Resumo No endoleak tipo 1A, a endoprótese não sela completamente o colo do aneurisma proximal, e o fluxo arterial está presente entre a parede do colo aórtico e o material do implante. Este é um relato de um caso no qual foi utilizada embolização com molas, associado a uma revisão de literatura (PubMed, LILACS e SciELO). Foram pesquisados artigos publicados nos últimos 5 anos com os descritores “endoleak 1A”, “coil embolization” e “treatment”, combinados de formas aleatórias, sendo encontrados 25 artigos. O tipo 1A ocorre em 1,1% dos pacientes após 30 dias do implante. O tratamento consiste em aumentar a vedação do implante proximal, principalmente com o uso de stents e balões para alargar a zona de aterragem ou aumentar a força radial do implante. Alguns trabalhos sugerem técnicas de embolização com cianoacrilato, cola de fibrina e uso de Onyx, mostrando taxas de sucesso superiores a 97%. Contudo, a correção de endoleaks tipo 1A mediante embolização com molas é pouco descrita.

Abstract In a type 1A endoleak, the endograft is unable to fully seal the proximal aneurysm neck and blood flow leaks between the wall of the aortic neck and the graft material. This article reports a case in which coil embolization was used and presents a literature review (PubMed, LILACS, and SciELO). Searches were run for articles published in the past 5 years using the descriptors “endoleak 1A”, “coil embolization,” and “treatment”. Type 1A endoleak occurs in 1.1% of patients within 30 days of graft placement. Treatment of an endoleak is obligatory and usually consists of sealing the proximal graft neck using stents and balloons to expand the landing zone or to increase the radial force of the graft. Some studies have suggested using embolization techniques with cyanoacrylate, fibrin glue, and Onyx, demonstrating success rates that exceed 97%. However, correction of type 1A endoleak using coil embolization has seldom been described.

Intoxicações podem ter suas consequências minimizadas através da ampliação do conhecimento sobre suas origens, evoluções e providências quanto a medidas preventivas. No Brasil, o aumento progressivo das emergências tóxicas justifica a sua análise, de forma descentralizada e regionalizada. Este trabalho objetivou caracterizar dados sobre a ocorrência de intoxicações admitidas no Hospital Universitário/UFJF, entre 2000 e 2004. A coleta foi realizada mediante pesquisa em prontuários cadastrados no banco de dados do referido hospital. Os dados foram analisados através de estatística descritiva, permitindo estabelecer o perfil do grupo quanto às variáveis idade, sexo, local de origem do paciente, profissão, período de hospitalização, etiologia, razão da intoxicação, classe terapêutica de fármacos envolvidos e via de exposição ao agente toxicante. Crianças de zero a cinco anos e indivíduos do sexo masculino foram os mais acometidos, representando 24% e 68%, respectivamente. A maioria dos casos ocorreu em Juiz de Fora (78%) e a via oral foi a mais frequente. Os psicotrópicos foram os principais agentes toxicantes (60%). Os resultados evidenciaram a importância de atividades educativas dirigidas às comunidades e a relevância dos serviços de informação para prevenir e reduzir as intoxicações e o uso irracional de fármacos.

Poisonings may have their consequences minimized by the acquisition of knowledge concerning its etiologies, evolutions and means of prevention. In Brazil, the progressive increase of toxic emergencies justifies the acquisition and analysis of regional and decentralized data concerning toxic emergencies. The aim of this retrospective and descriptive study was to evaluate data on the toxicology occurrence registered at the University Hospital/UFJF from 2000 to 2004. Data were collected using a structured instrument which comprised: age range, gender, profession, average hospitalization time, etiology and possible reasons for the intoxication, drug categories, where the patients live and the most important exposure route to the poisonous agent. The possible relationship among the data was also examined. The profile found for poisoning in the 50 cases analyzed, was that accidents are more common from 0 to 5 years old (24%) and male gender (68%), the majority of the cases happened in the city of Juiz de Fora (78%) and oral exposure. The most important poisonous agents were found to be the psychotropics (60%). Definition of a profile helps promoting educative activities and expands poisoning prevention campaigns by public health agencies. Therefore, these facts strengthen the importance of an Information Service net to prevent and reduce intoxications and the irrational use of drugs.

