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Biomedical subjects

B Wanke

Publications and source records attributed to B Wanke.

At least 37 records · Page 2Linked to original sources
PubMed1994

Paracoccidioidin and histoplasmin sensitivity in Tupí-Mondé Amerindian populations from Brazilian Amazonia.

A cross-sectional epidemiological survey for paracoccidioidomycosis and histoplasmosis, including skin tests with paracoccidioidin and histoplasmin, physical examinations and X-rays, was conducted among three Tupí-Mondé Amerindian populations from Brazilian Amazonia. The study followed the diagnosis of an increasing number of cases of paracoccidioidomycosis among the Suruí in recent years. Positivity rates to paracoccidioidin and histoplasmin (> or = 5 mm of intradermal induration 24-48 h post-injection) were 43.8% and 78.7% for the Suruí, 6.4% and 5.8% for the Gavião and 14.9% and 80.5% for the Zoró, respectively. There was no significant difference in the results for males and females but marked differences were noted across age groups. The results of the univariate analysis were confirmed after adjustment for confounding variables by multiple logistic regression analysis: paracoccidioidin positivity was relatively high in the Suruí and histoplasmin positivity was relatively high in the Suruí and Zoró. The Suruí's greater exposure to Paracoccidioides brasiliensis, the causative agent of paracoccidioidomycosis, is probably associated with their adoption of new subsistence practices. The epidemiology of this mycosis among the Tupí-Mondé appears to be related to the environmental and socio-economic changes taking place in Amazonia.

Adolescent↗
PubMed1994

Effects of histoplasmin M antigen chemical and enzymatic deglycosylation on cross-reactivity in the enzyme-linked immunoelectrotransfer blot method.

The enzyme-linked immunoelectrotransfer blot (EITB) method was evaluated as a suitable method for detecting antibodies against M antigen of Histoplasma capsulatum by use of both glycosylated and deglycosylated M protein of histoplasmin (HMIN). Sera from patients with histoplasmosis, paracoccidioidomycosis, blastomycosis, coccidioidomycosis, and aspergillosis were tested by the EITB with glycosylated M protein of HMIN. This assay demonstrated 100% sensitivity with histoplasmosis serum samples, all of which reacted with the 94-kDa glycoprotein (M antigen). Although the EITB is highly sensitive, it is not specific for histoplasmosis when glycosylated M protein is used as an antigen. A total of 81% of paracoccidioidomycosis, 25% of blastomycosis, 33% of coccidioidomycosis, 73% of aspergillosis, and 16% of tuberculosis serum samples cross-reacted with M protein of HMIN and yielded patterns indistinguishable from those obtained with histoplasmosis serum samples. The EITB reactions with both untreated M antigen and M antigen altered by periodate oxidation or by deglycosylation with endoglycosidases were compared. Cross-reactions with heterologous sera in the EITB could be attributed to periodate-sensitive carbohydrate epitopes, as reflected by the increase in the test specificity from 46.1 to 91.2% after periodate treatment of M protein. The EITB for the detection of antibodies to M antigen is a potential diagnostic test for histoplasmosis, provided that periodate-treated M protein is used as an antigen.

Antibody Specificity↗
PubMed1993

Recovery of adrenal function after treatment of paracoccidioidomycosis.

In endemic areas, the systemic mycosis paracoccidioidomycosis (PCM) is the most frequent etiology of Addison's disease. Paracoccidioides brasiliensis, the causative agent of PCM, exhibits a high tropism for the adrenal glands, which results in a low hormone reserve and in more severe cases, in symptoms of primary adrenal insufficiency. In these cases, the hormone deficit is usually treated with replacement corticoid therapy for the rest of the patient's life. Recently, we identified three patients with disseminated PCM who had adrenal insufficiency; one of them had Addison's disease. All showed complete recovery of adrenal function after a 1-2-year period of specific therapy with ketoconazole or sulfonamides. Plasma cortisol levels were determined by radioimmunoassay of baseline blood samples, as well as those taken after the rapid stimulation test with synthetic adrenocorticotrophic hormone, and before and after the antifungal therapy.

