Search

A total of 114 of 195 patients with Crohn's disease had perianal involvement. The average age at the beginning of symptomatology was 30.3 years. The interval between symptoms and diagnosis was 3.1 years. PAC was associated with colonic disease and in these patients, was multiple. PAC preceded intestinal disease in 11 percent, was coincident in 66 percent and appeared later in 23 percent. Sixty one patients (53.5%) were operated on 104 times (1.7 operations per patient). None of these patients developed faecal incontinence. Two patients were treated with hyperbaric oxygenation. The association of perianal disease and extra-intestinal manifestation occurred in 76 patients. There was no association in 38 patients. Forty patients had extra-intestinal manifestation without perianal disease. Twenty two patients had panproctocolectomy because of perianal disease. Twenty one had a stoma, with or without intestinal resection. The stoma improved perianal symptoms, but all remain defunctioned. After mean follow-up of 8.8 years, 45 patients present some kind of perianal complication.the surgical treatment of perianal disease well indicated and performed don't result in incontinence; PAC combined with colonic or rectal disease is associated with higher need of performing a proctocolectomy or a defunctioning stoma. Only 22.8 percent presented resolution of perianal disease maintaining anal sphincter function.

Fifty patients with epilepsy seen in three Londrina Neurological Services, in Paraná, were studied. The positivity prevalence of the enzyme-linked immunosorbent assay (ELISA) for cysticercosis in the cerebrospinal fluid (CSF) and in the serum of these patients was 34.0% and 20.0%, respectively. There was statistically significant difference when these two rates were compared with the reaction positivity in the CSF and the serum in the control group, formed by individuals without neurological diseases. There was no association between the type of seizure (generalized or partial) and the positivity index of ELISA for cysticercosis in the CSF. A greater number of patients with positive ELISA for cysticercosis in the rural area dwellers was found, in relation with the urban area dwellers. From the obtained results in our study we came to the following conclusions: 1. The high positivity ELISA rates for cysticercosis in the CSF and in the patients serum with epilepsy indicate that neurocysticercosis is an important seizure cause in Londrina, PR. 2. The positivity prevalence of ELISA for cysticercosis in CSF was greater in epileptic patients from the rural area than the ones from the urban area. 3. There was no association between the type seizure (generalized or partial) and the ELISA cysticercosis positivity rate in the CSF. 4. The high positivity prevalence of ELISA in the CSF and in the epileptic patients serum in Londrina indicates the priority of performing epidemiologic inquiry to establish the real cysticercosis prevalence in the city. ELISA may be used with this finality due to its high sensibility, its low cost and its simple performance.

We evaluated, comparatively, the performance of female and male Triatoma infestans in the 5th instar of development, in xenodiagnosis for Chagas' disease. Xenodiagnosis were done in 40 patients with chronic infectans. For each diagnosis 20 nymphs female and 20 nymphs males were used, which were weighed immediately before and after the meal. Intestinal contents were examined about 20, 30, 60 and 90 days after the xenodiagnosis application. The females and males ingested the mean of 230 and 210 mg of blood, respectively. The results revealed positivity of 15 (37.5%) out of 40 xenodiagnosis, but any of the positive tests show 100% of the nymphs, female and/or male infected by T. cruzi. The females ingested significantly more blood than the males; this is coincidental with the higher female positivation to T. cruzi here observed. Our results suggest that the female nymphs seem able to increase the sensibility of the xenodiagnosis for chronic patients with Chagas' disease being necessary further studies are necessary to confirm this hypothesis.

In order to simplify breeding of triatominae in the laboratory, for performing xenodiagnosis and other biologic studies, we tried to feed the insects "in vitro" with citrated or defibrinated blood from commercially abated chicken. Two types of efficacy observations were carried out with Triatoma infestans: a) analysis of the chaining of successive nymphal stages, viability of satisfactory matching, fertile oviposition and adequate reproduction; b) assessment of viability and infectivity of Trypanosoma cruzi in the insects. As a conclusion, it became evident that, despite operational easiness, the objectives were not achieved, since the classical procedure used as the control, was always superior.