Intoxicações podem ter suas consequências minimizadas através da ampliação do conhecimento sobre suas origens, evoluções e providências quanto a medidas preventivas. No Brasil, o aumento progressivo das emergências tóxicas justifica a sua análise, de forma descentralizada e regionalizada. Este trabalho objetivou caracterizar dados sobre a ocorrência de intoxicações admitidas no Hospital Universitário/UFJF, entre 2000 e 2004. A coleta foi realizada mediante pesquisa em prontuários cadastrados no banco de dados do referido hospital. Os dados foram analisados através de estatística descritiva, permitindo estabelecer o perfil do grupo quanto às variáveis idade, sexo, local de origem do paciente, profissão, período de hospitalização, etiologia, razão da intoxicação, classe terapêutica de fármacos envolvidos e via de exposição ao agente toxicante. Crianças de zero a cinco anos e indivíduos do sexo masculino foram os mais acometidos, representando 24% e 68%, respectivamente. A maioria dos casos ocorreu em Juiz de Fora (78%) e a via oral foi a mais frequente. Os psicotrópicos foram os principais agentes toxicantes (60%). Os resultados evidenciaram a importância de atividades educativas dirigidas às comunidades e a relevância dos serviços de informação para prevenir e reduzir as intoxicações e o uso irracional de fármacos.

Poisonings may have their consequences minimized by the acquisition of knowledge concerning its etiologies, evolutions and means of prevention. In Brazil, the progressive increase of toxic emergencies justifies the acquisition and analysis of regional and decentralized data concerning toxic emergencies. The aim of this retrospective and descriptive study was to evaluate data on the toxicology occurrence registered at the University Hospital/UFJF from 2000 to 2004. Data were collected using a structured instrument which comprised: age range, gender, profession, average hospitalization time, etiology and possible reasons for the intoxication, drug categories, where the patients live and the most important exposure route to the poisonous agent. The possible relationship among the data was also examined. The profile found for poisoning in the 50 cases analyzed, was that accidents are more common from 0 to 5 years old (24%) and male gender (68%), the majority of the cases happened in the city of Juiz de Fora (78%) and oral exposure. The most important poisonous agents were found to be the psychotropics (60%). Definition of a profile helps promoting educative activities and expands poisoning prevention campaigns by public health agencies. Therefore, these facts strengthen the importance of an Information Service net to prevent and reduce intoxications and the irrational use of drugs.

Since 1995 more than 1000 cases of hantavirus pulmonary syndrome (HPS) were reported in Argentina, a severe disease and often fatal to humans. Most cases were associated with Andes virus (AND) that caused few events of person-to-person transmission. Several lineages of pathogenic AND viruses have been described, including AND South, hosted by the rodent Oligoryzomys longicaudatus which affects the Patagonian region of Argentina and Chile. We studied the clinical and epidemiological characteristics of a HPS case. The objective was to describe the clinical presentation of the case, its epidemiology, the likely site of infection, the viral variant implicated and its relationship with the closest reported cases. We carried out the clinical follow up, serological and molecular diagnosis and the epidemiological research, including a rodent reservoir study. The clinical presentation of the case was the classical and moderate, caused by AND South virus. Its viral nucleotide sequence was compared with cases from Southern Argentina and Chile. This case was found to be the most Southern (48° 46´ 1.2´´ S; 70° 15´ O) case reported and involved a new Argentinean province.

Desde 1995 se han informado más de 1000 casos de síndrome pulmonar por hantavirus (SPH) en la Argentina, enfermedad grave y muchas veces fatal para los humanos. La mayoría de los casos fueron asociados al virus Andes (AND) único hantavirus que ha sido informado como causante de transmisión persona a persona. Se han descrito varios linajes patogénicos del virus AND, de los cuales AND Sur, cuyo reservorio es el roedor Oligoryzomys longicaudatus, afecta a la región patagónica de Argentina y Chile. En el presente estudio se informan las manifestaciones clínicas y las características epidemiológicas de un caso de SPH. El objetivo fue describir la presentación clínica del caso, su entorno epidemiológico, el sitio probable de contagio, la variante viral implicada y su relación con los casos más cercanos notificados. Se realizó el seguimiento clínico, el diagnóstico serológico y molecular y la investigación epidemiológica, incluyendo un estudio de la población de roedores reservorios en las áreas involucradas. Se trató de una presentación clásica de SPH moderada, causada por el linaje viral AND sur y su secuencia nucleotídica se comparó con casos del sur argentino y chileno. El caso de hantavirus investigado resultó ser el más austral (48° 46´ 1.2´´ S; 70° 15´ 0´´ O) notificado hasta el momento e involucró a una nueva provincia argentina.

