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Reproductive performance is known to differ between co‐sexual and non‐co‐sexual species. Thus, our aim was to determine whether: (i) the distance between sex structures is negatively associated with sex expression; (ii) male gametangia take longer to mature in rhizautoicous species than in gonioautoicous species; and (iii) the gonioautoicous sexual system has greater reproductive success (i.e. percentage of ramets with sporophyte) than the rhizautoicous sexual system.One population each of the mosses Fissidens scariosus and F. submarginatus, rhizautoicous and gonioautoicous, respectively, in a remnant of Atlantic Forest in Brazil were sampled monthly from September 2016 until August 2017. The number and phenophases of antheridia, archegonia and sporophytes were analysed for each species. Sexual expression and reproductive success were calculated, and reproductive phenology compared across environmental variables.As expected, sexual expression was significantly higher for the gonioautoicous species, which produced antheridia throughout the year and archegonia over many months, while gametangia production by the rhizautoicous species occurred only during the rainy season. Mean number of gametangia per perigonium and perichaetium were slightly higher for the rhizautoicous species (6.84 antheridia; 11.38 archegonia) than for the gonioautoicous species (4.39; 7.62). Gametangia and sporophyte production in the rhizautoicous species were markedly seasonal compared to that of the gonioautoicous species, although reproductive success did not differ.Therefore, we infer that the rhizautoicy (i.e. a functional dioicy) promotes lower expression of gametangia compared to gonioautoicy but is more efficient and so obtains the same reproductive success. Sexual systems are associated with reproductive performance in species of the moss genus Fissidens. [ABSTRACT FROM AUTHOR]

In Brazilian public hospitals, the number of patients needing assistance is often much greater than the capacity of the hospital. In such situations, medical procedures are performed as quickly as possible, and mobile X-ray equipment is used intensively. This equipment is used for several types of examination, in different areas of the hospital. During the examination procedure, apart from the radiology technicians involved, there are always other people in the room who are also exposed to the radiation scattered by the patient. The objective of this study was to determine the exposure, due to the use of mobile X-ray equipment, of hospital personnel, divided into two categories named ‘monitored’ and ‘non-monitored’. Evaluation of 413 radiographies was performed, the vast majority of them being chest examinations (75 %). During the procedures, specific information was collected to allow measurement in simulated situations. Air kerma rates were measured at different distances from the mobile X-ray equipment using an ionisation chamber and an acrylic phantom with dimensions of 30×30×15 cm3. From the results, it was possible to estimate the personal dose equivalent received by the individuals in the room during the procedure and to determine the dose maps associated with the use of the mobile X-ray equipment. The results obtained in this study were in accordance with dose limits, but some observed situations were considered critical. [ABSTRACT FROM AUTHOR]

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Spirocerca lupi is a nematode parasite that can be found in the esophagus and aorta of carnivores, including humans. Affected animals may develop mild to severe lesions, depending on the degree of infection, route of larval migration and the inflammatory response. The present work describes the occurrence of S. lupi in a 16-year old male Chow Chow dog, presenting a chronic esophagus infection, associated with a critical obstruction. After the identification of the parasite egg by faecal exam, the patient was treated with milbemycin in combination with praziquantel P.O., in days zero, seven and 28 after the diagnose. An esophagogram was also performed, confirming the secondary megaesophagus. The team of clinicians decide to perform a euthanasia due to the complication of the patient's condition, even after the anthelmintic treatment. This report is important as it describes a case after 18 years of epidemiological silence in the Metropolitan region of Curitiba, PR, Brazil. The present data aims to raise awareness about the prevalence of this zoonotic disease and the importance of a specific clinical and radiographic diagnose in dogs. It is noteworthy to report the difficulty to reduce the size of the associated esophagus mass even after a potent anthelmintic treatment. [ABSTRACT FROM AUTHOR]

