STUDIES ON HAEMOLYMPH CONSTITUENTS OF PILA VIRENS (LAMARCK) AND THE EFFECTS OF PESTICIDES ON THE ACTIVITY PATTERN OF SELECTED ENZYMES

The present study is an attempt to understand the physiological responses of a freshwater gastropod, in terms of haematological parameters, in normal conditions as well as in various natural and man made altered conditions of the environment.Pila virens, a freshwater prosobranch,commonly found in paddy fields, ponds, and streams of Kerala is selected as the test animal for the present investigation. Various haemolymph constituents such as total carbohydrate, glycogen, total protein, total lipid, urea,ammonia,sodium,potasium, calcium, and chloride which are directly involved in the control and maintenance of different physiological systems, were analysed in the present study. Selected haematological parameters like total haemocyte number, and packed cell volume were also determined. Besides , the activity pattern of selected haemolymph enzymes such as acid phosphatase (ACP), alkaline phosphatase (ALP),Glutamate-oxaloacetate transaminase (GOT), and glutamate-pyruvate transaminase (GPT), all having diagnostic value in terms of internal defence system and metabolism of the organism, were also studied.

Radio 33 comparado con el patrón de oro para diagnóstico de osteoporosis

Introducción: la medición de la densidad mineral ósea en el fémur y columna lumbar es considerada la prueba de oro para el diagnóstico de osteoporosis en mujeres postmenopáusicas, sin tener suficiente evidencia de la utilidad al medir de manera individual o simultanea el radio 33 con este mismo propósito. Metodología Se realizó un estudio de pruebas diagnósticas, valorando concordancia anidada para determinar el valor diagnóstico del radio 33 comparado con los resultados por dual fémur y columna, actualmente patrón de oro el en diagnóstico. Se incluyeron mujeres mayores de 50 años entre el periodo de 2008 y 2011. Resultados Se incluyeron 3241 osteodensitometrias de pacientes femeninas con columna AP, dual fémur, radio ultradistal y radio 33. Tomando como estándar de oro la medición en columna y/o femur, el radio-33 obtuvo una sensibilidad de 95.5% y especificidad de 91% (p= 0,000) para osteoporosis, y una sensibilidad de 76.5% y especificidad de 54.9% p=0,000 para el diagnóstico de osteopenia. El radio 33 permite diagnosticar un 35% adicional de casos que no son captados con la medición en fémur y columna lumbar. Discusión La osteodensitometría en los sitios usados comúnmente, predice únicamente el 40% del riesgo de fractura (1). Si se incluye la medición de radio 33, la sensibilidad de la osteodensitometría sube en un 35.66% adicional, logrando detectar más pacientes con este riesgo y generando un impacto en la oportunidad del tratamiento y quizás reducción en la morbi-mortalidad secundaria a fracturas en esta población susceptible.

Goblet cell carcinoid tumors (adenocarcinoid) of the appendix

Purpose: Goblet cell appendiceal carcinoids represent rare tumors that exhibit histologic features of both adenocarcinomas and neuroendocrine tumors. We present the long-term results of a series of 15 patients, focusing on clinical manifestations, diagnosis, and management.

Methods: Eight male and seven female patients (median age, 52.8 years) were included. Final diagnosis was confirmed by histology. Patients were evaluated clinically, biochemically, and radiologically every four months. Median follow-up was 30 months.

Results: The majority of patients (7/15) presented with symptoms compatible with acute appendicitis. Right hemicolectomy was performed in all except one, who subsequently developed metastases. Three patients had metastases at previous diagnosis. Plasma chromogranin-A was slightly elevated in two of them, while urinary 5-hydroxy-indol-acetic acid was normal. 111Indium-labeled octreotide scintigraphy was positive only in two of the four patients with metastases. Ki67 index was greater than 20 percent in all of them, while in only one with local tumor. Combination chemotherapy with either cisplatin plus etoposide or with 5-fluorouracil, cisplatin, and streptozotocin was administered to all patients with metastases resulting in temporary stabilization of disease. Twelve patients are alive, while three died of their disease 9, 13, and 14 months after diagnosis.

Conclusions: The diagnostic value of chromogranin-A, urinary 5-hydroxy-indol-acetic acid, and 111Indium-labeled octreotide scintigraphy seems to be limited in these tumors. Ki67 index appears to predict tumor behavior. Right hemicolectomy may reduce the risk of developing metastases. Chemotherapy may have efficacy in metastatic disease, however, more data are required to determine this and the optimal regimen.

