O movimento da medicina psicossomática no Brasil: a trajetória teórica e institucional de Danilo Perestrello / Danilo Perestrello and the psychosomatic medicine movement in Brazil: from theory to institutional acceptance

Resumo Na década de 1950, surgia o movimento da medicina psicossomática no Brasil, tendo como protagonista o psiquiatra e psicanalista Danilo Perestrello. A configuração dessa proposta e a análise das estratégias construídas para a formação desse campo disciplinar são o objeto deste estudo. Desde o início, esse movimento foi marcado por um projeto teórico-institucional de refundação da medicina sobre bases psicanalíticas e de institucionalização. Em sua trajetória, Perestrello publicou artigos e livros que tinham como intuito formar um novo estilo de pensamento entre os médicos, bem como a ocupação de instituições estratégicas. Seu afastamento profissional, devido a uma grave doença em 1976, representou um fator desagregador do movimento psicossomático no contexto brasileiro.

Abstract In the 1950s, the psychosomatic medicine movement emerged in Brazil, led by psychiatrist and psychoanalyst Danilo Perestrello. This article analyzes the strategies developed to configure this proposal and establish this field of study. From the beginning, this movement was characterized by a plan to reformulate medicine based on psychoanalytic theory and obtain favorable reception in institutions. During his career, Perestrello published articles and books with the intention of establishing a new way of thinking among physicians and worked at strategic institutions. His withdrawal from professional work due to a serious illness in 1976 was a factor contributing to the fragmentation of the psychosomatic movement in Brazil.

Assessment of the impact of changes in temperature in Biomphalaria glabrata (Say, 1818) melanic and albino variants infected with Schistosoma mansoni (Sambon, 1907)

Abstract Fluctuations in population density of planorbid hosts of S. mansoni are influenced by climatic factors. The knowledge about interference from changes in water temperature in these populations is an important aspect of the epidemiology of schistosomiasis. In this experiment, it is explored the influence of different temperatures on the development of Schistosoma mansoni in Biomphalaria glabrata melanic and albino variants. The results indicated an intrinsic relationship between temperature and development of the parasite in the intramollusc phase, independent of the pigmentation of the mantle of the molluscs. The higher the temperature, the shorter the period necessary for the development of the parasite was while the higher the mortality of infected mollusks. It is concluded that, in the presence of climate change, the increasement of temperature in cold and flooded regions may encourage the establishment of new foci of transmission of schistosomiasis by changing the geographic extent and extending the epidemiological transmission potential. In warm climates, higher temperatures, however, could compromise the transmission of the disease because of biological stress suffered by parasite and host. Under these conditions, it can result in the death of the parasite or a change in their ability to infect new host species of molluscs in new areas. Mantle pigmentation patterns in molluscs have not shown significant interference in the development of the parasite.

Resumo Flutuações na densidade populacional de planorbídeos hospedeiros do S. mansoni são influenciadas por fatores climáticos. O conhecimento sobre a interferência de alterações na temperatura da água nestas populações é um aspecto importante da epidemiologia da esquistossomose. Neste experimento avaliou-se a influência de diferentes temperaturas no desenvolvimento de Schistosoma mansoni em Biomphalaria glabrata variantes melânica e albina. Os resultados indicaram uma relação intrínseca entre temperatura e desenvolvimento do parasito na fase intramolusco, independente da pigmentação do manto dos moluscos. Quanto mais elevada a temperatura, menor o período necessário para desenvolvimento do parasito e maior mortalidade dos moluscos infectados. Conclui-se que, na presença de alterações climáticas, o aumento da temperatura em regiões frias e alagadas poderá favorecer o estabelecimento de novos focos de transmissão da esquistossomose alterando a extensão geográfica e ampliando o potencial epidemiológico da transmissão. Em regiões de clima quente, o aumento da temperatura, por sua vez, poderá comprometer a transmissão da doença em virtude do estresse biológico sofrido por parasito e hospedeiro. Nestas condições, poderá ocorrer a morte do parasito ou uma alteração na sua habilidade de infectar novas espécies de moluscos hospedeiros em novas áreas. Padrões de pigmentação do manto nos moluscos não demonstraram interferência significativa no desenvolvimento do parasita.

