Publications by authors named "Paulo Eduardo Neves Ferreira Velho"

58 Publications

Spinal cord and cutaneous involvement in paracoccidioidomycosis.

Rev Soc Bras Med Trop 2021 28;54:e0115 2021. Epub 2021 Apr 28.

Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Radiologia, Campinas, SP, Brasil.

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http://dx.doi.org/10.1590/0037-8682-0115-2021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083893PMC
May 2021

Prevalence of infection by Bartonella spp. in patients with psoriasis.

An Bras Dermatol 2021 Jan-Feb;96(1):107-110. Epub 2020 Nov 20.

Dermatology Division, Department of Clinical Medicine, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil. Electronic address:

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http://dx.doi.org/10.1016/j.abd.2020.07.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838093PMC
March 2021

Bartonella henselae infection induces a persistent mechanical hypersensitivity in mice.

Rev Inst Med Trop Sao Paulo 2020 30;62:e79. Epub 2020 Oct 30.

Universidade Estadual de Campinas , Laboratório de Pesquisa Aplicada em Dermatologia e Bartoneloses , Campinas , São Paulo , Brazil.

Bartonella spp. are re-emerging and neglected bacterial pathogens. The natural reservoirs for several species of this genus are domestic animals such as cats and dogs, the most common pets in the USA and Brazil. Some cat studies suggest that the infection is more prevalent in tropical and poverty-stricken areas. These bacteria were associated with a wide spectrum of clinical manifestations: fever of unknown origin, endocarditis, angiomatosis, chronic lymphadenopathy, hepatitis, fatigue, paresthesia and pain. Our group has already demonstrated that B. henselae -infected sickle cell disease mice present with hyperalgesia. We hypothesized that even immunocompetent mice infected by B. henselae would show an increased and persistent mechanical sensitivity. Five ten-week old male BALB/c mice were intraperitoneally inoculated with a 30 µL of suspension containing 10 4 CFU/mL of B. henselae, while five others were inoculated with an equal volume of saline solution. Four days after bacterial inoculation, the mechanical paw withdrawal threshold was measured using von Frey filaments in all animals, for five consecutive days. The infected animals showed hypersensitivity to mechanical stimuli for five consecutive days. The present study has demonstrated that B. henselae infection induces persistent mechanical hypersensitivity, a signal consistent with pain.
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http://dx.doi.org/10.1590/S1678-9946202062079DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7608073PMC
January 2021

Bartonella henselae endocarditis in an elderly patient.

PLoS Negl Trop Dis 2020 07 30;14(7):e0008376. Epub 2020 Jul 30.

Applied Research in Dermatology and Bartonella Infection Laboratory, University of Campinas (UNICAMP) Medical School, Campinas, Sao Paulo, Brazil.

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http://dx.doi.org/10.1371/journal.pntd.0008376DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392202PMC
July 2020

Chronic Venous Insufficiency as a Predisposing Factor for Basal Cell Carcinoma on Legs.

Ann Vasc Surg 2020 Oct 16;68:185-191. Epub 2020 May 16.

Department of Pathology, Medical School, Unicamp, Campinas, SP, Brazil. Electronic address:

Background: The main risk factor associated with basal cell carcinomas (BCCs) is believed to be exposure to ultraviolet radiation (UVR). In the case of lower limb BCC, the frequency is higher in women, possibly because of greater exposure of the leg to UVR. Chronic venous insufficiency (CVI), also more common in women, may have some association with leg BCCs.

Methods: We retrospectively evaluated the histopathological features of leg BCCs removed between 1993 and 2017 in a tertiary referral center. The patients' clinical data were obtained from medical records, considering, in particular, CVI.

Results: We selected 149 patients with leg BCCs, predominately occurring in elderly Caucasian women. Of those, 71 had a clinical diagnosis of CVI in whom the clinical tumor size and frequency of recurrences were significantly higher than patients without CVI. There was an association between clinical diagnosis of CVI and histological findings of (1) follicular induction in epidermis and (2) distal sweat duct hyperplasia.

Conclusions: CVI, besides the already known UVR exposure, is probably associated with leg BCCs and may determine a worse BCC course.
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http://dx.doi.org/10.1016/j.avsg.2020.04.053DOI Listing
October 2020

Atypical cutaneous mycobacteriosis caused by M. fortuitum acquired in domestic environment.

