Sheep and goat's milk allergy--a case study.
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Biomedical subjects
Publications and source records attributed to P L Pinto.
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Larvae and adult forms of Aedes albopictus were found during ecological study of anopheline mosquitos in the rural zone of the state of Mato Grosso do Sul in Brazil. This occurrence was registered, for the first time in Brazil, in an enzoootic area if sylvatic yellow fever virus. This implies a potential risk of the transfer of this virus to an urban area infested with Aedes aegypti.
The northeastern highlands of Brazil are endemic for several tropical diseases, especially American trypanosomiasis (Chagas' disease) and schistosomiasis. Twenty years ago, we measured the seroprevalence of protozoan diseases in Santo Inácio, a village of approximately 1,000 inhabitants located 1,000 m above sea level. We detected small numbers of sera with antibodies against Trypanosoma cruzi and Toxoplasma gondii, and the area had a low prevalence both of American trypanosomiasis (3.54%) and toxoplasmosis (27.43%) compared with nearby Brazilian areas. This was attributed to a specific triatomine vector and local housing conditions. Twenty years later, we again determined the prevalences of both diseases and compared these results with those from Iraquara, a larger town with the same ethnic and social background but with a higher prevalence of rural activities. The incidence of Chagas' disease in San Inácio showed the same low level, i.e., 3.78% (5 of 132) with only adult males affected in contrast with Iraquara, which had an incidence of 34.5%, but a low prevalence of only one of 22 among children up to 14 years of age. Santo Inácio maintained a low (25.8%) seroprevalence for toxoplasmosis. Housewives presented a higher incidence of toxoplasmosis during both periods, probably due to related risk factors. Cats were found less frequently in Santo Inácio than in Iraquara, which showed an incidence of 65.5% seropositivity for Toxoplasma gondii. These results suggest that the environmental conditions of Santo Inácio were preserved after 20 years, with a low incidence of these selected protozoan diseases.
Elevated levels of soluble CD30-sCD30 (possibly related to Th2) are seen in atopy and other diseases. Dehydroepiandrosterone (DHEA) may regulate Th1/Th2 balance. The aim was to study the relationship between the levels of sCD30, DHEAS and DHEA in atopic (A) and non atopic (B) children, to assess immune-endocrine interactions. We studied 36 children (8-15 years), 18 (A) monosensitised to Dermatophagoides Pteronyssinus (Dpt.), and 18 (B) with isolate rhinitis (R) or asthma (BA) and R (33.3%) without differences in age and sex. They were all HIV negative and free from any medication. It was determined sCD30, DHEAS and DHEA. There was no statistically significant differences between A and B for the levels of DHEAS, DHEA suggesting that the role of this regulation in Th2 type is not important in patients with allergic disease in this age group. sCD30: A-mean 121.1U/ml; B-mean 53.9U/ml. This difference is statistically significant-p = 0.02. sCD30 in patients only with R showed also significant differences-p = 0.01. These results could reflect the Th2 profile. There is an overlap of the values (for R < 80 U/ml; for BA + R < 140 U/ml). Due to this only values > 80 U/ml for R and > 140 U/ml for BA + R could be considered discriminating for atopy.
UNLABELLED: There are not many studies about the intestinal parasitosis (IP) and atopic asthma (AA) relationship, and these show discordant results, possibly due to different studies design and differences in population selection. On the basis of personal results obtained by an epidemiological inquiry designed to estimate the prevalence of enteroparasitoses in asthmatic children and vice vesa, the aim of this study was to compare the prevalence of IP in AA and in a control group (CG) by a cross sectional study using clinical and laboratorial parameters, applied to 63 children (47 with AA and 16 in CG) aged 6 to 11 years, 37 males and 26 females, Caucasians, with the same socioeconomical conditions, consecutively selected in our Hospital. The results showed: The IP in AA children was 21.3%; the IP in CG was 25%; in the group with AA and IP, 40% of them had symptomology of IP; in the CG with IP, 100% had symptoms. CONCLUSIONS: The IP prevalence in AA was not statistically different from the IP in CG (p > 0.05) More data are needed to clarify the significant differences between the symptomatology rates of IP in asthmatic and non asthmatics; the reduced number of patients with symptoms in AA may reflect modulation of IP in AA and/or different parasite load.
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UNLABELLED: ALATOP is an "in vitro" radioimmunoassay screening test for atopy, previously validated in a caucasian population. The aim of the study was to assess the usefulness of a screening test of atopy in a non caucasian population. We select a non caucasian population (n = 208), from hospital immunoallergy consultations, Cape Verde Republic (Africa). It was determined the sensitivity, specificity and predictive values comparing with skin prick tests (SPT) results for the 208 patients, and with clinical data (Clin) in 115 patients. It was also determined the levels of total IgE, done by IRMA. RESULTS: Using different corrections factors, 0.85 gives the best results: ALATOP/SPT-Sensitivity-88.5% +/- 4.34; Specificity-73.8% +/- 8.41; Positive predictive value-66.9%; Negative predictive value-91.4%; Efficiency of the test-79.3%. ALATOP/CLIN-Sensitivity-95.2% +/- 3.89; Specificity-71.2% +/- 12.07; Positive predictive value-65.6%; Negative predictive value-96.2%; Efficiency of the test-80.0%. The mean values of total IgE were-406 IU/ml. CONCLUSIONS: The mean value of total IgE was significantly increased even in the ALATOP-/SPT-not saw in caucasian populations. The use of a different correction factor (0.85) for ALATOP, optimize the test, showing a good negative predictive value, but raises the question of adapted compositions of screening tests for different populations.