Assessment of the impact of changes in temperature in Biomphalaria glabrata (Say, 1818) melanic and albino variants infected with Schistosoma mansoni (Sambon, 1907) / Avaliação de impacto de alterações na temperatura em Biomphalaria glabrata variantes melânica e albina infectadas com Schistosoma mansoni

Abstract Fluctuations in population density of planorbid hosts of S. mansoni are influenced by climatic factors. The knowledge about interference from changes in water temperature in these populations is an important aspect of the epidemiology of schistosomiasis. In this experiment, it is explored the influence of different temperatures on the development of Schistosoma mansoni in Biomphalaria glabrata melanic and albino variants. The results indicated an intrinsic relationship between temperature and development of the parasite in the intramollusc phase, independent of the pigmentation of the mantle of the molluscs. The higher the temperature, the shorter the period necessary for the development of the parasite was while the higher the mortality of infected mollusks. It is concluded that, in the presence of climate change, the increasement of temperature in cold and flooded regions may encourage the establishment of new foci of transmission of schistosomiasis by changing the geographic extent and extending the epidemiological transmission potential. In warm climates, higher temperatures, however, could compromise the transmission of the disease because of biological stress suffered by parasite and host. Under these conditions, it can result in the death of the parasite or a change in their ability to infect new host species of molluscs in new areas. Mantle pigmentation patterns in molluscs have not shown significant interference in the development of the parasite.

Resumo Flutuações na densidade populacional de planorbídeos hospedeiros do S. mansoni são influenciadas por fatores climáticos. O conhecimento sobre a interferência de alterações na temperatura da água nestas populações é um aspecto importante da epidemiologia da esquistossomose. Neste experimento avaliou-se a influência de diferentes temperaturas no desenvolvimento de Schistosoma mansoni em Biomphalaria glabrata variantes melânica e albina. Os resultados indicaram uma relação intrínseca entre temperatura e desenvolvimento do parasito na fase intramolusco, independente da pigmentação do manto dos moluscos. Quanto mais elevada a temperatura, menor o período necessário para desenvolvimento do parasito e maior mortalidade dos moluscos infectados. Conclui-se que, na presença de alterações climáticas, o aumento da temperatura em regiões frias e alagadas poderá favorecer o estabelecimento de novos focos de transmissão da esquistossomose alterando a extensão geográfica e ampliando o potencial epidemiológico da transmissão. Em regiões de clima quente, o aumento da temperatura, por sua vez, poderá comprometer a transmissão da doença em virtude do estresse biológico sofrido por parasito e hospedeiro. Nestas condições, poderá ocorrer a morte do parasito ou uma alteração na sua habilidade de infectar novas espécies de moluscos hospedeiros em novas áreas. Padrões de pigmentação do manto nos moluscos não demonstraram interferência significativa no desenvolvimento do parasita.

Infecciones del tracto urinario bajo en adultos y embarazadas: consenso para el manejo empírico / Lower Urinary Tract Infections in Adults and Pregnant Women: A Consensus for Empirical Treatment

Introducción: La infección no complicada del tracto urinario bajo y la bacteriuria asintomática son causas frecuentes de consulta médica ambulatoria y en el servicio de urgencias en Colombia y el mundo. La falta de pautas y consenso para el manejo, así como la emergencia de resistencia a las múltiples opciones terapéuticas disponibles en los uropatógenos provenientes de la comunidad, hacen necesario elaborar unas recomendaciones que orienten al clínico sobre el abordaje óptimo de estas entidades. Objetivo: Definir un consenso sobre el manejo empírico de la bacteriuria asintomática y la infección del tracto urinario (ITU) bajo en adultos y mujeres embarazadas en Colombia. Metodología: Se lleva a cabo una metodología de consenso con expertos en urología, infectología, medicina interna, ginecología y microbiología basada en la revisión de las referencias bibliográficas disponibles en los términos de búsqueda relacionados, haciendo énfasis en estudios locales. Resultados: Se elaboró un algoritmo de manejo para el tratamiento empírico de la ITU baja no complicada en adultos con antisépticos urinarios como nitrofurantoína y fosfomicina trometamol como primera línea, con recomendaciones terapéuticas específicas para el tratamiento de la bacteriuria asintomática en mujeres embarazadas. Adicionalmente, se formuló un algoritmo de decisión para el procesamiento de cultivos de orina. La recurrencia o recaída frecuente justifica remisión a urología e infectología. Conclusiones: Se generan recomendaciones prácticas de fácil implementación en el diagnóstico y manejo de la ITU bajo en adultos y embarazadas, y de los casos donde es necesario tratar la bacteriuria asintomática, con opciones terapéuticas efectivas y de espectro reducido.

