Canine tegumentary leishmaniasis in Morada das Aguias (Serra da Tiririca), Maricá, Rio de Janeiro, Brazil

This is a report of canine tegumentary leishmaniasis in Morada das Aguias (in the Serra da Tiririca mountain range), Maricá, Rio de Janeiro State, Brazil. A clinical, serological, and parasitological survey was performed in 83 dogs. Eleven (13.2%) were positive on indirect immunofluorescence (IIF) and 30 (36.1%) on enzyme-linked immunosorbent assay (ELISA). Ulcerated cutaneous or mucosal lesions were observed in 18 (n = 83; 21.7%) dogs. Leishmania was isolated from 11 of the animals. The disease occurrence and local occupational characteristics are discussed.     

Non-fatal occupational injuries: gender and job contract differences

In Brazil, workers without a formal job contract comprise more than half of the labor force, a contingent formed mainly by women. This study presents estimates of the annual incidence of non-fatal work-related injuries and their distribution by gender and type of job contract in an urban area of Brazil. This was a community-based study with a random cluster area sample of the inhabitants from the city of Salvador, capital of the State of Bahia. The study population included all individuals from 18 to 65 years of age who reported having a paid job (n = 2,947). Data were obtained through individual household interviews. The overall estimated annual incidence rate was 5.80%, with a non-statistically significant difference between men (6.05%) and women (5.53%) or workers with (5.67%) and without (5.92%) a formal job contract. These similarities between work-related accidents across gender and type of job contract highlighted the need for greater attention to this problem among women and informal workers, who are largely ignored in official statistics.     

Control of lead emissions from a battery repair shop in the city of Rio de Janeiro using the air as indicator

Lead levels in the air surrounding a battery repair shop (BRS) located in the Olaria neighborhood (Rio de Janeiro, Brazil) were monitored from April to July 1999. Most of the samples collected within 25 meters of the BRS exceeded the limit of 1.5 micro g.Pb.m-3 established by the United States Environmental Protection Agency (EPA). These results were published in a previous article (Quiterio et al., 2001). In the current study, installation of a Venture ventilation system and some changes in the operational procedure were proposed. After the modifications in the BRS, a new monitoring campaign was performed (August and September, 2000). Three points were selected for air collection, corresponding to the most critical points found in the previous assessments. The new concentrations ranged from 0.8 to 17.6 micro g.Pb.m-3, showing that lead emissions into the environment had decreased adequately. However, concentration at the chimney exhaust was still higher than EPA limits, and further improvements in the installations and procedures are definitely needed.     

The resurgence of pertussis in developed countries: a problem for Brazil as well?

Pertussis is currently considered an important public health problem in developed countries. In most of these countries, mass immunization for pertussis was initiated in the 1950s and was followed by a marked decrease in disease incidence. In the 1970s, pertussis was apparently under control in countries were vaccine coverage was maintained high. However, in the last two decades of the 20th century, the number of reported cases increased in all age groups, including adolescents and adults, indicating resurgence of the disease. This brief note aims to present the possible reasons for resurgence of this disease and to discuss the prospects of its future dynamics in Brazil. There has been no evidence to date for the resurgence of pertussis in Brazil. However, since mass immunization in Brazil began only in the 1980s, one cannot rule out the possibility that pertussis will resurge in the near future. Therefore, it is important that public health services closely monitor the epidemiological situation of pertussis in order, if necessary, to rapidly update the current immunization strategy.     

Reevaluation of long-term outcomes of dynamic cardiomyoplasty

BACKGROUND: Palliative procedures have been proposed for treatment of dilated cardiomyopathies. This study analyzes long-term outcomes of 43 patients who underwent dynamic cardiomyoplasty. METHODS: Patients were in New York Heart Association class III (n = 35) or IV (n = 8) before the procedure. Hospital mortality was 2.2%, and patients were followed for 44 +/- 33 months. Thirty-nine patients completed the skeletal muscle adaptation period, and the muscle flaps were stimulated to contract in concert with every cardiac beat (n = 27) or with every other beat (n = 12). RESULTS: One-year event-free survival was 81.3% +/- 5.9%; 2-year, 65.1% +/- 7.2%; 5-year, 34.7% +/- 7.2%; and 9-year, 10.8% +/- 5.3%. Causes of late deaths were equally divided between progressive heart failure and arrhythmia-related events. Multivariable Cox proportional hazard regression identified that functional class IV, high pulmonary vascular resistance, and muscle flap stimulation synchronized to every cardiac beat were independent predictors of poor event-free survival. The same factors were associated with the occurrence of progressive heart failure, but none was a predictor of arrhythmia-related deaths. Five-year survival of patients maintained with the muscle flap stimulated at every other cardiac beat was 58.3% +/- 14.2%. Skeletal muscle stimulation protocols also influenced the long-term behavior of left ventricular ejection fraction. CONCLUSIONS: Long-term results of dynamic cardiomyoplasty are limited by the patient's preoperative condition and by a high incidence of sudden cardiac death. These results may be improved using modified skeletal muscle stimulation protocols and cardioverter-defibrillator implantation, while maintaining dynamic cardiomyoplasty as an option for selected patients.     

