Acute hepatitis due to dengue virus in a chronic hepatitis patient

We present a case of acute hepatitis caused by dengue virus, with a significant increase in aspartate transferase and alanine transferase levels in a chronic hepatitis patient attended at the Cane Sugar Planters Hospital of Campos dos Goytacazes, RJ.

Apolipoprotein CIII polymorphism and triglyceride levels of a Japanese population living in Southern Brazil

Apolipoprotein CIII (apo-CIII) participates in the regulation of triglyceride-rich lipoprotein metabolism. Several polymorphic sites have been detected within and around the apo-CIII gene. Here, we examined the relationship between apo-CIII SstI polymorphism (CC, CG, GG genotypes) and plasma triglyceride (TG) levels in a group of 159 Japanese individuals living in Southern Brazil. The sample was divided into a group of Japanese descendants (N = 51) with high TG (HTG; >200 mg/dL) and a group of Japanese descendants (N = 108) with normal TG (NTG; <200 mg/dL). TG and total cholesterol levels were analyzed by an enzymatic method using the Labtest-Diagnostic kit and high- and low-density lipoproteins by a direct method using the Labtest-Diagnostic kit and DiaSys Diagnostic System International kit, respectively. A 428-bp sequence of apo-CIII gene was amplified using oligonucleotide primers 5' GGT GAC CGA TGG CTT CAG TTC CCT GA 3' and 5' CAG AAG GTG GAT AGA GCG CTG GCC T 3'. The PCR products were digested with a restriction endonuclease SstI. Rare G allele was highly prevalent in our study population (0.416) compared to Caucasians (0.00-0.11). G allele was almost two times more prevalent in the HTG group compared to the NTG group (P < 0.001). The genotype distribution was consistent with the Hardy-Weinberg equilibrium. There was a significant association between rare G allele and HTG in Japanese individuals living in Southern Brazil as indicated by one-way ANOVA, P < 0.05.

Transient high-level expression of ß-galactosidase after transfection of fibroblasts from GM1 gangliosidosis patients with plasmid DNA

GM1 gangliosidosis is an autosomal recessive disorder caused by the deficiency of lysosomal acid hydrolase ß-galactosidase (ß-Gal). It is one of the most frequent lysosomal storage disorders in Brazil, with an estimated frequency of 1:17,000. The enzyme is secreted and can be captured by deficient cells and targeted to the lysosomes. There is no effective treatment for GM1 gangliosidosis. To determine the efficiency of an expression vector for correcting the genetic defect of GM1 gangliosidosis, we tested transfer of the ß-Gal gene (Glb1) to fibroblasts in culture using liposomes. ß-Gal cDNA was cloned into the expression vectors pSCTOP and pREP9. Transfection was performed using 4 µL lipofectamine 2000 and 1.5-2.0 µg DNA. Cells (2 x 10(5)/well) were harvested 24 h, 48 h, and 7 days after transfection. Enzyme specific activity was measured in cell lysate and supernatant by fluorometric assay. Twenty-four hours after transfection, treated cells showed a higher enzyme specific activity (pREP9-ß-Gal: 621.5 ± 323.0, pSCTOP-ß-Gal: 714.5 ± 349.5, pREP9-ß-Gal + pSCTOP-ß-Gal: 1859.0 ± 182.4, and pREP9-ß-Gal + pTRACER: 979.5 ± 254.9 nmol·h-1·mg-1 protein) compared to untreated cells (18.0 ± 3.1 for cell and 32.2 ± 22.2 nmol·h-1·mg-1 protein for supernatant). However, cells maintained in culture for 7 days showed values similar to those of untreated patients. In the present study, we were able to transfect primary patients' skin fibroblasts in culture using a non-viral vector which overexpresses the ß-Gal gene for 24 h. This is the first attempt to correct fibroblasts from patients with GM1 gangliosidosis by gene therapy using a non-viral vector.