Background: Uncomplicated infection of the lower urinary tract and asymptomatic bacteriuria are frequent causes of visits to outpatient clinics and emergency departments in Colombia and worldwide. The lack of guidelines and a consensus for their management, and the emergence of resistance of community-based uropathogens to the available therapeutic options, make it necessary to develop recommendations to guide clinicians on the optimal approach to these entities. Objective: Define a consensus for the empiric management of asymptomatic bacteriuria and Urinary Tract Infection (UTI) in adults and pregnant women in Colombia. Methods: We carried out a consensus methodology with experts in urology, infectious diseases, internal medicine, gynecology and clinical microbiology; based on reviewing the available literature on the related terms, and emphasizing local studies. Results: We developed a management algorithm for the empirical treatment of uncomplicated lower UTI in adults with urinary antiseptics such as nitrofurantoin and fosfomycin trometamol as first line, with specific therapeutic recommendations for the treatment of asymptomatic bacteriuria in pregnant women. Additionally, we created a decision algorithm for processing urine cultures. Frequent recurrence or relapse justifies referral to urology and infectious disease professionals. Conclusions: We generated straightforward and easy-to-implement recommendations for the diagnosis and management of UTI in adults and pregnant women, and in cases where it is necessary to treat asymptomatic bacteriuria, with effective therapeutic and narrow spectrum options.

A system for aceessing a collection of histology images using content-based strategess / Sistema para acceder una colección de imágenes histológicas mediante estrategias basadas en el contenido

Histology images are an important resource for research, education and medical practice. The availability of image collections with reference purposes is limited to printed formats such as books and specialized journals. When histology image sets are published in digital formats, they are composed of some tens of images that do not represent the wide diversity of biological structures that can be found in fundamental tissues. Making a complete histology image collection available to the general public having a great impact on research and education in different areas such as medicine, biology and natural sciences. This work presents the acquisition process of a histology image collection with 20,000 samples in digital format, from tissue processing to digital image capturing. The main purpose of collecting these images is to make them available as reference material to the academic comunity. In addition, this paper presents the design and architecture of a system to query and explore the image collection, using content-based image retrieval tools and text-based search on the annotations provided by experts. The system also offers novel image visualization methods to allow easy identification of interesting images among hundreds of possible pictures. The system has been developed using a service-oriented architecture and allows web-based access in http://www.informed.unal.edu.co.

Las imágenes histológicas son un importante recurso para la investigación, la educación y la práctica médica. La disponibilidad de imágenes individuales o colecciones de imágenes de referencia está limitada a formatos impresos como libros y revistas científicas. En aquellos casos en donde se publican conjuntos de imágenes digitales, éstos están compuestos por algunas cuantas decenas de imágenes que no representan la gran diversidad de estructuras biológicas que pueden encontrarse en los tejidos fundamentales. Contar con una completa colección de imágenes histológicas es de gran apoyo para los procesos de investigación y educación en diferentes áreas de la medicina, biología y ciencias. En este trabajo se presenta el proceso de adquisición de una colección de 20.000 imágenes histológicas en formato digital, desde la preparación y fijación de los tejidos hasta su digitalización bajo el microscopio, con el propósito de publicarlas como material de referencia para la comunidad académica en general. Además, se presenta el diseño y la arquitectura de un sistema para consultar y explorar la colección de imágenes, utilizando herramientas de búsqueda basadas en el contenido de las imágenes y en las anotaciones provistas por los expertos. El sistema también ofrece novedosos mecanismos de visualización de las imágenes, para facilitar la tarea de identificar las imágenes interesantes entre otros cientos posibles en la colección. El sistema fue desarrollado usando una arquitectura orientada a servicios y ofrece acceso a través de la Web en http://www.informed.unal.edu.co.

Performance of IFAT, ELISA, direct parasitological examination and PCR on lymph node aspirates for canine visceral leishmaniasis diagnosis

Canine visceral leishmaniasis (CVL) is endemic in numerous Brazilian regions. The greatest difficulty in controlling the disease is the diagnostic limitation. In the present study, the most common tests employed for visceral leishmaniasis diagnosis were compared: immunofluorescence antibody test (IFAT), immunoenzymatic assay (ELISA), direct parasitological examination and polymerase chain reaction (PCR). Samples of lymph node aspirates and blood were collected from 100 dogs that lived in an endemic area (Bauru city, São Paulo state) and from 100 negative controls from a non-endemic area (Botucatu city, São Paulo state). Specificity of both IFAT and PCR was 100 percent whereas ELISA was 99 percent. Sensitivities were 97.77, 93.33 and 91.11 percent respectively for IFAT, ELISA and PCR.