An Bras Dermatol 2020 May - Jun;95(3):390-391. Epub 2020 Mar 13.

Department of Medical Clinic, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.

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http://dx.doi.org/10.1016/j.abd.2019.06.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253846PMC
June 2020

Mycetoma-like phaeohyphomycosis treated with terbinafine.

IDCases 2020 28;19:e00705. Epub 2020 Jan 28.

Department of Pathology, University of Campinas (UNICAMP) Medical School, Campinas, Sao Paulo, Brazil.

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http://dx.doi.org/10.1016/j.idcr.2020.e00705DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996009PMC
January 2020

Prevalence of spp. Infection in Patients with Sickle Cell Disease.

Vector Borne Zoonotic Dis 2020 07 3;20(7):509-512. Epub 2020 Feb 3.

Division of Dermatology, Department of Medicine, University of Campinas (UNICAMP) Medical School, Campinas, Brazil.

The inherent characteristics of the sickle cell disease (SCD), the most common genetic hematological disorder, increase the propensity of infections. spp. are emerging and neglected bacteria. A large spectrum of clinical manifestations has been linked to bartonella bloodstream infection in the last two decades that can cause fatal outcomes, especially in immunodeficient patients. The goal of this study was to evaluate the prevalence of bartonella infection in SCD patients. We evaluated spp. prevalence in 107 SCD patients. Blood samples and enrichment blood cultures were analyzed by molecular detection of spp. DNA. Bartonella DNA was amplified using conventional genus-specific PCR which amplifies the Intergenic Transcribed Spacer region and specific nested PCR which amplifies the gene. Positive patient DNAs were tested with ssrA conventional PCR. All amplicons were sequenced. Ten of 107 patients tested positive for infection in at least one molecular test. All obtained amplicons were sequenced and similar to sequences deposited in GenBank (accession number BX897699). Based on statistical results, bloodstream infection with was not associated with animal contact or blood transfusions. We detected DNA in 10 (9.3%) SCD studied patients. These patients were notified and treatment was offered to them.
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http://dx.doi.org/10.1089/vbz.2019.2545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336878PMC
July 2020

Herpes simplex virus mucocutaneous tumoural lesions - Systematic review.

J Clin Virol 2020 02 23;123:104246. Epub 2019 Dec 23.

Pathology Department, University of Campinas (UNICAMP), Rua Tessália Vieira de Camargo, 126 - Cidade Universitária Zeferino Vaz., CEP 13083-887, Campinas, SP, Brazil. Electronic address:

The goal was to characterize the clinical-epidemiological profile of patients with mucocutaneous tumoural herpes simplex virus (MCT HSV) lesions across the world. Two researchers extracted and independently reviewed data from the literature search engine PubMed/MEDLINE through October 2018. From 110 reported patients, the following data were available: the patients' ages ranged from 7 to 76 years; the majority was male (62.73 %-69/110) and immunosuppression was found in 97.25 % (106/109, missing 1) cases, of whom 88 were HIV- related. Lesions size varied from 0.2-13 cm, settling in the anogenital region in 76.36 % (84/110) patients; 84.13 % (53/63, missing 47) complained of pain and multiple recurrences were found in 44.94 % (40/89, missing 21) cases. On clinical basis, the initial hypothesis was neoplasia in 36/53 patients. Histopathological diagnosis was achieved in 90 % (90/100, missing 10) cases and was sample size-dependent. Type 2 HSV was detected in 86.07 % (68/79, missing 31) lesions. MCT HSV lesions recurrence after treatment was reported in 33.96 % (18/53, missing 57) patients. Pathophysiology is poorly understood. Physicians should be aware of MCT HSV lesions in immunosuppressed patients to avoid inappropriate therapeutic strategies.
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http://dx.doi.org/10.1016/j.jcv.2019.104246DOI Listing
February 2020

Cutaneous manifestations of bartonellosis.

An Bras Dermatol 2019 Sep - Oct;94(5):594-602. Epub 2019 Oct 2.

