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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.

We propose a screening process for detection of therapeutic activity of drugs against experimental infection with Trypanosoma cruzi. It is based on the use of infected triatominae that are fed on mice which have received the study drug. Blood meals are made at different time schedule in order to adapt with serum drug levels. The digestive tube of the hemiptera will, thus, work as a suitable structure for examination. In a initial observation, benzonidazole was used, and was shown to be only partially active at least in the conditions of this new procedure.

Because of taxonomic similarities to previous data found in the literature, and with the aim of improving treatment of toxoplasmosis, we considered it of interest to assay artemisinin, an effective anti-malarial agent, for the treatment of experimental infection in mice by Toxoplasma gondii. Different amounts of the anti-parasitic agent were administered, including after previous contact in vitro with toxoplasma and stimulated macrophage production. With the methodology used artemisinin was not effective. Suggestions for further studies are made.

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.

Very few well-established information is available about the frequency and timeliness of relapses in cases of Plasmodium vivax malaria acquired in Brazil. So, we analysed a series of correctly treated patients observed out of endemic areas. The rate of relapses seen in São Paulo, which may represent that of the parasitosis in the whole country, was high, ranging from 7.5% to 24.5%, and early in most cases, i.e. appearing by three months, what anticipates a high endemicity.

The fungicidal action of sodium hypochlorite (0.3, 1, 2.5, 5 and 10%); formaldehyde (2, 5, and 10%); and ethyl alcohol (70%) on yeast forms of Paracoccidioides brasiliensis Pb 18 and a newly-isolated Goiana strain was described. Contact between the fungus and the disinfectants was maintained for 1, 2, 24, 48 and 72 hours at room temperature. Viability was evaluated by the fluorescein diacetate-ethidium bromide treatment, culture in solid and liquid media (36ºC and 26ºC); yeast to mycelial germination at room temperature; and radiometric study of metabolic activity. All concentrations of disinfectants were found to be effective in inactivating Pb 18 and Goiana strains, except for the 1-hour contact with 2% formaldehyde, in which fluorescein diacetate-ethidium bromide treatment was found to reveal 40 and 27% of viable cells, respectively. The yeast to mycelial germination method was considered to reveal faster and similar results as compared to culture in solid and liquid media. Descreveu-se a ação fungicida do hipoclorito de sódio (0,3; 1; 2,5; 5 e 10%); do formaldeído (em solução aquosa a 2,5 e 10%); e álcool etílico a 70,0% sobre formas leveduriformes de 2 cepas de Paraccoccidioides brasiliensis: Pb 18 e cepa Goiana, recentemente isolada. A incubação do fungo e desinfetantes foi realizada à temperatura ambiente por períodos de 1, 2, 24, 48 e 72 horas. A viabilidade foi avaliada pelo tratamento com diacetato de fluoresceína-brometo de etídeo; pela cultura em meios sólidos e líquidos a 36ºC e 26ºC; transformação de levedura em micélio à temperatura ambiente; e estudo radiométrico da atividade metabólica. Todas as concentrações de todos os desinfetantes estudados foram capazes de inativar ambas as cepas, exceto na incubação com formaldeído a 2% por 1 hora, em que o tratamento por diacetato de fluoresceína-brometo de etídeo revelou 40% e 27% de células viáveis, respectivamente, para a cepa Pb 18 e Goiana. A transformação de levedura em micélio foi considerada um método rápido, com resultados semelhantes ao cultivo em meios sólidos e líquidos.

Deferoxamine is a compound with iron chelating properties. Body depletion of this mineral, according to some authors, might influence the metabolism of plasmodia that thrive in the erythrocytes. In order to verify this possibility, we administered daily doses of 300 or 1.000 mg/kg of the compound, for five days and again 15 days, to mice infected with Plasmodium berghei. The parameters used to check the activity of deferoxamine were mortality of the animals and the count of blood parasites. The results showed a progressive increase of mortality and of the parasitemia in all animals, without differences in relation to the controls. So, at least on hand of the present study, the mentioned substance cannot be considered useful for the treatment of malaria.