Typing class I HLA-A gene using a nested PCR-RFLP procedure

In order to detect several new HLA-A class I alleles that have been described since 1998, the original PCR-RFLP method developed to identify the 78 alleles recognized at that time at high resolution level was adapted by us for low and medium resolution levels using a nested PCR-RFLP approach. The results obtained from blood samples of 23 subjects using both the PCR-RFLP method and a commercial kit (MicroSSP1A®, One Lambda Inc.) showed an agreement higher than 95 percent. The PCR-RFLP adapted method was effective in low and medium resolution histocompatibility evaluations.

The frontal sinus morphology in radiographs of Brazilian subjects: its forensic importance

The determination of gender of unknown persons is of vital importance in forensic investigations, such as anthropologic,medical and dental forensic studies, mainly in cases where only fragments of the skull remain and there is no possibility of identification based on the dental arch. The aim of the present study was to develop a mathematical method based on logistic regression analysis capable of determining the gender of individuals using measurements of the frontal sinus. The right and left areas and the maximum height and width of the frontal sinus were determined in 100 radiographs taken by the Caldwell technique of 50 women and 50 men between 20 and 30 years old, with the help of the prog ram SIARCS 3.0 (EMBRAPA). The mean values of the frontal sinus were greater in males and the left area was larger than the right area, based on Student’s t-test at the 5% level of significance. The mathematical model based on logistic regression analysis gave a concordanceindex for gender of 79.7% in the cases studied. The areas of the frontal sinus and the logistic regression technique proved to be useful in the determination of gender. (Logit = 1.6905 – 0.5383* left area).

Effects of crude extracts of Agaricus blazei on DNA damage and on rat liver carcinogenesis induced by diethylnitrosamine

The effects of crude extracts of the mushroom Agaricus blazei Murrill (Agaricaceae) on both DNA damage and placental form glutathione S-transferase (GST-P)-positive liver foci induced by diethylnitrosamine (DEN) were investigated. Six groups of adult male Wistar rats were used. For two weeks, animals of groups 3 to 6 were treated with three aqueous solutions of A. blazei (mean dry weight of solids being 1.2, 5.6, 11.5 and 11.5 mg/ml, respectively). After this period, groups 2 to 5 were given a single ip injection 200 mg/kg DEN and groups 1 and 6 were treated with 0.9 NaCl. All animals were subjected to 70 partial hepatectomy at week five and sacrificed 4, 24 and 48 h or 8 weeks after DEN or 0.9 NaCl treatments (10th week after the beginning of the experiment). The alkaline comet assay and GST-P-positive liver foci development were used to evaluate the influence of the mushroom extracts on liver cell DNA damage and on the initiation of liver carcinogenesis, respectively. Previous treatment with the highest concentration of A. blazei (11.5 mg/ml) significantly reduced DNA damage, indicating a protective effect against DEN-induced liver cytotoxicity/genotoxicity. However, the same dose of mushroom extract significantly increased the number of GST-P-positive liver foci

Aberrant crypt foci and colon cancer: comparison between a short- and medium-term bioassay for colon carcinogenesis using dimethylhydrazine in Wistar rats

Aberrant crypt foci (ACF) in the colon of carcinogen-treated rodents are considered to be the earliest hallmark of colon carcinogenesis. In the present study the relationship between a short-term (4 weeks) and medium-term (30 weeks) assay was assessed in a model of colon carcinogenesis induced by dimethylhydrazine (DMH) in the rat. Six-week-old male Wistar rats were given subcutaneous injections of DMH (40 mg/kg) twice a week for 2 weeks and killed at the end of the 4th or 30th week. ACF were scored for number, distribution pattern along the colon and crypt multiplicity in 0.1 percent methylene-blue whole-mount preparations. ACF were distinguished from normal crypts by their larger size and elliptical shape. The incidence, distribution and morphology of colon tumors were recorded. The majority of ACF were present in the middle and distal colon of DMH-treated rats and their number increased with time. By the 4th week, 91.5 percent ACF were composed of one or two crypts and 8.5 percent had three or more crypts, while by the 30th week 46.9 percent ACF had three or more crypts. Thus, a progression of ACF consisting of multiple crypts was observed from the 4th to the 30th week. Nine well-differentiated adenocarcinomas were found in 10 rats by the 30th week. Seven tumors were located in the distal colon and two in the middle colon. No tumor was found in the proximal colon. The present data indicate that induction of ACF by DMH in the short-term (4 weeks) assay was correlated with development of well-differentiated adenocarcinomas in the medium-term (30 weeks) assay