In Río Negro Province, Argentina, human cases of hantavirus pulmonary syndrome (HPS) appeared in the region of subantartic forests. The Andes virus (ANDV) has been identified in the region both in Oligoryzomys longicaudatus rodents and in humans, with the main transmission being from rodents to humans but also showing the possibility of human to human transmission. Between 1996 and 2004, in 40 campaigns, 29.960 night-traps for capturing live rodents were set up. Blood samples were obtained from the rodents and processed using enzyme immunoassay with recombinant antigens made from ANDV. A total of 1767 rodents were captured, with a capture success of 5.9% and an antibody prevalence of 2.1%. Important differences were observed among the species captured from Andes and Steppe regions. Seropositive Oligoryzomys longicaudatus, Abrotrix olivaceus, Abrotrix xanhtothinus and Loxodontomus microtus were captured. During the 1993-2004 period, 40 HPS cases were registered.

En la Provincia de Río Negro, Argentina, se presentaron casos humanos de síndrome pulmonar por hantavirus (SPH) en la región de los bosques subantárticos. El virus Andes (AND) fue identificado en la región, tanto en el roedor Oligoryzomys longicaudatus como en seres humanos, demostrándose la transmisión principalmente del roedor al hombre y la posibilidad de la transmisión de persona a persona. Para ello, se procedió a la colocación de 29.960 trampas para captura viva de roedores, tipo Sherman, en 40 operativos efectuados desde 1996 hasta 2004. Se obtuvieron muestras de sangre de los roedores, las que fueron procesadas mediante enzimoinmunoensayo con antígenos recombinantes elaborados a partir de virus AND. Fueron capturados 1767 roedores, con un éxito de trampeo del 5.9% y una prevalencia de anticuerpos contra hantavirus del 2.1%. Se observaron importantes diferencias en las especies capturadas en cada una de las regiones. Se capturaron O. longicaudatus, Abrothrix olivaceus y Abrothrix xanhtothinus y Loxodontomys microtus seropositivos. Se registraron 40 casos humanos en el período 1993-2004.

The recent distribution of the murine opossum Gracilinanus microtarsus (Wagner, 1842) is restricted to southeastern Brazil. In this note we present the first documented record for this species in Argentina. One specimen of G. microtarsus was caught in an ecotonal area between the perisylvan grasslands of the Northern Campos and the Paranense forests (Santa Ana, Candelaria, Misiones; 27º 36' S, 55º 56' O). This record expands the known distribution of this species about 500 km W.

La distribución actual de la comadrejita Gracilinanus microtarsus (Wagner, 1842) se restringe al sudeste de Brasil. En esta nota se presenta el primer registro documentado para esta especie en la Argentina. Se capturó un ejemplar de G. microtarsus en la localidad de Santa Ana (27º 36' S, 55º 56' O; Candelaria, Misiones), en un área que se ubica mayormente en un ecotono entre la ecorregión de los Campos y Malezales del sur de Misiones y la Selva Paranense. Este registro extiende ca. 500 km al O el área de distribución conocida para esta especie.

Hantavírus é o agente etiológico da síndrome cardio-pulmonar por hantavirus (SCPH), uma importante doença transmitida por roedores no Brasil. Com o objetivo de se conhecer a ocorrência de infecção por hantavírus em pequenos roedores silvestres, uma análise sorológica foi conduzida em três diferentes áreas do subúrbio da cidade de Pedreira, São Paulo. Dos 145 animais silvestres capturados, pertecentes a 12 diferentes espécies identificadas por morfologia e por análise cariológica, 107 eram roedores das seguintes espécies: Akodon montensis, Bolomys lasiurus, Calomys tener, Oligoryzomys nigripes, Oligoryzomys flavescens, e Myocastor coypus. Amostras de sangue desses roedores foram testadas para a presença de anticorpos IgG contra o antígeno do nucleocapsídeo do vírus Andes através do teste ELISA. Reatividade sorológica ao vírus Andes foi observada em duas espécies diferentes, O. nigripes and O. flavescens. Estes resultados indicam o potencial risco de transmissão de hantaví-rus nesta região, onde roedores reservatórios freqüentemente são vistos em peridomicílio.