Aminas bioativas e características físico-químicas de salames tipo italiano / Bioactive amines and physico-chemical characteristics of Italian sausages

Amostras de seis lotes de sete marcas de salames tipo italiano foram analisadas quanto a aminas bioativas e características físico-químicas de qualidade. Oito das 10 aminas pesquisadas foram detectadas em todas as amostras com teores totais de 28,33 a 53,27mg/100g. A tiramina foi a amina predominante seguida da putrescina e da cadaverina. Todas as marcas apresentaram teores de tiramina capazes de causar efeito tóxico em indivíduos sensíveis dependendo da quantidade ingerida. Duas marcas apresentaram também teores potencialmente tóxicos de histamina e de feniletilamina. Nenhuma das marcas atendeu à legislação em pelo menos um parâmetro físico-químico. Os teores de umidade e de açucares totais foram as características com maior percentual de não-atendimento. Os teores de cinzas variaram de 5,54 a 7,12g/100g, sendo os cloretos 66 a 79 por cento desses teores. As amostras apresentaram valores de pH de 4,86 a 5,78, acidez de 16,61 a 55,03ml NaOH N/100g e índice de peróxidos de não detectado a 334,82mEq/kg.

Six batches of seven brands of Italian sausages purchased in Belo Horizonte, MG were analyzed for bioactive amines and physico-chemical characteristics. Eight out of 10 amines investigated were detected in every sample with total levels varying from 28.33 to 53.27mg/100g. Tyramine was the predominant amine followed by putrescine and cadaverine. Every brand contained toxic tyramine levels for sensitive individuals depending on the amount of sausage consumption. Two brands also contained toxic levels of histamine and phenylethylamine. No brand was in conformity to legislation levels for at least one physico-chemical parameter. The highest discrepancies to legislation levels were observed for moisture and total sugar contents. The levels of ash varied from 5.54 to 7.12g/100g, with chlorides representing 66 to 79 percent of the levels.The pH varied from 4.86 to 5.78, acidity from 16.61 to 55.03ml NaOH N/100g and peroxide values from 0.0 (no detected) to 334.82mEq/kg.

Ser do tempo em Bergson / Being and time in Bergson

O artigo apresenta a concepção bergsoniana de duração. Pretende-se mostrar que, segundo Bergson, o tempo dos filósofos e cientistas é um tempo fictício, um esquema espacial que oculta a natureza do tempo real, o qual não pode ser separado dos acontecimentos físicos e psicológicos. Para Bergson, o tempo real é sucessão, continuidade, mudança, memória e criação.

Aumento do torque muscular apos tratamento em esteira com suporte parcial de peso em pacientes com hemiparesia cronica / Muscular torque increase after treadmill training with body weigth support in chronic hemiparesis

A melhora da marcha e a meta mais comum apos um Acidente Vascular Cerebral(AVC), sendo assim, o objetivo deste estudo foi compara o trino da marcha sobre esteira eletrica com suporte parcial de peso corporal por meio da tecnica Kabatm em pacientrs com hemiparesia cronica. Essa comparacao foi feita pela analise das bvariaveis espaco-temporais e do toque muscular em maxima contracao isometrica dos flexores plantares. Doze pacientes com hemiparesia cronica causada por um AVC na regiao da arteria cerebral media completaram o estudo. O sistema A-B-A de analise comparou o trinamento em esteira com suporte parcial de peso corporal (A) a fisioterapia com base no metod Kabat(B), cada fase durando tres semanas. O intervalo minimo apos o AVC foi de seis meses. Observamos que o treinamento em esteira foi mais efetivo no aumento em ciclo (p<0,01), a velocidade da marcha (p<0,01) e torque muscular quando comparado ao metodo Kabat em sujeitos com hemiparesia cronica

Germinoma de haste hipofisária: relato de caso e revisão de literatura / Pituitary stalk germinoma: case report and literature review

Os germinomas intracranianos são histologicamente indistinguíveis do neurinoma testicular e disgerminoma ovariano; eles ocorrem mais frequentemente na região pineal, supra-selar e gânglios da base. O envolvimento primário do germinoma na haste hipofisária é raro. Neste artigo, relatamos um germinoma da haste hipofisária e revisamos a literatura sobre o assunto.

