Patients In Southern Brazil Research Articles

Fabry Disease in Hemodialysis Patients in Southern Brazil: Prevalence Study and Clinical Report

Background. Fabry disease (FD) is a lysosomal storage disorder caused by a deficiency of α-Galactosidase A (α-Gal A). Fabry nephropathy typically progresses throughout the fifth decade to end-stage renal disease (ESRD), requiring hemodialysis and/or kidney transplantation. Objective. To estimate the prevalence of FD among ESRD males on hemodialysis treatment in Rio Grande do Sul, the southernmost state of Brazil. Methods. Screening for α-Gal A activity was performed by a dried blood spot (normal reference value: >1.5 nmoles/hour/mL). Positive screening results were confirmed by plasma α-Gal A activity assay (reference value: >3.3 nmoles/hour/mL). Results. Five hundred fifty-eight male patients on hemodialysis were evaluated. Of these, only two had low α-Gal A activity and were diagnosed with Fabry disease (0.36%). One of these, age 42, had left ventricular hypertrophy and renal manifestations of Fabry disease without the classic symptoms. The other, age 46, had the classical manifestations of angiokeratomas, acroparesthesias, hypohidrosis, and ocular opacities. Conclusions. Although the prevalence of Fabry disease was very low in our study (0.36%), routine screening of male hemodialysis patients would enable earlier identification of many other affected relatives in their families who might benefit from specific clinical treatment.

Fatty acid composition and cholesterol content of beef and chicken meat in Southern Brazil

The aim of the present study was to analyze the fatty acid composition and cholesterol content of the beef and chicken meat most often consumed by a population of type 2 diabetic patients in Southern Brazil: for beef, semimembranosus and biceps femoris; and for chicken, drumstick and thigh. The moisture content (gravimetrically), protein content (Kjeldahl procedure), cholesterol content (HPLC or enzymatic methods), lipid content (gravimetric method) and fatty acid composition (gas chromatography) were analyzed in three different brands of these raw cuts in duplicate. The results were compared with data extracted from the United States Department of Agriculture (USDA) Handbook and Brazilian tables (TACO-UNICAMP and TBCAUSP 4.1). Chicken meat had a lower proportion of saturated (36.4±3.6%; P<0.001) and a higher proportion of polyunsaturated fatty acids (21.3±3.5%; P<0.0001) than beef (53.3±2.12 and 3.0±0.5%). Long chain omega-3 polyunsaturated fatty acids (PUFA) eicosapentaenoic and docosahexaenoic were observed only in dark chicken meat (23±3 and 14±1 mg/100 g, respectively) and were found in less than 0.1 mg/100 g in beef cuts. The amount of gamma and alpha linolenic acids in biceps femoris (39/22 mg/100 g) was higher than in dark chicken meat (1/25 mg/100 g). A discrepancy was observed between the composition of the experimental meats and those reported in the USDA Handbook, mainly for beef. Total lipid content as well as PUFA and monounsaturated fatty acid (MUFA) levels were lower than the values reported in the USDA Handbook (26.5, 49 and 25% difference than USDA values, respectively) for beef. Chicken meat presents a more favorable fatty acid profile regarding serum cholesterol levels than beef cuts. Furthermore, the discrepancies observed between our experimental data and the USDA Handbook suggest that it is important to construct regional food composition tables.

0809 Acute bacterial meningitis in HIV infected patients in southern Brazil

0809 Acute bacterial meningitis in HIV infected patients in southern Brazil

Genetic relationships between Trypanosoma cruzi strains isolated from chronic chagasic patients in southern Brazil as revealed by RAPD and SSR–PCR analysis

30 Trypanosoma cruzi strains isolated from chronic chagasic patients were studied at the genotype level by RAPD with arbitrary primers and SSR–PCR analysis. The genetic distance of strains was measured by the percentage of unshared bands. The results showed that the strains isolated from chronic patients from different Chagas' disease endemic areas of Brazil constituted a broad group significantly more correlated than reported in previous studies, presenting RAPD profiles with an average of 71% of shared bands and SSR–PCR patterns with a mean of 59% of shared bands. In contrast to other findings in the literature, these strains did not group on the basis of their geographic origin. These results suggest that a special adaptation of a parasite population in human hosts from mixed infective T. cruzi populations circulating in nature may have occurred.

A controlled study of endemic sporadic diarrhoea among adult residents of southern Brazil

The aetiology of sporadic summer diarrhoea and enterotoxin (LT) antibody titres was studied among 43 adult patients in southern Brazil who had an acute, untreated diarrhoeal illness and 43 age- and sex-matched controls from the same area. A potential pathogen was identified in 33 of 34 patients and in 17 of 43 controls (p<0·01). 10 Shigella, one invasive Escherichia coli, one Salmonella and one Entamoeba histolytica were identified in 17 patients with inflammatory diarrhoea (faecal polymorphonuclear neutrophil leucocytes (PMN) present). In the other four only enterotoxigenic strains of E. coli were identified. Among 26 patients with non-inflammatory (no faecal PMN) diarrhoea, heat-stable (ST) toxin-producing coliforns were the most common pathogens isolated (27%). Heat-labile (LT) toxin-producing coliforms or serological rises to LT were seen in five patients, Strongyloides larvae in five, Giardia lamblia trophozoites in four and an LT-producing Salmonella in one. No pathogen was found in 10 patients with non-inflammatory diarrhoea. Among 43 controls, 11 LT coliforms, two Shigella and two Strongyloides larvae were found. 40 of 41 controls had detectable serum anti-LT antibody. A single ST-producing E. coli was found in one other control. No pathogen was identified in 26 controls. No rotaviruses or Norwalk-like viral agents were seen by direct or immune electron microscopy of stool filtrates. While LT-producing E. coli are frequently associated with endemic summer childhood diarrhoea in southern Brazil and are recognized causes of travellers' diarrhoea, this study shows that they are often carried asymptomatically by adults living in this region. ST-producing coliforms are the major non-invasive pathogen in adult residents with summer diarrhoea in an endemic area.