Prognostic factors associated with death from visceral leishmaniasis: a case-control study in Brazil.

Background: The aim of this study was to identify the prognostic factors associated with death from visceral leishmaniasis (VL) considering the clinical evolution of patients through a case-control study.

Methods: We randomly selected 180 cases (death caused by VL) and 180 controls (cured) from Belo Horizonte's hospitals in Brazil, according to data found in the patients' medical records. Five models of multivariate logistic regression were performed following the chronological order of the variables between the onset of the symptoms and evolution of the VL cases.

Anemia and functional capacity in elderly Brazilian hospitalized patients.

This study evaluated the association between anemia and physical functional capacity in a cross-sectional population-based sample of 709 hospitalized elderly patients aged 60 years and over admitted to the Madre Teresa Hospital, Belo Horizonte, State of Minas Gerais, Brazil. The Mann-Whitney or "t" test, and chi-square or Fisher exact test were used for quantitative and categorical variables, respectively, and hierarchical binary logistic regression was used to identify significant predictors. The presence of anemia was found in 30% of participants and was significantly associated with decreased functionality according to the two measures which were used - ADL (activities of daily living) and IADL (instrumental activities of daily living).

Ultrasound and magnetic resonance imaging findings in Schistosomiasis mansoni: expanded gallbladder fossa and fatty hilum signs.

Introduction: There is no study relating magnetic resonance imaging (MRI) to ultrasound (US) findings in patients with Schistosomiasis mansoni. Our aim was to describe MRI findings inpatients with schistosomal liver disease identified by US.

Methods: Fifty-four patients (mean age 41.

Longitudinal anthropometric assessment of infants born to HIV-1-infected mothers, Belo Horizonte, Southeastern Brazil.

Objective: To evaluate the growth parameters in infants who were born to HIV-1-infected mothers.

Methods: The study was a longitudinal evaluation of the z-scores for the weight-for-age (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) data collected from a cohort. A total of 97 non-infected and 33 HIV-infected infants born to HIV-1-infected mothers in Belo Horizonte, Southeastern Brazil, between 1995 and 2003 was studied.

Early right cardiac dysfunction in patients with schistosomiasis mansoni.

Background: Pulmonary hypertension (PH) is a complication of schistosomiasis mansoni (SM), mainly in the hepatosplenic form. However, its prevalence is not well established. We evaluated the usefulness of Doppler echocardiographic indexes to detect right heart dysfunction in SM.

Prognosis for patients diagnosed with pregnancy-associated breast cancer: a paired case-control study.

Context And Objective: Previous studies have suggested that the occurrence of pregnancy concomitantly with a diagnosis of breast cancer may affect the evolution of the neoplasia. The present study aimed to compare pregnancy-associated breast cancer (PABC) patients with non-pregnant cancer patients (controls) in relation to the time taken to diagnose the disease, tumor characteristics and mortality.

Design And Setting: A retrospective, paired case-control study was conducted at the Hospital da Santa Casa de Misericórdia and Centro de Quimioterapia Antiblástica e Imunoterapia in Belo Horizonte, Brazil.

Schistosoma mansoni: magnetic resonance analysis of liver fibrosis according to WHO patterns for ultrasound assessment of schistosomiasis-related morbidity.

For the last two decades, ultrasound (US) has been considered a surrogate for the gold standard in the evaluation of liver fibrosis in schistosomiasis. The use of magnetic resonance imaging (MRI) is not yet standardised for diagnosing and grading liver schistosomal fibrosis. The aim of this paper was to analyse MRI using an adaptation of World Health Organization (WHO) patterns for US assessment of schistosomiasis-related morbidity.

Correlation between ELISA and ML Flow assays applied to 60 Brazilian patients affected by leprosy.

Serological tests can be helpful in classifying leprosy patients as having either the paucibacillary or the multibacillary form. The aim of this study was to evaluate the concordance between two serological assays, i.e.

Efficacy of killed whole-parasite vaccines in the prevention of leishmaniasis: a meta-analysis.

Despite decades of investigation in countries on three continents, an efficacious vaccine against Leishmania infections has not been developed. Although some indication of protection was observed in some of the controlled trials conducted with "first-generation" whole, inactivated Leishmania parasite vaccines, convincing evidence of protection was lacking. After reviewing all previously published or unpublished randomized, controlled field efficacy clinical trials of prophylactic candidate vaccines, a meta-analysis of qualified trials was conducted to evaluate whether there was some evidence of protection revealed by considering the results of all trials together.

First generation leishmaniasis vaccines: a review of field efficacy trials.

First generation candidate vaccines against leishmaniasis, prepared using inactivated whole parasites as their main ingredient, were considered as promising because of their relative ease of production and low cost. These vaccines have been the subject of many investigations over several decades and are the only leishmaniasis vaccine candidates which have undergone phase 3 clinical trial evaluation. Although the studies demonstrated the safety of the vaccines and several studies showed reasonable immunogenicity and some indication of protection, an efficacious prophylactic vaccine is yet to be identified.

Longitudinal growth of infants born to HIV-1-infected mothers in Belo Horizonte, Brazil.

Objective: To prospectively evaluate growth parameters assessed by weight and length in infected and uninfected infants born to HIV-1-infected mothers and followed from birth to 18 months.

Methods: A cohort consisting of ninety-seven uninfected and forty-two infected infants born to HIV-infected mothers enrolled from 1995 to 2004, and admitted during their first 3 months of life at a referral Pediatric AIDS Clinic in Belo Horizonte, Brazil. Infants were followed until 18 months of age.