Because the organ transplantation is currently involving patients with Chagas' disease, we evaluated the therapeutic activity of benzonidazole in mice immunosuppressed by cyclosporine and prednisone. The purpose was to obtain further knowledge regarding the infection with Trypanosoma cruzi when the immune system is depressed. It was verified that benzonidazole, at least in the conditions of the present study, decreased the severity of the parasitic component of the infection and of the inflammatory process; it has not protected the animals, that died at the same proportion in the treated and non-treated series.

The authors reviewed medical literature concerning viral infections potentially hazardous to pregnant health workers. Precautions are suggested specially involving AIDS and cytomegalovirus infection.

In Catolé do Rocha, State of Paraíba, Brasil several people were concomitantly contaminated by Chagas' disease and had the acute form of the infection. Because of this event, the hypothesis that Trypanosoma cruzi might have been transmitted by the digestive route, through the ingestion of accidentally contaminated sugar cane juice, was made. In the present study, we verified that the parasite has remained viable for four hours in the liquid, at room temperature. We have also demonstrated that, after one hour, it was capable of promoting infection in one mouse, by gastric tube administration. These observations enhance the interest on this alternative mechanism of disease transmission.

In Brazil, there has been growing interest on alternative therapeutic approaches, as shown by asi increase of homeopathic prescriptions, and use of acupuncture and of the so called natural products. This study evaluated the usefulness of garlic (Allium sativum) for the treatment of ascaridiasis, trying to confirm the popular belief on this matter. Eight grams daily, as an infusion were used during five days, in children known to be infected with Ascaris lumbricoides. Little efficacy was observed, and this fact enhances the importance of not accepting propositions not based on adequately conducted studies.

Toxoplasma gondii has been found in saliva of patients with toxoplasmosis. We tried to isolate parasites in saliva in patients with AIDS. As it is known, the finding of antitoxoplasma antibodies is not useful for diagnosis of cerebral abscess in toxoplasmosis occurring in AIDS patients in Brazil where 90% or more adults have serological evidence of past infection with Toxoplasma gondii. In 26 patients with AIDS, including six with tomographical evidence suggesting cerebral abscess caused by Toxoplasma gondii, no parasites were found in the saliva by the use of the mouse inoculation model. This trial that the search for Toxoplasma gondii in the saliva is not an alternative method for the diagnosis of toxoplasmosis in patients with AIDS.Toxoplasma gondii has been found in the saliva of patients with toxoplasmosis. The authors attempted to isolate parasites from the saliva of those patients with AIDS. As it is known, the finding of antitoxoplasma antibodies is not useful for the diagnosis of cerebral abscess in toxoplasmosis occurring in AIDS patients in Brazil, where 90% or more of the adults have serological evidence of past infection with Toxoplasma gondii. In 26 patients with AIDS, including 6 with tomographical evidence suggesting cerebral abscess caused by Toxoplasma gondii, no parasites were found in the saliva through the use of the mouse inoculation model. This trial indicates that the search for Toxoplasma gondii in saliva is not an alternative method for the diagnosis of toxoplasmosis in patients with AIDS. (author's modified)

With the objective of knowing adequately the spectrum of activity of albendazole against intestinal helminthiases, we made observations regarding hymenolepiasis caused by Hymenolepis nana. Two series of investigations were carried out: a) treatment of mice with single doses of either 25 or 50 mg/kg, repeated after ten days, using as controls animals treated with 25 mg/kg of praziquantel or not treated with any antiparasitic drugs; b) treatment of adults and children with 400 mg daily for three consecutive days, repeated after ten days.

We describe a case of a patient presenting tetanus after mastectomy with postoperative complications. Risk factors and prophylaxis of this disease after surgery are discussed, emphasizing the need for vaccine protection and evaluation of all patients before any kind of surgical procedure.

