteins and that the invasion rate of this parasite increases in the presence of cholesterol, suggesting that drugs that inhibit cholesterol synthesis, such as statins, could affect infection and the development of Chagasic cardiomyopathy. The dual epidemic of diabetes and obesity in Latin America, the endemic regions for Chagas Disease, has led to many patients in the endemic region of infection having hyperlipidemia that is being treated with statins such as atorvastatin. The current study was performed to examine using mice fed on either regular or high fat diet the effect of atorvastatin on T. cruzi infection-induced myocarditis and to evaluate the effect of this treatment during infection on adipose tissue physiology and cardiac pathology. Atorvastatin was found to regulate lipolysis and cardiac lipidopathy during acute T. cruzi infection in mice and to enhance tissue parasite load, cardiac LDL levels, inflammation, and mortality in during acute infection. Overall, these data suggest that statins, such as atorvastatin, have deleterious effects during acute Chagas disease. PMID:27416748

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

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

2012-09-01

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

Usefulness of FC-TRIPLEX Chagas/Leish IgG1 as confirmatory assay for non-negative results in blood bank screening of Chagas disease.

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Campos, Fernanda Magalhães Freire; Repoles, Laura Cotta; de Araújo, Fernanda Fortes; Peruhype-Magalhães, Vanessa; Xavier, Marcelo Antônio Pascoal; Sabino, Ester Cerdeira; de Freitas Carneiro Proietti, Anna Bárbara; Andrade, Mariléia Chaves; Teixeira-Carvalho, Andréa; Martins-Filho, Olindo Assis; Gontijo, Célia Maria Ferreira

2018-04-01

A relevant issue in Chagas disease serological diagnosis regards the requirement of using several confirmatory methods to elucidate the status of non-negative results from blood bank screening. The development of a single reliable method may potentially contribute to distinguish true and false positive results. Our aim was to evaluate the performance of the multiplexed flow-cytometry anti-T. cruzi/Leishmania IgG1 serology/(FC-TRIPLEX Chagas/Leish IgG1) with three conventional confirmatory criteria (ELISA-EIA, Immunofluorescence assay-IIF and EIA/IIF consensus criterion) to define the final status of samples with actual/previous non-negative results during anti-T. cruzi ELISA-screening in blood banks. Apart from inconclusive results, the FC-TRIPLEX presented a weak agreement index with EIA, while a strong agreement was observed when either IIF or EIA/IIF consensus criteria were applied. Discriminant analysis and Spearman's correlation further corroborates the agreement scores. ROC curve analysis showed that FC-TRIPLEX performance indexes were higher when IIF and EIA/IIF consensus were used as a confirmatory criterion. Logistic regression analysis further demonstrated that the probability of FC-TRIPLEX to yield positive results was higher for inconclusive results from IIF and EIA/IIF consensus. Machine learning tools illustrated the high level of categorical agreement between FC-TRIPLEX versus IIF or EIA/IIF consensus. Together, these findings demonstrated the usefulness of FC-TRIPLEX as a tool to elucidate the status of non-negative results in blood bank screening of Chagas disease. Copyright © 2018. Published by Elsevier B.V.

[Knowledge of vector-borne diseases (dengue, rickettsiosis and Chagas disease) in physicians].

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Lugo-Caballero, César I; Dzul-Rosado, Karla; Dzul-Tut, Irving; Balam-May, Ángel; Zavala-Castro, Jorge

2017-01-01

The ecological conditions of Yucatan made it a suitable region for the acquisition of vector-borne diseases such as dengue, rickettsiosis, and Chagas disease. As the epidemiological burden of these diseases shows an alarming increase of severe cases, the early establishment of diagnosis and therapeutics by first-contact physicians is a critical step that is not being fulfilled due to several reasons, including poor knowledge. To determine the level of knowledge related to dengue, Chagas disease, and rickettsiosis among rural first-contact physicians of Yucatan. A survey was applied to 90 first-contact physicians from rural clinics of Yucatan, which included 32 items related to the diagnosis, treatment, and prevention of dengue, rickettsiosis, and Chagas disease. Answers were analyzed by central tendency statistics. Differences were observed among every category, however; diagnosis and therapeutics showed the lower values. Globally, 62.5% of respondents showed moderate knowledge, 37.5% poor knowledge, and 0% adequate knowledge. Results suggest that a strong campaign for a continuous diffusion of knowledge regarding these diseases is needed. In regions with high prevalence of these kinds of diseases, like Yucatan, the impact of these results on the epidemiological burden of these diseases must be evaluated.

Impact of Helminth Infection on the Clinical and Microbiological Presentation of Chagas Diseases in Chronically Infected Patients.

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Fernando Salvador

2016-04-01

Full Text Available Helminth infections are highly prevalent in tropical and subtropical countries, coexisting in Chagas disease endemic areas. Helminth infections in humans may modulate the host immune system, changing the Th1/Th2 polarization. This immunological disturbance could modify the immune response to other infections. The aim of this study is to evaluate the relationship between clinical, microbiological and epidemiological characteristics of Chagas disease patients, with the presence of helminth infection.A prospective observational study was conducted at Vall d'Hebron University Hospital (Barcelona, Spain. Inclusion criteria were: age over 18 years, diagnosis of Chagas disease, and not having received specific treatment for Chagas disease previously to the inclusion. The study protocol included Chagas disease assessment (cardiac and digestive evaluation, detection of T. cruzi DNA measured by PCR in peripheral blood, and helminth infection diagnosis (detection of IgG anti-Strongyloides stercoralis by ELISA, microscopic examination of stool samples from three different days, and specific faecal culture for S. stercoralis larvae.Overall, 65 patients were included, median age was 38 years, 75.4% were women and most of them came from Bolivia. Cardiac and digestive involvement was present in 18.5% and 27.7% of patients respectively. T. cruzi PCR was positive in 28 (43.1% patients. Helminth infection was diagnosed in 12 (18.5% patients. No differences were observed in clinical and epidemiological characteristics between patients with and without helminth infection. Nevertheless, the proportion of patients with positive T. cruzi PCR was higher among patients with helminth infection compared with patients without helminth infection (75% vs 35.8%, p = 0.021.We observed a high prevalence of S. stercoralis infection among chronic Chagas disease patients attended in our tropical medicine unit. Strongyloidiasis was associated with significantly higher proportion of

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

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Roberto Briceño-León

2007-01-01

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

II Consenso Brasileiro em Doença de Chagas, 2015

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João Carlos Pinto Dias

Full Text Available RESUMO A doença de Chagas é uma condição crônica negligenciada com elevada carga de morbimortalidade e impacto dos pontos de vista psicológico, social e econômico. Representa um importante problema de saúde pública no Brasil, com diferentes cenários regionais. Este documento traduz a sistematização das evidências que compõe o Consenso Brasileiro de Doença de Chagas. O objetivo foi sistematizar estratégias de diagnóstico, tratamento, prevenção e controle da doença de Chagas no país, de modo a refletir as evidências científicas disponíveis. Sua construção fundamentou-se na articulação e contribuição estratégica de especialistas brasileiros com conhecimento, experiência e atualização sobre diferentes aspectos da doença. Representa o resultado da estreita colaboração entre a Sociedade Brasileira de Medicina Tropical e o Ministério da Saúde. Espera-se com este documento fortalecer o desenvolvimento de ações integradas para enfrentamento da doença no país com foco em epidemiologia, gestão, atenção integral (incluindo famílias e comunidades, comunicação, informação, educação e pesquisas.

Prevalence of Chagas disease in pregnant women and congenital transmission of Trypanosoma cruzi in Brazil: a systematic review and meta-analysis.

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Martins-Melo, Francisco Rogerlândio; Lima, Mauricélia da Silveira; Ramos, Alberto Novaes; Alencar, Carlos Henrique; Heukelbach, Jörg

2014-08-01

To estimate the prevalence of Chagas disease in pregnant women and the risk of congenital transmission of Trypanosoma cruzi infection in Brazil, through a systematic review and meta-analysis. We searched electronic databases, grey literature and reference lists of included publications to identify epidemiological studies on the prevalence of Chagas disease in pregnant women and on the congenital transmission rate of T. cruzi infection in Brazil published between January 1980 and June 2013. Pooled estimates and 95% confidence intervals (95% CIs) were calculated using fixed- and random-effects models. Sixteen articles were included - 12 studies on the prevalence of Chagas disease in pregnant women (549,359 pregnant women) and nine on congenital transmission rates (1687 children born to infected mothers). Prevalence of Chagas disease in pregnant women ranged from 0.1% to 8.5%, and congenital transmission rates from 0% to 5.2%. The pooled prevalence of Chagas disease among pregnant women across studies was 1.1% (95% CI: 0.6-2.0); the pooled congenital transmission rate was 1.7% (95% CI: 0.9-3.1). In 2010, 34,629 pregnant women were estimated to be infected with T. cruzi, and 312-1073 children born (mean: 589 cases) with congenital infection. Congenital Chagas disease is a neglected public health problem in Brazil. Systematic congenital Chagas disease control programs through routine prenatal screening for T. cruzi should be widely implemented in Brazil's endemic areas, to identify infected pregnant women and newborns at risk of congenital infection. © 2014 John Wiley & Sons Ltd.

Next-generation ELISA diagnostic assay for Chagas Disease based on the combination of short peptidic epitopes

DEFF Research Database (Denmark)

Mucci, Juan; Carmona, Santiago J.; Volcovich, Romina

2017-01-01

Chagas Disease, caused by the protozoan Trypanosoma cruzi, is a major health and economic problem in Latin America for which no vaccine or appropriate drugs for large-scale public health interventions are yet available. Accurate diagnosis is essential for the early identification and follow up....... cruzi linear B-cell epitopes using high-density peptide chips, leading to the identification of several hundred novel sequence signatures associated to chronic Chagas Disease. Here, we performed a serological assessment of 27 selected epitopes and of their use in a novel multipeptide-based diagnostic...... method. A combination of 7 of these peptides were finally evaluated in ELISA format against a panel of 199 sera samples (Chagas-positive and negative, including sera from Leishmaniasis-positive subjects). The multipeptide formulation displayed a high diagnostic performance, with a sensitivity of 96...

Evaluation of the Chagas disease control program in Açucena Municipality, Rio Doce Valley, State of Minas Gerais, Brazil.

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Santos, Adriana dos; Letro, Rejane Balmant; Lemos do Bem, Vitor Antônio; Azeredo, Bernardino Vaz de Melo; Coelho, George Luiz Lins Machado; Diotaiuti, Liléia; Machado-de-Assis, Girley Francisco; de Lana, Marta

2014-01-01

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. 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. 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. 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.

Packaging development needs to support environmental restoration

International Nuclear Information System (INIS)

Hummer, J.H.; Kuklinski, J.L.

1993-01-01

The U.S. Department of Energy is bringing its facilities into compliance with present environmental protection regulations. At the Hanford Site, this includes cleanup of its vast nuclear and chemical wastes. Cleanup will involve extensive collecting, consolidating, and processing of radioactive and other hazardous wastes. The Hanford Site was established by the Federal government in 1943 to produce plutonium. Natural uranium was fabricated into fuel slugs, inserted into nuclear reactors, and converted into plutonium. The irradiated slugs were then sent through plutonium extraction facilities. Process waste was discharged to the ground, stored on-site, or shipped off-site for disposal. Activities grew to include nine production reactors, five coal-fired power plants, nuclear fuel fabrication, other support facilities including underground waste storage tanks, and numerous chemical and waste processing plants. Cleanup activities will require extensive transport of radioactive and other hazardous materials. Packaging developments and research are required in the following areas to enhance environmental cleanup; (1) Packaging for Large Contaminated and Activated Components. (2) Bulk Packaging for Contaminated Solids. (3) Bulk Packaging for Contaminated Liquids. (4) Environmental Samples. (J.P.N.)

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

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J. Pellegrino

1953-12-01

Full Text Available O grande impulso que têm tornado, nestes últimos anos, as investigações sôbre a doença de Chagas, não sòmente em Minas Gerais, como também em outros Estados do Brasil e países do novo continente atingidos pela endemia; o interêsse cada vez mais crescente por parte dos médicos em geral e a facilidade com que vêm sendo por êles assimiladas as recentes contribuições ao estudo desta entidade mórbida; a importância médico-social e a repercussão econômica que tem sido atribuída à esquizotripanose como fator de letalidade e de incapacidade relativa ou total para o trabalho, depois de conhecidos os resultados de inquéritos clínico-epidemiológicos realizados em zonas infestadas por triatomíneos; a recente adoção, por parte das autoridades responsáveis pela saúde publica, de medidas concretas de contrôle da doença pelo combate aos seus transmissores domiciliares, por meio de inseticidas de ação residual aplicados em larga escala; e, principalmente, a escassez de trabalhos de conjunto e de fácil acesso, com referencias bibliográficas adequadas e extensas, que facilitassem aos não especializados no assunto, o conhecimento e a consulta das investigações já realizadas sôbre êste importante problema de medicina tropical; tais são os principais motivos que sugeriram a elaboração de um esbôço crítico do desenvolvimento dos trabalhos até agora publicados sôbre a esquizotripanose em Minas Gerais. De fato, foi aí descoberta a nova entidade mórbida do homem, foram aí estudados e esclarecidos problemas relativos à etiologia, epidemiologia, aspectos clínicos e anatomo-patológicos da esquizotripanose, foram aí realizadas investigações experimentais e desenvolvidos métodos de profilaxia, constituindo, em conjunto, os trabalhos realizados sôbre a esquizotripanose em Minas Gerais, fundamentados nos alicerces sólidos legados pelo seu grande descobridor, uma obra verdadeiramente monumental, que tanto orgulha e

Transmissão da doença de Chagas por transplante renal: ocorrência da forma aguda da doença em dois receptores de um mesmo doador Transmission of Chagas' disease through transplantede kidney: occurrence of the acute form of the disease in two recipients from the same donor

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A.S. Ferraz

1993-10-01

Full Text Available São apresentados dois casos de doença de Chagas aguda, adquiridos através de transplante de rins originários de um mesmo doador. O presente relato confirma a transmissão da doença de Chagas a partir do transplante renal e reforça a necessidade de exclusão de doadores renais infectados pelo Trypanosoma cruzi.Two cases of acute Chagas' disease acquired after renal transplantation are reported. The two patients received the kidney from the same donor. The present paper confirms this form of transmission of Chagas' disease and reinforces the need to exclude kidney donors with Trypanosoma cruzi infection.

Increased osmotic sensitivity for antidiuretic response in chronic chagas' disease

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Joel Paulo Russomano Veiga

1985-06-01

Full Text Available The osmotic threshold for attaining the antidiuretic response to hypertonic saline infusion and Progressive dehydration was studied in 31 patients with the chronic form of Chagas' disease and 16 control patients. The chagasic patients exhibited enhanced osmoticsensitivity to the antidiuretic response. This was demonstrated by lower values of the increments in plasma osmolarity sufficient to induce a significant fall in water clearance, without alterations in the osmolar clearance or creatinine excretion. The time needed to attain the antidiuretic response was shorterfor chagasics in relation to normal subjects. The results suggest the existence of a disturbance in the fine control of osmoregulation in the chagasic patients. They are interpreted to be a consequence of the denervation in hypothalamic or extrahypothalamic areas that regulate the secretion of vasopressin in chronic Chagas' disease.O limiar de sensibilidade osmótíca para obtenção de resposta antídiurética foi avaliado em 31 pacientes com a forma crônica da moléstia de Chagas, através de infusão de salina hipertônica ou desidratação. Os resultados, quando comparados com os obtidos em 16 pacientes-controle, mostram uma sensibilidade osmótíca aumentada para os chagásicos, dados os menores valores do incremento na osmolaridade plasmática, suficiente para induzir uma queda significativa na depuração de água livre, sem alterações na depuração osmolar ou na excreção de creatínina. Também, o tempo necessário para atingir a antídiurese foi mais curto para os chagásicos do que para os controles. Os resultados sugerem a existência de um distúrbio na osmorregulação, nos pacientes chagásicos, caracterizado por uma sensibilidade osmótíca aumentada dos osmorreceptores para liberação da vasopressina. Estes dados interpretam-se como conseqüente à desnervação em áreas hipotalâmicas ou extra-hipotalâmicas, relacionadas com a secreção do horm

Method of forming a package for MEMS-based fuel cell

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Morse, Jeffrey D; Jankowski, Alan F

2013-05-21

A MEMS-based fuel cell package and method thereof is disclosed. The fuel cell package comprises seven layers: (1) a sub-package fuel reservoir interface layer, (2) an anode manifold support layer, (3) a fuel/anode manifold and resistive heater layer, (4) a Thick Film Microporous Flow Host Structure layer containing a fuel cell, (5) an air manifold layer, (6) a cathode manifold support structure layer, and (7) a cap. Fuel cell packages with more than one fuel cell are formed by positioning stacks of these layers in series and/or parallel. The fuel cell package materials such as a molded plastic or a ceramic green tape material can be patterned, aligned and stacked to form three dimensional microfluidic channels that provide electrical feedthroughs from various layers which are bonded together and mechanically support a MEMS-based miniature fuel cell. The package incorporates resistive heating elements to control the temperature of the fuel cell stack. The package is fired to form a bond between the layers and one or more microporous flow host structures containing fuel cells are inserted within the Thick Film Microporous Flow Host Structure layer of the package.

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

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Iván Darío BRAVO-TOBAR

2015-10-01

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

Inhibition of Autoimmune Chagas-Like Heart Disease by Bone Marrow Transplantation

Czech Academy of Sciences Publication Activity Database

Guimaro, M.C.; Alves, R. J. V.; Rose, E.; Sousa, A.O.; Rosa, A.D.; Hecht, M.M.; Sousa, M.V.; Andrade, R.R.; Vital, T.; Plachý, Jiří; Nitz, N.; Hejnar, Jiří; Gomes, C.C.; Teixeira, A.R.L.

2014-01-01

Roč. 8, č. 12 (2014) ISSN 1935-2735 Institutional support: RVO:68378050 Keywords : Chagas disease * inbred chicken * adoptive transfer of immunity Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 4.446, year: 2014

Chagas' disease: an algorithm for donor screening and positive donor counseling

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Nelson Hamerschlak

1997-06-01

Full Text Available Classical serological screening assays for Chagas' disease are time consuming and subjective. The objective of the present work is to evaluate the enzyme immuno-assay (ELISA methodology and to propose an algorithm for blood banks to be applied to Chagas' disease. Seven thousand, nine hundred and ninety nine blood donor samples were screened by both reverse passive hemagglutination (RPHA and indirect immunofluorescence assay (IFA. Samples reactive on RPHA and/or IFA were submitted to supplementary RPHA, IFA and complement fixation (CFA tests. This strategy allowed us to create a panel of 60 samples to evaluate the ELISA methodology from 3 different manufacturers. The sensitivity of the screening by IFA and the 3 different ELISA's was 100%. The specificity was better on ELISA methodology. For Chagas disease, ELISA seems to be the best test for blood donor screening, because it showed high sensitivity and specificity, it is not subjective and can be automated. Therefore, it was possible to propose an algorithm to screen samples and confirm donor results at the blood bank.Os testes sorológicos clássicos utilizados na triagem de doadores de sangue são trabalhosos e subjetivos. O objetivo do presente trabalho é o de avaliar a metodologia imuno-enzimática (ELISA e propor um algorítmo para doença de Chagas em bancos de sangue. Foram estudados 7999 doadores de sangue e/ou componentes cujas amostras foram testadas com o objetivo de tria-las sorologicamente para doença de Chagas utilizando hemaglutinação passiva reversa (RPHA e imunofluorescência indireta (IFA. As amostras reativas em pelo menos uma destas metodologias, foram retestadas com reativos diferentes por RPHA, IFA e fixação de complemento (CFA. Esta estratégia nos permitiu criar um painel de 60 amostras com as quais tornou-se possível a avaliação do método imunoenzimático (ELISA. A sensibilidade da triagem dos doadores pelos métodos ELISA e IFA foi de 100%. A especificidade

Access to benznidazole for Chagas disease in the United States-Cautious optimism?

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Jonathan D Alpern

2017-09-01

Full Text Available Drugs for neglected tropical diseases (NTD are being excessively priced in the United States. Benznidazole, the first-line drug for Chagas disease, may become approved by the Food and Drug Administration (FDA and manufactured by a private company in the US, thus placing it at risk of similar pricing. Chagas disease is an NTD caused by Trypanosoma cruzi; it is endemic to Latin America, infecting 8 million individuals. Human migration has changed the epidemiology causing nonendemic countries to face increased challenges in diagnosing and managing patients with Chagas disease. Only 2 drugs exist with proven efficacy: benznidazole and nifurtimox. Benznidazole has historically faced supply problems and drug shortages, limiting accessibility. In the US, it is currently only available under an investigational new drug (IND protocol from the CDC and is provided free of charge to patients. However, 2 companies have stated that they intend to submit a New Drug Application (NDA for FDA approval. Based on recent history of companies acquiring licensing rights for NTD drugs in the US with limited availability, it is likely that benznidazole will become excessively priced by the manufacturer-paradoxically making it less accessible. However, if the companies can be taken at their word, there may be reason for optimism.

Access to benznidazole for Chagas disease in the United States-Cautious optimism?

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Alpern, Jonathan D; Lopez-Velez, Rogelio; Stauffer, William M

2017-09-01

Drugs for neglected tropical diseases (NTD) are being excessively priced in the United States. Benznidazole, the first-line drug for Chagas disease, may become approved by the Food and Drug Administration (FDA) and manufactured by a private company in the US, thus placing it at risk of similar pricing. Chagas disease is an NTD caused by Trypanosoma cruzi; it is endemic to Latin America, infecting 8 million individuals. Human migration has changed the epidemiology causing nonendemic countries to face increased challenges in diagnosing and managing patients with Chagas disease. Only 2 drugs exist with proven efficacy: benznidazole and nifurtimox. Benznidazole has historically faced supply problems and drug shortages, limiting accessibility. In the US, it is currently only available under an investigational new drug (IND) protocol from the CDC and is provided free of charge to patients. However, 2 companies have stated that they intend to submit a New Drug Application (NDA) for FDA approval. Based on recent history of companies acquiring licensing rights for NTD drugs in the US with limited availability, it is likely that benznidazole will become excessively priced by the manufacturer-paradoxically making it less accessible. However, if the companies can be taken at their word, there may be reason for optimism.

Omega-3 supplementation on inflammatory markers in patients with chronic Chagas cardiomyopathy: a randomized clinical study.

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Silva, Paula Simplício da; Mediano, Mauro Felippe Felix; Silva, Gilberto Marcelo Sperandio da; Brito, Patricia Dias de; Cardoso, Claudia Santos de Aguiar; Almeida, Cristiane Fonseca de; Sangenis, Luiz Henrique Conde; Pinheiro, Roberta Olmo; Hasslocher-Moreno, Alejandro Marcel; Brasil, Pedro Emmanuel Alvarenga Americano do; Sousa, Andrea Silvestre de

2017-06-09

Several studies have been focusing on the effect of omega-3 polyunsaturated fatty acids on modulation of inflammatory markers in several cardiopathies. Although immunoregulatory dysfunction has been associated to the chronic cardiac involvement in Chagas disease, there is no study examining the effects of omega-3 supplementation in these patients. We investigated the effects of omega-3 PUFAs on markers of inflammation and lipid profile in chronic Chagas cardiomyopathy patients. The present study was a single-center double-blind clinical trial including patients with chronic Chagas cardiomyopathy. Patients were randomly assigned to receive omega-3 PUFAs capsules (1.8g EPA and 1.2g DHA) or placebo (corn oil) during an 8-week period. Cytokines, fasting glucose, lipid, and anthropometric profiles were evaluated. Forty-two patients (23 women and 19 men) were included in the study and there were only two losses to follow-up during the 8-week period. Most of sociodemographic and clinical characteristics were similar between the groups at baseline, except for the cytokines IL-1β, IL-6, IL-8, IL-10, IL-17α, and IFNγ. The omega-3 PUFAs group demonstrated greater improvements in serum triglycerides (-21.1 vs. -4.1; p = 0.05) and IL-10 levels (-10.6 vs. -35.7; p = 0.01) in comparison to controls after 8 weeks of intervention. No further differences were observed between groups. Omega-3 PUFAs supplementation may favorably affect lipid and inflammatory profile in chronic Chagas cardiomyopathy patients, demonstrated by a decrease in triglycerides and improvements on IL-10 concentration. Further studies examining the clinical effects of omega-3 fatty acids supplementation in chronic Chagas cardiomyopathy are necessary. NCT01863576.

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

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Martha Elba Gonzalez-Mejia

2014-04-01

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

Mapping of Chagas disease research: analysis of publications in the period between 1940 and 2009 Mapeamento de pesquisa da doença de Chagas: análise da produção de publicações no período entre 1940 e 2009

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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.INTRODUÇÃO: Publicações são frequentemente utilizadas como uma medida de sucesso do trabalho de pesquisa. A doença de Chagas (DCh ocorre na América Central e do Sul. Porém, durante os últimos anos, a doença tem ocorrido fora da América Latina, devido à migração das zonas endêmicas. Este artigo descreve uma análise bibliométrica da literatura sobre as pesquisas da doença de

Discrete typing units of Trypanosoma cruzi detected by real-time PCR in Chilean patients with chronic Chagas cardiomyopathy.

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Muñoz-San Martín, Catalina; Zulantay, Inés; Saavedra, Miguel; Fuentealba, Cristián; Muñoz, Gabriela; Apt, Werner

2018-05-07

Chagas disease is a major public health problem in Latin America and has spread to other countries due to immigration of infected persons. 10-30% of patients with chronic Chagas disease will develop cardiomyopathy. Chagas cardiomyopathy is the worst form of the disease, due to its high morbidity and mortality. Because of its prognostic value and adequate medical monitoring, it is very important to identify infected people who could develop Chagas cardiomyopathy. The aim of this study was to determine if discrete typing units (DTUs) of Trypanosoma cruzi are related to the presence of heart disease in patients with chronic Chagas disease. A total of 86 untreated patients, 41 with cardiomyopathy and 45 without heart involvement were submitted to clinical study. Electrocardiograms and echocardiograms were performed on the group of cardiopaths, in which all important known causes of cardiomyopathy were discarded. Sinus bradycardia and prolonged QTc interval were the most frequent electrocardiographic alterations and patients were classified in group I (46%) and group II (54%) of New York Hearth Association. In all cases real-time PCR genotyping assays were performed. In the group with cardiomyopathy, the most frequent DTU was TcI (56.1%), followed by TcII (19.5%). Mixed infections TcI + TcII were observed in 7.3% of the patients. In the group without cardiac pathologies, TcI and TcII were found at similar rates (28.9 and 31.1%, respectively) and mixed infections TcI + TcII in 17.8% of the cases. TcIII and TcIV were not detected in any sample. Taken together, our data indicate that chronic Chagas cardiomyopathy in Chile can be caused by strains belonging to TcI and TcII. Copyright © 2018 Elsevier B.V. All rights reserved.

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

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José Rodrigues Coura

2007-10-01

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

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

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

2006-03-01

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

Prevalence and Risk Factors for Chagas Disease in Pregnant Women in Casanare, Colombia

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Cucunubá, Zulma M.; Flórez, Astrid C.; Cárdenas, Ángela; Pavía, Paula; Montilla, Marleny; Aldana, Rodrigo; Villamizar, Katherine; Ríos, Lyda C.; Nicholls, Rubén S.; Puerta, Concepción J.

2012-01-01

Knowledge of the prevalence and risk factors associated with maternal infection is the first step to develop a surveillance system for congenital transmission of Chagas disease. We conducted a cross-sectional study in Casanare, a disease-endemic area in Colombia. A total of 982 patients were enrolled in the study. A global prevalence of Trypanosoma cruzi infection of 4.0% (95% confidence interval [CI] = 2.8–5.3%) was found. Multivariate analysis showed that the most important risk-associated factors were age > 29 years (adjusted odds ratio [aOR] = 3.4, 95% CI = 0.9–12.4), rural residency (aOR = 2.2, 95% CI = 1.0–4.6), low education level (aOR = 10.2, 95% CI = 1.6–82.7), and previous knowledge of the vector (aOR = 2.2, 95% CI = 1.0–4.9). Relatives and siblings of infected mothers showed a prevalence of 9.3%. These findings may help physicians to investigate congenital cases, screen Chagas disease in siblings and relatives, and provide early treatment to prevent the chronic complications of Chagas disease. PMID:23033397

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

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

2014-01-01

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

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.

A Review of Patents for the Smart Packaging of Meat and Muscle-based Food Products.

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Holman, Benjamin; Kerry, Joseph P; Hopkins, David L

2017-10-31

Meat packaging once acted primarily as an inert barrier to protect its contents against contamination and this function has shifted. Packaging now includes complementary functions that improve product quality, longevity and customer/retail appeal. The devices and methods applied to achieve these functions may be categorised as smart packaging, which includes intelligent packaging, devised to monitor and communicate packaged content status, and active packaging, to provide passive adjustment of in-pack conditions from its interactions with the packaged meat. Smart packaging examples already available from recent patents include antimicrobial and antioxidant packaging coatings and inserts; sensors or indicators that identify spoilage and freshness; functional engineering customisations; improvements to packaging integrity; leak or tamper detectors; and, environmentally sustainable options. Together, these inventions respond to industry and customer demands for meat packaging and are therefore the focus of this review, in which we discuss their applications and limitations in meat packaging. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Cardiomiopatía de Chagas.

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Fernando Rosas A.

2000-08-01

Full Text Available

La cardiomiopatía de Chagas es la causa más frecuente de cardiomiopatía en América Latina. Se constituye en la cuarta enfermedad parasitaria del continente, y es uno de los mayores problemas de salud pública en Colombia estimándose que existen 1.200.000 personas infectadas y que de éstos proba-blemente 25% desarrollaran una miocardiopatia crónica.

En nuestro país pocas series clínicas han sido descritas, generalmente asociadas a falla cardíaca secundaria a una cardiomiopatía dilatada. El propósito de este trabajo es presentar una reseña histórica de la enfermedad en la que se incluyen los primeros trabajos clínicos desarrollados en nuestro medio. Así mismo, algunos aspectos de la fisiopatología y de la evolución clínica. Finalmente presentaremos la reciente experiencia acumulada en nuestro país en este campo por diferentes investigadores.

Reseña Histórica
En el año 1909 fue publicado el artículo original del Dr. Carlos Chagas, titulado “Nueva Trypanosomiasis Humana: estudios sobre la morfología y el ciclo evolutivo del Schizotrypanum Cruzi, agente etiológico de una nueva entidad mórbida en el hombre” (1. En él se describe como el Dr. Chagas, fue encomendado en 1907, por el Dr. Oswaldo Cruz (Director del instituto que posteriormente llevó su nombre, para ejecutar una campaña antipalúdica en los servicios de construcción de ferrocarriles en el norte del estado de Minas Gerais.

En esa zona conoció la existencia de una hematófago denominado por los campesinos como “Barbeiro”, llamado así por que su picadura se localizaba usualmente en el rostro y era poco sintomática. El insecto habitaba en domicilios humanos, atacaba al hombre en la noche (después de apagar las luces, se ocultaba durante el día en las paredes y en los techos de las casas construidas en bahareque y paja. El hematófago fue identificado como perteneciente a la familia Reduviidae. Algunos de los

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

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José R. Coura

1993-12-01

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

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

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H. C. de Souza-Araujo

1954-06-01

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

Chagas' disease: IgG isotypes against cytoplasmic (CRA) and flagellar (FRA) recombinant repetitive antigens of Trypanosoma cruzi in chronic Chagasic patients.

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Verçosa, A F A; Lorena, V M B; Carvalho, C L; Melo, M F A D; Cavalcanti, M G A; Silva, E D; Ferreira, A G P; Pereira, V R A; Souza, W V; Gomes, Y M

2007-01-01

The wide range of clinical Chagas' disease manifestations, of which heart involvement is the most significant, because of its characteristics, frequency and consequences, and lack of treatment and cure, justify research in this area. Specific immunoglobulin G (IgG) antibody subclasses have been associated with human Chagas' disease. Thus, in this study, the profile of IgG subclasses against cytoplasmic (CRA) and flagellar (FRA) recombinant repetitive T. cruzi-specific antigens was correlated with cardiac (CARD, n=33), cardiodigestive (CD, n=7), and indeterminate (IND, n=20) forms of Chagas' disease by indirect enzyme-linked immunosorbent assay (ELISA). IgG subclasses were detected in almost all Chagas patients studied. Nevertheless, only specific IgG2 isotype FRA was found with a significant statistical difference in CARD patients when compared to IND patients. This result suggests the potential use of this isotype for prognostic purposes, for monitoring the progression of chronic Chagas' disease, and for predicting the risk of CARD damage. This is important information, as it could help physicians to evaluate and manage the treatment of their patients. However, a follow-up study is necessary to confirm our result. (c) 2007 Wiley-Liss, Inc.

A Wrapping Method for Inserting Titanium Micro-Mesh Implants in the Reconstruction of Blowout Fractures

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Tae Joon Choi

2016-01-01

Full Text Available Titanium micro-mesh implants are widely used in orbital wall reconstructions because they have several advantageous characteristics. However, the rough and irregular marginal spurs of the cut edges of the titanium mesh sheet impede the efficacious and minimally traumatic insertion of the implant, because these spurs may catch or hook the orbital soft tissue, skin, or conjunctiva during the insertion procedure. In order to prevent this problem, we developed an easy method of inserting a titanium micro-mesh, in which it is wrapped with the aseptic transparent plastic film that is used to pack surgical instruments or is attached to one side of the inner suture package. Fifty-four patients underwent orbital wall reconstruction using a transconjunctival or transcutaneous approach. The wrapped implant was easily inserted without catching or injuring the orbital soft tissue, skin, or conjunctiva. In most cases, the implant was inserted in one attempt. Postoperative computed tomographic scans showed excellent placement of the titanium micro-mesh and adequate anatomic reconstruction of the orbital walls. This wrapping insertion method may be useful for making the insertion of titanium micro-mesh implants in the reconstruction of orbital wall fractures easier and less traumatic.

Avaliação eletromanométrica do esfíncter superior do esôfago em portadores da forma indeterminada da doença de Chagas Manometric evaluation of upper esophageal sphincter in patients with indeterminate form of Chagas' disease

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Eduardo Crema

2006-04-01

Full Text Available Objetivou-se avaliar as alterações do esfíncter superior esofágico pela eletromanometria em 37 pacientes portadores da forma clínica indeterminada da doença de Chagas. Foram encontrados 18 (48,6% pacientes portadores de ondas sincrônicas. A média das pressões máximas do esfíncter foi significativamente maior entre os portadores de ondas sincrônicas. Assim, alguns indivíduos portadores da forma indeterminada da doença de Chagas possuem alterações funcionais caracterizadas pelo aumento da pressão do esfíncter superior do esôfago, que podem ser detectadas à eletromanometria.The objective was to study the disorders of upper esophageal sphincter in 37 patients with indeterminate clinical form of Chagas' disease. Eighty (48.6% patients with synchronic waves were found. The average maximum pressure value of the upper esophageal sphincter was significantly higher in the synchronic group. Subjects with indeterminate clinical form of Chagas' disease may have functional disorders demonstrated by an increase in the pressure of the upper esophageal sphincter.

Tendência da mortalidade relacionada à doença de Chagas, Estado de São Paulo, Brasil, 1985 a 2006: estudo usando causas múltiplas de morte Chagas disease-related mortality trends, state of São Paulo, Brazil, 1985 to 2006: a study using multiple causes of death

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Augusto Hasiak Santo

2009-10-01

Full Text Available OBJETIVO: Estudar a tendência da mortalidade relacionada à doença de Chagas informada em qualquer linha ou parte do atestado médico da declaração de óbito. MÉTODOS: Os dados provieram dos bancos de causas múltiplas de morte da Fundação Sistema Estadual de Análise de Dados de São Paulo (SEADE entre 1985 e 2006. As causas de morte foram caracterizadas como básicas, associadas (não-básicas e total de suas menções. RESULTADOS: No período de 22 anos, ocorreram 40 002 óbitos relacionados à doença de Chagas, dos quais 34 917 (87,29% como causa básica e 5 085 (12,71% como causa associada. Foi observado um declínio de 56,07% do coeficiente de mortalidade pela causa básica e estabilidade pela causa associada. O número de óbitos foi 44,5% maior entre os homens em relação às mulheres. O fato de 83,5% dos óbitos terem ocorrido a partir dos 45 anos de idade revela um efeito de coorte. As principais causas associadas da doença de Chagas como causa básica foram as complicações diretas do comprometimento cardíaco, como transtornos da condução, arritmias e insuficiência cardíaca. Para a doença de Chagas como causa associada, foram identificadas como causas básicas as doenças isquêmicas do coração, as doenças cerebrovasculares e as neoplasias. CONCLUSÕES: Para o total de suas menções, verificou-se uma queda do coeficiente de mortalidade de 51,34%, ao passo que a queda no número de óbitos foi de apenas 5,91%, tendo sido menor entre as mulheres, com um deslocamento das mortes para as idades mais avançadas. A metodologia das causas múltiplas de morte contribuiu para ampliar o conhecimento da história natural da doença de Chagas.OBJECTIVES: To study mortality trends related to Chagas disease taking into account all mentions of this cause listed on any line or part of the death certificate. METHODS: Mortality data for 1985-2006 were obtained from the multiple cause-of-death database maintained by the São Paulo

Perfil sorológico para doença de Chagas dos doadores de sangue do Hemocentro Regional de Uberaba Serological profile concerning Chagas' disease of blood donors at Uberaba Blood Center

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Helio Moraes-Souza

2006-06-01

Full Text Available Atualmente, um dos maiores problemas na triagem sorológica de doadores de sangue para doença de Chagas é a alta freqüência de reações indeterminadas, o que faz com que muitos indivíduos sadios sejam rotulados como portadores de uma doença grave. O presente trabalho tem o objetivo de analisar o comportamento sorológico para doença de Chagas dos doadores do Hemocentro Regional de Uberaba, MG e propor mecanismos para reduzir o índice de inaptidão sorológica para essa doença. Através de estudo retrospectivo, foi analisado o resultado sorológico de 79.729 amostras obtidas de doações de sangue realizadas neste Serviço entre janeiro de 2000 e dezembro de 2004. Os resultados foram analisados quanto às variáveis: tipo de doador (novo e de retorno, gênero e idade (inferior ou igual a 30 anos e superior a 30 anos. Para a análise estatística foram realizados os testes do Qui-Quadrado e de comparação de proporções (Z. A ocorrência de doações com sorologia não negativa para doença de Chagas entre doadores novos foi significativamente superior aos de retorno, com pCurrently one of the major problems in the serological selection of blood donors in respect to Chagas' disease is the high incidence of indeterminate reactions, making a large number of healthy individuals incorrectly diagnosed as seriously ill. This paper aims at evaluating the serological pattern of Chagas' disease of donors of the Uberaba Blood Center and also to propose mechanisms to reduce the rate of serological ineligibility due to suspicion of this disease. A retrospective study of the serological results of 79,729 samples of blood was carried out between January 2000 and December 2004. The results were analyzed according to the following variables: type of donor (first-time and multiple, gender and age (less than or equal to 30 or more than 30 years old. The statistical analysis was made using the chi-square test and a comparison of proportions (Z

A doença de Chagas e seu controle na América Latina: uma análise de possibilidades Chagas' disease and its control in Latin America: an analysis of possibilities

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João Carlos P. Dias

1993-06-01

Full Text Available A doença de Chagas segue como importante agravo à saúde na maior parte da América Latina, afetando 16 milhões de pessoas e colocando sob risco outras dezenas de milhões de indivíduos, geralmente de origem rural, pobres e socialmente marginalizados. As estratégias e insumos ao controle da endemia concentram-se no controle do vetor e da transmissão transfusional, mostrando-se eficientes e estando disponíveis há pelo menos duas décadas. Sua implementação depende basicamente de vontade política e de disponibilidade técnica e orçamentária, como demonstrado no exemplo brasileiro. São discutidos aspectos epidemiológicos e operacionais da luta antichagásica, o que envolve um horizonte de reformulação e aprimoramento dos próprios sistemas de saúde dos países endêmicos. O controle da doença é viável, constituindo-se num desafio às autoridades sanitárias e à opção dos países pela esfera social. Em particular, a superação da doença de Chagas pode ser um importante fator de catálise para a almejada unidade latino-americana.Chagas' disease is still a major public health problem in Latin America, affecting about 15 million individuals and leaving tens of millions of others at risk, most of whom are from rural areas and are socially marginalized. The main strategies and tools for the control of the disease are related to the vectorial and transfusional transmission of the parasite. Regular programs have proven effective, as in Brazil, and they depend basically on political will and basic technical and financial conditions. Epidemiologic and operational aspects of Chagas' disease control are discussed in this study, involving the reformulation and improvement of the health systems in affected countries. The fact that control can be attained is emphasized as a challenge to Latin American governments and public health officials. Control of Chagas' disease may be an additional part of the dream of Latin American unity.