Hantaviruses are the etiological agents of the Hantavirus Cardio-Pulmonary Syndrome, a serious rodent-borne disease in Brazil. In order to investigate the occurrence of hantavirus infection in wild rodents, a survey was conducted in three different suburban areas of the municipality of Pedreira, State of São Paulo, Brazil. Of the 145 wild animals captured belonging to 12 different species identified by morphology and karyological analysis, 107 were rodents of the following species: Akodon montensis, Bolomys lasiurus, Calomys tener, Oligoryzomys nigripes, Oligoryzomys flavescens, and Myocastor coypus. Blood samples from these rodents were assayed for the presence of antibodies against hantavirus by IgG ELISA using Andes recombinant nucleocapsid antigen. Antibody reactive to Andes virus was found in two different species, O. nigripes and O. flavescens. These results indicate a potential risk for hantavirus transmission to humans in this area, where reservoir rodents are present in peridomestic settings.

After the Hantavirus Pulmonary Syndrome (HPS) outbreak occurred in Southern Argentina (Patagonia) in 1996, a new mechanism of hantavirus spread was described for Andes virus (AND): person-to-person transmission. Since then, this mode of transmission has been limited to the endemic area of AND Sout lineage. We report here an HPS case, patient A, with residence in Buenos Aires Province, whose unique epidemiological risk factor was to have shared a trip to Southern Argentina with an already ill person, later confirmed as an HPS case (patient I). A third case (patient B), with residence in Buenos Aires Province, developed HPS after several contact events with patient A, with no additional risk factors. Hantavirus infection was confirmed in all three patients by serological diagnosis and viral genetic characterization. The viral lineage characterized was AND Sout, being the same strain in the three cases. The clinical picture of patient A showed profound compromise, with gastrointestinal symptoms, with no clinical evidence of pulmonary involvement. In this work we present new evidence supporting person-to-person transmission for AND Sout lineage, where there was an only contact with the index case, occasional, prolonged and non-repeated, established out of the endemic area for AND Sout lineage.

A partir de un brote de síndrome pulmonar por hantavirus ocurrido en 1996 en el sur de Argentina un nuevo mecanismo de infección quedó demostrado para el virus Andes (AND): la transmisión viral de persona a persona. La sospecha de ocurrencia de este mecanismo de transmisión ha sido restringida a la zona endémica del linaje AND Sout. Describimos el caso de un paciente (caso A) residente en Buenos Aires, que desarrolló una infección por hantavirus sin haber tenido ningún otro riesgo epidemiológico más que el contacto con un caso previo (caso I) en un viaje al sur de Argentina. Posteriormente un tercer caso (caso B) residente de la provincia de Buenos Aires, desarrolló un síndrome pulmonar por hantavirus (SPH) teniendo como antecedente de riesgo varios encuentros con A. La confirmación de la enfermedad en los tres pacientes se realizó mediante diagnóstico serológico y caracterización genética viral. El linaje viral en los tres casos fue el AND Sout siendo idéntica la cepa viral. Entre los hallazgos clínicos del caso A es destacable el gran compromiso general, con síntomas gastrointestinales pero sin evidencia clínica de daño pulmonar. En el presente informe presentamos nueva evidencia para el mecanismo de transmisión interhumana del linaje AND Sout, con las características particulares de haber ocurrido por un contacto ocasional, no repetido, pero prolongado como un viaje en ómnibus de larga distancia y fuera del área endémica.