Emergency room retrograde transbrachial arteriography for the management of axillosubclavian vascular injuries

BACKGROUND: Our purpose was to determine the accuracy of single-injection, retrograde transbrachial arteriography (RTBA), performed in the emergency room, for suspected axillosubclavian injuries. METHODS: Thirty-three patients were prospectively assigned for RTBA. Clinical indications for RTBA included high-risk mechanism of injury, decreased (n = 19) or absent (n = 5) brachial pulse, neurologic deficits (n = 11), external or intrathoracic bleeding (n = 4), and bruit (n = 2). Brachial artery was cannulated with an 18-gauge catheter. A sphygmomanometer cuff was placed at the forearm and inflated to 250 mm Hg. Twenty milliliters of nonionic contrast media was injected countercurrent and a single anteroposterior chest radiograph was obtained. Small intimal flaps were followed by serial ultrasound. Surgical findings were used to establish RTBA accuracy. RESULTS: RTBA was successfully performed in all cases. Arterial lesions were detected in 28 (84.8%) patients, including thrombosis (n = 8), arteriovenous fistula (n = 8), and false aneurysm (n = 7) as the most frequent lesions. A sensitivity of 96.5%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 80% were observed with RTBA. CONCLUSION: We conclude that RTBA is a safe and accurate technique to be used in the emergency room for the rapid detection of axillosubclavian arterial injuries.     

Benefits of intraluminal injection of glutamine for intestinal mucosa during ischemia-reperfusion

BACKGROUND: We investigated the effect of intraluminal glutamine on the intestinal mucosa in the presence of ischemia-reperfusion injury (IRI). METHODS: Six blind sacs were created in the small bowel (3 at the jejunum and 3 at the ileum) in 10 Wistar rats. The lateral sacs of both bowel regions were submitted to IRI (30/30 min), while the medial sacs were left free to receive blood supply. In the lateral sacs, a solution containing either saline plus 4% glutamine or pure saline was injected at the bowel lumen. No fluid was injected in the medial sacs. RESULTS: Both at the jejunum and at the ileum, the score of the mucosal injury was higher in saline-injected sacs than in either glutamine-injected or control sacs. There was a significantly greater number of neutrophils in the sacs treated with saline than in the other two groups of sacs. CONCLUSION: Glutamine protects the mucosa and diminishes the accumulation of neutrophils at the lamina propria of the small bowel in IRI.     

Acylated preatroxigenin glycosides from Atroxima congolana

Six new acylated bisdesmosidic preatroxigenin saponins named atroximasaponins E1, E2 (1, 2), F1, F2 (3, 4), and G1, G2 (5, 6) were isolated as three inseparable mixtures of the trans- and cis-p-methoxycinnamoyl derivatives, from the roots of Atroxima congolana. Their structures were established through extensive NMR spectroscopic analysis as 3-O-beta-D-glucopyranosylpreatroxigenin-28-O-beta-D-xylopyranosyl-(1-->4)-alpha-L-rhamnopyranosyl-(1-->2)-[beta-D-glucopyranosyl-(1-->3)]-[4-O-trans-p-methoxycinnamoyl]-beta-D-fucopyranoside (atroximasaponin E1, 1), and its cis-isomer, atroximasaponin E2 (2), 3-O-beta-D-glucopyranosylpreatroxigenin-28-O-beta-D-xylopyranosyl-(1-->4)-alpha-L-rhamnopyranosyl-(1-->2)-[6-O-acetyl-beta-D-glucopyranosyl-(1-->3)]-[4-O-trans-p-methoxycinnamoyl]-beta-D-fucopyranoside (atroximasaponin F1, 3), and its cis-isomer, atroximasaponin F2 (4), 3-O-beta-D-glucopyranosylpreatroxigenin-28-O-beta-D-apiofuranosyl-(1-->3)-[alpha-l-rhamnopyranosyl-(1-->2)]-[4-O-trans-p-methoxycinnamoyl]-beta-D-fucopyranoside (atroximasaponin G1, 5), and its cis-isomer, atroximasaponin G2 (6), respectively.     

Polycationic peptides as inhibitors of mast cell serine proteases

When mast cells are activated, e.g. during allergic responses, they secrete the serine proteases chymase and tryptase, which both are complex-bound to heparin proteoglycan in vivo. Previous reports have demonstrated potent pro-inflammatory effects of both tryptase and chymase in different animal models, suggesting that these serine proteases may be relevant targets for therapeutic intervention. Recent investigations have shown that heparin-binding compounds can cause tryptase inhibition and it has been suggested that the inhibitory activity of such compounds is due to interference with the binding of heparin to tryptase. Here we tested various polycationic peptides for their ability to inhibit heparin-free human recombinant betaI-tryptase. We demonstrate powerful direct inhibition of tryptase (IC(50) values approximately 1-100 nM) by poly-Arg and poly-Lys of different molecular weights. Poly-Arg and poly-Lys showed predominantly competitive inhibition kinetics, although decreases in the k(cat) values for the chromogenic substrate S-2288 were also observed. Peptides built up from heparin-binding motifs were also inhibitors of tryptase, albeit of lower efficiency than poly-Arg/Lys. Tryptase inhibition was strongly dependent on the size of the polycationic peptides. The various polycationic peptides were also inhibitory for heparin-dependent activities of chymase. The tryptase inhibition caused by the polycationic peptides could be reversed by adding heparin. After heparin-induced rescue of tryptase activity, the major part of the tryptase activity was sensitive to inhibition by bovine pancreatic trypsin inhibitor, whereas tryptase before addition of polycationic peptide was completely resistant. Taken together, our findings indicate that polycationic peptides can be used as powerful agents for combined inhibition of mast cell tryptase and chymase.