Bacterial phagocytosis by macrophage of autogenous splenic implant

Autogenous splenic implant seems to be the only alternative for preservation of splenic tissue after total splenectomy. This work was carried out to analyze the morphologic regeneration of autotransplanted splenic tissue in Wistar rats and to determine the bacterial phagocytic function of their macrophages. We utilized an experimental model with thirty-two rats, of both sexes, submitted to total splenectomy combined with autotransplantation in greater omentum of slices of the whole spleen mass. The animals were divided into two groups: I - young rats weighing 100 to 150 g; and II - adult rats weighing 250 to 300 g. Sixteen weeks later animals were intravenously inoculated with a suspension of Escherichia coli AB1157. Twenty minutes after inoculation, the animals were sacrificed and the splenic autotransplants were removed for morphological study. There was regeneration of autotransplanted splenic tissue in all animals. A similar morphological aspect among all animals was observed, with splenic tissue showing red and white pulps, lymphoid follicles, and marginal zone, with a moderate architectural disarrangement. Macrophages containing gram-negative bacterial aggregates as well as macrophages with hemosiderin pigments within the cytoplasm were observed. Blood vessels showed preserved walls, with no signs of vasculitis or thrombosis. The present results suggest that autogenous splenic implants in the greater omentum of the rat acquire the macro- and microscopic architecture of a normal spleen, with reduced dimensions, and preserve bacterial phagocyte function.

Dengue virus infection of the central nervous system (CNS): a case report from Brazil.

Dengue infection that is accompanied by unusual complications has been described in Brazil. We report on the presence of dengue virus in the central nervous system (CNS) of a patient who died in 1998 in Rio Grande do Norte, northeast Brazil. DEN-2 viruses were isolated from the brain liver, and lymphnode tissue of a 67-year-old man whose signs and symptoms were those of dengue infection and a secondary immune response. A postmortem revealed nose bleeds a liver that was brownish with yellow areas, and pulmonary and cerebrae congestion. Immunoperoxidase staining showed a dengue antigen-specific positive reaction in the gray matter cells of the cerebrall cortex; a granular citoplasmatic reaction was seen in the neurons. Dengue infection should always be considered as a cause encephalitis in tropical countries, especially in those where the disease is endemic.

Effect of dimethylsulfoxide on sphingomyelinase activity and cholesterol metabolism in Niemann-Pick type C fibroblasts

Niemann-Pick type C (NPC) fibroblasts present a large concentration of cholesterol in their cytoplasm due to a still unidentified deficiency in cholesterol metabolism. The influence of dimethylsulfoxide (DMSO) on the amount of intracellular cholesterol was measured in 8 cultures of normal fibroblasts and in 7 fibroblast cultures from NPC patients. DMSO was added to the fibroblast cultures at three different concentrations (1, 2 and 4 percent, v/v) and the cultures were incubated for 24 h. Sphingomyelinase activity was significantly increased in both groups of cells only when incubated with 2 percent DMSO (59.4 9.1 and 77.0 9.1 nmol h-1 mg protein-1, controls without and with 2 percent DMSO, respectively; 47.7 5.2 and 55.8 4.1 nmol h-1 mg protein-1, NPC without and with 2 percent DMSO, respectively). However, none of the DMSO concentrations used altered the amount of cholesterol in the cytoplasm of NPC cells (0.704 0.049, 0.659 0.041, 0.688 0.063 and 0.733 0.088 mg/mg protein, without DMSO, 1 percent DMSO, 2 percent DMSO and 4 percent DMSO, respectively). This finding suggests that sphingomyelinase deficiency is a secondary defect in NPC and shows that DMSO failed to remove the stored cholesterol. These data do not support the use of DMSO in the treatment of NPC patients

Custo do transplante hepático no Hospital de Clínicas da Universidade Federal do Paraná / Cost of liver transplantation at the Clinical Hospital of Parana, Brazil