We studied hantavirus seroprevalence and virus variability in rodent populations in Diego Gaynor, northwest of Buenos Aires province, Argentina. Rodent samplings were conducted in railroads and cropfield borders in March and July 1999, September and December 2000, and March 2001. Antibody detection was performed by an enzyme link immunosorbent assay (ELISA), using the recombinant nucleoprotein of Andes (AND) virus as antigen. Tissue samples were taken from positive antibody individuals in order to confirm the presence of hantavirus genomic material and to identify virus genotypes. Akodon azarae was the most abundant species, followed by Oligoryzomys flavescens, while Calomys laucha and C. musculinus were rarely caught. We found a rate of seroprevalence of 9.3% for a total sample of 291 A. azarae and 13.5% for 37 O. flavescens. After molecular analyses of hantavirus, we confirmed the presence of hantavirus genomic material in 16 individuals with ELISA (+) results and two individuals with ELISA (-). Four amplimers for each species were sequenced and compared to the corresponding sequences of representative hantaviruses. We identified the AND Cent Lec from three O. flavescens, and the Pergamino virus from four A. azarae and from one O. flavescens. A. azarae males had higher seroprevalence than females, and heavier individuals showed higher seroprevalence than lighter ones. We did not find seroprevalence differences according to sex in O. flavescens, although this result may have been produced by the low sample size. The lowest seroprevalence was found in a period of high rodent density, when juveniles prevailed in the population. We found higher seroprevalences than those detected in previous studies for other localities of central Argentina where cases of hantavirus pulmonary syndrome (HPS) have been reported. The presence of AND Cent Lec virus in rodent populations of the study area, which is responsible of HPS cases in central Argentina, suggests that human populations are at risk of HPS disease, although there were not reported cases of this disease until today.

In the Province of Río Negro, Argentina, human cases of hantavirus pulmonary syndrome (HPS) have occurred in the region of the Patagonian Andean range. The Andes virus has been identified in the region, both in the rodent Oligoryzomys longicaudatus and in human beings, demonstrating mainly transmission from rodents to human and the possibility of person-to-person transmission. The goal of this paper is to present new information on hantavirus rodent carrier species in Argentina, the prevalence of antibodies to hantavirus (1999-2001 period) and the relationship of the rodent population size and seroprevalence with the occurrence of human cases (1996-2001 period). To this end, a total of 3,973 Sherman type traps for capturing live rodents were placed in six campaigns from October 1999 to May 2001. Rodent blood samples were obtained and processed by means of enzymoimmunoassay with antigens developed from the Andes virus. A summary of results indicates 397 captured rodents, with a 10% trapping success rate and a 1.0% prevalence of antibodies to hantavirus. Considerable differences were observed in species captured in each region. Seropositive O. longicaudatus and A. olivaceus specimens, as well as potential hantavirus O. flavescens and C. laucha carriers, were captured. Six human cases were recorded during the 1993-1995 period (corresponding to retrospective studies), while 21 cases were reported in 1996-1998 and 6 in 1999-2001. The correlation between occurrence of human cases, seroprevalence in rodents and trapping success is analyzed.

En la Provincia de Río Negro, Argentina, se presentaron casos humanos de síndrome pulmonar por hantavirus (SPH) en la región de la cordillera andino patagónica. El virus Andes ha sido identificado en la región, tanto en el roedor Oligoryzomys longicaudatus como en seres humanos, demostrándose la transmisión principalmente del roedor al hombre y la factibilidad de la transmisión de persona a persona. El objetivo del presente trabajo es presentar nueva información sobre especies de roedores portadores de hantavirus en Argentina, su prevalencia de anticuerpos para hantavirus (período 1999-2001) y la relación del tamaño de las poblaciones de roedores y su seroprevalencia con la ocurrencia de casos humanos (período 1996-2001). Para ello, se procedió a la colocación de 3973 trampas para captura viva de roedores, tipo sherman en seis operativos efectuados entre octubre de 1999 y mayo de 2001. Se obtuvieron muestras de sangre de los roedores las que fueron procesadas mediante enzimoinmunoensayo con antígenos elaborados a partir de virus Andes. Una síntesis de los resultados indica 397 roedores capturados, con un éxito de trampeo del 10% y una prevalencia de anticuerpos contra hantavirus del 1.0%. Se observaron importantes diferencias en las especies capturadas en cada una de las regiones. Se capturaron O. longicaudatus y A. Olivaceus seropositivos y O. flavescens y C. Laucha potencialmente portadores de hantavirus Se registraron 6 casos humanos en el período 1993-1995 (correspondientes a estudios retrospectivos), 21 casos se notificaron en el período 1996-1998 y 6 en el período 1999-2001 Se analiza la correlación entre ocurrencia de casos humanos, seroprevalencia en roedores y éxito de trampeo.

