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At least 523 records · Page 29Linked to original sources
PubMed2004

Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: IV. Clinical and histopathology.

Tungiasis is a parasitic skin disease caused by the sand flea Tunga penetrans. This ectoparasitosis is endemic in South America, the Caribbean and sub-Saharan Africa, where it is an important but neglected health problem in resource-poor communities. As part of a study of tungiasis-related morbidity in a typical slum in Fortaleza, Brazil, we identified 86 individuals with tungiasis. Lesions were counted, classified according to the stage of development, and clinical pathology was documented. One hundred and nine lesions were biopsied and examined by histological sectioning. The patients had between 1 and 145 lesions (median 14.5), the majority occurring in clusters. In all, 77% of patients reported severe pain at the site of the lesion, and 52% had one or more nails lost or severely deformed. Intense inflammation and/or fissures hindered 45% of the patients from walking normally. Signs of superinfection were observed in 29%, and signs of generalized inflammation in 2% of patients. Clinical pathology was significantly related to the number of lesions, and the total number of parasites present correlated with the number of fleas occurring in clusters. Clinical pathology was frequently accompanied by a pathological alteration of the epidermis (predominantly hyperplasia, parakeratosis, hyperkeratosis, and spongiosis) and the dermis. Tungiasis causes a broad spectrum of clinical histopathological alterations, and is a serious health threat in a typical, impoverished community in northeast Brazil. The clinical pathology is closely related to the parasite burden of an individual and the clustering of embedded fleas at certain predilection sites.

Adolescent↗
PubMed2005

Molecular identification and characterization of canine Hepatozoon species from Brazil.

Canine Hepatozoon species from Brazil was molecular identified and characterized for the first time. From 31 dogs, 7 were positive for blood smear examination and 21 positive for PCR. Partial sequences of the 18S rRNA gene from eight naturally infected dogs were analyzed. Sequences revealed that Brazilian Hepatozoon is closely related with the Japanese Hepatozoon, that has 99% nucleotide identity with Hepatozoon canis from Israel, and different from Hepatozoon americanum. These results indicate that the canine Hepatozoon species from Brazil is H. canis.

Animals↗
PubMed2026

Estimated prevalence and distribution of causes of immune-mediated hypertrophic pachymeningitis in São Paulo, Brazil.

BACKGROUND: The prevalence of hypertrophic pachymeningitis (HP) remains poorly defined worldwide. In Japan, the estimated prevalence is 0.949 cases per 100,000 inhabitants, with most cases related to ANCA-associated vasculitis or IgG4-related disease. In contrast, epidemiological data from other regions, including Latin America, are scarce. METHODS: This study was conducted at a tertiary referral center in the city of São Paulo, Brazil. The prevalence of HP was estimated by comparison with the known prevalence of multiple sclerosis (MS), based on the number of patients with each condition followed at our institution. The etiological distribution of HP was also analyzed. In addition, HP prevalence was compared with that of tuberculous meningoencephalitis, a compulsory notifiable disease and a well-established cause of chronic meningitis in Brazil, using data from the national surveillance system (SINAN). RESULTS: We identified 55 patients with HP: 36 (65%) idiopathic, 10 (18%) IgG4-related disease, 4 (7%) ANCA-associated pachymeningitis, 4 (7%) probable or definite neurosarcoidosis, and 1 (2%) secondary to rheumatoid arthritis. Among 968 registered MS patients and assuming an MS prevalence of 15 per 100,000 inhabitants in São Paulo, the estimated HP prevalence was 0.85 per 100,000 inhabitants. This estimate was comparable to the prevalence of tuberculous meningoencephalitis in the same region. CONCLUSION: The estimated prevalence of HP in São Paulo (0.85 per 100,000) is consistent with reports from other regions and is comparable to that of tuberculous meningeal disease, although with a distinct etiological profile. IgG4-related disease was the most frequent systemic association, differing from previous reports. ANCA-associated HP appears to be less frequent than in other geographic regions, possibly reflecting differences in disease phenotype. Key Points • The estimated prevalence of HP in São Paulo was 0.85 per 100,000 inhabitants. • IgG4-related disease was the most common systemic disease identified among patients with HP. • ANCA-associated HP was less common than reported in Asian and European cohorts. • The prevalence of HP was comparable to that of tuberculous meningoencephalitis in São Paulo.