The relations between immunosuppression and human or experimental infection by Trypanosoma cruzi have recently been the subject of great interest, specially because of the wider use of drugs acting on immunity and of organ transplantation programs, now in frank expansion. The use of cyclosporin turned necessary to know adequately its interactions with T. cruzi parasitosis, and this has been the objective of the present study, regarding the acute phase in mice, in comparison to the use of prednisone. It was verified that cyclosporin, alone or associated to the corticosteroids, promotes and enhancement of the parasitosis, as shown by the assessment of parasitemia, the amount of amastigote forms in the heart and the severity of cardiac inflammation. Such observations may be useful in clinical practice, calling the attention for necessity of a strict control of such cases an eventually the use of an antiparasitic agent.

The authors report clinical features and therapeutic response of 24 outpatients with acute Chagas' disease, and 3 in the initial chronic phase, referred to the Clinic for Infectious and Parasitic Diseases of the FMUSP "Clínicas" Hospital between 1974 and 1987. The following transmission routes were involved: triatominae in 7 cases, blood transfusion in 9, kidney transplantation and/or blood transfusion in 4, accidental in 1, oral route in 3, probably breast feeding in 1, congenital or breast feeding in 1, and congenital or blood transfusion in 1. Six patients infected by triatominac acquired the disease between 1974 and 1980 and one in 1987. The blood transfusion infected patients acquired the disease in Greater São Paulo, seven of whom after 1983. The acute phase Chagas' disease was oligosymptomatic in 4 patients: three of such patients being immunocompromised by drugs or other diseases. Another two adult immunocompromised patients developed myocarditis and congestive heart failure. Clinical features were severe in 5 from 6 children under two years, irrespective of the transmission route. Evaluation of the acute phase patients treated with benznidazol (4-10 mg/kg/day) showed: therapeutic failure in 4/16 (25.0%); possible cure in 9/16 (53.2%) and inconclusive results in 3/16 (18.8%). The antibody and complement-mediated lysis reaction was in keeping with the xenodiagnosis in 18/22 cases, having shown negative results after treatment earlier than classical serological reactions. One aplastic anaemia patient receiving corticosteroid presented lymphoproliferative disease 6 years after being treated with benznidazol for acute Chagas' disease.

Background D-dimer is considered a marker of hypercoagulable state and of endogenous fibrinolysis, so increased d-dimer is detectable in patients affected by thrombosis. Yet, several studies showed that also infertility, in particular secondary infertility due to recurrent fetal losses, has been often related to thrombotic events, in particular in women carrying thrombotic risk factors such as inherited thrombophilia (MTHFRC677T, PTHRA20210G, Factor V Leiden polimorphisms and/or inhAfter this screening we selected 39erited protein C, protein S, AT III deficiency) or acquired thrombophilia (primary antiphospholipid syndrome, acquired protein C, protein S, AT III deficiency, drugs induced thrombophilia). However, because its high predictive negative value in case of suspected thrombosis, increased d-dimer has been often associated to subclinical thrombophilia. The aim of this study is to investigate the role of d-dimer as first marker of thrombophilia in women affected by unexplained infertility and subsequently to search the cause of increased d-dimer, such as inherited and/or acquired thrombophilia.

A infeccao pelo virus da imunodeficiencia humana (HIV) e a sindrome da imunodeficiencia ad q u irid a (A I D S ), d ela d eco rren te, estao promovendo claras modificacoes nos decursos, configuracoes clinico-laboratoriais, gravidades e terapeuticas, entre outras circunstâncias, de varias enfermidades. Isso tambem comeca a ser percebido em relacao as que mais intimamente dizem respeito ao con texto n o so lo g ic o v ig e n te no B rasil, envolvendo por exemplo a doenca de Chagas, as leishmanioses e a paracoccidioidomicose. Tais possibilidades ja foram antevistas e salientadas em materia ha pouco divulgada e, paulatinamente, passaram a ficar comprovadas, temendo-se que assumam dimensoes expressivas, agravando ainda mais as dificuldades que vigoram no âmbito medico-sanitario1 2 3 4 5 6. N o dia 5 de setembro de 1991, em sessao cientifico-didatica promovida pela D ivisao de