Addison Disease↗
PubMed1992

Cryptococcus neoformans varieties as agents of cryptococcosis in Brazil.

The study of the clinical isolates of Cryptococcus neoformans from 83 Brazilian patients with disseminated cryptococcosis showed that 75 were C. neoformans var. neoformans and 8 were var. gattii. Twenty-seven isolates were serotyped; all 19 var. neoformans were serotype A and all 8 var. gattii were serotype B. The correlation of the varieties of C. neoformans with the presence or not of hosts predisposing conditions to the mycosis showed that: (1) cryptococcosis caused by gattii variety occurred in 7 (58.3%) of the 12 nonimmunosuppressed patients, and (2) cryptococcosis caused by neoformans variety occurred in 65 (98.5%) of the 66 AIDS patients and in all 5 patients with other immunosuppressive conditions. The comparison of the distribution of the gattii and neoformans varieties between the nonimmunosuppressed and immunosuppressed patients showed a significant statistical difference (p < 0.01).

Acquired Immunodeficiency Syndrome↗
PubMed1991

Computed tomography and ultrasonography of the adrenal glands in paracoccidioidomycosis. Comparison with cortisol and aldosterone responses to ACTH stimulation.

Fifteen patients with proven disseminated paracoccidioidomycosis (PCM) had computed tomography (CT) and ultrasonography (US) performed to evaluate the form, shape, density and size of their adrenal glands. Plasma and urinary cortisol were determined and adrenal reserve assessed by measuring the cortisol and aldosterone responses to synthetic ACTH. The adrenal CT showed unilateral lesions in two cases and bilateral in another four. The US study showed more frequent alterations, unilateral in seven and bilateral in three subjects. Combining both methods increased the sensitivity to 85% of the cases. All patients had normal plasma cortisol concentrations and normal or increased urinary cortisol excretion. Plasma aldosterone concentration was also normal except in one patient with hypokalemia. Seven patients showed diminished cortisol responses, five had subnormal aldosterone responses and in five plasma aldosterone concentration increased more than normally after stimulation by ACTH. There was an incidence of limited adrenal reserve in 53% of the patients on ACTH stimulation. No correlation was evident between the disorders in adrenal steroid responses to ACTH and changes in morphology revealed by CT and/or US.

Adrenal Glands↗
PubMed1990

Study of antibodies in paracoccidioidomycosis: follow-up of patients during and after treatment.

The relevance of the humoral response in the prognosis of paracoccidioidomycosis was assessed by measuring the serological responses of individual patients to Paracoccidioides brasiliensis by double immunodiffusion (DID). Sixty-six patients with paracoccidiodomycosis were studied. Sera from 31 individuals were tested before and during treatment with sulfonamide (Group I). Sera from a further 35 individuals were tested after completion of a 2-year course of treatment (Group II). In Group I, clinical improvement was associated with a decrease in antibody titer in all patients. The only patient in this group who had a clinical relapse during specific treatment presented with a 4-fold increase in antibody titer immediately before relapse. In Group II, nine patients remained antibody positive at follow-up (61.9 +/- 40.0 months), despite their good physical health, indicating that the detection of antibodies to P. brasiliensis by the DID test does not necessarily indicate active disease. These data suggest that changes in antibody titers to P. brasiliensis detected by DID may be useful indicators of the extent of active disease. Measurement of antibody titers may be valuable for determining the prognosis of the infection and for deciding on a suitable treatment protocol.

Antibodies, Fungal↗
PubMed1988

Conidiobolus coronatus infection treated with ketoconazole.

We describe a case of subcutaneous zygomycosis caused by Conidiobolus coronatus of six years' duration. Following treatment failure using potassium iodide, the patient responded with ketoconazole therapy. She remained well three years following therapy. Brazilian cases of subcutaneous infections caused by C coronatus and Basidiobolus ranarum are reviewed.