Laboratory of Applied Research in Dermatology and Bartonella Infection, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil; Discipline of Dermatology, Department of Clinical Medicine, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil. Electronic address:

Bartonellosis are diseases caused by any kind of Bartonella species. The infection manifests as asymptomatic bacteremia to potentially fatal disorders. Many species are pathogenic to humans, but three are responsible for most clinical symptoms: Bartonella bacilliformis, Bartonella quintana, and Bartonella henselae. Peruvian wart, caused by B. bacilliformis, may be indistinguishable from bacillary angiomatosis caused by the other two species. Other cutaneous manifestations include maculo-papular rash in trench fever, papules or nodules in cat scratch disease, and vasculitis (often associated with endocarditis). In addition, febrile morbilliform rash, purpura, urticaria, erythema nodosum, erythema multiforme, erythema marginatus, granuloma annularis, leukocytoclastic vasculitis, granulomatous reactions, and angioproliferative reactions may occur. Considering the broad spectrum of infection and the potential complications associated with Bartonella spp., the infection should be considered by physicians more frequently among the differential diagnoses of idiopathic conditions. Health professionals and researchers often neglected this diseases.
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http://dx.doi.org/10.1016/j.abd.2019.09.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6857551PMC
December 2019

Bartonella henselae bacteremia diagnosed post-mortem in a myelodysplastic syndrome patient.

Rev Inst Med Trop Sao Paulo 2019 Sep 12;61:e50. Epub 2019 Sep 12.

Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, São Paulo, Brazil.

This study involves a 49-year-old male, who for three years suffered with a myelodysplastic syndrome and who needed frequent blood transfusions. One day following a transfusion, he presented fever and abdominal pain. The fever became persistent and only improved temporarily with two cycles of intravenous ciprofloxacin. Nearly 120 days after beginning the second cycle of treatment, he had experienced a weight loss of 16 kg and recurring fever. Screening for fever of unknown origin was conducted, including Bartonella infection. No etiology could be found. The patient improved with an antimicrobial regimen composed of oral doxycycline and intravenous ciprofloxacin. After 15 days afebrile, the patient was discharged with a four-month oral prescription of doxycycline and ciprofloxacin. Eight months following the antibiotic treatment, the patient received an allogeneic bone marrow transplant. Five days following the transplant, the patient initiated a febrile neutropenia and died. From a blood sample collected and stored at the time of hospitalization, a microbiological and molecular study was performed again. Blood- and liquid culture-PCRs from the same blood sample were all negative, but an isolate from solid subculture was found. The molecular reactions from this isolate were all positive and the sequence was 100% homologous to Bartonella henselae . The present report points to the limitations of laboratory techniques currently available for investigation of possible cases of bartonellosis in clinical practice, and the potential risk of Bartonella spp. transmission through blood transfusions.
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http://dx.doi.org/10.1590/S1678-9946201961050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746197PMC
September 2019

False Negative Results in Bartonellosis Diagnosis.

Vector Borne Zoonotic Dis 2019 06 7;19(6):453-454. Epub 2019 Feb 7.

1 Department of Medicine, University of Campinas (UNICAMP), Campinas, Brazil.

We report a fatal case of bacteremic patient. He had negative serology and PCRs from whole blood and liquid culture; only nested PCR was positive from the blood liquid culture. The isolate had positive PCRs. When considered, bartonellosis diagnosis can be still challenging because of technical limitations.
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http://dx.doi.org/10.1089/vbz.2018.2378DOI Listing
June 2019

Topical essential fatty acid oil on wounds: Local and systemic effects.

PLoS One 2019 4;14(1):e0210059. Epub 2019 Jan 4.

Laboratory of Applied Research in Dermatology and Bartonella Infection, School of Medical Sciences, University of Campinas, Campinas, Sao Paulo, Brazil.

Background: The use of medicinal plants and their derivatives is increasing, and approximately one-third of all traditional herbal medicines are intended for wound treatment. Natural products used in these treatments include vegetable oils, which are rich in essential fatty acids. Once in contact with an ulcerative surface, the oil reaches the blood and lymphatic vessels, thus eliciting systemic effects.

Objective: This study evaluated the local and possible systemic effects of essential fatty acids (sunflower oil) applied topically to rat wounds.

Methods: Cutaneous punch wounds (6 mm) were produced on the dorsa of 30 rats. Saline (SS), mineral oil (MO) or essential fatty acid (EFA) solutions were applied topically. Healing was evaluated after 2, 4 and 10 days (n = 5 per group) by visual and histological/morphometric examination, second harmonic generation (SHG) microscopy, and cytokine and growth factor quantification in the scar tissue (real-time PCR) and in serum (ELISA).