Laboratory features of common causes of fever in returned travelers

There can be considerable overlap in the clinical presentation and laboratory features of dengue, malaria, and enteric fever, three important causes of fever in returned travelers. Routine laboratory tests including full blood examination (FBE), liver function tests (LFTs), and C-reactive protein (CRP) are frequently ordered on febrile patients, and may help differentiate between these possible diagnoses.

O exame direto do lavado broncoalveolar para o diagnóstico precoce de pneumonia nosocomial : um modelo experimental em ratos

A pneumonia nosocomial é a principal causa de infecção nosocomial em unidades de tratamento intensivo e possui alta morbi/mortalidade. A incidência cumulativa varia, conforme os autores, entre limites amplos desde 8% até 51%, dependendo do tipo de paciente e do uso de instrumentação das vias respiratórias. Nos casos específicos das pneumonias de má resolução e da pneumonia associada à ventilação mecânica, o diagnóstico é problemático devido à ausência de uma padronização definitiva, decorrente não só da grande variabilidade fisiopatológica como também da pouca acurácia dos critérios clínicos, microbiológicos e radiológicos. Estes fatos ensejaram a utilização progressiva de técnicas invasivas sofisticadas para coleta de amostras respiratórias endobrônquicas. Entretanto, a validação dessas técnicas para uso sistemático depende ainda de estudos que avaliem não só o seu custo/benefício em cenários clínicos diversos como também a comparação de seu desempenho para o diagnóstico com um padrão-ouro histopatológico. Além disso, o rendimento das técnicas invasivas é freqüentemente limitado quando são aplicadas em pacientes sob antibioticoterapia, que constituem a maioria dos casos em unidades de cuidados intensivos. A otimização desses testes, discutindo suas indicações e avaliando sua capacidade técnica para a confirmação ou exclusão de pneumonia, é justificada pela necessidade da instituição precoce e correta do tratamento, pois disto resulta menor mortalidade, redução de custos e permanência no hospital. Entre os testes que podem auxiliar no diagnóstico encontra-se o exame direto do lavado broncoalveolar, que proporciona resultados precoces e úteis para a tomada de decisão, mas não suficientemente testados em diferentes situações clínicas ou experimentais. Com o objetivo de avaliar o rendimento diagnóstico do exame direto precoce e das culturas quantitativas obtido por lavado broncoalveolar, estudou-se sua utilização em um modelo experimental de pneumonia provocada através de inoculação bacteriana intrabrônquica em ratos. O estudo comparou a acurácia do exame direto e dos exames culturais em três grupos de animais: Grupo A com pneumonia pneumocócica (37 animais); Grupo P com pneumonia por P. aeruginosa (26 animais) e Grupo B controle (10 animais), utilizando a histopatologia dos pulmões como teste de referência para o diagnóstico. Os Grupos A e P foram ainda randomizados em dois subgrupos cada, para tratamento ou não com antibióticos, usando penicilina no grupo pneumococo e amicacina no grupo Pseudomonas. Como resultado, observou-se que nos animais com pneumonia e ausência de antibióticos a pesquisa de bactéria fagocitada (BIC) no exame direto mostrou um rendimento elevado para o diagnóstico, sendo superior ao das culturas quantitativas. No grupo com pneumonia pneumocócica a BIC mostrou: S:94,4% a 100%, E:100%, VPP:100% e VPN:100%; e as culturas quantitativas mostraram: S:77,8%, E:100%, VPP:100%, VPN:40%. Nos com pneumonia por Pseudomonas a BIC obteve: S: 69%, E:100%; VPP:100% e VPN:71,4%); e as culturas quantitativas mostraram valores muito baixos: S:28,6%, E:100%, VPP:100% e VPN:50%). Nos animais com pneumonia pneumocócica sob tratamento antibiótico havia uma queda acentuada de sensibilidade das culturas quantitativas (S:21%) e, em menor grau da BIC (S:57,9%), mas sem perda da especificidade de ambos os exames. Ao contrário, nos animais com pneumonias por Pseudomonas sob tratamento não havia alteração no rendimento dos dois exames, cujos resultados foram semelhantes aos dos animais sem tratamento. Não havia diferenças de leitura da BIC para o diagnóstico, contando a sua positividade em macrófagos ou em neutrófilos infectados. A avaliação global dos casos estudados, reunindo todos os grupos (tratados e não-tratados) em ambos os modelos de pneumonia, mostrou que a acurácia do exame direto, representado pela pesquisa da BIC, foi superior (66%) ao das culturas quantitativas (53%). As conclusões principais do estudo foram: 1) o exame direto do lavado broncoalveolar (LBA) mostrou-se um teste útil e de alto rendimento para o diagnóstico de pneumonia quando realizado na ausência de antibióticos; 2) o LBA feito na vigência de antibióticos efetivos para a pneumonia perde mais de 50% de sua acurácia, mas não é afetado quando o antibiótico for ineficaz ou houver resistência ao mesmo; 3) a pesquisa de BIC no LBA é um exame de resultado precoce, de alta especificidade e com melhor rendimento do que as culturas quantitativas.

