Artrogripose Múltipla Congênita: Relato de dois casos / Arthrogryposis Multiplex Congenita: Report of two cases

RESUMO: A Artrogripose Múltipla Congênita (AMC) é uma síndrome rara, que representa um grupo de condições congênitas caracterizado por contraturas articulares em duas ou mais articulações, não progressivas, geralmente simétricas, de etiologia desconhecida e que pode estar associada a outras malformações, como viscerais e neurológicas. Apresenta-mos dois casos isolados com achados característicos de AMC, atendidos em ambulatório de pediatria de alto risco de uma cidade do Oeste do Paraná. Caso 1: lactente, sexo feminino, 14 dias de vida, com redução dos movimentos fetais referidos pela mãe, apresentando malformações envolvendo somente os membros, visualizadas logo após o nasci-mento. Caso 2: lactente, sexo masculino, quatro meses de vida, com diagnóstico de hipocinesia fetal ao ultrassom obstétrico de 23 semanas, ao nascimento apresenta contraturas dos membros e disfunção do sistema nervoso cen-tral. O diagnóstico da artrogripose é complexo e essencialmente clínico, sendo necessária uma anamnese meticulosa, contemplando uma avaliação da gestação, via de parto, história familiar e um exame físico minucioso, classificando quais os tipos de contraturas, membros envolvidos, presença de musculatura alterada e de alterações neurológicas, a fim de diferenciar a AMC das outras síndromes que também cursam com contraturas articulares. O seguimento e tratamento dos lactentes com artrogripose devem ocorrer em acompanhamento multidisciplinar devido às variadas manifestações que a doença pode apresentar e à característica de recidiva ao longo dos anos. (AU)

ABSTRACTArthrogryposis Multiple Congenita (AMC) is a rare syndrome that represents a group of congenital conditions character-ized by joint contractures in two or more joints, non-progressive, usually symmetrical, of unknown etiology and which may be associated with other malformations, such as visceral and neurological. We present two isolated cases with characteristic features of AMC, seen in a high-risk pediatrics outpatient clinic in a city in western Paraná. Case 1: infant, female, 14 days old, with reduced fetal movements reported by the mother, presenting malformations involving only the limbs, seen immediately after birth. Case 2: infant, male, four months old, diagnosed with fetal hypokinesia on 23-week obstetric ultrasound, at birth, presents limb contractures and central nervous system dysfunction. The diagnosis of ar-throgryposis is complex and essentially clinical, requiring a meticulous anamnesis, including an assessment of pregnan-cy, delivery, family history and a thorough physical examination, classifying what types of contractures, involved limbs, presence of altered musculature and neurological changes to differentiate AMC from other syndromes that also have joint contractures. The aftercare and treatment of infants with arthrogryposis must occur in multidisciplinary follow-up due to the varied manifestations that the disease may present and the characteristic of recurrence over the years. (AU)

Sepsis: evolving concepts and challenges

Sepsis remains a major cause of morbidity and mortality worldwide, with increased burden in low- and middle-resource settings. The role of the inflammatory response in the pathogenesis of the syndrome has supported the modern concept of sepsis. Nevertheless, a definition of sepsis and the criteria for its recognition is a continuous process, which reflects the growing knowledge of its mechanisms and the success and failure of diagnostic and therapeutic interventions. Here we review the evolving concepts of sepsis, from the "systemic inflammatory response syndrome triggered by infection" (Sepsis-1) to "a severe, potentially fatal, organic dysfunction caused by an inadequate or dysregulated host response to infection" (Sepsis-3). We focused in the pathophysiology behind the concept and the criteria for recognition and diagnosis of sepsis. A major challenge in evaluating the host response in sepsis is to characterize what is protective and what is harmful, and we discuss that, at least in part, the apparent dysregulated host response may be an effort to adapt to a hostile environment. The new criteria for recognition and diagnosis of sepsis were derived from robust databases, restricted, however, to developed countries. Since then, the criteria have been supported in different clinical settings and in different economic and epidemiological contexts, but still raise discussion regarding their use for the identification versus the prognostication of the septic patient. Clinicians should not be restricted to definition criteria when evaluating patients with infection and should wisely use the broad array of information obtained by rigorous clinical observation.

