Cutaneous larva migrans on the scalp: atypical presentation of a common disease

Cutaneous larva migrans is a pruritic dermatitis due to the inoculation of helminths larvae in the skin, and it often occurs in children in tropical and subtropical areas. The authors describe an atypical case of cutaneous larva migrans in a 11 year-old child with scalp involvement, an unusual topography for this lesion.     

Lanreotide autogel-induced acute pancreatitis in a patient with acromegaly

Somatostatin and somatostatin analogues are considered very useful for the treatment of hormone producing tumors and acute variceal bleeding. They have also been proposed for the treatment of acute pancreatitis and for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis although clinical trials have failed to show any efficacy. The authors report the case of a 45-year-old man, recently diagnosed of acromegaly, which developed an acute pancreatitis shortly after his first injection of lanreotide autogel. The patient developed a severe dilatation of his hypocontractile gallbladder with distension of the intra and extrahepatic biliary ducts, the choledochus and the main pancreatic duct, without lithiasis or other abnormalities at the papilla, which resolved spontaneously in a month. We consider that lanreotide most likely induced a functional spasm of the Sphincter of Oddi, with impairment of the biliary-pancreatic outflow, leading to an acute pancreatitis, and review the literature concerning this drug related pancreatitis.     

Contaminant driven genetic erosion and associated hypotheses on alleles loss, reduced population growth rate and increased susceptibility to future stressors: an essay

Microevolution due to pollution can occur mainly through genetic drift bottlenecks, especially of small sized populations facing intense lethal pulses of contaminants, through mutations, increasing allelic diversity, and through natural selection, with the disappearance of the most sensitive genotypes. This loss of genotypes can lead to serious effects if coupled to specific hypothetical scenarios. These may be categorized as leading, first, to the loss of alleles—the recessive tolerance inheritance hypothesis. Second, leading to a reduction of the population growth rate—the mutational load and fitness costs hypotheses. Third, leading to an increased susceptibility of further genetic erosion both at future inputs of the same contaminant—differential physiological recovery, endpoints (dis)association, and differential phenotypic plasticity hypotheses—and at sequential or simultaneous inputs of other contaminants—the multiple stressors differential tolerance hypothesis. Species in narrowly fluctuating environments (tropics and deep sea) may have a particularly high susceptibility to genetic erosion—the Plus ça change (plus c’est la meme chose) hypothesis. A discussion on the consequences of these hypotheses is what this essay aimed at.     

ASSOCIATION BETWEEN SMOKING,CRACK COCAINE ABUSE AND THE DISCONTINUATION OF COMBINATION ANTIRETROVIRAL THERAPY IN RECIFE,PERNAMBUCO, BRAZIL

Despite the effectiveness of combination antiretroviral therapy in the treatment of people living with HIV/AIDS (PLWHA), nonadherence to medication has become a major threat to its effectiveness. This study aimed to estimate the prevalence of self-reported irregular use of antiretroviral therapy and the factors associated with such an irregularity in PLWHA. A cross-sectional study of PLWHA who attended two referral centers in the city of Recife, in Northeastern Brazil, between June 2007 and October 2009 was carried out. The study analyzed socioeconomic factors, social service support and personal habits associated with nonadherence to antiretroviral therapy, adjusted by multivariable logistic regression analysis. The prevalence of PLWHA who reported irregular use of combination antiretroviral therapy (cART) was 25.7%. In the final multivariate model, the irregular use of cART was associated with the following variables: being aged less than 40 years (OR = 1.66, 95%-CI: 1.29-2.13), current smokers (OR = 1.76, 95%-CI: 1.31-2.37) or former smokers (OR = 1.43, 95%-CI: 1.05-1.95), and crack cocaine users (OR = 2.79, 95%-CI: 1.24-6.32). Special measures should be directed towards each of the following groups: individuals aged less than 40 years, smokers, former smokers and crack cocaine users. Measures for giving up smoking and crack cocaine should be incorporated into HIV-control programs in order to promote greater adherence to antiretroviral drugs and thus improve the quality of life and prolong life expectancy.     

Lice infestation in goats in western Santa Catarina,Brazil

Parasitic diseases affecting goats are able to cause major economic losses, standing out, among them, the lice infestation. According to the literature, lice can act as vectors of other diseases, including the ones caused by blood protozoan. In this sense, this survey study aimed to assess the ectoparasites of goats in the west region of Santa Catarina (SC). Two hundred seventeen goats from 24 different rural properties located in 17 towns in SC were examined. From them, ectoparasites were collected and evaluated in laboratory, where the parasitological classification was performed. In 13 properties, it was possible to identify ectoparasites. Damalinia caprae lice were observed in 126 animals (58 %), while Linognathus stenopsis were found in 10 animals (4.6 %). It is noteworthy that, in these properties, all the animals were under lice parasitism, independent of sex or age. The goats had peeling skin, particularly in the back region (lumbar). All of the 24 properties evaluated were reported having problems with lice in different seasons of the year, even under regular treatment with cypermethrin (spraying). Based on our findings, it was possible to conclude that D. caprae is the major ectoparasite of goats in the investigated area.