Background: Studies analyzing the prevalence of postpartum depression in Brazil have recently increased. However, few studies have examined the Northeast region of Brazil, and no studies have investigated the Amazon region. Therefore, the aim of this study was to investigate postpartum depression in these two regions.Methods: We administered the Edinburgh Postnatal Depression Scale to a total of 3060 women who used the Brazilian public health system and had given birth between one and three months prior to the interview. A cut-off score ≥11 was used to indicate symptoms of postpartum depression. After calculating the prevalence, univariate logistic regressions were performed separately for several possible risk factors (p<0.05).Results: The overall rate of reported symptoms of postpartum depression was 19.5%. The prevalence in the northeast region and Amazon region were 19.0% and 20.3%, respectively (p=0.36). In the univariate logistic regression, low education level (<7 years: p<0.001; 8-10 years: p=0.003), ethnicity (Black: p=0.02; Pardo: p=0.02), few prenatal visits (1 or 2 visits: p=0.04), prenatal care self-assessed as "not very good" (p<0.001) and the prenatal care adequacy index of partially suitable (p=0.01) or not suitable (p<0.001) were identified as significant risk factors for postpartum depression symptoms.Limitations: Mothers who did not bring their children for immunization. The cross-sectional study does not allow for causality to be established.Conclusion: the prevalence rates of postpartum depression were similar to the rates observed for developing countries and higher than the rates observed in developed countries. Based on these findings, we recommend that screening and treatment of pregnant women should be considered a public health priority. [ABSTRACT FROM AUTHOR]

Chicken (Gallus gallus domesticus) is one of the primary sources of animal protein for the Brazilian population. Thus, the safety of this food is highly relevant. This study was based on the evidence of severe contamination of these animals by metals such as lead in Santo Amaro, Bahia. This exploratory study aimed to evaluate associations between lead levels in blood of chicken exposed to a contaminated area with the occurrence of chromosomal alterations, evidencing genotoxic effects. Serum lead analysis was performed by GF-AAS after dilution with a matrix modifier solution (Triton X-100 0.2% v/v and HNO3 0.1% v/v), while chromosomal damage was evaluated using the comet assay. The results showed genotoxic effects (positive comet assay) only for the specimen sample with higher serum lead concentrations (33.9 µg dL-1), suggesting the occurrence of toxic effects at this level of exposure. This work evaluated a relationship between the reduction of serum lead levels in chicken and increased distance from the primary polluting source - a lead processing plant (COBRAC). It also showed that lead is bioavailable in this territory, contaminating chicken and causing genotoxic effects in these animals, further expanding the concern with the local biota and the health of the residents of Santo Amaro.

Purpose: Build and validate the content of conceptual and operational definitions of the defining characteristics of the nursing diagnosis of NANDA-I "Ineffective health self-management" in people living with HIV/AIDS., Methods: Methodological study, with a quantitative approach. The validation was performed by 26 specialist nurses selected through the Lattes do Brazil platform. The process followed two steps: (a) proposal of new defining characteristics to the Nursing Diagnosis "Ineffective Health Self-Management" and elaboration of conceptual and operational definitions; (b) content validation of the new defining characteristics of the Nursing Diagnosis "Ineffective Health Self-Management" and the conceptual and operational definitions. Data were collected between October 2020 and May 2021., Findings: The researchers included six defining characteristics as components of the diagnosis, adding to the 10 already existing in the NANDA-I version (2021-2023). Then, the experts judged these components and 13 defining characteristics were validated using the binominal test with adequacy ratio above 85% and p value <0.05. After this stage, the conceptual and operational definitions of these defining characteristics were constructed, validating them by the content validation index ≥0.80 by the expert nurses., Conclusions: Three new defining characteristics for Ineffective health self-management were proposed and validated by specialists. Conceptual and operational definitions of the new and current defining characteristics were elaborated and validated for people living with HIV/AIDS., Implications for Nursing Practice: The knowledge and study of the conceptual and operational definitions of nursing diagnoses can contribute to good nursing practices, assisting in the care and evaluation of nurses in the provision of care to people living with HIV/AIDS, and can avoid misunderstandings and inappropriate interpretations and can guarantee assertive clinical judgment., Search Terms: Nursing diagnosis, validation studies, nursing processes, acquired immunodeficiency syndrome., (© 2021 NANDA International, Inc.)