High Resolution Esophageal Manometry in Patients with Chagas Disease: A Cross-Sectional Evaluation.

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Adrián Sánchez-Montalvá

2016-02-01

Full Text Available Gastrointestinal involvement affects 30-40% of the patients with chronic Chagas disease. Esophageal symptoms appear once the structural damage is established. Little is known about the usefulness of high resolution manometry to early identification of esophageal involvement.We performed a cross-sectional study at the Vall d'Hebron University Hospital (Barcelona, Spain between May 2011 and April 2012. Consecutive patients diagnosed with Chagas disease in the chronic phase were offered to participate. All patients underwent a structured questionnaire about digestive symptoms, a barium esophagogram (Rezende classification and an esophageal high resolution manometry (HRM. A control group of patients with heartburn who underwent an esophageal HRM in our hospital was selected.62 out of 73 patients that were included in the study fulfilled the study protocol. The median age of the Chagas disease group (CG was 37 (IQR 32-45 years, and 42 (67.7% patients were female. Twenty-seven (43.5% patients had esophageal symptoms, heartburn being the most frequent. Esophagogram was abnormal in 5 (8.77%. The esophageal HRM in the CG showed a pathological motility pattern in 14 patients (22.6%. All of them had minor disorders of the peristalsis (13 with ineffective esophageal motility and 1 with fragmented peristalsis. Hypotonic lower esophageal sphincter was found more frequently in the CG than in the control group (21% vs 3.3%; p<0.01. Upper esophageal sphincter was hypertonic in 22 (35.5% and hypotonic in 1 patient. When comparing specific manometric parameters or patterns in the CG according to the presence of symptoms or esophagogram no statistically significant association were seen, except for distal latency.The esophageal involvement measured by HRM in patients with chronic Chagas disease in our cohort is 22.6%. All the patients with esophageal alterations had minor disorders of the peristalsis. Symptoms and esophagogram results did not correlate with the HRM

Assessment of the insertion of reprocessed fuel spiked with thorium in a PWR core

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Castro, Victor F.; Monteiro, Fabiana B.A.; Pereira, Claubia, E-mail: victorfc@fis.grad.ufmg.br, E-mail: claubia@nuclear.ufmg.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Departamento de Engenharia Nuclear

2017-07-01

Reprocessed fuel by UREX+ technique and spiked with thorium was inserted in a PWR core and neutronic parameters have been analyzed. Based on the Final Safety Analysis Report (FSAR) of the Angra-2 reactor, the core was modeled and simulated with SCALE6.0 package. The neutronic data evaluation was carried out by the analysis of the effective and infinite multiplication factors, and the fuel evolution during the burnup. The conversion ratio (CR) was also evaluated. The results show that, when inserting reprocessed fuel spiked with thorium, the insertion of burnable poison rods is not necessary, due to the amount of absorber isotopes present in the fuel. Besides, the conversion ratio obtained was greater than the presented by standard UO{sub 2} fuel, indicating the possibility of extending the burnup. (author)

Synthetic Medicinal Chemistry in Chagas' Disease: Compounds at The Final Stage of "Hit-To-Lead" Phase.

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Cerecetto, Hugo; González, Mercedes

2010-03-25

Chagas' disease, or American trypanosomosiasis, has been the most relevant illness produced by protozoa in Latin America. Synthetic medicinal chemistry efforts have provided an extensive number of chemodiverse hits at the "active-to-hit" stage. However, only a more limited number of these have been studied in vivo in models of Chagas' disease. Herein, we survey some of the cantidates able to surpass the "hit-to-lead" stage discussing their limitations or merit to enter in clinical trials in the short term.

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

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

2015-05-01

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

The current screening programme for congenital transmission of Chagas disease in Catalonia, Spain.

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Basile, L; Oliveira, I; Ciruela, P; Plasencia, A

2011-09-22

Due to considerable numbers of migrants from Chagas disease-endemic countries living in Catalonia, the Catalonian Health Department has recently implemented a screening programme for preventing congenital transmission, targeting Latin American pregnant women who attend antenatal consultations. Diagnosis of Trypanosoma cruzi infection in women is based on two positive serological tests. Screening of newborns from mothers with positive serology is based on a parasitological test during the first 48 hours of life and/or conventional serological analysis at the age of nine months. If either of these tests is positive, treatment with benznidazole is started following the World Health Organization's recommendations. The epidemiological surveillance of the programme is based on the Microbiological Reporting System of Catalonia, a well established network of laboratories. Once a positive case is reported, the responsible physician is asked to complete a structured epidemiological questionnaire. Clinical and demographic data are registered in the Voluntary Case Registry of Chagas Disease, a database administered by the Catalonian Health Department. It is expected that this programme will improve the understanding of the real burden of Chagas disease in the region. Furthermore, this initiative could encourage the implementation of similar programmes in other regions of Spain and even in other European countries.

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

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Abelin, N.M.A.

1978-01-01

The TSH and T 3 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 T 4 , 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 T 3 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 T 3 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) [pt

Chronic gastritis and Helicobacter pylori in digestive form of Chagas' disease Gastrite crônica e Helicobacter Pylori na forma digestiva da doença de Chagas

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A. J. A. Barbosa

1993-04-01

Full Text Available Patients with the digestive form of Chagas'disease frequently present chronic gastritis. As the microorganism Helicobacter pylori is now accepted as the most common cause of human chronic gastritis, the present work was undertaken to verify a possible relationship between the presence of this bacterium and inflammatory changes of antral mucosa in chagasic patients. Seventeen chagasics, with megaesophagus and or megacolon were studied. Fragments from two different regions of antral mucosa were obtained by endoscopy, fixed in 4% neutral formaldehyde and embedded in paraffin. The sections were stained by haematoxylin and eosin for histology analysis, and by carbolfuchsin for H. pylori identification. H. pylori was found in 16 (94.1% chagasic patients, all of them presenting chronic gastritis. Superficial gastritis was seen in 9 (52.9% while atrophic gastritis was present in 8 (47.1% patients. H. pylori was present on gastric mucosa of 8 (100% patients with atrophic gastritis and of 8 (88.8% patients with superficial gastritis. We concluded that the microorganism H. pylori should be considered a possible factor connected with the etiopathogenesis of chronic superficial and atrophic gastritis frequently observed in patients with the digestive form of Chagas' disease.Pacientes com a forma digestiva da doença de Chagas frequentemente apresentam gastrite crônica. Tendo em vista que o microrganismo Helicobacter pylori é hoje considerado a causa mais comum de gastrite crônica no homem, propôs-se a realização deste trabalho para se verificar a possibilidade de esta bactéria estar também associada com as alterações inflamatórias da mucosa gástrica em pacientes com a forma digestiva da doença de Chagas. Fragmentos de duas regiões diferentes da mucosa antral foram obtidos endoscopicamente de 17 pacientes chagásicos com megaesôfago e ou megacolon. Os fragmentos foram processados rotineiramente para inclusão em parafina e cortes de 5 |im de

A Multi-species Bait for Chagas Disease Vectors

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Mota, Theo; Vitta, Ana C. R.; Lorenzo-Figueiras, Alicia N.; Barezani, Carla P.; Zani, Carlos L.; Lazzari, Claudio R.; Diotaiuti, Liléia; Jeffares, Lynne; Bohman, Björn; Lorenzo, Marcelo G.

2014-01-01

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. PMID:24587457

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

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Náquira, César

2014-04-01

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

Increased levels of IgA antibodies against CRA and FRA recombinant antigens of Trypanosoma cruzi differentiate digestive forms of Chagas disease.

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Vasconcelos, Romero H T; Amaral, Fábio N; Cavalcanti, Maria G A M; Silva, Edimilson D; Ferreira, Antonio G P; Morais, Clarice N L; Gomes, Yara M

2010-10-01

In the chronic phase of Chagas disease, individuals infected by Trypanosoma cruzi may be asymptomatic or may present cardiac and/or digestive complications. Our aim here was to analyze the relationship between the presence of specific immunoglobulin A antibodies and the different chronic clinical forms of Chagas disease using two recombinant antigens of Trypanosoma cruzi, cytoplasmatic repetitive antigen and flagellar repetitive antigen. The association of this immunoglobulin isotype with the digestive and cardio-digestive forms of the disease determined by indirect enzyme-linked immunosorbent assay, strongly suggests that IgA antibodies against these recombinant antigens of T. cruzi can be used as an immunological marker of the digestive alterations caused by Chagas disease. The tests performed in this study show that it is possible to differentiate digestive forms of Chagas disease. The knowledge provided by these results may help physicians to manage early alterations in the digestive tract of patients with the indeterminate or cardiac forms of Chagas disease. Prospective studies, however, with follow-up of the patients that presenting with high levels of immunoglobulin A against cytoplasmatic repetitive antigen and flagellar repetitive antigen recombinant antigens, need to be conducted to confirm this hypothesis. 2010 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

A ciência como profissão: entrevista com Carlos Chagas Filho Science as a profession: an interview with Carlos Chagas Filho

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Nara Azevedo

2012-06-01

Full Text Available A edição desta entrevista privilegia aspectos da extensa trajetória profissional de Carlos Chagas Filho, fundador do Instituto de Biofísica da Universidade do Brasil, atual Universidade Federal do Rio de Janeiro. Evidencia seu papel científico e político na ciência brasileira e no cenário internacional. As memórias de Chagas Filho abrangem a vivência no Instituto Oswaldo Cruz, onde iniciou seu treinamento científico; os esforços para estruturar o Laboratório de Física Biológica, sucedido pelo Instituto de Biofísica; a atuação no Conselho Nacional de Pesquisas e na Academia Brasileira de Ciências; a participação na Organização das Nações Unidas para a Educação, a Ciência e a Cultura; a presidência da Academia Pontifícia do Vaticano, que o leva a tecer considerações sobre a relação entre ciência e religião.The editing of this interview focuses on aspects of the extensive professional career of Carlos Chagas Filho, who was the founder of the Instituto de Biofísica of the Universidade do Brasil, currently the Universidade Federal do Rio de Janeiro. It highlights the scientific and political role he played in Brazilian science and on the international scene. His memoirs include his experience at the Instituto Oswaldo Cruz, where he began his scientific training; the efforts to create the Laboratório de Física Biológica, succeeded by the Instituto de Biofísica; his work on the Conselho Nacional de Pesquisas and the Academia Brasileira de Ciências; the part he played at the United Nations Educational, Scientific and Cultural Organization; his time as president of the Pontifical Academy of Sciences of the Vatican, which led him to ponder questions about the relationship between science and religion.

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.

Next-generation ELISA diagnostic assay for Chagas Disease based on the combination of short peptidic epitopes.

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Juan Mucci

2017-10-01

Full Text Available Chagas Disease, caused by the protozoan Trypanosoma cruzi, is a major health and economic problem in Latin America for which no vaccine or appropriate drugs for large-scale public health interventions are yet available. Accurate diagnosis is essential for the early identification and follow up of vector-borne cases and to prevent transmission of the disease by way of blood transfusions and organ transplantation. Diagnosis is routinely performed using serological methods, some of which require the production of parasite lysates, parasite antigenic fractions or purified recombinant antigens. Although available serological tests give satisfactory results, the production of reliable reagents remains laborious and expensive. Short peptides spanning linear B-cell epitopes have proven ideal serodiagnostic reagents in a wide range of diseases. Recently, we have conducted a large-scale screening of T. cruzi linear B-cell epitopes using high-density peptide chips, leading to the identification of several hundred novel sequence signatures associated to chronic Chagas Disease. Here, we performed a serological assessment of 27 selected epitopes and of their use in a novel multipeptide-based diagnostic method. A combination of 7 of these peptides were finally evaluated in ELISA format against a panel of 199 sera samples (Chagas-positive and negative, including sera from Leishmaniasis-positive subjects. The multipeptide formulation displayed a high diagnostic performance, with a sensitivity of 96.3% and a specificity of 99.15%. Therefore, the use of synthetic peptides as diagnostic tools are an attractive alternative in Chagas' disease diagnosis.

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.

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.

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%.

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

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Domingues, Heloisa Maria Bertol

2012-06-01

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

[Possible oral transmission of Chagas disease among hydrocarbons sector workers in Casanare, Colombia, 2014].

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Zuleta-Dueñas, Liliana Patricia; López-Quiroga, Ángela Johana; Torres-Torres, Fernando; Castañeda-Porras, Oneida

2017-06-01

Trypanosoma cruzi, the etiological agent for Chagas disease, can be transmitted by oral intake of contaminated food or drinks. During epidemiological week 14 of 2014, two cases of acute Chagas disease were notified among hydrocarbons sector workers in Paz de Ariporo, Casanare. To characterize the affected population, to establish control and prevention measures and to confirm the outbreak. We conducted an outbreak investigation that included the following components: a) Search for symptomatic people compatible with Chagas disease according to the case definition for their referral to medical services; b) entomological survey (192/197 houses); c) sanitary inspection and microbiological analysis of food samples; and d) study of reservoirs. Data management and analysis were done with Epi-Info 7.1.5 using descriptive statistics. We also calculated intradomicile and peridomicile triatomine infestation indexes. We detected 552 exposed people; 40 had the disease (7.2%), of whom seven were women (17,5%) and 33, men (82.5%), i.e., a male-female ratio of 5:1. The mean age was 39.1 ± 10.8 years; the attack rate was 7.2% and lethality, 5% (2/40). Symptoms included fever (100% of cases), headache (80%), myalgia and arthralgia (65%), facial edema (55%), and abdominal pain (37.5%). The mean incubation time was 17 days (range: 3-21). Rhodnius prolixus domiciliary infestation index was 3.3 % and 2.2% in the peridomicile. In the five restaurants inspected sanitary conditions were deficient and food samples were microbiologically non-conforming. We found a dog and two opossums positive for IgG antibodies by ELISA. Environmental, sanitary and epidemiological conditions at the place confirmed an outbreak of Chagas diseases related to occupational exposure, possibly by oral transmission, which may be the largest to date in Colombia.

Congenital Chagas's disease in an urban population: investigation of infected twins.

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Hoff, R; Mott, K E; Milanesi, M L; Bittencourt, A L; Barbosa, H S

1978-01-01

In the Nordeste de Amaralina suburb of Salvador Bahia, Brazil, 47 of 285 pregnant women surveyed had complement fixing antibodies to Trypanosoma cruzi. At delivery T. cruzi was detected in one of 17 placentas from the sero-positive women. The offspring of this case were premature twins and T. cruzi was detected in the peripheral blood of each before death. At autopsy the gastro-intestinal tract and urinary bladder of both were severely affected. Immunofluorescence tests on cord sera, including the single case with T. cruzi in the placenta, were negative for IgM antibodies to T. cruzi. The mother of the infected twins and three of her living children, who were born and have resided in the city, were also infected with T. cruzi. Although the children had visited an area endemic for Chagas's disease for short periods, the mode of transmission in this family may have been transplacental. The value of the immunofluorescence test in the diagnosis of congenital Chagas's disease is discussed.

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.

Clínica e terapêutica da doença de Chagas

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Francisco S. Laranja

1948-06-01

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

La enfermedad de Chagas en la zona central de Honduras: conocimientos, creencias y prácticas Knowledge, beliefs and practices about Chagas' disease in central Honduras

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Gustavo Ávila Montes

1998-03-01

Full Text Available En el período de noviembre a diciembre de 1991 y en marzo de 1993 se realizó una encuesta en 17 comunidades rurales de la parte central de Honduras. Las comunidades correspondían a dos zonas en las que la enfermedad de Chagas es endémica. En una de las zonas habían tenido lugar actividades de control de la enfermedad. Fueron entrevistados 849 adultos, uno en cada uno de otros tantos hogares familiares. El objetivo de la encuesta fue investigar y comparar en ambas zonas los conocimientos sobre la enfermedad de Chagas y sus mecanismos de transmisión, las prácticas para evitar la presencia de triatómidos en las viviendas, las creencias acerca de los triatómidos y su control, y las fuentes a partir de las cuales la población obtiene información sobre la enfermedad. Se utilizó un cuestionario de 23 preguntas validado y precodificado. Casi 100% de los entrevistados pudieron reconocer el vector y conocían sus hábitos, pero solo 30,1% sabían que el Triatoma es vector transmisor de la enfermedad y apenas 6% pudieron mencionar su relación con una afección cardíaca crónica. El 47,9% de los entrevistados indicó que la responsabilidad de eliminar los triatómidos de la vivienda es personal, aunque 78% consideraron como medida de control la aplicación institucional de insecticidas. El contacto personal entre el funcionario institucional y los miembros de la comunidad fue la principal fuente de información entre los que mencionaron haber oído de la enfermedad de Chagas (41,0%. Los resultados sugieren que al planificar medidas de control se debe incluir el componente de educación sanitaria. Ha de ponerse énfasis en el papel que desempeñan los triatómidos en la transmisión, así como en la importancia de mejorar la vivienda como medida eficaz y sostenible mediante la participación de la comunidad. Este componente deberá ser desarrollado por canales de comunicación interpersonales para obtener un mayor impacto.From November to

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

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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

Longitudinal study of the indirect immunofluorescence and complement fixation tests for diagnosis of chagas' disease in immunosuppressed patients submitted to renal transplantation

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José Fernando de Castro Figueiredo

1993-12-01

Full Text Available Clinical and serological follow-up of 7 patients submitted to renal transplantation and presenting positive serological reactions to Chagas 'disease before immunossupression did not show significant changes in indirect immunofluorescence and complement fixation titres for Chagas ' disease, or signs and symptoms indicating exacerbation of the disease during follow- up. In addition, 18 of 66 recipients of renal transplants considered to be non-chagasic before immunosuppression showed at least one positive result to the indirect immunofluorescence test for Chagas ' disease during the study period. The results suggest that the immunosuppression State induced in chagasic patients submitted to renal transplant did notpromoted exacerbation of the chronic infection in these patients and not interfere with the serological response of chronic chagasics, thus permitting the use of these serologic reactions for diagnostic purposes in these cases. However, the positive results ofthe indirect immunofluorescence test in non- chagasic patients indicate the needforjudicious interpretation ofthe indirect immunofluorescence test for the diagnosis of Chagas' disease in renal transplanted patients.

Estudo clínico-epidemiológico da doença de Chagas no distrito de Serra Azul, Mateus Leme, centro-oeste do Estado de Minas Gerais Clinic and epidemiological study on Chagas disease in the Serra Azul district of Mateus Leme, central-western region of the State of Minas Gerais, Brazil

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Élvio Marques da Silva

2010-04-01

Full Text Available INTRODUÇÃO: A doença de Chagas permanece como grave problema de saúde pública na América Latina, mesmo com o controle de sua transmissão. Esse estudo avaliou a prevalência da doença de Chagas no distrito de Serra Azul, Centro-Oeste de Minas Gerais, identificando as anormalidades eletrocardiografias dos indivíduos com sorologia positiva. MÉTODOS: A sorologia para doença de Chagas foi realizada em 676 indivíduos (48% da população. O exame clínico e o eletrocardiograma (ECG foram realizados na população sorologicamente positiva. Selecionou-se um grupo controle para comparação dos dados do ECG. RESULTADOS: A população estudada residia principalmente em área rural, com baixo nível sóciocultural. Quatorze indivíduos foram positivos, com prevalência de 2,1%. Os indivíduos chagásicos eram de faixa etária mais avançada (67 vs 39 anos; p INTRODUCTION: Chagas disease remains a severe public health problem in Latin America, despite control over its transmission. This study evaluated the prevalence of Chagas disease in the Serra Azul district, in the central-western region of the State of Minas Gerais, through identifying electrocardiographic (EKG abnormalities among serologically positive individuals. METHODS: Specific serological tests for Chagas disease were carried out on 676 individuals (48% of the population. Clinical examinations and EKGs were performed on the serologically positive population. A control group was selected for comparison with the EKG data. RESULTS: The study population lived mainly in rural areas, with low sociocultural level. Forty subjects were positive (prevalence of 2.1%. The individuals with Chagas disease were in an older age group (67 vs. 39 years; p < 0.001. EKG abnormalities were frequent among the individuals with Chagas disease (79%. Among the seropositive individuals, the EKGs showed greater prevalence of ventricular premature beats and conduction disorder of the right branch alone or in

Lineage Analysis of Circulating Trypanosoma cruzi Parasites and Their Association with Clinical Forms of Chagas Disease in Bolivia

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del Puerto, Ramona; Nishizawa, Juan Eiki; Kikuchi, Mihoko; Iihoshi, Naomi; Roca, Yelin; Avilas, Cinthia; Gianella, Alberto; Lora, Javier; Gutierrez Velarde, Freddy Udalrico; Renjel, Luis Alberto; Miura, Sachio; Higo, Hiroo; Komiya, Norihiro; Maemura, Koji; Hirayama, Kenji

2010-01-01

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. PMID:20502516

La enfermedad de Chagas ya no es tan exótica

Centers for Disease Control (CDC) Podcasts

Este podcast tiene el propósito de informar a los profesionales de la salud sobre la enfermedad de Chagas, su diagnóstico y tratamiento, así como orientar en la identificación de pacientes infectados.

Análise comparativa de embalagens secundárias e bulas de medicamentos contendo Panax ginseng C. A. Meyer A comparative analysis of inner wrapping and package inserts for medicines containing Panax ginseng C. A. Meyer

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Mariangela Tirico Auricchio

2007-10-01

Full Text Available As informações contidas nas bulas e embalagem de medicamentos de diferentes fabricantes contendo Panax ginseng foram analisadas comparativamente com os dados encontrados na literatura científica. Observaram-se bulas longas, com várias informações em relação às indicações de uso, muitas das quais sem comprovação em humanos, e todas foram deficitárias em relação aos .efeitos adversos e interações medicamentosas. Foi observada falta de padronização quanto às posologias, em relação tanto ao extrato seco, quanto ao teor dos ginsenosídeos presentes. Constatou-se a falta de homogeneidade nas informações aos usuários sobre indicações de uso, efeitos adversos e interações medicamentosas entre as oito amostras estudadas.The information provided on package inserts and inner wrapping of eight products containing Panax ginseng from different manufacturers was compared internally and checked against data from the scientific literature. The inserts included extensive text, containing abundant information on indications for use, but no scientific evidence in humans. All the inserts lacked information on potential adverse effects and drug interaction. There was no standardization as to dose regimens, particularly in relation to the dried extract and ginsenoside concentration. The eight inserts thus showed no concern over standardization, indication for usage, or possible side effects and drug interactions.

Doença de Chagas: Desafios no Desenvolvimento de Novas Substâncias Líderes Tripanomicidas

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Fernando de C. da Silva; Universidade Federal Fluminense; Sabrina B. Ferreira; Universidade Federal do Rio de Janeiro; David R. da Rocha; Universidade Federal Fluminense; Vitor F. Ferreira; Universidade Federal Fluminense

2012-01-01

A doença de Chagas teve seu ciclo completamente elucidado em 1909 por Carlos Chagas, quando ele relatou sua descoberta para a comunidade científica em dois artigos seminais. Hoje ainda existem inúmeros fatores que limitam o seu tratamento terapêutico. Um deles é a falta de novas drogas no mercado, pois é bem conhecido que as drogas existentes são fracamente ativas e tem baixa eficácia e consideráveis efeitos colaterais. Atualmente muitos esforços têm sido feito em química combinatória e sínte...

Polymorphisms in the gene for lymphotoxin-alpha predispose to chronic Chagas cardiomyopathy.

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Ramasawmy, Rajendranath; Fae, Kellen C; Cunha-Neto, Edecio; Müller, Natalie G; Cavalcanti, Vanessa L; Ferreira, Renata C; Drigo, Sandra A; Ianni, Barbara; Mady, Charles; Goldberg, Anna C; Kalil, Jorge

2007-12-15

Chagas disease, caused by Trypanosoma cruzi infection, displays clinical heterogeneity and may be attributable to differential genetic susceptibility. Chronic Chagas cardiomyopathy (CCC) develops only in a subset of T. cruzi-infected individuals and may lead to heart failure that has a worse clinical course and that leads to reduced life expectancy, compared with heart failure of other etiologies. Proinflammatory cytokines play a key role in the development of CCC. Clinical, genetic, and epidemiological studies have linked lymphotoxin-alpha (LTA), a proinflammatory cytokine, to coronary artery disease and myocardial infarction. We used polymerase chain reaction to genotype the LTA +80A-->C and LTA +252A-->G variants in 169 patients with CCC and in 76 T. cruzi-infected asymptomatic (ASY) patients. Homozygosity with respect to the LTA +80C and LTA +252G alleles was significantly more frequent in the patients with CCC than in the ASY patients (homozygosity for LTA +80C, 47% vs. 33%; homozygosity for LTA +252G, 16% vs. 8%). Haplotype LTA +80A-252A was associated with protection against CCC, whereas haplotype LTA +80C-252G was associated with susceptibility to CCC. Furthermore, homozygosity for the LTA +80A allele correlated with the lowest levels of plasmatic tumor-necrosis factor-alpha. Our results suggest that the study of genetic variations in patients with Chagas disease may help in the identification of individuals at increased risk of progressing to CCC and, by providing early treatment, reduce the morbidity and mortality associated with this disease.

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

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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.

Epidemiology of Chagas disease in Ecuador. A brief review

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Aguilar V H Marcelo

1999-01-01

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

[Management of Chagas disease in Europe. Experiences and challenges in Spain, Switzerland and Italy].

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Jackson, Y; Angheben, A; Carrilero Fernandez, B; Jansa i Lopez del Vallado, J M; Jannin, J G; Albajar-Viñas, P

2009-12-01

The intention of this article is not to describe the illness or evaluate the number of cases diagnosed in Spain, Switzerland and Italy, nor to analyse the protocols followed in various centres. The authors rather seek to examine the main technical, local and national challenges involved in the care of patients with Chagas disease. To this end, they review concisely a number of themes which are common to the three countries. These are: the detection of disease; confirmation of the diagnosis; treatment; response to treatment; follow-up; the risk of transmission by transfusion, by organ donation and from mother to child; the psychosocial and socio-economic aspects of Chagas disease outside endemic areas; and what progress needs to be made in improving information about the condition.

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

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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.

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

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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.

Lutte contre la maladie de Chagas en Amérique centrale | CRDI ...

International Development Research Centre (IDRC) Digital Library (Canada)

Guatemala,. En Amérique centrale, les insectes qui transmettent la maladie de Chagas sont nombreux. Les équipes de chercheurs mettent la démarche écosanté à l'épreuve dans 15 emplacements différents se trouvant dans les ...

The Prevalence of Chagas Heart Disease in a Central Bolivian Community Endemic for Trypanosoma Cruzi

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Yager, Jessica E.; Lozano Beltran, Daniel F.; Torrico, Faustino; Gilman, Robert H.; Bern, Caryn

2015-01-01

Background Though the incidence of new Trypanosoma cruzi infections has decreased significantly in endemic regions in the Americas, medical professionals continue to encounter a high burden of resulting Chagas disease among infected adults. The current prevalence of Chagas heart disease in a community setting is not known; nor is it known how recent insecticide vector control measures may have impacted the progression of cardiac disease in an infected population. Objectives and Methods Nested within a community serosurvey in rural and periurban communities in central Bolivia, we performed a cross-sectional cardiac substudy to evaluate adults for historical, clinical, and electrocardiographic evidence of cardiac disease. All adults between the ages of 20 and 60 years old with T. cruzi infection and those with a clinical history, physical exam, or ECG consistent with cardiac abnormalities were also scheduled for echocardiography. Results and conclusions Of the 604 cardiac substudy participants with definitive serology results, 183 were seropositive for infection with T. cruzi (30.3%). Participants who were seropositive for T. cruzi infection were more likely to have conduction system defects (1.6% versus 0 for complete right bundle branch block and 10.4% versus 1.9% for any bundle branch block; p=0.008 and p<0.001, respectively). However, there was no statistically significant difference in the prevalence of bradycardia among seropositive versus seronegative participants. Echocardiogram findings were not consistent with a high burden of Chagas cardiomyopathy: valvulopathies were the most common abnormality, and few participants were found to have low ejection fraction or left ventricular dilatation. No participants had significant heart failure. Though almost one third of adults in the community were seropositive for T. cruzi infection, few had evidence of Chagas heart disease. PMID:26407509

Wafer-Level Packaging Method for RF MEMS Applications Using Pre-Patterned BCB Polymer

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Zhuhao Gong

2018-02-01

Full Text Available A radio-frequency micro-electro-mechanical system (RF MEMS wafer-level packaging (WLP method using pre-patterned benzo-cyclo-butene (BCB polymers with a high-resistivity silicon cap is proposed to achieve high bonding quality and excellent RF performance. In this process, the BCB polymer was pre-defined to form the sealing ring and bonding layer by the spin-coating and patterning of photosensitive BCB before the cavity formation. During anisotropic wet etching of the silicon wafer to generate the housing cavity, the BCB sealing ring was protected by a sputtered Cr/Au (chromium/gold layer. The average measured thickness of the BCB layer was 5.9 μm. In contrast to the conventional methods of spin-coating BCB after fabricating cavities, the pre-patterned BCB method presented BCB bonding layers with better quality on severe topography surfaces in terms of increased uniformity of thickness and better surface flatness. The observation of the bonded layer showed that no void or gap formed on the protruding coplanar waveguide (CPW lines. A shear strength test was experimentally implemented as a function of the BCB widths in the range of 100–400 μm. The average shear strength of the packaged device was higher than 21.58 MPa. A RF MEMS switch was successfully packaged using this process with a negligible impact on the microwave characteristics and a significant improvement in the lifetime from below 10 million to over 1 billion. The measured insertion loss of the packaged RF MEMS switch was 0.779 dB and the insertion loss deterioration caused by the package structure was less than 0.2 dB at 30 GHz.

Real-Time PCR in HIV/Trypanosoma cruzi Coinfection with and without Chagas Disease Reactivation: Association with HIV Viral Load and CD4+ Level

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de Freitas, Vera Lúcia Teixeira; da Silva, Sheila Cristina Vicente; Sartori, Ana Marli; Bezerra, Rita Cristina; Westphalen, Elizabeth Visone Nunes; Molina, Tatiane Decaris; Teixeira, Antonio R. L.; Ibrahim, Karim Yaqub; Shikanai-Yasuda, Maria Aparecida

2011-01-01

Background Reactivation of chronic Chagas disease, which occurs in approximately 20% of patients coinfected with HIV/Trypanosoma cruzi (T. cruzi), is commonly characterized by severe meningoencephalitis and myocarditis. The use of quantitative molecular tests to monitor Chagas disease reactivation was analyzed. Methodology Polymerase chain reaction (PCR) of kDNA sequences, competitive (C-) PCR and real-time quantitative (q) PCR were compared with blood cultures and xenodiagnosis in samples from 91 patients (57 patients with chronic Chagas disease and 34 with HIV/T. cruzi coinfection), of whom 5 had reactivation of Chagas disease and 29 did not. Principal Findings qRT-PCR showed significant differences between groups; the highest parasitemia was observed in patients infected with HIV/T. cruzi with Chagas disease reactivation (median 1428.90 T. cruzi/mL), followed by patients with HIV/T. cruzi infection without reactivation (median 1.57 T. cruzi/mL) and patients with Chagas disease without HIV (median 0.00 T. cruzi/mL). Spearman's correlation coefficient showed that xenodiagnosis was correlated with blood culture, C-PCR and qRT-PCR. A stronger Spearman correlation index was found between C-PCR and qRT-PCR, the number of parasites and the HIV viral load, expressed as the number of CD4+ cells or the CD4+/CD8+ ratio. Conclusions qRT-PCR distinguished the groups of HIV/T. cruzi coinfected patients with and without reactivation. Therefore, this new method of qRT-PCR is proposed as a tool for prospective studies to analyze the importance of parasitemia (persistent and/or increased) as a criterion for recommending pre-emptive therapy in patients with chronic Chagas disease with HIV infection or immunosuppression. As seen in this study, an increase in HIV viral load and decreases in the number of CD4+ cells/mm3 and the CD4+/CD8+ ratio were identified as cofactors for increased parasitemia that can be used to target the introduction of early, pre-emptive therapy. PMID

An empirical study on the relationship of purchasing a chocolate based on its packaging

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Yasaman Giyahi

2012-04-01

Full Text Available Chocolate is one of popular gifts among people in many societies. Packaging of such product plays an important role on marketing this item and the primary question of this survey is to determine the impact of packaging on better introducing a product. The inference statistical tests show that packaging is an important item in selection of chocolate as a gift. Percentage of chocolate is the most important information on packaging and color of packaging is of paramount significance when customers purchase chocolate for individuals with official relationship. In this paper, we present an empirical study to measure the effects of chocolates' packaging on purchasing them. The proposed study of this paper designs a questionnaire and distributes them among different people. The results are analyzed using some non-parametric tests and they are discussed. The preliminary results indicate that the number of purchased packages within a year, cost of purchasing chocolate within a year, type of relationship of recipients of chocolate as gift, gender of recipient of chocolate as gift, age group of recipient of gift, type of store, nationality of chocolate, significance of packaging in various price ranges, type of packaging, insertion of information on package and color of packaging, are important factors influencing people to buy more.

Chagas Disease in Dogs from Endemic Areas of Costa Rica

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Montenegro Victor M

2002-01-01

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

Chagas disease transmission by consumption of game meat: systematic review.

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Sangenis, Luiz Henrique Conde; Nielebock, Marco Antonio Prates; Santos, Ceumara da Silva; Silva, Mateus Curty Carriello da; Bento, Glauber Motta Ribeiro

2016-01-01

To evaluate the influence of game meat consumption in Chagas disease (CD) transmission, the conditions under which it occurs and the frequency of reports in the literature. Through systematic review, databases PubMed, LILACS, MEDLINE, and SciELO were consulted, and articles written in Portuguese, English, and Spanish were included, with no limitation over publication date. We used the following descriptors: oral, transmission, meat, wild animals, hunt, carnivory, and Chagas disease. Articles that mentioned consumption of animal meat as a form of human transmission of CD were included. We used epidemiological, clinical, and laboratory evidence criteria to confirm cases. Among the 298 articles identified, only six met the eligibility criteria. Only five episodes of oral transmission through wild animal meat or blood consumption were identified. However, in two of them, the possibility of vectorial transmission could not be ruled out. Most reports met the epidemiological, clinical, and laboratory evidence criteria established to support the transmission. Though CD transmission is uncommon, hunting and consumption of wild mammals that serve as Trypanosoma cruzi reservoirs should be discouraged in endemic countries in light of the risks inherent to these practices.

First installation of DT and RPC packages into the CMS iron yoke

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Jesus Puerta-Pelayo

2004-01-01

These pictures illustrate the installation process of muon barrel packages (DT + RPC) into the pockets of the CMS iron yoke at SX5. The chambers are first transported in groups of four from the ISR area (where they are certified and coupled together) to the construction hall in Cessy (neighbouring France), called Point 5 (or SX5). Once there, they pass through a fast high voltage and electronic certification test, before being slid into the insertion cradle. This cradle is attached to the yoke and aligned to the chamber rails, allowing an easy insertion. A rate of 3 chambers per day can be achieved. This set of pictures was taken during the first final insertion round at Point 5, where most chambers for the lower part of YB+2 were installed.

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

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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

Molecular diagnostics for Chagas disease: up to date and novel methodologies.

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Alonso-Padilla, Julio; Gallego, Montserrat; Schijman, Alejandro G; Gascon, Joaquim

2017-07-01

Chagas disease is caused by the parasite Trypanosoma cruzi. It affects 7 million people, mainly in Latin America. Diagnosis is usually made serologically, but at some clinical scenarios serology cannot be used. Then, molecular detection is required for early detection of congenital transmission, treatment response follow up, and diagnosis of immune-suppression reactivation. However, present tests are technically demanding and require well-equipped laboratories which make them unfeasible in low-resources endemic regions. Areas covered: Available molecular tools for detection of T. cruzi DNA, paying particular attention to quantitative PCR protocols, and to the latest developments of user-friendly molecular diagnostic methodologies. Expert commentary: In the absence of appropriate biomarkers, molecular diagnosis is the only option for the assessment of treatment response. Besides, it is very useful for the early detection of acute infections, like congenital cases. Since current Chagas disease molecular tests are restricted to referential labs, research efforts must focus in the implementation of easy-to-use diagnostic tools in order to overcome the access to diagnosis gap.

Representaciones sociales sobre la problemática de Chagas en un servicio de salud comunitaria del Gran La Plata, Buenos Aires, Argentina.

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Sanmartino, Mariana; Amieva, Carolina; Medone, Y Paula

2017-03-01

Hablar de Chagas es hablar de una problemática compleja, definida por elementos de carácter biomédico, epidemiológico, sociocultural y político, que se conjugan dinámicamente. En este trabajo buscamos identificar y analizar las representaciones sobre Chagas de los integrantes del equipo de salud de un centro de atención periurbano de la ciudad de La Plata, Argentina. Mediante un abordaje cualitativo, se realizaron entrevistas semiestructuradas y se analizaron las respuestas con la técnica del análisis de contenido. Los resultados mostraron que la mayor parte de las personas entrevistadas no contempla al Chagas como una problemática en su contexto laboral cotidiano y manifiestan un fuerte sesgo biologicista en su formación profesional. Con este trabajo señalamos la urgente necesidad de reflexionar críticamente en torno a la formación de los profesionales de la salud en relación a problemáticas socioambientales complejas de importancia regional, como lo es el Chagas.

Acute Chagas' cardiopathy in a polar bear (Ursus maritimus in Guadalajara, Mexico

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J. Jaime-Andrade G.

1997-08-01

Full Text Available We report a 24 year old female polar bear (Ursus maritimus who contracted Chagas' infection at the Guadalajara Zoo, in Jalisco, México, and died of acute Chagas' carditis 15 days later. The histopathological findings are described, as well as the presence of triatomines (Triatoma longipennis Usinger infected with Trypanosoma cruzi collected within 5 meters from the place where the animal lived in the city of Guadalajara.Relatamos o caso de uma ursa polar (Ursus maritimus de 24 anos de idade, que contraiu a infecção chagásica no Zoológico de Guadalajara, em Jalisco, no México, e morreu de cardite chagásica aguda 15 dias após o início da sintomatologia. Os achados histopatológicos são descritos, bem como a presença de triatomíneos (Triatoma longipennis Usinger infectados por Trypanosoma cruzi coletados a 5 metros do local onde o animal vivia, na cidade de Guadalajara.

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

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González-Alcaide, Gregorio; Park, Jinseo; Huamaní, Charles; Gascón, Joaquín; Ramos, José Manuel

2012-08-01

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.

Through-glass copper via using the glass reflow and seedless electroplating processes for wafer-level RF MEMS packaging

International Nuclear Information System (INIS)

Lee, Ju-Yong; Lee, Sung-Woo; Lee, Seung-Ki; Park, Jae-Hyoung

2013-01-01

We present a novel method for the fabrication of void-free copper-filled through-glass-vias (TGVs), and their application to the wafer-level radio frequency microelectromechanical systems (RF MEMS) packaging scheme. By using the glass reflow process with a patterned silicon mold, a vertical TGV with smooth sidewall and fine pitch could be achieved. Bottom-up void-free filling of the TGV is successfully demonstrated through the seedless copper electroplating process. In addition, the proposed process allows wafer-level packaging with glass cap encapsulation using the anodic bonding process, since the reflowed glass interposer is only formed in the device area surrounded with silicon substrate. A simple coplanar waveguide (CPW) line was employed as the packaged device to evaluate the electrical characteristics and thermo-mechanical reliability of the proposed packaging structure. The fabricated packaging structure showed a low insertion loss of 0.116 dB and a high return loss of 35.537 dB at 20 GHz, which were measured through the whole electrical path, including the CPW line, TGVs and contact pads. An insertion loss lower than 0.1 dB and a return loss higher than 30 dB could be achieved at frequencies of up to 15 GHz, and the resistance of the single copper via was measured to be 36 mΩ. Furthermore, the thermo-mechanical reliability of the proposed packaging structure was also verified through thermal shock and pressure cooker test. (paper)

Advanced megaesophagus (Group III secondary to vector-borne Chagas disease in a 20-month-old infant

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Anis Rassi

2012-04-01

Full Text Available The authors report the case of a female infant with Group III (or Grade III megaesophagus secondary to vector-borne Chagas disease, resulting in severe malnutrition that reversed after surgery (Heller technique. The infant was then treated with the antiparasitic drug benznidazole, and the infection was cured, as demonstrated serologically and parasitologically. After follow-up of several years without evidence of disease, with satisfactory weight and height development, the patient had her first child at age 23, in whom serological tests for Chagas disease yielded negative results. Thirty years after the initial examination, the patient's electrocardiogram, echocardiogram, and chest radiography remained normal.