Results: MO/EFA-treated animals had higher IGF-1, leptin, IL-6 and IFN-γ mRNA expression and lower serum IL-6 levels than the control (SS/MO) animals. SHG analysis showed no difference in collagen density between the animals treated with MO and EFA.

Conclusion: EFA treatment induces topical (observed by local IGF-1, leptin, IL-6 and IFN-γ production) and systemic effects, lowering IL-6 levels in the serum. As the oil is widely used to shorten ulcer healing time, studies are needed to evaluate the treatment safety and possible undesired effects.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0210059PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319702PMC
September 2019

Second-harmonic generation imaging analysis can help distinguish sarcoidosis from tuberculoid leprosy.

J Biomed Opt 2018 12;23(12):1-7

Technology on Photonics Applied to Cell Biology, Campinas, Brazil.

Sarcoidosis and tuberculoid leprosy (TL) are prototypes of granulomatous inflammation in dermatology, which embody one of the histopathology limitations in distinguishing some diseases. Recent advances in the use of nonlinear optical microscopy in skin have enabled techniques, such as second-harmonic generation (SHG), to become powerful tools to study the physical and biochemical properties of skin. We use SHG images to analyze the collagen network, to distinguish differences between sarcoidosis and TL granulomas. SHG images obtained from skin biopsies of 33 patients with TL and 24 with sarcoidosis retrospectively were analyzed using first-order statistics (FOS) and second-order statistics, such as gray-level co-occurrence matrix (GLCM). Among the four parameters evaluated (optical density, entropy, contrast, and second angular moment), only contrast demonstrated statistical significance, being higher in sarcoidosis (p  =  0.02; 4908.31 versus 2822.17). The results may indicate insufficient differentiating power for most tested FOS and GLCM parameters in classifying sarcoidosis and TL granulomas, when used individually. But in combination with histopathology (H&E and complementary stains, such as silver and fast acid stains), SHG analysis, like contrast, can contribute to distinguishing between these diseases. This study can provide a way to evaluate collagen distribution in granulomatous diseases.
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http://dx.doi.org/10.1117/1.JBO.23.12.126001DOI Listing
December 2018

Subclinical leprosy manifesting as a reversal reaction after LHRH agonist administration.

IDCases 2018 7;12:32-33. Epub 2018 Mar 7.

Oncology Division, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Brazil.

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http://dx.doi.org/10.1016/j.idcr.2018.02.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010934PMC
March 2018

Improvement of Bartonella henselae DNA Detection in Cat Blood Samples by Combining Molecular and Culture Methods.

J Clin Microbiol 2018 05 25;56(5). Epub 2018 Apr 25.

University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.

spp. are bacteria of worldwide distribution that cause asymptomatic to fatal infections in animals and humans. The most common zoonotic species is , for which cats are the major natural reservoir host. To better understand sp. diagnostic limitations, we determined the frequency of bloodstream infection in 112 cats by comparing and combining the results of multiple conventional and nested PCRs from blood and liquid culture samples. Using liquid culture conventional PCR, sp. DNA was amplified from 27.7% of samples (31/112) compared to 90.2% of samples (101/112) by combining nested PCR from blood and liquid culture, indicating that PCR testing of more than one type of sample provides better sensitivity than a standalone PCR and that bloodstream infection is very frequent among cats in southeastern Brazil. This study reinforces the need for multistep testing for sp. infection to prevent false-negative diagnostic results, even in reservoir hosts such as cats that typically maintain higher bacteremia levels.
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http://dx.doi.org/10.1128/JCM.01732-17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5925714PMC
May 2018

Topical use and systemic action of green and roasted coffee oils and ground oils in a cutaneous incision model in rats (Rattus norvegicus albinus).

PLoS One 2017 13;12(12):e0188779. Epub 2017 Dec 13.

Laboratory of Applied Research in Dermatology and Bartonella Infection,-School of Medical Sciences-University of Campinas. Campinas, Sao Paulo, Brazil.

Introduction: Wounds are a common health problem. Coffee is widely consumed and its oil contains essential fatty acids. We evaluated the local (skin) and systemic effects associated with the topical use of coffee oils in rats.