Objetivo. Determinar o custo do transplante hepático no Hospital de Clínicas da Universidade Federal do Paraná. Método. Os dados do prontuário de 24 pacientes submetidos a 25 transplantes hepáticos foram avaliados do dia da internaçao para o transplante hepático até a data da alta hospitalar ou óbito para determinar o número de dias de internaçao, o local de internaçao, a quantidade de material e medicamentos usados, os exames complementares e procedimentos realizados. Honorários médicos nao foram incluídos no estudo. Resultados. A idade dos pacientes variou de 6 a 56 anos, tendo seis deles menos que 14 anos de idade. Cinco pacientes foram a óbito durante a internaçao hospitalar. Retransplante foi realizado em somente um paciente. O custo médio da retirada do fígado do doador foi de US$ 2,783.19. O custo total do transplante hepático variou amplamente entre os pacientes, na dependência de ocorrência de complicaçoes pós-operatórias, do número de dias de internaçao hospitalar e da quantidade de transfusao de hemoderivados. O custo total variou de US$ 6,359.84 a US$ 75,434.18, com média de US$ 21,505.53. O item mais caro do transplante hepático foi o custo com a hemoterapia, seguido do custo com medicamentos e diária hospitalar. Conclusao. O custo do transplante hepático varia muito entre os pacientes e pode ser realizado no Brasil a um custo inferior ao relatado nos Estados Unidos e na Europa.

Reinforcing properties of the substance P C-fragment analog DiMe-C7 in Carassius auratus

The aim of the present study was to investigate whether two substance P (SP) fragments have reinforcing effects in Carassius auratus when the fish were tested in a place-preference experimental model. Fish were placed in a 3-compartment box in which one compartment gives access to two others that are not connected. The time spent in each compartment was recorded for 10 min in order to determine which one was preferred. Twenty-four hours later the fish were given one of the following ip treatments: 1) group VEH (N = 12), injected with teleost saline, 2) group DiMe-C7 (N = 12), injected with 33 mug/kg DiMe-C7, and 3) group SP1-7 (N = 12), injected with 167 mug/kg SP1-7. Immediately after treatment the fish were kept for 30 min in the compartment that was the least preferred on the day before and this procedure was repeated for 3 days. On the fifth day the fish were retested for 10 min to determine the time spent in each compartment. Two-way analysis of variance with treatments and testing as factors indicated a main effect (P<0.0025) as well as a testing effect (P<0.009). The post-hoc Scheffé multiple comparison test indicated that only the DiMe-C7 group presented an increase in the time spent in the paired compartment after treatment. We suggest that the C-tenninal fragment of SP has reinforcing effects in Carassius auratus.

Intragastric infection induced in marmosets (Callithrix jacchus) by a Brazilian hepatitis A virus (HAF-203)

Several specied of non-human primates have been used in studies on experimental infection with hepatitis A virus (HAV). Attempts to infect a South-American marmoset (Callithrix jacchus) with a Brazilian HAV isolate (HAF-203) are described here. Four seronegative animals were inoculated intragastrically and one was sacrificed on day 11,20,47 and 62 after infection. One uninfected animal was included as control. Liver, small intestine, lymph node, spleen and kidney samples were collected for histological diagnosis and immunocytochemistry studies. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) serum enzymes and anti-HAV antibodies were monitored by a colorimetric procedure (Abbott) and an enzyme immunoassay (ELISA), respectively. Feces were collected daily for HAV antigen (HAVAg) detection by ELISA. Increased levels of HAVAg were detected in hepatocytes 11 days after infection, with a gradual decrease during the course of infection. Shedding of HAVAg in feces was observed from the late incubation to the early acute phase (20th day to 47th day after infection). The end of the incubation period was indicated by the initial increases in serum ALT and AST. Severe hepatic lesions such as piecemeal necrosis and bridging necrosis were detected during the acute phase, coinciding with the maximum transaminase levels and the appearance of anti-HAV antibodies. On the 62nd day (convalescent phase), the hepatic tissue showed evidence of regeneration and the transaminase values had returned to baselines. The serological, biochemical, antigenic and histological evidence of hepatitis A was similar to that observed in several primate models inoculated with other HAV isolates. The data suggest that C. jacchus can be a valuable model for the study of hepatitis A and for the evaluation of HAV vaccines

Doaçäo de órgäos: opiniäo e conhecimento de médicos intensivistas da cidade de Curitiba / Organ donation: opinion and knowledge of intensive care unit physicians in the city of Curitiba