Fungal infection in single and bilateral lung transplantation: report of 17 cases in 42 consecutive recipients

We reviewed the frequency and type of fungal infections in patients undergoing lung transplantation at Pavilhäo Pereira Filho Hospital between may 1989 and january 1995. Among the 42 lung transplant recipients studies, 17 ( 40 por cento ) had histologic diagnosis of fungal infection: aspergillosis 8 casos, candidosis 6 cases, and aspergillosis combined with candidosis 3 cases. Among all fungal infections, 47 por cento ( 8 of 17 cases ) occurred in the first month after transplantation, and 82 por cento occurred within the first six months after the transplant. The diagnosis was done during life in candidosis in 77 por cento of patients by transbronchial biopsy. However, aspergillosis was revealed in autopsy material in 82 por cento of cases. Most of the patients with candidosis had a local infection in the transplanted lung. On the contrary, in aspergillosis patients 88 por cento had the mycosis in the native lung

Experiencia de la prostatectomia radical en pacientes con cancer localizado de prostata en el Hospital de San Jose de Bogotá / Experience in radical prostatectomy with cancer of prostate patients in San Jose Hospital, Bogotá

Objetivos: Presentar los resultados de la prostatectomía radical como tratamiento del cáncer localizado de próstata en la serie estudiada. Compararlos con las series publicadas. Determinar los valores predictivos del PSA y Gleason preoperatorios relacionados con la patología definitiva. Establecer complicaciones perioperatorias, morbi-mortalidad, recidiva tumoral, incontinencia e impotencia asociados a la cirugía. Diseño: Estudio descriptivo de casos con información de historias clínicas, seguimiento y entrevistas con pacientes. Población y lugar: 88 pacientes con diagnóstico de cáncer de próstata localizado, intervenidos entre septiembre/1992 y abril/1997. Intervención: prostatectomía radical con técnica modificada de Waish, previa linfadenectomía ilio-obturadora bilateral examinada por congelación. Medición y resultados: Se utilizaron medidas de tendencia central y de dispersión, mediante EpiInfo 6.04b. La patología definitiva fue organoconfinado 58,8 por ciento, extracapsular 13,8 por ciento, márgenes positivas 15 por ciento y otros 12,5 por ciento. Grado de diferenciación: bien 20.5 por ciento, moderado 39,7 por ciento y mal 39,77o. Tiempo quirúrgico promedio: 3,7 horas, complicaciones perioperatorias: 5,8 por ciento, sin mortalidad. La continencia: 95 por ciento, potencia: 23,4 por ciento POP. El 34,5 por ciento de los pacientes requirieron dilataciones uretrales, con promedio de 2,5/paciente. Recurrencia serológica: 31,87o, recidiva local comprobada: 4,17o y 2 pacientes tienen gamagrafías óseas positivas. Promedio de seguimiento: 17,3 meses. Conclusiones: Se observó subestadificación del 357o. Es una cirugía segura, con baja morbilidad, sin mortalidad perioperatoria. Los índices de continencia y potencia son similares a los reportados en la literatura. No hay un parámetro objetivo que permita predecir la recurrencia real

Estudio comparativo entre anestesia general vs. anestesia peridural en cesáreas electivas / Comparative estudy among general anesthesia vs. periddural anesthesia en elective cesarean

Existe una creciente tendencia hacia el uso de anestesia regional en cesáreas electivas. Dicho tipo de anestesia, permite que la madre esté despierta, disminuye el riesgo de aspiración materna, y evita la depresión neonatal por las drogas anestésicas. Por otro lado, se ha registrado un índice mayor de acidemia neonatal en los niños nacidos po4 cesárea con anestesia regional

Manejo de lesiones del ureter no iatrogenicas / Management of non iatrogenic ureter lesions

