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Overview of artemisinin effectiveness during outset years of its implementation in the western Brazilian Amazon
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Pinto, Raquel de Medeiros

; Sampaio, Vanderson de Souza

; de Melo, Gisely Cardoso

; Alecrim, Maria das Graças Costa

; Mattos, Karine

; Perdomo, Renata Trentin

; Cordeiro, Sabrine da Costa

; Parente, Ana Flávia Alves

; de Carvalho, Lídia Raquel

; Mendes, Rinaldo Pôncio

; Lacerda, Marcus Vinícius Guimarães

; Monteiro, Wuelton Marcelo

; Weber, Simone Schneider

Memórias do Instituto Oswaldo Cruz

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2019, Volume 114 elocation e190075

Abstract: En | Text: En | PDF: En

BACKGROUND The elimination of malaria depends on the blocking of transmission and of an effective treatment. In Brazil, artemisinin therapy was introduced in 1991, and here we present a performance overview during implementation outset years. METHODS It is a retrospective cohort (1991 to 2002) of patients treated in a tertiary centre of Manaus, with positive microscopic diagnosis of Plasmodium falciparum malaria, under treatment with using injectable or rectal artemisinin derivatives, and followed over 35-days to evaluate parasite clearance, death and recurrence. FINDINGS This cohort outcome resulted 97.6% (1554/1593) of patients who completed the 35-day follow-up, 0.6% (10/1593) of death and 1.8% (29/1593) of follow-up loss. All patients that died and those that presented parasitaemia recurrence had pure P. falciparum infections and received monotherapy. Considering patients who completed 35-day treatment, 98.2% (1527/1554) presented asexual parasitaemia clearance until D4 and 1.8% (27/1554) between D5-D10. It is important to highlight that had no correlation between the five treatment schemes and the sexual parasite clearance. Finally, it is noteworthy that we were able to observe also gametocytes carriage during all follow-up (D0-D35). MAIN CONCLUSIONS Artemisinin derivatives remained effective in the treatment of falciparum malaria during first 12-years of use in north area of Brazil.

https://doi.org/10.1590/0074-02760190075 1863 downloads

II Consenso Brasileiro em Paracoccidioidomicose - 2017
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Shikanai-Yasuda, Maria Aparecida

; Mendes, Rinaldo Pôncio

; Colombo, Arnaldo Lopes

; Telles, Flávio de Queiroz

; Kono, Adriana

; Paniago, Anamaria Mello Miranda

; Nathan, André

; Valle, Antonio Carlos Francisconi do

; Bagagli, Eduardo

; Benard, Gil

; Ferreira, Marcelo Simão

; Teixeira, Marcus de Melo

; Vergara, Mario Leon Silva

; Pereira, Ricardo Mendes

; Cavalcante, Ricardo de Souza

; Hahn, Rosane

; Durlacher, Rui Rafael

; Khoury, Zarifa

; Camargo, Zoilo Pires de

; Moretti, Maria Luiza

; Martinez, Roberto

Epidemiologia e Serviços de Saúde

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2018, Volume 27 N. spe elocation e0500001

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo A paracoccidioidomicose (PCM) é uma micose sistêmica, relacionada às atividades agrícolas, com incidência e prevalência subestimadas, pela ausência de notificação em várias Unidades da Federação (UFs). A evolução insidiosa do quadro clínico pode ter como consequência sequelas graves se o diagnóstico e o tratamento não forem instituídos precoce e adequadamente. Ao lado do complexo Paracoccidioides brasiliensis (P. brasiliensis), a descrição de nova espécie, Paracoccidioides lutzii (P. lutzii), em Rondônia, onde a doença alcançou níveis epidêmicos, bem como na região Centro-Oeste e no Pará, constituem-se em desafios para a instituição do diagnóstico e a urgente disponibilização de antígenos que tenham reatividade com os soros dos pacientes. Este consenso visa atualizar o primeiro consenso brasileiro em PCM, estabelecendo recomendações para o manejo clínico do paciente, com base nas evidências conhecidas. São apresentados dados de etiologia, epidemiologia, imunopatogenia, diagnóstico, terapêutica e sequelas, enfatizando-se o diagnóstico e a terapêutica, bem como recomendações e desafios atuais nessa área do conhecimento.

