Biomedical subjects
V Amato Neto
Publications and source records attributed to V Amato Neto.
[Treatment of american cutaneous leishmaniasis, with lesions in the mucosa, using pentamidine isethionate].
Ten patients with mucosal lesions caused by American tegumental leishmaniasis were treated with pentamidine isethionate at the dose 4 mg/kg on alternate days by the intravenous route. The mean posology was 2,140 mg. Healing of the lesions occurred in 9 (90%) of the patients who completed treatment. There was no recurrence during a follow-up time of 1 to 24 months (mean, 7,7 months). One patient discontinued treatment before healing of the lesion because be developed diabetes mellitus. In 3 (30%) patients, blood exams showed increased urea and creatinine levels and leucopenia, which were corrected by increasing the interval between administrations of the drug. Pentamidine isethionate is efficient in bringing about cicatrization of the lesions but needs further evaluation in terms of its value in preventing recurrence.
Parotid enlargement due to adenovirus infection in patient with human immunodeficiency virus infection.
The authors report a case of adenovirus-induced enlargement of the parotid gland involving a patient infected with human immunodeficiency virus (HIV). Physical examination revealed good general condition, no fever and bilateral enlargement of the parotid region, which was of increased consistency and slightly tender to palpation. Histological examination of the parotid gland demonstrated a slight periductal lymphomononuclear inflammatory infiltrate with the presence of focal points of necrosis. Tests to determine the presence of fungi and alcohol-acid resistant bacilli were negative. Immunohistochemistry for cytomegalovirus, herpes simplex, HIV p24 antigen and adenovirus showed positivity only for adenovirus in the epithelial nuclei of numerous gland ducts. This is the third case of this type reported in the literature, indicating the importance of including adenovirus in the differential diagnosis of this condition.
[Oocysts of Cryptosporidium sp in feces: comparison of the modified Kinyoun and Heine methods].
The diagnosis of intestinal infection by Cryptosporidium sp is crucial today; with the progression of the AIDS epidemic, many cases of cryptosporidiosis have appeared in this setting and in other immunodeficiency diseases. We compared the advantages and disadvantages of Heine's method and modified Kinyoun's method in the following parameters: morphology of the parasite, quantitation of cysts, stability of the staining characteristics timewise on the slides and time spend at staining. All positive fecal smears were obtained from patients with AIDS. The sensitivity of these two techniques was the same. The choice should be made by the best aspects of each method. Heine's was better for quantitation of the cysts and was faster. Kinyoun's was better for conserving the stained smear.
[Trials for the use of gamma rays in the prevention of Trypanosoma cruzi transfusion infection].
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[Cutaneous lesions as the only manifestations of reactions to Trypanosoma cruzi infection in a recipient of a kidney transplant].
We report a patient with chronic asymptomatic Chagas' disease that presented Trypanosoma cruzi reactivation after kidney transplantation and immune depression. The only clinical manifestation of the disease was ulcerative skin lesions, which is unusual in Chagas' disease.
[The influence of corticoids, in Chronic Chagas disease, administered in virtue of associated disorders].
Patients with chronic Chagas' disease and simultaneous medical problems treated with corticosteroid were studied in order to evaluate steroid influence on chronic Trypanosoma cruzi infection. Parasitological assessment, radiological and electrocardiographic studies as well as non specific tests were performed in patients and in a control group that included chronic infected patients not treated with steroid. Xenodiagnosis showed a clear increase in T. cruzi parasitemia, related to the corticosteroid dosage, without clinical manifestations during the study follow-up period.
[Evaluation of the quality of life in patients with Chagas' disease undergoing a heart transplant].
Quality of life was evaluated in 11 patients with Chagas' disease 26 to 126 months after submission to heart transplantation. There was an objective improvement in their quality of life, after the transplant.
Chagas' disease: an algorithm for donor screening and positive donor counseling.
Classical serological screening assays for Chagas' disease are time consuming and subjective. The objective of the present work is to evaluate the enzyme immuno-assay (ELISA) methodology and to propose an algorithm for blood banks to be applied to Chagas' disease. Seven thousand, nine hundred and ninety nine blood donor samples were screened by both reverse passive hemagglutination (RPHA) and indirect immunofluorescence assay (IFA). Samples reactive on RPHA and/or IFA were submitted to supplementary RPHA, IFA and complement fixation (CFA) tests. This strategy allowed us to create a panel of 60 samples to evaluate the ELISA methodology from 3 different manufacturers. The sensitivity of the screening by IFA and the 3 different ELISA's was 100%. The specificity was better on ELISA methodology. For Chagas disease, ELISA seems to be the best test for blood donor screening, because it showed high sensitivity and specificity, it is not subjective and can be automated. Therefore, it was possible to propose an algorithm to screen samples and confirm donor results at the blood bank.