Com o objetivo de avaliar as opiniöes e conhecimentos de médicos intensivistas sobre doaçäo de órgäos, todos os intensivistas dos 13 hospitais de Curitiba com unidade de terapia intensiva de adulto participaram do estudo. De 81 intensivistas entrevistados, 75 (92,6 por cento) responderam o questionário. Todos responderam que säo favoráveis à doaçäo de órgäos, 74 (98,7 por cento) doariam seus próprios órgäos e 72 (96 por cento) autorizariam a doaçäo de órgäos de um membro da sua família. Sessenta e três (84 por cento) intensivistas näo conheciam ou näo souberam explicar a legislaçäo atual sobre doaçäo de órgäos. Quarenta e um (54,7 por cento) responderam errado ou näo sabiam os critérios médicos e legais para doaçäo de órgäos. Cinco (6,7 por cento) desconheciam a necessidade do doador ter morte encefálica, três (4 por cento) acreditavam que o doador deveria ter morte cardíaca para ser doador e 44 (58,7 por cento) näo souberam explicar o que é morte encefálica. A maioria desconhecia a sobrevida atual dos pacientes submetidos a transplante dos vários órgäos. Conclui-se deste estudo que quase todos os médicos intensivistas de Curitiba säo favoráveis a doaçäo de órgäos e estäo dispostos a participar ativamente na obtençäo de consentimento de familiares para doaçäo. O conhecimento básico sobre a legislaçäo brasileira e os vários aspectos médicos do transplante de órgäos é insatisfatório.

Electromyography of the small bowel following inversion of a jejunal segment in dogs

A atividade mioeletrica do intestino delgado foi estudada apos a inversao de um segmento jejunal em sete caes. Sete pares de eletrodos bipolares foram implantados na camada seromuscular do intestino delgado em diferentes locais, incluindo a alca jejunal invertida. Os registros eletromiograficos foram obtidos no 7§ e 10§ dias pos-operatorios, durante os periodos de jejum e alimentar. O complexo mioeletrico migratorio (CMM) estava presente em todos os locais registrados, inclusive na alca jejunal invertida. A duracao do CMM duodenal foi 70,3ñ14,8 minutos...

Intragastric microflora study in patients with gastroduodenal disease

O conteudo normal de bacterias no estomago e menor que 10ü/ml de suco gastrico. A ausencia de bacterias na cavidade gastrica, muito frequente, e principalmente devida a secrecao acida e a motilidade do orgao. Varias situacoes podem comprometer esses mecanismos de defesa e levar a colonizacao bacteriana, com alta incidencia de complicacoes infecciosas pos-operatorias. Para avaliar a alteracao da microflora gastrica, estudaram-se 25 pacientes, 19 com doenca gastroduodenal e seis controles, divididos em quatro grupos distintos, de acordo com a afeccao de base. Dos portadores de doenca gastroduodenal, 18 (94,73 por cento) apresentaram cultura positiva para aerobios e seis (3,57 por cento), para anaerobios. Cinco pacientes (26,31 por cento) tiveram cultura positiva para Candida sp e cinco outros para S. fecalis. A principal contagem bacteriologica foi de 1,2x10 elevado a seis CFU/ml de suco gastrico, e de 1,4x10 elevado a um CFU/ml de suco gastrico, para anaerobios. As bacterias mais comumente isoladas foram E. coli, Enterobacter sp e Staphylococcus epidermidis.

Apresentacao incomum do carcinoma indiferenciado da glandula tiroide. / An unusual presentation of unspecified carcinoma of the thyroid gland

O carcinoma indiferenciado da tiroide e raro e geralmente ocorre em pacientes na 7a. e 8a. decada da vida. Ha uma discreta predilecao pelo sexo feminino. O sintoma clinico mais frequente e um aumento de volume da glandula tiroide. Manifestacoes clinicas relacionadas com a invasao dos tecidos adjacentes e metastases a distancia sao frequentes. Foi relatado um caso de uma paciente de 39 anos de idade que apresentou um quadro clinico de aumento doloroso de lobo direito da tiroide e presenca de calor e rubor da regiao cervical anterior. Febre e leucocitose importante com neutrofilia e desvio nuclear a esquerda acompanhavam o quadro clinico. A puncao da tiroide revelou a presenca de um abscesso asseptico. Com a recidiva dos sintomas no pos-operatorio imediato, realizou-se uma exploracao da tiroide e constatou-se a presenca de um carcinoma indiferenciado da tiroide com invasao dos tecidos subjacentes