In the Province of Río Negro, Argentina, human cases of hantavirus pulmonary syndrome (HPS) have occurred in the region of the Patagonian Andean range. The Andes virus has been identified in the region, both in the rodent Oligoryzomys longicaudatus and in human beings, demonstrating mainly transmission from rodents to human and the possibility of person-to-person transmission. The goal of this paper is to present new information on hantavirus rodent carrier species in Argentina, the prevalence of antibodies to hantavirus (1999-2001 period) and the relationship of the rodent population size and seroprevalence with the occurrence of human cases (1996-2001 period). To this end, a total of 3,973 Sherman type traps for capturing live rodents were placed in six campaigns from October 1999 to May 2001. Rodent blood samples were obtained and processed by means of enzymoimmunoassay with antigens developed from the Andes virus. A summary of results indicates 397 captured rodents, with a 10% trapping success rate and a 1.0% prevalence of antibodies to hantavirus. Considerable differences were observed in species captured in each region. Seropositive O. longicaudatus and A. olivaceus specimens, as well as potential hantavirus O. flavescens and C. laucha carriers, were captured. Six human cases were recorded during the 1993-1995 period (corresponding to retrospective studies), while 21 cases were reported in 1996-1998 and 6 in 1999-2001. The correlation between occurrence of human cases, seroprevalence in rodents and trapping success is analyzed.

En la Provincia de Río Negro, Argentina, se presentaron casos humanos de síndrome pulmonar por hantavirus (SPH) en la región de la cordillera andino patagónica. El virus Andes ha sido identificado en la región, tanto en el roedor Oligoryzomys longicaudatus como en seres humanos, demostrándose la transmisión principalmente del roedor al hombre y la factibilidad de la transmisión de persona a persona. El objetivo del presente trabajo es presentar nueva información sobre especies de roedores portadores de hantavirus en Argentina, su prevalencia de anticuerpos para hantavirus (período 1999-2001) y la relación del tamaño de las poblaciones de roedores y su seroprevalencia con la ocurrencia de casos humanos (período 1996-2001). Para ello, se procedió a la colocación de 3973 trampas para captura viva de roedores, tipo sherman en seis operativos efectuados entre octubre de 1999 y mayo de 2001. Se obtuvieron muestras de sangre de los roedores las que fueron procesadas mediante enzimoinmunoensayo con antígenos elaborados a partir de virus Andes. Una síntesis de los resultados indica 397 roedores capturados, con un éxito de trampeo del 10% y una prevalencia de anticuerpos contra hantavirus del 1.0%. Se observaron importantes diferencias en las especies capturadas en cada una de las regiones. Se capturaron O. longicaudatus y A. Olivaceus seropositivos y O. flavescens y C. Laucha potencialmente portadores de hantavirus Se registraron 6 casos humanos en el período 1993-1995 (correspondientes a estudios retrospectivos), 21 casos se notificaron en el período 1996-1998 y 6 en el período 1999-2001 Se analiza la correlación entre ocurrencia de casos humanos, seroprevalencia en roedores y éxito de trampeo.

In Chile, three Hantavirus seropositive rodent species (O longicaudatus, A olivaceus and A longipilis) are distributed from the Pacific coast to the Andes mountains and represent nearly 90% of the rodents captured in the Xth Region. Aim: To study the seroprevalence of Hantavirus among captured rodent species and its relationship with the appearance of human cases of pulmonary syndrome. Material and methods: From May 1998 to September 2001, 675 rodents were captured in the region. Serum samples were tested by ELISA for the presence of IgG antibodies against Andes and Sin Nombre virus. Sera from human cases with a suspected Hantavirus infection were analyzed for IgM antibodies against Black Lagoon virus and for IgG antibodies against Andes and Sin Nombre virus. Results: Twenty two of the 675 rodents were seropositive for the virus, 18 O longicaudatus and 4 A longipilis. Regional seroprevalence changed from 2.2% in 1998, 0.0% in 1999, 1.0% in 2000 and up to 7.1% in 2001. A total of 77 positive human cases were studied from 1998 to March 2002. Although there were positive cases in all seasons, data showed a spring-summer seasonal preponderance. A relationship between the flowering of "colihue" bushes and the increased values of rodent abundance, seroprevalence and positive animals was established. Conclusions: A dispersal movement of O longicaudatus to open habitats close to human outdoor activities during the dry season was confirmed (Rev Méd Chile 2003; 131: 169-76)