Humans↗
PubMed2007

A model for adapting evidence-based behavioral interventions to a new culture: HIV prevention for psychiatric patients in Rio de Janeiro, Brazil.

As in other countries worldwide, adults with severe mental illness in Brazil have elevated rates of HIV infection relative to the general population. However, no HIV prevention interventions have been tested for efficacy with psychiatric patients in Brazil. We conducted participatory research with local providers, community leaders, patient advocates, and patients using an intervention adaptation process designed to balance fidelity to efficacious interventions developed elsewhere with fit to a new context and culture. Our process for adapting these interventions comprised four steps: (1) optimizing fidelity; (2) optimizing fit; (3) balancing fidelity and fit; and (4) pilot testing and refining the intervention. This paper describes how these steps were carried out to produce a Brazilian HIV prevention intervention for people with severe mental illness. Our process may serve as a model for adapting existing efficacious interventions to new groups and cultures, whether at a local, national, or international level.

Brazil↗
PubMed2006

Prevalence and demographic characteristics of celiac disease among blood donors in Ribeirão Preto, State of São Paulo, Brazil.

Celiac disease (CD) is an underdiagnosed disease occurring in different clinical forms. This study aimed to determine the prevalence of CD among blood donors from Ribeirão Preto, Brazil, and to study some demographic characteristics of celiac patients. Blood samples from 3000 blood donors were tested for the presence of tissue transglutaminase antibody and positive samples were tested for endomysial antibody. Donors positive to both tests were referred for clinical evaluation and for a jejunal biopsy. Twenty-four samples were moderately/strongly positive for transglutaminase, with 9 of them being endomysial negative and 15 positive. Of the 13 biopsies obtained from 12 females and 1 male, 1 was classified as Marsh grade IV, 4 as grade III, 2 as grade II, 4 as grade I, and 2 as grade 0. Estimated prevalence was therefore 1:273 (0.33%; 95% CI, 0.127 to 0.539). The 1:273 estimated prevalence of CD detected indicates that the disease is not rare in Brazil. The frequency was higher among females and among individuals of European descent, with a significantly higher frequency for a family history of digestive tract cancer or epilepsy.

Adolescent↗
PubMed2004

A case of eumycetoma due to Madurella grisea in northern Brazil.

A case of mycetoma caused by the black fungus Madurella grisea in northern Brazil is reported. The lesion was located on the patient's right foot without bone involvement. Clinical samples were collected by opening the fistules with a scalp and the grains removed for microbiological and histopathological analyses. Although mycetoma caused by M. grisea has been previously reported in Brazil, this is the first time that of this fungus has been identify in this particular region of the country.

Adult↗
PubMed2006

In vitro activities of caspofungin, amphotericin B and azoles against Coccidioides posadasii strains from Northeast, Brazil.

Coccidioidomycosis is a systemic infection caused by the soil-dwelling dimorphic fungi Coccidioides spp. The disease is endemic in semiarid Northeast Brazil, where it is caused by C. posadasii. The aim of this study was to perform antifungal susceptibility tests of clinical and environmental strains of C. posadasii from Northeast Brazil. The in vitro activities of caspofungin, amphotericin B and azoles against clinical and environment isolates of C. posadasii were determined in accordance with the NCLLS M-38P macrodilution method. The antifungal susceptibility analysis showed that all the strains of C. posadasii (n = 10) were sensitive to caspofungin (16 microg/ml < or = MIC < or = 32 microg/ml), amphotericin B (0.0625 mug/ml < or = MIC < or = 0.125 microg/ml), ketoconazole (0.039 microg/ml < or = MIC < or = 0.156 microg/ml), itraconazole (0.125 microg/ml < or = MIC < or = 0.5 microg/ml), fluconazole (3.125 microg/ml < or = MIC < or = 6.25 microg/ml), and voriconazole (0.125 microg/ml). This study is the first description of in vitro antifungal susceptibility pattern of Brazilian strains of C. posadasii.

Amphotericin B↗
PubMed2005

Clinical pharmacy at the university hospital from São Paulo, Brazil.

Clinical Pharmacy includes all services performed by pharmacists practicing in hospitals, community pharmacies, nursing homes, home-based care services, clinics and any other setting where medicines are prescribed and used. Clinical Pharmacy activities may influence the correct use of medicines at three different levels: before, during and after the prescription is written. At the same time, pharmaceutical care philosophy is coming to Brazil. This paper comments on the development of the Clinical Pharmacy concept in Brazil, mainly in its practice and experience in the University Hospital of São Paulo.

