Maria Suzana de Lemos Souza

Viability of Ascaris lumbricoides eggs eliminated after anti-helminthic therapy

The viability of Ascaris lumbricoides eggs passed in the feces was evaluated after treatment of patients with one of the anti-helminthic drugs (thiabendazole, levamisole, cambendazole, pyrantel pamoate, mebendazole or praziquantel). For each drug, a group of 5 children was selected and their feces collected 24 h before treatment and 24, 48 and 72 h after drug administration, except for mebendazole, with the feces being collected throughout the period of treatment. After sedimentation, the total amount of eggs from each collection was transferred to tissue culture flasks containing 10 ml H2SO4 0,1N, with the addition of 3 drops of a miconazole solution, and incubated at 28 degrees C, individually, for 80 days. The flasks were maintained open and the culture were oxygenated daily by manual agitation. On the 80th day of culture, 20-days-old albino mice were inoculated with 3,200 embryonated eggs, per os. Larvae were recovered from their lungs and hearts, on the 8th day after infection, according to Baermans method (Morais, 1948). Thiabendazole showed 100.0% ovicidal capacity as early as 48 h after treatment. Inhibition of embryonal development was observed when thiabendazole was used. This drug also had an effect on the eggs infectivity when inoculated into normal mice. No significant effect on embryonal development was observed for the other drugs tested.

Viabilidade de ovos de Ascaris lumbricoides após tratamento humano com medicamentos específicos: I - Levamisole e pamoato de pirantel

A total of 15 patients from 4 to 14 years of age were submitted to specific treatment for Ascaris lumbricoides infection. Seven out of these 15 patients received Levamisole (150 mg/ kg of body weight), and eight received Pyrantel Pamoate (10 mg/kg of body weight). Eggs collected directly from the uteri of the female were incubated for 18 days in H2SO4 N/10 solution. These eggs were administered per os to groups of five white mice per patient. Eight days after the infection, the mice were sacrificed to permit microscopic searching of larvae in lung specimens. Only in one out of the 75 examined mice, in the group of patients treated with Levamisole, larvae were not recovered from the lungs. Thus, it is to conclude that the drugs used in the treatment did not demonstrate deleterious effect on the A. lumbricoides eggs. However, the drugs really promote the elimination of infectious eggs. In these circumstances it is possible to believe in the in- creasing of the pollution level in communities without adequate basic sanitation facilities.A total of 15 patients from 4 to 14 years of age were submitted to specific treatment for Ascaris lumbricoides infection. Seven out of these 15 patients received Levamisole (150 mg/ kg of body weight), and eight received Pyrantel Pamoate (10 mg/kg of body weight). Eggs collected directly from the uteri of the female were incubated for 18 days in H2SO4 N/10 solution. These eggs were administered per os to groups of five white mice per patient. Eight days after the infection, the mice were sacrificed to permit microscopic searching of larvae in lung specimens. Only in one out of the 75 examined mice, in the group of patients treated with Levamisole, larvae were not recovered from the lungs. Thus, it is to conclude that the drugs used in the treatment did not demonstrate deleterious effect on the A. lumbricoides eggs. However, the drugs really promote the elimination of infectious eggs. In these circumstances it is possible to believe in the in- creasing of the pollution level in communities without adequate basic sanitation facilities.

Inter-relação entre parasitoses e hipovitaminose A: Infecção por Schistosoma mansoni e o nível sérico de retinol de população de zona endêmica de Minas Gerais (Brasil)

Estudou-se a relacao entre a esquistossomose e o nivel serico de retinol num modelo duplo cego, comparando-se a vitamina A dos grupos infectado e nao-infectado de uma populacao de zona endemica da helmintiase no Estado de Minas Gerais. O grupo infectado era composto por 106 pessoas com carga parasitaria inferior a 500 ovos de S. mansoni por grama de fezes, com formas intestinal e hepatointestinal; o nao-parasitado era constituido por 112 habitantes desta mesma zona endemica que apresentaram exame parasitologico (metodo de Kato modificado) e intradermor-reacao negativos, bem como ausencia de historia de infeccao e tratamento previos para esquistossomose nos seis meses anteriores. A determinacao do retinol foi feita pelo metodo do acido trifluoracetico, considerando aceitavel um nivel > 20,0 μg/100 ml. A analise dos resultados mostrou que, nas condicoes em que foram realizadas esta observacao, as diferencas encontradas nos niveis sericos do retinol entre os grupos estudados indica nao haver correlacao significativa entre a infeccao pelo S. mansoni e o nivel serico da vitamina A.

