L. Camillo-Coura

Histopathological criteria for the diagnosis of abdominal angiostrongyliasis.

An increasing number of cases of abdominal angiostrongyliasis have recently been diagnosed in southern Brazil. A comparative study of 19 confirmed cases and 15 suspected cases was undertaken to review the anatomo-pathology of the disease and to establish histopathological criteria for its diagnosis. The results were similar in both groups, except for the identification of the worm in the confirmed cases. Macroscopic features comprised two types: a predominant thickening of the intestinal wall (pseudo-neoplasic pattern) and a congestive necrotic lesion (ischemic-congestive pattern). Microscopically, three fundamental histopathological findings were detected: (1) a massive infiltration of eosinophils in al layers of the intestinal wall, (2) a granulomatous reaction and (3) eosinophilic vasculitis affecting arteries, veins, lymphatics and capillaries. We conclude that observation of this histopathological triplet excludes other causes of “eosinophilic gastroentertis” and establishes the diagnosis of probable abdominal angiostrongyliasis.

Phillocaulis variegatus: an intermediate host of Angiostrongylus costaricensis in south Brazil

Molluscs collected in five localities in the State of Rio Grande do Sul (Brazil) were digested and examined. The infected slugs were identified as Phyllocaulis variegatus and the larvae found were inoculated per os into mice. After 50 days, worms with the caracteristics of Angiostrongylus costaricensis were recovered from the mesenteric arterial system. The results establish the role of P. variegatus as intermediate host of A. costaricensis in south Brazil, where many cases of abdominal angiostrongyliasis have been diagnosed.

Clinical and epidemiological aspects of abdominal angiostrongyliasis in Southern Brazil

Most of the cases of abdominal angiostrongyliasis in Brazil were reported from the southern States of São Paulo, Paraná, Santa Catarina and Rio Grande do Sul (RS). A study in 27 cases from RS revealed a distinct local epidemiology. Peasants were usually affected, either adults or children, from the mountainous areas in the north of the State. There was a seasonal increase in the number of cases, from late spring to autumn, that does not coincide with the rainy season. Besides the most common clinical features of abdominal pain, fever and eosinophilia in the leukogram, painful relapsing episodes were detected in some patients. The abdominal pain could be either localized or diffuse during the rapid evolution to a surgical abdominal condition, with a lethality of 7.4%. The use of a serological test and the greater awareness of physicians working in endemic areas is expected to improve the recognition of uncomplicated and benign courses of the disease. This study confirms the known clinical manifestations of abdominal angiostrongyliasis and demonstrates the diversity of its epidemiology.

Identificação de roedores silvestres como hospedeiros do Angiostrongylus costaricensis no sul do Brasil

Os autores sao gratos ao apoio da comunidade de Arvorezinha, em especial ao Dr. Carlos Moi, Dr. Pedro Marafon, Dr. Ernesto Doege, irmas e funcionarios (Hospital Beneficente Sao Joao), ex-prefeito Darcy Pompermayer e prefeito Sr. Leonir Fornari. Dra. Carmen Tagliari, Prof. Aventino Agostini e a Universidade de Passo Fundo (RS) contribuiram decisivamente para o exito das expedicoes. A equipe de auxilio ao usuario do IBGE, Rio de Janeiro colaborou com os dados referenciais a localizacao geografica.

Sobre a presença de ovos de Toxocara em praças da cidade do Rio de Janeiro

The authors present a study on the prevalence of Toxocara eggs in the soil of 24 city parks in Rio de Janeiro; 10 of them were contaminanted by Toxocara eggs. Attention is called to the possibility of human cases of infection, namely visceral larva migrans although no cases have been reported up to the present.

Avaliação das condições de estocagem da vacina contra o sarampo nas unidades sanitárias dos municípios de Niterói e São Gonçalo, estado do Rio de Janeiro

Twenty two Public Health Units were visited and evaluated as to standards of storage recommended by the Brazilian Immunization Programme. In 86.4% of the units, refrigerators were adequately or regularly maintained. However, when items such as proper inside location of the vaccines in the refrigerator or the control of temperature were checked, only 60% and 54.5% respectively presented adequate storage conditions. In 90% of the Units health workers complained of lack of immediate technical support in emergency situations. In 100% of the vaccine samples tilers were well under the minimal recommended potency. Inadequacy and lack of uniformity, at regional and local levels, concerning conditions of vaccine storage as well as insufficient training of health personnel must have contributed to the above results.

Ocorrência da doença meningocócica em japoneses e descendentes no município de Londrina, Paraná, Brasil (1965-1975)

In the case of Japanese and their descendants living in the municipality of Londrina, State of Parana, the morbidity of meningococcic disease was about seven times lower than for the rest of the population, the death rate having been nil during both endemic and epidemic phases. A review of medical and hospital records, covering registered cases, showed no diagnoses of meningococcic disease in 75% of patients of Japanese origin or in 20% of samplings of non-Japanese patients. The possible relationship of socioeconomic and cultural (nutritional) factors, as regards above observations is discussed.

Influence of Compound 16.842 on hookworm infections

Compound 16.842 was tried with three different groups of patients in order to evaluate its tolerancy, and efficacy as well, with a view of using the drug in mass campaigns against hookworm. Group I, used for a preliminary trial, consisted of 38 patients attending an out-patient clinic, and living either in the out-skirts or in the various urban areas of the city of Rio de Janeiro, including some inmates of an orphanage. Group II, a field trial, was carried out in two farms, where the drug was administered both to the positive cases (124) and to the rest of the population (nearly 90%). Group III, a field trial was also carried out in a small town where nearly 40% of the total population was treated with the Compound. Tolerability was considered rather satisfactory, mainly among the patients receiving two single doses (50-150mg), according to the age, 4 - 6 weeks apart). These results suggest that 2-4 courses of therapy within a shorter span of time should be the ideal for a mass treatment campaign. Efficacy varied from 26.6% to 76.2% parasitological cure in the various groups, with a wide range of variation also in the percent of mean reduction of eggs for hookworm. The drug showed also some effect against Ascaris lumbricoides giving cure rates between 10,5% and 35.7% in the various groups, with a percentage reduction in mean egg counts of 27% to 83.3% according to the various groups. It was concluded that Compound 16.842 possesses a marked effect on hookworm and a mild effect on A. lumbricoides. The findings indicate the need for more accurate studies to determine the most efficient schedules of treatment and the real value of the drug, as compared to other antihelminthics against the two parasites under study.

Testagem do 1 - beta - D - Ribofuranosil, 1.2.4 - triazole - 3 - carboxamide em pacientes com hepatite

A double-blind study was perfomed in 18 patients with infectious hepatitis; the experimental group was given 1 β-ribofuranosyl-1,2,4- triazole-3- carboxamide, a broad spectrum antiviral drug; the placebo group was given lactose. Patients were carefully selected, in order to fullfill the established criteria and were followed-up with clinical and labotorial examinations once a week. Results did not present significative differences; the authors suggest that a greater number of patients must be observed, specially considering in - patients, to evaluate the real efficacy and toxicity of the drug.