Brazil↗
PubMed2005

Translation and cultural adaptation of Health Utilities Index (HUI) Mark 2 (HUI2) and Mark 3 (HUI3) with application to survivors of childhood cancer in Brazil.

INTRODUCTION: There are few publications reporting health-related quality of life (HRQL) in developing nations. Most instruments measuring HRQL have been developed in English-speaking countries. These instruments need to be culturally adapted for use in non-English-speaking countries. The HUI2 and HUI3 are generic, preference-based systems for describing health status and HRQL. Developed in Canada, the systems have been translated into more than a dozen languages and used worldwide in hundreds of studies of clinical and general populations. METHODS: The Brazilian-Portuguese translation of the HUI systems was supervised by senior HUInc staff having experience with both the HUI systems and translations. The process included two independent forward translations of the multi-attribute health status classification systems and related questionnaires, consensus between translators on a forward translation, back-translation by two independent translators of the forward translation, and review of the back-translations by original developers of the HUI. The final questionnaires were tested by surveying a sample of convenience of 50 patients recruited at the Centro de Tratamento e Pesquisa-Hospital do Cancer in São Paulo, Brazil. RESULTS: Fifty patients were enrolled in the study. No assessor, patient or nurse or physician, reported problems answering the HUI questionnaires. No significant differences were found in mean overall HUI2 or HUI3 utility scores among types of assessors. Variability in scores are similar to those from other studies in Latin America and Canada. CONCLUSION: Test results provide preliminary evidence that the Brazilian-Portuguese translation is acceptable, understandable, reliable and valid for assessing health-status and HRQL among survivors of cancer in childhood in Brazil.

Adult↗
PubMed1995

A field trial with Lambda-cyhalothrin (ICON) for the intradomiciliary control of malaria transmitted by Anopheles darlingi root in Rondonia, Brazil.

A two stage field trial comparing the effects of Lambdacyhalothrin (ICON) and DDT when used as residual sprays on the inside surfaces of houses, was conducted in the Machadinho and Jaru areas of Rodonia, Brazil, in 1987 and 1988. In 1987 houses along two 16 km contiguous stretches of a main and a side road were sprayed and the effects on malaria vectors monitored for the succeeding year. In the second stage approximately 55,000 houses in both districts were sprayed with ICON and the effect on malaria incidence measured by passive case detection. Of the eleven species of Anopheles caught in indoor and peridomiciliary collections A. darlingi was the commonest and is recognised as the most important vector in Brazil. ICON at either of two concentrations in bioassays killed more mosquitoes than DDT at each test from seven to twelve months after spraying. A rise in the number of A. darlingi collected eight months after spraying with DDT was not so marked in the ICON areas. Side effects of the insecticide were limited. The number of reported Plasmodium falciparum cases in the second phase declined 76% in Machadinho after spraying with ICON to 2851 cases. In Jaru there was a 28% reduction. The observed efficacy of the insecticide, its ready acceptance by the local populace, and its cost effectiveness make it a more useful insecticide for anti-malaria campaigns than DDT.

Adult↗
PubMed1994

Misoprostol: the experience of women in Fortaleza, Brazil.

Misoprostol is used by women in Brazil in case of unwanted pregnancy to attempt abortion. This paper reports the characteristics, pattern of misoprostol use and opinions of a group of 102 women (median age 25 years, range 16-49 years), from Fortaleza, capital of Ceará state, who had used misoprostol to attempt abortion. Seventy-five percent were women of lower social class, 58% had less than 8 years of education and 46% were never married. Misoprostol was used for the first induced abortion by 65 women. Modal dose was 4 tablets--200 micrograms of misoprostol each--most frequently 2 tablets by oral route and 2 tablets by intravaginal route. This pattern of use was associated with the highest rate of abortion, mainly at 9-12 weeks of amenorrhea. Fifty-five percent of women had no pregnancy test; 41% had 8 weeks or less of amenorrhea. Curettage was performed in 49 of 84 women who reported abortion and in 41 of 43 women who entered the hospital. Infection and uterine perforation were the complications described. Seventy-two percent of women were in favor of legalization of abortion, but 52% were also in favor of the prohibition of misoprostol sales; 66% would not repeat misoprostol use and 53% would not suggest it to a friend. The poorest women were less favorable to misoprostol ban. Despite the current lack of safer alternatives, misoprostol does not seem a satisfactory solution to illegal abortion in Brazil.