Esophageal cancer is an aggressive tumor that has a high rate of incidence and mortality worldwide. It is the 10th most frequent type in Brazil, being squamous cell carcinoma (ESCC) the predominant subtype. There is currently an incessant search to identify the frequently altered genes associated with esophageal squamous cell carcinoma biology that could be druggable. This study aimed to analyze the somatic mutation profile of a large panel of cancer-related genes in Brazilian ESCC. In a series of 46 ESCC diagnoses at Barretos Cancer Hospital, DNA isolated from paired fresh-frozen and blood tissue, a panel of 150 cancer-related genes was analyzed by next-generation sequencing. The genes with the highest frequency of mutations were TP53 (39/46, 84.8%), followed by NOTCH1 (7/46, 15.2%), NFE2L2 (5/46, 10.8%), RB1 (3/46, 6.5%), PTEN (3/46, 6.5%), CDKN2A (3/46, 6.5%), PTCH1 (2/46, 4.3%) and PIK3CA (2/46, 4.3%). There was no significant association between molecular and patients' clinicopathological features. Applying an evolutionary action score of p53 (EAp53), we observed that 14 (35.9%) TP53 mutations were classified as high-risk, yet no association with overall survival was observed. Concluding, this the largest mutation profile of Brazilian ESCC patients, which helps in the elucidation of the major cancer-related genes in this population., (© 2021. The Author(s).)

Objectives: To assess SARS-CoV-2 prevalence and health outcomes among inmates over 60 years during a COVID-19 outbreak in a major penitentiary complex in the Federal District, Brazil., Methods: A mass test campaign was performed on May 13, 2020, using antibody-detection rapid tests for asymptomatic inmates and reverse transcriptase-polymerase chain reaction testing for those who were symptomatic. Those with negative results were retested on June 16. Inmates were interviewed to characterise background health conditions and the presence of symptoms., Results: A total of 159 inmates were evaluated. In the first mass testing, 79.9% (127/159) of inmates had been infected, of whom 53.5% (68/127) reported symptoms. In the second testing round, 17 new cases were identified, increasing the total to 90.6% (144/159) of inmates with a positive result. Comorbidities were present in 67.3% of inmates; 2 hospitalisations and no COVID-related deaths were recorded., Conclusion: More than 90% of inmates aged >60 years were infected with SARS-CoV-2 during the outbreak. Periodic health monitoring, active case finding and early care for symptomatic patients contributed to positive post-infection outcomes. Such measures must be considered essential for the surveillance of COVID-19 in environments with limited capacity to promote social distance, such as penitentiary institutions., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

An outbreak of coronavirus disease began in a large penitentiary complex in Brazil on April 1, 2020. By June 12, there were 1,057 confirmed cases among inmates and staff. Nine patients were hospitalized, and 3 died. Mean serial interval was ≈2.5 days; reproduction number range was 1.0-2.3.

Early diagnosis, efficient clinical support, and proper antifungal therapy are essential to reduce death and sequels caused by cryptococcosis. The emergence of resistance to the antifungal drugs commonly used for cryptococcosis treatment is an important issue of concern. Thus, the in vitro antifungal susceptibility of clinical strains from northern Brazil, including C. neoformans VNI (n = 62) and C. gattii VGII (n = 37), to amphotericin B (AMB), 5-flucytosine, fluconazole, voriconazole, and itraconazole was evaluated using the Etest and Vitek 2 systems and the standardized broth microdilution (CLSI-BMD) methodology. According to the CLSI-BMD, the most active in vitro azole was voriconazole (C. neoformans VNI modal MIC of 0.06 μg/ml and C. gattii VGII modal MIC of 0.25 μg/ml), and fluconazole was the least active (modal MIC of 4 μg/ml for both fungi). Modal MICs for amphotericin B were 1 μg/ml for both fungi. In general, good essential agreement (EA) values were observed between the methods. However, AMB presented the lowest EA between CLSI-BMD and Etest for C. neoformans VNI and C. gattii VGII (1.6% and 2.56%, respectively, P < .05 for both). Considering the proposed Cryptococcus spp. epidemiological cutoff values, more than 97% of the studied isolates were categorized as wild-type for the azoles. However, the high frequency of C. neoformans VNI isolates in the population described here that displayed non-wild-type susceptibility to AMB is noteworthy. Epidemiological surveillance of the antifungal resistance of cryptococcal strains is relevant due to the potential burden and the high lethality of cryptococcal meningitis in the Amazon region., (© The Author(s) 2019. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.)

