Experimentos com os nematieidas D. D, E.D.B., C.B.P. e Vapam no combate aos nematódeos que parasitam a batatinha em São Paulo

The writers report results on the application of four fumigants (D. D., E. D. B.-40, C. B. P. and Vapam) for control of root-knot and meadow nematodes attacking potato in beds filled with soil artificially inoculated. The data obtained were as follows: a) as reported by previous authors, potato is sensitive to C.B.P., the toxical effects of which disapearing only about 6 and half months after application. On the other hand, C.B.P. proved to have a significative residual nematicidal value, protecting the seeds from root-knot nematodes for a period of two years; b) D. D., E. D. B., and Vapam were effective for controling root-knot but with no residual value, having to be used prior to each planting; c) at the rates used, no nematicide was effective to control meadow nematodes; d) in the conditions of the experiments, all nematicides incited attacks bv Streptomyces scabies. Actually, in some cases scab did not affect any tuber from the check while the entire production from the treated beds was heavily desfigured. The writers assume that as the nematicides killed protozoa and too many bacteria-eating nematodes, they destroyed the biological equilibrium existing in the soil, thus allowing the S. scabies population to reach a high level.

Terapia nutricional precoce no trauma: após o A, B, C, D, E, a importância do F (FEED)

Um número significativo de mortes no trauma ocorre dias a semanas após a injúria inicial, sendo causado por infecções e insuficiência orgânica, relacionadas a hipercatabolismo e consequente desnutrição proteica aguda. A terapia nutricional deve ser planejada e incluída com as demais condutas de reanimação para pacientes politraumatizados e grandes queimados. A rápida aquisição de uma via para suporte nutricional é importante para inicio da terapia nutricional precoce em até 48 horas do atendimento. A via enteral é a opção preferencial no pós-operatório de pacientes traumatizado mas a via parenteral deve ser prescrita quando a enteral está contraindicada ou insuficiente. Após as medidas iniciais ditadas pelo ATLS, sintetizadas em A (air), B (breath), C (circulation), D (disability) e E (exposure), nós incluímos a letra F (feed) para enfatizar a importância do atendimento nutricional precoce no trauma.

Erythrocytes may contain a ouabain-insensitive K+-ATPase which plays a role in internal K+ balance

Erythrocytes are useful in evaluating K+ transport pathways involved in internal K+ balance. Several forms of H+,K+-ATPase have been described in nephron segments active in K+ transport. Furthermore, the activity of a ouabain-insensitive isoform of H+,K+-ATPase expressed in collecting duct cells may be modulated by acid-base status. Various assays were performed to determine if a ouabain-insensitive K+-ATPase is present in rat erythrocytes and, if so, whether it plays a role in internal K+ balance. Kinetic studies demonstrated that maximal stimulation of enzyme activity was achieved with 2.5 mM K+ at pH 7.4. Subsequent experiments were performed on erythrocyte membranes collected from animals submitted to varying degrees of K+ homeostasis: control rats, K+-depleted rats, K+-loaded rats, and rats rendered hyperkalemic due to acute renal failure. As observed in the collecting duct cell studies, there was a significant decrease in the activity of ouabain-insensitive K+-ATPase in the erythrocytes of both K+-loaded and metabolically alkalotic K+-depleted rats. However, this enzyme activity in erythrocyte membranes of rats with metabolic acidosis-related hyperkalemia was similar to that of control animals. This finding may be interpreted as resulting from two potentially modulating factors: the stimulating effect that metabolic acidosis has on K+-ATPase and the counteracting effect that hyperkalemia and uremia have on metabolic acidosis. In summary, we present evidence of a ouabain-insensitive K+-ATPase in erythrocytes, whose activity is modulated by acid-base status and K+ levels.

How frequently should a patient taking amiodarone be screened for thyroid dysfunction?