Abortion, Induced↗
PubMed1977

The identification by isoenzyme patterns of two distinct strain-groups of Trypanosoma cruzi, circulating independently in a rural area of Brazil.

Culture forms of 17 Trypanosoma cruzi stocks, primarily isolated from a rural area of endemic Chagas disease at São Felipe, Bahia, Brazil, were compared by the electrophoretic patterns of six enzymes: aspartate aminotransferase, alanine aminotransferase, glucose-6-phosphate dehydrogenase, malate dehydrogenase (decarb-oxylating) (NADP+), glucosephosphate isomerase and phosphoglucomutase. Two markedly distinct combinations of isoenzyme patterns were seen, justifying the arrangement of the 17 stocks into two strain-groups, each of which was enzymically homogeneous. One combination was characteristic of the 11 domestic stocks of T. cruzi derived from both human infections and domiciliated animals; the second was characteristic of the six sylvatic stocks derived from opossums and a sylvatic triatomine species. The enzyme patterns were independent of the original host and the type of culture medium used. Distinction of the two strain-groups accords with epidemiological evidence that the domestic and sylvatic transmission cycles in São Felipe do not overlap. It is suggested that the diverse enzyme characters of the two strain-groups circulating in São Felipe reflect diverse origins; the domestic form of T. cruzi probably invaded the area from the south of Brazil with the domestic triatomine vector, Panstrongylus megistus.

Animals↗
PubMed1982

Leishmaniasis in Brazil: XVII. Enzymic characterization of a Leishmania from the armadillo, Dasypus novemcinctus (Edentata), from Pará State.

A comparison of enzyme profiles, by starch-gel electrophoresis, has distinguished a Leishmania of armadillos (Dasypus novemcinctus), from Pará State, north Brazil, from Leishmania braziliensis braziliensis, L. braziliensis guyanensis, L. mexicana amazonensis, L. donovani sensu lato (from Bahia, Brazil), and L. hertigi deanei. The parasite was separated from L. b. braziliensis and L. b. guyanensis by 8 of the 14 enzymes used (ASAT, ALAT, PGM, GPI, G6PD, PEP, MPI and GD), although differences in the mobility of some of the enzymes were small. At least 9 of the enzymes separated the organism from L. m. amazonensis, L. donovani s.l., and L. h. deanei.

Animals↗
PubMed1983

Leishmaniasis in Brazil. XIX: visceral leishmaniasis in the Amazon Region, and the presence of Lutzomyia longipalpis on the Island of Marajó, Pará State.

Sporadic cases of visceral leishmaniasis in Amazonian Brazil appear limited to Pará State, in the lower Amazon valley and principally near the Atlantic coast. The fox Cerdocyon thous (L.) has been incriminated as a natural host of the causative parasite, Leishmania donovani chagasi, but past doubts have existed over the identification of the most likely vector as Lutzomyia (Lutzomyia) longipalpis (Lutz & Neiva, 1912). Investigations on two of five recent cases of visceral leishmaniasis of man in the Districts of Cachoeira do Arari and Salvaterra, on the eastern part of the Island of Marajó, Pará showed undoubted Lu. longipalpis to be abundant in one house and in numerous chicken-houses. This is the first record of Lu. longipalpis on Marajó Island, and the finding supports previous implication of this sandfly in the epidemiology of visceral leishmaniasis in other parts of Pará. Morphological differences have been noted between this insect from Marajó and other specimens from more highly endemic regions in the States of Ceará and Minas Gerais, Brazil.

Adult↗
PubMed1984

A controlled study of endemic sporadic diarrhoea among adult residents of southern Brazil.