Methods: Punch skin wounds (6 mm) incisions were generated on the backs of 75 rats. Saline (SS), mineral oil (MO), green coffee oil (GCO), roasted coffee oil (RCO), green coffee ground oil (GCGO) or roasted coffee ground oil (RCGO) were topically applied to the wounds. Healing was evaluated by visual and histological/morphometric optical microscopy examination; second harmonics generation (SHG) microscopy, wound tissue q-PCR (values in fold-change) and blood serum (ELISA, values in pg/mL).

Results: RCO treated animals presented faster wound healing (0.986 vs. 0.422), higher mRNA expression of IGF-1 (2.78 vs. 1.00, p = 0.01), IL-6 (10.72 vs. 1.00, p = 0.001) and IL-23 (4.10 vs. 1.2, p = 0.05) in early stages of wound healing; higher IL-12 (3.32 vs. 1.00, p = 0.05) in the later stages; and lower serum levels of IFN-γ (11.97 vs. 196.45, p = 0.01). GCO treatment led to higher mRNA expression of IL-6 (day 2: 7.94 vs. 1.00, p = 0.001 and day 4: 6.90 vs. 1.00, p = 0.01) and IL-23 (7.93 vs. 1.20, p = 0.001) in the early stages. The RCO treatment also produced higher serum IFN-α levels throughout the experiment (day 2: 52.53 vs. 21.20; day 4: 46.98 vs.21.56; day 10: 83.61 vs. 25.69, p = 0.05) and lower levels of IL-4 (day 4: 0.9 vs.13.36, p = 0.01), adiponectin (day 10: 8,367.47 vs. 16,526.38, p = 0.001) and IFN-γ (day 4: 43.03 vs.196.45, p = 0.05). The SHG analysis showed a higher collagen density in the RCO and GCO treatments (p = 0.05).

Conclusion: Topical treatment with coffee oils led to systemic actions and faster wound healing in rats. Further studies should be performed are necessary to assess the safety of topical vegetal oil use for skin lesions.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0188779PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728535PMC
January 2018

Histomorphometric approach to differentiate skin lesions of tuberculoid leprosy from sarcoidosis.

J Cutan Pathol 2018 Feb 5;45(2):111-117. Epub 2017 Dec 5.

Pathology Department, University of Campinas (UNICAMP), Campinas, Brazil.

Background: More than 200 000 new cases of leprosy are detected worldwide annually. Physicians commonly have difficulty in differentiating tuberculoid form of leprosy (TL) from sarcoidosis' cutaneous manifestation.

Methods: Skin biopsies of 33 patients with TL and 24 with sarcoidosis were reviewed on hematoxylin and eosin- and Gomori-stained sections, in order to find reliable criteria for distinguishing one disease from another.

Results: Nine of the 24 features analyzed presented significant predictive value for diagnosis (P < .05). Predominance of tuberculoid granulomas in adnexal and neural distribution, and granulomas replacing the nerves localized within sweat gland glomeruli were predictive to TL diagnosis. For sarcoidosis, dermal fibrosis, back-to-back distribution of the granulomas, presence of atypical giant cells and plasma cells, greater number of conventional giant cells, and spared nerves beside the granuloma were predictive criteria. The median surface density of reticulin fibers was significantly higher in sarcoidosis (3.44) than in TL (2.99). Nonetheless, using logistic regression, this variable did not discriminate between the diseases (P = .096).

Conclusions: Isolated histological features are not fully predictive to differentiate the 2 diseases. However, those with statistical value can assist this distinction in diagnostic practice. Although the results of the analysis of the reticulin fibers density did not tell apart TL from sarcoidosis, they corroborate the idea of fiber fragmentation within tuberculoid leprosy granulomas, reiterating the importance of morphometry in the histological examination.
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http://dx.doi.org/10.1111/cup.13064DOI Listing
February 2018

Chronic lymphadenopathy caused by a Brazilian strain of Bartonella henselae.

Rev Inst Med Trop Sao Paulo 2017 Sep 4;59:e62. Epub 2017 Sep 4.

Western University of Health Sciences, Pomona, California, USA.

Bartonella henselae is a relevant causative agent of bartonelloses in humans. We described an immunocompetent patient with clinical manifestation of chronic cervical lymphadenopathy after a cat-scratch in her forearm. This case shows B. henselae infection persistence even after prolonged antibiotic treatment.
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http://dx.doi.org/10.1590/S1678-9946201759062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587032PMC
September 2017

Sexually transmitted infections and PRO-LIVES: based on a clinical report.