The molecular basis of colorectal cancer (CRC) can guide patient prognosis and therapy. In Brazil, knowledge on the CRC mutation landscape is limited. Here, we investigated the mutation profile of 150 cancer-related genes by next-generation sequencing and associated with microsatellite instability (MSI) and genetic ancestry in a series of 91 Brazilian CRC patients. Driver mutations were found in the APC (71.4%), TP53 (56.0%), KRAS (52.7%), PIK3CA (15.4%) and FBXW7 (10.9%) genes. Overall, genes in the MAPK/ERK, PIK3/AKT, NOTCH and receptor tyrosine kinase signaling pathways were mutated in 68.0%, 23.1%, 16.5%, and 15.3% of patients, respectively. MSI was found in 13.3% of tumors, most of which were proximal (52.4%, P< 0.001) and had a high mutation burden. European genetic ancestry was predominant (median of 83.1%), followed by Native American (4.1%), Asian (3.4%) and African (3.2%). NF1 and BRAF mutations were associated with African ancestry, while TP53 and PIK3CA mutations were inversely correlated with Native American ancestry. Our study suggests that Brazilian CRC patients exhibit a mutation profile similar to other populations and identify the most frequently mutated genes, which could be useful in future target therapies and molecular cancer screening strategies.

Introduction:: Factor analysis of the Edinburgh Postnatal Depression Scale (EPDS) could result in a shorter and easier to handle screening tool. Therefore, the aim of this study was to check and compare the metrics of two different 6-item EPDS subscales., Methods:: We administered the EPDS to a total of 3,891 women who had given birth between 1 and 3 months previously. We conducted confirmatory and exploratory factor analyses and plotted receiver-operating characteristics (ROC) curves to, respectively, determine construct validity, scale items' fit to the data, and ideal cutoff scores for the short versions., Results:: A previously defined 6-item scale did not exhibit construct validity for our sample. Nevertheless, we used exploratory factor analysis to derive a new 6-item scale with very good construct validity. The area under the ROC curve of the new 6-item scale was 0.986 and the ideal cutoff score was ≥ 6., Conclusions:: The new 6-item scale has adequate psychometric properties and similar ROC curve values to the10-item version and offers a means of reducing the cost and time taken to administer the instrument.

Cryptococcus neoformans and Cryptococcus gattii are responsible globally for almost one million cryptococcosis cases yearly, mostly in immunocompromised patients, such as those living with HIV. Infections due to C. gattii have mainly been described in tropical and subtropical regions, but its adaptation to temperate regions was crucial in the species evolution and highlighted the importance of this pathogenic yeast in the context of disease. Cryptococcus gattii molecular type VGII has come to the forefront in connection with an on-going emergence in the Pacific North West of North America. Taking into account that previous work pointed towards South America as an origin of this species, the present work aimed to assess the genetic diversity within the Brazilian C. gattii VGII population in order to gain new insights into its origin and global dispersal from the South American continent using the ISHAM consensus MLST typing scheme. Our results corroborate the finding that the Brazilian C. gattii VGII population is highly diverse. The diversity is likely due to recombination generated from sexual reproduction, as evidenced by the presence of both mating types in clinical and environmental samples. The data presented herein strongly supports the emergence of highly virulent strains from ancestors in the Northern regions of Brazil, Amazonia and the Northeast. Numerous genotypes represent a link between Brazil and other parts of the world reinforcing South America as the most likely origin of the C. gattii VGII subtypes and their subsequent global spread, including their dispersal into North America, where they caused a major emergence.

