Tissue alterations in the pirarucu, Arapaima gigas, infected by Goezia spinulosa (Nematoda).

Five specimens of Arapaima gigas caught in the Araguaia River (State of Mato Grosso, Brazil) were investigated for helminths in 2004. Numerous adult specimens of the rhapidascarid nematode Goezia spinulosa were found in stomach ulcers in all the specimens of A. gigas and were surrounded by thickening of the mucosa.

Treatment of refractory feline sporotrichosis with a combination of intralesional amphotericin B and oral itraconazole.

OBJECTIVE To describe the use of intralesional amphotericin B in localised lesions for the treatment of 26 cats from Rio de Janeiro, Brazil, with sporotrichosis refractory to oral itraconazole. DESIGN Uncontrolled intervention study. METHOD The 26 cats in this study were diagnosed with sporotrichosis, confirmed by isolation of Sporothrix schenckii, and presented residual localised skin lesions refractory to treatment with oral itraconazole for a minimum period of 8 weeks.

Correlation of antifungal susceptibility and molecular type within the Cryptococcus neoformans/C. gattii species complex.

Members of the Cryptococcus neoformans/C. gattii species complex are grouped into eight molecular types, differing in their epidemiology, disease severity and geographic range. Recent in vitro antifungal susceptibility studies of isolates of the complex revealed contradictory results.

Endemic tegumentary leishmaniasis in Brazil: correlation between level of endemicity and number of cases of mucosal disease.

The purpose of this study was to establish a correlation between the endemic level of tegumentary leishmaniasis in different regions of Brazil during 2002-2009 and the number of cases of mucosal or mucocutaneous leishmaniasis. The proportion of mucosal leishmaniasis was inversely correlated with prevalence of infection. In areas with a lower infection prevalence, the proportion of mucosal leishmaniasis increased (P < 0.

Treatment of cutaneous sporotrichosis with itraconazole--study of 645 patients.

Background: Itraconazole has become the first choice for treatment of cutaneous sporotrichosis. However, this recommendation is based on case reports and small series. The safety and efficacy of itraconazole were evaluated in 645 patients who received a diagnosis on the basis of isolation of Sporothrix schenckii in Rio de Janeiro, Brazil.

Interobserver agreement on signs and symptoms of patients with acute febrile illness.

Purpose: To assess the interobserver agreement on clinical history and physical examination when using a semi-structured questionnaire to evaluate patients with an acute febrile illness (AFI).

Methods: A cross-sectional study was conducted with outpatients aged 12 years and over, presenting with an AFI defined as fever up to 7 days and no evident focus of infection. Clinical data were collected independently by two physicians using a semi-structured questionnaire.

Systematic review of the effectiveness and safety of assisted reproduction techniques in couples serodiscordant for human immunodeficiency virus where the man is positive.

Objective: To evaluate the effectiveness and safety of assisted reproduction techniques (ART) in human immunodeficiency virus (HIV) serodiscordant couples.

Design: Systematic review of five databases of noncomparative open intervention and observational studies of serodiscordant couples undergoing ART, with study selection and data extraction performed independently and in duplicate.

Setting: Tertiary fertility centers.

Risk factors associated with dizziness during treatment of mucosal leishmaniasis with meglumine antimoniate: 16-year retrospective study of cases from Rio de Janeiro, Brazil.

Objective: To evaluate dizziness in patients receiving meglumine antimoniate for the treatment of mucosal leishmaniasis.

Materials And Methods: We retrospectively studied 127 patients treated at the Laboratory of Leishmaniasis Surveillance, Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil, between 1 January 1989 and 31 December 2004.

Results: A low dose of meglumine antimoniate (5 mg/kg/day) was used in 86.

Sporothrix schenckii meningitis in AIDS during immune reconstitution syndrome.

Sporotrichosis is a fungal disease usually restricted to the cutaneous and lymphatic systems. Visceral involvement is unusual. To date, only 21 cases of sporotrichosis meningitis have been reported, some of these associated with immunosuppression.

Visceral leishmaniasis in Rio de Janeiro, Brazil: eco-epidemiological aspects and control.

From 1977 (index case) to 2006, 87 cases of visceral leishmaniasis were confirmed in the municipality of Rio de Janeiro, Brazil, in periurban areas on the continental and coastal slopes of the Pedra Branca massif and the continental slopes of the Gericinó massif. The majority (65.5%) of the patients were more than five years old, predominantly males (61.

Dimensional structure of the demand control support questionnaire: a Brazilian context.

Unlabelled: According to Karasek, job strain results from an interaction between high demands and low decision latitude.

Purpose: To reassess the dimensional structure and evaluate the internal consistency of demand control support questionnaire (DCSQ), a shortened version of job content questionnaire that was not sufficiently evaluated in validation studies.

Methods: The study investigated 825 workers who completed the DCSQ in Rio de Janeiro, Brazil; to 399 workers, the questionnaire was self-administered at a hospital (2004-2005), and 426 workers were interviewed at nine restaurants (2006-2007).

Intralesional amphotericin B in a cat with refractory localised sporotrichosis.

The present report concerns a case of sporotrichosis in a 3-year-old male crossbred cat. After 9 months of oral itraconazole (20mg/kg) therapy, all skin lesions had resolved with the exception of a single nodular lesion located on the bridge of the nose. Therefore, a combined therapy that included intralesional (IL) amphotericin B (1mg/kg) was started.

HTLV-1 and neurological conditions: when to suspect and when to order a diagnostic test for HTLV-1 infection?