Avaliação de dados nosológicos em prontuários ambulatoriais

A Medicina Social tem enfrentado inumeras dificuldades na construcao de metodologias que permitam uma correlacao entre o marco teorico desenhado e a realidade sensivel. Nas investigacoes em Saude Coletiva, os dados nosologicos se constituem numa questao da maior importância, pois estes representam as informacoes basicas sobre as quais se construirao os estudos epidemiologicos, o planejamento e a organizacao dos servicos de saude. O estudo se propoe a analisar: (a) os alcances e limites da qualidade dos dados nosologicos contidos em prontuarios de pacientes ambulatoriais; (b) os sistemas classificatorios de doenca utilizados na organizacao destes dados. Foram selecionados, por amostra aleatoria, 340 prontuarios de pacientes de ambulatorio do Hospital das Clinicas da Universidade Federal de Minas Gerais, registrados no periodo de 01/07/87 a 30/06/88. Analisou-se a presenca da hipotese diagnostica (HD) na folha de anamnese e exame fisico, a legibilidade e a apresentacao deste dado. A descricao das HDs encontradas foram agrupadas segundo o padrao da Classificacao Internacional das Doencas (CID - 9). As HDs que nao se enquadravam na CID foram, tambem, analisadas. O estudo concluiu que: (a) os dados nosologicos registrados seguem a logica da CID. Esta tem um padrao no qual enquadra-se o raciocinio clinico, refletindo a concepcao hegemonica da medicina cientifica. Apesar de buscar em suas continuas revisoes um maior grau de especificidade, a CID incorporou mecanismos que refletem suas limitacoes: a existencia da categoria de Sinais, Sintomas e Estados Maldefinidos e a presenca, em todas as categorias, de um digito que expressa a nao-especificidade. No estudo realizado, em 83% dos prontuarios, as HDs eram codificaveis pela CID, apesar de seu uso nao estar normatizado; 6% das HDs encontravam-se na categoria de Sinais, Sintomas e Estados Morbidos Maldefinidos e 38% nao possuiam o grau de especificidade pretendido pela CID; (b) a analise das HDs nao-classificaveis evidenciou que a CID nao incorpora a caracterizacao de aspectos normais, tipicos da Pediatria; as conclusoes nosologicas analiticas, presentes na Psiquiatria, e a dimensao da doenca; (c) nenhum dos sistemas classificatorios alternativos analisados responde aos limites da CID.

Estudo imunológico da esquistossomose mansoni intestinal antes e após tratamento com aminonitrotiazol

The amount of immunoglobulins serum and the cutaneous sensitivity to specific antigen in 19 patients with intestinal schistosomiasis were determined, as an attempt to study the incidence of delayed and imediate type of hypersensitivity. The tests were performed before and thirty, sixty and ninety days after treatment with aminonitrotiazol. The immunoglobulin levels before treatment were found to be 1,893 ± 472, 186 ± 74 and 91 ± 26 mg%, respectively for IgG, IgA and IgM; ninety days after treatment the level for IgG became normal (1,266 ± 389 mg%) and a slight increase of IgA (270 ± 89 mg%) and IgM (111 ± 31 mg%) was observed. The patients were intradermally tested with schistosomin and with anti IgE serum. The tests before treatment gave the following resulta: 1.22 ± 0.36 cm2 for schistosomin and 1.04 ± 0.25 cm2 for anti IgE. Ninety days afterwards a slight increase of the reactions was observed and the results respectively were 1.42 ± 0.65 cm2 and 1.15 ± 0.32 cm2. The studies for delayed hypersenstivity indicated that 35% of patients showed an area of induration larger than 0.5 cm2, 48 hours after the intradermal injection with schistosomin, and 71% developed positive reaction when challenged with dinitrofluorobenzene