Myocarditis is not an uncommon finding in autopsy series of patients with AIDS, although clinically important myocarditis is rarely noted. We describe a 50-year-old woman with AIDS and chronic chagasic megaesophagus, without previous cardiac abnormalities, who experienced reactivation of Chagas' disease, characterized by the finding of Trypanosoma cruzi via direct microscopic examination of the buffy coat, xenodiagnosis, and blood culture; she developed fatal acute myocarditis. Reactivation of Chagas' disease in patients with AIDS has been reported, but in the great majority of cases it has been associated with central nervous system involvement. In areas where Chagas' disease is endemic, reactivation may occur in patients with AIDS.
The CAP System compared with RAST has a greater sensitivity, with the same specificity, as well as an excellent correlation with skin prick tests (SPT), as documented by others. Standardization of SPT is essential for routine and investigational purposes. We used a standardized lancet (DHS), and the methodology of reading the SPT was a computerized digitalized graphics tablet coupled to an IBM-PC AT using CAD software, expressing the result as wheal areas with cut off +/- at 7 mm2. The method is precise and reproducible with a mean coefficient of variation (cv) intratester--T1: 3.1%, T2: 3.5% and a cv intertester: 2.93%. We compare the results of SPT of two different allergen extracts for Dermatophagoides Pteronissynus (DPt) (Bencard; Merck/Allergo-Pharma, standardized in SBU) and correlate them with specific IgE, in 122 patients, 72 males and 50 females, aged 3 to 19 years. The results between the extracts and the results of specific IgE obtained by CAP System with each of the extracts, were correlated. 34 patients were considered to be non atopic. 88 patients showed at least one positive result with one test, being those used to correlate the positive results.... The results showed good correlations for quantitative SPT between Bencard and Merck/Allergo-Pharma, as well as for the capacity of eliciting positive results. When SPT were compared to specific IgE as +/- and as quantitative results, there were good correlation for Bencard/CAP and Merck/CAP. The results obtained suggest that CAP can be used to validate allergen extracts of DPt and that studies with other extract are advisable.
UNLABELLED: The limitations of total IgE for the screening of atopy, gave rise to in vitro multispecific IgE tests to common allergens. These should have an increased sensitivity and specificity when compared to total IgE. Previous data showed the interest of such tests in screening procedures. ALATOP is a new in vitro multispecific IgE test including common aero and food allergens, in liquid phase, for paediatric and adult population. The result is expressed only in positive/negative. The aim of the study was to determine the sensitivity, specificity, positive and negative predictive value and test efficiency, by comparing the results obtained in 266 paediatric patients (selected in our Unit based on a good correlation between clinical history and skin prick tests--SPT), between ALATOP and SPT. RESULTS: 1) Sensitivity: 89.57%; 2) Specificity: 98.06%; 3) Positive predictive value: 98.65%; 4) Negative predictive value: 85.59%; 5) Efficiency of the test: 92.86%; 6) Reproducibility of the test--average: 5.63%. Based on this results and when they are compared to single specific IgE determinations, that are assumed to be about 80% of the sensitivity of SPT, ALATOP showed excellent results, allowing its use in the screening of atopic disease.
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For the therapy of human strongyloidiasis, are necessary effective drugs to eliminate both larvae and adult worm parasitism, which may also be used by parenteral route, to obviate the particular conditions presented by many patients. A study based on the experimental infection by Strongyloides venezuelensis in rats was done, administering injectable ivermectin or levamisole. Both drugs were shown to be active, when used in single doses of 0.2 to 0.5 mg/kg of ivermectin, or 26 mg/kg for levamisole. Ivermectin was slightly more effective as far as larval stage of the infection is concerned, and the same happened for levamisole for the adult worm stage. Promising perspectives are visualized to improve the therapy of patients with serious disseminated infection by Strongyloides stercoralis.
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.
Human schistosomiasis, caused by Schistosoma mansoni, is highly prevalent in Brazil and usually diagnosed by time consuming stool analysis. Serological tests are of limited use in this disease, mainly for epidemiological studies, showing no discrimination between previous contact with the parasite and active infections. In the present study, we standardized and compared a Dot-ELISA for IgM and IgG antibodies against S. mansoni antigens from eggs and worms with a routine IgG and IgM immunofluorescence assay using similar antigens, in the study of sera from 27 patients who had quantified egg stool excretion. The positivity obtained for IgG Dot-ELISA was 96.3% and 88.9% for IgM Dot-ELISA with worm antigen and 92.6% and 90.9% with egg antigen. The IFI presented similar positivities using worm antigen, 92.6% (IgG) and 96.3% (IgM), and lower results with egg antigen, 77.8%(IgG and IgM). The patients studied were divided into two groups according to their egg excretion, with greater positivity of serological tests in higher egg excreters. When comparing the quantitative egg excretion and the serological titers of the patients, we detected a correlation only with IgM Dot-ELISA, with r = 0.552 (p = 0.0127). These data show that Dot-ELISA can be used for the detection of specific antibodies against S. mansoni in sera from suspected patients or in epidemiological studies and, with further purification of egg antigen and larger samples, IgM Dot-ELISA could be a possible tool for rough estimates of parasite burden in epidemiological studies.