Amiodarone-induced thyroid dysfunction (AITD) is a common complication of amiodarone therapy and its prevalence varies according to iodine intake, subclinical thyroid disorders and the definition of AITD. There is no consensus about the frequency of screening for this condition. We evaluated 121 patients on chronic regular intake of amiodarone (mean intake = 248.5 ± 89 mg; duration of treatment = 5.3 ± 3.9 years, range = 0.57-17 years) and with stable baseline cardiac condition. Those with no AITD were followed up for a median period of 3.2 years (range: 0.6-6.7) and the incidence rate of AITD, defined by clinical and laboratorial findings as proposed by international guidelines, was obtained (62.8 per 1000 patients/year). We applied the Cox proportional hazard model to adjust for potential confounding factors and used sensitivity analysis to identify the best screening time for follow-up. We detected thyroid dysfunction in 59 (48.7%) of the 121 patients, amiodarone-induced hypothyroidism in 50 (41.3%) and hyperthyroidism in 9 (7.5%). Compared with patients without AITD, there was no difference regarding dosage or duration of therapy, heart rhythm disorder or baseline cardiac condition. During the follow-up of the 62 patients without AITD at baseline evaluation, 11 developed AITD (interquartile range, IR: 62.8 (95%CI: 31.3-112.3) cases per 1000 patients/year), 9 of them with hypothyroidism - IR: 11.4 (95%CI: 1.38-41.2), and 2 hyperthyroidism - IR: 51.3 (95%CI: 23.4-97.5). Age, gender, dose, and duration of treatment were not significant after adjustment. During the first 6 months of follow-up the incidence rate for AITD was 39.3 (9.2-61.9) cases per 1000 patients/year. These data show that AITD is quite common, and support the need for screening at 6-month intervals, unless clinical follow-up dictates otherwise or further information regarding the prognosis of untreated subclinical AITD is available.

GB virus C/Hepatitis G virus and other putative hepatitis non A-E viruses

The identification of the major agents causing human hepatitis (Hepatitis A, B, C, D and E Viruses) was achieved during the last 30 years. These viruses are responsible for the vast majority of human viral hepatitis cases, but there are still some cases epidemiologically related to infectious agents without any evidence of infection with known virus, designated as hepatitis non A - E. Those cases are considered to be associated with at least three different viruses: 1 - Hepatitis B Virus mutants expressing its surface antigen (HBsAg) with altered epitopes or in low quantities; 2 - Another virus probably associated with enteral transmitted non A-E hepatitis, called Hepatitis F Virus. Still more studies are necessary to better characterize this agent; 3 - Hepatitis G Virus or GB virus C, recently identified throughout the world (including Brazil) as a Flavivirus responsible for about 10% of parenteral transmitted hepatitis non A-E. Probably still other unknown viruses are responsible for human hepatitis cases without evidence of infection by any of these viruses, that could be called as non A-G hepatitis.

THE INFLUENCE OF HIV-1 SUBTYPES C, CRF31_BC AND B ON DISEASE PROGRESSION AND INITIAL VIROLOGIC RESPONSE TO HAART IN A SOUTHERN BRAZILIAN COHORT

Background: Although most HIV-1 infections in Brazil are due to subtype B, Southern Brazil has a high prevalence of subtype C and recombinant forms, such as CRF31_BC. This study assessed the impact of viral diversity on clinical progression in a cohort of newly diagnosed HIV-positive patients. Methods: From July/2004 to December/2005, 135 HIV-infected patients were recruited. The partial pol region was subtyped by phylogeny. A generalized estimating equation (GEE) model was used to examine the relationship between viral subtype, CD4+ T cell count and viral load levels before antiretroviral therapy. Hazard ratio (Cox regression) was used to evaluate factors associated with viral suppression (viral load < 50 copies/mL at six months). Results: Main HIV-1 subtypes included B (29.4%), C (28.2%), and CRF31_BC (23.5%). Subtypes B and C showed a similar trend in CD4+ T cell decline. Comparison of non-B (C and CRF31_BC) and B subtypes revealed no significant difference in the proportion of patients with viral suppression at six months (week 24). Higher CD4+ T cell count and lower viral load were independently associated with viral suppression. Conclusion: No significant differences were found between subtypes; however, lower viral load and higher CD4+ T cell count before therapy were associated with better response.