An Bras Dermatol 2017 Mar-Apr;92(2):279-280

Division of Dermatology and Division of Medical Education of the School of Medical Sciences - Universidade Estadual de Campinas (FCM-UNICAMP) - Campinas (SP), Brazil.

Physicians are also responsible for the increase in sexually transmitted infections. We report a case of patient inadequately monitored, that shows the importance of physicians to take basic measures with any individual at risk of acquiring such infections. We propose the following mnemonic acrostic: PRO-LIVES (Protection: usual and proper codom use, Responsibility, Other orientations, Laboratory tests -HIV infection, syphilis and B and C hepatitis-, Immunization: B hepatitis vaccination, Various: at least two patients, Ensure: case history and physical examination, Single dose treatment: whenever possible). Clinicians should take these measures when treating any patient who has been exposed to risk or with a diagnosis of sexually transmitted infections.
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http://dx.doi.org/10.1590/abd1806-4841.20175433DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429127PMC
October 2017

Periungual tegumentary leishmaniasis: a diagnostic challenge.

An Bras Dermatol 2017 Mar-Apr;92(2):268-269

Department of Clinical Medicine, Dermatology Unit, of the School of Medical Sciences of the State University of Campinas (Unicamp) - Campinas (SP), Brazil.

Periungual and paronychia-like skin lesions can mimic various diseases, setting up a diagnostic challenge that invariably requires correlation with complementary tests. We report a case of an ulcerated tumor of the nailfold diagnosed as leishmaniasis. Although paronychia-like cutaneous leishmaniasis is a rare variant, its epidemiological relevance in Brazil should prompt dermatologists to include it as a plausible diagnosis thus leading to correct work up and treatment.
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http://dx.doi.org/10.1590/abd1806-4841.20176352DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429122PMC
October 2017

Acute and Late Bartonella henselae Murine Model Infection.

Vector Borne Zoonotic Dis 2017 03 6;17(3):206-208. Epub 2017 Feb 6.

1 Division of Dermatology, Department of Medicine, University of Campinas (UNICAMP) Medical School , Campinas, Brazil .

Bartonella spp. are fastidious gram-negative neglected bacilli with worldwide distribution. They are able to cause intraerythrocytic and potentially fatal infection. Cats and dogs are reservoirs of some species of these agents. Blood-sucking arthropods are potential vectors. Our aim was to evaluate the blood, skin, liver, and spleen in BALB/c mice by using molecular tests and confocal microscopy to demonstrate Bartonella henselae infection in the bloodstream and organs after 4 and 21 days of intraperitoneally injected bacterial suspension. We demonstrate that the occurrence of infection in organs precedes the detectable infection in blood. Therefore, late manifestation in blood may be another challenge in early detection and diagnosis of B. henselae infection.
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http://dx.doi.org/10.1089/vbz.2016.2007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333569PMC
March 2017

Bartonella henselae AS A PUTATIVE CAUSE OF CONGENITAL CHOLESTASIS.

Rev Inst Med Trop Sao Paulo 2016 07;58:56

University of Sao Paulo (USP), Institute of Tropical Medicine, Laboratory of Seroepidemiology and Immunobiology. Sao Paulo, SP, Brazil.

Severe anemia and cholestatic hepatitis are associated with bartonella infections. A putative vertical Bartonella henselae infection was defined on the basis of ultrastructural and molecular analyses in a three-year-old child with anemia, jaundice and hepatosplenomegaly since birth. Physicians should consider bartonellosis in patients with anemia and hepatitis of unknown origin.
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http://dx.doi.org/10.1590/S1678-9946201658056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4964325PMC
July 2016

[Awareness and education regarding sexually transmitted diseases among undergraduate students].

Cien Saude Colet 2016 Jun;21(6):1975-84

Universidade Estadual de Campinas, Departamento de Clínica Médica, FCM, Unicamp, Campinas SP , Brasil, Departamento de Clínica Médica, FCM, Unicamp. Campinas SP Brasil.