Efeitos da cimetidina na resposta cronotrópica ao teste cardiopulmonar

Introdução: A histamina exerce vários efeitos no desempenho cardíaco em humanos, os quais são mediados por receptores H1e H2. A ocorrência de bradicardia e distúrbio da condução atrioventricular tem sido descrita após a injeção intravenosa de cimetidina ou ranitidina, porém ainda não foi avaliado seu potencial efeito na resposta cronotrópica ao exercício com suas implicações sobre o valor prognóstico e diagnóstico do teste de esforço Objetivo: Testar a hipótese, através de ensaio clinico randomizado, de que a administração de cimetidina altera a resposta cronotrópica ao exercício. Material e Métodos: Foram submetidos a dois testes cardiopulmonares, 20 indivíduos, após uso de placebo e de cimetidina. Os testes foram realizados em esteira rolante, com protocolo de rampa com analises diretas dos gases expirados. Foi avaliada freqüência cardíaca máxima atingida, além da freqüência cardíaca de repouso e no limiar anaeróbio. Resultados: Os indivíduos estudados estavam igualmente distribuídos por sexo, com idade média (± desvio padrão) de 43 ±11 anos. Os exames com placebo e com cimetidina tiveram igual duração (578 ± 90 seg vs 603 ± 131 seg) e igual VO2 pico (35 ± 8 ml/Kg.min vs 35 ± 8 ml/Kg.min). A administração de cimetidina não apresentou efeito significativo na freqüência cardíaca de repouso (75 ± 10 vs 74 ± 8 bpm), no pico do esforço (176 ± 12 vs176±11 bpm) e, da mesma forma, também não houve diferença entre as freqüências cardíacas de pico e de repouso (101 ± 14 vs101 ± 13 bpm). Conclusão: A administração de cimetidina por sete dias não altera a resposta cronotrópica ao exercício.

Detection of anti-Toxoplasma gondii antibodies in experimentally and naturally infected non-human primates by Indirect Fluorescence Assay (IFA) and indirect ELISA

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Interleukin-6 and procalcitonin in children with sepsis and septic shock

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Foliar anatomy of the subfamily Myrtoideae (Myrtaceae)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Detection of the 43,000-molecular-weight glycoprotein in sera of patients with paracoccidioidomycosis

The 43,000-molecular-weight (43K) soluble glycoprotein was detected in sera of patients with paracoccidioidomycosis by the immunoblot technique by using as the probe rabbit monospecific antisera to this fraction. The 43K antigen was present before treatment in sera of patients with the acute (juvenile) form; it started to disappear from circulation after 10 months of chemotherapy, and it was undetectable afer 2 years of treatment. In the chronic cases, the 43K antigen was detected in patients without treatment, and it was absent in the healed cases. The detection of the 43K protein specific to Paracoccidioides brasiliensis may be important for its diagnostic value as well as for modulation of the host immune response.

Detection of circulating Paracoccidioides brasiliensis antigen in urine of paracoccidioidomycosis patients before and during treatment

For the diagnosis and follow-up of paracoccidioidomycosis patients undergoing therapy, we evaluated two methods (immunoblotting and competition enzyme immunoassay) for the detection of circulating antigen in urine samples. A complex pattern of reactivity was observed in the immunoblot test. Bands of 70 and 43 kDa were detected more often in urine samples from patients before treatment. The immunoblot method detected gp43 and gp70 separately or concurrently in 11 (91.7%) of 12 patients, whereas the competition enzyme immunoassay detected antigenuria in 9 (75%) of 12 patients. Both tests appeared to be highly specific (100%), considering that neither fraction detectable by immunoblotting was present in urine samples from the control group. gp43 remained present in the urine samples collected during the treatment period, with a significant decrease in reactivity in samples collected during clinical recovery and increased reactivity in samples collected during relapses. Reactivity of some bands was also detected in urine specimens from patients with 'apparent cure.' The detection of Paracoccidioides brasiliensis antigens in urine appears to be a promising method for diagnosing infection, for evaluating the efficacy of treatment, and for detecting relapse.

