RESUMO
Strongyloides stercoralis is an intestinal helminth of systemic distribution, which, once in its host, has the ability to perpetuate itself through an autoinfection cycle, leading to chronic infection. In healthy hosts, the parasite usually does not cause any symptoms, or only mild symptoms that are limited mainly to the small intestine. However, in immunocompromised hosts, uncontrolled multiplication with massive infection may occur, causing hyperinfection syndrome or disseminated strongyloidiasis, which are both associated with high morbidity and mortality. There are few reports of gastric involvement, particularly presenting as ulcer in the stomach. We report a case of gastric ulcer caused by S. stercoralis in HIV-infected patient.
Assuntos
Infecções por HIV/complicações , Gastropatias/diagnóstico , Gastropatias/parasitologia , Estrongiloidíase/diagnóstico , Adulto , Humanos , Masculino , Gastropatias/etiologia , Estrongiloidíase/etiologiaRESUMO
Previous studies on infection of Trypanosoma cruzi in the Poço das Antas Biological Reserve population of wild free-ranging Leontopithecus rosalia have shown the presence of genotype T. cruzi II, associated in Brazil with human disease. Herein, this study has been extended, the infection being evaluated in L. rosalia of 3 different tamarin populations, inhabiting distinct forest areas located in the same Atlantic Coastal Rainforest. Edentata, Marsupialia, Rodentia and Chiroptera were examined exclusively in the Poço das Antas Biological Reserve. Excluding Chiroptera, T. cruzi infection was found in all orders. Biochemical and molecular characterization demonstrated that golden lion tamarins maintained stable infections by T. cruzi II. The isolates from the other mammals corresponded to T. cruzi I, suggesting independent transmission cycles occurring among the sylvatic mammals inside Poço das Antas Biological Reserve. Significant differences in the infection patterns presented by the 3 populations of wild and captive-born golden lion tamarins were noticed. In Poço das Antas a considerably higher number of positive haemocultures from tamarins with positive serological titres was observed in comparison to those obtained from other areas. The implications for conservation and public health of an active sylvatic cycle in the Atlantic Coastal Rainforest of Rio de Janeiro are discussed.
Assuntos
Callitrichinae/parasitologia , Doença de Chagas/veterinária , Doenças dos Macacos/epidemiologia , Trypanosoma cruzi/fisiologia , Animais , Brasil/epidemiologia , Doença de Chagas/epidemiologia , Feminino , Seguimentos , Genótipo , Masculino , Trypanosoma cruzi/genéticaRESUMO
Barrett's esophagus is a metaplastic condition that occurs in patients with gastroesophageal reflux disease (GERD) and its importance lies in its potential to develop adenocarcinoma of the esophagus. The diagnosis of Barrett's esophagus is based on finding of intestinal metaplasia of at least 3 cm of the distal esophagus. The diagnosis of intestinal metaplasia of less than 3 cm of the distal esophagus is controversial, regarding implications with GERD, adenocarcinoma, and Helicobacter pylori. The aims of the study were to determine the prevalence of intestinal metaplasia in the distal esophagus in patients with short segments of esophageal columnar-appearing mucosa (less than 3 cm), diagnosed endoscopically, in two groups of patients, with and without symptoms of GERD. In total, 97 patients were examined, with endoscopic finding of esophageal columnar-appearing mucosa less than 3 cm. From the total, 52 patients had symptoms of GERD and 45 patients were without these symptoms. These patients were subjected to distal esophageal biopsies obtained immediately below the epithelial transition. The biopsies were stained with hematoxylin-eosin and alcian blue at pH 2.5. Urease test for H. pylori detection in two fragments of gastric antrum was carried out. The presence of intestinal metaplasia in the distal esophagus was diagnosed in 16 (30.8%) patients in the GERD group and 12 (26.7%) patients without GERD symptoms. No statistical differences were observed (P = 0.82; 95% CI: 0.61-2.17). The variables sex, mean age and positivity for H. pylori did not show statistical differences. This study diagnosed high prevalence of intestinal metaplasia in the distal esophagus with columnar-appearing mucosa, less than 3 cm, with no statistical differences in the two groups studied with and without GERD symptoms.