Estudo longitudinal do eletrocardiograma na doença de Chagas desde a fase aguda

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Roberto C. Pedrosa

1993-09-01

Full Text Available Vários trabalhos com eletrocardiograma na doença de Chagas têm sido feitos. Alguns referindo-se a grupos selecionados de casos, outros a estudos longitudinais, relatam as características da mortalidade nas diversas fases da doença. Com o objetivo de avaliar o valor do eletrocardiograma como índice de avaliação terapêutica e de seu comportamento na doença de Chagas desde a fase aguda, no presente trabalho, analisou-se evolutivamente o eletrocardiograma de 42 pacientes (18 mulheres e 24 homens procedentes da zona rural do Norte de Minas Gerais; predomínio etário foi nas duas primeiras décadas; todos com comprometimento cardíaco; todos receberam tratamento específico. O acompanhamento dos 42 pacientes foi de 9 anos dos quais 3 pacientes tiveram seguimento de 20 anos. Foram analisados 270 eletrocardiogramas. Nós utilizamos os seguintes critérios para a análise do ECG: código de Minnesota modificado para doença de Chagas; WHO/I. S. F. C. TASK FORCE para condução intraventricular e critérios de Pieretti para área eletricamente inativa. Concluímos que as alterações eletrocardiográficas agravam com a evolução da doença e que o eletrocardiograma não serve de índice de avaliação terapêutica.Several studies have been done to analyse the relationship between the characteristics of the electrocardiogram (ECG and mortality in the several stages of the disease, using different methods like multiple case and longitudinal studies. We anatysed the ECGfrom the acute stage up to twenty years of follow-up (±9 years in 42 patients with Chagas ' disease to determine their evolution and it 's value like an indexfor therapeutic evaluation. The 42 patients (18 female, 24 males were originalty from the North of the State of Minas Gerais (Brazil and the initial stage was mainly in the first two decades of age. All bad cardiac involvementand received fiill specific treatment. We utilized the following criteria for the ECG analyses

Barriers to treatment access for Chagas disease in Mexico.

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Manne, Jennifer M; Snively, Callae S; Ramsey, Janine M; Salgado, Marco Ocampo; Bärnighausen, Till; Reich, Michael R

2013-01-01

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. 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). 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 countries in the region with similar problems in access to

Comparison of parasite loads in serum and blood samples from patients in acute and chronic phases of Chagas disease.

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Hernández, Carolina; Teherán, Aníbal; Flórez, Carolina; Ramírez, Juan David

2018-04-17

Molecular methods have been developed for the detection and quantification of Trypanosoma cruzi DNA in blood samples from patients with Chagas disease. However, aspects of sample processing necessary for quantitative real-time PCR (qPCR), such as the addition of guanidine hydrochloride to whole blood samples, may limit timely access to molecular diagnosis. We analysed 169 samples from serum and guanidine-EDTA blood (GEB) obtained from patients in acute and chronic phases of Chagas disease. We applied qPCR targeted to the satellite DNA region. Finally, we compared the parasite loads and cycle of threshold values of the qPCR. The results confirmed the usefulness of serum samples for the detection and quantification of parasite DNA in patients with Chagas disease, especially in the acute phase. However, the parasite loads detected in serum samples from patients in the chronic phase were lower than those detected in GEB samples. The epidemiological implications of the findings are herein discussed.

Enfermedad de Chagas en Colombia

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Fernando Serpa Florez

1985-12-01

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Generalidades.

La tripanosomiasis americana o enfermedad de Chagas se halla ampliamente distribuida en Centro y Sur América. La Organización Mundial de la Salud considera que pueden haber doce millones de casos de esta dolencia en el continente (1, estudiados principalmente en Argentina, Brasil y Venezuela. Se calcula que en Colombia tendríamos una incidencia muy alta de casos, (Marinkelle (2 estima que 7.140/0 de la población podría estar infectada o sea cerca de dos millones de personas, distribuidos en las zonas rurales del nordeste del país (cuenca del Catatumbo Magdalena Medio y Llanos Orientales (Piedemonte, Macarena y Meta cercano (3 (4 (5 Y que seis millones de nuestros compatriotas -22.30/0 de la población total- (2 corren el riesgo de adquirir la enfermedad pues habitan en regiones donde se dan las condiciones para que ésta se propague.

RESEÑA HISTORICA DE LA ENFERMEDAD EN COLOMBIA
La existencia de casos de tripanosomiasis americana y de sus vectores fue comprobada en Colombia desde 1929 cuando César Uribe Piedrahita (6 encontró en Prado, Tolima, vectores del mal infectados con T.

cruzi e Ignacio Moreno Pérez observó dicho hemoflagelado en sangre de seres humanos en Cali (4. En los años siguientes Hernando Ucrós, Benjamín Otálora, Hernando Groot, Santiago Renjifo, Hernando Osorno, Carlos Duarte Rangel, C.J. Marinkelle, Augusto Corredor, Ernesto Suescún y varios otros investigadores colomb iano s describieron diversos focos de la enfermedad en Colombia y estudiaron la distribución de sus vectores y huéspedes intermediarios. En 1947 1. Caicedo y C. Hernández publicaron su informe sobre los primeros casos crónicos de enfermedad de Chagas comprobados en nuestro país, procedentes de la región de Fusagasugá, Cundinamarca (7 en tanto que, en 1961, Marcos Duque inicia los estudios sobre cardiopatía chagásica (8 y Hernando Rocha, en 1971, comunica

Estudo longitudinal do eletrocardiograma na doença de Chagas desde a fase aguda

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Roberto C. Pedrosa

1993-09-01

Full Text Available Vários trabalhos com eletrocardiograma na doença de Chagas têm sido feitos. Alguns referindo-se a grupos selecionados de casos, outros a estudos longitudinais, relatam as características da mortalidade nas diversas fases da doença. Com o objetivo de avaliar o valor do eletrocardiograma como índice de avaliação terapêutica e de seu comportamento na doença de Chagas desde a fase aguda, no presente trabalho, analisou-se evolutivamente o eletrocardiograma de 42 pacientes (18 mulheres e 24 homens procedentes da zona rural do Norte de Minas Gerais; predomínio etário foi nas duas primeiras décadas; todos com comprometimento cardíaco; todos receberam tratamento específico. O acompanhamento dos 42 pacientes foi de 9 anos dos quais 3 pacientes tiveram seguimento de 20 anos. Foram analisados 270 eletrocardiogramas. Nós utilizamos os seguintes critérios para a análise do ECG: código de Minnesota modificado para doença de Chagas; WHO/I. S. F. C. TASK FORCE para condução intraventricular e critérios de Pieretti para área eletricamente inativa. Concluímos que as alterações eletrocardiográficas agravam com a evolução da doença e que o eletrocardiograma não serve de índice de avaliação terapêutica.

Investigación de vectores y reservorios en brote de Chagas agudo por posible transmisión oral en Aguachica, Cesar, Colombia

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Hugo Soto

2014-04-01

Full Text Available Colombia tiene un registro de 11 casos de Chagas agudo y 80 casos por contaminación oral con Trypanosoma cruzi. Este trabajo analiza los hallazgos entomológicos y parasitológicos del brote de Aguachica, Cesar, en 2010. Un grupo interdisciplinario de profesionales de la salud y de universidades regionales realizó las pruebas de laboratorio a los pacientes y el estudio del foco de transmisión. Se detectaron 11 casos agudos de enfermedad de Chagas en una sola familia con vivienda sin triatominos domiciliados y, Rhodnius pallescens, Pantrongylus geniculatus, Eratyrus cuspidatus y dos Didelphis marsupialis infectados con T. cruzi en palmas de Attalea butyracea y Elaeis oleifera del área urbana de Aguachica. Se analiza la participación del R. pallescens y el rol de las palmas en el ciclo silvestre de T. cruzi y para la transmisión oral de la enfermedad de Chagas. Incursiones esporádicas de R. pallescens, P. geniculatus y E. cuspidatus silvestres desde palmas cercanas al domicilio humano pueden provocar brotes cada vez más frecuentes de Chagas oral.

Prova do esforço na forma indeterminada da doença de Chagas

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Vanize Macedo

1973-10-01

Full Text Available Os autores realizaram a prova do esforço sub-máximo em 30 portadores da forma indeterminada da doença de Chagas e em 30 normais, a fim de avaliar a capacidade física e a função miocárdica. Os resultados não mostraram diferenciação do grupo positivo e do controle negativo, quanto a queixas, freqüência cardíaca ou respiratória, tensão arterial, consumo de oxigênio e alterações eletrocardiográficas.To evaluate the physical capacity and the myoeardial function in 30 patientes with latent Chagas' disease, the effort test was performed. 30 Controls mere used. According to complains, cardiac and respiratory rate, maximum oxigen consumption and eletrocardiographic changes there was no difference between both groups.

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

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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.

Cytokine profiling in Chagas disease: towards understanding the association with infecting Trypanosoma cruzi discrete typing units (a BENEFIT TRIAL sub-study.

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Cristina Poveda

Full Text Available Chagas disease caused by the protozoan Trypanosoma cruzi is an important public health problem in Latin America. The immunological mechanisms involved in Chagas disease pathogenesis remain incompletely elucidated. The aim of this study was to explore cytokine profiles and their possible association to the infecting DTU and the pathogenesis of Chagas disease.109 sero-positive T. cruzi patients and 21 negative controls from Bolivia and Colombia, were included. Flow cytometry assays for 13 cytokines were conducted on human sera. Patients were divided into two groups: in one we compared the quantification of cytokines between patients with and without chronic cardiomyopathy; in second group we compared the levels of cytokines and the genetic variability of T. cruzi.Significant difference in anti-inflammatory and pro-inflammatory cytokines profiles was observed between the two groups cardiac and non-cardiac. Moreover, serum levels of IFN-γ, IL-12, IL-22 and IL-10 presented an association with the genetic variability of T.cruzi, with significant differences in TcI and mixed infections TcI/TcII.Expression of anti-inflammatory and pro-inflammatory cytokines may play a relevant role in determining the clinical presentation of chronic patients with Chagas disease and suggests the occurrence of specific immune responses, probably associated to different T. cruzi DTUs.

Cytokine profiling in Chagas disease: towards understanding the association with infecting Trypanosoma cruzi discrete typing units (a BENEFIT TRIAL sub-study).

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Poveda, Cristina; Fresno, Manuel; Gironès, Núria; Martins-Filho, Olindo A; Ramírez, Juan David; Santi-Rocca, Julien; Marin-Neto, José A; Morillo, Carlos A; Rosas, Fernando; Guhl, Felipe

2014-01-01

Chagas disease caused by the protozoan Trypanosoma cruzi is an important public health problem in Latin America. The immunological mechanisms involved in Chagas disease pathogenesis remain incompletely elucidated. The aim of this study was to explore cytokine profiles and their possible association to the infecting DTU and the pathogenesis of Chagas disease. 109 sero-positive T. cruzi patients and 21 negative controls from Bolivia and Colombia, were included. Flow cytometry assays for 13 cytokines were conducted on human sera. Patients were divided into two groups: in one we compared the quantification of cytokines between patients with and without chronic cardiomyopathy; in second group we compared the levels of cytokines and the genetic variability of T. cruzi. Significant difference in anti-inflammatory and pro-inflammatory cytokines profiles was observed between the two groups cardiac and non-cardiac. Moreover, serum levels of IFN-γ, IL-12, IL-22 and IL-10 presented an association with the genetic variability of T.cruzi, with significant differences in TcI and mixed infections TcI/TcII. Expression of anti-inflammatory and pro-inflammatory cytokines may play a relevant role in determining the clinical presentation of chronic patients with Chagas disease and suggests the occurrence of specific immune responses, probably associated to different T. cruzi DTUs.

Value of the radiological study of the thorax for diagnosing left ventricular dysfunction in Chagas' disease

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Perez Amanda Arantes

2003-01-01

Full Text Available OBJECTIVE: To determine the value of the radiological study of the thorax for diagnosing left ventricular dilation and left ventricular systolic dysfunction in patients with Chagas' disease. METHODS: A cross-sectional study of 166 consecutive patients with Chagas' disease and no other associated diseases. The patients underwent cardiac assessment with chest radiography and Doppler echocardiography. Sensitivity, specificity, and positive and negative predictive values of chest radiography were calculated to detect left ventricular dysfunction and the accuracy of the cardiothoracic ratio in the diagnosis of left ventricular dysfunction with the area below the ROC curve. The cardiothoracic ratio was correlated with the left ventricular ejection fraction and the left ventricular diastolic diameter. RESULTS: The abnormal chest radiogram had a sensitivity of 50%, specificity of 80.5%, and positive and negative predictive values of 51.2% and 79.8%, respectively, in the diagnosis of left ventricular dysfunction. The cardiothoracic ratio showed a weak correlation with left ventricular ejection fraction (r=-0.23 and left ventricular diastolic diameter (r=0.30. The area calculated under the ROC curve was 0.734. CONCLUSION: The radiological study of the thorax is not an accurate indicator of left ventricular dysfunction; its use as a screening method to initially approach the patient with Chagas' disease should be reevaluated.

Urban transmission of Chagas disease in Cochabamba, Bolivia

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N Medrano-Mercado

2008-08-01

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

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

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Samanta Cristina das Chagas Xavier

2014-05-01

Full Text Available BACKGROUND: The new epidemiological scenario of orally transmitted Chagas disease that has emerged in Brazil, and mainly in the Amazon region, needs to be addressed with a new and systematic focus. Belém, the capital of Pará state, reports the highest number of acute Chagas disease (ACD cases associated with the consumption of açaí juice. METHODOLOGY/PRINCIPAL FINDINGS: The wild and domestic enzootic transmission cycles of Trypanosoma cruzi were evaluated in the two locations (Jurunas and Val-de Cães that report the majority of the autochthonous cases of ACD in Belém city. Moreover, we evaluated the enzootic cycle on the three islands that provide most of the açaí fruit that is consumed in these localities. We employed parasitological and serological tests throughout to evaluate infectivity competence and exposure to T. cruzi. In Val-de-Cães, no wild mammal presented positive parasitological tests, and 56% seroprevalence was observed, with low serological titers. Three of 14 triatomines were found to be infected (TcI. This unexpected epidemiological picture does not explain the high number of autochthonous ACD cases. In Jurunas, the cases of ACD could not be autochthonous because of the absence of any enzootic cycle of T. cruzi. In contrast, in the 3 island areas from which the açaí fruit originates, 66.7% of wild mammals and two dogs displayed positive hemocultures, and 15.6% of triatomines were found to be infected by T. cruzi. Genotyping by mini-exon gene and PCR-RFLP (1f8/Akw21I targeting revealed that the mammals and triatomines from the islands harbored TcI and Trypanosoma rangeli in single and mixed infections. CONCLUSION/SIGNIFICANCE: These findings show that cases of Chagas disease in the urban area of Belém may be derived from infected triatomines coming together with the açaí fruits from distant islands. We term this new epidemiological feature of Chagas disease as "Distantiae transmission".

O perfil dos portadores de doença de Chagas, com ênfase na forma digestiva, em hospital terciário de Ribeirão Preto, SP Features of Chagas' disease patients with emphasis on digestive form, in a tertiary hospital of Ribeirão Preto, SP

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Mayra Mayumi Kamiji

2005-08-01

Full Text Available Para caracterizar o perfil clínico e demográfico dos portadores da forma digestiva da doença de Chagas atualmente atendidos no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, foram revistos 377 prontuários de pacientes com resultado positivo para reação sorológica para a doença de Chagas atendidos entre janeiro de 2002 a março de 2003. A idade mediana dos pacientes era de 67 anos e 210 (56% eram mulheres. Megaesôfago e/ou megacólon chagásicos estavam presentes em 135 pacientes, dos quais, 59% apresentavam cardiopatia. Para 49% dos pacientes com doença digestiva, havia prescrição de pelo menos dois medicamentos para tratamento de doença cardiovascular. Em 66 pacientes, foram detectadas comorbidades crônicas. A população de portadores da forma digestiva da doença de Chagas do HCFMRP é majoritariamente geriátrica e apresenta freqüência elevada de doenças cardiovasculares, o que sugere risco elevado das modalidades de tratamento cirúrgico do megaesôfago e megacólon.In order to characterize the demographic and clinical profile of patients with digestive manifestations of Chagas' disease, the medical records were reviewed of patients (n = 377 currently attended at Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto with positive serologic reaction for Chagas' disease and admitted from January 2002 to March 2003. Median age was 67 years and 210 (56% were women. Megaesophagus and/or megacolon were present in 135 patients, 59% of these had cardiopathy. For 49% of patients with digestive disease, at least two medical prescriptions of medicines for the treatment of cardiovascular diseases were found. In 66 patients, chronic comorbidities were detected. The population with digestive manifestation of Chagas' disease referred to HCFMRP is mostly geriatric, with an elevated frequency of cardiopathy, which may indicate a high risk for surgical approach to the treatment of chagasic megaesophagus and

Readability of medicinal package leaflets: a systematic review.

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Pires, Carla; Vigário, Marina; Cavaco, Afonso

2015-01-01

OBJECTIVE To review studies on the readability of package leaflets of medicinal products for human use. METHODS We conducted a systematic literature review between 2008 and 2013 using the keywords "Readability and Package Leaflet" and "Readability and Package Insert" in the academic search engine Biblioteca do Conhecimento Online, comprising different bibliographic resources/databases. The preferred reporting items for systematic reviews and meta-analyses criteria were applied to prepare the draft of the report. Quantitative and qualitative original studies were included. Opinion or review studies not written in English, Portuguese, Italian, French, or Spanish were excluded. RESULTS We identified 202 studies, of which 180 were excluded and 22 were enrolled [two enrolling healthcare professionals, 10 enrolling other type of participants (including patients), three focused on adverse reactions, and 7 descriptive studies]. The package leaflets presented various readability problems, such as complex and difficult to understand texts, small font size, or few illustrations. The main methods to assess the readability of the package leaflet were usability tests or legibility formulae. Limitations with these methods included reduced number of participants; lack of readability formulas specifically validated for specific languages (e.g., Portuguese); and absence of an assessment on patients literacy, health knowledge, cognitive skills, levels of satisfaction, and opinions. CONCLUSIONS Overall, the package leaflets presented various readability problems. In this review, some methodological limitations were identified, including the participation of a limited number of patients and healthcare professionals, the absence of prior assessments of participant literacy, humor or sense of satisfaction, or the predominance of studies not based on role-plays about the use of medicines. These limitations should be avoided in future studies and be considered when interpreting the results.

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

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

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Shivali Gupta

Full Text Available 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.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.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.

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

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Tassi, Eduardo Marinho, E-mail: etassi@ibest.com.br [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Continentino, Marcelo Abramoff [Hospital Frei Galvão, Guaratinguetá, SP (Brazil); Nascimento, Emília Matos do; Pereira, Basílio de Bragança [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil); Coppe - Instituto Alberto Luiz Coimbra de Pós-Graduação e Pesquisa de Engenharia - UFRJ, Rio de Janeiro, RJ (Brazil); Pedrosa, Roberto Coury [Instituto de Cardiologia Edson Saad - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

2014-05-15

Patients with Chagas disease and segmental wall motion abnormality (SWMA) have worse prognosis independent of left ventricular ejection fraction (LVEF). Cardiac magnetic resonance (CMR) is currently the best method to detect SWMA and to assess fibrosis. To quantify fibrosis by using late gadolinium enhancement CMR in patients with Chagas disease and preserved or minimally impaired ventricular function (> 45%), and to detect patterns of dependence between fibrosis, SWMA and LVEF in the presence of ventricular arrhythmia. Electrocardiogram, treadmill exercise test, Holter and CMR were carried out in 61 patients, who were divided into three groups as follows: (1) normal electrocardiogram and CMR without SWMA; (2) abnormal electrocardiogram and CMR without SWMA; (3) CMR with SWMA independently of electrocardiogram. The number of patients with ventricular arrhythmia in relation to the total of patients, the percentage of fibrosis, and the LVEF were, respectively: Group 1, 4/26, 0.74% and 74.34%; Group 2, 4/16, 3.96% and 68.5%; and Group 3, 11/19, 14.07% and 55.59%. Ventricular arrhythmia was found in 31.1% of the patients. Those with and without ventricular arrhythmia had mean LVEF of 59.87% and 70.18%, respectively, and fibrosis percentage of 11.03% and 3.01%, respectively. Of the variables SWMA, groups, age, LVEF and fibrosis, only the latter was significant for the presence of ventricular arrhythmia, with a cutoff point of 11.78% for fibrosis mass (p < 0.001). Even in patients with Chagas disease and preserved or minimally impaired ventricular function, electrical instability can be present. Regarding the presence of ventricular arrhythmia, fibrosis is the most important variable, its amount being proportional to the complexity of the groups.

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

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Tassi, Eduardo Marinho; Continentino, Marcelo Abramoff; Nascimento, Emília Matos do; Pereira, Basílio de Bragança; Pedrosa, Roberto Coury

2014-01-01

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

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

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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

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

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Carme Roca

2011-04-01

Full Text Available 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.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.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.

Method of inserting fuel rod

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Kamimoto, Shuji; Imoo, Makoto; Tsuchida, Kenji.

1991-01-01

The present invention concerns a method of inserting a fuel rod upon automatic assembling, automatic dismantling and reassembling of a fuel assembly in a light water moderated reactor, as well as a device and components used therefor. That is, a fuel rod is inserted reliably to an aimed point of insertion by surrounding the periphery of the fuel rod to be inserted with guide rods, and thereby suppressing the movement of the fuel rod during insertion. Alternatively, a fuel rod is inserted reliably to a point of insertion by inserting guide rods at the periphery of the point of insertion for the fuel rod to be inserted thereby surrounding the point of insertion with the guide rods or fuel rods. By utilizing fuel rods already present in the fuel assembly as the guide rods described above, the fuel rod can be inserted reliably to the point of insertion with no additional devices. Dummy fuel rods are previously inserted in a fuel assembly which are then utilized as the above-mentioned guide rods to accurately insert the fuel rod to the point of insertion. (I.S.)

A serological, parasitological and clinical evaluation of untreated Chagas disease patients and those treated with benznidazole before and thirteen years after intervention

Science.gov (United States)

Machado-de-Assis, Girley Francisco; Diniz, Glaucia Alessio; Montoya, Roberto Araújo; Dias, João Carlos Pinto; Coura, José Rodrigues; Machado-Coelho, George Luiz Lins; Albajar-Viñas, Pedro; Torres, Rosália Morais; de Lana, Marta

2013-01-01

The etiological treatment of Chagas disease is recommended for all patients with acute or recent chronic infection, but controversies remain regarding the benefit of chemotherapy and interpretations of the parasitological cure after etiological treatment. This study compares the laboratory and clinical evaluations of Chagas disease patients who were diagnosed 13 years earlier. Fifty-eight Chagas disease patients (29 treated with benznidazole and 29 untreated) were matched at the time of treatment based on several variables. Conventional serology revealed the absence of seroconversion in all patients. However, lower serological titres were verified in the treated group, primarily among patients who had the indeterminate form of the disease. Haemoculture performed 13 years after the intervention was positive for 6.9% and 27.6% of the treated and untreated patients, respectively. Polymerase chain reaction tests were positive for 44.8% and 13.8% of the treated and untreated patients, respectively. Patients who presented with the indeterminate form of the disease at the beginning of the study exhibited less clinical progression (17.4%) compared with the untreated group (56.5%). Therefore, this global analysis revealed that etiological treatment with benznidazole may benefit patients with respect to the clinical progression of Chagas disease and the prognosis, particularly when administered to patients with the indeterminate form of the disease. PMID:24037109

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

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Felipe Lozano Kasten

1993-12-01

Full Text Available Mulher de 80 anos de idade, com doença de Chagas aguda diagnosticada à necrópsia, adquirida, provavelmente, através de triatomíneos no município de Zacoelo de Torres, no Estado de Jalisco, México. Assinala-se a raridade do encontro de casos de doença de Chagas agudo, na faixa etária da paciente. O exame anatomopatológico mostrou comprometimento do coração, esôfago e intestino grosso. Encontrou-se lesões no sistema nervoso autônomo intramural do esôfago e do intestino grosso, sendo estes achados de interesse, por ocorrer em área geográfica onde os megas tem sido pouco relatados.A case of acute Chagas' disease, diagnosed by necropsy, in a 80-year-old woman, is reported. lt is assumed that infection was acquired through triatomine bite in Zacoelo de Torres, Jalisco State, Mexico. There were lesions due to american trypanosomiasis in the heart, esophagus and bowel. Autonomic nervous lesions were detected in the esophagus and bowel. lt is emphasized the importance of these findings in an area where few cases of megas were reported

Blasting agent package

Energy Technology Data Exchange (ETDEWEB)

Fox, R.

1971-03-17

A protected preassembled package for blasting agents susceptible to desensitization by water consists of, in combination: (1) an inner rigid and self-supporting tube, the upper end of which is suited to be connected, or attached, to the discharge end of a loading hose for a blasting agent and the lower end of which is open; and (2) a flexible tubular liner made of water-resistant film, having a diameter greater than that of the inner tube and a length at least equal to the desired depth of its insertion into the borehole, the liner being sleeved over the length of the inner tube, the upper end of the liner being attached to the inner tube and the lower end of the liner being closed so as to prevent substantial discharge of the explosive mixture therefrom when the latter is pumped into it. (24 claims)

Low-temperature, low-loss zero level packaging techniques for RF applications by using a photopatternable dry film

International Nuclear Information System (INIS)

Kim, J; Seok, S; Rolland, N; Rolland, P-A

2012-01-01

This paper presents a low-temperature zero-level packaging technique using a dry film type of PerMX polymer for RF devices. Silicon cap packaging with PerMX sealing ring and PerMX cap packaging through multilayer lamination have been implemented. All of the fabrication process has been performed at temperature less than 150 °C. The influence of each packaging cap on the packaged coplanar waveguide was first investigated using the HFSS electromagnetic simulation. The RF measurement results showed that both packaging caps did not have significant influence on the performance of transmission lines. The insertion loss changes before and after packaging were almost negligible up to 30 GHz, and the return losses were better than 20 dB. Also, the deformation of PerMX structures concerning the packaging processes has been studied. For silicon capping, the volumetric compression of PerMX sealing ring by the bonding process has been observed. For PerMX cap packaging, the deflection of the polymer cap has been investigated as a function of sealing ring width for the different cap size. Measured results had good agreement with the ANSYS simulated ones. (paper)

One Health Interactions of Chagas Disease Vectors, Canid Hosts, and Human Residents along the Texas-Mexico Border.

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Melissa N Garcia

2016-11-01

Full Text Available Chagas disease (Trypanosoma cruzi infection is the leading cause of non-ischemic dilated cardiomyopathy in Latin America. Texas, particularly the southern region, has compounding factors that could contribute to T. cruzi transmission; however, epidemiologic studies are lacking. The aim of this study was to ascertain the prevalence of T. cruzi in three different mammalian species (coyotes, stray domestic dogs, and humans and vectors (Triatoma species to understand the burden of Chagas disease among sylvatic, peridomestic, and domestic cycles.To determine prevalence of infection, we tested sera from coyotes, stray domestic dogs housed in public shelters, and residents participating in related research studies and found 8%, 3.8%, and 0.36% positive for T. cruzi, respectively. PCR was used to determine the prevalence of T. cruzi DNA in vectors collected in peridomestic locations in the region, with 56.5% testing positive for the parasite, further confirming risk of transmission in the region.Our findings contribute to the growing body of evidence for autochthonous Chagas disease transmission in south Texas. Considering this region has a population of 1.3 million, and up to 30% of T. cruzi infected individuals developing severe cardiac disease, it is imperative that we identify high risk groups for surveillance and treatment purposes.

Treatment of Chagas' disease with itraconazole: electrocardiographic and parasitological conditions after 20 years of follow-up.

Science.gov (United States)

Apt, Werner; Arribada, Arturo; Zulantay, Inés; Rodríguez, Jorge; Saavedra, Miguel; Muñoz, Andrea

2013-09-01

To evaluate cases of chronic Chagas' disease for the long-term effects of treatment with itraconazole on Trypanosoma cruzi infections and the regression or development of ECG abnormalities. In March 1992, we treated 46 patients with chronic Chagas' disease with 6 mg/kg/day of itraconazole for 120 days in a blind evaluation. The patients came from an area of Chile where the disease was endemic and were checked for ECG abnormalities and with xenodiagnosis (XD) or real-time XD-quantitative PCR (XD-qPCR) for Trypanosoma cruzi infection before treatment and once a year for 20 years. Twenty-one patients proved to be uninfected after 20 years and 15 of the patients had a normal ECG. Of the latter cases, 32.6% could be considered cured, although all of them had positive serology. Itraconazole prevents the development of ECG abnormalities, because after 20 years of treatment only 10.86% of patients developed ECG abnormalities (Z = 1.70, P = 0.046). XD-qPCR performed on 16 patients demonstrated 10 cases with XD; these cases correspond to therapy failure, since re-infection was ruled out. In one case, XD-qPCR did not present amplification. Itraconazole is useful in the treatment of chronic Chagas' disease as it prevented the development of ECG abnormalities and cured 32.6% of patients.

Therapeutic effects of sphingosine kinase inhibitor N,N-dimethylsphingosine (DMS) in experimental chronic Chagas disease cardiomyopathy.

Science.gov (United States)

Vasconcelos, Juliana Fraga; Meira, Cássio Santana; Silva, Daniela Nascimento; Nonaka, Carolina Kymie Vasques; Daltro, Pâmela Santana; Macambira, Simone Garcia; Domizi, Pablo Daniel; Borges, Valéria Matos; Ribeiro-Dos-Santos, Ricardo; de Freitas Souza, Bruno Solano; Soares, Milena Botelho Pereira

2017-07-21

Chagas disease cardiomyopathy is a parasite-driven inflammatory disease to which there are no effective treatments. Here we evaluated the therapeutic potential of N,N-dimethylsphingosine(DMS), which blocks the production of sphingosine-1-phosphate(S1P), a mediator of cellular events during inflammatory responses, in a model of chronic Chagas disease cardiomyopathy. DMS-treated, Trypanosoma cruzi-infected mice had a marked reduction of cardiac inflammation, fibrosis and galectin-3 expression when compared to controls. Serum concentrations of galectin-3, IFNγ and TNFα, as well as cardiac gene expression of inflammatory mediators were reduced after DMS treatment. The gene expression of M1 marker, iNOS, was decreased, while the M2 marker, arginase1, was increased. DMS-treated mice showed an improvement in exercise capacity. Moreover, DMS caused a reduction in parasite load in vivo. DMS inhibited the activation of lymphocytes, and reduced cytokines and NO production in activated macrophage cultures in vitro, while increasing IL-1β production. Analysis by qRT-PCR array showed that DMS treatment modulated inflammasome activation induced by T. cruzi on macrophages. Altogether, our results demonstrate that DMS, through anti-parasitic and immunomodulatory actions, can be beneficial in the treatment of chronic phase of T. cruzi infection and suggest that S1P-activated processes as possible therapeutic targets for the treatment of Chagas disease cardiomyopathy.

Lattice insertions for POPAE

International Nuclear Information System (INIS)

Cho, Y.; Crosbie, E.A.; Diebold, R.; Johnson, D.E.; Ohnuma, S.; Ruggiero, A.G.; Teng, L.C.

1977-01-01

Four types of insertions are described for the six 200-m straight sections of POPAE. All have dispersion matched to zero. (1) Injection-ejection insertion--This has proper high-β values and phase advances for horizontal injection and vertical ejection. (2) Phase-adjust insertion--The phase advance in this insertion is adjustable over a range of approximately 100 0 . (3) General-purpose insertion--The β* is adjustable from 2.5. to 200 m and the crossing angle is adjustable from 0 to 11 mrad. (4) High-luminosity insertion--This gives an even lower β + of meter

Epidemiologia de um caso de doença de Chagas na Ilha do Mosqueiro - Pará

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Adelson A.A. de Souza

1988-12-01

Full Text Available Os autores apresentam os resultados do estudo epidemiológico de um caso autóctone da fase aguda da doença de Chagas na ilha do Mosqueiro, Estado do Pará, aproximadamente 75km da capital, Belém. 0 caso já havia sido objeto de uma publicação anterior. Agora são apresentadas informações epidemiológicas. Nas proximidades da casa do paciente foram capturados em duas palmeiras de Inajá ('Maximilian regi ay e em uma de Mucajá (Acrocomia sclerocarpia 114 triatomíneos: Rhodnius pictipes, R. robustus, Panstrongylus lignarius, P. geniculatus e Microtriatoma trinidadensis, com tripanossomas em 31 deles. Na casa do paciente foram encontrados exemplares de Rhodnius pictipes, infectados com formas metacíclicas do Trypanosoma cruzi. Em 14 marsupiais, capturados na localidade, haviam 3 infectados com organismos semelhantes ao T. cruzi. A eletroforese dos isoenzimas nos tripanossomas isolados do paciente, de R. pictipes e de Didelphis marsupialis os classificou como zimodema 1. Os autores concluem que a doença de Chagas do paciente teve origem silvestre.The authors present the results of an epidemiological study relating to a case of acute Chagas' disease acquired in the island of Mosqueiro, State of Para, approximately 75 km from the capital Belem. The patient has been the object of a previous publication but now epidemiological information is reported. Near the house of the patient in two Inaja palm trees (Maximilian regia and one Mucaja palm (Acrocomia sclerocarpia 114 triatomine bugs were captured of the following species: Rhodnius pictipes, R. robustus, Panstrongylus lignarius, P. geniculatus and Microtriatoma trinidadensis. Trypanosomes were found in 31 bugs. In the house of the patient specimens of R. pictipes were captured infected with metacyclic forms óf Trypanosoma cruzi. In 14 marsupials captured in the locality three had infections with cruzi like trypanosomes. Enzyme electrophoresis of the trypanosomes isolated from the patient, R

Trypanosoma cruzi in the chicken model: Chagas-like heart disease in the absence of parasitism

Czech Academy of Sciences Publication Activity Database

Teixeira, A.R.L.; Gomes, C.; Nitz, N.; Sousa, A.O.; Alvez, R.M.; Guimaro, M.C.; Cordeiro, C.; Bernal, F.M.; Rosa, A.C.; Hejnar, Jiří; Leonardecz, E.; Hecht, M.M.

2011-01-01

Roč. 5, č. 3 (2011), e1000 ISSN 1935-2735 Institutional research plan: CEZ:AV0Z50520514 Keywords : Chagas disease * Trypanosoma cruzi * kDNA minicircles * inbred chicken Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 4.716, year: 2011

Insertion Modeling and Its Applications

OpenAIRE

Alexander Letichevsky; Oleksandr Letychevskyi; Vladimir Peschanenko

2016-01-01

The paper relates to the theoretical and practical aspects of insertion modeling. Insertion modeling is a theory of agents and environments interaction where an environment is considered as agent with a special insertion function. The main notions of insertion modeling are presented. Insertion Modeling System is described as a tool for development of different kinds of insertion machines. The research and industrial applications of Insertion Modeling System are presented.

Reliability of CGA/LGA/HDI Package Board/Assembly (Final Report)

Science.gov (United States)

Ghaffaroam. Reza

2014-01-01

Package manufacturers are now offering commercial-off-the-shelf column grid array (COTS CGA) packaging technologies in high-reliability versions. Understanding the process and quality assurance (QA) indicators for reliability are important for low-risk insertion of these advanced electronics packages. The previous reports, released in January of 2012 and January of 2013, presented package test data, assembly information, and reliability evaluation by thermal cycling for CGA packages with 1752, 1517, 1509, and 1272 inputs/outputs (I/Os) and 1-mm pitch. It presented the thermal cycling (-55C either 100C or 125C) test results for up to 200 cycles. This report presents up to 500 thermal cycles with quality assurance and failure analysis evaluation represented by optical photomicrographs, 2D real time X-ray images, dye-and-pry photomicrographs, and optical/scanning electron Microscopy (SEM) cross-sectional images. The report also presents assembly challenge using reflowing by either vapor phase or rework station of CGA and land grid array (LGA) versions of three high I/O packages both ceramic and plastic configuration. A new test vehicle was designed having high density interconnect (HDI) printed circuit board (PCB) with microvia-in-pad to accommodate both LGA packages as well as a large number of fine pitch ball grid arrays (BGAs). The LGAs either were assembled onto HDI PCB as an LGA or were solder paste print and reflow first to form solder dome on pads before assembly. Both plastic BGAs with 1156 I/O and ceramic LGAs were assembled. It also presented the X-ray inspection results as well as failures due to 200 thermal cycles. Lessons learned on assembly of ceramic LGAs are also presented.

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.

Mannose-Binding Lectin and Toll-Like Receptor Polymorphisms and Chagas Disease in Chile

Science.gov (United States)

Zulantay, Inés; Danquah, Ina; Hamann, Lutz; Schumann, Ralf R.; Apt, Werner; Mockenhaupt, Frank P.

2012-01-01

Mannose-binding lectin (MBL) and Toll-like receptor (TLR) polymorphisms may influence susceptibility and manifestation of Trypanosoma cruzi infection. In northern Chile, we examined 61 asymptomatic patients with chronic Chagas disease (CD), 64 patients with chronic Chagas cardiomyopathy (CCC), and 45 healthy individuals. Low-producer MBL2*B genotypes were more common in CD patients (48%) than healthy individuals (31%; adjusted odds ratio = 2.3, 95% confidence interval = 1.01–5.4, P = 0.047) but did not differ with manifestation. In contrast, the heterozygous Toll-like receptor 4 (TLR4)-deficiency genotype D299G/T399I occurred more frequently in asymptomatic (14.8%) than CCC patients (3.1%; P = 0.02). TLR1-I602S, TLR2-R753Q, TLR6-S249P, and MAL/TIRAP-S180L did not associate with CD or CCC. These findings support the complement system to be involved in defense against Trypanosoma cruzi infection and indicate that curbed TLR4 activation might be beneficial in preventing CCC. PMID:22302853

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

OpenAIRE

de Oliveira, Amanda Priscila; Bernardo, C?ssia Rubia; Camargo, Ana Vit?ria da Silveira; Ronchi, Luiz S?rgio; Borim, Aldenis Albaneze; Brand?o de Mattos, Cinara C?ssia; de Campos J?nior, Eumildo; Castiglioni, L?lian; Netinho, Jo?o Gomes; Cavasini, Carlos Eug?nio; 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 C...

COMPARATIVE STUDY OF EARLY POSTPARTUM IUCD INSERTION TO INTERVAL IUCD INSERTION

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Shibani Devi

2016-07-01

Full Text Available INTRODUCTION According to National Family Health Survey-3, Indian women have 13% unmet need for contraception and according to District Level Household & Facility Survey-3, it is 21.3% in the postpartum period. Postpartum intrauterine contraceptive device insertion - both immediately post-placental delivery and somewhat later, but within 48 hours after delivery are options which merit consideration as the woman is likely to have a high motivation for accepting contraception and the healthcare centre provides a convenient setting for insertion of IUCD. AIM Comparison of efficacy and complications of IUCD insertions in post-placental with interval period: 6-month followup. METHOD This perspective study was conducted among 100 women: - 50 women had IUCD inserted within 10 minutes of placental delivery and 50 had insertion more than 6 weeks after delivery. They were followed till 6 months post insertion and were compared regarding early and late complications, continuation rates and expulsion rates. RESULT At the end of six months, we found higher occurrence of lower abdominal pain, heavy menstrual bleeding in case of interval insertion as compared to post-placental insertion which was statistically significant (p value-0.04 & 0.007 respectively. However, the expulsion rates of post-placental IUCD were somewhat elevated (14% compared to interval insertions (2%. Continuation rates at the end of 6 months in both the groups were 82% and 86% respectively which is comparable. CONCLUSION Post-placental IUCD is thus found to be an ideal method to meet the unmet need of postpartum women as it is easily accessible and convenient for both women and their health care providers, is associated with less discomfort and fewer side effects and allow women to obtain safe, long acting, highly effective contraception while still in the health care system.

