Epidemiological studies of paracoccidioidomycosis have been based on surveys achieved with intradermal tests, and paracoccidioidin is the most common antigen used in most cases. The glycoprotein of 43-kDa (gp43) has been used in intradermal tests. It is the most antigenic component of Paracoccidioides brasiliensis, and it provides greater specificity to evaluate infection for this fungus. In this study, the prevalence of P. brasiliensis infection was estimated with intradermal tests involving gp43 for 695 people in rural Central-West Brazil. The infection rate was 45.8 % (95 % CI = 42.1-49.5), and the average age of those infected was 45.8 ± 18.2 years. The prevalence did not show gender-based differences but increased with age. The results demonstrate the importance of P. brasiliensis infection in rural settlements and the early exposure of children in the region to the fungus. Despite the high antigenicity and specificity of gp43, its usage must be standardized, so that epidemiological surveys will be comparable and more accurately reflect P. brasiliensis infection in endemic areas.
With the objective to evaluate the behavior of paracoccidioidomycosis
in the last three decades, clinical and epidemiological data of 595 patients
admitted to clinical services of the Federal University of Mato Grosso do Sul
from 1980 to 2009 were investigated. Gender, age distribution, clinical form,
comorbidity with tuberculosis or AIDS, and mortality were compared by decades of
clinical admission. It was shown that during the three decades there was a
decrease in women percentage, and the same manner occurred a reduction in
participants in the age group of 20 to 39 years. Moreover, the acute/subacute
forms have been diminished in the period. These fluctuations are closely related
and can be simultaneously analyzed. Increased AIDS co-infection prevalence from
the first to the second decade was also revealed, coinciding with the appearance
of the retroviral epidemic and stabilizing during the third decade. No change in
the tuberculosis co-infection rate was observed (overall = 6.9%). It
reinforces the importance of this co-morbidity. The overall mortality rate
remained steady at 6.7%, not varying significantly from one decade to another.
The persistent mortality rate calls attention to the importance of this
neglected disease.
Objective: To evaluate the treatment compliance of patients with paracoccidioidomycosis. Methods: We studied 188 patients with paracoccidioidomycosis admitted to a tertiary referral hospital in the Central-West Region of Brazil from 2000 to 2010, to assess their compliance to treatment. In order to be considered compliant, patients needed to present two established criteria: (1) receive medicines from the pharmacy, and (2) achieve a self-reported utilization of at least 80% of the dispensed antifungal compounds prescribed since their previous appointment. Results: Most patients were male (95.7%), had the chronic form of the disease (94.2%), and were treated with cotrimoxazole (86.2%). Only 44.6% of patients were treatment compliant. The highest loss to follow-up was observed in the first 4 months of treatment (p < 0.02). Treatment compliance was higher for patients with than for those without pulmonary involvement (OR: 2.986; 95%CI 1.351-6.599), and higher for patients with than without tuberculosis as co-morbidity (OR: 2.763; 95%CI 1.004-7.604). Conclusions: Compliance to paracoccidioidomycosis treatment was low, and the period with the highest loss to follow-up corresponds to the first four months. Pulmonary paracoccidioidal involvement or tuberculosis comorbidity predicts a higher compliance to paracoccidioidomycosis therapy.
The aims of this study were to determine whether S. aureus could be killed by toluidine blue-mediated photosensitization in vivo in an animal model. Twelve Wistar rats divided into three groups (n = 12): Group I: Control Group, the wounds were made and submitted to the application of the laser without the drug photosensitizing; Group II: The implementation of wounds received the toluidine blue, without application of laser; Group III: it was used toluidine blue, and application of laser-Indio phosphide Gallium-Aluminum (InGaAIP) 660nm power and density of 20 Joules/cm2. Statistical analysis of CFU by analysis of variance Kruskal-Wallis test shows significant intraoperative difference, photodynamic therapy group (p < 0, 05), the Dunns post hoc test shows significant difference between Group I when compared to Group II treated with LLLT (p < 0001). The results of this study show that photodynamic therapy with toluidine blue has reduced the number of Staphylococcus aureus in vivo.
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