Several studies have described the use of non-invasive collection methods, mostly based on the detection of parasite DNA, for diagnosis. However, no Leishmania specimens have been isolated from saliva. Here, we report the first isolation of Leishmania braziliensis from the saliva of humans with cutaneous leishmaniasis but without lesions on their mucosa. The isolates were obtained from salivary fluid inoculated in hamsters and were tested by multilocus enzyme electrophoresis. Seven samples from 43 patients suspected of having the disease were identified for in vivo culture. These findings suggest that saliva is a clinical sample that allows the isolation of Leishmania sp.

RESUMO Objetivo: Este estudo teve como objetivo investigar os sentidos do trabalho dos artistas circenses, nas três dimensões: individual, organizacional e social, seguindo a adaptação do modelo de Morin (2001), propostas por Oliveira et al. (2004) e Morin, Tonelli e Pliopas (2007). Originalidade/valor: O artigo se destaca por tratar de uma categoria de artistas que está perdendo espaço dentro da sociedade, sendo cada vez mais marginalizada. Diante disso, torna-se relevante entender qual o sentido de uma atividade que está em declínio. Design/metodologia/abordagem: Trata-se de um estudo descritivo e exploratório, de natureza qualitativa, em que, por meio de entrevistas semiestruturadas, foram coletados dados primários com dez artistas circenses. Para coleta de dados, utilizou-se a técnica da análise de conteúdo com o uso do software Atlas.ti. Resultados: Os resultados apontam que há sentido no trabalho para os artistas circenses em todas as dimensões: 1. Na dimensão individual, o fator que predominou foi o prazer, pois em mais de um momento todos os entrevistados enalteceram sua satisfação em pertencer ao circo; 2. Na dimensão organizacional, a utilidade predominou, já que todos consideram contribuir e atender às necessidades do circo; e 3. Na dimensão social, as relações interpessoais demonstraram que, mesmo com o preconceito em evidência, é possível relacionamentos externos ao circo. Os resultados contribuem para a literatura que envolve pesquisas com artistas circenses, levando-se em conta os seus sentidos do trabalho.

ABSTRACT Purpose: This study aimed to investigate the meanings of the work of circus artists in three dimensions, individual, organizational, and social, following the adaptation to the model of Morin (2001) proposed by Oliveira, Piccinini, Fontoura, and Schweig (2004) and Morin, Tonelli, and Pliopas (2007). Originality/value: The article stands out because it deals with a category of artists that is losing space within society, being increasingly marginalized. Given this, it becomes relevant to understand the meaning of an activity that is in decline. Design/methodology/approach: This is a descriptive and exploratory study of a qualitative nature, in which primary data were collected through semi-structured interviews with ten circus artists. For data collection, the content analysis technique was used in Atlas.ti software. Findings: The results point out that there is meaning in work for the circus artists across all dimensions: 1. In the individual dimension, the pleasure was the predominant factor, since in more than one moment, all the interviewees expressed their satisfaction in belonging to the circus; 2. In the organizational dimension, utility prevailed, since everyone considered contributing and meeting the needs of the circus; 3. In the social dimension, interpersonal relations, demonstrating that even with evidence of prejudice, external relationships can be formed in the circus. The results contribute to the literature that involves studies with circus artists, considering their meanings of work.

Abstract In Brazil, visceral Leishmaniasis is caused by Leishmania chagasi. The development of cutaneous lesions in visceral leishmaniasis patients has been described in two different clinical contexts. Patients with compromised immunity can develop skin lesions as a direct consequence of a current visceral disease. Equally, patients with a history of kala-azar and progressive, immune improvement occasionally develop skin lesions as a consequence of immune reconstitution infl ammatory syndrome. These cases manifest in similar fashion to the classic form of post-kala-azar dermal Leishmaniasis. We describe different cases that exemplify these two clinical presentations.

Os poromas são neoplasias benignas incomuns oriundas das porções ductais terminais das glândulas sudoríparas. Caracterizam-se principalmente por pápula ou nódulo cor da pele ou róseo, em geral nas extremidades. Devido à raridade, a hipótese clínica da forma pigmentada dificilmente é aventada, sendo fundamental a histopatologia. Relata-se caso de poroma écrino pigmentado na região palmar direita, localização considerada atípica. Ressalta-se a importância da dermoscopia como método auxiliar no diagnóstico do poroma e, principalmente, no diagnóstico diferencial com outras lesões pápulo-nodulares pigmentadas.