Adult↗
PubMed1988

[Dermatophytosis and atopy].

The association of dermatophytosis and atopy on patients from the University Hospital, Federal University of Rio de Janeiro, was carried out during 1984-1985 as follows: a) 141 cases exhibiting lesions on feet, glabrous skin, groins, nails and scalp. The dermatophytes were demonstrated in the material from skin and nail scrapings and depilated hairs by direct microscopic examination and culture; b) 131 cases of several skin diseases other than dermatophytosis (control group). Both were inquired about personal history of atopic dermatitis, asthma and rhinitis. In the first group 14 (9.9%) patients gave a positive personal history of atopy while in the control group only one (0.7%) did it. The comparison between the studied groups was made be means of the chi-square test and a statistically significant difference was established (p less than 0.001) giving a greater risk for getting dermatophytosis to those suffering from atopic disease.

Adolescent↗
PubMed1987

Prevalence of paracoccidioidomycosis in hospitalized adults in Rio de Janeiro (RJ) Brazil.

Double immunodiffusion were used as screening test for the diagnosis of paracoccidioidomycosis. Five hundred hospitalized adults from general (150 patients--group I) and from a specialized chest disease hospital (350 patients--group II), were tested. All of them were without definitive etiological diagnosis and clinical specimens were obtained from the patients with positive serology. Testing sera obtained from 150 patients of the group I, fifty six cases of paracoccidioidomycosis were diagnosed. Specimens for mycological examination were subsequently obtained from 50 of these patients; P. brasiliensis could be recovered in 49 (98%). Fundamental importance was the finding of 17 (4.8%) cases of paracoccidioidomycosis among the 350 patients referred from a chest disease hospital (group II). Serological evidence of paracoccidioidomycosis found in 73 (14.6%) of the 500 screened patients, indicates a relatively high prevalence of this mycosis in adults patients admitted to several hospitals in RJ. These data probably do not reflect the real prevalence of paracoccidioidomycosis in RJ and should be considered as a gross underestimation. Thus, attention should also be paid to juvenile forms and DID could be of a great value in screening these cases too.

Brazil↗
PubMed1987

Canine histoplasmosis in Rio de Janeiro: natural and experimental infections.

Seven of 73 mongrel dogs in Rio de Janeiro gave positive results in skin tests with a polysaccharide mycelial antigen from Histoplasma capsulatum. Five of the positive reactors were necropsied and four of them had disseminated histoplasmosis proved by histopathology and culture. Four healthy puppies exposed for 10 min to soil at the site of a known outbreak of histoplasmosis developed symptoms and died 7-14 days after exposure with fulminant histoplasmosis. These experiments show the value of dogs as epidemiological indicator of histoplasmosis and as experimental models for the disease.

Animals↗
PubMed1985

[Tinea manuum. Report of 13 cases].

The authors report 13 cases of tinea manuum and emphasize that this condition is not commonly described in the Brazilian medical literature. Eight males and five females, aged 18 to 72 years, presented an infection ranging from 1 month to 20 years. The main clinical picture was of desquamating type on the palms without fingernails lesions. All patients had associated dermatophytosis of the feet. Trichophyton mentagrophytes, T. rubrum and Epidermophyton floccosum were the species isolated from the hands. The trichophytin test was positive in all cases and treatment with oral griseofulvin and topical clotrimazole and miconazole was rather effective. Clinical evaluation at the end of the treatment and afterwards did not show relapses.

Adolescent↗
PubMed1984

[Mycological and clinical study of 102 cases of dermatosis].

With the main purpose to recognize the pathogenic fungi which can be isolated from skin diseases and simultaneously from normal and abnormal toe spaces, the authors studied 102 patients with several dermatoses and a control group with 21 cases of dermatophytosis which were diagnosed by direct examination and culture of infected skin and nails, and by clinical features. All patients were submitted to mycological examination of the skin lesions and interdigital spaces. No pathogenic fungi were isolated from dermatoses but species of candida could be found from skin lesions and nails in the control group and from normal and abnormal toe webs in the dermatoses group. The authors conclude that in these previous skin lesions there was no local predisposition to fungus infection and they seem to be less important than heat, moisture, friction, immunosuppression, lymphoma, a variety of endocrine abnormalities and cachetic states.