Endosonografía con biopsia por aspiración con aguja fina de glándula suprarrenal izquierda para el diagnóstico de paracoccidioidomicosis: aporte de un nuevo caso a la literatura / Endosonography with Fine Needle Aspiration Biopsy of the Left Adrenal Gland for Diagnosis of Paracoccidioidomycosis: Contribution of a New Case to the Literature

Resumen La endosonografía nació hace más de 30 años como parte de las modalidades diagnósticas de patologías benignas y malignas del tracto gastrointestinal. En los últimos años se ha demostrado la eficacia y seguridad superior de la biopsia con aguja fina de las glándulas suprarrenales por vía transgástrica (izquierda) o tranduodenal (derecha) guiadas por endosonografía, en comparación con los abordajes percutáneos guiados por tomografía axial computarizada (TAC) o ecografía. Uno de los diagnósticos diferenciales de insuficiencia suprarrenal con evidencia de masas en glándulas suprarrenales es la paracoccidioidomicosis, a pesar de ser una entidad de presentación exclusiva de las áreas geográficas de Latinoamérica, donde se encuentra su agente etiológico. Se presenta un caso de paciente con paracoccidioidomicosis con insuficiencia suprarrenal y engrosamiento adrenal bilateral, cuyo diagnóstico se logró mediante biopsia transgástrica de glándula suprarrenal izquierda guiada por endosonografía.

Abstract Endosonography, born more than 30 years ago, is one diagnostic modality for benign and malignant pathologies of the gastrointestinal tract. In recent years, transgastric (left) or transduodenal (right) fine needle biopsies of the adrenal glands guided by endosonography has been demonstrated to be safer and more efficacious than percutaneous approaches guided by CT or ultrasound. Differential diagnoses of adrenal insufficiency with evidence of masses in adrenal glands must consider paracoccidioidomycosis despite the fact that it is exclusively present in Latin America where its etiological agent is found. We present a case of paracoccidioidomycosis with adrenal insufficiency and bilateral adrenal thickening whose diagnosis was achieved by transgastric biopsy of the left adrenal gland guided by endosonography.

Relação zinco cobre em dietas de codornas japonesas em postura / Zinc copper ratio of Japanese quails diets posture

Objetivou-se verificar o efeito da suplementação de diferentes relações de zinco orgânico e de cobre inorgânico, bem como comparar os resultados com a dieta controle de codornas japonesas, sobre o desempenho produtivo e a qualidade dos ovos. Foram realizados dois experimentos na área experimental da Universidade Federal do Espírito Santo: variando os níveis de zinco orgânico e mantendo os de cobre recomendados e outro variando os níveis de cobre inorgânico. O período experimental foi de 84 dias, divididos em períodos de 21 dias. Foram usadas cinco pré-misturas minerais. Foram analisadas variáveis de desempenho e qualidade dos ovos. Foi observado primeiramente que as variáveis avaliadas não foram afetadas de forma significativa pelas diferentes relações dos minerais, exceto para pesos relativo e absoluto da casca. No segundo ensaio, não houve interação entre os níveis de zinco e de cobre nem entre estes e a dieta controle, para nenhuma das variáveis observadas; quando analisadas as médias individuais, foi observada diferença significativa para taxa de postura, relação ovos comerciais e totais, consumo de ração e na unidade Haugh. Pode-se concluir que a relação de 35mg/kg de zinco orgânico e a de 3,5mg/kg de cobre inorgânico atenderam as necessidades nutricionais dos animais para desempenho e qualidade de ovos.(AU)

The objective of this study was to verify the effect of the supplementation of different organic zinc and inorganic copper ratios and to compare the results with the Japanese quail control diet on the productive performance and egg quality. Two experiments were carried out in the experimental area of the Federal University of Espírito Santo, varying the levels of organic zinc and maintaining the recommended copper and the other varying levels of inorganic copper. The experimental period was 84 days. Five mineral premixes were used. Performance and egg quality variables were analyzed. It was first observed that the evaluated variables were not affected significantly by the different mineral relations, except for relative and absolute weight of the bark. In the second test, there was no interaction between the zinc and copper levels, neither between the control and the control diet, for any of the variables observed, when analyzing the individual means, a significant difference was observed for posture rate, commercial and total eggs ratio, feed intake, and in the Haugh Unit. It can be concluded that the ratio of 35mg/kg organic zinc and 3,5mg/kg of inorganic copper met the nutritional requirements of the animals for performance and egg quality.(AU)

Associação da ocorrência do ectima contagioso (ORF vírus) em ovinos com os cuidadores desses animais / Occurrence of the Association contagious ecthyma (ORF virus) in sheep with these animals' caregivers

A enfermidade ectima contagioso está difundida em todo o estado de São Paulo. Foram amostrados 42 (8,64%) cuidadores de animais e 444 (91,36%) ovinos (n=486). A prevalência de reagentes para vírus-neutralização foi de 67% (IC95%=62-71%) nos ovinos, e em seus cuidadores de 76% (IC95%=63-89%), sendo P=0,22, ou seja, não houve diferença estatística significativa entre as espécies. A distribuição dos títulos teve diferença estatística significativa entre as espécies, com P=0,0048. As variações de titulação foram de 0,6 a 2,1 tanto nos ovinos quanto nos seus cuidadores. Dentre os 42 cuidadores de ovinos participantes do estudo, 32 apresentaram títulos de anticorpos expressos por log10 acima de 0,6.(AU)

