Herein, we describe a unique case of concomitant angioinvasive pulmonary aspergillosis due to Aspergillus fumigatus and yellow fever in a free‐ranging howler monkey (Alouatta sp). Lung samples were negative for influenza viruses A and B.
Formalin-fixed paraffin-embedded (FFPE) tissues are an important source for investigation of dengue virus (DENV) infection, particularly when blood or fresh frozen (FF) samples are unavailable. Histopathologic features and immunohistochemistry may have poor sensitivity and serotype determination is not always possible. Viral RNA genome detection tests are faster and considered the most sensitive technique for this kind of analysis, however, the use of molecular methods applied to FFPE tissues is still limited. The authors applied a single-step multiplex reverse transcription-quantitative polymerase chain reaction (RT-qPCR) for the investigation of DENV infection and typing to FFPE samples of 32 fatal cases received during the 2019 outbreak that occurred in São Paulo state, Brazil. The authors compared the results with those obtained using FF tissues. Of the 24 cases with both FF and FFPE samples, 22 (91.67%) of the FF and 19 (76.20%) of the FFPE specimens were positive. Two cases (8.33%) tested negative in both types of samples. All 8 cases with only FFPE samples available were positive. The accuracy (87.5%) of the RT-qPCR for DENV in FFPE samples were satisfactory. Although the cycle quantification (Cq) values were significantly higher in these materials (P<0.0001, Wilcoxon signed-rank test) when compared with FF tissues, Spearman’s rank coefficient indicated a good correlation between the Cq values from both sample types (P=0.0063; rho=0.576). RT-qPCR applied to FFPE samples improved detection of DENV in fatal cases and represents a useful tool for diagnosis and epidemiologic studies.
OBJECTIVE To evaluate the performance of post mortem laboratory analysis in identifying the causes of hemorrhagic fever and/or neuroinvasive disease in deaths by arbovirus infection. METHODS Retrospective cross-sectional study based on the differential analysis and final outcome obtained in patients whose samples underwent laboratory testing for arboviruses at the Pathology Center of the Adolfo Lutz Institute, in São Paulo, Brazil. RESULTS Of the 1355 adults clinically diagnosed with hemorrhagic fever and/or neuroinvasive disease, the most commonly attributed cause of death and the most common final outcome was dengue fever. Almost half of the samples tested negative on all laboratory tests conducted. CONCLUSION The failure to identify the causative agent in a great number of cases highlights a gap in the diagnosis of deaths of unknown etiology. Additional immunohistochemical and molecular assessments need to be added to the post-mortem protocol if all laboratory evaluations performed fail to identify a causative agent. While part of our findings may be due to technical issues related to sample fixation, better information availability when making the initial diagnosis is crucial. Including molecular approaches might lead to a significant advancement in diagnostic accuracy.
Este trabalho analisou dois destinos turísticos: Dourados e Ponta Porã, em Mato Grosso do Sul, sob os aspectos do marketing e da infraestrutura básica, tendo como parâmetros critérios já estabelecidos pelo Projeto 65 Destinos Indutores lançado em 2008 pelo Ministério do Turismo (MTur). Nenhuma das duas cidades faz parte da medição do Projeto do MTur, mas apresentam fluxo turístico relevante para o estado e para a economia local. Apesar de aproveitar critérios já estabelecidos, a metodologia fundamentou-se na elaboração de uma escala com valores específicos para esta pesquisa. Além disso, fez-se revisão teórica e entrevistas com os atores representativos do setor turístico em ambos os municípios. Os resultados indicam que a metodologia aplicada é válida para analisar qualquer aspecto importante para o desenvolvimento do turismo, principalmente quando a abordagem for qualitativa. No caso de Dourados e Ponta Porã, conclui-se que ambas possuem boa infraestrutura para o turismo e buscam divulgar-se enquanto destino, porém, muitos dos critérios abordados precisam ser melhorados ou implantados, principalmente em relação à segurança pública e ao marketing.
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