Infections and emotions

This paper based on review of the literature about mind body interactions, show us the role of emotional alterations like stress and depression in diminishing the immunity and causing a body disease.O presente artigo mostra através de revisão da literatura pertinente sobre a interação mente-corpo, de como as alterações emocionais como estresse, angústia, depressão, levam a alteração da imunidade com consequente predisposição ao surgimento de doença física

SPf66 vaccine trial in Brazil : conceptual framework study design and analytical approach

O presente artigo descreve a população de estudo e o desenho do ensaio de campo de fase III da vacina sintética SPf66 no Brasil. São avaliados os princípios básicos de validade e precisão, essenciais para a estimação adequada da eficácia vacinal. Os resultados da análise exploratória de dados são discutidos assim como, a abordagem analítica para a estimação da eficácia vacinal. Este trabalho fornece o marco conceitual para futuras publicações. ___________________________________________________________________________________________________________ ABSTRACTThis paper describes the study population and the study design of the phase III field trial of the SPf66 vaccine in Brazil. Assessment of validity and precision principles necessary for the appropriate evaluation of the protective effect of the vaccine are discussed, as well as the results of the preliminary analyses of the gathered data. The analytical approach for the estimation of the protective effect of the vaccine is presented. This paper provides the conceptual framework for future publications

Neuroinfection survey at a neurological ward in a Brazilian tertiary teaching hospital

OBJECTIVES: This study was undertaken to characterize the neuroinfection profile in a tertiary neurological ward. INTRODUCTION: Neuroinfection is a worldwide concern and bacterial meningitis, tetanus and cerebral malaria have been reported as the commonest causes in developing countries. METHODS: From 1999 to 2007, all patients admitted to the Neurology Ward of Hospital das Clínicas, São Paulo University School of Medicine because of neuroinfection had their medical records reviewed. Age, gender, immunological status, neurological syndrome at presentation, infectious agent and clinical outcome were recorded. RESULTS: Three hundred and seventy four cases of neuroinfectious diseases accounted for 4.2% of ward admissions and the identification of infectious agent was successful in 81% of cases. Mean age was 40.5 + 13.4 years, 63.8% were male, 19.7% were immunocompromised patients and meningoencephalitis was the most common clinical presentation despite infectious agent. Viruses and bacteria were equally responsible for 29.4% of neuroinfectious diseases; parasitic, fungal and prion infections accounted for 28%, 9.6% and 3.5% respectively. Human immunodeficiency virus (HIV), herpes simplex virus 1 (HSV1), Mycobacterium tuberculosis, Treponema pallidum, Taenia solium, Schistosoma mansoni, Cryptococcus neoformans and Histoplasma capsulatum were the more common infectious pathogens in the patients. Infection mortality rate was 14.2%, of which 62.3% occurred in immunocompetent patients. CONCLUSION: Our institution appeared to share some results with developed and developing countries. Comparison with literature may be considered as quality control to health assistance

Diagnóstico baseado em PCR para avaliar o desempenho de centros de referência em malária

Although the Giemsa-stained thick blood smear (GTS) remains the gold standard for the diagnosis of malaria, molecular methods are more sensitive and specific to detect parasites and can be used at reference centers to evaluate the performance of microscopy. The description of the Plasmodium falciparum, P. vivax, P. malariae and P. ovale ssrRNA gene sequences allowed the development of a polymerase chain reaction (PCR) that had been used to differentiate the four species. The objective of this study was to determine Plasmodium species through PCR in 190 positive smears from patients in order to verify the quality of diagnosis at SUCEN's Malaria Laboratory. Considering only the 131 positive results in both techniques, GTS detected 4.6% of mixed and 3.1% of P. malariae infections whereas PCR identified 19.1% and 13.8%, respectively.Embora a gota espessa corada por Giemsa (GTS) permaneça o padrão ouro para o diagnóstico de malária, métodos moleculares são mais sensíveis e específicos para detectar parasitas e podem ser utilizados em centros de referência para avaliar o desempenho da microscopia. A descrição das seqüências dos genes ssrRNA de Plasmodium falciparum, P. vivax, P. malariae e P. ovale permitiu o desenvolvimento de uma reação em cadeia da polimerase (PCR) que tem sido utilizada para diferenciar as quatro espécies. O objetivo deste estudo foi determinar as espécies de Plasmodium através de PCR em 190 lâminas positivas de pacientes para verificar a qualidade do diagnóstico realizado no Laboratório de Malária da SUCEN. Considerando somente os 131 resultados positivos em ambas as técnicas, GTS detectou 4,6% de infecções mistas e 3,1% de P. malariae enquanto o PCR identificou 19,1% e 13,8%, respectivamente

Atividade antiparasitária do artemether na esquistossomose mansônica experimental