These diseases are all widespread in the State of São Paulo. 42 (8.64%) animal caregivers and 444 (91.36%) sheep (n=486) were sampled. The reagents Prevalence paragraph virus neutralization was 67% (95% CI = 62-71%) in sheep and 76% (95% CI = 63-89%) for caregivers, with P=0.22 not being a statistically significant difference between the species. One of the distribution titles had significant difference between statistics as species with P=0.0048. The titration variations were 0.6 to 2.1, both in sheep and their caregivers. Among the 42 sheep caregivers participating in the study, 32 had antibody securities denominated in log10 above 0.6.(AU)

Hallazgos en endosonografía anorrectal en una cohorte prospectiva / Findings from anorectal endosonography in a prospective cohort

La endosonografía anorrectal permite diagnosticar múltiples patologías del canal anal y del recto. En Colombia se realiza en pocos sitios y es escaso el personal entrenado para ello. Un grupo de docentes de gastroenterología clínica quirúrgica de la Universidad de Caldas recibió entrenamiento en endosonografía anorrectal en Chile y España, después de lo cual inició su trayectoria, ya de 4 años. Con los datos del último año se realizó un estudio descriptivo en una cohorte prospectiva, tomando la información de los pacientes a quienes se les realizó endosonografía anorrectal entre octubre de 2014 y septiembre de 2015. Se obtuvieron datos de 136 pacientes, predominando el género femenino (72,05%); el 20,6% de los pacientes procedían de departamentos diferentes a Caldas. La principal indicación fue incontinencia fecal en 44 pacientes (32,35%), siendo 86% mujeres; otras indicaciones fueron neoplasia maligna rectal (23,5%), fístula perianal (12,5%), proctalgia (11,03%), endometriosis (7,35%) y absceso perianal (6,62%). El diagnóstico final más frecuente fue defecto de los esfínteres en 40 pacientes (29,41%), seguido por neoplasia maligna rectal (13,24%), fístula perianal (11,76%), absceso perianal (8,82%) y neoplasia benigna rectal (6,62%). Los resultados están en congruencia con la literatura mundial, donde la principal indicación es la incontinencia fecal en relación con el diagnóstico final, que es defectos de los esfínteres por alteraciones obstétricas. La endosonografía anorrectal es de gran importancia como método diagnóstico único o de apoyo para otros, con centros de referencia como el nuestro, donde se realiza en un volumen importante y siguiendo las pautas internacionales recomendadas.

Anorectal endosonography can diagnose many diseases of the anal canal and rectum. In Colombia, the procedure is performed in only a few medical centers because of the scarcity of trained personnel. Four years ago, a group of teachers from the gastroenterological surgery clinical at the University of Caldas received training in endoluminal ultrasonography in Chile and Spain and have been practicing these procedures ever since. This is a descriptive study of a prospective cohort using data from patients who underwent endoluminal ultrasonography between October 2014 and September 2015. Data were obtained from 136 patients, of whom 72.05% were women. 20.6% of the patients came from departments other than Caldas. Fecal incontinence was the reason for the procedure for 44 patients (32.35%, 86% of whom were women). Other indications were rectal malignancies (23.5%), perianal fistulas (12.5%), anal pain (11.03%), endometriosis (7.35%), and perianal abscesses (6.62%). The most common final diagnoses were defective sphincters in 40 patients (29.41%), rectal malignancy in 13.24% of the patients, perianal fistulas in 11.76% of the patients, perianal abscesses in 8.82% of the patients, and benign rectal neoplasms in 6.62% of the patients . The results are consistent with those found in the international literature where the most common final diagnoses reported for the reason for fecal incontinence are sphincter defects and obstetric disorders. Anorectal endosonography is of great importance when used alone or to support other diagnostic tools. It is recommended that this procedure be done in a referral center such as ours which performs a large volume of these procedures and which follows international guidelines.