Dermatomycoses↗
PubMed1983

Pulmonary function in paracoccidioidomycosis (South American blastomycosis). An analysis of the obstructive defect.

Comparison of the mean results of routine pulmonary function studies of 17 patients with diffuse pulmonary paracoccidioidomycosis (PM) and manifestations of chronic obstructive pulmonary disease (COPD) to those of 17 matched patients with pure COPD showed no significant differences. These findings were interpreted as fresh evidence suggesting that expiratory obstruction in PM may be secondary to underlying COPD. Other evidence to that effect is discussed.

Female↗
PubMed1977

[On the toxicology of carbromal. II. Pharmacokinetics of carbromal and its hypnotically active metabolites in the rat (author's transl)].

Oral doses up to 20 mg/kg of carbromal and of bromoethylbutyramide were rapidly absorbed in the rat. Absorption from the stomach ligated at the pyloric end was 5-8 fold less than absorption of carbromal injected directly into the small intestine. Oral doses greater than 20 mg/kg of carbromal disappeared more slowly from the gastro-intestinal tract because gastric emptying was delayed. Both carbromal and bromoethylbutyramide were able to reduce the basal tone and the acetylcholine-induced contraction of isolated rat fundus strips. Carbromal and bromoethylbutyramide distributed evenly between serum, brain and skeletal muscle. Concentrations in adipose tissue were three times those in the other three tissues. Concentrations of both carbromal and of bromoethylbutyramide in all four tissues declined at the same rate. Thus, serum concentration of either compound may be used to estimate the total body content. Intraperitoneally injected carbromal, bromoethylbutyramide and ethylbutyrylurea disappeared from the brain and from the serum with half-life of 3-4 h and 5-7 h, respectively. Traces only of unchanged carbromal, bromoethylbutyramide, or ethylbutyrylurea were excreted with urine or feces indicating rapid and extensive biotransformation of the three compounds in this species. No evidence was obtained of secretion of either carbromal or its two metabolites into the lumen of the stomach. The findings are discussed as to their relevance for acute carbromal poisoning in humans.

Administration, Oral↗
PubMed1976

[On the toxicology of carbromal. I. Estimation of carbromal and its hypnotically active metabolites in rats and humans (author's transl)].

To analyze the toxic effects of carbromal it was necessary to have information on the concentrations of carbromal and of its metabolites in the organism. This information can be obtained by a simple method based on gaschromatography that allows rapid, specific, sensitive and quantitative estimation of carbromal and of its hypnotically active metabolites bromoethylbutyramide and ethylbutyrylurea. Employing different detectors (flame ionisation or electron capture detector) the limit of detection for carbromal and of its two metabolites was 2-3 nmoles/g of tissue. The method was used to study in rats the absorption and elimination of carbromal including biotransformation of carbromal to bromoethylbutyramide and ethylbutyrylurea. Both metabolites, significant amounts of which were found in serum and brain, distribute evenly between serum and brain as does carbromal. Both metabolites were detectable in the organism for a longer time than carbromal. Carbromal was given orally to 4 healthy volunteers at a dose of 1 g (4.2 nmoles). Highest serum concentrations (30 nmoles/ml) were found 30 min after ingestion. Serum concentrations declined rapidly. Twenty-four hours later 3-4% of the values were present in the serum. Beside carbromal considerable amounts (up to 20 nmoles/ml) of bromoethylbutyramide were detected but only small amounts (2-3 nmoles/ml) of ethylbutyrylurea. Peak concentrations of these metabolites were recorded 4-5 h after ingestion of carbromal. As was the case in rats both metabolites were present in the organism for a longer time than carbromal.

Adult↗