On the possibility of autochthonous Chagas disease in Roraima, Amazon region, Brazil, 2000-2001 Sobre a possibilidade da ocorrência de doença de Chagas autóctone em Roraima, Amazônia brasileira, 2000-2001

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José Francisco Luitgards-Moura

2005-02-01

Full Text Available Chagas disease has been almost entirely eradicated from the arid zones in Central and Northeastern Brazil where rare or no autochthonous cases have been reported. However, in the last 10 years the disease has increasingly been registered in the Amazon Region. Aiming to investigate the possibility of the occurrence of autochthonous cycle of Chagas disease in Roraima, triatomine collections, vectorial susceptibility studies (this one to be shown elsewhere, parasitological and serological analyses were conducted in three agricultural settlement areas (Rorainópolis, Passarão Project and Ilha Community. Blood-donor candidates were also investigated. This is the first epidemiological survey on Chagas disease conducted in agricultural settlements in Roraima. Triatomine species found were Triatoma maculata, Rhodnius pictipes, Rhodnius robustus and Panstrongylus geniculatus. Trypanosoma cruzi detection analyses included xenodiagnosis, indirect immunofluorescence, indirect hemaglutination, ELISA and kinetoplast PCR amplification. Natural triatomine infection was not found in intestinal contents. Twenty-five adult settlers (1.4% out of 1821, all > 15 year-old, 20 migrants presented anti-T. cruzi antibodies. Two migrant settlers (from Minas Gerais and Maranhão tested positive for more than two serological tests, besides either being positive for xenodiagnosis or PCR. Results show that Chagas disease is not endemic in the areas studied. However, all elements of the transmission cycle are present, demanding for an adequate and continuous vigilance.A doença de Chagas foi quase inteiramente erradicada das zonas áridas do Brasil Central e Nordeste, onde ciclos autóctones de transmissão praticamente inexistem. Contudo, na última década a doença vem sendo registrada na Região Amazônica. Objetivando investigar a possibilidade da ocorrência de ciclos autóctones de transmissão em áreas de colonização agrícola no Estado de Roraima, foram realizadas

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

International Nuclear Information System (INIS)

Budni, Patrícia; Pedrosa, Roberto Coury; Dalmarco, Eduardo Monguilhott; Dalmarco, Juliana Bastos; Frode, Tânia Sílvia; Wilhelm, Danilo Filho

2013-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Budni, Patrícia, E-mail: budnip@gmail.com [Universidade Federal de Santa Catarina, Florianópolis, SC (Brazil); Pedrosa, Roberto Coury [Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil); Dalmarco, Eduardo Monguilhott; Dalmarco, Juliana Bastos; Frode, Tânia Sílvia; Wilhelm, Danilo Filho [Universidade Federal de Santa Catarina, Florianópolis, SC (Brazil)

2013-10-15

Chagas disease is still an important endemic disease in Brazil, and the cardiac involvement is its more severe manifestation. To verify whether the concomitant use of carvedilol will enhance the antioxidant effect of vitamins E and C in reducing the systemic oxidative stress in chronic Chagas heart disease. A total of 42 patients with Chagas heart disease were studied. They were divided into four groups according to the modified Los Andes classification: 10 patients in group IA (normal electrocardiogram and echocardiogram; no cardiac involvement); 20 patients in group IB (normal electrocardiogram and abnormal echocardiogram; mild cardiac involvement); eight patients in group II (abnormal electrocardiogram and echocardiogram; no heart failure; moderate cardiac involvement); and four patients in group III (abnormal electrocardiogram and echocardiogram with heart failure; severe cardiac involvement). Blood levels of markers of oxidative stress were determined before and after a six-month period of treatment with carvedilol, and six months after combined therapy of carvedilol with vitamins E and C. The markers analyzed were as follows: activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione S-transferase and reductase, myeloperoxidade and adenosine deaminase; and the levels of reduced glutathione, thiobarbituric-acid reactive substances, protein carbonyls, vitamin E, and nitric oxide. After treatment with carvedilol, all groups showed significant decrease in protein carbonyls and reduced glutathione levels, whereas nitric oxide levels and adenosine activity increased significantly only in the less severely affected group (IA). In addition, the activity of most of the antioxidant enzymes was decreased in the less severely affected groups (IA and IB). By combining the vitamins with carvedilol, a reduction in protein damage, in glutathione levels, and in the activity of most of the antioxidant enzymes were observed. The decrease in oxidative

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

Desbravamento, agricultura e doença: a doença de Chagas no Estado de São Paulo

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Luiz Jacintho da Silva

1986-06-01

Full Text Available Faz-se uma reconstrução do processo de surgimento, disseminação e desaparecimento da endemia chagásica no Estado de São Paulo, interpretando-se as informações epidemiológicas existentes, dentro de uma perspectiva histórico-materialista. Parte-se dos conceitos clássicos que procuram explicar a distribuição da doença, demonstrando sua insuficiência. Com a incorporação de conceitos e métodos de análise utilizados em Geografia, chega-se a uma compreensão do que foi o processo de evolução da doença em São Paulo, e quais os seus determinantes, mostrando que se tratou de um processo peculiar ao Centro-Sul brasileiro, num período histórico bem determinado. A doença de Chagas, ainda que uma endemia de expressão nacional, não pode ser vista como um todo indistinto, existindo diferentes padrões epidemiológicos em períodos históricos diferentes.A reconstruction of the emergence, distribution and disappearence of Chagas' disease in the State of São Paulo (Brazil is undertaken by interpretating existing epidemiological data through historical-materialism. Classical concepts concerning the distribution of the disease are shown inadequate to explain the epidemiology of Chagas'disease in São Paulo. By incorporating an analitical methodology and concepts used in geographical studies, an understanding of the evolution of the disease is achieved. The process is demonstrated peculiar to Central-South Brazil in a particular historical period. Chagas'disease, inasmuch as parasitosis of national expression, must be seen as having distinct epidemiological patterns occuring in differente historical periods.

La enfermedad de Chagas ya no es tan exótica

Centers for Disease Control (CDC) Podcasts

2008-04-03

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

Enfermedad de Chagas: correlación clínico-patológica. Serie de casos del Hospital Universitario de Santander - Departamento de Patología, Universidad Industrial de Santander Chagas disease: clinicopathologic correlation. Series of cases of the University Hospital of Santander - Department of Pathology, Universidad Industrial de Santander

Directory of Open Access Journals (Sweden)

Julio C Mantilla

2011-10-01

Full Text Available La enfermedad de Chagas es un padecimiento que predomina en aquellas regiones del continente americano que combinan condiciones geográficas, climáticas y ecológicas para que el hombre, el Trypanosoma cruzi, sus reservorios y vectores, interactúen de manera ideal. Objetivo: presentar nueve casos de enfermedad de Chagas diagnosticados mediante autopsia en el Departamento de Patología de la Universidad Industrial de Santander entre 2002 y 2009, correlacionar los hallazgos pos-mortem con las manifestaciones clínicas y comparar los datos obtenidos con la información referida en la literatura mundial. Materiales y Métodos: estudio descriptivo, retrospectivo en casos de autopsias realizadas en el Departamento de Patología de la Universidad Industrial de Santander entre el primero de enero de 2002 y el 30 de junio de 2009. Resultados: de un total de 756 autopsias, nueve (1,2% correspondieron a pacientes con diagnóstico confirmado de enfermedad de Chagas: siete hombres y dos mujeres. El rango de edad osciló entre 14 meses y 56 años. De los casos analizados cinco correspondieron a la forma aguda, dos a la forma crónica y dos a un proceso de reactivación. Todos tenían compromiso cardíaco, uno compromiso del colon y uno compromiso encefálico. La causa de muerte se relacionó de manera directa con estas afecciones. Conclusión: en zonas endémicas, ante la presencia de manifestaciones cardíacas, es necesario considerar la enfermedad de Chagas con el fin de realizar un diagnóstico precoz y oportuno que permita identificar casos y establecer medidas de manejo específico enfocado de acuerdo con su condición.Chagas disease is a condition that prevails in those regions of the Americas that combine geographical, climatic and ecological conditions so that man,Trypanosoma cruzi, their reservoirs and vectors may ideally interact. Objective: to present nine cases of Chagas disease diagnosed by autopsy at the Department of Pathology, Universidad

A Pre- and Post-Evaluation of Integrating Sustainability Curriculum by Inserting Okala Modules into an Interior Design Materials and Methods Course

Science.gov (United States)

Schneiderman, Deborah; Freihoefer, Kara

2012-01-01

Purpose: The purpose of this paper is to examine the integration of Okala curriculum into Interior Design coursework. Okala, as a teaching package, is utilized extensively in industrial design education. However, this study examines the expansion and insertion of Okala modules in an existing interior design curriculum. The Okala modules included…

Serological and molecular inquiry of Chagas disease in an Afro-descendant settlement in Mato Grosso do Sul State, Brazil.

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Mariana Furquim da Silva Martins

Full Text Available Furnas do Dionísio is a Brazilian Afro-descendant settlement in the city of Jaraguari, 21.4 miles from Campo Grande, Mato Grosso do Sul, Brazil. Approximately 96 families live in this quilombola (Maroon settlement, also known in Brazil as a remnant community of descendants of African slaves. Recent studies found 20% of households were infested by triatomines, 18% of insects captured in the community were infected by Trypanosoma cruzi, and 22.7% of dogs presented T. cruzi antibodies. The low prevalence of Chagas disease observed in humans in Mato Grosso do Sul State is attributed to its arrival via colonist migration and subsequent transplacental transmission. In order to gain a better understanding of the T. cruzi cycle in residents of the study community, serological and molecular tests were carried out to diagnose Chagas disease. In the present study, 175 residents between 2 and 80 years old were included. A total of 175 participants were interviewed and 170 provided blood samples, which were tested for T. cruzi antibodies with serological tests. Molecular diagnosis was performed in 167 participants by PCR (KDNA and NPCR (satellite DNA tests. One of the 170 samples tested positive for all serological tests performed. The overall frequency of Chagas disease in the community was low (0.6%. Interview responses revealed that 66.3% knew of triatomine insects and 65.7% reported having had no contact with them. Physical improvements to residences, together with vector surveillance and control by the State and municipal governments and local ecological conservation contribute to the low frequency of the Chagas disease in this quilombola community.

Serological and molecular inquiry of Chagas disease in an Afro-descendant settlement in Mato Grosso do Sul State, Brazil.

Science.gov (United States)

Martins, Mariana Furquim da Silva; Pereira, Mariane Barroso; Ferreira, Juliana de Jesus Guimarães; França, Adriana de Oliveira; Cominetti, Marlon Cézar; Ferreira, Eduardo de Castro; Dorval, Maria Elizabeth Moraes Cavalheiros; Rossi, Cláudio Lúcio; Mazon, Sílvia de Barros; de Almeida, Eros Antonio; Costa, Sandra Cecília Botelho; Marcon, Gláucia Elisete Barbosa

2018-01-01

Furnas do Dionísio is a Brazilian Afro-descendant settlement in the city of Jaraguari, 21.4 miles from Campo Grande, Mato Grosso do Sul, Brazil. Approximately 96 families live in this quilombola (Maroon) settlement, also known in Brazil as a remnant community of descendants of African slaves. Recent studies found 20% of households were infested by triatomines, 18% of insects captured in the community were infected by Trypanosoma cruzi, and 22.7% of dogs presented T. cruzi antibodies. The low prevalence of Chagas disease observed in humans in Mato Grosso do Sul State is attributed to its arrival via colonist migration and subsequent transplacental transmission. In order to gain a better understanding of the T. cruzi cycle in residents of the study community, serological and molecular tests were carried out to diagnose Chagas disease. In the present study, 175 residents between 2 and 80 years old were included. A total of 175 participants were interviewed and 170 provided blood samples, which were tested for T. cruzi antibodies with serological tests. Molecular diagnosis was performed in 167 participants by PCR (KDNA) and NPCR (satellite DNA) tests. One of the 170 samples tested positive for all serological tests performed. The overall frequency of Chagas disease in the community was low (0.6%). Interview responses revealed that 66.3% knew of triatomine insects and 65.7% reported having had no contact with them. Physical improvements to residences, together with vector surveillance and control by the State and municipal governments and local ecological conservation contribute to the low frequency of the Chagas disease in this quilombola community.

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.

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. © 2016 The Society for Vector Ecology.

Chagas disease cardiomyopathy: current concepts of an old disease Cardiomiopatia chagásica: conceitos atuais de doença antiga

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Angelina M.B. Bilate

2008-04-01

Full Text Available Chagas disease continues to be a significant public health problem, as ca. 10 million people are still infected with T. cruzi in Latin America. Decades after primary infection, 30% of individuals can develop a form of chronic inflammatory cardiomyopathy known as Chagas disease cardiomyopathy (CCC. Data from both murine models and human studies support the view that an autoimmune response as well as a parasite-driven immune response involving inflammatory cytokines and chemokines may both play a role in generating the heart lesions leading to CCC. This review aims to summarize recent advances in the understanding of the immunopathogenesis of Chagas disease cardiomyopathy.A doença de Chagas continua sendo importante problema de saúde pública uma vez que cerca de 10 milhões de indivíduos ainda estão infectados pelo T. cruzi. Décadas após a infecção primária, aproximadamente 30% dos indivíduos podem desenvolver uma cardiomiopatia inflamatória crônica, a chamada Cardiomiopatia Chagásica Crônica (CCC. Dados de modelos murinos e de estudos em humanos apóiam a visão de que tanto respostas auto-imunes como as determinadas pelo parasita em conjunto com citocinas e quimiocinas inflamatórias participam da geração das lesões cardíacas típicas da CCC. A presente revisão tem como objetivo sumarizar os recentes avanços no entendimento da imunopatogênese da Cardiomiopatia Chagásica Crônica.

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

New Scenarios of Chagas Disease Transmission in Northern Colombia

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Catalina Tovar Acero

2017-01-01

Full Text Available Chagas disease (CD is a systemic parasitic infection caused by the flagellated form of Trypanosoma cruzi. Córdoba department, located in the Colombian Caribbean Coast, was not considered as a region at risk of T. cruzi transmission. In this article, we describe the first acute CD case in Salitral village in Sahagún, Córdoba, confirmed by microscopy and serological tests. Our results draw attention to a new scenario of transmission of acute CD in nonendemic areas of Colombia and highlight the need to include CD in the differential diagnosis of febrile syndromes in this region.

Suicide risk and alcohol and drug abuse in outpatients with HIV infection and Chagas disease.

Science.gov (United States)

Guimarães, Patrícia M; Passos, Sonia R; Calvet, Guilherme A; Hökerberg, Yara H; Lessa, José L; Andrade, Carlos A de

2014-01-01

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. 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. 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). 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.

Probable brote de transmisión oral de enfermedad de Chagas en Turbo, Antioquia

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Juan Fernando Ríos

2011-03-01

Conclusión. Se identificó un probable brote agudo de enfermedad de Chagas en Antioquia y se plantea como hipótesis la transmisión por vía oral, mediante la ingestión de T. cruzi en alimentos contaminados con restos de triatominos o excrementos de marsupiales.

Congenital Chagas disease as an ecological model of interactions between Trypanosoma cruzi parasites, pregnant women, placenta and fetuses.

Science.gov (United States)

Carlier, Yves; Truyens, Carine

2015-11-01

The aim of this paper is to discuss the main ecological interactions between the parasite Trypanosoma cruzi and its hosts, the mother and the fetus, leading to the transmission and development of congenital Chagas disease. One or several infecting strains of T. cruzi (with specific features) interact with: (i) the immune system of a pregnant woman whom responses depend on genetic and environmental factors, (ii) the placenta harboring its own defenses, and, finally, (iii) the fetal immune system displaying responses also susceptible to be modulated by maternal and environmental factors, as well as his own genetic background which is different from her mother. The severity of congenital Chagas disease depends on the magnitude of such final responses. The paper is mainly based on human data, but integrates also complementary observations obtained in experimental infections. It also focuses on important gaps in our knowledge of this congenital infection, such as the role of parasite diversity vs host genetic factors, as well as that of the maternal and placental microbiomes and the microbiome acquisition by infant in the control of infection. Investigations on these topics are needed in order to improve the programs aiming to diagnose, manage and control congenital Chagas disease. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Epilepsia e doença de chagas cronica

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Edymar Jardim

1981-03-01

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

Mortalidad por enfermedad de Chagas: A propósito de los brotes de Chagas agudo como enfermedad reemergente de transmisión alimentaria

OpenAIRE

Rísquez, Alejandro

2009-01-01

Tras la ocurrencia de los primeros brotes de Chagas agudos en la capital (diciembre 2007) y Estado Vargas (marzo 2009) por trasmisión oral, se procedió a una revisión de la mortalidad por la enfermedad registrada entre 1997 y 2006, cuyos datos se analizaron de acuerdo a la edad, sexo y forma de presentación. El número absoluto de muertes sigue siendo elevado con promedio de 796 muertes anuales, de predominio en el sexo masculino, la mayoría en después de los 60 años de edad. Llama la atención...

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

Science.gov (United States)

2012-01-01

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

Packaging Aspects of Photodetector Modules for 100 Gbit/s Ethernet Applications

DEFF Research Database (Denmark)

Jiang, Chenhui; Mekonnen, G.G.; Krozer, Viktor

2008-01-01

Packaging is a major problem at millimetre-wave frequencies approaching 100 GHz. In this paper we present that insertion losses in a multi-chip module (MCM) can be less IL ...-backed coplanar waveguides (CBCPWs) with vias is accurately analyzed using 3D electromagnetic (EM) simulation over a wide frequency range. Patch antenna mode resonances are identified as a major origin of resonances in simulated and measured transmission characteristics of the CBCPW with vias. Based on EM...

Trypanosoma cruzi 80 kDa prolyl oligopeptidase (Tc80 as a novel immunogen for Chagas disease vaccine.

Directory of Open Access Journals (Sweden)

Augusto E Bivona

2018-03-01

Full Text Available Chagas disease, also known as American Trypanosomiasis, is a chronic parasitic disease caused by the flagellated protozoan Trypanosoma cruzi that affects about 8 million people around the world where more than 25 million are at risk of contracting the infection. Despite of being endemic on 21 Latin-American countries, Chagas disease has become a global concern due to migratory movements. Unfortunately, available drugs for the treatment have several limitations and they are generally administered during the chronic phase of the infection, when its efficacy is considered controversial. Thus, prophylactic and/or therapeutic vaccines are emerging as interesting control alternatives. In this work, we proposed Trypanosoma cruzi 80 kDa prolyl oligopeptidase (Tc80 as a new antigen for vaccine development against Chagas disease.In a murine model, we analyzed the immune response triggered by different immunization protocols based on Tc80 and evaluated their ability to confer protection against a challenge with the parasite. Immunized mice developed Tc80-specific antibodies which were able to carry out different functions such as: enzymatic inhibition, neutralization of parasite infection and complement-mediated lysis of trypomastigotes. Furthermore, vaccinated mice elicited strong cell-mediated immunity. Spleen cells from immunized mice proliferated and secreted Th1 cytokines (IL-2, IFN-γ and TNF-α upon re-stimulation with rTc80. Moreover, we found Tc80-specific polyfunctional CD4 T cells, and cytotoxic T lymphocyte activity against one Tc80 MHC-I peptide. Immunization protocols conferred protection against a T. cruzi lethal challenge. Immunized groups showed a decreased parasitemia and higher survival rate compared with non-immunized control mice. Moreover, during the chronic phase of the infection, immunized mice presented: lower levels of myopathy-linked enzymes, parasite burden, electrocardiographic disorders and inflammatory cells.Considering that

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.

CLINICAL AND EPIDEMIOLOGICAL PROFILE OF ELDERLY PATIENTS WITH CHAGAS DISEASE FOLLOWED BETWEEN 2005-2013 BY PHARMACEUTICAL CARE SERVICE IN CEARÁ STATE, NORTHEASTERN BRAZIL

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Laíse dos Santos PEREIRA

2015-04-01

Full Text Available By controlling the transmission of Chagas disease, the challenge of providing assistance to millions of infected patients that reach old age arises. In this study, the socioeconomic, demographic and comorbidity records of all elderly chagasic patients followed at the Pharmaceutical Care Service of the Chagas Disease Research Laboratory were assessed. The information related to the clinical form of the disease was obtained from medical records provided by the Walter Cantídio University Hospital. The profile of the studied population was: women (50.5%; mean age of 67 years; retired (54.6%; married (51.6 %; high illiteracy rate (40.2%; and family income equal to the minimum wage (51.5%. The predominant clinical forms of Chagas disease were cardiac (65.3% and indeterminate (14.7%. The main electrocardiographic changes were the right bundle branch block (41.0%, associated or not with the anterosuperior left bundle branch block (27.4%. The average number of comorbidities per patient was 2.23 ± 1.54, with systemic arterial hypertension being the main one found (67.0%. It was found that the elderly comprise a vulnerable group of patients that associate aging with cardiac and/or digestive disorders resulting from the evolution of Chagas disease and other comorbidities, which requires special attention from health services to ensure more appropriate medical and social care.

Humidity data for 9975 shipping packages with cane fiberboard

Energy Technology Data Exchange (ETDEWEB)

Daugherty, W. L. [Savannah River Site (SRS), Aiken, SC (United States)

2016-05-01

The 9975 surveillance program is developing a technical basis to support extending the storage period of 9975 packages in K-Area Complex beyond the currently approved 15 years. A key element of this effort is developing a better understanding of degradation of the fiberboard assembly under storage conditions. This degradation is influenced greatly by the moisture content of the fiberboard, which is not well characterized on an individual package basis. Direct measurements of humidity and fiberboard moisture content have been made on two test packages with cane fiberboard and varying internal heat levels from 0 up to 19W. With an internal heat load, a temperature gradient in the fiberboard assembly leads to varying relative humidity in the air around the fiberboard. However, the absolute humidity tends to remain approximately constant throughout the package. The moisture content of fiberboard varies under the influence of several phenomena. Changes in local fiberboard temperature (from an internal heat load) can cause fiberboard moisture changes through absorption or evaporation. Fiberboard degradation at elevated temperature will produce water as a byproduct. And the moisture level within the package is constantly seeking equilibrium with that of the surrounding room air, which varies on a daily and seasonal basis. One indicator of the moisture condition within a 9975 package might be obtained by measuring the relative humidity in the upper air space, by inserting a humidity probe through a caplug hole. However, the data indicate that for the higher internal heat loads (15 and 19 watts), a large variation in internal moisture conditions produces little or no variation in the air space relative humidity. Therefore, this approach does not appear to be sensitive to fiberboard moisture variations at the higher heat loads which are of most interest to maintaining fiberboard integrity.

Sperm Morphological Features Associated with Chronic Chagas Disease in the Semen of Experimentally Infected Dogs

Science.gov (United States)

Rodríguez-Morales, Olivia; Pedro-Martínez, Elvia; Hernández-Pichardo, José Ernesto; Alejandre-Aguilar, Ricardo; Aranda-Fraustro, Alberto; Graullera-Rivera, Verónica; Arce-Fonseca, Minerva

2014-01-01

The presence of trypanosomatids in the reproductive systems of different mammals (causing genital lesions in the acute stage of the disease) may predispose the animals to low semen quality. However, there are no studies examining the alterations in the sperm morphological features in the chronic stage of Trypanosoma cruzi infection. Knowledge of these aspects is important to understand the other ways of transmission of the Chagas disease. Progressive motility, mass motility, concentration, and sperm morphology of 84 ejaculates of dogs that were chronically infected with T. cruzi were evaluated. Most of the findings were consistent with the reference values and with those obtained from healthy control dogs. The scrotal circumference was not correlated with spermatozoa concentration in the infected animals. In conclusion, the T. cruzi Ninoa (MHOM/MX/1994/Ninoa) strain does not cause significant alterations in the semen quality of dogs experiencing chronic Chagas disease (at concentrations of 5 × 104 to 1 × 106 parasites per animal). PMID:25114010

Influence of the HLA class II polymorphism in chronic Chagas' disease.

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Fernandez-Mestre, M T; Layrisse, Z; Montagnani, S; Acquatella, H; Catalioti, F; Matos, M; Balbas, O; Makhatadze, N; Dominguez, E; Herrera, F; Madrigal, A

1998-04-01

Chagas' disease or American trypanosomiasis due to Trypanosoma cruzi has existed at least since the time of the Inca empire and contributes significantly to cardiovascular morbidity and mortality in several countries of this continent. Due to the fundamental role of human class II molecules polymorphic residues in the control of the immune response, a study was designed to define by DNA typing HLA class II alleles in a sample of 67 serologically positive individuals with and without cardiomyopathy and in 156 healthy controls of similar ethnic origin. Genomic DNA extraction, PCR amplification of the HLA-DRB1 and DQB1 second exon regions and hybridization to labelled specific probes were carried out following the 11th International Histocompatibility Workshop reference protocol. Comparison of DRB1 and DQB1 allele frequencies among the patients and control subjects showed a decreased frequency of DRB1*14 and DQB1*0303 in the patients, suggesting independent protective effects to the chronic infection in this population. Allele frequencies comparison between patients with and without cardiomyopathy showed a higher frequency of DRB1*01, DRB1*08 and DQB1*0501 and a decreased frequency of DRB1*1501 in the patients with arrhythmia and congestive heart failure. The results suggest that HLA Class II genes may be associated with the development of a chronic infection and with heart damage in Chagas' disease.

Soro-epidemiologia da doença de Chagas em Santa Catarina

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BR Schlemper Jr

1983-12-01

Full Text Available Em Santa Catarina, o Inquérito Sorológico Nacional para doença de Chagas (CNPq-SUCAM revelou positividade de 1,3% em cerca de 74.000 amostras de soro processadas pela reação de imunofluorescência indireta em papel de filtro, com 15 municípios apresentando prevalências de 5,4% a 41,3%. Na presente investigação, em 9 dos municípios com alta prevalência, foram obtidas amostras de sangue, por punção venosa, de 222 indivíduos dos quais 140 haviam sido sorologicamente positivos e 58 negativos no Inquérito Nacional. Em 24 outros indivíduos a reação foi executada pela primeira vez. Os testes sorológicos (imunofluorescência indireta, hemaglutinação indireta, aglutinação direta com e sem 2-mercaptoetanol e fixação do complemento realizados em 3 diferentes laboratórios evidenciaram 220 soros negativos e apenas 2 positivos. Dados epidenúológicos obtidos nas áreas trabalhadas confirmaram estes resultados negativos. Os resultados discordam daqueles encontrados pelo Inquérito Sorológico Nacional e confirmam a inexistência de focos domiciliares de transmissão da doença de Chagas em Santa Catarina.

Como as ações de saúde pensam o homem e como o homem as repensa: uma análise antropológica do controle da doença de Chagas How health activities view man and how man rethinks them: an anthropological analysis of Chagas disease control

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Claudia Magnani

2009-09-01

Full Text Available Estudo antropológico sobre a percepção cultural de um grupo de residentes no Município de Bambuí, Minas Gerais, Brasil, em relação à experiência de doença de Chagas e ao impacto das ações de saúde na vida social. Foi realizada uma pesquisa etnográfica baseada no instrumento de entrevista aberta, buscando identificar a percepção individual de 35 habitantes de Bambuí (chagásicos e não que viveram na região desde os anos quarenta, quando as ações de saúde foram promovidas para combater a doença de Chagas. Dentro de uma ampla análise da percepção social do efeito das ações de saúde implementadas, procurou-se observar as representações culturais do processo do adoecer. O estudo pretende contribuir para que as intervenções de saúde possam atuar de forma integral, incluindo os aspectos sócio-culturais com a população à qual se dirigem. A perspectiva cultural assume um importante papel para evitar sofrimento social.This anthropological study addresses the cultural perceptions of a group of residents in the city of Bambuí, Minas Gerais State, Brazil, in relation to experience with Chagas disease and the impact of health measures on social life. The ethnographic study was based on open interviews, seeking to identify individual perceptions among 35 inhabitants of Bambuí (with and without Chagas disease living in the region since the 1940s, when Chagas disease control activities were launched. Within a broad analysis of social perceptions concerning the effect of these health measures, the study sought to observe the cultural representations of the illness process. The study is intended to contribute to comprehensive work in health interventions, including the target population's socio-cultural characteristics. The cultural perspective plays an important role in preventing social distress.

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

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Felipe Lozano Kasten

1993-12-01

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

Chest tube insertion

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Chest drainage tube insertion; Insertion of tube into chest; Tube thoracostomy; Pericardial drain ... Be careful there are no kinks in your tube. The drainage system should always sit upright and be placed ...

Migração boliviana e doença de Chagas: limites na atuação do Sistema Único de Saúde brasileiro (SUS

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Nivaldo Carneiro Junior

2017-06-01

Full Text Available Migrações acarretam mudanças nos perfis epidemiológicos, impactando sistemas de saúde dos países receptores. O Brasil atrai imigrantes que se inserem precariamente nas metrópoles. Na Bolívia, a doença de Chagas é endêmica, fato relevante para o SUS brasileiro.O texto analisa a atuação e os limites dos profissionais de saúde no atendimento aos bolivianos no SUS, enfocando a doença de Chagas, por meio de entrevistas aplicadas nos serviços primário, secundário e terciário na região central da cidade de São Paulo, principal destino dos imigrantes bolivianos. As precárias condições de vida dos bolivianos caracterizam iniquidades em saúde. Idioma e cultura limitam a compreensão sobre o cuidado. Constata-se desconhecimento da clínica e epidemiologia da doença de Chagas entre os profissionais que atendem esses imigrantes. Faz-se necessária a revisão de estratégias assistenciais e de controle da doença de Chagas.

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

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Elsa L Segura

2005-06-01

Full Text Available OBJETIVO: Identificar la seroprevalencia de enfermedad de Chagas, los factores de riesgo de la vivienda e índices entomológicos, para proponer medidas de control en 11 jurisdicciones sanitarias del estado de Veracruz. MATERIAL Y MÉTODOS: Entre 1997 y 2001 se hizo un estudio transversal cuya muestra quedó integrada por 281 localidades, 2 526 viviendas y 9 782 individuos. Se aplicó un cuestionario sobre factores de riesgo, se tomó sangre en papel filtro y se buscaron triatominos en el intra y peridomicilio. Se obtuvo la prevalencia de exposición a factores de riesgo y de seropositividad para la enfermedad. Se hizo análisis bivariado mediante la razón de momios, ji de Mantel y Haenszel e intervalo de confianza a 95% como prueba de significancia estadística. El análisis multivariado se hizo mediante la regresión logística no condicional y se incluyeron las variables que durante el análisis bivariado mostraron un valor de p hasta de 0.20. El impacto potencial se estimó con base en la fracción etiológica en expuestos. RESULTADOS: La prevalencia de enfermedad de Chagas fluctuó entre 0 y 2.8%. Las jurisdicciones con mayor riesgo fueron Tuxpan, Pánuco y Córdoba, y sin riesgo, Orizaba. Los principales factores de riesgo de la vivienda fueron el techo y muro de palma/zacate y piso de tierra, así como la presencia del vector y la ventilación. CONCLUSIONES: Es necesario realizar vigilancia epidemiológica basada en educación para la salud, mejoramiento de la vivienda y uso de insecticidas.OBJECTIVE: To assess the seroprevalence, household risk factors, and entomological indicators, in order to frame control measures in 11 Sanitary Jurisdictions of the state. MATERIAL AND METHODS: This study included 281 towns, 2 526 households, and 9782 individuals. Data were collected using a questionnaire. Blood was obtained in filter paper and a search for triatomines was conducted inside of and around dwellings. Prevalence rates were used to

Echocardiographic parameters and survival in Chagas heart disease with severe systolic dysfunction.

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Rassi, Daniela do Carmo; Vieira, Marcelo Luiz Campos; Arruda, Ana Lúcia Martins; Hotta, Viviane Tiemi; Furtado, Rogério Gomes; Rassi, Danilo Teixeira; Rassi, Salvador

2014-03-01

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 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 70.71 mL/m2 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.

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.

Layered packaging: A synergistic method of transporting radioactive material

International Nuclear Information System (INIS)

Hohmann, G.L.

1989-01-01

The DOE certification for a transportation cask used to ship radioactive Krypton 85 from the Idaho Chemical Processing Plant (ICPP) to Oak Ridge National Laboratory (ORNL), was allowed to expire in 1987. The Westinghouse Idaho Nuclear Company (WINCO) was charged by DOE with modifying this cask to meet all current NRC requirements and preparing an updated Safety Analysis Report for Packaging, which would be submitted by DOE to the NRC for certification. However, an urgent need arose for ORNL to receive Krypton 85 which was in storage at the ICPP, which would not allow time to obtain certification of the modified shipping cask. WINCO elected to use a layered shipping configuration in which the gaseous Krypton 85 was placed in the uncertified, modified shipping cask to make use of its shielding and thermal insulation properties. This cask was then inserted into the Model No. 6400 (Super Tiger) packaging using a specially constructed plywood box and polyurethane foam dunnage. Structural evaluations were completed to assure the Super Tiger would provide the necessary impact, puncture, and thermal protection during maximum credible accidents. Analyses were also completed to determine the uncertified Krypton shipping cask would provide the necessary containment and shielding for up to 3.7 E+14 Bq of Krypton 85 when packaged inside the Super Tiger. The resulting reports, based upon this layered packaging concept, were adequate to first obtain DOE certification for several restricted shipments of Krypton 85 and then NRC certification for unrestricted shipments

Experimental insertions

International Nuclear Information System (INIS)

Sandweiss, J.; Kycia, T.F.

1975-01-01

A discussion is given of the eight identical experimental insertions for the planned ISABELLE storage rings. Four sets of quadrupole doublets are used to match the β functions in the insertions to the values in the cells, and the total free space available at the crossing point is 40 meters. An asymmetric beam energy operation is planned, which will be useful in a number of experiments

Conocimientos y factores de riesgo relacionados con la enfermedad de Chagas en dos comunidades panameñas donde Rhodnius pallescens es el vector principal

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Lisbeth A. Hurtado

2014-06-01

Full Text Available Introducción. La implementación de los programas de vigilancia, prevención y control de la enfermedad de Chagas requiere una aproximación integral. La sostenibilidad de los programas depende de la participación comunitaria amparada en un conocimiento básico del problema. Objetivo. Evaluar los conocimientos de los entrevistados que facilitan o limitan la vigilancia, prevención y control de la enfermedad de Chagas en dos comunidades endémicas de Panamá donde Rhodnius pallescens es el vector principal. Materiales y métodos. Mediante un cuestionario se evaluaron los conocimientos y los factores de riesgo relacionados con la enfermedad de Chagas en 201 personas mayores de 10 años de las comunidades endémicas de Las Pavas y Lagartera Grande, ubicadas en la ribera oeste del Canal de Panamá. Con ayuda de los moradores también se evaluó la presencia de chinches triatominos en 93 viviendas a lo largo de un año. Resultados. De las personas entrevistadas, 69,2 % (139/201 tenía pocos o muy pocos conocimientos sobre la enfermedad de Chagas y 93 % (187/201 estaba expuesto a factores de riesgo moderados o altos. Se capturaron chinches triatominos en 20,4 % (19/93 de las viviendas evaluadas, de los cuales, el 86,8 % (66/76 era R. pallescens. Se encontró asociación significativa entre la presencia de chinches dentro de las viviendas y las viviendas catalogadas como precarias (p<0,01. Conclusión. A pesar de que en estas dos comunidades se han desarrollado programas de educación sanitaria, es necesario reforzar los conocimientos básicos sobre la enfermedad de Chagas antes de establecer medidas de prevención y vigilancia que involucren la participación activa de sus habitantes.

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.

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

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

2014-10-01

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-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.

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

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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.

Acute myocardial infarction in chronic Chagas' cardiomyopathy: report of two cases with no obstructive coronary artery lesions

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Silvia G. Lage

1986-04-01

Full Text Available This report describes two patients with chronic Chagas' Heart Disease who developed clinical and laboratorial signs of myocardial infarction. Both patients presented sudden oppressive chest pain, without precipitating factor. In the first case, the highest MB-CK value was 65 IU, 22 hours after the beginning of the pain. On the second case, it was 77 IU at 18 hours after the beginning of the pain. In both cases ECG changes suggesting non-transmural infarction were present. The 99mTc PYP myocardial scintigram of the first case was positive. Coronary angiograms performed on the 18th and 9th day, respectively, after the acute infarction did not display obstructive lesions. Possible mechanisms causing myocardial infarction with normal coronary arteries in Chagas' Disease may include: embolic event's, particularly when there is associated congestive heart failure; coronary thrombosis and coronary spasms.

Clinical findings and prognosis of patients hospitalized for acute decompensated heart failure: Analysis of the influence of Chagas etiology and ventricular function

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Moreira, Henry Fukuda; Ayub-Ferreira, Silvia Moreira; Conceição-Souza, Germano Emilio; Salemi, Vera Maria Cury; Chizzola, Paulo Roberto; Oliveira, Mucio Tavares; Lage, Silvia Helena Gelas; Bocchi, Edimar Alcides; Issa, Victor Sarli

2018-01-01

Aims Explore the association between clinical findings and prognosis in patients with acute decompensated heart failure (ADHF) and analyze the influence of etiology on clinical presentation and prognosis. Methods and results Prospective cohort of 500 patients admitted with ADHF from Aug/2013-Feb/2016; patients were predominantly male (61.8%), median age was 58 (IQ25-75% 47–66 years); etiology was dilated cardiomyopathy in 141 (28.2%), ischemic heart disease in 137 (27.4%), and Chagas heart disease in 113 (22.6%). Patients who died (154 [30.8%]) or underwent heart transplantation (53[10.6%]) were younger (56 years [IQ25-75% 45–64 vs 60 years, IQ25-75% 49–67], P = 0.032), more frequently admitted for cardiogenic shock (20.3% vs 6.8%, Pheart transplant was higher among patients with Chagas (50.5%). Conclusions A physical exam may identify patients at higher risk in a contemporaneous population. Our findings support specific therapies targeted at Chagas patients in the setting of ADHF. PMID:29432453

Infectious agents and inflammation in donated hearts and dilated cardiomyopathies related to cardiovascular diseases, Chagas' heart disease, primary and secondary dilated cardiomyopathies.

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Mangini, Sandrigo; Higuchi, Maria de Lourdes; Kawakami, Joyce Tiyeko; Reis, Marcia Martins; Ikegami, Renata Nishiyama; Palomino, Suely Aparecida Pinheiro; Pomerantzeff, Pablo Maria Alberto; Fiorelli, Alfredo Inácio; Marcondes-Braga, Fabiana Goulart; Bacal, Fernando; Ferreira, Sílvia Moreira Ayub; Issa, Victor Sarli; Souza, Germano Emílio Conceição; Chizzola, Paulo Roberto; Bocchi, Edimar Alcides

2015-01-15

Clinical and experimental conflicting data have questioned the relationship between infectious agents, inflammation and dilated cardiomyopathy (DCM). The aim of this study was to determine the frequency of infectious agents and inflammation in endomyocardial biopsy (EMB) specimens from patients with idiopathic DCM, explanted hearts from different etiologies, including Chagas' disease, compared to donated hearts. From 2008 to 2011, myocardial samples from 29 heart donors and 55 patients with DCMs from different etiologies were studied (32 idiopathic, 9 chagasic, 6 ischemic and 8 other specific etiologies). Inflammation was investigated by immunohistochemistry and infectious agents by immunohistochemistry, molecular biology, in situ hybridization and electron microscopy. There were no differences regarding the presence of macrophages, expression of HLA class II and ICAM-I in donors and DCM. Inflammation in Chagas' disease was predominant. By immunohistochemistry, in donors, there was a higher expression of antigens of enterovirus and Borrelia, hepatitis B and C in DCMs. By molecular biology, in all groups, the positivity was elevated to microorganisms, including co-infections, with a higher positivity to adenovirus and HHV6 in donors towards DCMs. This study was the first to demonstrate the presence of virus in the heart tissue of chagasic DCM. The presence of inflammation and infectious agents is frequent in donated hearts, in the myocardium of patients with idiopathic DCM, myocardial dysfunction related to cardiovascular diseases, and primary and secondary cardiomyopathies, including Chagas' disease. The role of co-infection in Chagas' heart disease physiopathology deserves to be investigated in future studies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Análisis epidemiológico de pacientes coinfectados con enfermedad de Chagas y cisticercosis

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Ana Carolina Guimaraes

2009-03-01

Conclusión. En teoría, todos los pacientes tuvieron un riesgo similar de exposición para ambos parásitos. Sin embargo, este trabajo demuestra que, en la población estudiada, la enfermedad de Chagas fue, aproximadamente, 10 veces más frecuente en los casos coinfectados con cisticercosis.