Floristic and phytosociology in dense “terra firme” rainforest in the Belo Monte Hydroelectric Plant influence area, Pará, Brazil / Florística e fitossociologia de um trecho de Floresta ombrófila densa de terra firme na área de influência da Usina Hidrelétrica Belo Monte, Pará, Brasil

The objective of the present study was to characterise the floristic and phytosociological composition on a stretch of dense “Terra Firme” rainforest located in the Belo Monte hydroelectric plant area of influence, located in the state of Pará, Brazil. All trees with DAP >10 cm situated in 75 permanent plots of 1 ha were inventoried. 27,126 individuals trees (361 ind.ha-1), distributed in 59 botanical families, comprising 481 species were observed. The families with the largest number of species were Fabaceae (94), Araceae (65) and Arecaceae (43), comprising 43.7% of total species. The species Alexa grandiflora (4.41), Cenostigma tocantinum (2.50) and Bertholletia excelsa (2.28) showed the highest importance values (IV). The ten species with greater IV are concentrated (22%). The forest community has high species richness and can be classified as diverse age trees, heterogeneous and of medium conservation condition.

O presente estudo teve como objetivo caracterizar a composição florística e fitossociológica de um trecho de Floresta Ombrófila Densa de terra firme na área de influência da Usina Hidrelétrica Belo Monte, Pará, Brasil. Foram inventariadas todas as árvores com DAP > 10 cm em 75 parcelas permanentes de 1 ha. Foram observados 27.126 indivíduos arbóreos (361 ind.ha-1), distribuídos em 59 famílias botânicas, perfazendo 481 espécies. As famílias com maior número de espécies foram Fabaceae (94), Araceae (65) e Arecaceae (43), perfazendo 43,7% do total de espécies amostradas. As espécies Alexa grandiflora (4,41), Cenostigma tocantinum (2,50), Bertholletia excelsa (2,28), apresentaram os maiores valores de importância (VI), sendo que nas dez espécies com maiores IV, estão concentrados 22%. A comunidade florestal apresenta elevada riqueza florística e pode ser classificada como multiâneas, heterogêneas e com médio estado de conservação.

Preliminar results of paleontological salvage at Belo Monte Powerplant construction / Resultados preliminares do programa de salvamento paleontológico da construção da Hidrelétrica de Belo Monte

In this paper some preliminary fossil specimens are presented. They represent a collection sampled by Belo Monte’s Programa de Salvamento do Patrimônio Paleontológico (PSPP), which includes unprecedented invertebrate fauna and fossil vertebrates from Pitinga, Jatapu, Manacapuru, Maecuru e Alter do Chão formations from Amazonas basin, Brazil. The Belo Monte paleontological salvage was able to recover 495 microfossil samples and 1744 macrofossil samples on 30 months of sampling activities, and it is still ongoing. The macrofossils identified are possible plant remains, ichnofossils, graptolites, brachiopods, molluscs, athropods, Agnatha, palynomorphs (miosphores, acritarchs, algae cysts, fungi spores and unidentified types) and unidentified fossils. However, deep scientific research is not part of the scope of the program, and this collection must be further studied by researchers who visit Museu Paraense Emilio Goeldi, where the fossils will be housed. More material will be collected until the end of the program. The collection sampled allows a mosaic composition with the necessary elements to assign, in later papers, taxonomic features which may lead to accurate species identification and palaeoenvironmental interpretations.

Neste artigo são apresentados de forma preliminar alguns espécimes fósseis representativos do acervo coletado no Programa de Salvamento do Patrimônio Paleontológico (PSPP) da UHE Belo Monte, que inclui fauna vertebrada e invertebrada inédita das formações Pitinga, Jatapu, Manacapuru, Maecuru e Alter do Chão, da bacia do Amazonas, Brasil. No salvamento paleontológico de Belo Monte foi possível recuperar 495 amostras para microfósseis e 1744 amostras com macrofósseis em 30 meses de amostragem, que ainda continua em andamento. Os macrofósseis identificados são possíveis restos de plantas, icnofósseis, graptolitos, braquiópodes, moluscos, artópodes, Agnatha, palinomorfos (miósporos, acritarcas, cistos de alga, esporos de fungo e tipos indeterminados) além de fósseis não identificados. No entanto, pesquisa científica aprofundada não é parte do escopo do programa, e esta coleção deve ser estudada no futuro por pesquisadores pela visita ao Museu Paraense Emilio Goeldi, onde os fósseis ficarão depositados. Mais material será coletado até o fim de 2015. A assemblagem coletada permite a composição de mosaico com elementos necessários para a definição, em artigos futuros, características taxonômicas que levarão à identificação precisa de espécies e interpretações paleoambientais.