The work of recycling solid waste segregators allows a precarious livelihood, but triggers a disease process that exacerbates their health and well-being. This study aimed to estimate the prevalence of occupational accidents at the open dump in the Federal District and its associated factors. Most segregators have had an accident at work (55.5%), perceived the danger of their working environment (95.0%) and claimed they did not receive personal protective equipment (51.7%). Among other findings, 55.8% ate foods found in the trash, 50.0% experienced food insecurity at home and 44.8% received Bolsa Família. There was a statistically significant relationship between work accidents and perception of dangerous work environment, household food insecurity and the presence of fatigue, stress or sadness (p < 0.05). On the other hand, the fellowship between the segregators was associated with a lower prevalence of accidents (p < 0.006). Women are the majority of the segregators (56.5%) and reported more accidents than men (p < 0.025). We conclude that the solid waste segregators constitute a vulnerable community, not only from the perspective of labor, but also from the social and environmental circumstances. To reverse this situation, effective implementation of the National Policy of Solid Wastes is imperative, in association with affirmative policies to grant economic emancipation for this population.

The boll weevil Anthonomus grandis Boheman (Coleoptera: Curculionidae) is the most important cotton pest in Brazil. A large-scale field-testing of a Boll Weevil Suppression Program (BWSP) was implemented to assess its technical and operational feasibility for boll weevil suppression in the state of Goiás, Brazil. The pilot plan focused on 3,608 ha of cotton during the 2006/2007 and 6,011 ha in the 2007/2008 growing seasons; the areas were divided into four inner zones with an outer buffer zone. We analyzed data on boll weevil captures using pheromone traps installed in the BWSP fields, on the detection of the first insect and the first damaged floral bud, greatest damage, and number of insecticide applications. The nonparametric Mann-Whitney U test was used to evaluate the differences between presuppression and suppression years. Fourteen pheromone-baited trapping evaluations were used to compare the weevil populations from 2006/2007 and 2007/2008 growing seasons. The BWSP regime reduced in-season boll weevil captures from 15- to 500-fold compared to presuppression levels in the preceding year. The low capture rates were related to delays in infestation and damage by weevils. The smaller population size measured by trapping and field monitoring reduced the number of required insecticide treatments. The BWSP strategy was efficient in suppressing populations of this pest and is a viable program for cotton production in subtropical and tropical regions, with long-term economic and environmental benefits.

Wild felids and canids are usually the main predators in the food chains where they dwell and are almost invisible to behavior and ecology researchers. Due to their grooming behavior, they tend to swallow shed hair, which shows up in the feces. DNA found in hair shafts can be used in molecular studies that can unravel, for instance, genetic variability, reproductive mode and family structure, and in some species, it is even possible to estimate migration and dispersion rates in given populations. First, however, DNA must be extracted from hair. We extracted successfully and dependably hair shaft DNA from eight wild Brazilian felids, ocelot, margay, oncilla, Geoffroy's cat, pampas cat, jaguarundi, puma, and jaguar, as well as the domestic cat and from three wild Brazilian canids, maned wolf, crab-eating fox, and hoary fox, as well as the domestic dog. Hair samples came mostly from feces collected at the São Paulo Zoo and were also gathered from non-sedated pet or from recently dead wild animals and were also collected from museum specimens. Fractions of hair samples were stained before DNA extraction, while most samples were not. Our extraction protocol is based on a feather DNA extraction technique, based in the phenol:chloroform:isoamyl alcohol general method, with proteinase K as digestive enzyme.

Purpose: To analyze the possible predisposing factors of lawsuits involving ophthalmologists., Methods: Retrospective study of 70 lawsuits involving the practice of Ophthalmology. The patient's gender, age, medical and ophthalmic history were reviewed. The eye disorder that generated the prosecution, the pre-existing ophthalmic diagnosis, the preoperative exams and the operating room data were also analyzed. The informed consent form, the outcome of the litigation and the value of compensation were recorded., Results: Blindness was reported in 45 (64.3%) of the 70 lawsuits and was the principal eye disorder related to litigation. The pre-existing eye diseases associated with legal claims were: cataracts in 46 (65.7%) lawsuits, refractive errors in 12 (17.1%), ocular trauma in 8 (11.4%), glaucoma in 3 (4.3%) and retinal detachment in 1 (1.4%) lawsuit. The major surgical complications that possibly motivated the patient to sue the ophthalmologist were retinal detachment in 37 (52.8%) lawsuits, poor visual acuity after cataract surgery in 12 (17.1%), corneal disorders following refractive surgery in 8 (11.4%), endophthalmitis in 4 (5.7%), discomfort with refractive prescriptions in 4 (5.7%) and ocular atrophy in 4 (5.7%) lawsuits. Ophthalmic surgery was involved in 94.3% of the 70 prosecutions analyzed. Two or less visits to the ophthalmologist preceding the surgical or refractive event leading to legal dispute were recorded in 67.1% of the lawsuits. A pre-surgical Informed consent form was not used in 63% of the 66 surgical procedures leading to litigation. 62.9% of the lawsuits were unfavorable to the Ophthalmologist and the amount of compensation was less than R$ 50,000 in 72.7% of these legal claims., Conclusions: Blindness, surgery, retinal detachment, few pre-operative ophthalmic visits and the lack of informed consent forms were possible risk factors associated with lawsuits in the field of Ophthalmology.