Seroprevalence of ML Flow test in leprosy contacts from State of Minas Gerais, Brazil.

Leprosy is a public health problem in Brazil. Epidemiological control actions are based on the diagnosis and treatment of leprosy patients and household contact surveillance. Serological tests for leprosy could identify from among the contacts those at greater risk of developing leprosy in the future.

Impaired warm and cold perception thresholds in leprosy skin lesions.

The aim of the present study was to determine the frequency of alteration in warm perception thresholds (WPT), cold perception thresholds (CPT) and the warm and cold perception interval (WCPI) in leprosy-suspected skin lesions, and to determine if these tests could assist in the diagnosis of leprosy. Tests were conducted using a thermal sensory analyser TSA-2001 (Medoc Ltd, Israel) and the method of levels. A cross-sectional study of 112 patients presenting leprosy-suspected skin lesions ('patch'), with no clinical evidence of peripheral nerve damage, was conducted.

Comparative study of the cutaneous sensation of leprosy-suspected lesions using Semmes-Weinstein monofilaments and quantitative thermal testing.

The objective of the present study was to compare the warm cold perception thresholds (WPT), cold perception thresholds (CPT) and the warm and cold perception interval (WCPI) determined in our previous study with the touch-pressure thresholds, in leprosy-suspected skin lesions ('patch'). Thermal testing was conducted using a thermal sensory analyser TSA-2001 (Medoc Ltd., Israel) and the method of levels.

Disagreement between ultrasound and magnetic resonance imaging in the identification of schistosomal periportal fibrosis.

Abdominal ultrasound (US) has been widely used in the evaluation of patients with schistosomiasis mansoni. It represents an important indirect method of diagnosis and classification of the disease, and it has also been used as a tool in the evaluation of therapeutic response and regression of fibrosis. We describe the case of a man in whom US showed solid evidence of schistosomal periportal fibrosis and magnetic resonance imaging revealed that periportal signal alteration corresponded to adipose tissue which entered the liver together with the portal vein.

Diagnosing human asymptomatic visceral leishmaniasis in an urban area of the State of Minas Gerais, using serological and molecular biology techniques.

A population-based cross-sectional study was set up in Sabará country, Southeastern Brazil, to identify asymptomatic human visceral leishmaniasis in an urban area of low disease prevalence. Blood was collected on filter paper (n=1,604 inhabitants) and examined by indirect immunofluorescent test, enzyme-linked immunosorbent assay and immunochromatographic strip test. The prevalence rates of infection ranged from 2.

Risk factors for Leishmania chagasi infection in an urban area of Minas Gerais State.

In order to understand the determinants of human infection by Leishmania chagasi in an urban area, a cross-sectional population based study was conducted using molecular and serologic methods to identify infection. Participants were interviewed using a pre-coded questionnaire. Two criteria were tested to identify risk factors: Model 1--including all participants positive in hybridization by Leishmania donovani complex probe; Model 2--including all participants positive for hybridization and at least one serologic test.

Ultrasound and clinical investigation of hepatosplenic schistosomiasis: evaluation of splenomegaly and liver fibrosis four years after mass chemotherapy with oxamniquine.

The course of hepatosplenic schistosomiasis after mass chemotherapy with oxamniquine has been rarely reported. We report the effect of treatment in patients with advanced schistosomiasis mansoni living in area of Brazil highly endemic for this disease. A total of 739 inhabitants of a village were subjected to clinical and abdominal ultrasound examinations and were treated with oxamniquine.

Setting priorities for environmental sanitation interventions based on epidemiological criteria: a Brazilian study.

The present study addresses the use of analytical epidemiologic approaches to subsidize the establishment of priorities in environmental sanitation interventions. An epidemiological investigation was carried out in 1993 in the urban area of Betim, a southeast Brazilian City of 160,000 inhabitants. The case-control 'inclusive' (or case-cohort) design, with a sample of 997 cases and 999 controls, was employed.

Lessons from a national survey of Chagas disease transmission risk in Colombia.

In recent years, there has been a revitalization of large-scale programmes to control parasitic disease in developing countries. In 1997, the Governments of Colombia, Venezuela, Ecuador and Peru committed themselves to replicate the cost-effective elimination of Trypanosoma cruzi transmission achieved in the Southern Cone by using insecticides against the domestic triatomine vectors (in combination with blood-bank screening). Central American Governments launched a complementary initiative.

Failure of a killed Leishmania amazonensis vaccine against American cutaneous leishmaniasis in Colombia.

We report the results of a double-blind, randomized, placebo-controlled clinical trial of a killed whole-cell Leishmania amazonensis candidate vaccine against American cutaneous leishmaniasis (CL) in Colombia. The trial subjects were 2597 healthy volunteers with negative leishmanin skin test (LST) selected from rural Colombian soldiers who were going to patrol endemic areas. They were randomized to receive either three doses of vaccine (n=1295) or placebo (n=1302) given at 20-day intervals.

Alteration in the endogenous intestinal flora of Swiss Webster mice by experimental Angiostrongylus costaricensis infection.

The association between worm infections and bacterial diseases has only recently been emphasized. This study examined the effect of experimental Angiostrongylus costaricensis infection on endogenous intestinal flora of Swiss Webster mice. Eight mice aging six weeks were selected for this experiment.