Ressecção endoscópica de tumor polipoide da junção retossigmoidiana / Endoscopic resection of a polypoid tumor on the rectosigmoid junction

Os adenomas são classificados histologicamente conforme a participação do componente tubular e viloso na sua constituição, e também conforme o seu grau de displasia, que pode ser de baixo ou de alto grau. De acordo com o National Polyp Study, os fatores mais importantes relacionados aos adenomas com displasia de alto grau são o tamanho = 1 cm, idade avançada e a presença de componente viloso. Portanto, a identificação dos fatores de risco para os adenomas com displasia de alto grau pode contribuir de maneira significativa para o tratamento e seguimento dos pacientes com pólipos adenomatosos. A maioria (2/3) dos pólipos é assintomática, sobretudo os < 1,0 cm, podendo, eventualmente, ocorrer sintomas nos pólipos > 1,0 cm. A detecção e a remoção dos adenomas rompem a sequência patogênica, eliminando a progressão para a malignidade.

Colocação de prótese metálica autoexpansível, parcialmente coberta em colédoco distal, e prótese plástica em ducto cístico em paciente com neoplasia de cabeça de pâncreas / Placement of self-expanding metalic stent, partially covered, in the distal choledochoal and plastic stent placement in the cystic duct in patient with cancer of head of the pancreas

A drenagem endoscópica da via biliar em casos inoperáveis de obstrução maligna é a conduta de escolha atualmente. O uso de próteses metálicas autoexpansíveis apresenta melhores resultados em relação às próteses plásticas em virtude dos menores índices de obstrução. No entanto, complicações como colecistite podem ocorrer em até 5% dos casos.

Occurrence of periodontal pathogens among patients with chronic periodontitis

The aim of the present study was to evaluate the presence of the periodontal pathogens that form the red complex (Tannerella forsythia, Porphyromonas gingivalis and Treponema denticola) and Aggregatibacter actinomycetemcomitans in patients with chronic periodontitis. The sample consisted of 29 patients with a clinical and radiographic diagnosis of chronic periodontitis based on the criteria of the American Academy of Periodontology (3). Samples for microbiological analysis were collected from the four sites of greatest probing depth in each patient, totaling 116 samples. These samples were processed using conventional polymerase chain reaction, which achieved the following positive results: 46.6% for P. gingivalis, 41.4% for T. forsythia, 33.6% for T. denticola and 27.6% for A. actinomycetemcomitans. P. gingivalis and T. forsythia were more prevalent (p < 0.05) in periodontal pockets ≥ 8 mm. The combinations T. forsythia + P. gingivalis (23.2%) and T. forsythia + P. gingivalis + T. denticola (20.0%) were more frequent in sites with a probing depth ≥ 8 mm. Associations with the simultaneous presence of A. actinomycetemcomitans + P. gingivalis, A. actinomycetemcomitans + T. forsythia, P. gingivalis + T. forsythia and T. forsythia + T. denticola were statistically significant (p < 0.05). It was concluded that the red complex pathogens are related to chronic periodontitis, presenting a higher occurrence in deep periodontal pockets. Moreover, the simultaneous presence of these bacteria in deep sites suggests a symbiotic relationship between these virulent species, favoring, in this way, a further progression of periodontal disease.

Aspergilosis broncopulmonar alérgica en un adolescente: reporte de un caso / Allergic bronchopulmonary aspergillosis in an adolescent: case report

INTRODUCCIÓN: La Aspergilosis broncopulmonar alérgica es una enfermedad poco frecuente con prevalencia de 1 a 2 por ciento a nivel mundial. Se diagnostica según Infectious Diseases Society of America por: episodios de obstrucción bronquial, eosinofilia periférica, test de reactividad cutánea a antígeno de Aspergillus, precipitación de anticuerpos para el antígeno de Aspergillus, elevación de IgE en suero, historia de infiltrados pulmonares y bronquiectasias centrales. Puede atravesar estadios de asmaaguda sensible a corticosteroides hasta estadios finales de fibrosis pulmonar. PRESENTACIÓN DEL CASO: Joven de 22 años acude al Instituto de Previsión Social, Hospital Central en la ciudad de Asunción, en donde es internado por malestar general, tos con expectoración amarillenta, sibilancias, sensación febril y dificultad respiratoria, con diagnóstico de ingreso de neumonía adquirida en la comunidad y enfermedad tipo influenza, que responde al tratamiento sintomático. Se practica una radiografía simple de tórax donde se observa un patrón algodonoso bilateral. Un mes después, acude de nuevo al Hospital Central por persistencia del cuadro con eosinofilia periférica de 60 por ciento, frotis de heces sin reporte de parásitos, IgE total en suero 530 KIU/L, tomografía axial computarizada con infiltrado pulmonar difuso bilateral, test de reactividad cutánea a antígeno de Aspergillus positivo y precipitación de anticuerpos para el antígeno de Aspergillus positivo. Se trató con prednisona e itraconazol por 16semanas, obteniéndose buena respuesta; tres meses después de suspender el tratamiento no manifiesta síntomas. DISCUSIÓN: Ante pacientes internados por cuadros respiratorios presistentes es necesario un diagnóstico temprano y adecuado con el objetivo de evitar secuelas posteriores.

