Multiple metals and agricultural use affects oxidative stress biomarkers in freshwater Aegla crabs / Presença de múltiplos metais e agricultura afetam biomarcadores de estresse oxidativo em caranguejos de água doce (Aegla)

Metals and agrochemicals are among the main aquatic contaminants, being able to trigger oxidative stress in exposed organisms. The objective of this work was to evaluate the correlation between the level of oxidative stress biomarkers in Aegla crabs (Crustacea, Anomura) with (i) the set of metals present in the streams sediment and (ii) with land uses of three hydrographic basins. The study was carried out in streams (≤ 2nd order) of hydrographic basins in southern Brazil (Basins of Rio Suzana, Rio Ligeirinho-Leãozinho and Rio Dourado). In these streams were quantified the land uses and Cu, Cr, Cd, Fe, Mn and Zn concentrations in the sediment. The enzymes Catalase (CAT) and Glutathione Reductase (GR), as well as the level of membrane lipid peroxidation (TBARS), were analyzed in adult females. The PCA analysis showed that the distribution of metals was different between the basins. Cd, Cr and Fe were correlated positively with CAT and negatively with TBARS and GR. The Dourado basin had the lowest concentrations of these three metals and the highest levels of TBARS. However, in Dourado basin there is predominance of agriculture land use, and TBARS was positively correlated with agricultural land use. Besides in Dourado basin, GR activity was higher than in the others basins, indicating a compensatory response in relation to CAT inhibition. The basins of Suzana and Ligeirinho-Leãozinho rivers had lower TBARS values, which may be due to the induction of CAT in response to metals accumulated in sediment. In summary, this work indicates that in the basins with a higher concentration of toxic metals there is an adaptive response of CAT induction, which reduces TBARS in Aegla. On the other hand, in the basin with lower metallic contamination, TBARS occurrence was primarily influenced by agricultural land use.

Os metais e agroquímicos estão entre os principais contaminantes aquáticos, podendo desencadear estresse oxidativo em organismos expostos. O objetivo deste trabalho foi avaliar uma possível correlação entre o nível de biomarcadores de estresse oxidativo em Aegla (Crustacea, Anomura) com (i) o conjunto de metais presentes no sedimento e (ii) com os usos da terra, em três bacias hidrográficas distintas. O estudo foi realizado em riachos (≤ 2ª ordem) de bacias hidrográficas do Sul do Brasil (Bacias do Rio Suzana, do Rio Ligeirinho-Leãozinho e do Rio Dourado), as quais foram caracterizadas em função do percentual de usos da terra e do nível de Cu, Cr, Cd, Fe, Mn e Zn no sedimento. As enzimas Catalase (CAT) e Glutationa Redutase (GR), bem como o nível de peroxidação lipídica das membranas (TBARS), foram analisadas em fêmeas adultas. Uma análise de PCA mostrou que a distribuição de metais foi distinta entre as bacias. Cd, Cr e Fe no sedimento correlacionaram positivamente com a CAT e negativamente com TBARS e GR. Entretanto, a bacia do Dourado apresentou os menores níveis destes três metais e os maiores níveis de TBARS, o que pode ser justificado pelo predomínio da agricultura nesta bacia, já que o TBARS correlacionou positivamente com o percentual de uso agrícola. Nesta bacia, a atividade da GR foi mais alta do que nas outras, indicando uma resposta compensatória em relação a inibição da CAT. As bacias do rio Suzana e rio Ligeirinho-Leãozinho apresentaram valores menores de TBARS, o que pode decorrer da indução da CAT em função dos metais acumulados no sedimento. Em síntese, este trabalho indica que nas bacias com maior concentração de metais tóxicos ocorre uma resposta adaptativa de indução da CAT, o que reduz os níveis de TBARS em Aegla. Por outro lado, na bacia com menor contaminação metálica os níveis de TBARS foram primariamente influenciados pelo uso agrícola.

Multiple metals and agricultural use affects oxidative stress biomarkers in freshwater Aegla crabs / Presença de múltiplos metais e agricultura afetam biomarcadores de estresse oxidativo em caranguejos de água doce (Aegla)