HTLV-1 is a retrovirus associated with a myriad of clinical conditions, especially hematological and neurological ones. Regarding nervous system diseases, it is of utmost importance to select those cases in which HTLV-1 infection could really be associated. This is particularly true for patients from endemic areas and for HIV-infected patients and drug users, since that these groups are at a higher risk for HTLV infection.

Atypical cerebrospinal fluid profile in tuberculous meningitis.

The aim of this study was to describe atypical cerebrospinal fluid (CSF) alterations in tuberculous meningitis (TBM) and to analyse the differences in outcome between patients with typical and atypical profiles. We did a retrospective study during the period of 2000 to 2005 including the cases of TBM assisted in a referral centre for infectious diseases in Rio de Janeiro State, Brazil. Neutrophilic plecytosis at the first spinal tap was found in 32.

Postnatal acquired toxoplasmosis patients in an infectious diseases reference center.

Infection caused by Toxoplasma gondii, toxoplasmosis, is one of the most frequent zoonoses in the world; it normally affects both genders equally. Humans are one of several possible intermediate hosts, and the disease is oligosymptomatic in most cases. Vertical transmission is an important cause of fetal malformation and sequels in newborns.

Accuracy of an ELISA and indirect immunofluorescence for the laboratory diagnosis of American tegumentary leishmaniasis.

We compared the accuracy of ELISA and indirect immunofluorescence (IIF) using Leishmania braziliensis and L. major-like antigens and antigens from the Bio-Manguinhos kit for serological diagnosis of American tegumentary leishmaniasis (ATL). Cut-off values were defined by the area under the receiver-operating characteristic curve.

Clinical and laboratory signs as dengue markers during an outbreak in Rio de Janeiro.

Background: One of the main challenges for clinical research in dengue is the low validity of clinical diagnosis.

Objective: To analyze clinical and laboratory data as predicitve factors of dengue diagnosis at Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, during the 2001-2002 dengue outbreak in Rio de Janeiro.

Methods: Cross sectional study comparing clinical laboratory data collected from the National Information System for Compulsory Notification Diseases (SINAN) in two serologically confirmed groups: dengue D (N = 453) and non-dengue ND (N = 80).

Cat scratch disease complicated with aseptic meningitis and neuroretinitis.

Cat scratch disease (CSD) is a self limited condition characterized by fever, lymph node enlargement and less often eye involvement. Central nervous system involvement by Bartonella henselae infection is possibly an important cause of morbidity; its role as an agent of aseptic meningitis is unknown. We report a case of a 40 years-old man with CSD accompanied by aseptic meningitis and neuroretinitis.

Endemic of zoonotic sporotrichosis: profile of cases in children.

Background: Sporotrichosis in childhood is rare in most countries. Isolated cases and small outbreaks related to recreational activities or without identification of the transmission mechanism have been reported.

Methods: Series of case reports.

Safety and efficacy of the HIV-1 integrase inhibitor raltegravir (MK-0518) in treatment-experienced patients with multidrug-resistant virus: a phase II randomised controlled trial.

Background: Raltegravir (MK-0518) is an HIV-1 integrase inhibitor with potent in-vitro activity against HIV-1 strains including those resistant to currently available antiretroviral drugs. The aim of this study was to assess the safety and efficacy of raltegravir when added to optimised background regimens in HIV-infected patients.

Methods: HIV-infected patients with HIV-1 RNA viral load over 5000 copies per mL, CD4 cell counts over 50 cells per muL, and documented genotypic and phenotypic resistance to at least one nucleoside reverse transcriptase inhibitor, one non-nucleoside reverse transcriptase inhibitor, and one protease inhibitor were randomly assigned to receive raltegravir (200 mg, 400 mg, or 600 mg) or placebo orally twice daily in this multicentre, triple-blind, dose-ranging, randomised study.

Safety, efficacy and pharmacokinetics of ritonavir 400mg/saquinavir 400mg twice daily plus rifampicin combined therapy in HIV patients with tuberculosis.

Objective: To assess the drug concentrations, efficacy and safety of concomitant use of rifampicin and regimens containing ritonavir/saquinavir (400mg/400mg twice daily) in tuberculosis-HIV treatment-naive patients.

Design And Methods: This was an open-label, non-randomised, multiple-dose study. On study day (D)1, tuberculosis treatment (rifampicin 600mg/isoniazid 400mg per day fasting plus pyrazinamide 2 g/day) was introduced in 30 patients.

Prevalence of psychoactive drug use among medical students in Rio de Janeiro.

Background: Drug use and abuse may hamper learning capabilities and the development of technical skills in medical students and, therefore, the quality of care offered to patients. The aim of this investigation was to estimate the prevalence of psychoactive drug use among medical students of public universities in Rio de Janeiro, Brazil, and to identify characteristics associated with substance use.

Method: This was a cross-sectional investigation designed to include all medical students of four universities.

In situ detection of SOCS and cytokine expression in the uterine cervix from HIV/HPV coinfected women.

The purpose of this study was to look for associations between a newly described class of suppressors of cytokine signaling (SSI/SOCS) and cytokine expression in the uterine cervix from HIV/HPV coinfected women. We examined the pro-inflammatory cytokines TNF-alpha and IL-6 since their expressions are linked and responsible for many aspects of both localized and systemic inflammatory responses. Further, expression of SSI/SOCS has been implicated in the negative feedback regulation of cytokine receptor signaling.

Assessing sexually transmitted infections in a cohort of women living with HIV/AIDS, in Rio de Janeiro, Brazil.

A cohort of 458 HIV-positive women under antiretroviral therapy has been followed at a reference hospital in Rio de Janeiro, Brazil. Most of them belong to impoverished social strata. Patients were screened for sexually transmitted infections (STIs) and gynaecologic conditions.