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

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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

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

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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. Copyright © 2012 Elsevier Inc. All rights reserved.

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

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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.

Migração interna e a distribuição da mortalidade por doença de Chagas, Brasil, 1981/1998

OpenAIRE

Drumond João Augusto Guimarães; Marcopito Luiz Francisco

2006-01-01

No Brasil, observa-se mortalidade por doença de Chagas até em áreas reconhecidas como livres da transmissão vetorial. Considerando que as taxas de mortalidade referem-se a residentes, e que houve imenso movimento migratório interno no país, este estudo objetiva quantificar a participação dos migrantes brasileiros no obituário por doença de Chagas de 1981 a 1998. Por outro lado, se os trabalhos da Iniciativa do Cone Sul alcançaram o sucesso que se propaga, espera-se que tenha havido redução da...

Safety Analysis Report - Packages, 9965, 9968, 9972-9975 Packages

International Nuclear Information System (INIS)

Blanton, P.

2000-01-01

This Safety Analysis Report for Packaging (SARP) documents the analysis and testing performed on four type B Packages: the 9972, 9973, 9974, and 9975 packages. Because all four packages have similar designs with very similar performance characteristics, all of them are presented in a single SARP. The performance evaluation presented in this SARP documents the compliance of the 9975 package with the regulatory safety requirements. Evaluations of the 9972, 9973, and 9974 packages support that of the 9975. To avoid confusion arising from the inclusion of four packages in a single document, the text segregates the data for each package in such a way that the reader interested in only one package can progress from Chapter 1 through Chapter 9. The directory at the beginning of each chapter identifies each section that should be read for a given package. Sections marked ''all'' are generic to all packages

Le Honduras se démarque dans la lutte contre la maladie de Chagas

International Development Research Centre (IDRC) Digital Library (Canada)

25 janv. 2011 ... ... en partenariat avec la fondation nationale du logement, ont grandement contribué à la lutte contre la transmission de la maladie de Chagas. À ce jour, 45 % des habitants du comté vivent dans de nouvelles maisons faites de matériaux − murs d'adobe, planchers de ciment, toits de zinc − qui n'attirent pas ...

Human Chagas Disease and Migration in the Context of Globalization: Some Particular Aspects

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João Carlos Pinto Dias

2013-01-01

Full Text Available Human Chagas disease originated in Latin America, being spread around the world in relation with multiple bioecological, sociocultural, and political factors. The process of the disease production and dispersion is discussed, emphasizing the human migration and correlated aspects, in the context of globalization. Positive and negative consequences concern the future of this trypanosomiasis, mainly in terms of the ecologic and sociopolitical characteristics of the endemic and nonendemic countries.

Follow-up Evaluation of Air Force Blood Donors Screening Positive for Chagas Disease

Science.gov (United States)

2017-08-27

Blood Donors Screening Positive for Cbagas Disease presented at/published to Military Health System Research Symposium (Florida, 27-30 Aug 2017) in...disease upon blood donation at JBSA -Lackland 6. TITLE OF MATERIAL TO BE PUBLISHED OR PRESENTED: Follow-up evaluation of Air Force blood donors ...Designated Exempt Reviewer Follow-up evaluation of Air Force blood donors screening positive for Chagas disease Joseph Marcus1, Bryant Webber2, Leo Cropper2

White LED with High Package Extraction Efficiency

International Nuclear Information System (INIS)

Yi Zheng; Stough, Matthew

2008-01-01

in the package may cause a deterioration of encapsulant materials, affecting the performance of both the LED die and phosphor, leading to a decrease in the luminous efficacy over lifetime. Recent studies from research groups at Rensselaer Polytechnic Institute found that, under the condition to obtain a white light, about 40% of the light is transmitted outward of the phosphor layer and 60% of the light is reflected inward.1,2 It is claimed that using scattered photon extraction (SPE) technique, luminous efficacy is increased by 60%. In this project, a transparent/translucent monolithic phosphor was used to replace the powdered phosphor layer. In the normal pcLED package, the powdered phosphor is mixed with silicone either to be deposited on the top of LED die forming a chip level conversion (CLC) white LED or to be casted in the package forming a volume conversion white LED. In the monolithic phosphors there are no phosphor powder/silicone interfaces so it can reduce the light scattering caused by phosphor particles. Additionally, a multi-layer thin film selectively reflecting filter is inserted in the white LED package between the blue LED die and phosphor layer. It will selectively transmit the blue light from the LED die and reflect the phosphor's yellow inward emission outward. The two technologies try to recover backward light to the outward direction in the pcLED package thereby improving the package extraction efficiency.

Estudo de fatores pró-trombóticos e pró-inflamatórios na cardiomiopatia chagásica Study of pro-thrombotic and pro-inflammatory factors in chagas cardiomyopathy

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Leila Maria Magalhães Pessoa de Melo

2010-10-01

Full Text Available FUNDAMENTO: A relação entre atividade inflamatória e pró-trombótica na cardiomiopatia chagásica e em outras etiologias é obscura. OBJETIVO: Estudar o perfil de marcadores pró-trombóticos e pró-inflamatórios em pacientes com insuficiência cardíaca chagásica e compará-los com os de etiologia não chagásica. MÉTODOS: Coorte transversal. Critérios de inclusão: fração de ejeção do VE (FEVE um mês. Os pacientes foram divididos em dois grupos: grupo 1 (G1 - sorologias positivas para Chagas - e grupo 2 (G2 - sorologias negativas para Chagas. Fator pró-inflamatório: PCR ultrassensível. Fatores pró-trombóticos: fator trombina-antitrombina, fibrinogênio, antígeno do fator de von Willebrand, P-selectina plasmática e tromboelastograma. Amostra calculada para poder de 80%, assumindo-se diferença de 1/3 de desvio-padrão; p significativo se BACKGROUND: The relationship between inflammatory and prothrombotic activity in chagas cardiomyopathy and in other etiologies is unclear. OBJECTIVE: To study the profile of pro-thrombotic and pro-inflammatory markers in patients with Chagas' heart failure and compare them with patients of non-chagas etiology. METHODS: Cross-sectional cohort. Inclusion criteria: left ventricle ejection fraction (LVEF one month. The patients were divided into two groups: group 1 (G1 - seropositive for Chagas - and group 2 (G2 - seronegative for Chagas. Pro-inflammatory factor: Ultra-sensitive CRP. Pro-thrombotic factors: thrombin-antithrombin factor, fibrinogen, von Willebrand factor antigen, plasma P-selectin and thromboelastography. Sample calculated for 80% power, assuming a standard deviation difference of 1/3; significant p if it is < 0.05. Statistical analysis: Fisher's exact test for categorical variables; unpaired Student's t-test for parametric continuous variables and Mann-Whitney test for nonparametric continuous variables. RESULTS: Between January and June 2008, 150 patients were included, 80 in G1

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

Cultivation-independent methods reveal differences among bacterial gut microbiota in triatomine vectors of Chagas disease.

Science.gov (United States)

da Mota, Fabio Faria; Marinho, Lourena Pinheiro; Moreira, Carlos José de Carvalho; Lima, Marli Maria; Mello, Cícero Brasileiro; Garcia, Eloi Souza; Carels, Nicolas; Azambuja, Patricia

2012-01-01

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. 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. The microbiota of triatomine guts represents one of the factors that may interfere with T. cruzi transmission and virulence in humans. The knowledge of its composition according to insect species is important for designing measures of biological control for T. cruzi. We found that the predominant species of the bacterial microbiota in triatomines form a group of low complexity whose structure differs according to the vector genus.

Soroprevalência da doença de Chagas em crianças em idade escolar do Estado do Espírito Santo, Brasil, em 1999-2000 Chagas' disease seroprevalence among school-age children in Espírito Santo State, Brazil, 1999-2000

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Paulo Augusto Sessa

2002-12-01

Full Text Available Embora o Estado do Espírito Santo não seja considerado endêmico para a doença de Chagas, triatomíneos silvestres que lá ocorrem freqüentemente invadem as casas, com chances de transmissão da doença às pessoas. Avaliou-se o padrão epidemiológico da moléstia no Estado por meio de um inquérito sorológico realizado em 5.243 escolares de 7 a 14 anos de idade, residentes em 17 municípios. Os testes de Imunofluorescência Indireta, Hemaglutinação Indireta e Imunoenzimático (ELISA foram positivos em apenas uma pessoa, representando 0,019% do total. O resultado foi semelhante aos encontrados por outros autores em investigações anteriores. Concluiu-se que, apesar da intensa destruição da Mata Atlântica ocorrida nas últimas décadas, o padrão epidemiológico da doença de Chagas permanece estável, a julgar pelo resultado dos testes sorológicos.Although the Brazilian State of Espírito Santo is not considered endemic for Chagas' disease, the sylvatic triatomines occurring there frequently invade houses, increasing the chances of Trypanosoma cruzi transmission to man. The epidemiological pattern of the disease in Espírito Santo was evaluated by a serological survey of 5,243 schoolchildren ages 7 to 14 years, residents of 17 municipalities. Indirect immunofluorescence, indirect hemagglutination, and immunoenzymatic (ELISA tests were positive in only one person, representing only 0.019% of the total. This result was similar to those found by other authors in previous studies. Based on the results of serological tests it is concluded that the epidemiological pattern of Chagas' disease in Espírito Santo remains stable, despite the intensive destruction of the Atlantic Forest that has occurred in recent decades.

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

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Renata Trotta Barroso Ferreira

2014-11-01

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

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

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Maria Regina Branquinho

2014-11-01

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

Aspectos raciais dos "megas" e da cardiopatia na doença de Chagas crônica

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Lineu José Miziara

1981-06-01

Full Text Available O estudo de 724 pacientes chagásicos crônicos mostrou que a insuficiência cardíaca congestiva é mais freqüente e de aparecimento mais precoce nos pacientes de raça negra do que nos brancos. A ocorrência de "megas" foi ligeiramente inferior nos chagásicos negros não sendo estatisticamente significativa a diferença observada. A maior freqüência de insuficiência cardíaca nos pretos parece estar relacionada a características biológicas do tecido conjuntivo que condicionam uma resposta fibrosante mais acentuada no miocârdio agredido pela Tripanossomose. Estas observações estariam de acordo com outros estudos sobre a doença de Chagas que admitem ser a denervação o fator mais importante para o aparecimento dos "megas" e a inflamação com fibrose miocârdica acentuada um elemento básico para explicar a insuficiência cardíaca.The study of 724 patients with chronic chagas's disease showed that the cardiac faiture is more frequent and appears earlier in negroes patients when compared to white patients. The occurrence of "megas" was slightly lover in the negroes but the difference was not statisticaiiy significant. The higher frequency of cardiac faiture in the negrões seems to be caused by biological characteristics of the conective tissue which respond to trypanossomiasis with a more severe degree of fibrosis. These findings agree with other reports on Chagas's disease in which it is admitted that the "megas" are chiefly the result of dennervation and cardiac faiture is principally caused by infiammation with myocardial fibrosis.

Spatiotemporal analysis of reported cases of acute Chagas disease in the State of Pernambuco, Brazil, from 2002 to 2013

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Fred Luciano Neves Santos

2015-04-01

Full Text Available INTRODUCTION: Control strategies to eliminate the transmission of Chagas disease by insect vectors have significantly decreased the number of reported acute cases in Brazil. However, data regarding the incidence and distribution of acute Chagas disease cases in the State of Pernambuco are unavailable in the literature. METHODS: A geographical information system was used to delineate the spatiotemporal distribution profile of the cases from 2002 to 2013 in 185 municipalities of Pernambuco based on the municipality where notification occurred. The results were presented in digital maps generated by the TerraView software (INPE. RESULTS: A total of 302 cases of acute disease were recorded in 37.8% of the municipalities, for a total of 0.13 cases per 1,000,000 inhabitants per year. Out of the 302 cases, 99.3% were reported between 2002 and 2006. The most affected municipalities were Carnaubeira da Penha, Mirandiba and Terra Nova. The risk maps showed a significant decrease in the number of notifications and a concentration of cases in the Midwest region. CONCLUSIONS: This study highlights a significant decrease in new cases of acute Chagas disease in Pernambuco starting in 2006 when Brazil received an international certification for the interruption of vectorial transmission by Triatoma infestans. However, control strategies should still be encouraged because other triatomine species can also transmit the parasite; moreover, other transmission modes must not be neglected.

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

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Marly Uellendahl

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

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

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Lázzari Julio O.

1998-01-01

Full Text Available 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 (k index for concordance. The results showed a high degree of interobserver concordance with respect to the diagnosis of normal vs. abnormal tracings (k = 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.

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

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Julio O. Lázzari

1998-11-01

Full Text Available 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 (k index for concordance. The results showed a high degree of interobserver concordance with respect to the diagnosis of normal vs. abnormal tracings (k = 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.

Prevalence of Chagas disease in medical students from 16 Latin American countries attending

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Miguel A. Serra Valdés

2012-06-01

Full Text Available Introduction: One of the infectious illnesses that have repercussion in Latin America are the Chagas illness. Objective: with the objective of identifying the students with positive serology for the illness of Chagas and describe the characteristics in the same thing with focussing epidemiological carried out to him the present study. Method: It become fulfilled a observational investigation, descriptive and prospectival. It decided the prevalencial in the Latin American students of medicine that resides in the school Salvador Allende in the period understanded between October of the 2009 to January of the 2010 by means of serology, other clinical studieses and examination. They took shelter the variables of the clinical records and of personal interview.. Results: Affected 50 of the Bolivian delegation. The prevalence went of 6.6% of this delegation. Have clinical symptoms. The detected alterations went the ventricular hypertrophy left and the disorders of transportation and of the rhythm for electrocardiogram. It predominated the masculine sex and the rural origin. It found variability in the results of laboratory, being positive in their country and negative in Cuba and vice versa. Single 56% fulfilled the treatment. The adverse reactions went minims. Conclusion: It constitutes a sanitary problem and demands a better diagnosis, control and follow-up.

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.

Control and management of congenital Chagas disease in Europe and other non-endemic countries: current policies and practices.

Science.gov (United States)

Soriano-Arandes, Antoni; Angheben, Andrea; Serre-Delcor, Nuria; Treviño-Maruri, Begoña; Gómez I Prat, Jordi; Jackson, Yves

2016-05-01

Identifying pregnant women infected with Trypanosoma cruzi is one of the major challenges for preventing and controlling Chagas disease (CD) in non-endemic countries. The aim of this paper was to perform a policy evaluation of the current practices of congenital Chagas disease (CCD) control in non-endemic countries and to propose specific targets for enhanced interventions to tackle this emerging health problem outside the endemic areas of Latin America. We conducted a mixed method review of CCD policy strategies by searching the literature in the PubMed, Google Scholar and the World Health Organization (WHO) databases using the key terms 'CCD', 'paediatric Chagas disease' and 'non-endemic countries'; as free text and combined as one phrase to increase the search sensitivity. Reviews, recommendations, guidelines and control/surveillance programme reports were included. Of 427 CCD papers identified in non-endemic countries, 44 matched the inclusion. Although local programmes were launched in different countries with large numbers of Latin American immigrants, there were considerable disparities in terms of the programmes' distribution, delivery, integration and appropriated CCD control strategies. Moreover, Catalonia, Spain is the only region/country with an established systematic monitoring of CCD in pregnant women from Latin American countries. Given the worldwide dissemination of CD, the nature of its vertical transmission, and the gaps of the current strategies in non-endemic countries, there is an urgent need to standardise, expand and reinforce the control measures against CCD transmission. © 2016 John Wiley & Sons Ltd.

Insertion device and method for accurate and repeatable target insertion

Science.gov (United States)

Gubeli, III, Joseph F.; Shinn, Michelle D.; Bevins, Michael E.; Dillon-Townes, Lawrence; Neil, George R.

2017-07-04

The present invention discloses a device and a method for inserting and positioning a target within a free electron laser, particle accelerator, or other such device that generates or utilizes a beam of energy or particles. The system includes a three-point registration mechanism that insures angular and translational accuracy and repeatability of positioning upon multiple insertions within the same structure.

A Deep Insight Into the Sialotranscriptome of the Chagas Disease Vector, Panstrongylus megistus (Hemiptera: Heteroptera)

Czech Academy of Sciences Publication Activity Database

Ribeiro, J.M.C.; Schwarz, Alexandra; Francischetti, I.M.B.

2015-01-01

Roč. 52, č. 3 (2015), s. 351-358 ISSN 0022-2585 R&D Projects: GA MŠk LH12002; GA ČR GPP302/11/P798 Institutional support: RVO:60077344 Keywords : Chagas disease * vector biology * salivary gland * transcriptome * medical entomology Subject RIV: FN - Epidemiology, Contagious Diseases ; Clinical Immunology Impact factor: 1.712, year: 2015

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

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Cynara Carvalho Parente

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

"Estudo comparativo da função erétil em pacientes portadores da forma digestiva da Doença de Chagas"

OpenAIRE

Valdi Camarcio Bezerra

2003-01-01

O objetivo deste estudo foi correlacionar as alterações causadas pela doença de Chagas no sistema nervoso autônomo e a possibilidade destas alterações provocarem disfunção erétil. Foram incluídos 60 pacientes, do sexo masculino, entre 40 e 70 anos, sendo 30 com a forma digestiva da doença de Chagas e 30 como grupo controle negativos para tripanossomíase; foram utilizados o questionário auto-aplicável do Índice Internacional de Função Erétil (IIFE) e o algoritmo de pontuação para análise e int...

Facility target insert shielding assessment

Energy Technology Data Exchange (ETDEWEB)

Mocko, Michal [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2015-10-06

Main objective of this report is to assess the basic shielding requirements for the vertical target insert and retrieval port. We used the baseline design for the vertical target insert in our calculations. The insert sits in the 12”-diameter cylindrical shaft extending from the service alley in the top floor of the facility all the way down to the target location. The target retrieval mechanism is a long rod with the target assembly attached and running the entire length of the vertical shaft. The insert also houses the helium cooling supply and return lines each with 2” diameter. In the present study we focused on calculating the neutron and photon dose rate fields on top of the target insert/retrieval mechanism in the service alley. Additionally, we studied a few prototypical configurations of the shielding layers in the vertical insert as well as on the top.

Packaging Solutions : Delivering customer value through Logistical Packaging: A Case Study at Stora Enso Packaging

OpenAIRE

Shan, Kun; Julius, Joezer

2015-01-01

AbstractBackground;Despite of the significant role of packaging within logistics and supply chain management, packaging is infrequently studied as focal point in supply chain. Most of the previous logistics research studies tend to explain the integration between packaging and logistics through logistical packaging. In very rare cases, the studies mentioned about customer value. Therefore the major disadvantage of these studies is that, they didn’t consider logistical packaging and customer v...

Association of L-ficolin levels and FCN2 genotypes with chronic Chagas disease.

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Paola R Luz

Full Text Available BACKGROUND: L-ficolin (encoded by FCN2 binds to acetylated sugar moieties of many pathogens, including Trypanosoma cruzi, promoting their phagocytosis and lysis by the complement system. METHODS: We investigated L-ficolin levels in 160 T. cruzi infected patients with chronic Chagas disease and 71 healthy individuals, and FCN2 polymorphisms (-986 G>A, -602 G>A, and -4 A>G in the promoter and A258S in exon 8 in 243 patients, being 88 indeterminate (asymptomatic, 96 with cardiac, 23 with digestive and 33 with cardiodigestive manifestations (two were unspecified and 305 controls (135 for A258S. RESULTS: Patients presented lower L-ficolin plasma levels than controls (p<0.0001. Among the different groups of cardiac commitment, individuals with moderate forms had higher L-ficolin levels than the severe forms (P = 0.039. Lower L-ficolin levels were found associated with the 258S variant in the patients (P = 0.034. We found less -4A/G heterozygotes in the cardiac patients, than in the controls (OR = 0.56 [95% CI = 0.33-0.94], P = 0.034. Heterozygote -4A/G genotypes with the 258S variant and 258SS homozygotes were nevertheless more frequent among cardiodigestive patients than in controls (OR = 14.1 [95% CI = 3.5-56.8], P = 0.0001 and in indeterminate patients (OR = 3.2 [95% CI = 1.1-9.4], P = 0.037. We also found an association of the allelic frequency of the 258S variant with cardiodigestive Chagas disease compared to controls (OR = 2.24 [95% CI = 1.1-4.5], P = 0.037. Thus, decreased patient levels of L-ficolin reflect not only protein consumption due to the disease process, but also the higher frequency of the 258S variant in patients with cardiodigestive symptoms. CONCLUSION: The very first study on Brazilian cohort associates both L-ficolin plasma levels and FCN2 variants to Chagas disease and subsequent disease progression. The prognostic value of L-ficolin levels and the FCN2*A258S polymorphism

Packaging fluency

DEFF Research Database (Denmark)

Mocanu, Ana; Chrysochou, Polymeros; Bogomolova, Svetlana

2011-01-01

Research on packaging stresses the need for packaging design to read easily, presuming fast and accurate processing of product-related information. In this paper we define this property of packaging as “packaging fluency”. Based on the existing marketing and cognitive psychology literature on pac...

Chagas disease: national survey of seroprevalence in children under five years of age conducted in 2008.

Science.gov (United States)

Russomando, Graciela; Cousiño, Blanca; Sanchez, Zunilda; Franco, Laura X; Nara, Eva M; Chena, Lilian; Martínez, Magaly; Galeano, María E; Benitez, Lucio

2017-05-01

Since the early 1990s, programs to control Chagas disease in South America have focused on eradicating domiciliary Triatoma infestans, the main vector. Seroprevalence studies of the chagasic infection are included as part of the vector control programs; they are essential to assess the impact of vector control measures and to monitor the prevention of vector transmission. To assess the interruption of domiciliary vector transmission of Chagas disease by T. infestans in Paraguay by evaluating the current state of transmission in rural areas. A survey of seroprevalence of Chagas disease was carried out in a representative sample group of Paraguayans aged one to five years living in rural areas of Paraguay in 2008. Blood samples collected on filter paper from 12,776 children were tested using an enzyme-linked immunosorbent assay. Children whose serology was positive or undetermined (n = 41) were recalled to donate a whole blood sample for retesting. Their homes were inspected for current triatomine infestation. Blood samples from their respective mothers were also collected and tested to check possible transmission of the disease by a congenital route. A seroprevalence rate of 0.24% for Trypanosoma cruzi infection was detected in children under five years of age among the country's rural population. Our findings indicate that T. cruzi was transmitted to these children vertically. The total number of infected children, aged one to five years living in these departments, was estimated at 1,691 cases with an annual incidence of congenital transmission of 338 cases per year. We determined the impact of vector control in the transmission of T. cruzi, following uninterrupted vector control measures employed since 1999 in contiguous T. infestans-endemic areas of Paraguay, and this allowed us to estimate the degree of risk of congenital transmission in the country.

Chagas disease: national survey of seroprevalence in children under five years of age conducted in 2008

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Graciela Russomando

Full Text Available BACKGROUND Since the early 1990s, programs to control Chagas disease in South America have focused on eradicating domiciliary Triatoma infestans, the main vector. Seroprevalence studies of the chagasic infection are included as part of the vector control programs; they are essential to assess the impact of vector control measures and to monitor the prevention of vector transmission. OBJECTIVE To assess the interruption of domiciliary vector transmission of Chagas disease by T. infestans in Paraguay by evaluating the current state of transmission in rural areas. METHODS A survey of seroprevalence of Chagas disease was carried out in a representative sample group of Paraguayans aged one to five years living in rural areas of Paraguay in 2008. Blood samples collected on filter paper from 12,776 children were tested using an enzyme-linked immunosorbent assay. Children whose serology was positive or undetermined (n = 41 were recalled to donate a whole blood sample for retesting. Their homes were inspected for current triatomine infestation. Blood samples from their respective mothers were also collected and tested to check possible transmission of the disease by a congenital route. FINDINGS A seroprevalence rate of 0.24% for Trypanosoma cruzi infection was detected in children under five years of age among the country’s rural population. Our findings indicate that T. cruzi was transmitted to these children vertically. The total number of infected children, aged one to five years living in these departments, was estimated at 1,691 cases with an annual incidence of congenital transmission of 338 cases per year. MAIN CONCLUSION We determined the impact of vector control in the transmission of T. cruzi, following uninterrupted vector control measures employed since 1999 in contiguous T. infestans-endemic areas of Paraguay, and this allowed us to estimate the degree of risk of congenital transmission in the country.

La migrazione del chagas: Costruzione bio-medica e socio-politica delle malattie tropicali dimenticate

OpenAIRE

Ciannameo, Anna

2014-01-01

Questo studio propone un'esplorazione dei nessi tra processi migratori ed esperienze di salute e malattia a partire da un'indagine sulle migrazioni provenienti dall'America latina in Emilia-Romagna. Contemporaneamente indaga i termini del dibattito sulla diffusione della Malattia di Chagas, “infezione tropicale dimenticata” endemica in America centro-meridionale che, grazie all'incremento dei flussi migratori transnazionali, viene oggi riconfigurata come 'emergente' in alcuni contesti di imm...

Aspectos da padronização de testes sorológicos para a doença de Chagas: um teste imunoenzimático para a triagem de doadores de sangue Standardization of serological tests in Chagas' disease: immunoenzimatic test for screening of blood bank donnors

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A. Walter Ferreira

1991-04-01

Full Text Available No diagnóstico sorológico da doença de Chagas podem ser encontradas acentuadas divergências mesmo entre laboratórios de grande experiência. Para a padronização de um teste imunoenzimático destinado primariamente à seleção de doadores de sangue foram cuidadosamente escolhidos painéis de soros que se buscaram como representativos das populações de chagásicos e de não chagásicos. Produzido para máxima sensibilidade e estabilidade, o novo reagente (bioELISA - cruzi* foi testado em 1648 soros, com diagnóstico clínico de doença de Chagas em 219 e de outras afecções em 104. O teste foi comparado com testes já bem padronizados, de imunofluorescência (IF e de hemaglutinação (HA, em 1325 soros. O limiar de reatividade (cut off, estabelecido como ideal, foi indicado nos testes pela absorbância de um soro de reatividade mínima. A sensibilidade do teste imunoenzimático foi de 0,9954 e a especificidade, como conegatividade, de 0,9969. Não foram vistos resultados falso-positivos em casos de sífilis, toxoplasmose, mononucleose e de soros com altos títulos de anti-estreptolisina 0, mas foram encontrados em 5 de 15 casos de leishmaniose tegumentar, 10 de 24 casos de calazar, 1 de 15 casos de artrite reumatóide e 1 de 12 casos de lupus eritematoso sistêmico. Os altos índices de sensibilidade em chagásicos e de especificidade na população geral, traduzem a elevada confiabilidade do teste para triagem de doadores de sangue e para a confirmação de suspeita clínica de doença de Chagas.In the serological diagnosis of Chagas disease large divergences may be found even between laboratories with experience, as a consequence of different criteria for the standardization of the tests. To standardize a immunoenzimatic test developed primarily for screening blood donors, serum panels were carefully chosen so as to best represent chagasic and non-chagasic populations. Produced for the highest sensibility and stability, the new

Miradas Caleidoscópicas sobre el Chagas. Una experiencia educativa en el Museo de La Plata

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Mariana Sanmartino

2012-01-01

Full Text Available Presentamos resultados y reflexiones en torno a la experiencia "Semana del Chagas en el Museo de La Plata" (La Plata, Provincia de Buenos Aires, Argentina realizada en mayo de 2011. La propuesta tuvo como objetivo la difusión y sensibilización acerca de la problemática del Chagas desde una mirada integral. Las actividades incluyeron una muestra de obras plásticas; la proyección de materiales audiovisuales innovadores; talleres con estudiantes de escuelas primarias y secundarias de la zona; charlas abiertas a cargo de especialistas; la presentación y distribución de materiales didácticos a docentes de escuelas; así como el desarrollo de actividades destinadas al público general. La evaluación de la experiencia es altamente satisfactoria, y de la reflexión sobre lo transitado -durante la organización y en la implementación- surgen múltiples aprendizajes tanto para participantes como para organizadores, de lo cual se desprende el interés por compartir la propuesta y la posibilidad de adecuarla a otros contextos.

La enfermedad de Chagas congenita en la Provincia de Salta, Argentina, años 1980-1997

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Zaidenberg Mario

1999-01-01

Full Text Available Se presenta la experiencia de 18 años en la provincia de Salta en el manejo de recién nacidos con enfermedad de Chagas congénita. Desde distintos ámbitos del sistema provincial de salud, el Hospital Materno-infantil de la ciudad de Salta, hospitales del interior y la atención ambulatoria se detectaron y diagnosticaron 102 recién nacidos (RN y lactantes con infección congénita. Los RN se dividieron en dos grupos mayores, el último subdivido, de acuerdo a la oportunidad diagnóstica. Se describe la metodología diagnóstica, presentación clínica, tratamiento y el seguimiento posterior de los niños tratados. Se analizan las características de la experiencia y se discuten las condiciones específicas del diagnóstico, tratamiento y seguimiento de los niños estudiados. Se describen las recomendaciones empleadas en la provincia en el programa de control de Chagas perinatal así como las conclusiones derivadas de esta experiencia.

Feeding tube insertion - gastrostomy

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/002937.htm Feeding tube insertion - gastrostomy To use the sharing features on this page, please enable JavaScript. A gastrostomy feeding tube insertion is the placement of a feeding ...

Evolution of anti-Trypanosoma cruzi antibody production in patients with chronic Chagas disease: Correlation between antibody titers and development of cardiac disease severity.

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Ingebourg Georg

2017-07-01

Full Text Available Chagas disease is one of the most important endemic infections in Latin America affecting around 6-7 million people. About 30-50% of patients develop the cardiac form of the disease, which can lead to severe cardiac dysfunction and death. In this scenario, the identification of immunological markers of disease progression would be a valuable tool for early treatment and reduction of death rates. In this observational study, the production of anti-Trypanosoma cruzi antibodies through a retrospective longitudinal follow-up in chronic Chagas disease patients´ cohort and its correlation with disease progression and heart commitment was evaluated. Strong inverse correlation (ρ = -0.6375, p = 0.0005 between anti-T. cruzi IgG1 titers and left ventricular ejection fraction (LVEF in chronic Chagas cardiomyopathy (CCC patients were observed after disease progression. Elevated levels of anti-T. cruzi IgG3 titers were detected in all T. cruzi-infected patients, indicating a lack of correlation of this IgG isotype with disease progression. Furthermore, low levels of anti-T. cruzi IgG2, IgG4, and IgA were detected in all patients through the follow-up. Although without statistical significance anti-T. cruzi IgE tends to be more reactive in patients with the indeterminate form (IND of the disease (p = 0.0637. As this study was conducted in patients with many years of chronic disease no anti-T. cruzi IgM was detected. Taken together, these results indicate that the levels of anti-T. cruzi IgG1 could be considered to seek for promising biomarkers to predict the severity of chronic Chagas disease cardiomyopathy.

Microelectronic packaging

CERN Document Server

Datta, M; Schultze, J Walter

2004-01-01

Microelectronic Packaging analyzes the massive impact of electrochemical technologies on various levels of microelectronic packaging. Traditionally, interconnections within a chip were considered outside the realm of packaging technologies, but this book emphasizes the importance of chip wiring as a key aspect of microelectronic packaging, and focuses on electrochemical processing as an enabler of advanced chip metallization.Divided into five parts, the book begins by outlining the basics of electrochemical processing, defining the microelectronic packaging hierarchy, and emphasizing the impac

Primeira evidência de Trypanosoma rangeli no sudeste do Brasil, região endêmica para doença de Chagas First evidence of Trypanosoma rangeli in the southeast of Brazil, an endemic region to Chagas' disease

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Luis Eduardo Ramirez

1998-02-01

Full Text Available Informa-se, pela primeira vez, os achados de Trypanosoma rangeli no Triângulo Mineiro, Sudeste do Brasil, área altamente endêmica para doença de Chagas, assim como a infecção natural da espécie Didelphis albiventris.com este mesmo tripanosoma. Estes foram demonstrados por esfregaços sangüíneos, xenodiagnóstico, hemocultura, microhematócrito e PCR. A PCR foi realizada nas fezes e hemolinfa de Triatoma infestans, usando como controle cepas de T. rangeli provenientes da Colômbia.This short communication informs the discovery of Trypanosoma rangeli for the first time at Triângulo Mineiro region, South-east of Brazil, a highly endemic area of Chagas'disease and also the natural infection of Didelphis albiventris with the same trypanosome. Both the findings were demonstrated through blood smears, xenodiagnosis, microhematocrit technics and PCR. The last one was realized in faeces and hemolymph of Triatoma infestans utilizing as controls strains of T. rangeli from Colombia.

[Immunofluorescence assay with Crithidia luciliae for the detection of anti-DNA antibodies. Atypical images and their relationship with Chagas' disease and leishmaniasis].

Science.gov (United States)

Griemberg, Gloria; Ferrarotti, Nidia F; Svibel, Graciela; Ravelli, Maria R; Taranto, Nestor J; Malchiodi, Emilio L; Pizzimenti, Maria C

2006-01-01

Anti-native DNA antibodies can be detected by indirect immunofluorescence assay with Crithidia luciliae, displaying an annular image due to a kinetoplast containing double stranded DNA. Other structures such as membrane, flagellum and basal corpuscle can be stained as well, showing what is called atypical fluorescent images. As C. luciliae belongs to the Trypanosomatidae family, which include the human pathogens Trypanosoma cruzi and Leishmania spp., it was considered that these atypical images could be caused by cross-reactions. Serological studies for Chagas' disease were performed in 105 serum samples displaying atypical images. Sixty four percent of the samples from non endemic and 78.3% from endemic areas for Chagas' disease showed fluorescence in both, membrane and flagellum (joint image). Fifty samples from normal blood donors and 57 samples from patients with conective tissue diseases were tested with C. luciliae. None of them presented the joint image except for two patients with lupus who were also chagasic. In addition, 54 samples from chagasic patients were studied and all of them presented the joint image. We also studied 46 samples from patients with leishmaniasis from whom 28 were coinfected with T. cruzi. The joint image was observed in 88.0% of the samples with leishmaniasis and in 89.3% of the co-infected samples. The results suggest that C. luciliae could be used as an economical, and of low risk, alternative substrate for the serological diagnosis of Chagas' disease, even though it does not discriminate for Leishmania spp. infection. This study also suggests that whenever atypical images are observed in C. luciliae during the search for anti-DNA antibodies, it would be convenient to submit the patient to clinical and serological tests for the diagnosis of leishmaniosis and Chagas' disease.

Antimicrobial, antioxidant and sensory features of eugenol, carvacrol and trans-anethole in active packaging for organic ready-to-eat iceberg lettuce.

Science.gov (United States)

Wieczyńska, Justyna; Cavoski, Ivana

2018-09-01

In this study, bio-based emitting sachets containing eugenol (EUG), carvacrol (CAR) and trans-anethole (ANT) were inserted into cellulose (CE) and polypropylene (PP) pillow packages of organic ready-to-eat (RTE) iceberg lettuce to investigate their functional features. EUG, CAR and ANT sachets in CE; and CAR in PP packages showed antimicrobial activities against coliforms (Δlog CFU g -1 of -1.38, -0.91, -0.93 and -0.93, respectively). EUG and ANT sachets in both packages reduced discoloration (ΔE of 9.5, 1.8, 9.4 and 5.6, respectively). ANT in both, and EUG only in PP packages induced biosynthesis of caffeoyl derivatives (C a T A , D i C a T A , D i C a Q A ), total phenolics and antioxidant activity (FRAP). Also, ANT and EUG in both packages improved overall freshness and odor. Principal component analysis separated ANT and EUG from CAR in both packages. The Pearson correlation confirmed that overall quality improvements were more pronounced by ANT inside the packages in comparison to EUG and CAR. Copyright © 2018 Elsevier Ltd. All rights reserved.

Representações, mitos e comportamentos do paciente submetido ao implante de marcapasso na doença de Chagas Representations, myths, and behaviors among Chagas disease patients with pacemakers

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Claudia Magnani

2007-07-01

Full Text Available Estudo antropológico sobre o modo de incorporação e as repercussões do implante do marcapasso na vida do indivíduo portador da doença de Chagas. Foi realizada uma pesquisa etnográfica baseada no instrumento de entrevista aberta, buscando identificar a percepção do estado de saúde de um grupo de 15 pacientes portadores de cardiopatia Chagásica crônica que necessitaram de implante de marcapasso, atendidos no Ambulatório de Marcapasso do Hospital das Clínicas da Universidade Federal de Minas Gerais, em Belo Horizonte, Minas Gerais, Brasil. Utilizou-se o referencial da qualidade de vida para observar os recursos culturais, físicos e psicológicos que os pacientes utilizam para enfrentar, explicar e aceitar o processo de adoecimento, incluindo as representações mentais que constroem o sentido cultural da doença e definem as relações sociais. O estudo pretende contribuir para que os profissionais de saúde atendam seus pacientes em sua integralidade. A orientação decodificada e integrada no âmbito cultural assume um papel importante para evitar que a desinformação perpetue a difusão de mitos populares, que, por vezes, se tornam preconceitos e elementos sociais ativos de estigma do indivíduo portador de cardiopatia.This anthropological study aimed to evaluate the incorporation of pacemakers into the lives of individuals with Chagas disease. An ethnographic methodology was used, based on an open interview focusing on the personal perceptions of 15 patients with chronic Chagas cardiopathy who had required pacemaker implants at the Federal University Hospital in Belo Horizonte, Minas Gerais State, Brazil. As part of a broader quality of life analysis, the study investigated the cultural, physical, and psychological resources used by patients to confront, explain, and accept the disease process, including mental representations on the cultural perception of the illness and definition of social relations. The study was intended to

A revision of thirteen species of Triatominae (Hemiptera: Reduviidae vectors of Chagas disease in Mexico

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Salazar-Schettino Paz Maria

2010-10-01

Full Text Available Vectors of Trypanosoma cruzi, parasite responsible for Chagas disease, are divided in intradomestic, peridomestic and sylvatic. The intradomestic are Triatoma barberi and Triatoma dimidiata, two species that represent the highest health risk among the Mexican population. Triatoma dimidiata is a species found mainly inside human habitats, but in Yucatan, it corresponds to the peridomicile vectors. Also in the peridomicile most of Chagas disease vectors are found: Meccus bassolsae, M. longipennis, M. mazzottii, M pallidipennis, M. phyllosomus, M picturata, Triatoma gerstaeckeri, T mexicana, T rubida, Dipetalogaster máxima (the last two are in the process of becoming adapted to the domicile, Panstrongylus rufotuberculatus which occasionally enters the domicile in its adult stage, and Rhodnius prolixus, which is practically controlled in the country. Peridomestic vectors are of lower risk in the transmission dynamics, as compared to the intradomestic ones. For the control of the intradomestic vectors, health education programs, improvements of housing, and the use of pesticides are essential To control the peridomestic vectors, health education programs are required, as well as the use of mosquito nets on doors and windows and around beds, aside from cementing the stone wall fences.

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.

Gas exchange during exercise in different evolutional stages of chronic Chagas' heart disease.

Science.gov (United States)

Oliveira, F P; Pedrosa, R C; Giannella-Neto, A

2000-12-01

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. We studied 15 healthy volunteers and 52 patients grouped according to the Los Andes clinical and hemodynamic classification as follows: 17 patients in group IA (normal electrocardiogram and echocardiogram), 9 patients in group IB (normal electrocardiogram and abnormal echocardiogram), 14 patients in group II (abnormal electrocardiogram and echocardiogram, without congestive heart failure), and 12 patients in group III (abnormal electrocardiogram and 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). When compared with the healthy group, patients in groups II and III showed significant changes in the following variables: V O2 peak, V CO2 peak, V IC peak, V EC peak, E, HR, and maximum load. Group IA showed significantly better results for these same variables as compared with group III. 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.