Radon activities measured in several types of natural waters from the Santos region in Brazil are presented. Makrofol E polycarbonate plastic detector was used. The detector foils were exposed to radon emanating from the water samples for 30 days in a system of two tightly coupled cups, one of which contained the detector foil and the other hosted the analyzed water sample. After irradiation and chemical etching of the plastic foils, the tracks produced by the alpha particles emitted by radon and its progeny were counted with a system consisting of an optical microscope and a video camera. The measured radon radioactivities ranged from 0.95 to 36.00 Bq/l for ground waters, from 0.30 to 0.54 Bq/l for sea waters, from 0.39 to 0.47 Bq/l for tap waters, from 0.43 to 2.40 Bq/l for river waters, and amounted to 2.35 Bq/l for water from the Santos/São Vicente public water supply.

The aim of this study was to investigate the presence of the Hepatitis G Virus on a population of blood donors from S o Paulo, Brazil and to evaluate its association to sociodemographic variables. Two RT-PCR systems targeting the putative 5'NCR and NS3 regions were employed and the former has shown a higher sensitivity. The observed prevalence of HGV-RNA on 545 blood donors was 9.7% (CI 95% 7.4;12.5). Statistical analysis depicted an association with race/ethnicity, black and mulatto donors being more frequently infected; and also with years of education, less educated donors presenting higher prevalences. No association was observed with other sociodemographic parameters as age, gender, place of birth and of residence. DNA sequencing of nine randomly chosen isolates demonstrated the presence of genotypes 1, 2 and 3 among our population but clustering of these Brazilian isolates was not detected upon phylogenetic analysis.

Naturally exposed dogs of an endemic area were vaccinated with the fucose mannose ligand (FML) antigen of Leishmania donovani in formulation with QuilA saponin. The 100% of vaccinees were seropositive to FML and showed intradermal reaction to L. donovani lysate, 2 months after vaccination. The absorbency values and size of intradermal reaction were both significantly higher in vaccinees than in controls along a 3.5 years period (ANOVA, P<0.0001). The 25% of the control animals (two dogs on the first year and six dogs on the fourth year, respectively) and 5% of the vaccinees (one dog during the fourth year) developed clinical and fatal disease until the end of experiment. This difference was significant (chi(2)=3.93, P<0.05). This means that 95% protection against kala-azar was achieved in vaccinees, after FML-QuilA vaccination (80% of vaccine efficacy (VE)). Leishmania infection was also confirmed, 3.5 years after vaccination, in saline controls that showed positive polymerase chain reaction (PCR) for Leishmania DNA and FML-serology with no intradermal reaction. Higher seropositivities and intradermal reactions with no Leishmanial DNA were detected in vaccinees. The FML-QuilA vaccine induced a significant, long lasting and strong protective effect against canine kala-azar in the field.

Brazil is the only country endemic for zoonotic visceral leishmaniasis (ZVL) that regularly conducts epidemiologic and prophylactic control programs that involve the treatment of human cases, insect vector control, and the removal of seropositive infected dogs. This report reviews 60 studies reporting data on the efficacy of these recommended control tools and concludes that in Brazil 1) eradication of the disease in Minas Gerais was achieved by the concomitant use of the three control methods, 2) although seropositivity by an immunofluorescent assay is not completely related to infectiousness, the removal of seropositive dogs leads to a significant reduction of canine and human incidence, 3) improvement of the sensitivity of the diagnostic tool used for canine control should optimize the efficacy of control, and 4) although difficult and expensive, the public health dog control campaigns performed in Brazil reduced the incidence of ZVL and should be maintained since treatment of dogs is an unrealistic intervention, both because of its prohibitive cost and relatively poor effectiveness.