Metals and agrochemicals are among the main aquatic contaminants, being able to trigger oxidative stress in exposed organisms. The objective of this work was to evaluate the correlation between the level of oxidative stress biomarkers in Aegla crabs (Crustacea, Anomura) with (i) the set of metals present in the streams sediment and (ii) with land uses of three hydrographic basins. The study was carried out in streams (≤ 2nd order) of hydrographic basins in southern Brazil (Basins of Rio Suzana, Rio Ligeirinho-Leãozinho and Rio Dourado). In these streams were quantified the land uses and Cu, Cr, Cd, Fe, Mn and Zn concentrations in the sediment. The enzymes Catalase (CAT) and Glutathione Reductase (GR), as well as the level of membrane lipid peroxidation (TBARS), were analyzed in adult females. The PCA analysis showed that the distribution of metals was different between the basins. Cd, Cr and Fe were correlated positively with CAT and negatively with TBARS and GR. The Dourado basin had the lowest concentrations of these three metals and the highest levels of TBARS. However, in Dourado basin there is predominance of agriculture land use, and TBARS was positively correlated with agricultural land use. Besides in Dourado basin, GR activity was higher than in the others basins, indicating a compensatory response in relation to CAT inhibition. The basins of Suzana and Ligeirinho-Leãozinho rivers had lower TBARS values, which may be due to the induction of CAT in response to metals accumulated in sediment. In summary, this work indicates that in the basins with a higher concentration of toxic metals there is an adaptive response of CAT induction, which reduces TBARS in Aegla. On the other hand, in the basin with lower metallic contamination, TBARS occurrence was primarily influenced by agricultural land use.

Os metais e agroquímicos estão entre os principais contaminantes aquáticos, podendo desencadear estresse oxidativo em organismos expostos. O objetivo deste trabalho foi avaliar uma possível correlação entre o nível de biomarcadores de estresse oxidativo em Aegla (Crustacea, Anomura) com (i) o conjunto de metais presentes no sedimento e (ii) com os usos da terra, em três bacias hidrográficas distintas. O estudo foi realizado em riachos(≤ 2ª ordem) de bacias hidrográficas do Sul do Brasil (Bacias do Rio Suzana, do Rio Ligeirinho-Leãozinho e do Rio Dourado), as quais foram caracterizadas em função do percentual de usos da terra e do nível de Cu, Cr, Cd, Fe, Mn e Zn no sedimento. As enzimas Catalase (CAT) e Glutationa Redutase (GR), bem como o nível de peroxidação lipídicadas membranas (TBARS), foram analisadas em fêmeas adultas. Uma análise de PCA mostrou que a distribuição de metais foi distinta entre as bacias. Cd, Cr e Fe no sedimento correlacionaram positivamente com a CAT e negativamente com TBARS e GR. Entretanto, a bacia do Dourado apresentou os menores níveis destes três metais e os maiores níveis de TBARS, o que pode ser justificado pelo predomínio da agricultura nesta bacia, já que o TBARS correlacionou positivamente com o percentual de uso agrícola. Nesta bacia, a atividade da GR foi mais alta do que nas outras, indicando uma resposta compensatória em relação a inibição da CAT. As bacias do rio Suzana e rio Ligeirinho-Leãozinho apresentaram valores menores de TBARS, o que pode decorrer da indução da CAT em função dos metais acumulados no sedimento. Em síntese, este trabalho indica que nas bacias com maior concentração de metais tóxicos ocorre uma resposta adaptativa de indução da CAT, o que reduz os níveis de TBARS em Aegla. Por outro lado, na bacia com menor contaminação metálica os níveis de TBARS foram primariamente influenciados pelo uso agrícola.

Multiple metals and agricultural use affects oxidative stress biomarkers in freshwater Aegla crabs

Abstract Metals and agrochemicals are among the main aquatic contaminants, being able to trigger oxidative stress in exposed organisms. The objective of this work was to evaluate the correlation between the level of oxidative stress biomarkers in Aegla crabs (Crustacea, Anomura) with (i) the set of metals present in the streams sediment and (ii) with land uses of three hydrographic basins. The study was carried out in streams ( 2nd order) of hydrographic basins in southern Brazil (Basins of Rio Suzana, Rio Ligeirinho-Leãozinho and Rio Dourado). In these streams were quantified the land uses and Cu, Cr, Cd, Fe, Mn and Zn concentrations in the sediment. The enzymes Catalase (CAT) and Glutathione Reductase (GR), as well as the level of membrane lipid peroxidation (TBARS), were analyzed in adult females. The PCA analysis showed that the distribution of metals was different between the basins. Cd, Cr and Fe were correlated positively with CAT and negatively with TBARS and GR. The Dourado basin had the lowest concentrations of these three metals and the highest levels of TBARS. However, in Dourado basin there is predominance of agriculture land use, and TBARS was positively correlated with agricultural land use. Besides in Dourado basin, GR activity was higher than in the others basins, indicating a compensatory response in relation to CAT inhibition. The basins of Suzana and Ligeirinho-Leãozinho rivers had lower TBARS values, which may be due to the induction of CAT in response to metals accumulated in sediment. In summary, this work indicates that in the basins with a higher concentration of toxic metals there is an adaptive response of CAT induction, which reduces TBARS in Aegla. On the other hand, in the basin with lower metallic contamination, TBARS occurrence was primarily influenced by agricultural land use.