Durante 4 años consecutivos 12 pacientes con heridas iatrogénicas de Uréter fueron atendidos en los hospitales San José y Kennedy. El 66 por ciento eran hombres y el 33 por ciento mujeres con una edad media de 32.6 años. Solo un (1) paciente falleció En el 75 por ciento de los pacientes el origen del trauma fue heridas por arma de fuego. A todos los pacientes se les practicó urografía Excretora y a cuatro (4) pacientes se les manejó su lesión en forma conservadora pero ocho (8) requirieron tratamiento quirúrgico en forma inicial. Nuestra técnica quirúrgica incluye una adecuada movilización, desbridamiento y espatulación para lograr una Anastomosis libre de tensión y hermética. Se exponen los resultados de la experiencia en el manejo deI trauma del Uréter de etiología no iatrogénica

Acute effect of the somatostatin analogue sms-201995 on plasma glucose and triglycerides in insulin-dependent diabetic patients

The effect of the long-acting somatostatin analogue SMS-201995 on diabetes control was assessed in 6 insulin-dependent diabetic patients (3 men and 3 women agged 19-38 years). Plasma glucose and triglyceride profiles were obtained ion 4 consecutive days, from 8:00 a.m. to 2:00 p. m. On the first 2 days the patients received their usual dose of insulin and ate at 8:00 a. m. and noon. On the third and fourth days they received 1/3 of their usual insulin dose together with 100 ug SMS-201995 injected subcutaneously. Postprandial glucose and triglyceride increases were blunted during the 360 min of observation on both day after SMS-201995 administration. The areas under the glucose-time plots fell from 23.72 ñ 12.29 (mean ñ SD) to 7.98 ñ 14.26 (P<0.05) and the areas under the triglyceride-time plots from 10.51 ñ 9.01 to -3.15 ñ 4.30 g. min.dl-1 (P<0.01). No adverse rfeactions were observed after SMS-201995 administration for 2 days. We conclude that administration of the somatostatin analogue SMS-201995 may be beneficial for insulin-dependent diabetic patients

Medium-term protocols for in vivo evaluation of chemical modifiers of carcinogenesis

Cancer development is a long-term multistep process which allows interventional measure before the clincial disease emerges. the detection of natural substances which can block the process of carcinogenesis is a important as the identification of anti-tumoral drugs since they might be used in chemoprevention of cancer in high-risk groups. In vivo rodent models of chemical caecinogenesis have been used to study plant-derived inhibitors of carcinofenesis such as indols, coumarins, isothiocyanates, flavones, phenols and allyl-sulfides. Since the standard in vivo rodent bioassay is prolonged and expensive, shorter reliable protocols are needed. Two in vivo medium-term protocols for evaluation of modifiers of carcinogenesis are presented, one related to liver and the other to bladder cancer. Both protocols use rats, last 8 and 36 weeks and are based on the two-step concept of carcinogenesis: initiation and promotion. The protocols use respectively the development of altered foci of hepatocytes expressing immunochistochemically the placental form of gluthation S-transferase and the appearence of pre-neoplastic urothelium and papillomas as the "end-points". the use of these protocols for detection of plantpderived inhibitors of carcinogenesis appear warranted.

Lesöes histológicas da mucosa vesical em 91 autópsias / Histological lesions of the vesical mucosa in 91 autopsies

As bexigas de 91 autópsias foram estudadas histologicamente para se avaliar a freqüência e a distribuiçäo anatômica de alteraçöes uroteliais proliferativas. Sessenta e sete (74%) dos casos apresentaram pelo menos uma das lesöes estudadas, sendo os ninhos de Brünn a lesäo mais freqüente (60%), seguida de "cistite" glandular (45%) e metaplasia escamosa (24%). Todas as lesöes foram mais freqüentes no trígono vesical. Ninhos de Brünn e "cistite" glandular ocorreram em todas as faixas etárias e indiferentemente nos dois sexos, sendo mais freqüentes acima dos 15 anos de idade, quando ocorreram no sexo masculino. A metaplasia escamosa foi alteraçäo observada só acima dos 15 anos de idade, em 70 a 100% das mulheres e somente em 3 a 12% dos homens. frente à baixa freqüência do carcinoma de bexiga em nosso meio, näo há razäo para considerar estas alteraçöes epiteliais täo ubíquas como lesöes pré-neoplásicas

Acute pulmonary histoplasmosis and first isolation of histoplasma capsulatum from soil of Rio Grande do Sul, Brazil

Apresenta-se um caso de histoplasmose pulmonar aguda, onde a história clínica orientada levou à identificaçäo da fonte natural do Histoplasma capsulatum. O fungo foi obtido em cultivo a partir de fragmentos de baço e fígado de ratos inoculados intraperitonealmente com solo da zona rural de General Câmara, pela primeria vez no Rio Grande do Sul