Abstract Paracoccidioidomycosis is a systemic fungal disease associated with agricultural activities. Its incidence and prevalence are underestimated because of the lack of reporting in several Brazilian states. If paracoccidiodomycosis is not diagnosed and treated early and adequately, endemic fungal infection may result in serious sequelae. In addition to the Paracoccidioides brasiliensis (P. brasiliensis) complex, the appearance of a new species, Paracoccidioides lutzii (P. lutzii), in Rondônia state, where the disease has reached epidemic levels, and in the country’s Midwest region and Pará state, are challenges to diagnosis and to the urgent availability of antigens that are reactive with patients’ sera. These guidelines aim to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. The guidelines provide data on etiology, epidemiology, immunopathogenesis, diagnosis, treatment and sequelae, with emphasis on diagnosis and treatment, as well as current recommendations and challenges in this field of knowledge.

Resumen La paracoccidioidomicosis es una micosis sistémica, relacionada con las actividades agrícolas, con incidencia y prevalencia subestimadas por la ausencia de notificación en varios estados. La evolución insidiosa del cuadro clínico puede tener como consecuencia secuelas graves si el diagnóstico y el tratamiento no se establecen precoz y adecuadamente. Al lado del complejo Paracoccidioides brasiliensis (P. brasiliensis), la descripción de nueva especie, Paracoccidioides lutzii (P. lutzii) en Rondonia, donde la enfermedad alcanzó niveles epidémicos, y en la región Centro Oeste y en Pará, se constituyen en desafíos para la institución del diagnóstico y la urgente puesta a disposición de antígenos que tengan reactividad con los sueros de los pacientes. El presente consenso tiene por objeto actualizar el primer consenso brasileño en paracoccidioidomicosis, estableciendo recomendaciones para el manejo del paciente al borde del lecho, con base en las evidencias conocidas. Se presentan datos de etiología, epidemiología, inmunopatogenia, diagnóstico, terapéutica y secuelas, enfatizando el diagnóstico y terapéutica, así como recomendaciones desafíos y actuales en esta área del conocimiento.

https://doi.org/10.5123/s1679-49742018000500001 29 downloads

II Consenso Brasileiro em Paracoccidioidomicose - 2017
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Shikanai-Yasuda, Maria Aparecida

; Mendes, Rinaldo Pôncio

; Colombo, Arnaldo Lopes

; Telles, Flávio de Queiroz

; Kono, Adriana

; Paniago, Anamaria Mello Miranda

; Nathan, André

; Valle, Antonio Carlos Francisconi do

; Bagagli, Eduardo

; Benard, Gil

; Ferreira, Marcelo Simão

; Teixeira, Marcus de Melo

; Vergara, Mario Leon Silva

; Pereira, Ricardo Mendes

; Cavalcante, Ricardo de Souza

; Hahn, Rosane

; Durlacher, Rui Rafael

; Khoury, Zarifa

; Camargo, Zoilo Pires de

; Moretti, Maria Luiza

; Martinez, Roberto

Epidemiologia e Serviços de Saúde

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2018, Volume 27 N. spe elocation e0500001

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.5123/s1679-49742018000500001 42486 downloads

Brazilian guidelines for the clinical management of paracoccidioidomycosis
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Shikanai-Yasuda, Maria Aparecida

; Mendes, Rinaldo Pôncio

; Colombo, Arnaldo Lopes

; Queiroz-Telles, Flávio de

; Kono, Adriana Satie Gonçalves

; Paniago, Anamaria M. M

; Nathan, André

; Valle, Antonio Carlos Francisconi do

; Bagagli, Eduardo

; Benard, Gil

; Ferreira, Marcelo Simão

; Teixeira, Marcus de Melo

; Silva-Vergara, Mario León

; Pereira, Ricardo Mendes

; Cavalcante, Ricardo de Souza

; Hahn, Rosane

; Durlacher, Rui Rafael

; Khoury, Zarifa

; Camargo, Zoilo Pires de

; Moretti, Maria Luiza

; Martinez, Roberto

Revista da Sociedade Brasileira de Medicina Tropical

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sep 2017, Volume 50 N. 5 Pages 715 - 740