Resumo Os metais e agroquímicos estão entre os principais contaminantes aquáticos, podendo desencadear estresse oxidativo em organismos expostos. O objetivo deste trabalho foi avaliar uma possível correlação entre o nível de biomarcadores de estresse oxidativo em Aegla (Crustacea, Anomura) com (i) o conjunto de metais presentes no sedimento e (ii) com os usos da terra, em três bacias hidrográficas distintas. O estudo foi realizado em riachos ( 2ª ordem) de bacias hidrográficas do Sul do Brasil (Bacias do Rio Suzana, do Rio Ligeirinho-Leãozinho e do Rio Dourado), as quais foram caracterizadas em função do percentual de usos da terra e do nível de Cu, Cr, Cd, Fe, Mn e Zn no sedimento. As enzimas Catalase (CAT) e Glutationa Redutase (GR), bem como o nível de peroxidação lipídica das membranas (TBARS), foram analisadas em fêmeas adultas. Uma análise de PCA mostrou que a distribuição de metais foi distinta entre as bacias. Cd, Cr e Fe no sedimento correlacionaram positivamente com a CAT e negativamente com TBARS e GR. Entretanto, a bacia do Dourado apresentou os menores níveis destes três metais e os maiores níveis de TBARS, o que pode ser justificado pelo predomínio da agricultura nesta bacia, já que o TBARS correlacionou positivamente com o percentual de uso agrícola. Nesta bacia, a atividade da GR foi mais alta do que nas outras, indicando uma resposta compensatória em relação a inibição da CAT. As bacias do rio Suzana e rio Ligeirinho-Leãozinho apresentaram valores menores de TBARS, o que pode decorrer da indução da CAT em função dos metais acumulados no sedimento. Em síntese, este trabalho indica que nas bacias com maior concentração de metais tóxicos ocorre uma resposta adaptativa de indução da CAT, o que reduz os níveis de TBARS em Aegla. Por outro lado, na bacia com menor contaminação metálica os níveis de TBARS foram primariamente influenciados pelo uso agrícola.

Avaliação da atividade antiedematogênica, antimicrobiana e mutagênica das sementes de Amburana cearensis (A. C. Smith) (Imburana-de-cheiro) / Assessment of the antiedematogenic, antimicrobial and mutagenic activity of Amburana cearensis seeds (A.C. Smith) (Imburana-de-cheiro)

Foram avaliados os efeitos antiinflamatório, antibacteriano e mutagênico do extrato aquoso das sementes de Amburana cearensis. A atividade antiinflamatória foi avaliada em modelo de edema de pata induzido por carragenina, utilizando o extrato em concentrações de 10 % e 20 % nos grupos experimentais; AAS 10 mg/kg (v.o) no grupo padrão e água destilada no grupo controle. A atividade antimicrobiana foi determinada através do método de diluição em Agar, utilizando concentrações de extrato de 10 %, 7,5 %, 5 %, 2,5 % e 1 % em cepas de Sthaphylococcus aureus ATCC 27853, Escherichia coli ATCC 25922 e Pseudomonas aeruginosas ATCC 25923) e a atividade mutagênica foi determinada pelo teste de Allium cepa, utilizando extrato em concentrações de 0,02 mg/mL, 0,1 mg/mL e 0,5 mg/mL. O extrato aquoso das sementes de Amburana cearensis nas concentrações de 10 % e 20 % apresentou efeito antiedematogênico, estatisticamente significativo a partir de duas horas após administração do flogógeno, e tal efeito persistiu até 24 horas após a indução da resposta inflamatória. Quanto à atividade antibacteriana, o extrato não apresentou ação contra as cepas bacterianas de Sthaphylococcus aureus, Escherichia coli e Pseudomonas aeruginosas nas concentrações testadas. A análise dos resultados do teste de Allium cepa evidenciou ação tóxica (em concentração de 0,5 mg/mL) e mutagênica (micronúcleo 0,1 mg/mL e aberrações cromossômicas 0,1 mg/mL e 0,5 mg/mL) do extrato de Amburana cearensis em células meristemáticas de Allium cepa. Tais resultados sugerem potencial aplicação terapêutica no tratamento da inflamação. Contudo, também demonstram a necessidade de estudar para comprovar a segurança na utilização dessa espécie.