Sexually transmitted diseases (STDs) are the main global cause of acute illness and death and represent a high socioeconomic cost. Undergraduate students are highly exposed to STDs. The research developed at UNICAMP sought to quantify and generate self-perception of knowledge(or lack thereof) about STDs, as well as evaluate the interest of the students in a course on the topic. The data collection instrument was a questionnaire sent electronically to students about to graduate at the end of 2011 and to freshmen in 2012. The questionnaire was answered by 1,448 seniors and 371 freshmen. Twenty percent of seniors and 38% of freshmen had no sexual activity. Among sexually active students, 26.9% had no regular partner and 28.2% more than two partners per year. The condom was used by 99% of students, but less than 20% used them appropriately. About 80% were unaware that condoms do not provide protection outside the barrier area; they intended to read more about STDs and learnt something about the subject. Nearly half of the students considered that a course should be offered to all undergraduates. These findings will be of use in defining strategies for prevention and the teaching tool could be used in other learning environments.
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http://dx.doi.org/10.1590/1413-81232015216.00492015DOI Listing
June 2016

initial infection of mature human erythrocytes observed in real time using bacterial endogenous fluorescence.

J Trop Dis Public Health 2016 Apr 20;4(2). Epub 2016 Feb 20.

Division of Dermatology, Department of Medicine, State University of Campinas, Medical Sciences School, Campinas, Brazil.

is a causative agent of anemia, cat scratch disease, bacillary angiomatosis, recurrent fever, hepatitis, endocarditis, chronic lymphadenopathy, joint and neurological disorders. are intra-erythrocytic bacteria. The goal of this study was to visualize the invasion into enucleated human red blood cells in real time using bacterium endogenous fluorescence. We took advantage of the unique fluorescence emission spectral profile of the bacteria. We used a linear unmixing approach to separate the fluorescence emission spectra of human erythrocytes from native when excited at 488nm. Human blood samples were inoculated with and incubated for 60 hours. 3-D live images were captured at select intervals using multi-photon laser scanning microscopy. Uninfected blood samples were also analyzed. This study revealed bacteria entering mature erythrocytes over a 60 hour time period.
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http://dx.doi.org/10.4172/2329-891X.1000207DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639914PMC
April 2016

Risk Factors for Bartonella species Infection in Blood Donors from Southeast Brazil.

PLoS Negl Trop Dis 2016 Mar 21;10(3):e0004509. Epub 2016 Mar 21.

Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.

Bacteria from the genus Bartonella are emerging blood-borne bacteria, capable of causing long-lasting infection in marine and terrestrial mammals, including humans. Bartonella are generally well adapted to their main host, causing persistent infection without clinical manifestation. However, these organisms may cause severe disease in natural or accidental hosts. In humans, Bartonella species have been detected from sick patients presented with diverse disease manifestations, including cat scratch disease, trench fever, bacillary angiomatosis, endocarditis, polyarthritis, or granulomatous inflammatory disease. However, with the advances in diagnostic methods, subclinical bloodstream infection in humans has been reported, with the potential for transmission through blood transfusion been recently investigated by our group. The objective of this study was to determine the risk factors associated with Bartonella species infection in asymptomatic blood donors presented at a major blood bank in Southeastern Brazil. Five hundred blood donors were randomly enrolled and tested for Bartonella species infection by specialized blood cultured coupled with high-sensitive PCR assays. Epidemiological questionnaires were designed to cover major potential risk factors, such as age, gender, ethnicity, contact with companion animals, livestock, or wild animals, bites from insects or animal, economical status, among other factors. Based on multivariate logistic regression, bloodstream infection with B. henselae or B. clarridgeiae was associated with cat contact (adjusted OR: 3.4, 95% CI: 1.1-9.6) or history of tick bite (adjusted OR: 3.7, 95% CI: 1.3-13.4). These risk factors should be considered during donor screening, as bacteremia by these Bartonella species may not be detected by traditional laboratory screening methods, and it may be transmitted by blood transfusion.
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http://dx.doi.org/10.1371/journal.pntd.0004509DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801220PMC
March 2016

Use of clobetasol in lacquer for plaque psoriasis treatment.

An Bras Dermatol 2016 Jan-Feb;91(1):113-5

Universidade Estadual de Campinas, Campinas, SP, Brazil.

Clobetasol benefits to control psoriasis lesions are well defined, but there were not studies about its action when used in lacquer vehicle to control skin lesions. A double-blind study was conducted with 40 patients that utilized clobetasol 0.05% in one hemibody and just the vehicle in the other hemibody. Twenty of them used petrolatum as vehicle and the others used lacquer. An assessment was conducted using the clinical index PASI and a quality of life questionnaire (Dermatological Life Quality Index). There was no statistical difference between groups. There was a trend of favorable response particularly in the hemibody treated with clobetasol.
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http://dx.doi.org/10.1590/abd1806-4841.20164228DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782662PMC
October 2016

Bartonella henselae transmission by blood transfusion in mice.