OBJECTIVE: To evaluate the effect of intramuscular injection of artemether in mice experimentally infected with Schistosoma mansoni , at the time of infection, during schistosomula maturation and after the beginning of egg-laying. METHODS: Eighty adult females Balb/c mice were divided into 8 groups with 10 animals each. Seven groups were infected with S. mansoni using 60 cercariae for each animal, inoculated subcutaneously, and the remaining group was maintained without infection. Among the seven infected groups, six were treated with artemether, according to the following schedule: three groups received doses of 100 mg/kg on days 0, 20 or 60 after inoculation of the cercariae; the other three received 50 mg/kg of artemether, also on days 0, 20 or 60. At the end of the 9th, 10th and 11th weeks after infection all the mice infected with S. mansoni were submitted to fecal examination using the Kato-Katz technique. On the 80th day of the experiment, the surviving animals were sacrificed and submitted to perfusion of the portal system in order to recover the worms. Body, liver and spleen weights of each animal were determined at that time. RESULTS: A reduction in egg-laying and the number of worms recovered was observed in mice treated with artemether (50 or 100 mg/kg) on the 20th day after infection. The decrease in the number of worms was more notable among S. mansoni females. A significant decrease in liver and spleen weights was also seen on the 20th day among animals treated with 50 or 100 mg/kg of artemether and also among those that received the drug at a dose of 50 mg/kg 60 days after infection. CONCLUSIONS: Evidence of the antischistosomal activity of artemether was shown, even at a dose of 50 mg/kg, when the drug was administered during the schistosomula maturation period in the portal system of the vertebrate host.OBJETIVO: Avaliar o efeito da administração intramuscular de artemether a camundongos infectados experimentalmente por Schistosoma mansoni no momento da infecção, durante a maturação dos esquistossômulos e após iniciada a oviposição. MÉTODOS: Oitenta camundongos Balb/c, fêmeas adultas, foram divididos em oito grupos com 10 animais cada. Sete grupos foram infectados por S. mansoni empregando-se 60 cercárias para cada animal, inoculadas por via subcutânea; o grupo restante foi mantido sem infecção. Entre os sete grupos infectados, seis foram tratados com artemether, segundo o seguinte esquema: três grupos receberam dose correspondente a 100 mg/kg no dia 0, 20 ou 60 após inoculação das cercárias; os demais receberam 50 mg/kg de artemether, no mesmo período que os lotes anteriores. Da 9ª, 10ª e 11ª semanas após infecção os camundongos infectados por S. mansoni foram submetidos a exames de fezes pela técnica de Kato-Katz. No 80º dia do experimento, os animais sobreviventes foram sacrificados e submetidos à perfusão do sistema porta para recuperação de vermes. Determinaram-se, nessa ocasião, os pesos corporal, hepático e esplênico de cada animal. RESULTADOS: Observou-se queda na oviposição e no número de vermes recuperados entre os camundongos tratados com artemether (50 ou 100 mg/kg) no 20º dia após infecção. A diminuição do número de vermes foi mais expressiva no caso de fêmeas de S. mansoni. Verificou-se, ainda, diminuição significativa nos pesos hepático e esplênico entre os animais tratados com 50 e 100 mg/kg de artemether no 20º dia e também entre os que receberam a droga na dose de 50 mg/kg 60 dias após infecção. CONCLUSÕES: Ficou evidenciada a atividade anti-Schistosoma do artemether, mesmo ao se empregar dose correspondente a 50 mg/kg, quando a droga foi administrada durante o período de maturação dos esquistossômulos no sistema porta do hospedeiro vertebrado

Investigação epidemiológica de casos de febre amarela na região noroeste do Estado de São Paulo, Brasil

An epidemiological investigation was carried out in the North-west region of the State of S. Paulo of Brazil with the purpose of clarifying three suspected cases of yellow fever that occurred in people resident in the area. In this region the presence of Aedes aegypti had been verified. It was concluded that the patients had contrated yellow fever during a trip to the forested region of the Mato Grosso State, where there are enzootic cycles of the virus. Despite of the presence of Ae. aegypti, no evidence of yellow fever transmission in the local population was detected. MAC ELISA (enzyme-linked immunosorbent assay with capture of IgM antibodies) proved very useful in the rapid diagnosis of suspected cases and in the serological investigation among the relatives, neighbors and schoolmates of the patients, providing additional support for the traditional techniques.Descreve-se investigação epidemiológica conduzida a partir da notificação de três casos suspeitos de febre amarela em moradores da região noroeste do Estado de São Paulo, Brasil, onde se identificou a presença de Aedes aegypti. Concluiu-se que se tratavam de casos de febre amarela silvestre adquirida em área endêmica do Estado vizinho de Mato Grosso. Apesar da presença de focos de Aedes aegypti nos locais de residência dos doentes, não foram encontradas evidências de transmissão do vírus amarílico nesses locais. O teste MAC ELISA mostrou-se de grande utilidade no rápido esclarecimento diagnóstico dos casos suspeitos da moléstia, ao lado das técnicas tradicionais, e no inquérito sorológico conduzido entre familiares, vizinhos e colegas de trabalho dos doentes