Abstract: En | Text: En | PDF: En

Abstract Paracoccidioidomycosis is a systemic fungal disease occurring in Latin America that is associated with rural environments and agricultural activities. However, the incidence and prevalence of paracoccidiodomycosis is underestimated because of the lack of compulsory notification. If paracoccidiodomycosis is not diagnosed and treated early and adequately, the endemic fungal infection could result in serious sequelae. While the Paracoccidioides brasiliensis ( P. brasiliensis ) complex has been known to be the causal agent of paracoccidiodomycosis, a new species, Paracoccidioides lutzii ( P. lutzii ), has been reported in Rondônia, where the disease has reached epidemic levels, and in the Central West and Pará. Accurate diagnoses and availability of antigens that are reactive with the patients’ sera remain significant challenges. Therefore, the present guidelines aims to update the first Brazilian consensus on paracoccidioidomycosis by providing evidence-based recommendations for bedside patient management. This consensus summarizes etiological, ecoepidemiological, molecular epidemiological, and immunopathological data, with emphasis on clinical, microbiological, and serological diagnosis and management of clinical forms and sequelae, as well as in patients with comorbidities and immunosuppression. The consensus also includes discussion of outpatient treatments, severe disease forms, disease prevalence among special populations and resource-poor settings, a brief review of prevention and control measures, current challenges and recommendations.

https://doi.org/10.1590/0037-8682-0230-2017 10753 downloads

Identification and antifungal susceptibility of Candida species isolated from the urine of patients in a university hospital in Brazil
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Lima, Gláucia Moreira Espíndola

; Nunes, Maína de Oliveira

; Chang, Marilene Rodrigues

; Tsujisaki, Rosianne Assis de Sousa

; Nunes, Joslaine de Oliveira

; Taira, Cleison Ledesma

; Thomaz, Danilo Yamamoto

; Negro, Gilda Maria Bárbaro Del

; Mendes, Rinaldo Pôncio

; Paniago, Anamaria Mello Miranda

Revista do Instituto de Medicina Tropical de São Paulo

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2017, Volume 59 elocation e75

Abstract: En | Text: En | PDF: En

ABSTRACT The aim of this study was to identify Candida spp. isolated from candiduria episodes at a tertiary hospital in the Midwest region of Brazil, and to determine their susceptibility profiles to antifungal compounds. From May 2011 to April 2012, Candida spp. isolated from 106 adult patients with candiduria admitted to the University Hospital of the Federal University of Mato Grosso do Sul were evaluated. Both, species identification and susceptibility testing with fluconazole-FLC, voriconazole-VRC, and amphotericin B-AmB were carried out using the Vitek 2. To discriminate species of the C. parapsilosis complex, a RAPD-PCR technique using the RPO2 primer was performed. From the total of 106 isolates, 42 (39.6%) C. albicans and 64 (60.4%) Candida non-albicans (CNA) - 33 C. tropicalis, 18 C. glabrata, 5 C. krusei, 4 C. parapsilosis sensu stricto, 2 C. kefyr, 1 C. lusitaniae, and 1 C. guilliermondii were identified. All isolates were susceptible to AmB and VRC, whereas all C. glabrata isolates presented either resistance (5.6%) or dose-dependent susceptibility (94.4%) to FLC. The study of Candida spp. and their resistance profiles may help in tailoring more efficient therapeutic strategies for candiduria.

https://doi.org/10.1590/s1678-9946201759075 2262 downloads

DECREASING PREVALENCE OF THE ACUTE/SUBACUTE CLINICAL FORM OF PARACOCCIDIOIDOMYCOSIS IN MATO GROSSO DO SUL STATE, BRAZIL
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Fabris, Larissa Rodrigues

; Andrade, Úrsulla Vilella

; Santos, Aline Ferreira Dos

; Marques, Ana Paula da Costa

; Oliveira, Sandra Maria do Valle Leone de

; Mendes, Rinaldo Pôncio

; Paniago, Anamaria Mello Miranda

Revista do Instituto de Medicina Tropical de São Paulo

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apr 2014, Volume 56 N. 2 Pages 121 - 125