Positive Montenegro's skin test is a delayed type hypersensitivity reaction widely used as indicative of previous infection with Leishmania in both humans and dogs. Montenegro's antigen consists of a crude Leishmania antigen solution, usually containing thimerosal as preserving agent. In this work it is shown that a large proportion of dogs (11 out of 56) examined in an endemic area of leishmaniasis presented induration at the site of injection of a diluent containing thimerosal alone. This clearly demonstrates that thimerosal leads to a high number of false positive skin reactions in dogs and that its use in Montenegro's skin test antigenic preparations should be avoided.

American visceral leishmaniasis is a main public health matter in Brazil. Since dogs have been incriminated as the main urban reservoir of AVL agent Leishmania chagasi, a cohort study aimed at understanding the dynamics of the canine infection was carried out in Jequié--an endemic community in the Northeast of Brazil. The inhabited urban and periurban areas of Jequié were divided into 140 clusters of 0.25 km2. All 1681 dogs domiciled in 34 randomly selected clusters were screened for Leishmania antibodies in an enzyme-linked immunosorbent assay. After the seropositive dogs were painlessly eliminated, a cohort of 1286 seronegative dogs was followed up for 18 months, yielding a total of 1739.7 dog-years. The overall incidence of Leishmania infection, as assessed by the detection of Leishmania antibodies in blood samples collected every six months, was 6.55 cases/100 dog-years (95% confidence interval; CI 6.04-7.26). Two subsets of clusters, with 0.70 and 1.35 relative risks of infection, were identified. The annual emigration rate was 2.26 cases/100 dog-years (95% CI 1.86-2.66). The implications of these findings for the control of American visceral leishmaniasis are discussed.

Jequie, a community of about 144,500 inhabitants located in the State of Bahia, Brazil, is endemic for both visceral and cutaneous leishmaniases. In the present epidemiologic study, the urban and inhabited periurban areas of the town were divided into 140 clusters of 0.25 km2 each. The seroprevalence of canine Leishmania antibodies was investigated using an enzyme-linked immunosorbent assay as a screening test since its sensitivity was significantly higher than that of an indirect immunofluorescence assay. A total of 1,681 dogs was surveyed in 34 randomly sampled clusters. The overall prevalence of Leishmania antibodies in the dog population was 23.5%, with intracluster prevalences ranging from 0% to 67%. There was no correlation of these seroprevalences with the intracluster densities of canine populations, or with the distances from individual clusters to the town center. Moreover, the Leishmania transmission did not seem to follow any clear-cut spatial pattern, since large disparities in the seroprevalences of contiguous clusters were found. Curiously, human cases of visceral leishmaniasis have never been observed in some clusters with a relatively high prevalence of canine seroprevalences. Eight parasite isolates from seropositive dogs were found to belong to the same serodeme and zymodeme as Leishmania (L.) chagasi. The implications of these findings with respect to the epidemiology and control of American visceral leishmaniasis are discussed.

We relate a case of an 18-year-old man, resident of Xapuri (state of Acre, Brazil), with a history of repeated episodes of meningoencephalitis (three in one year), each one was examined by a local doctor. In our service (Emílio Ribas Institute of Infectology) we observed a patient with polyjoint aches, radiological and bronchoscopic pulmonary alterations (without clinical features), meningeal and brain stem manifestations--with normal brain computed tomography and cerebrospinal fluid. Blood eosinophils and serological Toxocara canis test (ELISA) were greatly increased. With the hypothesis of Toxocariasis (visceral larva migrans) we administered thiabendazole that brought complete clinical and laboratory remission. Inspite of a new episode of headache with meningeal manifestation approximately one month later (treated with dexamethasone resulting in a full remission after three days) we have not found other manifestations in approximately three and a half years of ambulatory care.