Transfusion 2016 06 10;56(6 Pt 2):1556-9. Epub 2016 Mar 10.

Division of Dermatology, Department of Medicine, University of Campinas (UNICAMP) Medical School, Campinas, SP, Brazil.

Background: Bartonella spp. are neglected fastidious Gram-negative bacilli. We isolated Bartonella henselae from 1.2% of 500 studied blood donors and demonstrated that the bacteria remain viable in red blood cell units after 35 days of experimental infection. Now, we aim to evaluate the possibility of B. henselae transmission by blood transfusion in a mouse model.

Study Design And Methods: Eight BALB/c mice were intraperitoneal inoculated with a 30 µL of suspension with 10(4) CFU/mL of B. henselae and a second group of eight mice were inoculated with saline solution and used as control. After 96 hours of inoculation, the animals were euthanized. We collected blood and tissue samples from skin, liver, and spleen. Thirty microliters of blood from four Bartonella-inoculated animals were transfused into a new group (n = 4). Another group received blood from the control animals. B. henselae infection was investigated by conventional and nested polymerase chain reaction (PCR).

Results: Blood samples from all 24 mice were negative by molecular tests though half of the tissue samples were positive by nested PCR in the intraperitoneal Bartonella-investigated animals. Tissues from two of the four mice that received blood transfusions from Bartonella-inoculated animals were also nested PCR positives.

Conclusions: Transmission of B. henselae by transfusion is possible in mice even when donor animals have undetectable bloodstream infection. The impact of human Bartonella sp. transmission through blood transfusion recipients must be evaluated.
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http://dx.doi.org/10.1111/trf.13545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4905798PMC
June 2016

Dermatology relevance to graduates from the Universidade Estadual de Campinas Medical School.

An Bras Dermatol 2015 Sep-Oct;90(5):631-7

Universidade Estadual de Campinas, Campinas, SP, Brasil.

Background: Some research indicates that physicians do not dominate the expected dermatological content for the proper exercise of the profession. This fact compromises their diagnostic and therapeutic performance, generating unnecessary costs.

Objective: The aim of this study was to evaluate the relevance of Dermatology and the knowledge acquired in the specialty during the undergraduate course in clinical practice of graduates at the State University of Campinas Medical School (FCM/UNICAMP).

Method: A questionnaire with 22 closed questions and two open ones was electronically sent to physicians who had graduated more than 10 years ago and others for less than 10 years. In the first group, physicians were trained by the same curriculum and in the second group there were subjects trained by the old and the new curriculum.

Results: Of the 126 respondents, 83% had completed a specialization course. Among all, 82% did not study dermatology after graduation. The majority considered that Dermatology has high relevance in clinical practice, regardless of the group. There was a statistically significant difference between non-dermatologist doctors graduated for more than 10 years and those graduated for less than 10 years regarding confidence about lesion diagnosis, diagnostic investigation and treatment of skin diseases. Physicians who have graduated for a longer time feel more insecure in relation to patients with dermatoses. Concerning contributions offered by graduation program completion they prioritized outpatient care, ability to diagnose, knowledge of pathology, research and knowledge of lesions.

Conclusion: This study has shown that Dermatology is relevant in medical practice and more recent graduates from the FCM/UNICAMP feel less insecure when treating a patient with dermatoses.
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http://dx.doi.org/10.1590/abd1806-4841.20153740DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631227PMC
March 2016

Bartonella spp. and Coxiella burnetii Associated with Community-Acquired, Culture-Negative Endocarditis, Brazil.

Emerg Infect Dis 2015 Aug;21(8):1429-32

We evaluated culture-negative, community-acquired endocarditis by using indirect immunofluorescent assays and molecular analyses for Bartonella spp. and Coxiella burnetii and found a prevalence of 19.6% and 7.8%, respectively. Our findings reinforce the need to study these organisms in patients with culture-negative, community-acquired endocarditis, especially B. henselae in cat owners.
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http://dx.doi.org/10.3201/eid2108.140343DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517744PMC
August 2015
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