Poromas are uncommon benign neoplasms originating from the terminal ductal portion of the sweat glands, mainly characterized by skin-colored or pink pa pules or nodules, usually on the extremities. Due to their rarity, the pigmented form clinical hypothesis is hardly ever suggested and psychopathology is fundamental. We report a case of pigmented eccrine poroma in the right palmer area, a location considered atypical. We stress the importance of dermoscopy as a method for diagnosis of poromas, especially in the differential diagnosis with other pigmented nodular-popular lesions.

Resumo Objetivos: Analisar o perfil clínico e laboratorial de idosos portadores de estenose aórtica severa e possíveis diferenças entre os sexos. Método: Foram estudados 30 pacientes (18 homens e 12 mulheres), com média de idade de 70,7±5,3 anos, portadores de estenose aórtica acentuada, sendo avaliados quanto a sintomas clínicos, presença de fatores de risco, padrões eletrocardiográficos, ecocardiográficos e associação com doença arterial coronariana, pela realização de angiografia coronariana. Resultados: Dispnéia foi o sintoma mais frequente (40%). Mulheres tinham mais angina que os homens. Apenas dois pacientes tinham fração de ejeção baixa. Homens apresentaram menores frações de ejeção que mulheres (p<0,05). Houve alta prevalência (53,3%) de doença arterial coronariana associada através de coronariografia. Conclusões: Os achados de dispnéia como sintoma mais frequente no grupo total, diferença da frequência de sintomas entre os sexos e fração de ejeção menor nos homens sugeriram que os mecanismos de adaptação ventricular à estenose aórtica possam ser diferentes entre os sexos. Existe forte associação entre estenose aórtica senil calcificada e doença arterial coronariana em idosos.

Abstract Objectives: To evaluate clinical and laboratorial profile in elderly patients with severe aortic stenosis and possible gender differences. Method: We studied 30 patients (18 males and 12 females) aged 70,7±5,3 years with severe aortic stenosis, analyzing clinical manifestations, risk factors, eletrocardiographic and ecocardiographic indexes and association with coronary artery disease by coronary angiographic assessment. Results: Dyspnea was the most frequent symptom with overall prevalence of 40%. Women had more angina than men. Ejection fraction was low in only two patients. Male patients had lower ejection fraction (p<0,05). High prevalence (53,3%) of associated coronary artery disease was observed. Conclusions: Data showed dyspnea as the most common clinical manifestation, gender differences of clinical manifestations and lower ejection fraction in male patients suggest that adaptive mechanisms to this condition may be different in both genders. There is a strong association between aortic stenosis in elderly and coronary artery disease.

INTRODUCTION: American tegumentary leishmaniasis (ATL) represents one of the most important public health issues in the world. An increased number of autochthonous cases of ATL in the Northeastern region of São Paulo State has been documented in the last few years, leading to a desire to determine the Leishmania species implicated. METHODS: PCR followed by DNA sequencing was carried out to identify a 120bp fragment from the universal kDNA minicircle of the genus Leishmania in 61 skin or mucosal biopsies from patients with ATL. RESULTS: DNA sequencing permitted the identification of a particular 15bp fragment (5' …GTC TTT GGG GCA AGT... 3') in all samples. Analysis by the neighbor-joining method showed the occurrence of two distinct groups related to the genus Viannia (V) and Leishmania (L), each with two subgroups. Autochthonous cases with identity to a special Leishmania sequence not referenced in Genbank predominated in subgroup V.1, suggesting the possible existence of a subtype or mutation of Leishmania Viannia in this region. In the subgroup L.2, which showed identity with a known sequence of L. (L.) amazonensis, there was a balanced distribution of autochthonous and non-autochthonous cases, including the mucosal and mucocutaneus forms in four patients. The last observation may direct us to new concepts, since the mucosal compromising has commonly been attributed to L. (V.) braziliensis, even though L. (L.) amazonensis is more frequent in the Amazonian region. CONCLUSIONS: These results confirm the pattern of distribution and possible mutations of these species, as well as the change in the clinical form presentation of ATL in the São Paulo State.