Abstract. Dengue fever is the most common arbovirus disease, and presents with a large spectrum of clinical manifestations ranging from asymptomatic disease through to the development of dengue hemorrhagic fever. These extreme cases can lead to dengue shock syndrome, and sometimes death. Spinal cord involvement in dengue virus (DENV) infections is rare. Here, we report a case in which the patient developed acute transverse myelitis (TM) without paraparesis following a DENV infection. This case highlights the importance of physicians' awareness of the possible link between DENV and TM in endemic areas. BACKGROUND
Introduction:We describe the epidemiology of intestinal parasites in patients from an AIDS reference service in Northeastern São Paulo, Brazil. Methods: Retrospective evaluation was done for all HIV-1/AIDS-positive patients whose Hospital de Base/São José do Rio Preto laboratorial analysis was positive for enteroparasites after diagnosis of HIV-1 infection, from January 1998 to December 2008. Statistical analysis was performed using the R statistical software version 2.4.1. The level of significance adopted was 5%. Results: The most frequent protozoan was Isospora belli (4.2%), followed by Giardia lamblia (3.5%), Entamoeba coli (2.8%), and Cryptosporidium parvum (0.3%). Ancylostoma duodenale (1.4%) was the most frequently detected helminth, while Taenia saginata and Strongiloides stercoralis were found in 0.7% of the samples. The results showed that diarrhea was significantly associated with giardiasis and isosporiasis. However, no association was observed between CD4 + cell counts, viral load, and the characteristics of any particular parasite. Conclusions: Our data may be useful for further comparisons with other Brazilian regions and other developing countries. The data may also provide important clues toward improving the understanding, prevention, and control of enteric parasites around the world. Keywords: Epidemiology. HIV-1. AIDS. Enteroparasites. HAART. Brazil. RESUMOIntrodução: Descrevemos a epidemiologia de enteroparasitoses em pacientes de um serviço de referência de AIDS, no noroeste paulista, Brasil. Métodos: Durante o período de janeiro de 1998 a dezembro de 2008, foi realizado este estudo retrospectivo por meio da análise dos prontuários dos pacientes diagnosticados com HIV-1/AIDS atendidos no Ambulatório de Doenças Infecto-Parasitárias do Hospital de Base, São José do Rio Preto, São Paulo. As análises estatísticas foram realizadas usando a versão 2.4.1 do software estatístico R. O nível de significância adotado foi de 5%. Resultados: O protozoário mais frequente foi o Isospora belli (4,2%), seguido da Giardia lamblia (3,5%), Entamoeba coli (2,8%) e Criptosporidium parvum (0,3%). O Ancylostoma duodenalis (1,4%) foi o helminto mais detectado, enquanto a Taenia saginata e o Strongiloides stercoralis foram observados em 0,7% das amostras. Os resultados mostraram que a diarreia foi significativamente associada com giardíase e isosporíase. Entretanto, nenhuma associação foi observada entre as contagens de células T CD4 + , carga viral e da característica de qualquer parasita em particular. Conclusões: Nossos dados podem ser úteis para futuras comparações com outras regiões do Brasil e outros países em desenvolvimento. Os dados também podem fornecer pistas importantes para a melhoria da compreensão, prevenção e controle de parasitas entéricos em todo o mundo. Palavras-chaves: Epidemiologia. HIV-1. AIDS. Enteroparasitas. HAART. Brasil.
SummaryBackground: Several infectious agents have been investigated since the association between atherosclerosis and infection was demonstrated; however, the results of these studies are contradictory.
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