[Heart sounds and their changes. Systolic and diastolic clicks].
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Biomedical subjects
Publications and source records attributed to A C Barretto.
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Lutzomyia (N.) whitmani was infected on leishmaniotic lesions of three out of nine dogs infected with Leishmania braziliensis braziliensis. The infectivity rates in these sandflies were 8.3% (1/12), 7.1% (1/14) and 1.8% (3/160), respectively. In addition, 180 Lu. whitmani fed on non-ulcerated regions of one of the infected dogs and none became infected. We emphasize the vector potentiality of Lu. whitmani for L.b. braziliensis in the endemic region of Três Braços, Bahia, Brazil.
Several species of wild caught sand flies were collected in the same site where a subspecies of Leishmania mexicana was isolated from the rodent Proechimys iheringi denigratus. The absence of natural infection in these sand flies permitted us to test, with relative assurance, the susceptibility of wild caught females to infection by this parasite. The success obtained in these experimental infections suggest that one or more of the sand fly species encountered in high numbers in the same site where the infected rodents were captured may be the vector(s) of this subspecies of L. mexicana.
In Corte de Pedra, Valença, state of Bahia, a donkey, Equus asinus, was found naturally infected with Leishmania braziliensis braziliensis. The parasite was isolated from a lesion located on a castration scar, and identified by means of monoclonal antibodies.
The phlebotomine fauna is highly varied in Três Braços, an endemic area of american cutaneous leishmaniasis, situated in the cacao growing region in the southeast of Bahia State, Brazil. Thirty spécies of the Lutzomyia genus were identified in 13,535 specimens collected between 1976 and 1984. Lutzomyia whitmani was the dominant species accounting for 99% of flies in the peridomicile and 97.5% of those caught in homes. In the forest the predominant species were Lu. ayrozai and Lu. yuilli. Lu. whitmani accounted for only 1.0% of the specimens examined. Lu. flaviscutellata, the proven vector of Leishmania mexicana amazonensis, was also collected in small numbers. Lu. wellcomei, a known vector of L. braziliensis braziliensis in the Serra dos Carajás, Pará, Brazil was not encountered in the Três Braços region where the parasite causing human infections is usually L.b. braziliensis. Although we have not encountered a natural infection with leishmanial promastigotes in 1,832 females of the various species examined, we discuss the probability that Lu. whitmani is the vector of L.b. braziliensis in the region maintaining transmission in dogs and man.
The undetermined form of Chagas' disease is diagnosed in asymptomatic subjects with a positive blood test for Chagas' disease, normal resting electrocardiogram, chest X-ray, barium esophageal and large bowel radiological studies. Other investigation methods are not recommended for identification of other organs damage lesions in this phase of the disease. When other methods of investigation were employed, cardiac and digestive abnormalities of small magnitude were detected without prognostic implications. These findings do not warrant frequent examinations of patients with undetermined form of the disease except for the electrocardiogram or if the patients report other clinical manifestations. The benign course of the disease does not preclude ability to work and the subjects should be considered apt for work in any profession.
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The case history of a heart transplant patient who died of an acute myocardial infarction 6 months after the procedure is described. The finding of contraction bands and thrombosis associated with endarteritis suggests that coronary vasospasm may have contributed to the acute myocardial infarction during an episode of vascular rejection.
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