Assuntos
Esôfago de Barrett/patologia , Refluxo Gastroesofágico/patologia , Infecções por Helicobacter/patologia , Helicobacter pylori/isolamento & purificação , Mucosa Intestinal/patologia , Adulto , Distribuição por Idade , Idoso , Esôfago de Barrett/epidemiologia , Esôfago de Barrett/microbiologia , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Estudos de Coortes , Esofagoscopia , Feminino , Mucosa Gástrica/patologia , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/microbiologia , Gastroscopia , Infecções por Helicobacter/epidemiologia , Humanos , Masculino , Metaplasia/patologia , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Probabilidade , Prognóstico , Valores de Referência , Medição de Risco , Distribuição por SexoRESUMO
PURPOSE: To demonstrate the frequency of micronucleus in esophageal mucous cells of smokers, consumers of alcoholic beverages and "maté" drinkers. METHODS: Material collected from the midlle esophagus in 250 consecutive patients submitted to upper digestive endoscopy was stained with acridine orange and the cytologist determined the number of micronuclei vizualized per each 500 cells examined. RESULTS: The frequency of micronucleated cells did not vary significantly (p > 0.05) when the following variables were considered: sex, place of residence (rural or urban), type of care (outpatient or inpatient), ingestion of alcohol. For two variables, smoking and "maté" consumption, there were significant differences in the frequency of micronuclei in the categories exposed and formerly exposed in relation to never exposed. CONCLUSION: A higher frequency of micronucleus in the esophageal mucous in smoking and "maté" drinkers was evidenced by this study.
Assuntos
Neoplasias Esofágicas/ultraestrutura , Esôfago/ultraestrutura , Testes para Micronúcleos , Bebidas Alcoólicas/efeitos adversos , Alcoolismo/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa/ultraestrutura , Plantas Tóxicas , Fatores de Risco , Fumar/efeitos adversos , Nicotiana/efeitos adversosRESUMO
Micronúcleos sao fragmentos de DNA nao incorporados ao núcleo na divisao celular e que apresentam relaçao com agentes genotóxicos (mutagênicos ou clastogênicos). Os micronúcleos podem ser detectados nas células esfoliadas dos tecidos. OBJETIVO: Determinar a freqüência de micronúcleos na mucosa esofágica, relacionando com determinados hábitos. PACIENTES E MÉTODOS: Em pacientes submetidos à endoscopia digestiva alta e sem evidências de anormalidades esofágicas, foram colhidos materiais através de escovado do esôfago médio, para pesquisa de micronúcleos. Após à endoscopia, os pacientes foram questionados sobre seus hábitos. RESULTADOS: A freqüência de micronúcleos nao mostrou diferenças significativas (p > 0,05) em relaçao ao sexo, local de residência (rural ou urbana), tipo de atendimento (ambulatorial ou hospitalizado), ingestao de álcool. Nas variáveis fumo e mate houve diferenças significativas entre as categorias expostos e ex-expostos em relaçao à categoria nunca expostos. CONCLUSAO: A freqüência de micronúcleos na mucosa esofágica foi maior nos pacientes fumantes e bebedores de mate
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias Esofágicas/etiologia , Micronúcleos com Defeito Cromossômico , Esôfago/citologia , Plantas/efeitos adversos , Nicotiana/efeitos adversos , Bebidas/efeitos adversos , Fumar , Fatores de Risco , Alcoolismo , Mucosa/citologiaRESUMO
UNLABELLED: "Matè", a popular hot infusion of a herb (Ilex paraguayensis) drunk in large volumes, is a known risk factor for squamous cell carcinoma of the esophagus and there is a suspicion that high temperature of boiled water used for the infusion may contribute for carcinogenesis. METHODS: We measured the temperature of "matè" infusion drunk by a sample of the population at risk for this carcinoma in Taquara, southern Brazil. We interviewed inhabitants for drinking habits and the temperature of the infusion was measured with high precision thermometers. Temperature of the infusion was asked to consumers and their estimate compared to our measurements. We considered 60 degrees C or higher as "hot". RESULTS: In 36 residencies, 107 individuals were drinking "matè". Most individuals drank it daily (97.2%), and the medium daily volume was 1,265 ml (SD +/- 1,132 mL) ranging from 250 to 6,000 mL. The measured temperature was 60 degrees C or higher in 72% of residencies with medium of 63.4 degrees C (51-78 degrees C) and median 64.4 degrees C. CONCLUSION: In this study, "matè" was consumed in large volumes at high temperature and individuals did not estimate correctly the temperature of infusion. High temperatures of "matè" may contribute to carcinogenesis in this population.
Assuntos
Bebidas/efeitos adversos , Carcinoma de Células Escamosas/etiologia , Neoplasias Esofágicas/etiologia , Comportamento Alimentar , Temperatura Alta/efeitos adversos , Adulto , Idoso , Brasil , Feminino , Humanos , Magnoliopsida/efeitos adversos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estatísticas não Paramétricas , Inquéritos e Questionários , Sensação Térmica , População UrbanaRESUMO
Wild golden lion tamarins (Leontopithecus rosalia) - endangered primates that are native to the Brazilian Atlantic coastal forest - were surveyed for the presence of Trypanosoma cruzi with the use of Giemsa-stained blood smears, hemocultures and an indirect immunofluorescence assay (IFAT). Positive IFAT with titers ranging from 1:20 to 1:1280 were observed in 52% of the 118 wild tamarins examined and the parasite was isolated from 38 tamarins. No patent parasitemia was observed among the tamarins from which T. cruzi was isolated. Serum conversion and positive hemoculture was observed for three animals that had yielded negative results some months earlier, which indicates that T. cruzi is actively transmitted among tamarins. In contrast to observations with other sylvatic isolates, those from the tamarins were significantly more virulent and most of them produced mortality in experimentally infected Swiss mice. Some variation in the kDNA restriction profiles among the isolates was observed. Electrophoresis with GPI, G6PDH, IDH, MDH and ME enzymes showed a Z2 profile.