INTRODUCTION: Allergic Bronchopulmonary Aspergillosisis a rare disease with a prevalence of 1 to 2 percent worldwide. It is diagnosed according to the Infectious Diseases Society of America by: episodes of bronchial obstruction, peripheral eosinophilia, positive skin-prick test to Aspergillus antigen, precipitating antibodies to Aspergillus antigen, elevated serum IgE, history of pulmonary infiltrates and central bronchiectasis. It can go through stages of corticosteroid-sensitive acute asthma to end-stage pulmonary fibrosis. CASE REPORT: A 22 year old man goes to Instituto de Prevision Social, Hospital Central de Asuncion, where is hospitalized accompanied by general malaise, cough with yellow sputum, wheezing, feverish feeling andshortness of breath, with admission diagnosis of Community Acquired Pneumonia and influenza-like illness that responds to symptomatic treatment. Chest radiography shows a bilateral cottony pattern. A month later, a persistence of the symptoms is observed with 60 percent peripheral eosinophilia, faeces smear is reported without parasites, total serum IgE 530 KIU / L chest, computed tomography with diffuse bilateral pulmonary infiltrates, positive skin antigen reactivity test for Aspergillus, positive precipitating antibodies to Aspergillus species. He was treated with prednisone and itraconazole for 16 weeks, with good response. Three months after treatment there are no symptoms. DISCUSSION: Patients hospitalized for persistently respiratory symptoms, early diagnosis is necessary and appropriate in order to prevent sequelae.

Metodologias de aplicação de AIB no enraizamento de estacas semilenhosas de Sapium glandulatum (vell. ) pax / Methodologies of IBA application in the rooting of Sapium glandulatum (vell. ) pax semi-hardwood cuttings

A espécie Sapium glandulatum, conhecida vulgarmente como leiteiro, é uma das espécies nativas potencialmente recomendada para a recuperação de áreas degradadas, devido principalmente ao seu caráter pioneiro, além de possivelmente possuir características medicinais, uma vez que a família Euphorbiaceae, a qual pertence, é rica em compostos fenólicos. Em abril/2000 e dezembro/2000 foram conduzidos experimentos em casa-de-vegetação para verificar o efeito da aplicação de diferentes concentrações de ácido indolilbutírico (AIB), em solução concentrada (10 segundos de imersão), solução diluída (16 horas de imersão) e em talco, associadas ou não ao ácido bórico, no enraizamento de estacas semilenhosas de Sapium glandulatum. As estacas foram confeccionadas a partir de brotações do ano, coletadas de plantas matrizes localizadas no município de Bocaiúva do Sul -PR, mantendo- as com comprimento de cerca de 10 cm e 2 folhas apicais reduzidas à metade. Os tratamentos utilizados foram: 0, 4000, 6000 e 8000 mg L-1 de AIB, sozinhos e em associação com 150 mg L-1 de ácido bórico (solução concentrada), 0, 200 e 400 mg L-1 de AIB, sozinhos e em associação com 150 mg L-1 ácido bórico (solução diluída) e 0, 4000, 6000 e 8000 mg L-1 de AIB, na forma de talco. Pelos resultados obtidos foi possível concluir que, após 70 dias em casa-de-vegetação, a melhor época para coleta das estacas correspondeu à instalação realizada em dezembro/2000 (verão), onde o tratamento com 8000 mg L-1 de AIB, em solução concentrada, proporcionou o maior percentual de enraizamento (14 por cento), porém não diferindo significativamente dos demais tratamentos. A utilização da solução diluída não se mostrou promissora para a indução do sistema radicial devido à alta mortalidade das estacas. Os tratamentos com AIB veiculados em talco não superaram os resultados obtidos pelos melhores tratamentos para estacas enraizadas em solução concentrada, não sendo um método recomendável para o aumento da indução radicial de Sapium glandulatum. Pelo exposto, pode-se considerar que estacas de brotações do ano desta espécie não são indicadas para sua propagação vegetativa, de acordo com os tratamentos realizados.