Chagas disease study using satellite image processing: A Bolivian case

Science.gov (United States)

Vargas-Cuentas, Natalia I.; Roman-Gonzalez, Avid; Mantari, Alicia Alva; Muñoz, Luis AnthonyAucapuma

2018-03-01

Remote sensing is the technology that has enabled us to obtain information about the Earth's surface without directly contacting it. For this reason, currently, the Bolivian state has considered a list of interesting applications of remote sensing in the country, including the following: biodiversity and environment monitoring, mining and geology, epidemiology, agriculture, water resources and land use planning. The use of satellite images has become a great tool for epidemiology because with this technological advance we can determine the environment in which transmission occurs, the distribution of the disease and its evolution over time. In that context, one of the important diseases related to public health in Bolivia is Chagas disease, also known as South American Trypanosomiasis. Chagas is caused by a blood-sucking bug or Vinchuca, which causes serious intestinal and heart long term problems and affects 33.4% of the Bolivian population. This disease affects mostly humble people, so the Bolivian state invests millions of dollars to acquire medicine and distribute it for free. Due to the above reasons, the present research aims to analyze some areas of Bolivia using satellite images for developing an epidemiology study. The primary objective is to understand the environment in which the transmission of the disease happens, and the climatic conditions under which occurs, observe the behavior of the blood-sucking bug, identify in which months occur higher outbreaks, in which months the bug leaves its eggs, and under which weather conditions this happens. All this information would be contrasted with information extracted from the satellite images and data from the Ministry of Health, and the Institute of Meteorology in Bolivia. All this data will allow us to have a more integrated understanding of this disease and promote new possibilities to prevent and control it.

The Packaging Handbook -- A guide to package design

International Nuclear Information System (INIS)

Shappert, L.B.

1995-01-01

The Packaging Handbook is a compilation of 14 technical chapters and five appendices that address the life cycle of a packaging which is intended to transport radioactive material by any transport mode in normal commerce. Although many topics are discussed in depth, this document focuses on the design aspects of a packaging. The Handbook, which is being prepared under the direction of the US Department of Energy, is intended to provide a wealth of technical guidance that will give designers a better understanding of the regulatory approval process, preferences of regulators in specific aspects of packaging design, and the types of analyses that should be seriously considered when developing the packaging design. Even though the Handbook is concerned with all packagings, most of the emphasis is placed on large packagings that are capable of transporting large radioactive sources that are also fissile (e.g., spent fuel). These are the types of packagings that must address the widest range of technical topics in order to meet domestic and international regulations. Most of the chapters in the Handbook have been drafted and submitted to the Oak Ridge National Laboratory for editing; the majority of these have been edited. This report summarizes the contents

Estudo comparativo da freqüência da morte súbita inesperada por doença de Chagas, em Uberaba, nos anos de 1980 e 1990

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Edison Reis Lopes

1995-06-01

Full Text Available Realizou-se estudo comparativo da freqüência e etiologia das mortes súbitas ocorridas no Município de Uberaba, Minas Gerais, em maiores de 15 anos de idade, nos anos de 1980 e de 1990, com o objetivo fundamental de analisar a freqüência atual do óbito súbito em nossa região e o eventual papel de medidas profiláticas e terapêuticas na morte súbita por doença de Chagas. Dos 1226 óbitos de 1980, 54 (4,4% foram súbitos e destes, 13 (24,1% etiologia atribuída à doença de Chagas. Em 1990foram pesquisados 1740 óbitos, dos quais 44 (2,5% foram súbitos; destes, somente 3 (6,8% devidos â tripanosomose cruzi. Os resultados indicam redução significativa na freqüência tanto da morte súbita em geral, como daquela devida à doença de Chagas, no ano de 1990, em relação ao de 1980, discutindo-se suas prováveis razões.

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

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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.

Comparison of conventional Injection Mould Inserts to Additively Manufactured Inserts using Life Cycle Assessment

DEFF Research Database (Denmark)

Hofstätter, Thomas; Bey, Niki; Mischkot, Michael

2016-01-01

Polymer Additive Manufacturing can be used to produce soft tooling inserts for injection moulding. Compared to conventional tooling, the energy and time consumption during production are significantly lower. As the life time of such inserts is significantly shorter than the life time of traditional...... of their potential environmental impact and yield throughout the development and pilot phase. Insert geometry is particularly advantageous for pilot production and small production sizes. In this research, Life Cycle Assessment is used to compare the environmental impact of soft tooling by Additive Manufacturing...... (using Digital Light Processing) and three traditional methods for the manufacture of inserts (milling of brass, steel, and aluminium) for injection moulds during the pre-production phase....

Population structure of the Chagas disease vector, Triatoma infestans, at the urban-rural interface

OpenAIRE

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

2013-01-01

The increasing rate of biological invasions resulting from human transport or human-mediated changes to the environment have had devastating ecologic and public health consequences. The kissing bug, Triatoma infestans, has dispersed through the Peruvian city of Arequipa. The biological invasion of this insect has resulted in a public health crisis, putting thousands of residents of this city at risk of infection by Trypanosoma cruzi and subsequent development of Chagas disease. Here we show t...

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.

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

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

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José R. Coura

1993-12-01

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

Behavioural biology of Chagas disease vectors.

Science.gov (United States)

Lazzari, Claudio Ricardo; Pereira, Marcos Horácio; Lorenzo, Marcelo Gustavo

2013-01-01

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

Behavioural biology of Chagas disease vectors

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Claudio Ricardo Lazzari

2013-01-01

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

Data Insertion in Bitcoin's Blockchain

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Andrew Sward

2018-04-01

Full Text Available This paper provides the first comprehensive survey of methods for inserting arbitrary data into Bitcoin’s blockchain. Historical methods of data insertion are described, along with lesser-known techniques that are optimized for efficiency. Insertion methods are compared on the basis of efficiency, cost, convenience of data reconstruction, permanence, and potentially negative impact on the Bitcoin ecosystem.

A Comparative study of early postpartum IUCD insertion to interval IUCD insertion at Tertiary Care Centre

OpenAIRE

Roopal, Dr.; Bisht, Vandana

2018-01-01

Background: A Comparative study of early postpartum IUCD insertion to interval IUCD insertion at Tertiary Care Centre.Methods: This prospective study was conducted among 100 women at tertiary care centre, Haldwani, Nainital. Patients were divided in to two groups. Group A (n=50)-post placental insertion within 10 minutes of delivery of placenta. Group B (n=50)-Interval insertion after 6 weeks of delivery. Both groups were compared in terms of pain abdomen, bleeding, missing thread, expulsion,...

Helietta apiculata: a tropical weapon against Chagas disease.

Science.gov (United States)

Elena Ferreira, Maria; Rojas de Arias, Antonieta; Yaluff, Gloria; Vera de Bilbao, Ninfa; Nakayama, Hector; Torres, Susana; Schinini, Alicia; Torres, Susana; Serna, Elva; Torrecilhas, Ana Claudia; Fournet, Alain; Cebrián-Torrejón, Gerardo

2018-05-10

The present study pretends to evaluate the in vivo efficacy of the crude chloroform bark extract of Helietta apiculata, then the activity will be compared with the reference drug, benznidazole, in acute Trypanosoma cruzi infected mice when administered by oral route. The chloroformic extract of Helieta apiculata was administered by oral route at 5, 10 and 50 mg/kg daily for two weeks. This study has shown a moderate efficacy of the H. apiculata bark extract in reducing T. cruzi parasitaemia in 42 to 54% after a monitoring of 60 days post-infection and when compared with control groups. Concerning mice mortality, only two only two mice died, one from the control group and the other one from the group threated with 10 mg of the chlorofom extract of H. apiculata, suggesting the potential of H. apiculta extracts as a safe and inexpensive treatment of Chagas disease.

Modeling the effects of palm-house proximity on the theoretical risk of Chagas disease transmission in a rural locality of the Orinoco basin, Colombia

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Diana Erazo

2016-11-01

Full Text Available Abstract Background Chagas disease is a major public health concern in Latin America and it is transmitted by insects of the subfamily Triatominae, including Rhodnius spp. Since palm trees are ubiquitous in Colombia and a habitat for Rhodnius spp., the presence of palms near villages could increase contact rates between vectors and humans. Therefore, knowing whether a relationship exists between the proximity of palms to villages and the abundance and distribution of vectors therein, may be critical for Chagas disease prevention programs. Adapting a mathematical model for R. prolixus population dynamics in a small village, we model the implications of changing distances between palms and dwellings, to the risk of Chagas disease infection. Methods We implemented a mathematical model that reflects R. prolixus population dynamics in a small village located in the department of Casanare (Colombia to study the role of palm-house proximity. We varied the distance between palms and houses by monitoring the network global efficiency metric. We constructed 1,000 hypothetical villages varying distances and each one was run 100 times. Results According to the model, as palm-house proximity increases, houses were more likely to be visited by triatomine bugs. The number of bugs per unit time increased progressively in a non-linear fashion with high variability. We stress the importance of village configuration on the model output. Conclusions From a theoretical perspective, palm-house proximity may have a positive effect on the incidence of Chagas disease. The model predicts a 1% increase in new human cases per year when houses and palms are brought closer by 75%.

Esophageal motor disorders in subjects with incidentally discovered Chagas disease: a study using high-resolution manometry and the Chicago classification.

Science.gov (United States)

Remes-Troche, J M; Torres-Aguilera, M; Antonio-Cruz, K A; Vazquez-Jimenez, G; De-La-Cruz-Patiño, E

2014-08-01

In patients with chronic indeterminate Chagas disease, conventional manometry has shown that 25-48% had esophageal motor disorders. Recently, esophageal high-resolution manometry (HRM) has revolutionized the assessment of esophageal motor function. In this study, we performed esophageal HRM in a group of subjects with incidentally positive serological findings for Trypanosoma cruzi. In this prospective observational study, we evaluated subjects who had positive serological tests for Chagas disease detected during a screening evaluation for blood donation. All subjects underwent symptomatic evaluation and esophageal HRM with a 36 solid-state catheter. Esophageal abnormalities were classified using the Chicago classification. Forty-two healthy subjects (38 males) aged 18-61 years (mean age, 40.7 years) were included. When specific symptoms questionnaire was applied, 14 (33%) subjects had esophageal symptoms. Esophageal high-resolution manometry revealed that 28 (66%) of the subjects had an esophageal motility disorder according to the Chicago classification. Most common findings were hypocontractile disorders in 18 subjects (43%) and esophagogastric junction (EGJ) outflow obstruction in 6 (15%). Esophageal high-resolution manometry reveals that up to two thirds of the subjects with an incidental diagnosis of Chagas disease have esophageal abnormalities. This technology increases the detection and allows a more complete assessment of esophageal motor function in subjects infected with T. cruzi even in the early stages of the disease. © 2012 Copyright the Authors. Journal compilation © 2012, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

Intracellular Distribution of Capsid-Associated pUL77 of Human Cytomegalovirus and Interactions with Packaging Proteins and pUL93.

Science.gov (United States)

Köppen-Rung, Pánja; Dittmer, Alexandra; Bogner, Elke

2016-07-01

DNA packaging into procapsids is a common multistep process during viral maturation in herpesviruses. In human cytomegalovirus (HCMV), the proteins involved in this process are terminase subunits pUL56 and pUL89, which are responsible for site-specific cleavage and insertion of the DNA into the procapsid via portal protein pUL104. However, additional viral proteins are required for the DNA packaging process. We have shown previously that the plasmid that encodes capsid-associated pUL77 encodes another potential player during capsid maturation. Pulse-chase experiments revealed that pUL77 is stably expressed during HCMV infection. Time course analysis demonstrated that pUL77 is expressed in the early late part of the infectious cycle. The sequence of pUL77 was analyzed to find nuclear localization sequences (NLSs), revealing monopartite NLSm at the N terminus and bipartite NLSb in the middle of pUL77. The potential NLSs were inserted into plasmid pHM829, which encodes a chimeric protein with β-galactosidase and green fluorescent protein. In contrast to pUL56, neither NLSm nor NLSb was sufficient for nuclear import. Furthermore, we investigated by coimmunoprecipitation whether packaging proteins, as well as pUL93, the homologue protein of herpes simplex virus 1 pUL17, are interaction partners of pUL77. The interactions between pUL77 and packaging proteins, as well as pUL93, were verified. We showed that the capsid-associated pUL77 is another potential player during capsid maturation of HCMV. Protein UL77 (pUL77) is a conserved core protein of HCMV. This study demonstrates for the first time that pUL77 has early-late expression kinetics during the infectious cycle and an intrinsic potential for nuclear translocation. According to its proposed functions in stabilization of the capsid and anchoring of the encapsidated DNA during packaging, interaction with further DNA packaging proteins is required. We identified physical interactions with terminase subunits pUL56 and p

Progreso en la interrupción de la transmisión de la enfermedad de Chagas en América Latina

Directory of Open Access Journals (Sweden)

Alvaro Moncayo

2000-08-01

Full Text Available

Alrededor de 18 millones de personas estaban infectadas en América Latina con el parásito Trypanosoma cruzi, causante de la epidemia de Chagas. Estudios de prevalencia hechos en la década de los 80, mostraron además que un 25% de estas personas desarrollaron lesiones cardíacas crónicas y digestivas irreversibles.

La Organización Mundial de la Salud y el Banco Mundial vienen adelantando invtigaciones por cerca de un cuarto de siglo, conducentes al control y eventual eliminación de esta patología en el sub-continente.

Este artículo enumera las actividades desarrolladas por este programa hasta la fecha y describe tres iniciativas multinacionales que adelantan las actividades referentes a la Enfermedad de Chagas y que se denominan iniciativas del Cono Sur, de los países andinos y de los países centro americanos. Se calcula que un veinticinco por ciento de los 484 millones de habitantes de América Latina (1 , están en riesgo de contraer la infección por el Trypanosoma cruzi, el agente causal de la Enfermedad de Chagas que es transmitido por insectos hematófagos del género Triatoma. Estudios de prevalencia epidemiológica adelantados en la década de 1980-90, mostraron que existen en el Continente 16 – 18 millones de personas infectadas por el parásito y que cerca de un 25% de ellas desarrollará lesiones cardíacas crónicas y digestivas irreversibles.

Desde su inicio en 1978, el componente de investigación y control de la Enfermedad de Chagas del Programa PNUD/Banco Mundial/OMS de Investigación y adiestramiento en Enfermedades Tropicales (TDR, ha financiado investigaciones conducentes al control y eventual eliminación de esta enfermedad en el Continente...

A Practical Green Synthesis and Biological Evaluation of Benzimidazoles Against Two Neglected Tropical Diseases: Chagas and Leishmaniasis.

Science.gov (United States)

Bandyopadhyay, Debashis; Samano, Selina; Villalobos-Rocha, Juan Carlos; Sanchez-Torres, Luvia Enid; Nogueda-Torres, Benjamin; Rivera, Gildardo; Banik, Bimal K

2017-01-01

Antimicrobial resistance is an ever-increasing problem throughout the world and has already reached severe proportions. Two very common neglected tropical diseases are Chagas' disease and leishmaniasis. Chagas' disease is a severe health problem, mainly in Latin America, causing approximately 50000 deaths a year and millions of people are infected. About 25-30% of the patients infected with Trypanosoma cruzi develop the chronic form of the disease. On the other hand, Leishmaniasis represents complex diseases with an important clinical and epidemiological diversity. It is endemic in 88 countries 72 of which are developing countries and it has been estimated that are 12 million people infected and 350 million are in areas with infection risk. On this basis, research on organic compounds that can be used against these two diseases is an important target. A very simple, green, and efficient protocol is developed in which bismuth nitrate pentahydrate is employed as a Lewis acid catalyst in aqueous media under microwave irradiation for the synthesis of various 2-aryl substituted benzimidazoles from aldehydes and o-phenylenediamine. Other salient features of this protocol include milder conditions, atom-economy, easy extraction, and no wastes. Nine 1H-benzimidazole derivatives (1-9) with substituents at positions 2 and 5 were synthesized and the structure of the compounds was elucidated by spectroscopic methods. The compounds were screened to identify whether they posses pharmacological activity against Chagas' disease and leishmaniasis. Compound 8 showed better activity than the control Nifurtimox against INC-5 Trypanosoma cruzi strain whereas compounds 3 and 9 have demonstrated potent leshmanicidal activity. A systematic green synthetic procedure and in vitro biological evaluation of nine 1H-benzimidazoles are described. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

[Acute Chagas' disease: transmission routes, clinical aspects and response to specific therapy in diagnosed cases in an urban center].

Science.gov (United States)

Shikanai-Yasuda, M A; Lopes, M H; Tolezano, J E; Umezawa, E; Amato Neto, V; Barreto, A C; Higaki, Y; Moreira, A A; Funayama, G; Barone, A A

1990-01-01

The authors report clinical features and therapeutic response of 24 outpatients with acute Chagas' disease, and 3 in the initial chronic phase, referred to the Clinic for Infectious and Parasitic Diseases of the FMUSP "Clínicas" Hospital between 1974 and 1987. The following transmission routes were involved: triatominae in 7 cases, blood transfusion in 9, kidney transplantation and/or blood transfusion in 4, accidental in 1, oral route in 3, probably breast feeding in 1, congenital or breast feeding in 1, and congenital or blood transfusion in 1. Six patients infected by triatominac acquired the disease between 1974 and 1980 and one in 1987. The blood transfusion infected patients acquired the disease in Greater São Paulo, seven of whom after 1983. The acute phase Chagas' disease was oligosymptomatic in 4 patients: three of such patients being immunocompromised by drugs or other diseases. Another two adult immunocompromised patients developed myocarditis and congestive heart failure. Clinical features were severe in 5 from 6 children under two years, irrespective of the transmission route. Evaluation of the acute phase patients treated with benznidazol (4-10 mg/kg/day) showed: therapeutic failure in 4/16 (25.0%); possible cure in 9/16 (53.2%) and inconclusive results in 3/16 (18.8%). The antibody and complement-mediated lysis reaction was in keeping with the xenodiagnosis in 18/22 cases, having shown negative results after treatment earlier than classical serological reactions. One aplastic anaemia patient receiving corticosteroid presented lymphoproliferative disease 6 years after being treated with benznidazol for acute Chagas' disease.

A Field Trial of Alternative Targeted Screening Strategies for Chagas Disease in Arequipa, Peru

Science.gov (United States)

Hunter, Gabrielle C.; Borrini-Mayorí, Katty; Ancca Juárez, Jenny; Castillo Neyra, Ricardo; Verastegui, Manuela R.; Malaga Chavez, Fernando S.; Cornejo del Carpio, Juan Geny; Córdova Benzaquen, Eleazar; Náquira, César; Gilman, Robert H.; Bern, Caryn; Levy, Michael Z.

2012-01-01

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 epidemiology that

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

Directory of Open Access Journals (Sweden)

Gabrielle C Hunter

2012-01-01

Full Text Available 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.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.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.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 epidemiology that emerges during screening is key to

The kinetics of porous insertion electrodes

Energy Technology Data Exchange (ETDEWEB)

Atlung, S; West, K [British Columbia Univ., Vancouver (Canada)

1989-05-01

The principles of porous electrodes are discussed as well as the discharge of the insertion compound, the working potential, transport in the electrolyte, the time dependence of the electrolyte concentration, and modeling of the porous electrode. The simulation of a TiS2 porous electrode and the composite insertion electrode are considered as well. The influence of electrode thickness and porosity in a typical porous TiS2 electrode is revealed. It is shown that the use of insertion compounds as battery electrodes is limited by the requirement that the inserted ion must be distributed in the interior of the insertion compound particle. 15 refs.

ALS insertion devices

International Nuclear Information System (INIS)

Hoyer, E.; Chin, J.; Halbach, K.; Hassenzahl, W.V.; Humphries, D.; Kincaid, B.; Lancaster, H.; Plate, D.

1990-11-01

The Advanced Light Source (ALS), the first US third generation synchrotron radiation source, is currently under construction at the Lawrence Berkeley Laboratory. The low-emittance, 1.5 GeV electron storage ring and the insertion devices are specifically designed to produce high brightness beams in the UV to soft X-Ray range. The planned initial complement of insertion devices includes four 4.6 m long undulators, with period lengths of 3.9 cm, 5.0 cm (2) and 8.0 cm, and a 2.9 m long wiggler of 16 cm period length. Undulator design is well advanced and fabrication has begun on the 5.0 cm and 8.0 cm period length undulators. This paper discusses ALS insertion device requirements; general design philosophy; and design of the magnetic structure, support structure/drive systems, control system and vacuum system. 18 refs., 9 figs., 5 tabs

Optimizing Pretreatment of Medicinal Raw Materials by RFC Plasma before Extraction

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O.Yu. Kuznetsova

2016-06-01

Full Text Available Optimization of the RF-plasma treatment modes of chaga raw materials using the Statistica 6.0 software package has been performed. Mathematical design has been carried out to calculate the optimum parameters of RF-plasma treatment using three plasma-forming gases – argon, air, and nitrogen. Plasma treatment of chaga raw materials has been undertaken at the constant parameters: pressure P = 30.0 Pa, anodic current J = 0.7 A, gas consumption G = 0.04 g/s; the variable parameters were power U = 5.0÷7.0 kV and treatment duration at the high-frequency capacitor category of the lowered pressure t = 30÷60 min. Optimization of four key parameters for extraction of chaga raw materials (solid residue, melanin yield, antioxidant activity of both extract and chaga melanin depending on the chosen plasma-forming gas (argon, air, or nitrogen has been achieved. The optimum modes of RF-plasma treatment allowing to obtain the extracts and melanin of chaga mushroom with the improved physicochemical and antioxidant characteristics have been calculated.

Percutaneous Ureteral stent insertion

Energy Technology Data Exchange (ETDEWEB)

Yoon, Yup; Sung, Dong Wook; Choi, Woo Suk; Lee, Dong Ho; Ko, Young Tae; Lee, Sun Wha; Lim, Jae Hoon [Kyung Hee University Hospital, Seoul (Korea, Republic of)

1990-10-15

Percutaneous ureteral stent insertion is a treatment of permanent or temporary urinary diversion to maintain continuity and function of the obstructed and injured ureter. We performed 31 cases of percutaneous double pig tall ureteral stent insertion in 21 patients, included 13 patients with malignant ureteral obstruction and eight patients with injured ureter as well as benign inflammatory stricture. Satisfactory resulted was obtained in all patients but one, who need percutaneous nephrostomy on week later for urinary diversion. No significant complication was encountered. The authors concluded that percutaneous ureteral stent insertion, an interventional procedure alternative to urologic retrograde method, is an effective method for urinary diversion.

Genetic association study of NLRP1, CARD, and CASP1 inflammasome genes with chronic Chagas cardiomyopathy among Trypanosoma cruzi seropositive patients in Bolivia.

Science.gov (United States)

Clipman, Steven J; Henderson-Frost, Josephine; Fu, Katherine Y; Bern, Caryn; Flores, Jorge; Gilman, Robert H

2018-01-01

About 20-30% of people infected with Chagas disease present with chronic Chagas cardiomyopathy (CCC), the most serious and frequent manifestation of the disease, while others remain asymptomatic and often do not experience Chagas-specific mortality. It is not currently well understood what causes these differential disease outcomes, but a genetic predisposition within the host could play an important role. This study examined variants in the NLRP1, CARD, and CASP1 inflammasome genes among 62 T. cruzi seropositive patients from Bolivia (38 cases with CCC and 24 asymptomatic controls) to uncover associations with CCC. All subjects underwent a complete medical examination including electrocardiogram (EKG) and echocardiogram. After genotype calling and quality control filtering with exclusion of 3 cases and 3 controls, association analysis was performed across 76 directly genotyped SNPs in NLRP1, CARD, and CASP1 genes, adjusting for age, sex, and population stratification. One SNP (rs11651270; Bonferroni-corrected p = 0.036) corresponding to a missense mutation in NLPR1 was found to be significant after adjustment for multiple testing, and a suggestive association was seen in CARD11 (rs6953573; Bonferroni-corrected p = 0.060). Although limited by sample size, the study results suggest variations in the inflammasome, particularly in NLRP1 and CARD11, may be associated with CCC.

Epidemiologia de um caso de doença de Chagas na Ilha do Mosqueiro - Pará

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Adelson A.A. de Souza

1988-12-01

Full Text Available Os autores apresentam os resultados do estudo epidemiológico de um caso autóctone da fase aguda da doença de Chagas na ilha do Mosqueiro, Estado do Pará, aproximadamente 75km da capital, Belém. 0 caso já havia sido objeto de uma publicação anterior. Agora são apresentadas informações epidemiológicas. Nas proximidades da casa do paciente foram capturados em duas palmeiras de Inajá ('Maximilian regi ay e em uma de Mucajá (Acrocomia sclerocarpia 114 triatomíneos: Rhodnius pictipes, R. robustus, Panstrongylus lignarius, P. geniculatus e Microtriatoma trinidadensis, com tripanossomas em 31 deles. Na casa do paciente foram encontrados exemplares de Rhodnius pictipes, infectados com formas metacíclicas do Trypanosoma cruzi. Em 14 marsupiais, capturados na localidade, haviam 3 infectados com organismos semelhantes ao T. cruzi. A eletroforese dos isoenzimas nos tripanossomas isolados do paciente, de R. pictipes e de Didelphis marsupialis os classificou como zimodema 1. Os autores concluem que a doença de Chagas do paciente teve origem silvestre.

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.

A regional fight against Chagas disease: lessons learned from a successful collaborative partnership.

Science.gov (United States)

Salerno, Rosina; Salvatella, Roberto; Issa, Julie; Anzola, Maria Carolina

2015-01-01

To identify the intangible elements that characterize the successful effort to fight Chagas disease in the Americas, determine how they contributed to the overall success of the partnership, and learn lessons from the experience that could be applied to other programs. This study was based on the Partnership Assessment Tool (PAT) developed by the Nuffield Institute for Health ("the Institute") at the University of Leeds (London). The PAT draws heavily on scientific literature and the extensive experience of sociologists and health experts working for the Institute. The Pan American Health Organization (PAHO) modified the tool slightly to adapt it to its needs and provide a general structure for the study. The six key principles of the PAT framework were applied in the design of the research questionnaires. The findings show that a successful collaboration requires a clear objective; a good-quality pool of data; and comprehensive qualitative and quantitative knowledge of the problem, its dimensions, and its impact. The collaboration was elaborated from a common idea and a shared, quantified plan based on data gathered by independent scientists plus a strategy with explicit milestones. The clarity of purpose allowed for an improved synergy of efforts and made it possible to resolve differences in opinions and approaches. PAHO's experience with effective collaborations such as the joint initiative to fight Chagas disease provides a rich knowledge base for analysis of the advantages, limitations, and paradigms of community involvement, collaborative practices, and partnerships.

A regional fight against Chagas disease: lessons learned from a successful collaborative partnership

Directory of Open Access Journals (Sweden)

Rosina Salerno

2015-01-01

Full Text Available Objective. To identify the intangible elements that characterize the successful effort to fight Chagas disease in the Americas, determine how they contributed to the overall success of the partnership, and learn lessons from the experience that could be applied to other programs. Methods. This study was based on the Partnership Assessment Tool (PAT developed by the Nuffield Institute for Health ("the Institute" at the University of Leeds (London. The PAT draws heavily on scientific literature and the extensive experience of sociologists and health experts working for the Institute. The Pan American Health Organization (PAHO modified the tool slightly to adapt it to its needs and provide a general structure for the study. The six key principles of the PAT framework were applied in the design of the research questionnaires. Results. The findings show that a successful collaboration requires a clear objective; a good-quality pool of data; and comprehensive qualitative and quantitative knowledge of the problem, its dimensions, and its impact. The collaboration was elaborated from a common idea and a shared, quantified plan based on data gathered by independent scientists plus a strategy with explicit milestones. The clarity of purpose allowed for an improved synergy of efforts and made it possible to resolve differences in opinions and approaches. Conclusions. PAHO's experience with effective collaborations such as the joint initiative to fight Chagas disease provides a rich knowledge base for analysis of the advantages, limitations, and paradigms of community involvement, collaborative practices, and partnerships.

MEMS packaging

CERN Document Server

Hsu , Tai-Ran

2004-01-01

MEMS Packaging discusses the prevalent practices and enabling techniques in assembly, packaging and testing of microelectromechanical systems (MEMS). The entire spectrum of assembly, packaging and testing of MEMS and microsystems, from essential enabling technologies to applications in key industries of life sciences, telecommunications and aerospace engineering is covered. Other topics included are bonding and sealing of microcomponents, process flow of MEMS and microsystems packaging, automated microassembly, and testing and design for testing.The Institution of Engineering and Technology is

Aspectos epidemiológicos, clínicos e parasitológicos da doença de Chagas em Mato Grosso do Sul Epidemiological, clinical and parasitological aspects of Chagas' disease in Mato Grosso do Sul State

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Maurício Antonio Pompilio

2005-12-01

Full Text Available Com o objetivo de avaliar aspectos epidemiológicos, clínicos e parasitológicos da doença de Chagas crônica, em pacientes do Hospital Universitário da Universidade Federal de Mato Grosso do Sul, realizamos um estudo seccional envolvendo 120 chagásicos e 120 controles não-chagásicos, de ambos os sexos, com idades de 16 a 82 anos. Os aspectos epidemiológicos foram avaliados por questionário, a cardiopatia por exame clínico, eletrocardiograma convencional, radiologia e ecodopplercardiograma e a presença de Trypanosoma cruzi no sangue por xenodiagnóstico e teste da reação em cadeia da polimerase. Os resultados mostraram predominância de alóctones com baixa escolaridade e referência de contato prévio com triatomíneos entre os chagásicos. Abortamento espontâneo foi mais freqüente nas mulheres chagásicas. A cardiopatia devido ao componente chagásico foi estimada em 20,2%. Apresentou-se com 7,5% de cardiomegalia, 6,2% de aneurisma de ventrículo esquerdo e com predominância de dispnéia, palpitações e hipertensão arterial. O xenodiagnóstico foi positivo em 26,1% dos chagásicos enquanto a PCR foi positiva em 53,7%. A análise dos resultados indicou que a doença de Chagas no grupo estudado apresenta características clínicas e parasitológicas que revelam peculiaridades regionais.With the objective of evaluating epidemiologic, clinical and parasitologic aspects of chronic Chagas' disease in patients from the University Hospital of the Federal University of Mato Grosso do Sul, a cross-sectional study was performed with groups of 120 chagasic and non-chagasic patients aged from 16 to 82 years. Epidemiologic aspects were evaluated by means of a questionnaire, cardiopathy by clinical examination, conventional electrocardiogram, radiology and Doppler echocardiograms (only in chagasic patients and the presence of Trypanosoma cruzi in the blood stream by way of xenodiagnosis and polymerase chain reaction test. The results

Packaging design criteria for the Hanford Ecorok Packaging

International Nuclear Information System (INIS)

Mercado, M.S.

1996-01-01

The Hanford Ecorok Packaging (HEP) will be used to ship contaminated water purification filters from K Basins to the Central Waste Complex. This packaging design criteria documents the design of the HEP, its intended use, and the transportation safety criteria it is required to meet. This information will serve as a basis for the safety analysis report for packaging

Accuracy of chimeric proteins in the serological diagnosis of chronic chagas disease - a Phase II study.

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Fred Luciano Neves Santos

2017-03-01

Full Text Available The performance of current serologic tests for diagnosing chronic Chagas disease (CD is highly variable. The search for new diagnostic markers has been a constant challenge for improving accuracy and reducing the number of inconclusive results.Here, four chimeric proteins (IBMP-8.1 to -8.4 comprising immunodominant regions of different Trypanosoma cruzi antigens were tested by enzyme-linked immunosorbent assay. The proteins were used to detect specific anti-T. cruzi antibodies in the sera of 857 chagasic and 689 non-chagasic individuals to evaluate their accuracy for chronic CD diagnosis. The antigens were recombinantly expressed in Escherichia coli and purified by chromatographic methods. The sensitivity and specificity values ranged from 94.3% to 99.3% and 99.4% to 100%, respectively. The diagnostic odds ratio (DOR values were 6,462 for IBMP-8.1, 3,807 for IBMP-8.2, 32,095 for IBMP-8.3, and 283,714 for IBMP-8.4. These chimeric antigens presented DORs that were higher than the commercial test Pathozyme Chagas. The antigens IBMP-8.3 and -8.4 also showed DORs higher than the Gold ELISA Chagas test. Mixtures with equimolar concentrations were tested in order to improve the diagnosis accuracy of negative samples with high signal and positive samples with low signal. However, no gain in accuracy was observed relative to the individual antigens. A total of 1,079 additional sera were used to test cross-reactivity to unrelated diseases. The cross-reactivity rates ranged from 0.37% to 0.74% even for Leishmania spp., a pathogen showing relatively high genome sequence identity to T. cruzi. Imprecision analyses showed that IBMP chimeras are very stable and the results are highly reproducible.Our findings indicate that the IBMP-8.4 antigen can be safely used in serological tests for T. cruzi screening in blood banks and for chronic CD laboratory diagnosis.

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

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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.

Present situation and new strategies for Chagas disease chemotherapy: a proposal

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José Rodrigues Coura

2009-07-01

Full Text Available Treatments for Chagas disease have been administered since the first attempts by Mayer & Rocha Lima (1912, 1914 and up to the drugs currently in use (nifurtimox and benznidazole, along with potential drugs such as allopurinol and first, second and third-generation antifungal agents (imidazoles and triazoles, in separate form. Several diseases such as tuberculosis, leprosy and AIDS only came under control after they were treated with associations of drugs with different mechanisms of action. This not only boosts the action of the different compounds, but also may avoid the development of parasite resistance .To this end, over the short term, we propose experimental studies on laboratory animals and clinical trials with the following associations: (i nifurtimox (8 mg/kg/day + benznidazole (5 mg/kg/day x 60 consecutive days; (ii nifurtimox (8 mg/kg/day or benznidazole (5 mg/kg/day + allopurinol (8-10 mg/kg/day x 60 days and (iii nifurtimox (8 mg/kg/day or benznidazole (5 mg/kg/day + ketoconazole, fluconazole or itraconazole (5-6 mg/kg/day x 60 consecutive days. The doses of the drugs and the treatment schedules for the clinical trials must be adapted according to the side effects. From these, other double or triple associations could be made, using drugs with different mechanisms of action. This proposal does not exclude investigations on new drugs over the median and long terms, targeting other aspects of the metabolism of Trypanosoma cruzi. Until such time as the ideal drug for specific treatment of Chagas disease might be discovered, we need to develop new strategies for achieving greater efficacy with the old drugs in associations and to develop rational experimentation with new drugs.

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

Trypanosomiasis americana en el Perú: III. Importancia del cobayo como reservorio de la enfermedad de Chagas en la región sudoccidental

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Arístides Herrer

1955-12-01

Full Text Available 1. En el Perú, a lo largo de toda la región infestada por el Triatoma infestans, la gente frecuentemente cría cobayos en las mismas habitaciones humanas o en corrales contiguos a éstas. 2. De la estrecha relación existente entre el cobayo y el T. infestans, en lo que concierne a la enfermedad de Chagas el citado roedor adquiere importancia como: a uno de los principales huéspedes del insecto; y b el reservorio más importante del Trypanosoma cruzi. 3. Debido al trasporte del cobayo de unas localidades a otras, deviene también este roedor como activo medio de diseminación del agente etiológico de la enfermedad de Chagas.

Packaging microservices

DEFF Research Database (Denmark)

Montesi, Fabrizio; Thrane, Dan Sebastian

2017-01-01

We describe a first proposal for a new packaging system for microservices based on the Jolie programming language, called the Jolie Package Manager (JPM). Its main features revolve around service interfaces, which make the functionalities that a service provides and depends on explicit. For the f......We describe a first proposal for a new packaging system for microservices based on the Jolie programming language, called the Jolie Package Manager (JPM). Its main features revolve around service interfaces, which make the functionalities that a service provides and depends on explicit...

Mining SNPs in extracellular vesicular transcriptome of Trypanosoma cruzi: a step closer to early diagnosis of neglected Chagas disease.

Science.gov (United States)

Gaur, Pallavi; Chaturvedi, Anoop

2016-01-01

One of the newest and strongest members of intercellular communicators, the Extracellular vesicles (EVs) and their enclosed RNAs; Extracellular RNAs (exRNAs) have been acknowledged as putative biomarkers and therapeutic targets for various diseases. Although a very deep insight has not been possible into the physiology of these vesicles, they are believed to be involved in cell-to-cell communication and host-pathogen interactions. EVs might be significantly helpful in discovering biomarkers for possible target identification as well as prognostics, diagnostics and developing vaccines. In recent studies, highly bioactive EVs have drawn attention of parasitologists for being able to communicate between different cells and having likeliness of reflecting both source and target environments. Next-generation sequencing (NGS) has eased the way to have a deeper insight into these vesicles and their roles in various diseases. This article arises from bioinformatics-based analysis and predictive data mining of transcriptomic (RNA-Seq) data of EVs, derived from different life stages of Trypanosoma cruzi ; a causing agent of neglected Chagas disease. Variants (Single Nucleotide Polymorphisms (SNPs)) were mined from Extracellular vesicular transcriptomic data and functionally analyzed using different bioinformatics based approaches. Functional analysis showed the association of these variants with various important factors like Trans-Sialidase (TS), Alpha Tubulin, P-Type H+-ATPase, etc. which, in turn, are associated with disease in different ways. Some of the 'candidate SNPs' were found to be stage-specific, which strengthens the probability of finding stage-specific biomarkers. These results may lead to a better understanding of Chagas disease, and improved knowledge may provide further development of the biomarkers for prognosis, diagnosis and drug development for treating Chagas disease.

Mining SNPs in extracellular vesicular transcriptome of Trypanosoma cruzi: a step closer to early diagnosis of neglected Chagas disease

Directory of Open Access Journals (Sweden)

Pallavi Gaur

2016-11-01

Full Text Available One of the newest and strongest members of intercellular communicators, the Extracellular vesicles (EVs and their enclosed RNAs; Extracellular RNAs (exRNAs have been acknowledged as putative biomarkers and therapeutic targets for various diseases. Although a very deep insight has not been possible into the physiology of these vesicles, they are believed to be involved in cell-to-cell communication and host-pathogen interactions. EVs might be significantly helpful in discovering biomarkers for possible target identification as well as prognostics, diagnostics and developing vaccines. In recent studies, highly bioactive EVs have drawn attention of parasitologists for being able to communicate between different cells and having likeliness of reflecting both source and target environments. Next-generation sequencing (NGS has eased the way to have a deeper insight into these vesicles and their roles in various diseases. This article arises from bioinformatics-based analysis and predictive data mining of transcriptomic (RNA-Seq data of EVs, derived from different life stages of Trypanosoma cruzi; a causing agent of neglected Chagas disease. Variants (Single Nucleotide Polymorphisms (SNPs were mined from Extracellular vesicular transcriptomic data and functionally analyzed using different bioinformatics based approaches. Functional analysis showed the association of these variants with various important factors like Trans-Sialidase (TS, Alpha Tubulin, P-Type H+-ATPase, etc. which, in turn, are associated with disease in different ways. Some of the ‘candidate SNPs’ were found to be stage-specific, which strengthens the probability of finding stage-specific biomarkers. These results may lead to a better understanding of Chagas disease, and improved knowledge may provide further development of the biomarkers for prognosis, diagnosis and drug development for treating Chagas disease.

CRISPR/Cas9 cleavages in budding yeast reveal templated insertions and strand-specific insertion/deletion profiles.

Science.gov (United States)

Lemos, Brenda R; Kaplan, Adam C; Bae, Ji Eun; Ferrazzoli, Alexander E; Kuo, James; Anand, Ranjith P; Waterman, David P; Haber, James E

2018-02-27

Harnessing CRISPR-Cas9 technology provides an unprecedented ability to modify genomic loci via DNA double-strand break (DSB) induction and repair. We analyzed nonhomologous end-joining (NHEJ) repair induced by Cas9 in budding yeast and found that the orientation of binding of Cas9 and its guide RNA (gRNA) profoundly influences the pattern of insertion/deletions (indels) at the site of cleavage. A common indel created by Cas9 is a 1-bp (+1) insertion that appears to result from Cas9 creating a 1-nt 5' overhang that is filled in by a DNA polymerase and ligated. The origin of +1 insertions was investigated by using two gRNAs with PAM sequences located on opposite DNA strands but designed to cleave the same sequence. These templated +1 insertions are dependent on the X-family DNA polymerase, Pol4. Deleting Pol4 also eliminated +2 and +3 insertions, which are biased toward homonucleotide insertions. Using inverted PAM sequences, we also found significant differences in overall NHEJ efficiency and repair profiles, suggesting that the binding of the Cas9:gRNA complex influences subsequent NHEJ processing. As with events induced by the site-specific HO endonuclease, CRISPR-Cas9-mediated NHEJ repair depends on the Ku heterodimer and DNA ligase 4. Cas9 events are highly dependent on the Mre11-Rad50-Xrs2 complex, independent of Mre11's nuclease activity. Inspection of the outcomes of a large number of Cas9 cleavage events in mammalian cells reveals a similar templated origin of +1 insertions in human cells, but also a significant frequency of similarly templated +2 insertions.