The aetiology of sporadic summer diarrhoea and enterotoxin (LT) antibody titres was studied among 43 adult patients in southern Brazil who had an acute, untreated diarrhoeal illness and 43 age- and sex-matched controls from the same area. A potential pathogen was identified in 33 of 34 patients and in 17 of 43 controls (p less than 0.01). 10 Shigella, one invasive Escherichia coli, one Salmonella and one Entamoeba histolytica were identified in 17 patients with inflammatory diarrhoea (faecal polymorphonuclear neutrophil leucocytes (PMN) present). In the other four only enterotoxigenic strains of E. coli were identified. Among 26 patients with non-inflammatory (no faecal PMN) diarrhoea, heat-stable (ST) toxin-producing coliforms were the most common pathogens isolated (27%). Heat-labile (LT) toxin-producing coliforms or serological rises to LT were seen in five patients, Strongyloides larvae in five, Giardia lamblia trophozoites in four and an LT-producing Salmonella in one. No pathogen was found in 10 patients with non-inflammatory diarrhoea. Among 43 controls, 11 LT coliforms, two Shigella and two Strongyloides larvae were found. 40 of 41 controls had detectable serum anti-LT antibody. A single ST-producing E. coli was found in one other control. No pathogen was identified in 26 controls. No rotaviruses or Norwalk-like viral agents were seen by direct or immune electron microscopy of stool filtrates. While LT-producing E. coli are frequently associated with endemic summer childhood diarrhoea in southern Brazil and are recognized causes of travellers' diarrhoea, this study shows that they are often carried asymptomatically by adults living in this region.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Leishmaniasis in Brazil. XXI. Visceral leishmaniasis in the Amazon Region and further observations on the role of Lutzomyia longipalpis (Lutz & Neiva, 1912) as the vector.

Further evidence is presented incriminating the sandfly Lutzomyia longipalpis as the vector of Leishmania chagasi, the causative agent of American visceral leishmaniasis, in the Amazon Region of Brazil. During an outbreak of the disease in Santarém, Pará State, this insect was shown to be the only species of sandfly consistently present in and around the patient's homes, where it often occurred in very large numbers. Of 491 specimens dissected, 35 (7.14%) proved to be infected, and isolates of L. chagasi were made from 16 of 27 of these sandflies following the inoculation of the promastigotes into hamsters. Finally, the parasite was transmitted to four other hamsters which had been subjected to the bites of large numbers of wild-caught Lu. longipalpis. Isolates of Leishmania from Lu. longipalpis captures in Santarém, and in another focus of visceral leishmaniasis on the Island of Marajó, Pará, have been shown to be biologically and biochemically indistinguishable from the parasite infecting man, dogs and foxes in Pará, and from stocks obtained from man elsewhere in Brazil (Bahia and Ceará States).

Animals↗
PubMed1985

Hereditary haemoglobin disorders in Brazil.

The data on the incidence and variability of hereditary haemoglobin (Hb) disorders in Brazil are reviewed. The most common abnormalities are HbS, HbC and beta-thalassaemias. Both homozygotes and compound heterozygotes for these genes (i.e., HbS/HbC disease, S/beta-thalassaemia, C/beta-thalassaemia) are common, owing to the free miscegenation of populations of Mediterranean and African ancestry. The diversity of beta-thalassaemias is similar to that observed in other regions. beta(0)-Thalassaemia is more frequent than the beta(+) variant among affected individuals. Most patients are descendants of Italian immigrants but occasional cases have other racial origins. Patients with thalassaemia major are mostly beta (0) homozygotes, while thalassaemia intermedia is more heterogeneous, including a variety of genotypes. alpha-Thalassaemias are not common although cases of HbH disease have been reported. Isolated examples of several Hb variants have been described, and two abnormal Hb were first found in Brazil: Hb Porto Alegre and Hb Niteroi.

Adolescent↗
PubMed1988

Prevalence of infection with hepatitis delta virus (HDV) among carriers of hepatitis B surface antigen in Amazonas State, Brazil.

Serum samples were non-randomly obtained from apparently healthy inhabitants of 5 villages in the Amazonas State, Brazil. Sera were tested by enzyme immunoassay for the presence of hepatitis B surface antigen (HBsAg) and, if this was found, for antibody to hepatitis delta virus (HDV). Of 574 people tested, 96 (16.7%) were reactive for HBsAg and 33 of these (34.4%) for anti-HDV. The results were analysed according to sex, age and history of jaundice and showed a high prevalence of hepatitis B virus (HBV) and HDV infections in these asymptomatic persons, mainly in young people. The rates of prevalence observed in Amazonas for both HBV and HDV are perhaps among the highest in the world, demonstrating that these viruses are endemic in this region of Brazil.

Adolescent↗