Assuntos
Callitrichinae/parasitologia , Doença de Chagas/veterinária , Doenças dos Macacos/parasitologia , Parasitemia/veterinária , Trypanosoma cruzi , Animais , Brasil/epidemiologia , Cebidae/parasitologia , Doença de Chagas/epidemiologia , Doença de Chagas/transmissão , Técnica Indireta de Fluorescência para Anticorpo , Seguimentos , Transmissão Vertical de Doenças Infecciosas , Camundongos , Doenças dos Macacos/epidemiologia , Doenças dos Macacos/transmissão , Parasitemia/epidemiologia , Parasitemia/transmissão , Trypanosoma cruzi/genética , Trypanosoma cruzi/isolamento & purificação , Trypanosoma cruzi/patogenicidadeRESUMO
UNLABELLED: There is increasing incidence of adenocarcinoma of the esophagus and esophagogastric junction in the USA and Europe, however, data in Brazil are scanty. OBJECTIVE AND METHODS: We reviewed all histology confirmed esophageal and esophagogastric junction cancer reports during a 10-year period (1987-1996) obtained by upper digestive endoscopy biopsies at a cancer referral center in Southern Brazil. Cancer cases were classified in three categories: adenocarcinoma, squamous cell carcinoma, and others. RESULTS: Among 349 cases, adenocarcinoma was found in 53 (15.2%), squamous cell carcinoma in 283 (81.1%) and others in 13 (3.7%). CONCLUSIONS: In this study, the prevalence of adenocarcinoma was 15%.
Assuntos
Adenocarcinoma/epidemiologia , Neoplasias Esofágicas/epidemiologia , Junção Esofagogástrica , Brasil/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Estudos RetrospectivosRESUMO
We collected data from wild and reintroduced golden lion tamarins (Leontopithecus rosalia) to describe the behavior of donor and recipient during food transfers, evaluate the effect of supplemental feeding on food transfer behavior, and examine various hypotheses concerning the function of food transfers in primates. Behavioral observations were conducted on 12 groups of tamarins with young (N = 30) between the ages of 1 week and 1 year old. Results show that food transfers involve various behaviors, from steals by recipients to offers by donors; transfers mostly derive from adults and are directed at immature weaned young (between 3 and 9 months old); and that most items transferred were prey or fruits that require skill to process. Eleven percent of food transfers were preceded by an adult vocalization specific to that context, whereas 86% were preceded by conspicuous infant vocalizations and begging behavior. The most common vocalizations were loud and atonal (rasps) and broad banded frequency modulated (trills). Infants born to reintroduced parents vocalized less, whereas reintroduced adults vocalized more before transferring food than their wild counterparts. Reintroduced adults and young received more food transfers (4.4 per hr) than did wild-born adults and young (2.2 per hr). Our findings suggest that food transfer in golden lion tamarins is best understood as provisioning of young that have not fully developed foraging skills to ensure they get the necessary resources for growth and survival.
Assuntos
Animais Selvagens/psicologia , Comportamento Alimentar , Saguinus/psicologia , Comportamento Social , Envelhecimento , Animais , Brasil , Feminino , Frutas , Comportamento Materno , Modelos Psicológicos , Comportamento Predatório , Vocalização AnimalRESUMO
Diagnosis of squamous cell carcinoma of the esophagus is usually late. Staining of the mucosa with Lugol's solution during endoscopy has been suggested to identify early cancer/dysplasia and may improve prognosis. Lugol was tested during endoscopy in 96 asymptomatic subjects at risk for this tumor, who were found to have atypias after exfoliative cytology in southern Brazil. Biopsies were obtained in Lugol's 'stained' and 'unstained' areas in the esophageal mucosa and the histologic results were compared. 'Unstained' areas were present in 64 (66.7%) instances: 44 'unstained' areas over mucosa with normal appearance revealed seven dysplasias (four high and three low grade), whereas 20 'unstained' areas with visible lesions contained only one dysplasia (low grade). 'Stained' areas in 96 (100%) subjects showed two additional dysplasias (one high and one low grade). In this study, Lugol 'unstained' areas were of great value for detection of dysplasias (sensitivity = 80%; specificity = 63%; p = 0.01, Fisher's exact test; CI = 95%; odds ratio = 6.7).