ISABELLE insertion quadrupoles

International Nuclear Information System (INIS)

Kaugerts, J.; Polk, I.; Sampson, W.; Dahl, P.F.

1979-01-01

Beam focussing and control at the beam intersection regions of ISABELLE is accomplished by a number of superconducting insertion quadrupoles. These magnets differ from the standard ISABELLE quadrupoles in various ways. In particular, the requirements of limited space near the intersections and aperture for beam extraction impose constraints on their configuration. To achieve optimum beam focussing and provide tuning flexibility calls for stronger quadrupole trim windings than those in the standard quadrupoles. The magnetic and mechanical design of the insertion quadrupoles and their associated correction and steering windings to accomplish the above tasks is presented

2-DE-based proteomic investigation of the saliva of the Amazonian triatomine vectors of Chagas disease: Rhodnius brethesi and Rhodnius robustus

DEFF Research Database (Denmark)

Costa, Camila M; Sousa, Marcelo V; Ricart, Carlos André O

2011-01-01

The triatomine bugs are obligatory haematophagous organisms that act as vectors of Chagas disease by transmitting the protozoan Trypanosoma cruzi. Their feeding success is strongly related to salivary proteins that allow these insects to access blood by counteracting host haemostatic mechanisms...

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

International Nuclear Information System (INIS)

Rassi, Daniela do Carmo; Vieira, Marcelo Luiz Campos; Arruda, Ana Lúcia Martins; Hotta, Viviane Tiemi; Furtado, Rogério Gomes; Rassi, Danilo Teixeira; Rassi, Salvador

2014-01-01

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 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

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

Energy Technology Data Exchange (ETDEWEB)

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.

PRIDE Surveillance Projects Data Packaging Project, Information Package Specification Version 1.0

Energy Technology Data Exchange (ETDEWEB)

Kelleher, D.M.; Shipp, R. L.; Mason, J. D.

2009-09-28

This document contains a specification for a standard XML document format called an information package that can be used to store information and the context required to understand and use that information in information management systems and other types of information archives. An information package consists of packaged information, a set of information metadata that describes the packaged information, and an XML signature that protects the packaged information. The information package described in this specification was designed to be used to store Department of Energy (DOE) and National Nuclear Security Administration (NNSA) information and includes the metadata required for that information: a unique package identifier, information marking that conforms to DOE and NNSA requirements, and access control metadata. Information package metadata can also include information search terms, package history, and notes. Packaged information can be text content, binary content, and the contents of files and other containers. A single information package can contain multiple types of information. All content not in a text form compatible with XML must be in a text encoding such as base64. Package information is protected by a digital XML signature that can be used to determine whether the information has changed since it was signed and to identify the source of the information. This specification has been tested but has not been used to create production information packages. The authors expect that gaps and unclear requirements in this specification will be identified as this specification is used to create information packages and as information stored in information packages is used. The authors expect to issue revised versions of this specification as needed to address these issues.

Sequential cooling insert for turbine stator vane

Science.gov (United States)

Jones, Russel B

2017-04-04

A sequential flow cooling insert for a turbine stator vane of a small gas turbine engine, where the impingement cooling insert is formed as a single piece from a metal additive manufacturing process such as 3D metal printing, and where the insert includes a plurality of rows of radial extending impingement cooling air holes alternating with rows of radial extending return air holes on a pressure side wall, and where the insert includes a plurality of rows of chordwise extending second impingement cooling air holes on a suction side wall. The insert includes alternating rows of radial extending cooling air supply channels and return air channels that form a series of impingement cooling on the pressure side followed by the suction side of the insert.

Fuel insert shuffler

International Nuclear Information System (INIS)

Naser, J.; Colley, R.; Gaiser, J.; Brookmire, T.; Engle, S.

1987-01-01

The potential for the use of expert systems in the nuclear power industry is widely recognized. The benefits of such systems include consistency of reasoning during off-normal situations when humans are under great stress, the reduction of time required to perform certain functions and the retention of human expertise in performing specialized functions. As the potential benefits are more and more demonstrated and realized, the development of expert systems becomes a necessary part of the nuclear power industry. The development of the fuel insert shuffle expert system is used as a case study. In fact, it shows that the potential benefits are realizable. Currently, the development of the insert shuffle plan requires three to four man-weeks of effort. Further modifications to this plan are sometimes required dur to either changes in the desired core load pattern or damaged fuel assemblies or inserts. These changes generally require two to four man-days of effort and could be stressful if they are critical path items on the outage schedule

In-Package Chemistry Abstraction

Energy Technology Data Exchange (ETDEWEB)

P.S. Domski

2003-07-21

The work associated with the development of this model report was performed in accordance with the requirements established in ''Technical Work Plan for Waste Form Degradation Modeling, Testing, and Analyses in Support of SR and LA'' (BSC 2002a). The in-package chemistry model and in-package chemistry model abstraction are developed to predict the bulk chemistry inside of a failed waste package and to provide simplified expressions of that chemistry. The purpose of this work is to provide the abstraction model to the Performance Assessment Project and the Waste Form Department for development of geochemical models of the waste package interior. The scope of this model report is to describe the development and validation of the in-package chemistry model and in-package chemistry model abstraction. The in-package chemistry model will consider chemical interactions of water with the waste package materials and the waste form for commercial spent nuclear fuel (CSNF) and codisposed high-level waste glass (HLWG) and N Reactor spent fuel (CDNR). The in-package chemistry model includes two sub-models, the first a water vapor condensation (WVC) model, where water enters a waste package as vapor and forms a film on the waste package components with subsequent film reactions with the waste package materials and waste form--this is a no-flow model, the reacted fluids do not exit the waste package via advection. The second sub-model of the in-package chemistry model is the seepage dripping model (SDM), where water, water that may have seeped into the repository from the surrounding rock, enters a failed waste package and reacts with the waste package components and waste form, and then exits the waste package with no accumulation of reacted water in the waste package. Both of the submodels of the in-package chemistry model are film models in contrast to past in-package chemistry models where all of the waste package pore space was filled with water. The

In-Package Chemistry Abstraction

International Nuclear Information System (INIS)

P.S. Domski

2003-01-01

The work associated with the development of this model report was performed in accordance with the requirements established in ''Technical Work Plan for Waste Form Degradation Modeling, Testing, and Analyses in Support of SR and LA'' (BSC 2002a). The in-package chemistry model and in-package chemistry model abstraction are developed to predict the bulk chemistry inside of a failed waste package and to provide simplified expressions of that chemistry. The purpose of this work is to provide the abstraction model to the Performance Assessment Project and the Waste Form Department for development of geochemical models of the waste package interior. The scope of this model report is to describe the development and validation of the in-package chemistry model and in-package chemistry model abstraction. The in-package chemistry model will consider chemical interactions of water with the waste package materials and the waste form for commercial spent nuclear fuel (CSNF) and codisposed high-level waste glass (HLWG) and N Reactor spent fuel (CDNR). The in-package chemistry model includes two sub-models, the first a water vapor condensation (WVC) model, where water enters a waste package as vapor and forms a film on the waste package components with subsequent film reactions with the waste package materials and waste form--this is a no-flow model, the reacted fluids do not exit the waste package via advection. The second sub-model of the in-package chemistry model is the seepage dripping model (SDM), where water, water that may have seeped into the repository from the surrounding rock, enters a failed waste package and reacts with the waste package components and waste form, and then exits the waste package with no accumulation of reacted water in the waste package. Both of the submodels of the in-package chemistry model are film models in contrast to past in-package chemistry models where all of the waste package pore space was filled with water. The current in-package

Inoculação experimental de Equus asinus com Leishmania chagasi Cunha & Chagas, 1937 Experimental infection of Equus asinus with Leishmania chagasi Cunha & Chagas, 1937

Directory of Open Access Journals (Sweden)

Elúzio José Lima Cerqueira

2003-12-01

Full Text Available Quatro Equus asinus foram inoculados com promastigotas de Leishmania chagasi Cunha & Chagas, 1937 e acompanhados durante 12 meses através de: pesquisa de amastigotas em esfregaços e culturas de sangue periférico em fragmentos de tecido do lábio inferior, medula óssea, baço e fígado e de testes de ELISA e TRALd. Estes foram positivos nos 8º, 10º e 12º meses após a inoculação. O exame histopatológico pós necropsia, demonstrou discreto número de amastigotas no fígado de dois dos eqüídeos inoculados. Apesar de desafiados com elevado número de promastigotas, os animais não desenvolveram infecções patentes e não infectaram experimentalmente a vetora Lutzomya longipalpis. Os resultados induzem a acreditar que os eqüídeos são desprovidos de importância como reservatórios na cadeia de transmissão da leishmaniose visceral, embora sirvam como boa fonte de alimentação sangüínea e proliferação da vetora Lutzomyia longipalpis.Four Equus asinus were challenged with promastigotes of Leishmania chagasi Cunha & Chagas, 1937, and followed up for 12 months. They were observed by means of direct testing for promastigotes in smears and culture of peripheral blood, fragments from inferior lip, bone marrow, spleen and liver and the immunological assays ELISA and TRALd. The post-necropsy histological examination demonstrated a small number of amastigotes in the liver of two animals. ELISA and TRALd tests were positive at the 8th, 10th and 12th month after inoculation. The results suggest that the donkeys were able to overcome the experimental leishmanial infection and did not infect the vector Lutzomyia longipalpis in the laboratory. Consequently they can not be considered an important reservoir in the epidemiological chain of transmission of visceral leishmaniasis, although they represent an important blood source for the vector and its proliferation.

Historia de la enfermedad de Chagas en Argentina: evolución conceptual, institucional y política The history of Chagas' disease in Argentina: conceptual, institutional, and political evolution

Directory of Open Access Journals (Sweden)

Juan Pablo Zabala

2009-07-01

Full Text Available La enfermedad de Chagas ha sufrido, a lo largo de sus cien años de reconocimiento, profundas modificaciones en su concepción científica, en su reconocimiento institucional y en su valoración política. Así, desde un punto de vista médico, se la ha concebido como causante del bocio, se han resaltado sus efectos agudos, y luego sus efectos sobre la salud cardiaca. Del mismo modo, la política sanitaria ha sucesivamente descartado la importancia de la enfermedad, luego elevado a nivel de una causa nacional y paulatinamente dejado en el margen de las agendas. El presente artículo presenta, de un modo resumido, los puntos centrales de esa trayectoria histórica en Argentina, dando cuenta de los aspectos cognitivos, políticos e institucionales que dieron sustento a la enfermedad, entendida como un hecho a la vez social y biológico.In the one hundred years since the identification of Chagas disease, major changes have occurred in its scientific conception, institutional recognition, and political weight. From a medical perspective, it was seen as the cause of goiter, next its acute effects were emphasized, and then its effects on cardiac health received greater attention. In similar fashion, sanitary policy first downplayed the disease's importance, then elevated it to the role of a national cause, and gradually relegated it to the bottom of the agenda. The article briefly presents the key points of this historical trajectory in Argentina, exploring the cognitive, political, and institutional underpinnings of the disease as both a social and biological fact.

Advancements in meat packaging.

Science.gov (United States)

McMillin, Kenneth W

2017-10-01

Packaging of meat provides the same or similar benefits for raw chilled and processed meats as other types of food packaging. Although air-permeable packaging is most prevalent for raw chilled red meat, vacuum and modified atmosphere packaging offer longer shelf life. The major advancements in meat packaging have been in the widely used plastic polymers while biobased materials and their integration into composite packaging are receiving much attention for functionality and sustainability. At this time, active and intelligent packaging are not widely used for antioxidant, antimicrobial, and other functions to stabilize and enhance meat properties although many options are being developed and investigated. The advances being made in nanotechnology will be incorporated into food packaging and presumably into meat packaging when appropriate and useful. Intelligent packaging using sensors for transmission of desired information and prompting of subsequent changes in packaging materials, environments or the products to maintain safety and quality are still in developmental stages. Copyright © 2017 Elsevier Ltd. All rights reserved.

Color in packaging design : Case: ZheJiang JinSheng packaging Co,Ltd

OpenAIRE

Hu, Cuicui

2010-01-01

Color occupies an important position in packaging design, with the improvement of living standard, the higher requirement of color design in packaging. The aim of this thesis was to discuss key issues concerning aesthetics of packaging design. Topics will include an overview of the packaging design, the influence factor of packaging design, and introduce the aesthetics from packaging aspect. This thesis will also identify common problems of the production process, and list the phases of ho...

Packaging for Sustainability

CERN Document Server

Lewis, Helen; Fitzpatrick, Leanne

2012-01-01

The packaging industry is under pressure from regulators, customers and other stakeholders to improve packaging’s sustainability by reducing its environmental and societal impacts. This is a considerable challenge because of the complex interactions between products and their packaging, and the many roles that packaging plays in the supply chain. Packaging for Sustainability is a concise and readable handbook for practitioners who are trying to implement sustainability strategies for packaging. Industry case studies are used throughout the book to illustrate possible applications and scenarios. Packaging for Sustainability draws on the expertise of researchers and industry practitioners to provide information on business benefits, environmental issues and priorities, environmental evaluation tools, design for environment, marketing strategies, and challenges for the future.

CDIAC catalog of numeric data packages and computer model packages

International Nuclear Information System (INIS)

Boden, T.A.; Stoss, F.W.

1993-05-01

The Carbon Dioxide Information Analysis Center acquires, quality-assures, and distributes to the scientific community numeric data packages (NDPs) and computer model packages (CMPs) dealing with topics related to atmospheric trace-gas concentrations and global climate change. These packages include data on historic and present atmospheric CO 2 and CH 4 concentrations, historic and present oceanic CO 2 concentrations, historic weather and climate around the world, sea-level rise, storm occurrences, volcanic dust in the atmosphere, sources of atmospheric CO 2 , plants' response to elevated CO 2 levels, sunspot occurrences, and many other indicators of, contributors to, or components of climate change. This catalog describes the packages presently offered by CDIAC, reviews the processes used by CDIAC to assure the quality of the data contained in these packages, notes the media on which each package is available, describes the documentation that accompanies each package, and provides ordering information. Numeric data are available in the printed NDPs and CMPs, in CD-ROM format, and from an anonymous FTP area via Internet. All CDIAC information products are available at no cost

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

Science.gov (United States)

Witschel, Matthias; Rottmann, Matthias; Kaiser, Marcel; Brun, Reto

2012-01-01

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.

[Effects of slow twisting needle insertion and tubing needle insertion at Neiguan (PC 6) on cardiovascular function: a comparative study].

Science.gov (United States)

Ning, Shaoli; Zhao, Lihua; Xu, Lingjun; Huang, Yu; Pang, Yong; Huang, Dingjian

2016-01-01

To compare the effects between slow twisting needle insertion and tubing needle insertion. With cross-over design, 100 healthy young subjects (half male and half female) aged from 19 to 23 years were randomly divided into two groups by random digital table, 50 cases in each one. At the first stage, subjects in the group A were treated with slow twisting needle insertion while, subjects in,the group B were treated with tubing needle insertion. One week later, the procedure of second stage was performed alternately. The needle was inserted into Neiguan (PC 6) with two methods by one acupuncturist. The needle was retained for 5 min before removal. Five min before needle insertion as well as needle withdrawal and 30 min after needle withdrawal, ZXG-E automatic cardiovascular diagnostic apparatus was used to test cardiovascular function. At the tim of needle withdrawal, slow twisting needle insertion could improve effect work of kinetics (EWK), effective blood volume (BV) and reduce elastic expansion coefficient of blood vessel (FEK) and left ventricular spray blood impedance (VER), which was significantly different from tubing needle insertion (all P 0.05). The slow twisting needle insertion is significantly superior to tubing needle insertion on lowering vascular tension and VER, improving EWK and BV.

Highly Effective Serodiagnosis for Chagas' Disease ▿

Science.gov (United States)

Hernández, Pilar; Heimann, Michael; Riera, Cristina; Solano, Marco; Santalla, José; Luquetti, Alejandro O.; Beck, Ewald

2010-01-01

Many proteins of Trypanosoma cruzi, the causative agent of Chagas' disease, contain characteristic arrays of highly repetitive immunogenic amino acid motifs. Diagnostic tests using these motifs in monomeric or dimeric form have proven to provide markedly improved specificity compared to conventional tests based on crude parasite extracts. However, in many cases the available tests still suffer from limited sensitivity. In this study we produced stable synthetic genes with maximal codon variability for the four diagnostic antigens, B13, CRA, TcD, and TcE, each containing between three and nine identical amino acid repeats. These genes were combined by linker sequences encoding short proline-rich peptides, giving rise to a 24-kDa fusion protein which was used as a novel diagnostic antigen in an enzyme-linked immunosorbent assay setup. Validation of the assay with a large number of well-characterized patient sera from Bolivia and Brazil revealed excellent diagnostic performance. The high sensitivity of the new test may allow future studies to use blood collected by finger prick and dried on filter paper, thus dramatically reducing the costs and effort for the detection of T. cruzi infection. PMID:20668136

Surveillance of vector-borne pathogens under imperfect detection: lessons from Chagas disease risk (mis)measurement.

Science.gov (United States)

Minuzzi-Souza, Thaís Tâmara Castro; Nitz, Nadjar; Cuba, César Augusto Cuba; Hagström, Luciana; Hecht, Mariana Machado; Santana, Camila; Ribeiro, Marcelle; Vital, Tamires Emanuele; Santalucia, Marcelo; Knox, Monique; Obara, Marcos Takashi; Abad-Franch, Fernando; Gurgel-Gonçalves, Rodrigo

2018-01-09

Vector-borne pathogens threaten human health worldwide. Despite their critical role in disease prevention, routine surveillance systems often rely on low-complexity pathogen detection tests of uncertain accuracy. In Chagas disease surveillance, optical microscopy (OM) is routinely used for detecting Trypanosoma cruzi in its vectors. Here, we use replicate T. cruzi detection data and hierarchical site-occupancy models to assess the reliability of OM-based T. cruzi surveillance while explicitly accounting for false-negative and false-positive results. We investigated 841 triatomines with OM slides (1194 fresh, 1192 Giemsa-stained) plus conventional (cPCR, 841 assays) and quantitative PCR (qPCR, 1682 assays). Detections were considered unambiguous only when parasitologists unmistakably identified T. cruzi in Giemsa-stained slides. qPCR was >99% sensitive and specific, whereas cPCR was ~100% specific but only ~55% sensitive. In routine surveillance, examination of a single OM slide per vector missed ~50-75% of infections and wrongly scored as infected ~7% of the bugs. qPCR-based and model-based infection frequency estimates were nearly three times higher, on average, than OM-based indices. We conclude that the risk of vector-borne Chagas disease may be substantially higher than routine surveillance data suggest. The hierarchical modelling approach we illustrate can help enhance vector-borne disease surveillance systems when pathogen detection is imperfect.

Are the London Declaration's 2020 goals sufficient to control Chagas disease?: Modeling scenarios for the Yucatan Peninsula.

Science.gov (United States)

Lee, Bruce Y; Bartsch, Sarah M; Skrip, Laura; Hertenstein, Daniel L; Avelis, Cameron M; Ndeffo-Mbah, Martial; Tilchin, Carla; Dumonteil, Eric O; Galvani, Alison

2018-03-01

The 2020 Sustainable Development goals call for 100% certified interruption or control of the three main forms of Chagas disease transmission in Latin America. However, how much will achieving these goals to varying degrees control Chagas disease; what is the potential impact of missing these goals and if they are achieved, what may be left? We developed a compartmental simulation model that represents the triatomine, human host, and non-human host populations and vector-borne, congenital, and transfusional T. cruzi transmission between them in the domestic and peridomestic settings to evaluate the impact of limiting transmission in a 2,000 person virtual village in Yucatan, Mexico. Interruption of domestic vectorial transmission had the largest impact on T. cruzi transmission and prevalence in all populations. Most of the gains were achieved within the first few years. Controlling vectorial transmission resulted in a 46.1-83.0% relative reduction in the number of new acute Chagas cases for a 50-100% interruption in domestic vector-host contact. Only controlling congenital transmission led to a 2.4-8.1% (30-100% interruption) relative reduction in the total number of new acute cases and reducing only transfusional transmission led to a 0.1-0.3% (30-100% reduction). Stopping all three forms of transmission resulted in 0.5 total transmission events over five years (compared to 5.0 with no interruption); interrupting all forms by 30% resulted in 3.4 events over five years per 2,000 persons. While reducing domestic vectorial, congenital, and transfusional transmission can successfully reduce transmission to humans (up to 82% in one year), achieving the 2020 goals would still result in 0.5 new acute cases per 2,000 over five years. Even if the goals are missed, major gains can be achieved within the first few years. Interrupting transmission should be combined with other efforts such as a vaccine or improved access to care, especially for the population of already

Chest tube insertion - series (image)

Science.gov (United States)

Chest tubes are inserted to drain blood, fluid, or air and allow full expansion of the lungs. The tube is placed in the pleural space. The area where the tube will be inserted is numbed (local anesthesia). The patient may also be sedated. The chest ...

Waste package performance assessment

International Nuclear Information System (INIS)

Lester, D.H.

1981-01-01

This paper describes work undertaken to assess the life-expectancy and post-failure nuclide release behavior of high-level and waste packages in a geologic repository. The work involved integrating models of individual phenomena (such as heat transfer, corrosion, package deformation, and nuclide transport) and using existing data to make estimates of post-emplacement behavior of waste packages. A package performance assessment code was developed to predict time to package failure in a flooded repository and subsequent transport of nuclides out of the leaking package. The model has been used to evaluate preliminary package designs. The results indicate, that within the limitation of model assumptions and data base, packages lasting a few hundreds of years could be developed. Very long lived packages may be possible but more comprehensive data are needed to confirm this

Edible packaging materials.

Science.gov (United States)

Janjarasskul, Theeranun; Krochta, John M

2010-01-01

Research groups and the food and pharmaceutical industries recognize edible packaging as a useful alternative or addition to conventional packaging to reduce waste and to create novel applications for improving product stability, quality, safety, variety, and convenience for consumers. Recent studies have explored the ability of biopolymer-based food packaging materials to carry and control-release active compounds. As diverse edible packaging materials derived from various by-products or waste from food industry are being developed, the dry thermoplastic process is advancing rapidly as a feasible commercial edible packaging manufacturing process. The employment of nanocomposite concepts to edible packaging materials promises to improve barrier and mechanical properties and facilitate effective incorporation of bioactive ingredients and other designed functions. In addition to the need for a more fundamental understanding to enable design to desired specifications, edible packaging has to overcome challenges such as regulatory requirements, consumer acceptance, and scaling-up research concepts to commercial applications.

Seroprevalencia de la enfermedad de Chagas y factores de riesgo asociados en una población de Morroa, Sucre

Directory of Open Access Journals (Sweden)

Richard Hoyos

2007-01-01

Conclusiones. Nuestros resultados indican que la zona estudiada presenta elementos de riesgo para el establecimiento de un ciclo de transmisión activa, se hace necesario verificar la presencia de triatominos en la zona de estudio y establecer medidas para prevenir la presencia de la enfermedad de Chagas en el área de Morroa, Sucre.

Lithium insertion in nanostructured titanates

NARCIS (Netherlands)

Borghols, W.J.H.

2010-01-01

Upon nano-sizing of insertion compounds several significant changes in Li-insertion behavior have been observed for sizes below approximately 50 nm. Although the origins of the phenomena are interrelated, the changes can be divided in three main observations. (1) The formation of new phases, leading

Active Packaging Coatings

Directory of Open Access Journals (Sweden)

Luis J. Bastarrachea

2015-11-01

Full Text Available Active food packaging involves the packaging of foods with materials that provide an enhanced functionality, such as antimicrobial, antioxidant or biocatalytic functions. This can be achieved through the incorporation of active compounds into the matrix of the commonly used packaging materials, or by the application of coatings with the corresponding functionality through surface modification. The latter option offers the advantage of preserving the packaging materials’ bulk properties nearly intact. Herein, different coating technologies like embedding for controlled release, immobilization, layer-by-layer deposition, and photografting are explained and their potential application for active food packaging is explored and discussed.

Test manufacture of a canister insert

International Nuclear Information System (INIS)

Raiko, H.

2004-11-01

This report describes the insert-manufacturing test of a disposal canister for spent nuclear fuel that was made by Metso Paper Oy, Jyvaeskylae Foundry, in 2003 on contract for Posiva Oy. The test manufacture was a part of the co-operation development programme of encapsulation technology between SKB AB and Posiva Oy. Insert casting was specified according to the current manufacturing specifications of SKB. The canister insert was of BWR-type with integral bottom. This was the first trial manufacture of this type of insert in Finland and, in total, the second test manufacture of insert by Metso Paper. The result fulfilled all the requirements but the material mechanical properties and metallurgical structure of the cast material. The measured tensile strength, ultimate strength and elongation at rupture were lower than specified. The reason for this was revealed in the metallurgical investigation of the cast material. The nodulizing of the graphite was not occurred during the casting process according to the requirements. (orig.)

Safety Analysis Report for packaging (onsite) steel waste package

International Nuclear Information System (INIS)

BOEHNKE, W.M.

2000-01-01

The steel waste package is used primarily for the shipment of remote-handled radioactive waste from the 324 Building to the 200 Area for interim storage. The steel waste package is authorized for shipment of transuranic isotopes. The maximum allowable radioactive material that is authorized is 500,000 Ci. This exceeds the highway route controlled quantity (3,000 A 2 s) and is a type B packaging

Concepts for stereoselective acrylate insertion

KAUST Repository

Neuwald, Boris

2013-01-23

Various phosphinesulfonato ligands and the corresponding palladium complexes [{((PaO)PdMeCl)-μ-M}n] ([{( X1-Cl)-μ-M}n], (PaO) = κ2- P,O-Ar2PC6H4SO2O) with symmetric (Ar = 2-MeOC6H4, 2-CF3C6H4, 2,6-(MeO)2C6H3, 2,6-(iPrO)2C 6H3, 2-(2′,6′-(MeO)2C 6H3)C6H4) and asymmetric substituted phosphorus atoms (Ar1 = 2,6-(MeO)2C6H 3, Ar2 = 2′-(2,6-(MeO)2C 6H3)C6H4; Ar1 = 2,6-(MeO)2C6H3, Ar2 = 2-cHexOC 6H4) were synthesized. Analyses of molecular motions and dynamics by variable temperature NMR studies and line shape analysis were performed for the free ligands and the complexes. The highest barriers of ΔGa = 44-64 kJ/mol were assigned to an aryl rotation process, and the flexibility of the ligand framework was found to be a key obstacle to a more effective stereocontrol. An increase of steric bulk at the aryl substituents raises the motional barriers but diminishes insertion rates and regioselectivity. The stereoselectivity of the first and the second methyl acrylate (MA) insertion into the Pd-Me bond of in situ generated complexes X1 was investigated by NMR and DFT methods. The substitution pattern of the ligand clearly affects the first MA insertion, resulting in a stereoselectivity of up to 6:1 for complexes with an asymmetric substituted phosphorus. In the consecutive insertion, the stereoselectivity is diminished in all cases. DFT analysis of the corresponding insertion transition states revealed that a selectivity for the first insertion with asymmetric (P aO) complexes is diminished in the consecutive insertions due to uncooperatively working enantiomorphic and chain end stereocontrol. From these observations, further concepts are developed. © 2012 American Chemical Society.

Method Of Wire Insertion For Electric Machine Stators

Science.gov (United States)

Brown, David L; Stabel, Gerald R; Lawrence, Robert Anthony

2005-02-08

A method of inserting coils in slots of a stator is provided. The method includes interleaving a first set of first phase windings and a first set of second phase windings on an insertion tool. The method also includes activating the insertion tool to radially insert the first set of first phase windings and the first set of second phase windings in the slots of the stator. In one embodiment, interleaving the first set of first phase windings and the first set of second phase windings on the insertion tool includes forming the first set of first phase windings in first phase openings defined in the insertion tool, and forming the first set of second phase windings in second phase openings defined in the insertion tool.

PRIDE Surveillance Projects Data Packaging Project Information Package Specification Version 1.1

Energy Technology Data Exchange (ETDEWEB)

Kelleher, D. M.; Shipp, R. L.; Mason, J. D.

2010-08-31

Information Package Specification version 1.1 describes an XML document format called an information package that can be used to store information in information management systems and other information archives. An information package consists of package information, the context required to understand and use that information, package metadata that describes the information, and XML signatures that protect the information. The information package described in this specification was designed to store Department of Energy (DOE) and National Nuclear Security Administration (NNSA) information and includes the metadata required for that information: a unique package identifier, information marking that conforms to DOE and NNSA requirements, and access control metadata. It is an implementation of the Open Archival Information System (OAIS) Reference Model archival information package tailored to meet NNSA information storage requirements and designed to be used in the computing environments at the Y-12 National Security Complex and at other NNSA sites.

Insertion profiles of 4 headless compression screws.

Science.gov (United States)

Hart, Adam; Harvey, Edward J; Lefebvre, Louis-Philippe; Barthelat, Francois; Rabiei, Reza; Martineau, Paul A

2013-09-01

In practice, the surgeon must rely on screw position (insertion depth) and tactile feedback from the screwdriver (insertion torque) to gauge compression. In this study, we identified the relationship between interfragmentary compression and these 2 factors. The Acutrak Standard, Acutrak Mini, Synthes 3.0, and Herbert-Whipple implants were tested using a polyurethane foam scaphoid model. A specialized testing jig simultaneously measured compression force, insertion torque, and insertion depth at half-screw-turn intervals until failure occurred. The peak compression occurs at an insertion depth of -3.1 mm, -2.8 mm, 0.9 mm, and 1.5 mm for the Acutrak Mini, Acutrak Standard, Herbert-Whipple, and Synthes screws respectively (insertion depth is positive when the screw is proud above the bone and negative when buried). The compression and insertion torque at a depth of -2 mm were found to be 113 ± 18 N and 0.348 ± 0.052 Nm for the Acutrak Standard, 104 ± 15 N and 0.175 ± 0.008 Nm for the Acutrak Mini, 78 ± 9 N and 0.245 ± 0.006 Nm for the Herbert-Whipple, and 67 ± 2N, 0.233 ± 0.010 Nm for the Synthes headless compression screws. All 4 screws generated a sizable amount of compression (> 60 N) over a wide range of insertion depths. The compression at the commonly recommended insertion depth of -2 mm was not significantly different between screws; thus, implant selection should not be based on compression profile alone. Conically shaped screws (Acutrak) generated their peak compression when they were fully buried in the foam whereas the shanked screws (Synthes and Herbert-Whipple) reached peak compression before they were fully inserted. Because insertion torque correlated poorly with compression, surgeons should avoid using tactile judgment of torque as a proxy for compression. Knowledge of the insertion profile may improve our understanding of the implants, provide a better basis for comparing screws, and enable the surgeon to optimize compression. Copyright �

HPLOT: the graphics interface package for the HBOOK histogramming package

International Nuclear Information System (INIS)

Watkins, H.

1978-01-01

The subroutine package HPLOT described in this report, enables the CERN histogramming package HBOOK to produce high-quality pictures by means of high-resolution devices such as plotters. HPLOT can be implemented on any scientific computing system with a Fortran IV compiler and can be interfaced with any graphics package; spectral routines in addition to the basic ones enable users to embellish their histograms. Examples are also given of the use of HPLOT as a graphics package for plotting simple pictures without histograms. (Auth.)

An in-silico investigation of anti-Chagas phytochemicals.

Science.gov (United States)

McCulley, Stephanie F; Setzer, William N

2014-01-01

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

Package

Directory of Open Access Journals (Sweden)

Arsić Zoran

2013-01-01

Full Text Available It is duty of the seller to pack the goods in a manner which assures their safe arrival and enables their handling in transit and at the place of destination. The problem of packing is relevant in two main respects. First of all the buyer is in certain circumstances entitled to refuse acceptance of the goods if they are not properly packed. Second, the package is relevant to calculation of price and freight based on weight. In the case of export trade, the package should conform to the legislation in the country of destination. The impact of package on environment is regulated by environment protection regulation of Republic if Serbia.

Packaging-radiation disinfestation relationships

International Nuclear Information System (INIS)

Highland, H.A.

1985-01-01

Foods that are susceptible to insect infestation can be irradiated to destroy the infestation; however, the food must be kept essentially insect-free until consumed, or it must be disinfested again, perhaps repeatedly. Insect-resistant packages can be used to prevent reinfestation, but there are certain requirements that must be fulfilled before a package can be made insect resistant. These include the use of insect-light construction and packaging materials that resist boring insects. The relative insect resistance of various packages and packaging materials is discussed, as are behavior traits such as egressive boring that enables insects to escape from packages and the ability of insects to climb on various packaging materials. Some successful and unsuccessful attempts to make various types of packages insect resistant are discussed, as are factors that must be considered in the selection or development of insect-resistant packages for radiation disinfested foods. The latter factors include biological and physical environments, length of storage periods, stresses on packages during shipment, types of storage facilities, governmental regulations, health requirements, and others

Initiation and termination of the bacteriophage phi X174 rolling circle DNA replication in vivo: packaging of plasmid single-stranded DNA into bacteriophage phi X174 coats

NARCIS (Netherlands)

van der Ende, A.; Teertstra, R.; Weisbeek, P. J.

1982-01-01

The bacteriophage phi X174 viral (+) origin when inserted in a plasmid can interact in vivo with the A protein produced by infecting phi X174 phages. A consequence of this interaction is packaging of single-stranded plasmid DNA into preformed phage coats resulting in infective particles (1). This

Packaging Printing Today

Directory of Open Access Journals (Sweden)

Stanislav Bolanča

2015-12-01

Full Text Available Printing packaging covers today about 50% of all the printing products. Among the printing products there are printing on labels, printing on flexible packaging, printing on folding boxes, printing on the boxes of corrugated board, printing on glass packaging, synthetic and metal ones. The mentioned packaging are printed in flexo printing technique, offset printing technique, intaglio halftone process, silk – screen printing, ink ball printing, digital printing and hybrid printing process. The possibilities of particular printing techniques for optimal production of the determined packaging were studied in the paper. The problem was viewed from the technological and economical aspect. The possible printing quality and the time necessary for the printing realization were taken as key parameters. An important segment of the production and the way of life is alocation value and it had also found its place in this paper. The events in the field of packaging printing in the whole world were analyzed. The trends of technique developments and the printing technology for packaging printing in near future were also discussed.

Packaged die heater

Science.gov (United States)

Spielberger, Richard; Ohme, Bruce Walker; Jensen, Ronald J.

2011-06-21

A heater for heating packaged die for burn-in and heat testing is described. The heater may be a ceramic-type heater with a metal filament. The heater may be incorporated into the integrated circuit package as an additional ceramic layer of the package, or may be an external heater placed in contact with the package to heat the die. Many different types of integrated circuit packages may be accommodated. The method provides increased energy efficiency for heating the die while reducing temperature stresses on testing equipment. The method allows the use of multiple heaters to heat die to different temperatures. Faulty die may be heated to weaken die attach material to facilitate removal of the die. The heater filament or a separate temperature thermistor located in the package may be used to accurately measure die temperature.

Safety Analysis Report for packaging (onsite) steel waste package

Energy Technology Data Exchange (ETDEWEB)

BOEHNKE, W.M.

2000-07-13

The steel waste package is used primarily for the shipment of remote-handled radioactive waste from the 324 Building to the 200 Area for interim storage. The steel waste package is authorized for shipment of transuranic isotopes. The maximum allowable radioactive material that is authorized is 500,000 Ci. This exceeds the highway route controlled quantity (3,000 A{sub 2}s) and is a type B packaging.

Packaging Printing Today

OpenAIRE

Stanislav Bolanča; Igor Majnarić; Kristijan Golubović

2015-01-01

Printing packaging covers today about 50% of all the printing products. Among the printing products there are printing on labels, printing on flexible packaging, printing on folding boxes, printing on the boxes of corrugated board, printing on glass packaging, synthetic and metal ones. The mentioned packaging are printed in flexo printing technique, offset printing technique, intaglio halftone process, silk – screen printing, ink ball printing, digital printing and hybrid printing process. T...

Integrating an infectious disease programme into the primary health care service: a retrospective analysis of Chagas disease community-based surveillance in Honduras.

Science.gov (United States)

Hashimoto, Ken; Zúniga, Concepción; Nakamura, Jiro; Hanada, Kyo

2015-03-24

Integration of disease-specific programmes into the primary health care (PHC) service has been attempted mostly in clinically oriented disease control such as HIV/AIDS and tuberculosis but rarely in vector control. Chagas disease is controlled principally by interventions against the triatomine vector. In Honduras, after successful reduction of household infestation by vertical approach, the Ministry of Health implemented community-based vector surveillance at the PHC services (health centres) to prevent the resurgence of infection. This paper retrospectively analyses the effects and process of integrating a Chagas disease vector surveillance system into health centres. We evaluated the effects of integration at six pilot sites in western Honduras during 2008-2011 on; surveillance performance; knowledge, attitude and practice in schoolchildren; reports of triatomine bug infestation and institutional response; and seroprevalence among children under 15 years of age. The process of integration of the surveillance system was analysed using the PRECEDE-PROCEED model for health programme planning. The model was employed to systematically determine influential and interactive factors which facilitated the integration process at different levels of the Ministry of Health and the community. Overall surveillance performance improved from 46 to 84 on a 100 point-scale. Schoolchildren's attitude (risk awareness) score significantly increased from 77 to 83 points. Seroprevalence declined from 3.4% to 0.4%. Health centres responded to the community bug reports by insecticide spraying. As key factors, the health centres had potential management capacity and influence over the inhabitants' behaviours and living environment directly and through community health volunteers. The National Chagas Programme played an essential role in facilitating changes with adequate distribution of responsibilities, participatory modelling, training and, evaluation and advocacy. We found that Chagas

Cultural barriers to effective communication between Indigenous communities and health care providers in Northern Argentina: an anthropological contribution to Chagas disease prevention and control.

Science.gov (United States)

Dell'Arciprete, Ana; Braunstein, José; Touris, Cecilia; Dinardi, Graciela; Llovet, Ignacio; Sosa-Estani, Sergio

2014-01-29

Ninety percent of the aboriginal communities of Argentina are located in areas of endemic vectorial transmission of Chagas disease. Control activities in these communities have not been effective. The goal of this research was to explore the role played by beliefs, habits, and practices of Pilaga and Wichi indigenous communities in their interaction with the local health system in the province of Formosa. This article contributes to the understanding of the cultural barriers that affect the communication process between indigenous peoples and their health care providers. Twenty-nine open ended interviews were carried out with members of four indigenous communities (Pilaga and Wichi) located in central Formosa. These interviews were used to describe and compare these communities' approach to health and disease as they pertain to Chagas as well as their perceptions of Western medicine and its incarnation in local health practice. Five key findings are presented: 1) members of these communities tend to see disease as caused by other people or by the person's violation of taboos instead of as a biological process; 2) while the Pilaga are more inclined to accept Western medicine, the Wichi often favour the indigenous approach to health care over the Western approach; 3) members of these communities do not associate the vector with the transmission of the disease and they have little awareness of the need for vector control activities; 4) indigenous individuals who undergo diagnostic tests and accept treatment often do so without full information and knowledge; 5) the clinical encounter is rife with conflict between the expectations of health care providers and those of members of these communities. Our analysis suggests that there is a need to consider the role of the cultural patterning of health and disease when developing interventions to prevent and control Chagas disease among indigenous communities in Northern Argentina. This is especially important when

La enfermedad de Chagas en la zona central de Honduras: conocimientos, creencias y prácticas

Directory of Open Access Journals (Sweden)

Gustavo Ávila Montes

1998-03-01

Full Text Available En el período de noviembre a diciembre de 1991 y en marzo de 1993 se realizó una encuesta en 17 comunidades rurales de la parte central de Honduras. Las comunidades correspondían a dos zonas en las que la enfermedad de Chagas es endémica. En una de las zonas habían tenido lugar actividades de control de la enfermedad. Fueron entrevistados 849 adultos, uno en cada uno de otros tantos hogares familiares. El objetivo de la encuesta fue investigar y comparar en ambas zonas los conocimientos sobre la enfermedad de Chagas y sus mecanismos de transmisión, las prácticas para evitar la presencia de triatómidos en las viviendas, las creencias acerca de los triatómidos y su control, y las fuentes a partir de las cuales la población obtiene información sobre la enfermedad. Se utilizó un cuestionario de 23 preguntas validado y precodificado. Casi 100% de los entrevistados pudieron reconocer el vector y conocían sus hábitos, pero solo 30,1% sabían que el Triatoma es vector transmisor de la enfermedad y apenas 6% pudieron mencionar su relación con una afección cardíaca crónica. El 47,9% de los entrevistados indicó que la responsabilidad de eliminar los triatómidos de la vivienda es personal, aunque 78% consideraron como medida de control la aplicación institucional de insecticidas. El contacto personal entre el funcionario institucional y los miembros de la comunidad fue la principal fuente de información entre los que mencionaron haber oído de la enfermedad de Chagas (41,0%. Los resultados sugieren que al planificar medidas de control se debe incluir el componente de educación sanitaria. Ha de ponerse énfasis en el papel que desempeñan los triatómidos en la transmisión, así como en la importancia de mejorar la vivienda como medida eficaz y sostenible mediante la participación de la comunidad. Este componente deberá ser desarrollado por canales de comunicación interpersonales para obtener un mayor impacto.