[The clinical evaluation of quinine for the treatment of Plasmodium falciparum malaria].
Quinine was the first antimalarial drug to be employed and also the first resistance was noticed to. After 1960 quinine urged to be reintroduced in routine therapy alone or in combination. Aiming at evaluating the effectiveness of different schedules we studied 484 patients seen at the Malaria Laboratory. We used quinine alone in 126 patients, quinine plus sulfadoxine and pyrimethamine in 119 patients and quinine plus tetracycline in 239 patients. The results shown that 81% of all patients were treated with success and only 0.6% were R2. and there is no R3. We emphasize a high resistance rate to quinine either alone (23.1%) or associated to sulfadoxine and pyrimethamine (37.8%). A higher resistance rate seen with the combination might be linked to the smaller dose of quinine used in that instance. It is worth noting the high cure rate with the quinine-tetracycline association.
[The treatment of rats experimentally infected with Strongyloides venezuelensis by orally administered ivermectin].
Strongyloides venezuelensis experimental infection in rats was treated by two different oral preparations of ivermectin, 0.2 mg/kg. One was a human formula used by WHO in the treatment of onchocerciasis; the other was a veterinary preparation. Adult worms and larvae were evaluated. The human formulation cleared both forms in 59.3% (adult worms) and 73.0% (larvae), whereas the veterinary one cleared 98.0% and 84.2%, respectively. The antilarval action is very useful when treating systemic strongyloidiasis.
[A case of mucocutaneous leishmaniasis treated with success with a low dose of pentavalent antimonial].
The authors report a case of a 89 years-old woman with mucocutaneous leishmaniasis and previous diabetes mellitus and high blood pressure, who had been treated with allopurinol for 10 months without healing of lesions. Afterwards, she has been treated with meglumine antimonate, "glucantime" for 4 days, with a total dose 2,380 mg of Sbv, but developed cardiac side effects and hypokalemia, hence the treatment was withdrawn. However, this patient developed total clinical regression of lesions, in spite of she has been received low dose of this drug.
[An attempt to detect Trypanosoma cruzi in the peripheral blood of patients with Chagas' disease, in chronic phase, using quantitative buffy coat (QBC)].
Taking for granted the sensitivity of the Quantitative Buffy Coat (QBC) system, as documented in a murine experimental model, we assayed to detect Trypanosoma cruzi in the peripheral blood of 100 patients with Chagas disease in its chronic phase. By means of the method, no positivity occurred, evently as a consequence of small parasitemias, undetectable by this technique as assessed by the cases in consideration.
[Utility of gamma rays in prophylaxis of transmissible malaria by blood transfusion].
This study was carried out to evaluate the fortuitons advantage of using gamma irradiation in the prophylaxis of transmissible malaria by blood transfusion, with mice as the experimental model. In the first step, when the infected blood with Plasmodium berghei was submitted to 2,500 rad and 5,000 rad, with or without metronidazol, there was no success, because the animals presented parasitaemia and died after inoculation of irradiated blood. However, there was partial success in the second step, when the infected blood received 10,000 and 15,000 rad, and was inoculated in mice, which showed infection, and presented a survival rate of 20% and 40%, respectively, with later negativation of blood infected by P. berghei.
[Cost effectiveness of the treatment of HIV infection].
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[Trichome staining method applied to stools from HIV-infected patients with diarrhea, for microsporidia investigation].
The microsporidia have been involved in several clinical manifestations in patients with AIDS, of whom diarrhoea is the commonest. The diagnosis of microsporidiasis depended on invasive procedures and the identification of the organisms is made by electron microscopy. The modified trichrome staining method allows that the diagnosis be made without such procedures by using light microscopy. In the present work, the modified trchrome method was applied in stools from 62 patients with diarrhoea, who had asymptomatic HIV infection or AIDS. Of the 62 samples analyzed, there was detection of microsporidial spores in one. This work confirms the existence of such protozoans in our patients, associated with manifestations of chronic diarrhoea in patients with AIDS who have severe immunodeficiency and ascertains that this staining method allows satisfactory identification of microsporidia from faeces, as well points out some directions to further studies.
[The evaluation of the efficacy of azithromycin and pyrimethamine used alone or in combination in the treatment of an experimental infection in mice by Toxoplasma gondii].
The efficacy of azithromycin and pyrimethamine in experimental infection of mice with Toxoplasma gondii was tested. Daily dosages of 200 mg/kg and 12.5 mg/kg, respectively, were given orally over a period of ten days. The medications were administered in combination or separately. The combined use of the drugs yielded better results, and a similar investigation using a cystogenic strain of the parasite will be conducted in a future study.