The anti-inflammatory, antibacterial and mutagenic effects of the aqueous extract of Amburana cearensis seeds were evaluated. The anti-inflammatory activity was evaluated by a paw edema model induced by carrageenan, using the extract at 10 % and 20 % concentrations in the experimental groups: AAS 10 mg/kg (orally administrated) in the standard group and distilled water in the control group. The antimicrobial activity was determined by the agar dilution method, using extract concentrations of 10 %, 7.5 %, 5 %, 2.5 % and 1% in strains of Staphylococcus aureus ATCC 27853, Escherichia coli ATCC 25922 and Pseudomonas aeruginosas ATCC 25923), and the mutagenic activity was determined by the Allium cepa test using extract concentrations of 0,02 mg/mL, 0,1 mg/mL and 0,5 mg/mL. The aqueous extract of Amburana cearensis seeds at 10 % and 20 % concentrations had an statistically significant antiedematogenic effect two hours after administering the flogogen, and this effect persisted for up to 24 hours after inducing the inflammatory response. Regarding the antibacterial activity, the extract showed no action against the bacterial strains of Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosas at the concentrations tested. The results of the Allium cepa test showed the toxic (at a concentration of 0,5 mg/mL) and mutagenicity (0.1 mg/mL micronucleus and 0.1 mg/mL and 0.5 mg/mL chromosomal aberrations) actions of the Amburana cearensis extract on meristematic cells of Allium cepa. These results suggest potential therapeutic applications to treat inflammations. However, they also show the need for further studies to demonstrate the safe use of this species.

Síndrome de Kartagener em um cão (Canis lupus familiaris) da raça Cocker Spaniel Inglês / Kartagener's syndrome in an English Cocker Spaniel dog (Canis lupus familiaris)

Kartagener is syndrome is a rare disorder described in dogs determined by the triad situs inversus totalis, chronic sinusitis, and bronchial disease. The clinical signs of chronic respiratory and other less common presentations (such as hydrocephalus and subfertility) are due to a concomitant ciliary dysfunction. This article describes the clinical, radiographic, and computed tomography findings and treatment in a dog affected by Kartagener is syndrome since early months of life. This is the first case report of this syndrome in a domestic dog in Brazil and the only known scientific report in the English Cocker Spaniel.

Lack of evidence for superantigen activity of Toxoplasma gondii towards human T cells

Toxoplasma gondii is an obligatory intracellular parasite whose life cycle may include man as an intermediate host. More than 500 million people are infected with this parasite worldwide. It has been previously reported that T. gondii contains a superantigen activity. The purpose of the present study was to determine if the putative superantigen activity of T. gondii would manifest towards human T cells. Peripheral blood mononuclear cells (PBMC) from individuals with no previous contact with the parasite were evaluated for proliferation as well as specific Vá expansion after exposure to Toxoplasma antigens. Likewise, PBMC from individuals with the congenital infection were evaluated for putative Vá family deletions in their T cell repertoire. We also evaluated, over a period of one year, the PBMC proliferation pattern in response to Toxoplasma antigens in patients with recently acquired infection. Some degree of proliferation in response to T. gondii was observed in the PBMC from individuals never exposed to the parasite, accompanied by specific Vá expansion, suggesting a superantigen effect. However, we found no specific deletion of Vá (or Valpha) families in the blood of congenitally infected individuals. Furthermore, PBMC from recently infected individuals followed up over a period of one year did not present a reduction of the Vá families that were originally expanded in response to the parasite antigens. Taken together, our data suggest that T. gondii does not have a strong superantigen activity on human T cells

Vigilância epidemiológica ambiental / Environmental epidemiological surveillance

Aborda a Agenda 21 do Município de Säo Paulo, em relaçäo ao binômio saúde-ambiente, que contempla, dentre outros objetivos, a eliminaçäo, diminuiçäo e prevençäo de riscos e agravos à saúde do indivíduo e da coletividade, por meio de açöes de saneamento ambiental, com fiscalizaçäo e controle sobre o meio ambiente, e os fatores que interferem na sua qualidade, propondo para isso, promover vigilância dos pontos de poluiçäo do ar, água e solo

Propranolol stimulates testicular interstitial fluid formation and testosterone secretion in rats

We investigated the effect of intratesticularly injected propranolol on testicular interstitial fluid (TIF) formation and on testosterone levels in the TIF of intact adult male Wistar rats (4-9 rats per group). D1-propranolol at doses of 0.6, 1.2 or 6.0 mg/kg was injected into the left (L) testis whereas the right (R) testis (control testis) received vehicle. d1-propranolol (6.0 mg/kg) caused a significant increase in both TIF volume (329 per cent) and TIF levels of testosterone (257 per cent) in the L testis but not in the R (control) testis 3 h post-injection. In rats treated simultaneously with human chorionic gonadotropin (hCG, 5 IU/rat, sc) the same dose of propranolol (6.0 mg/kg) significantly increased the stimulatory effect of hCG on testosterone secretion by 1.8-fold, but hCG did not modify the stimulatory effect of propranolol on TIF volume. These results demonstrate a direct stimulatory effect of propranolol on TIF volume and testosterone secretion, both under basal and hCG-stimulated conditions.