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.

Enfermedad de Chagas y Colonización en el Alto Catatumbo

Directory of Open Access Journals (Sweden)

Felipe Guhr

1992-03-01

Full Text Available

Introducción
El protozoario parásito Trypanosoma cruzi, agente causal de la enfermedad de Chagas, infecta alrededor de 10 millones de individuos en Latinoamérica pudiendo ocasionarse en algunos de ellos, patologías cardíacas o digestivas.

En Colombia, el T.cruzi se detecta frecuentemente en el Valle del Río Magdalena en la región del Catatumbo, la Sierra Nevada de Santa Marta y los Llanos Orientales.

Se estima que alrededor de17% de la población colombiana está infectada y cerca del 23% se encuentra bajo riesgo de adquirir la infección dependiendo de la distribución de los vectores (l.

Se han reportado 17 especies de triatomineos en el país y en siete de ellas se ha demostrado la presencia del parásito. Rhodnius prolixus es el insecto vector de mayor distribución en las áreas endémicas debido a sus hábitos antropofílicos y domiciliarios (2.

El esquema tradicional de la cadena epidemiológica de 1′. cruzi muestra que la transmisión estuvo primitivamente restringida a ciclos específicos en el ambiente selvático donde triatomineos silvestres acometían mamíferos pequeños y medianos en vastas extensiones del Continente Americano, sin que el hombre interviniera en este ciclo natural.

Esta situación persiste hasta hoy en regiones vírgenes de América configurándose el carácter epidemiológico de una enzootia silvestre (figura 1.

La presencia de T. cruzi parece no afectar significativamente a los triatomineos ni a los mamíferos silvestres naturales infectados, lo que sugiere un equilibrio entre las especies, fruto de largos períodos de adaptación. Es común encontrar mamíferos portadores de T. cruzi en el país; por ejemplo, se ha descrito más de un centenar de reservorios pertenecientes a especies diferentes (1.

La existencia de la enfermedad de Chagas humana es un hecho puramente accidental. En la medida en que el hombre fue entrando en contacto con los focos

[The history of Chagas' disease in Argentina: conceptual, institutional, and political evolution].

Science.gov (United States)

Zabala, Juan Pablo

2009-07-01

In the one hundred years since the identification of Chagas disease, major changes have occurred in its scientific conception, institutional recognition, and political weight. From a medical perspective, it was seen as the cause of goiter, next its acute effects were emphasized, and then its effects on cardiac health received greater attention. In similar fashion, sanitary policy first downplayed the disease's importance, then elevated it to the role of a national cause, and gradually relegated it to the bottom of the agenda. The article briefly presents the key points of this historical trajectory in Argentina, exploring the cognitive, political, and institutional underpinnings of the disease as both a social and biological fact.

Technological Innovations in the Food Packaging: a case study of adoption of active packaging in coffee roaster companies

Directory of Open Access Journals (Sweden)

Mário Otávio Batalha

2010-12-01

Full Text Available Most of technological innovations in agro-food systems are created by “supporting industries”, the group where packaging industries are inserted. This article presents the packaging innovations used in food industries, particularly, the active packaging. This paper deals with an adoption case of a degassing one-way valve, describing this innovation and its impacts in two coffee companies. This study can be classified as a documental, qualitative-descriptive and empirical research, using indirect documentation technique and case study analysis. According to this case, the valve made possible the diversification of the company product line and product quality improvement. There were no complications involving an additional cost to the customers. However, it has been observed that this additional cost from technology adoption makes difficult the diffusion of this valve in other similar products.Grande parcela das inovações tecnológicas dos sistemas agroindustriais é gerada pelas “indústrias de apoio”, grupo no qual as indústrias de embalagens se inserem. Esse artigo discute as inovações em embalagens destinadas à indústria de alimentos, em especial as chamadas embalagens ativas. Discute-se o caso de adoção da válvula unidirecional de alívio de gases, descrevendo a inovação e seus impactos em duas indústria processadoras de café nas empresas. A pesquisa desenvolvida é de ordem documental e qualitativo-descritiva de caráter empírica, usando técnica de análise de documentação indireta e estudo de caso . No caso abordado, a válvula possibilitou a diversificação da linha de produtos e o incremento da sua qualidade, não havendo complicações no que se refere ao repasse do custo adicional para o consumidor desse produto. Contudo, verifica-se que esse custo adicional da adoção da tecnologia dificulta a difusão da válvula em produtos similares.

Thermal Management of Power Semiconductor Packages - Matching Cooling Technologies with Packaging Technologies (Presentation)

Energy Technology Data Exchange (ETDEWEB)

Bennion, K.; Moreno, G.

2010-04-27

Heat removal for power semiconductor devices is critical for robust operation. Because there are different packaging options, different thermal management technologies, and a range of applications, there is a need for a methodology to match cooling technologies and package configurations to target applications. To meet this need, a methodology was developed to compare the sensitivity of cooling technologies on the overall package thermal performance over a range of power semiconductor packaging configurations. The results provide insight into the trade-offs associated with cooling technologies and package configurations. The approach provides a method for comparing new developments in power semiconductor packages and identifying potential thermal control technologies for the package. The results can help users select the appropriate combination of packaging configuration and cooling technology for the desired application.

Field errors in hybrid insertion devices

International Nuclear Information System (INIS)

Schlueter, R.D.

1995-02-01

Hybrid magnet theory as applied to the error analyses used in the design of Advanced Light Source (ALS) insertion devices is reviewed. Sources of field errors in hybrid insertion devices are discussed

Field errors in hybrid insertion devices

Energy Technology Data Exchange (ETDEWEB)

Schlueter, R.D. [Lawrence Berkeley Lab., CA (United States)

1995-02-01

Hybrid magnet theory as applied to the error analyses used in the design of Advanced Light Source (ALS) insertion devices is reviewed. Sources of field errors in hybrid insertion devices are discussed.

NRF TRIGA packaging

International Nuclear Information System (INIS)

Clements, M.D.

1995-11-01

Training Reactor Isotopes, General Atomics (TRIGA reg-sign) Reactors are in use at four US Department of Energy (DOE) complex facilities and at least 23 university, commercial, or government facilities. The development of the Neutron Radiography Facility (NRF) TRIGA packaging system began in October 1993. The Hanford Site NRF is being shut down and requires an operationally user-friendly transportation and storage packaging system for removal of the TRIGA fuel elements. The NRF TRIGA packaging system is designed to remotely remove the fuel from the reactor and transport the fuel to interim storage (up to 50 years) on the Hanford Site. The packaging system consists of a cask and an overpack. The overpack is used only for transport and is not necessary for storage. Based upon the cask's small size and light weight, small TRIGA reactors will find it versatile for numerous refueling and fuel storage needs. The NRF TRIGA packaging design also provides the basis for developing a certifiable and economical packaging system for other TRIGA reactor facilities. The small size of the NRF TRIGA cask also accommodates placing the cask into a larger certified packaging for offsite transport. The Westinghouse Hanford Company NRF TRIGA packaging, as described herein can serve other DOE sites for their onsite use, and the design can be adapted to serve university reactor facilities, handling a variety of fuel payloads

Feeding sources and trypanosome infection index of Rhodnius pallescens in a Chagas disease endemic area of Amador County, Panama Fontes de alimentação de R. pallescens e índice de infecção por Trypanosoma em área endêmica da doença de Chagas em Amador, região central do Panamá

Directory of Open Access Journals (Sweden)

Vanessa Pineda

2008-04-01

Full Text Available 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.O triatomíneo silvestre Rhodnius pallescens é considerado o mais importante vetor do Trypanosoma cruzi e Trypanosoma rangeli no Panamá. Entretanto, seu comportamento e características biológicas são pouco estudados. Para controlar a doença de Chagas no Panamá é necessário melhorar a compreensão dos aspectos eco-biológicos do R. pallescens. Neste estudo, investigaram-se as fontes de alimentação de R. pallescens usando dot-blot e o índice de infecção por Trypanosoma por metodologia molecular, em área endêmica da doença de Chagas na região central do Panamá. Foi observado que 20,3% dos barbeiros coletados em palmeiras peridom

Insertion mechanics of bioinspired needles into soft tissues.

Science.gov (United States)

Sahlabadi, Mohammad; Khodaei, Seyedvahid; Jezler, Kyle; Hutapea, Parsaoran

2017-12-22

Most studies to date confirm that any increase in the needle insertion force increases the damage to the tissue. When it comes to brain tissue, even minor damage can cause a long-lasting traumatic brain injury. Thus there is a great demand for innovative minimally invasive needles among the medical community. In our previous studies a novel bioinspired needle design with specially designed barbs was used to perform insertion tests into Polyvinyl chloride (PVC) tissue-mimicking gels, in which it decreased the insertion force by as much as 25%. In this work, bioinspired needles were designed using a CAD software, and were then manufactured using a 3 D printer. The insertion tests into bovine brain and liver were then performed to further investigate the performance of our bioinspired needles in real tissues. Our results show that there was a 10-25% decrease in the insertion force for insertions into bovine brain, and a 35-45% reduction in the insertion force for insertions into bovine liver using the proposed bioinspired needles. The reduction in the insertion force is due to the decrease in the friction force of the bioinspired needle with the bovine tissues, and its results are consistent with our previous results.

Value of cardiac MRI for evaluation of chronic Chagas disease cardiomyopathy

International Nuclear Information System (INIS)

Lee-Felker, S.A.; Thomas, M.; Felker, E.R.; Traina, M.; Salih, M.; Hernandez, S.; Bradfield, J.; Lee, M.; Meymandi, S.

2016-01-01

Aim: To determine whether cardiac magnetic resonance imaging (cMRI) is more sensitive than electrocardiogram (ECG) and echocardiogram (ECHO) for detecting myocardial involvement in a Latin American migrant population with untreated Chagas disease (CD) in the United States. Materials and methods: All untreated CD patients with ECG and ECHO examinations who underwent cMRI at Olive View-UCLA Medical Center from September 2010 to December 2013 (n=81) were analysed in three groups: Group 1, normal ECG and ECHO examinations (n=50); Group 2, abnormal ECG and normal ECHO examinations (n=10); and Group 3, abnormal ECHO examination (n=21). Frequencies of ECG, ECHO, and cMRI findings were compared across groups. Results: Seventy percent (57/81) of the study population was female, with a mean age of 47 years (range, 17–77 years). Twenty-six percent (21/81) had delayed myocardial enhancement (DME), which was most commonly inferolateral in location (27%, 32/117 segments) and transmural in pattern (56%, 65/117 segments). Eight percent (4/50), 30% (3/10), and 67% (14/21) of Groups 1–3, respectively, had DME. Of these individuals with DME, 50% (2/4), 67% (2/3), and 100% (14/14) of Groups 1–3, respectively, also had wall motion abnormality (WMA) on cMRI. In addition to the highest percentages of DME and WMA, Group 3 also had significantly higher mean myocardial mass (p<0.01), mean left ventricular end-diastolic (p<0.01) and end-systolic volumes (p<0.0005), and significantly lower mean left ventricular ejection fraction (p<0.001). Conclusion: cMRI may detect myocardial involvement in untreated CD that is otherwise unrecognised on ECG and ECHO. - Highlights: • Chagas disease (CD) is becoming more common outside Latin America, especially in the United States. • CD is often asymptomatic, with undetected myocardial involvement. • Cardiac magnetic resonance imaging may identify myocardial involvement prior to electrocardiogram and echocardiogram changes. • Early detection

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

Directory of Open Access Journals (Sweden)

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.

Are the London Declaration’s 2020 goals sufficient to control Chagas disease?: Modeling scenarios for the Yucatan Peninsula

Science.gov (United States)

Bartsch, Sarah M.; Skrip, Laura; Hertenstein, Daniel L.; Ndeffo-Mbah, Martial; Dumonteil, Eric O.; Galvani, Alison

2018-01-01

Background The 2020 Sustainable Development goals call for 100% certified interruption or control of the three main forms of Chagas disease transmission in Latin America. However, how much will achieving these goals to varying degrees control Chagas disease; what is the potential impact of missing these goals and if they are achieved, what may be left? Methods We developed a compartmental simulation model that represents the triatomine, human host, and non-human host populations and vector-borne, congenital, and transfusional T. cruzi transmission between them in the domestic and peridomestic settings to evaluate the impact of limiting transmission in a 2,000 person virtual village in Yucatan, Mexico. Results Interruption of domestic vectorial transmission had the largest impact on T. cruzi transmission and prevalence in all populations. Most of the gains were achieved within the first few years. Controlling vectorial transmission resulted in a 46.1–83.0% relative reduction in the number of new acute Chagas cases for a 50–100% interruption in domestic vector-host contact. Only controlling congenital transmission led to a 2.4–8.1% (30–100% interruption) relative reduction in the total number of new acute cases and reducing only transfusional transmission led to a 0.1–0.3% (30–100% reduction). Stopping all three forms of transmission resulted in 0.5 total transmission events over five years (compared to 5.0 with no interruption); interrupting all forms by 30% resulted in 3.4 events over five years per 2,000 persons. Conclusions While reducing domestic vectorial, congenital, and transfusional transmission can successfully reduce transmission to humans (up to 82% in one year), achieving the 2020 goals would still result in 0.5 new acute cases per 2,000 over five years. Even if the goals are missed, major gains can be achieved within the first few years. Interrupting transmission should be combined with other efforts such as a vaccine or improved access to

[Why defer blood donor candidates because of an exposure risk to Chagas disease?].

Science.gov (United States)

Garraud, O; Pelletier, B; Aznar, C

2008-06-01

Various infectious agents can be transmitted by blood exposure, which comprises of transfusion, of which hemoparasites that are commonly absent from European countries but that can have infected blood donor candidates born, raised or having been living in the Tropics. Among those hemoparasites is Trypanosoma cruzi, responsible for Chagas disease. T. cruzi is responsible for acute post-transfusion infections every year in endemic areas (South America) and also, more incidently, in North America. There are situations which expose European blood donors to this risk and the present essay discusses arguments which have now been taken into consideration by certain transfusion systems such as the French one.

Evolution of Chagas' disease in Brazil. Epidemiological perspective and challenges for the future: a critical review.

Science.gov (United States)

Bello Corassa, Rafael; Aceijas, Carmen; Alves, Paula Aryane Brito; Garelick, Hemda

2017-09-01

This article aimed to provide a critical review of the evolution of Chagas' disease (ChD) in Brazil, its magnitude, historical development and management, and challenges for the future. A literature search was performed using PubMed, SciELO and Google Scholar and throughout collected articles' references. Narrative analysis was structured around five main themes identified: vector transmission, control programme, transfusion, oral and congenital transmission. In Brazil, the Chagas' Disease Control Programme was fully implemented in the 1980s, when it reached practically all the endemic areas, and in 1991, the Southern Cone Initiative was created, aiming to control the disease transmission through eliminating the Triatoma infestans and controlling blood banks. As a result, the prevalence of chagasic donors in blood banks reduced from 4.4% in the 1980s to 0.2% in 2005. In 2006, Pan American Health Organization (PAHO) certified the interruption of transmission of ChD through this vector in Brazil. However, there are still challenges, such as the domiciliation of new vector species, the need for medical care of the infected individuals, the prevention of alternative mechanisms of transmission, the loss of political concern regarding the disease and the weakening of the control programme. Despite the progress towards control, there are still many challenges ahead to maintain and expand such control and minimise the risk of re-emergence.

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.

Presence of Triatominae (Hemiptera, Reduviidae and Risk of Transmission of Chagas Disease in Colima, México

Directory of Open Access Journals (Sweden)

Espinoza-Gómez Francisco

2002-01-01

Full Text Available With the purpose of evaluating the risk of transmission of the Chagas disease in the State of Colima, México, an entomological survey was performed to obtain triatominae and the rate of infection by Trypanosoma cruzi determined by examination of its dejections. Two hundred eighteen houses located in 16 villages were sampled. In each house the intradomestic and peridomestic habitats were examined by the man-hour-house method, sensor boxes and mouse-baited traps. Also, 12 silvatic places were explored around the same areas using the same techniques as the ones sampled. In total, 456 specimens were captured, of which 139 correspond to Triatoma phyllosoma pallidipennis; 80 to T. p. longipennis; one specimen of T. dimidiata and 236 nymphs of Triatoma sp. Two hundred ninety seven insects were captured in the intradomestic habitat, 132 in the peridomestic and 26 in the silvatic. The index of positive houses was 27%, located in the central area of the state. The rate of natural infection with T. cruzi showed 25.6%. This results confirmed the presence of two important vectors of the Chagas disease in Colima. Its preference for the domestic habitat and its high levels of natural infection with T. cruzi suggested the existence of a significant risk for its transmission in this area of the country.

Modeling the spatial distribution of Chagas disease vectors using environmental variables and people´s knowledge.

Science.gov (United States)

Hernández, Jaime; Núñez, Ignacia; Bacigalupo, Antonella; Cattan, Pedro E

2013-05-31

Chagas disease is caused by the protozoan Trypanosoma cruzi, which is transmitted to mammal hosts by triatomine insect vectors. The goal of this study was to model the spatial distribution of triatomine species in an endemic area. Vector's locations were obtained with a rural householders' survey. This information was combined with environmental data obtained from remote sensors, land use maps and topographic SRTM data, using the machine learning algorithm Random Forests to model species distribution. We analysed the combination of variables on three scales: 10 km, 5 km and 2.5 km cell size grids. The best estimation, explaining 46.2% of the triatomines spatial distribution, was obtained for 5 km of spatial resolution. Presence probability distribution increases from central Chile towards the north, tending to cover the central-coastal region and avoiding areas of the Andes range. The methodology presented here was useful to model the distribution of triatomines in an endemic area; it is best explained using 5 km of spatial resolution, and their presence increases in the northern part of the study area. This study's methodology can be replicated in other countries with Chagas disease or other vectorial transmitted diseases, and be used to locate high risk areas and to optimize resource allocation, for prevention and control of vectorial diseases.

Homenaje de los Institutos de Derecho Constitucional y Derechos Humanos a Justino Jiménez de Aréchaga en el centenario de su nacimiento

Directory of Open Access Journals (Sweden)

Alberto Pérez Pérez

2014-02-01

Full Text Available Nació hace cien años, pero su pensamiento sigue plenamente vigente.Su gran obra – verdadero tratado de Derecho Constitucional Uruguayo aunque él no le haya dado ese nombre –terminó de publicarse hace casi seis décadas, pero sigue siendo imprescindible obra de consulta para todos los juristas de nuestro país.Falleció en 1980, pero aún hoy – y sin duda por mucho tiempo más – no hay estudio serio de su especialidad que no comience por indagar lo que él pensaba al respecto.Ése es Justino Jiménez de Aréchaga, la grande, inmensa personalidad uruguaya de cuyo nacimiento se cumplen hoy cien años.Los Institutos de Derecho Constitucional y Derechos Humanos, que me honro en dirigir, le rinden hoy un merecidísimo homenaje, que podemos sintetizar en cuatro afirmaciones:I.Justino Jiménez de Aréchaga hizo una obra maestraII.Fue un Maestro del Derecho y de la vida en democraciaIII.Como verdadero Maestro, también nos enseñó/incitó a tratar de continuar su obraIV.El homenaje que le debemos al Maestro Aréchaga consiste, precisamente, no en palabras sino en obras que lo honren.

Packaging for Food Service

Science.gov (United States)

Stilwell, E. J.

1985-01-01

Most of the key areas of concern in packaging the three principle food forms for the space station were covered. It can be generally concluded that there are no significant voids in packaging materials availability or in current packaging technology. However, it must also be concluded that the process by which packaging decisions are made for the space station feeding program will be very synergistic. Packaging selection will depend heavily on the preparation mechanics, the preferred presentation and the achievable disposal systems. It will be important that packaging be considered as an integral part of each decision as these systems are developed.

Waste Package Lifting Calculation

International Nuclear Information System (INIS)

H. Marr

2000-01-01

The objective of this calculation is to evaluate the structural response of the waste package during the horizontal and vertical lifting operations in order to support the waste package lifting feature design. The scope of this calculation includes the evaluation of the 21 PWR UCF (pressurized water reactor uncanistered fuel) waste package, naval waste package, 5 DHLW/DOE SNF (defense high-level waste/Department of Energy spent nuclear fuel)--short waste package, and 44 BWR (boiling water reactor) UCF waste package. Procedure AP-3.12Q, Revision 0, ICN 0, calculations, is used to develop and document this calculation

Certification of packagings: compliance with DOT specification 7A packaging requirements

International Nuclear Information System (INIS)

Edling, D.A.

1976-01-01

A study was conducted to determine which of the packagings currently listed in CFR 49 Section 173.395 a.1-5, meet the Specification 7A requirements (CFR 49 Section 173.350). According to DOT HM-111 the present listing of various authorized DOT specifications in Section 173.394 and Section 173.395 (Type A containers) of ICC Tariff No. 27 would be deleted with complete reliance being placed on the use of DOT 7A, Type A general packaging specification. Each user of a Specification 7A package would be required to document and maintain on file for one year a written record of his determination of compliance with the DOT Specification 7A performance requirements. All the specification packagings listed in CFR 49 Section 173.395a.1-5 were tested and shown to meet the Specification 7A criteria; however, in many cases qualifications were placed on their use. Forty-nine specification packagings were tested and shown to meet the DOT Specification 7A performance requirements and since there were several styles of some specific packagings, this amounts to greater than 80 packagings. The extensive testing generally indicated a high degree of containment integrity in the packagings tested and the documentation discussed is a valuable tool for shippers of Type A quantities of radioactive materials

Chagas disease: modulation of the inflammatory response by acetylcholinesterase in hematological cells and brain tissue.

Science.gov (United States)

Silva, Aniélen D; Bottari, Nathieli B; do Carmo, Guilherme M; Baldissera, Matheus D; Souza, Carine F; Machado, Vanessa S; Morsch, Vera M; Schetinger, Maria Rosa C; Mendes, Ricardo E; Monteiro, Silvia G; Da Silva, Aleksandro S

2018-01-01

Chagas disease is an acute or chronic illness that causes severe inflammatory response, and consequently, it may activate the inflammatory cholinergic pathway, which is regulated by cholinesterases, including the acetylcholinesterase. This enzyme is responsible for the regulation of acetylcholine levels, an anti-inflammatory molecule linked to the inflammatory response during parasitic diseases. Thus, the aim of this study was to investigate whether Trypanosoma cruzi infection can alter the activity of acetylcholinesterase and acetylcholine levels in mice, and whether these alterations are linked to the inflammatory cholinergic signaling pathway. Twenty-four mice were divided into two groups: uninfected (control group, n = 12) and infected by T. cruzi, Y strain (n = 12). The animals developed acute disease with a peak of parasitemia on day 7 post-infection (PI). Blood, lymphocytes, and brain were analyzed on days 6 and 12 post-infection. In the brain, acetylcholine and nitric oxide levels, myeloperoxidase activity, and histopathology were analyzed. In total blood and brain, acetylcholinesterase activity decreased at both times. On the other hand, acetylcholinesterase activity in lymphocytes increased on day 6 PI compared with the control group. Infection by T. cruzi increased acetylcholine and nitric oxide levels and histopathological damage in the brain of mice associated to increased myeloperoxidase activity. Therefore, an intense inflammatory response in mice with acute Chagas disease in the central nervous system caused an anti-inflammatory response by the activation of the cholinergic inflammatory pathway.

Agitation within Mk-42 insert caused by air sparge

International Nuclear Information System (INIS)

Ramsey, C.J.

1991-01-01

Dissolution of Rocky Flats Pu alloys and Pu metal using a ''nested insert'' configuration (One Well Insert (S-3352) inside the Mk-42 Insert) will require a Nuclear Safety Study, a major assumption of which will be that the annular dissolver is well-mixed. The ''well-mixed'' assumption was theoretically and experimentally supported for alloy dissolution using the Three Well Insert, but the present situation differs significantly. In the former case, the insert was directly exposed to the agitation induced by air sparging; in the case under consideration, the One Well Insert would be shielded by the Mk-42 Insert. In an effort to determine if the ''nested insert'' approach should be pursued, the past studies and technical literature have been surveyed and an attempt made to predict the extent of mixing and bulk circulation for a ''nested insert'' configuration in the presence of air sparging

A wafer-level 3D packaging structure with Benzocyclobutene as a dielectric for multichip module fabrication

International Nuclear Information System (INIS)

Geng Fei; Ding Xiaoyun; Xu Gaowei; Luo Le

2009-01-01

A new wafer-level 3D packaging structure with Benzocyclobutene (BCB) as interlayer dielectrics (ILDs) for multichip module fabrication is proposed for application in the Ku-band wave. The packaging structure consists of two layers of BCB films and three layers of metallized films, in which the monolithic microwave IC (MMIC), thin film resistors, striplines and microstrip lines are integrated. Wet etched cavities fabricated on the silicon substrate are used for mounting active and passive components. BCB layers cover the components and serve as ILDs for interconnections. Gold bumps are used as electric interconnections between different layers, which eliminates the need to prepare vias by costly dry etching and deposition processes. In order to get high-quality BCB films for the subsequent chemical mechanical planarization (CMP) and multilayer metallization processes, the BCB curing profile is optimized and the roughness of the BCB film after the CMP process is kept lower than 10 nm. The thermal, mechanical and electrical properties of the packaging structure are investigated. The thermal resistance can be controlled below 2 0 C/W. The average shear strength of the gold bumps on the BCB surface is around 70 N/mm 2 . The performances of MMIC and interconnection structure at high frequencies are optimized and tested. The S-parameters curves of the packaged MMIC shift slightly showing perfect transmission character. The insertion loss change after the packaging process is less than 1 dB range at the operating frequency and the return loss is less than -8 dB from 10 to 15 GHz.

Anhydrous Ammonia Training Module. Trainer's Package. Participant's Package.

Science.gov (United States)

Beaudin, Bart; And Others

This document contains a trainer's and a participant's package for teaching employees on site safe handling procedures for working with anhydrous ammonia, especially on farms. The trainer's package includes the following: a description of the module; a competency; objectives; suggested instructional aids; a training outline (or lesson plan) for…

Estrategia para mejorar el acceso al tratamiento etiológico para la enfermedad de Chagas en el primer nivel de atención en Argentina

Directory of Open Access Journals (Sweden)

Karen Klein

2017-05-01

Full Text Available RESUMEN Objetivo Mejorar la distribución del tratamiento etiológico para la enfermedad de Chagas mediante la identificación de barreras para su descentralización al primer nivel de atención en Argentina. Métodos Se llevó a cabo un estudio cualitativo, de carácter exploratorio y descriptivo, en base a entrevistas semiestructuradas a actores clave pertenecientes al Programa Nacional de Chagas y miembros de los equipos de salud del primer nivel de atención con el objetivo de identificar barreras para el diagnóstico y tratamiento de la enfermedad de Chagas en diferentes niveles (administrativo, efectores de salud y comunidad que podrían afectar una estrategia descentralizada de distribución. Además, se implementó un piloto de descentralización en diez centros de atención primaria en una provincia argentina. Resultados Se realizaron 22 entrevistas semiestructuradas con responsables de programas y profesionales de la salud. Los principales obstáculos hallados fueron la falta de búsqueda sistemática de casos, la poca articulación entre los niveles de atención y los actores del sistema de salud, la falta de capacitación del equipo de salud respecto al tratamiento, el seguimiento de los pacientes y las barreras asociadas a los pacientes. Se llevó a cabo un programa piloto de descentralización y se evaluaron estrategias para optimizar la intervención a gran escala. Conclusiones Los resultados permitieron mejorar la implementación del plan de descentralización del tratamiento a través de una mejor articulación interprogramática, la capitalización de herramientas de monitoreo y de comunicación ya existentes, y la sensibilización de los equipos de salud. Además, se formularon recomendaciones tendientes a mejorar el diagnóstico y el tratamiento de la enfermedad de Chagas.

Green Packaging Development. : A way to efficient, effective and more environmental friendly packaging solutions.

OpenAIRE

Mian Muhammad, Masoud

2011-01-01

Growing pressure on the packaging design to enhance the environmental and logistics performance of a packaging system stresses the packaging designers to search new design strategies that not only fulfill logistics requirements in the supply chain, but also reduce the CO 2emissions during the packaging life cycle. This thesis focuses on the packaging design process and suggests some improvements by considering its logistics performance and CO 2emissions. A Green packaging development model wa...

Epidemiología de la enfermedad de Chagas en el municipio Andrés Eloy Blanco, Lara, Venezuela: infestación triatomínica y seroprevalencia en humanos Epidemiology of Chagas disease in Andrés Eloy Blanco, Lara, Venezuela: triatomine infestation and human seroprevalence

Directory of Open Access Journals (Sweden)

Claudina Rodríguez-Bonfante

2007-05-01

Full Text Available Se realizó un despistaje serológico y recolección de vectores en cuatro comunidades rurales del municipio Andrés Eloy Blanco, Estado Lara, Venezuela. La muestra fue escogida en forma sistemática y aleatoria basada en conglomerados familiares. Se muestrearon 869 habitantes para determinar anticuerpos anti-Trypanosoma cruzi y anti-Leishmania sp. por inmunofluorescencia indirecta, aceptando como positivo diluciones > a 1:32 para anticuerpos anti-T. cruzi no reactivos para antígenos de Leishmania sp., obteniendo una frecuencia de anticuerpos en la muestra de 6,9% (n = 60; de los cuales 46,66% son femeninos, 53,33% masculinos y 60% mayores de 40 años. Se observó que 5 (8,33% de los seropositivos eran menores de 10 años y 10 (16,66% menores de 20 años. Rhodnius prolixus y Panstrongylus geniculatus fueron los triatominos capturados, con índice de infestación de 1,9 y 10,54%, índice de colonización, del 0 y 18,18% en las viviendas infestadas e índice de infección a T. cruzi del 20 y 5,07%, respectivamente. Los resultados sugieren que existe una transmisión activa de la enfermedad de Chagas en el Municipio Andrés Eloy Blanco en las últimas dos décadas y que P. geniculatus está substituyendo a R. prolixus como vector de la enfermedad de Chagas.A seroepidemiological survey and vector captures were performed in four rural communities in Andrés Eloy Blanco, Lara State, Venezuela. Systematic random sampling was based on family clusters, with samples drawn from 869 individuals to determine anti-Trypanosoma cruzi and anti-Leishmania sp. antibodies by indirect immunofluorescence. Positive individuals were defined as > 1:32 for anti-T. cruzi antibody and non-reactive to Leishmania sp. antigen, revealing an antibody frequency of 6.9% (n = 60, of whom 46.66% were females and 53.33% males and 60% were over 39 years of age. Some 5 (8.33% seropositive individuals were under 10 years of age and 10 (16.66% under 20 years. Rhodnius prolixus and

Reactivity insertion accident analysis

International Nuclear Information System (INIS)

Moreira, J.M.L.; Nakata, H.; Yorihaz, H.

1990-04-01

The correct prediction of postulated accidents is the fundamental requirement for the reactor licensing procedures. Accident sequences and severity of their consequences depend upon the analysis which rely on analytical tools which must be validated against known experimental results. Present work presents a systematic approach to analyse and estimate the reactivity insertion accident sequences. The methodology is based on the CINETHICA code which solves the point-kinetics/thermohydraulic coupled equations with weighted temperature feedback. Comparison against SPERT experimental results shows good agreement for the step insertion accidents. (author) [pt

Trypanosoma cruzi Coexpressing Ornithine Decarboxylase and Green Fluorescence Proteins as a Tool to Study the Role of Polyamines in Chagas Disease Pathology

Directory of Open Access Journals (Sweden)

Jeremías José Barclay

2011-01-01

Full Text Available Polyamines are essential for Trypanosoma cruzi, the causative agent of Chagas disease. As T. cruzi behaves as a natural auxotrophic organism, it relies on host polyamines biosynthesis. In this paper we obtained a double-transfected T. cruzi parasite that expresses the green fluorescent protein (GFP and a heterologous ornithine decarboxylase (ODC, used itself as a novel selectable marker. These autotrophic and fluorescent parasites were characterized; the ODC presented an apparent Km for ornithine of 0.51 ± 0.16 mM and an estimated Vmax value of 476.2 nmoles/h/mg of protein. These expressing ODC parasites showed higher metacyclogenesis capacity than the auxotrophic counterpart, supporting the idea that polyamines are engaged in this process. This double-transfected T. cruzi parasite results in a powerful tool—easy to follow by its fluorescence—to study the role of polyamines in Chagas disease pathology and in related processes such as parasite survival, invasion, proliferation, metacyclogenesis, and tissue spreading.

IN-PACKAGE CHEMISTRY ABSTRACTION

Energy Technology Data Exchange (ETDEWEB)

E. Thomas

2005-07-14

This report was developed in accordance with the requirements in ''Technical Work Plan for Postclosure Waste Form Modeling'' (BSC 2005 [DIRS 173246]). The purpose of the in-package chemistry model is to predict the bulk chemistry inside of a breached waste package and to provide simplified expressions of that chemistry as a function of time after breach to Total Systems Performance Assessment for the License Application (TSPA-LA). The scope of this report is to describe the development and validation of the in-package chemistry model. The in-package model is a combination of two models, a batch reactor model, which uses the EQ3/6 geochemistry-modeling tool, and a surface complexation model, which is applied to the results of the batch reactor model. The batch reactor model considers chemical interactions of water with the waste package materials, and the waste form for commercial spent nuclear fuel (CSNF) waste packages and codisposed (CDSP) waste packages containing high-level waste glass (HLWG) and DOE spent fuel. The surface complexation model includes the impact of fluid-surface interactions (i.e., surface complexation) on the resulting fluid composition. The model examines two types of water influx: (1) the condensation of water vapor diffusing into the waste package, and (2) seepage water entering the waste package as a liquid from the drift. (1) Vapor-Influx Case: The condensation of vapor onto the waste package internals is simulated as pure H{sub 2}O and enters at a rate determined by the water vapor pressure for representative temperature and relative humidity conditions. (2) Liquid-Influx Case: The water entering a waste package from the drift is simulated as typical groundwater and enters at a rate determined by the amount of seepage available to flow through openings in a breached waste package.

IN-PACKAGE CHEMISTRY ABSTRACTION

International Nuclear Information System (INIS)

E. Thomas

2005-01-01

This report was developed in accordance with the requirements in ''Technical Work Plan for Postclosure Waste Form Modeling'' (BSC 2005 [DIRS 173246]). The purpose of the in-package chemistry model is to predict the bulk chemistry inside of a breached waste package and to provide simplified expressions of that chemistry as a function of time after breach to Total Systems Performance Assessment for the License Application (TSPA-LA). The scope of this report is to describe the development and validation of the in-package chemistry model. The in-package model is a combination of two models, a batch reactor model, which uses the EQ3/6 geochemistry-modeling tool, and a surface complexation model, which is applied to the results of the batch reactor model. The batch reactor model considers chemical interactions of water with the waste package materials, and the waste form for commercial spent nuclear fuel (CSNF) waste packages and codisposed (CDSP) waste packages containing high-level waste glass (HLWG) and DOE spent fuel. The surface complexation model includes the impact of fluid-surface interactions (i.e., surface complexation) on the resulting fluid composition. The model examines two types of water influx: (1) the condensation of water vapor diffusing into the waste package, and (2) seepage water entering the waste package as a liquid from the drift. (1) Vapor-Influx Case: The condensation of vapor onto the waste package internals is simulated as pure H 2 O and enters at a rate determined by the water vapor pressure for representative temperature and relative humidity conditions. (2) Liquid-Influx Case: The water entering a waste package from the drift is simulated as typical groundwater and enters at a rate determined by the amount of seepage available to flow through openings in a breached waste package

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. © 2014 The International Union of Biochemistry and Molecular Biology.

Hazardous materials package performance regulations

International Nuclear Information System (INIS)

Russell, N.A.; Glass, R.E.; McClure, J.D.; Finley, N.C.

1992-01-01

The hazardous materials (hazmat) packaging development and certification process is currently defined by two different regulatory philosophies, one based on specification packagings and the other based on performance standards. With specification packagings, a packaging is constructed according to an agreed set of design specifications. In contrast, performance standards do not specify the packaging design; they specify performance standards that a packaging design must be able to pass before it can be certified for transport. The packaging can be designed according to individual needs as long as it meets these performance standards. Performance standards have been used nationally and internationally for about 40 years to certify radioactive materials (RAM) packagings. It is reasonable to state that for RAM transport, performance specifications have maintained transport safety. A committee of United Nation's experts recommended the performance standard philosophy as the preferred regulation method for hazmat packaging. Performance standards for hazmat packagings smaller than 118 gallons have been adopted in 49CFR178. Packagings for materials that are classified as toxic-by-inhalation must comply with the performance standards by October 1, 1993, and packagings for all other classes of hazardous materials covered must comply by October 1, 1996. For packages containing bulk (in excess of 188 gallons) quantities of materials that are extremely toxic by inhalation, there currently are no performance requirements. This paper discusses a Hazmat Packaging Performance Evaluation (HPPE) project to look at the subset of bulk packagings that are larger than 2000 gallons. The objectives of this project are the evaluate current hazmat specification packagings and develop supporting documentation for determining performance requirements for packagings in excess of 2000 gallons that transport hazardous materials that have been classified as extremely toxic by inhalation (METBI)

Lithium niobate packaging challenges

International Nuclear Information System (INIS)

Murphy, E.J.; Holmes, R.J.; Jander, R.B.; Schelling, A.W.

1988-01-01

The use of lithium niobate integrated optic devices outside of the research laboratory is predicated on the development of a sound packaging method. The authors present a discussion of the many issues that face the development of a viable, robust packaging technology. The authors emphasize the interaction of lithium niobate's physical properties with available packaging materials and technologies. The broad range of properties (i.e. electro-optic, piezo-electric, pyro-electric, photorefractive...) that make lithium niobate an interesting material in many device applications also make it a packaging challenge. The package design, materials and packaging technologies must isolate the device from the environment so that lithium niobate's properties do not adversely affect the device performance

Turbine airfoil having near-wall cooling insert

Science.gov (United States)

Martin, Jr., Nicholas F.; Wiebe, David J.

2017-09-12

A turbine airfoil is provided with at least one insert positioned in a cavity in an airfoil interior. The insert extends along a span-wise extent of the turbine airfoil and includes first and second opposite faces. A first near-wall cooling channel is defined between the first face and a pressure sidewall of an airfoil outer wall. A second near-wall cooling channel is defined between the second face and a suction sidewall of the airfoil outer wall. The insert is configured to occupy an inactive volume in the airfoil interior so as to displace a coolant flow in the cavity toward the first and second near-wall cooling channels. A locating feature engages the insert with the outer wall for supporting the insert in position. The locating feature is configured to control flow of the coolant through the first or second near-wall cooling channel.

User friendly packaging

DEFF Research Database (Denmark)

Geert Jensen, Birgitte

2010-01-01

Most consumers have experienced occasional problems with opening packaging. Tomato sauce from the tinned mackerel splattered all over the kitchen counter, the unrelenting pickle jar lid, and the package of sliced ham that cannot be opened without a knife or a pair of scissors. The research project...... “User-friendly Packaging” aims to create a platform for developing more user-friendly packaging. One intended outcome of the project is a guideline that industry can use in development efforts. The project also points the way for more extended collaboration between companies and design researchers. How...... can design research help industry in packaging innovation?...

Recombinant Arthrobacter β-1, 3-glucanase as a potential effector molecule for paratransgenic control of Chagas disease.