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Com o objetivo de avaliar o comportamento da paracoccidioidomicose nas últimas três décadas, dados clínicos e epidemiológicos de 595 pacientes atendidos dentre 1980 a 2009 no Hospital da Universidade Federal de Mato Grosso do Sul foram estudados. Sexo, faixa etária, forma clínica, associação com tuberculose ou AIDS e mortalidade foram comparados por década em que a doença foi diagnosticada. Observou-se, nas três décadas do estudo, uma redução do percentual de mulheres, de pacientes do grupo de 20 a 39 anos, assim como de casos com a forma aguda/subaguda. Estas alterações estão intimamente relacionadas e podem ser analisadas simultaneamente. Houve aumento de casos de coinfecção com AIDS da primeira para segunda década, coincidindo com o surgimento da epidemia, e manteve-se estável durante a década seguinte. Não houve alteração da taxa de coinfecção com tuberculose, que no geral foi de 6,9% o que reforça a importância desta comorbidade. A taxa geral de mortalidade foi de 6,7% e também não variou entre as décadas estudadas. A manutenção da taxa de óbitos chama a atenção para a relevância dessa doença negligenciada.

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.

https://doi.org/10.1590/S0036-46652014000200006 2486 downloads

Cryptic species of Paracoccidioides brasiliensis: impact on paracoccidioidomycosis immunodiagnosis
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Machado, Gabriel Capella

; Moris, Daniela Vanessa

; Arantes, Thales Domingos

; Silva, Luciane Regina Franciscone

; Theodoro, Raquel Cordeiro

; Mendes, Rinaldo Pôncio

; Vicentini, Adriana Pardini

; Bagagli, Eduardo

Memórias do Instituto Oswaldo Cruz

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aug 2013, Volume 108 N. 5 Pages 637 - 643

Abstract: En | Text: En | PDF: En

We aimed to evaluate whether the occurrence of cryptic species of Paracoccidioides brasiliensis, S1, PS2, PS3 and Paracoccidioides lutzii, has implications in the immunodiagnosis of paracoccidioidomycosis (PCM). Small quantities of the antigen gp43 were found in culture filtrates of P. lutzii strains and this molecule appeared to be more variable within P. lutzii because the synonymous-nonsynonymous mutation rate was lower, indicating an evolutionary process different from that of the remaining genotypes. The production of gp43 also varied between isolates belonging to the same species, indicating that speciation events are important, but not sufficient to fully explain the diversity in the production of this antigen. The culture filtrate antigen AgEpm83, which was obtained from a PS3 isolate, showed large quantities of gp43 and reactivity by immunodiffusion assays, similar to the standard antigen (AgB-339) from an S1 isolate. Furthermore, AgEpm83 was capable of serologically differentiating five serum samples from patients from the Botucatu and Jundiaí regions. These patients had confirmed PCM but, were non-reactive to the standard antigen, thus demonstrating an alternative for serological diagnosis in regions in which S1 and PS2 occur. We also emphasise that it is not advisable to use a single antigen preparation to diagnose PCM, a disease that is caused by highly diverse pathogens.

https://doi.org/10.1590/0074-0276108052013016 2477 downloads

Consenso em paracoccidioidomicose
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Shikanai-Yasuda, Maria Aparecida

; Telles Filho, Flávio de Queiroz

; Mendes, Rinaldo Pôncio

; Colombo, Arnaldo Lopes

; Moretti, Maria Luiza

Revista da Sociedade Brasileira de Medicina Tropical

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jun 2006, Volume 39 N. 3 Pages 297 - 310

Abstract: Pt | Text: Pt | PDF: Pt

101606 downloads Cited 31 times in SciELO

Neurocysticercosis: treatment with albendazole and dextrochloropheniramine (Preliminary Report)
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Agapejev, Svetlana

; Meira, Domingos Alves

; Viera, Benedito Barra

; Machado, Jussara Marcondes

; Pereira, Paulo Câmara Marques

; Mendes, Rinaldo Pôncio

; Kamegasawa, Amélia

; Curi, Paulo Roberto

Revista do Instituto de Medicina Tropical de São Paulo

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oct 1988, Volume 30 N. 5 Pages 387 - 389

Abstract: En | Text: En | PDF: En

1092 downloads

10.

Paracoccidioidomycosis: a recently proposed classification of its clinical forms
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Franco, Marcello

; Montenegro, Mário Rubens

; Mendes, Rinaldo Pôncio

; Marques, Silvio Alencar

; Dillon, Neusa L.

; Mota, Norma Gerusa da Silva

Revista da Sociedade Brasileira de Medicina Tropical

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jun 1987, Volume 20 N. 2 Pages 129 - 132

Abstract: En | Text: En | PDF: En

2253 downloads Cited 31 times in SciELO

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