The species Sapium glandulatum, commonly known as "leiteiro", is one of the Brazilian native species potentially recommended for the recovery of degraded areas, mainly due to its pioneering character and probable medicinal properties since its family, Euphorbiaceae, is rich in phenolic compounds. In April/2000 and December/2001, experiments were carried out in a greenhouse to investigate the effects of different indolebutyric acid (IBA) levels in concentrated solution (10 seconds immersion), diluted solution (16 hours immersion) and as talc, associated or not with boric acid, on the rooting of Sapium glandulatum semi-hardwood cuttings. The latter were produced from sproutings of the year collected from stock plants located in Bocaiúva do Sul, Paraná State, Brazil. The length of each cutting was about 10 cm, with 2 half apical leaves. The following treatments were evaluated: 0, 4000, 6000 and 8000 mg L-1 IBA, alone and with 150 mg L-1 boric acid (concentrated solution); 0, 200 and 400 mg L-1 IBA, alone and with 150 mg L-1 boric acid (diluted solution); and 0, 4000, 6000 and 8000 mg L-1 IBA as talc. After 70 days in greenhouse, the best period for cutting collection was December/2000 (summer), and 8000 mg L-1 IBA in concentrated solution led to the highest rooting percentage (14 percent), although not significantly different from the remaining treatments. The diluted solution did not show promising results for root system induction due to the high mortality of cuttings. The results for IBA as talc were not higher than those for the best treatments in concentrated solution, which indicates this method is not recommended to increase Sapium glandulatum rooting induction. Thus, sprouting cuttings of the year from this species are not recommended for its vegetative propagation, according to the evaluated treatments.

Use of blends of bioabsorbable poly(L-lactic acid)/poly(hydroxybutyrate- co-hydroxyvalerate) as surfaces for Vero cell culture

Vero cells, a cell line established from the kidney of the African green monkey (Cercopithecus aethiops), were cultured in F-10 Ham medium supplemented with 10 percent fetal calf serum at 37°C on membranes of poly(L-lactic acid) (PLLA), poly(hydroxybutyrate-co-hydroxyvalerate) (PHBV) and their blends in different proportions (100/0, 60/40, 50/50, 40/60, and 0/100). The present study evaluated morphology of cells grown on different polymeric substrates after 24 h of culture by scanning electron microscopy. Cell adhesion was also analyzed after 2 h of inoculation. For cell growth evaluation, the cells were maintained in culture for 48, 120, 240, and 360 h. For cytochemical study, the cells were cultured for 120 or 240 h, fixed, processed for histological analysis, and stained with Toluidine blue, pH 4.0, and Xylidine ponceau, pH 2.5. Our results showed that cell adhesion was better when 60/40 and 50/50 blends were used although cells were able to grow and proliferate on all blends tested. When using PLLA/PHBV (50/50) slightly flattened cells were observed on porous and smooth areas. PLLA/PHBV (40/60) blends presented flattened cells on smooth areas. PLLA/PHBV (0/100), which presented no pores, also supported spreading cells interconnected by thin filaments. Histological sections showed that cells grew as a confluent monolayer on different substrates. Cytochemical analysis showed basophilic cells, indicating a large amount of RNA and proteins. Hence, we detected changes in cell morphology induced by alterations in blend proportions. This suggests that the cells changed their differentiation pattern when on various PLLA/PHBV blend surfaces.

Topographic abnormality of slow cortical potentials in schizophrenia

A recent study from our laboratory has provided evidence for the generation of slow potentials occurring in anticipation to task-performance feedback stimuli, in multiple association cortical areas, consistently including two prefrontal areas. In the present study, we intended to determine whether these slow potentials would indicate some abnormality (topographic) in schizophrenic patients, and thus serve as an indication of abnormal association cortex activity. We recorded slow potentials while subjects performed a paired-associates memory task. A 123-channel EEG montage and common average reference were used for 20 unmedicated schizophrenic (mean duration of illness: 11.3 ± 9.2 years; mean number of previous hospitalizations: 1.2 ± 1.9) and 22 healthy control subjects during a visual paired-associates matching task. For the topographic analysis, we used a simple index of individual topographic deviation from normality, corrected for absolute potential intensities. Slow potentials were observed in all subjects. Control subjects showed a simple spatial pattern of voltage extrema (left central positive and right prefrontal negative), whereas schizophrenic patients presented a more complex, fragmented pattern. Topographic deviation was significantly different between groups (P < 0.001). The increased topographic complexity in schizophrenics could be visualized in grand averages computed across subjects. Increased topographic complexity could also be seen when grand averages were computed for subgroups of patients assembled either according to task-performance (high versus low) or by their scores on psychopathological scales. There was no significant correlation between topographic deviation and psychopathology scores. We conclude that the slow potential topographic abnormalities of schizophrenia indicate an abnormality in the configuration of large-scale electrical activity in association cortices.