A concentração e a quantidade de micronutrientes e de alumínio no cafeeiro, Coffea arabica, L., variedade mundo novo (B.Rodr.) Choussy, aos dez anos de idade

O presente trabalho relata os dados obtidos sôbre a concentração e a quantidade de micronutrientes, boro (B), cloro (Cl), cobre (Cu), ferro (Fe), manganês (Mn), molibdênio (Mo) e zinco (Zn), no tronco, ramos, fôlhas e frutos do cafeeiro, Coffea arabica, L., variedade mundo novo (B.Rodr.) Choussy, aos dez anos de idade e crescendo em solo latosólico da Escola Superior de Agricultura "Luiz de Queiroz", em Piracicaba. Além dos micronutrientes, são apresentados dados sobre a concentração e a quantidade de alumínio, nas citadas partes do cafeeiro.

Tolerância do milheto (Pennisetum americanum) ao 2, 4-D

Objetivou-se com este trabalho avaliar os efeitos do 2,4-D sobre o crescimento das plantas, a produção de massa seca e verde e a produtividade de grãos do milheto. O experimento foi realizado no período de março a junho de 2006, em Rio Verde-GO, em um Latossolo Vermelho eutroférrico. O milheto (cultivar ADR 500) foi semeado manualmente em área cultivada sob sistema de plantio direto, em espaçamento de 0,45 m, distribuindo-se 12 sementes por metro. Utilizou-se o delineamento de blocos casualizados, em esquema fatorial 4 x 4, sendo avaliadas quatro doses de 2,4-D (0, 335, 670 e 1.005 g ha-1) aplicadas em quatro épocas [10 dias após a emergência das plantas de milheto (DAE) (3 folhas); 20 DAE (5 a 6 folhas expandidas); 30 DAE (início de emissão da inflorescência); e 40 DAE (florescimento pleno)]. Para evitar a interferência das plantas daninhas na cultura, esta foi capinada manualmente, sempre que necessário. Não se observou nenhum sinal de intoxicação das plantas de milheto pelo 2,4-D aos 15 dias após a aplicação, independentemente da dose ou época de aplicação do herbicida. Todavia, as maiores doses de 2,4-D, em qualquer época de aplicação, provocaram menor acúmulo de massa verde e seca das plantas de milheto, quando se avaliaram os resultados no ponto de rolagem da cultura. O 2,4-D, independentemente da dose utilizada ou época de aplicação, não influenciou a produtividade de grãos do milheto.

Hepatitis B virus genotype E detected in Brazil in an African patient who is a frequent traveler

Genotype E of hepatitis B virus (HBV) has not been described in Brazil and is found mainly in Africa. Genotype A is the most prevalent in Brazil, and genotypes B, C, D, and F have already been reported. We report here an HBV genotype E-infected patient and some characterization of surface (S) protein, DNA polymerase (P) and precore/core (preC/C) coding regions based on the viral genome. The patient is a 31-year-old black man with chronic hepatitis B who was born and raised in Angola. He has been followed by a hepatologist in São Paulo, Brazil, since November 2003, and he is a frequent traveler to Latin America, Africa, and Europe. In 2003, he was diagnosed with HBV infection and started treatment with lamivudine with the later addition of adefovir dipivoxil. No known risk factor was identified. Serologically, he is HBsAg and anti-HBe positive, but HBeAg and anti-HBs negative. DNA sequence analysis of the S/P region confirmed that this patient is infected with genotype E, subtype ayw4. The preC/C region showed G1896A and G1899A mutations but no mutations in the basal core promoter. Nucleotide substitutions common in genotype E were also observed (C1772, T1858 and A1757). Although this is not an autochthonous case and there is no evidence of further spread, the description of this case in Brazil highlights the current risk of viral genotypes spreading with unprecedented speed due to constant travel around the world.