Bone scintigraphy in testicular tumors

Purpose: Testicular tumors do not occur frequently. Primary treatment is surgical, and radiotherapy and chemotherapy can play important roles in cases of metastatic disease. Bone scintigraphy is used largely for early detection of skeletal metastases from several tumors, and conventional radiographic studies are less sensitive than the nuclear technique for such a purpose. The aim of this study was to identify the role of bone scintigraphy in cases of testicular tumors, regardless of the grade. Materials and Methods: The authors examined 28 patients (8 to 52 years old) with proved testicular tumors using Tc-99m MDP (750 MBq; 20 mCi) injected intravenously. Whole-body images were obtained 2 hours later, at 500,000 counts per image. Radiographic studies were obtained to investigate abnormal areas noted on scintigraphy. Results: The results of bone scintigraphy were abnormal in seven cases, consisting of variable but diffuse uptake in the iliac bone on the same side as the affected testicle. MDP uptake was substantial in five of these patients (four seminomas, one nonseminoma; only two radiographic studies were abnormal), and the two other patients had moderate uptake of the radiopharmaceutical (two seminomas; radiographic studies were normal). Metastases were confirmed by biopsy in three cases. Discussion: Early metastases from seminomas can occur through the lymphatic drainage toward the iliac lymph node chain. This could explain these findings. The scintigraphic aspects of the affected iliac bones seem characteristic. Conclusions: Early detection of metastases is very important to ensure the efficacy of radiotherapy and chemotherapy. Bone scintigraphy may play an important role in such cases and seems to be more sensitive than conventional radiography. Testicular tumor metastases should be considered when iliac involvement is observed. Paget's disease should be included in a differential diagnosis.

Immunohistochemical aspects of basal cell adenoma and canalicular adenoma of salivary glands

Basal cell adenoma is a benign epithelial neoplasm with a uniform histologic appearance dominated by basaloid cells. Those cells may be distributed in various arrangements as solid, trabecular, tubular and membranous. Canalicular adenoma is also a benign neoplasm composed by columnar cells arranged in branching and interconnecting cords of single or double cell thick rows. There is some disagreement among investigators about whether canalicular adenoma should be included within the basal cell adenoma histologic spectrum. In the present study we compared the expression of cytokeratins (CK), vimentin and muscle-specific actin, utilizing immunohistochemical technique, in three cases diagnosed as basal cell adenomas predominantly of the solid type, and three cases of canalicular adenomas. The results obtained showed a distinct immunoprofile for both neoplasms. Solid areas of basal cell adenomas did not stain for any of the tested antibodies; only when there was tubular differentiation, those structures expressed CKs 7, 8, 14, and 19 in luminal cells and vimentin in non-luminal cells. On the other hand, canalicular adenomas strongly expressed CKs 7 and 13. The panel of antibodies utilized supports the separation of the two entities. © 2001 Elsevier Science Ltd.

Somatic meiosis and development of the juvenile gametophyte in members of the Batrachospermales sensu lato (Rhodophyta)

Seven populations (six in culture and one sampled directly from nature) of the freshwater red algal families Batrachospermaceae, Lemaneaceae and Thoreaceae were examined, involving three species of Batrachospermum, two of Paralemanea and one of Thorea. All 'Chantransia' stages ultimately produced juvenile gametophytes. The production of juvenile gametophytes in the three populations of Batrachospermum was generally most abundant at 15°C and low irradiances (47-68 μmol photons m-2 s-1). The most abundant gametophyte development in the Paralemanea species was observed at 10°C and low or high irradiances (47-142 μmol photons m-2 s-1). Gametophyte production in Thoreaceae occurred at higher temperatures (20°C) and also at low irradiances. In species of the Batrachospermaceae and Lemaneaceae, the 'elimination cells' can be situated on the basal or suprabasal cell of the juvenile gametophyte, but the position is usually fixed in individual species. The presence and position of the elimination cells remain to be established in Thoreaceae. Our results corroborate a previous study suggesting that the position of elimination cells is such a constant feature that it is of potential diagnostic value at the generic or infrageneric (sectional or specific) level. The characteristics observed in the development of the juvenile gametophytes in species of Batrachospermaceae and Lemaneaceae essentially agreed with general descriptions in the previous studies. The characteristics of the Thoreaceae, with a distinctive developmental pattern of the juvenile gametophyte and the occurrence of two morphological types in the 'Chantransia' stage, support the proposal to elevate it to the ordinal level. Two remarkable observations in Batrachospermum species were the production of numerous juvenile gametophytes from filaments of the same plant of the 'Chantransia' stage and the formation of a system of rhizoidal filaments or cell agglomeration of the juvenile gametophytes, which produced new gametophytes. These two characteristics potentially increase the formation of additional gametophytes under favourable conditions.

Papilomavírus humano (HPV) em lesões benignas e malignas de mucosa oral pelos métodos de imuno-histoquímica e hibridização in situ

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)