Absence-like seizures in adult rats following pilocarpine-induced status epilepticus early in life

Administration of pilocarpine causes epilepsy in rats if status epilepticus (SE) is induced at an early age. To determine in detail the electrophysiological patterns of the epileptogenic activity in these animals, 46 Wistar rats, 7-17 days old, were subjected to SE induced by pilocarpine and electro-oscillograms from the cortex, hippocampus, amygdala, thalamus and hypothalamus, as well as head, rostrum and vibrissa, eye, ear and forelimb movements, were recorded 120 days later. Six control animals of the same age range did not show any signs of epilepsy. In all the rats subjected to SE, iterative spike-wave complexes (8.1 ± 0.5 Hz in frequency, 18.9 ± 9.1 s in duration) were recorded from the frontal cortex during absence fits. However, similar spike-wave discharges were always found also in the hippocampus and, less frequently, in the amygdala and in thalamic nuclei. Repetitive or single spikes were also detected in these same central structures. Clonic movements and single jerks were recorded from all the rats, either concomitantly with or independently of the spike-wave complexes and spikes. We conclude that rats made epileptic with pilocarpine develop absence seizures also occurring during paradoxical sleep, showing the characteristic spike-wave bursts in neocortical areas and also in the hippocampus. This is in contrast to the well-accepted statement that one of the main characteristics of absence-like fits in the rat is that spike-wave discharges are never recorded from the hippocampal fields.

Tratamento da estenose da artéria subclávia com utilizaçäo de stents em pacientes previamente submetidos à anastomose da artéria mamária interna com a artéria descendente anterior / Treatment of subclavian artery stenosis with stents in patients underwent internal mammary left anterior descending artery bypass surgery

Descrevemos dois casos de pacientes que haviam sido submetidos a revascularizaçäo do miocárdio com a utilizaçäo da artéria mamária interna esquerda e que desenvolveram na evoluçäo, quadro de insuficiência coronária por estenose da artéria subclávia esquerda. A cinecoronariografia evidenciou fluxo retrógrado da artéria descendente anterior para artéria mamária com enchimento da artéria subclávia distal à estenose que se localizava na sua origem. Após dilataçäo inicial com catater baläo de angioplastia coronária, foram implantados stents de Palmaz-Schantz, obtendo-se excelente aspecto angiográfico, sem complicaçöes e regressäo dos sintomas. Nossos resultados demonstram que a implantaçäo de stents nestes pacientes pode ser realizada com eficácia e segurança, mostrando ser um tratamento alternativo a outras formas de revascularizaçäo cirúrgica ou percutânea para esta doença.

We reported two cases of patients that underwent leftinternal mammary (LIMA) - coronary bypass graft and developed recurrent myocardial ischemia in the follow-up period caused by stenosis in the subclavian artery. The angiography showed retrograde flow from the left anterior descending artery to subclavian artery. After initial dilatation with a conventional angioplasty balloon catheter, we implanted Palmaz-Schatz Stents, achieving an excellent final result. Our finding suggest that Stent implantation is a safe and effective procedure, and provides an alternative to other forms of revascularization for the treatment of this disorder

Imunidade a carrapatos Rhipicephalus sanguineus (Acarina: ixodidae) em cachorro-do-mato Cerdocyon thous (Linnaeus) e no cäo doméstico / Immunity ticks Rhipicephalus sanguineus (Latreille) in crab-eating-fox Cerdocyon thous (Linnaeus) and mongrel dogs

Algumas das relaçöes hospedeiro-parasita säo marcadas por desenvolvimento de resistência pelo hospedeiro, limitando o número de parasitas. Tal näo ocorre na relaçäo cäo doméstico x Rhipicephalus sanguineus (carrapato do cäo). Teria o cäo doméstico perdido aquela capacidade em seu processo de domesticaçäo? Esta hipótese foi testada em duas condiçöes, comparando-se a aquisiçäo de imunidade ao carrapato R. sanguineus pelo cäo doméstico em relaçäo ao cachorro-do-mato-Cerdocyon thous após três infestaçöes sucessivas por carrapatos adultos, ou através de infestaçäo desafio após imunizaçäo com um homogenato bruto de carrapatos da mesma espécie. A aquisiçäo ou näo de resistência foi avaliada a partir da análise do desempenho alimentar e reprodutivo das carrapatas durante e após as infestaçöes. Os resultados indicaram uma pequena diferença significativa entre o cäo doméstico e o cachorro-do-mato quanto ao desenvolvimento de resistência ao carrapato R. sanguineus, que, entretanto, näo foi considerada relevante na caracterizaçäo de uma imunidade efetiva

Crioevisceracao do globo ocular. / Eye crioevisceration

A crioevisceracao representa precesso cirurgico de facil execucao, cujo ato operatorio transcorre praticamente sem sangramentos e com um minimo de trauma, em menor espaco de tempo e cuja recuperacao tambem se faz mais rapida