C-reactive protein in acute coronary syndrome: association with 3-year outcomes

Inflammatory markers have been associated with clinical outcome in patients with acute coronary syndrome (ACS). The present study evaluated the role of high-sensitivity C-reactive protein (CRP) measurements as a predictor of late cardiovascular outcomes after ACS. One hundred and ninety-nine ACS patients in a Coronary Care Unit from March to November 2002 were included and were reassessed clinically after ~3 years. Clinical variables and CRP levels were evaluated as predictors of major cardiovascular events (MACE, defined as the occurrence of cardiac death, ischemic stroke or myocardial infarction) and mortality. Statistical analyses included Cox multivariable analysis and survival curves (Kaplan-Meier). Of the 199 patients, 11 died within 1 month (5.5%). Of the 188 remaining patients, 22 died after a mean follow-up of 2.9 ± 0.5 years. Baseline CRP levels for patients with MACE (N = 57) were significantly higher than those of patients with no events (median = 0.67 mg/L; 25th-75th percentiles = 0.32 and 1.99 mg/L vs median = 0.45 mg/L; 25th-75th percentiles = 0.24 and 0.83 mg/L; P < 0.001). Patients with CRP levels >3 mg/L had a significantly lower survival than the other two groups (1-3 and <1 mg/L; P = 0.001, log-rank test). The odds ratio for MACE was 7.41 (2.03-27.09) for patients with CRP >3 mg/L compared with those with CRP <1 mg/L. For death by any cause, the hazard ratio was 4.58 (1.93-10.86). High CRP levels predicted worse long-term outcomes (MACE and death by any cause) in patients with ACS.

Effects of 174 G/C polymorphism in the promoter region of the interleukin-6 gene on plasma IL-6 levels and muscle strength in elderly women

We investigated the effect of -174 G/C single-nucleotide polymorphism in the promoter region of the IL6 gene on plasma IL-6 levels and muscle strength, and the relationship between IL-6 levels and muscle strength in elderly women. The sample consisted of 199 elderly residents (73.0 ± 7.8 years old) from rest homes and the community in Belo Horizonte, MG, Brazil. -174 G/C polymorphism was determined by direct sequencing of the product by PCR, and plasma IL-6 concentrations were measured by ELISA. Muscle strength in the knee joint was evaluated using a Biodex System 3 Pro® isokinetic dynamometer. ANCOVA was used to determine the effect of polymorphism on IL-6 levels and muscle strength, and the Pearson correlation coefficient to assess the relationship between IL-6 levels and muscle strength. -174 G/C polymorphism was associated with the plasma IL-6 levels of elderly women (P < 0.01) since homozygotes for the G allele showed high IL-6 levels (GG 3.85 pg/mL, GC + CC 2.13 pg/mL). There was no association of polymorphism on muscle strength (P > 0.05). No association was found between IL-6 levels and knee extensor muscle (r = 0.087, P = 0.306) or flexor (r = -0.011, P = 0.894) strength. An interaction between -174 G/C polymorphism and housing conditions of the sample of elderly women was identified, with the effect of genotype on IL-6 levels being higher in the institutionalized elderly. These results support the evidence that -174 G/C polymorphism of the IL6 gene associates with individual variability of plasma IL-6 levels in elderly women.

Qualidade microbiológica de leite humano obtido em banco de leite

OBJETIVO: Determinar a prevalência de microrganismos indicadores e potencialmente patogênicos que indicam as condições higiênico-sanitárias das amostras de leite humano ordenhado coletadas em banco de leite. MÉTODOS: Foram realizadas análises microbiológicas de 338 amostras de leite humano ordenhado, sendo 194 de leite cru e 144, pasteurizado, coletadas em banco de leite humano de um hospital materno infantil de Goiânia, GO. As análises microbiológicas foram realizadas com semeadura em ágar Mc Conkey, de acordo com o tipo de bactéria. RESULTADOS: No leite cru, verificou-se a presença de Staphylococcus spp. Streptococcus spp., bolores e leveduras e Enterobacteriaceae. Observou-se que Staphylococcus aureus esteve presente em 10 (5,2%) amostras, Staphylococcus epidermidis em 28 (14,4%), Streptococcus spp. em três (1,6%), bolores e leveduras em 43 (22,2%) e Enterobacteriaceae em 49 (25,3%). Das 144 amostras de leite humano ordenhado pasteurizado, detectaram-se Staphylococcus aureus em cinco (3,5%), Staphylococcus epidermidis em 15 (10,4%), Staphylococcus lugdenensis em duas (1,4%), Streptococcus spp. em quatro (2,8%), bolores e leveduras em 37 (25,7%) e Enterobacteriaceae em nove (6,3%). CONCLUSÕES: Os resultados mostraram um alto grau de contaminação no leite cru. No leite pasteurizado, apesar da eliminação da grande maioria de microrganismos potencialmente patogênicos, a percentagem de bolores e leveduras excedeu a de leite cru, mostrando a necessidade de obtenção de um leite com carga microbiana inicial mais baixa para que a pasteurização seja eficiente no controle microbiológico.