Paracoccidioidomycosis: epidemiological,clinical, diagnostic and treatment up-dating

Paracoccidioidomycosis is an acute - to chronic systemic mycosis caused by fungi of the genus Paracoccidioides. Due to its frequent tegument clinical expression, paracoccidioidomycosis is an important disease for dermatologists, who must be up-to-date about it. This article focuses on recent epidemiological data and discusses the new insights coming from molecular studies, as well as those related to clinical, diagnostic and therapeutic aspects. In the latter section, we give particular attention to the guideline on paracoccidioidomycosis organized by specialists in this subject.     

Phlebotomine fauna in the Ponta Porã city: epidemiological importance in border line between Brazil and Paraguay

ObjectiveTo identify the urban phlebotomine sandfly fauna in Ponta Porã, Mato Grosso do Sul State, Brazil.MethodsThe captures were undertaken from April 2009 to March 2010 with CDC light traps in 14 ecotopes (intra and peridomicile) in different areas of the city, Shannon traps being used in areas with abundant vegetation.ResultsA total of 707 specimens were captured with CDC light traps (565 males and 142 females) and 155 specimens (112 males and 43 females) with Shannon traps, a total of 862 phlebotomines. The specimens captured belonged to eight species: Lutzomyia longipalpis (Lutz & Neiva, 1912), Evandromyia cortelezzii (Brethes, 1923), Sciopemyia sordelli (Shannon & Del Ponte, 1927), Pintomyia pessoai (Coutinho & Barretto, 1940); Pintomyia monticola (Costa Lima, 1932); Brumptomyia brumpti (Larousse, 1920); Nyssomyia whitmani (Antunes & Coutinho, 1939) and Psathyromyia shannoni (Dyar, 1929). Lutzomyia longipalpis, the main vector of Leishmania (Leishmania) chagasi, was the species most frequently captured (97.03%) and also the most abundant according to the standardized abundance index (SAI)=0.86.ConclusionsThe highest species richness was captured, with CDC light traps, inside the domiciles and the species diversity and evenness in the peridomicile, clearly indicating a preference for anthropic environments.     

Additional benefit of combined therapy with melatonin and apoptotic adipose‐derived mesenchymal stem cell against sepsis‐induced kidney injury

This study tested whether combined therapy with melatonin and apoptotic adipose‐derived mesenchymal stem cells (A‐ADMSCs) offered additional benefit in ameliorating sepsis‐induced acute kidney injury. Adult male Sprague–Dawley rats (n = 65) were randomized equally into five groups: Sham controls (SC), sepsis induced by cecal‐ligation and puncture (CLP), CLP‐melatonin, CLP‐A‐ADMSC, and CLP‐melatonin‐A‐ADMSC. Circulating TNF‐α level at post‐CLP 6 hr was highest in CLP and lowest in SC groups, higher in CLP‐melatonin than in CLP‐A‐ADMSC and CLP‐melatonin‐A‐ADMSC groups (all P < 0.001). Immune reactivity as reflected in the number of splenic helper‐, cytoxic‐, and regulatory‐T cells at post‐CLP 72 hr exhibited the same pattern as that of circulating TNF‐α among all groups (P < 0.001). The histological scoring of kidney injury and the number of F4/80+ and CD14+ cells in kidney were highest in CLP and lowest in SC groups, higher in CLP‐melatonin than in CLP‐A‐ADMSC and CLP‐melatonin‐A‐ADMSC groups, and higher in CLP‐A‐ADMSC than in CLP‐melatonin‐A‐ADMSC groups (all P < 0.001). Changes in protein expressions of inflammatory (RANTES, TNF‐1α, NF‐κB, MMP‐9, MIP‐1, IL‐1β), apoptotic (cleaved caspase 3 and PARP, mitochondrial Bax), fibrotic (Smad3, TGF‐β) markers, reactive‐oxygen‐species (NOX‐1, NOX‐2), and oxidative stress displayed a pattern identical to that of kidney injury score among the five groups (all P < 0.001). Expressions of antioxidants (GR+, GPx+, HO‐1, NQO‐1+) were lowest in SC group and highest in CLP‐melatonin‐A‐ADMSC group, lower in CLP than in CLP‐melatonin and CLP‐A‐ADMSC groups, and lower in CLP‐melatonin‐ than in CLP‐A‐ADMSC‐tretaed animals (all P < 0.001). In conclusion, combined treatment with melatonin and A‐ADMSC was superior to A‐ADMSC alone in protecting the kidneys from sepsis‐induced injury.     

An attribute is worth more than a category: Testing different semantic memory organisation hy potheses in relation to the living/nonliving things dissociation

The present paper contrasted categorical and featural hypotheses of semantic memory organisation in relation to the living/nonliving things dissociation phenomenon. In the three experiments reported, normal subjects decided if word pairs representing living, nonliving, or both (mixed pairs) shared a particular perceptual (i.e., four legs, size, and hardness) or functional attribute (i.e., dangerousness, speed, and usefulness). The overall pattern of results is more in accordance with a general featural perspective and also emphasises the role of functional attributes. Both a categorical perspective and an attribute-category connection hypothesis have more difficulties in explaining the observed data. Implications for the study of semantic memory organisation and for the explanation of living/nonliving things dissociation cases are also considered.     

Pseudoxanthoma elasticum: report of two cases

Pseudoxanthoma elasticum is a rare inherited multisystem disorder that is characterized by a pathological mineralization of the elastic connective tissue, which involves predominantly the skin, eyes and cardiovascular system. Its cause lies on mutations in the ABCC6 gene, which lead to reduction or absence of the transmembrane transport ADP dependent protein (MRP6), causing an accumulation of extracellular material and subsequent deposition of calcium and other minerals in the elastic tissue. The authors report two cases of pseudoxanthoma elasticum, emphasizing its major clinical features and the importance of early diagnosis of the disorder, aiming for adequate therapeutic management of associated complications.     

Protein Oxidative Stress and Dyslipidemia in Dialysis Patients

Our aim was to investigate and determine the associations between oxidative stress (OS), dyslipidemia and inflammation in patients treated with continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) using observational cross‐sectional study. Twenty patients in CAPD and 48 in HD for at least 8 weeks and aged ≥18 years were included in the study. Individuals with malignant or acute inflammatory disease were excluded. A control group of 17 healthy individuals was also recruited. The biochemical parameter evaluations were analyzed using colorimetric kits for albumin, serum glucose, total cholesterol (TC) and lipid fractions. To determine the inflammatory status, CRP, IL‐6 and TNF‐α were analyzed by automated chemiluminescence kits. Plasma advanced oxidation protein products (AOPP) were determined by spectrophotometry. Mean AOPP levels were significantly higher for the HD group compared to the control, and there was no difference in AOPP concentrations between the control and CAPD groups. Dialysis patients had levels of inflammatory parameters higher than controls, and showed a high prevalence of patients with dyslipidemia, especially in CAPD. In the HD group, AOPP was positively correlated with triglycerides (TG) and inversely associated with HDL. Also the HD group was observed to have negative associations between TNF‐α and HDL, LDL and TC. In the CAPD group, CRP was inversely correlated with HDL. Hemodialysis patients had increased protein OS and associations of inflammation and dyslipidemia were also observed in these dialysis groups. A more detailed characterization of the relations between oxidative stress and other more traditional risk factors has therapeutic importance, since cardiovascular diseases are the leading cause of death among dialysis patients.