Infectiousness in a cohort of brazilian dogs: why culling fails to control visceral leishmaniasis in areas of high transmission

The elimination of seropositive dogs in Brazil has been used to control zoonotic visceral leishmaniasis but with little success. To elucidate the reasons for this, the infectiousness of 50 sentinel dogs exposed to natural Leishmania chagasi infection was assessed through time by xenodiagnosis with the sandfly vector, Lutzomyia longipalpis. Eighteen (43%) of 42 infected dogs became infectious after a median of 333 days in the field (105 days after seroconversion). Seven highly infectious dogs (17%) accounted for >80% of sandfly infections. There were positive correlations between infectiousness and anti-Leishmania immunoglobulin G, parasite detection by polymerase chain reaction, and clinical disease (logistic regression, r2=0.08-0.18). The sensitivity of enzyme-linked immunosorbent assay to detect currently infectious dogs was high (96%) but lower in the latent period (<63%), and specificity was low (24%). Mathematical modeling suggests that culling programs fail because of high incidence of infection and infectiousness, the insensitivity of the diagnostic test to detect infectious dogs, and time delays between diagnosis and culling.     

Nantenine blocks muscle contraction and Ca2+ transient induced by noradrenaline and K+ in rat vas deferens

The effect of nantenine, an aporphine alkaloid isolated from Ocotea macrophylla H.B.K., was studied on contractions and Ca(2+) translocation induced by noradrenaline, Ca(2+), or K(+) in the isolated rat vas deferens from reserpinized animals. Concentration-response curves of calcium chloride (CaCl(2)) were performed in the vas deferens, in a Ca(2+)-free nutrient solution, using potassium chloride (KCl, 80 mM) as a depolarizing agent. In these conditions, nantenine (2.35 x 10(-4) and 4.7 x 10(-4) M) significantly reduced the maximum contractions (E(max)) of Ca(2+) (IC(50)=2.6 x 10(-4) M) and noradrenaline (IC(50)=2.9 x 10(-4) M). The contractile responses were totally recovered after the withdrawal of nantenine. In addition, experiments performed to measure simultaneously the contraction and the increase of intracellular Ca(2+) induced by noradrenaline (10(-5) M) or KCl (80 mM) showed that nantenine (2.35 x 10(-4) and 4.7 x 10(-4) M) significantly decreased both effects. The results suggest that a reversible block of Ca(2+) entry could be involved on the non-competitive-like antagonism of nantenine in rat vas deferens.     

Hearing impairment and socioeconomic factors: a population-based survey of an urban locality in southern Brazil.

OBJECTIVE: To provide the first population-based data on deafness and hearing impairment in Brazil. METHODS: In 2003, a cross-sectional household survey was conducted of 2,427 persons 4 years old and over. The study population was composed of 1,040 systematically chosen households in 40 randomly selected census tracts (dwelling clusters) in the city of Canoas, which is in the state of Rio Grande do Sul, in southern Brazil. Hearing function was evaluated in all subjects by both pure-tone audiometry and physical examination, using the World Health Organization Ear and Hearing Disorders Survey Protocol and definitions of hearing levels. The socioeconomic data that were gathered included the amount of schooling of all individuals tested and the income of the head of the household. RESULTS: It was found that 26.1% of the population studied showed some level of hearing impairment, and 6.8% (95% confidence interval (CI) = 5.5%-8.1%) were classified in the disabling hearing impairment group. The prevalence of moderate hearing loss was 5.4% (95% CI = 4.4%-6.4%); for severe hearing loss, 1.2% (95% CI = 0.7%-1.7%); and for profound hearing loss, 0.2% (95% CI = 0.03%-0.33%). The groups at higher risk for hearing loss were men (odds ratio (OR) = 1.54; 95% CI = 1.06-2.23); participants 60 years of age and over (OR = 12.55; 95% CI = 8.38-18.79); those with fewer years of formal schooling (OR = 3.92; 95% CI = 2.14-7.16); and those with lower income (OR = 1.56; 95% CI = 1.06-2.27). CONCLUSIONS: These results support advocacy by health policy planners and care providers for the prevention of deafness and hearing impairment. The findings could help build awareness in the community, in universities, and in government agencies of the health care needs that hearing problems create.     

Phase II Study of Intravenous Doxil® in Malignant Pleural Mesothelioma

Twenty-four patients with pleural mesotheliomareceived 50 mg/m² of Doxil® every four weeks.At follow-up, the disease had stabilized in 43% percent ofpatients and had progressed in 57%. No objective responses wereobserved. Estimated median survival of all patients was 37 weeks.Major toxicities were erythrodysesthesia of hands and feet andmyelosuppression. No cardiac toxicity was observed. We concludedthat Doxil® at this dosage and schedule is inactiveagainst pleural mesothelioma.     

Autologous venous graft disease. Incidence, physiopathologic aspects and therapeutic means of graft salvage

From 1980 to 1985, 134 patients with severe ischemia of lower limbs benefited from surgical recovery by inversed autologous venous graft in subarticular femoropopliteal and distal femoral position. During the 5 year follow-up period, 14 grafts (9%) developed hemodynamic degradation requiring angiographic surveillance followed by surgical repair or percutaneous dilatation. A retrospective study of evolution of venous grafts implanted in the contralateral supra-articular femoropopliteal and femoro (ilio) femoral position demonstrated a lower incidence of hemodynamic degradation (5.3%). Localizations (proximal and distal anastomotic stenosis, valvular stenosis, stenotic degradation of the donor or receiving arterial segment) and physiopathologic mechanisms (progressive atheromatosis, anastomotic or valvular fibrosis, premature atheromatosis of graft) are systematically reviewed together with results of pathology. Etiopathogenic factors invoked for this affection are discussed as a function of findings, together with choice of therapy used, including surgical repair, fibrinolysis and percutaneous dilatation.     

Aneurysm of the abdominal aorta and horseshoe kidney. Apropos of a case and review of the literature

A case report of a 75 year old man with abdominal aortic aneurysm and horseshoe kidney is presented. The diagnosis of this unusual association was made prior to surgery and the aneurysmectomy was carried out without great problems, by insertion of a dacron tube combined with reimplantation of an accessory right renal artery. There was an uneventful postoperative recovery and outcome. Previous publications are reviewed. The authors insist of the importance of CT-Scan, intravenous pyelogram and aortography to establish a complete preoperative diagnosis of this rare association with anomalous vasculature and pyeloureteral pattern. The prognosis of an aneurysm in association with a horseshoe kidney should not be worse than that of routine resection of an ordinary aneurysm.