Clearance of a chylomicron-like emulsion from plasma is delayed in patients with coronary artery disease

To determine whether the metabolism of chylomicrons and their remmants is related to atherogenesis, a triglyceride-rich emulsion known to mimic chylomicron behavior in plasma and labeled with 1-14C-cholesteryl oleate was injected intravenously into 11 normolipidemic patients (triglycerides: 133 + or - 60 mg/dl; total cholesterol: 207 + or - 20 mg/dl; LDL: 143 + or - 20 mg/dl; VLDL: 27 + or - 13 mg/dl; and HDL cholesterol: 41 + or - 11 mg/dl; apo AI: 1.27 + or - 0.54 g/l and apo B: 1.42 + or - 0.31 gl) with atherosclerotic coronary artery disease and into 11 control subjects (triglycerides: 109 + or - 32 mg/dl; total cholesterol: 190 + or - 38 mg/dl; LDL: 125 + or - 29 mg/dl; VLDL: 22 + or - 6 mg/dl; and HDL cholesterol: 44 + or - 9 mg/dl; apo AI: 1.09 + or - 0.28 g/land apo B: 1.09 + or - 028 g/l) without the disease. The emulsion (69 percent triolein, 23 percent lecithin, 6 percent cholesteryl oleate and 2 percent cholesterol) was injected intravenously at approximately 9:00 a.m., after a 12-h fast. The clearance of the emulsion label from plasma, expressed as fractional clearance rate (FCR), was lower in coronary artery disease compared to controls (0.019 + or - 0.005/min vs 0.036 + or - 0.018/min, respectively, P<0.05). These results indicate that the rate of removal of chylomicron remmants is slower in patients with coronary artery disease

Symptomatic environmental enteropathy in infancy: bacterial proliferation, funcional and morphological alterations of the small bowel

Asymptomatic Environmental enteropathy may occur in the low social economic stratum of the population temporarily, thus contributing to marginal malnutrition. Bacterial proliferation in the upper portions of the small bowel may be responsible for alterations in the digestive-absorptive function leading to nutritional dwarfism. Forty infants of the Cidade Leonor slum who were under one year of age and presented with asymptomatic environmental enteropathy were investigated for digestive-absorptive function, bacterial proliferation in the small bowel lumen, and jejunal morphology. The mean value of the D-xylose absorption test was 21.0 ñ 10.0 mg per cent, significantly lower than controls (48.0 ñ 13.8 mg per cent) (p < 0.001). Bacterial proliferation in the small bowel of the colonic type was identified in 25 (62,5 per cent) of the infants and jejunal mucosa abnormalities were found in 29(72.5 per cent) of the specimens. Grade II villous atrophy was the most frequent alteration found. The inflammatory infiltration in the lamina propria increased in the total group, varying from light to severe. Alterations in the microecology of the small intestine can occur even in the absence of diarrhea. Therefore, the nonexistence of symptoms does not necessarily imply a condition of weillbeing. If true measures are proposed to improve the quality of life in these poor communities the whole infant population must be taken into account and not only the group with overt symptoms

Stress-induced desensitization of the cardiovascular response to noradrenaline in unanesthetized rats

The present study was undertaken in order to analyse the effect of swimming stress on the blood pressure response to noradrenaline (NA) in unanesthetized rats. Suwimming induced a desensitization of the blood pressure response to NA which was not blocked by previnous animal treatment with prazosin (0.1 mg/Kg). However, rats submitted to stress showed increased sensitivity to the prazosin blocking effect. The results suggest that swimming-induced desensitization of the cardiovascular response to NA is mediated by alpha rather than beta-1 adrenoceptors

Bacteriological and epidemiological aspects of the diagnosis of Mycobacterium tuberculosis as the etiological agent of menigitis

Difficulties facing bacteriological diagnosis of meningitis are frequent, specially those caused by mycobacteria. From 1983 to 1987 samples of cerebrospinal fluid (CSF) from 16,921 patients mainly from the Emílio Ribas Hospital, SP, with clinical signs of meningitis were examined at the Instituto Adolfo Lutz, SP. 2,951 of the patients were diagnosed as being cases of bacterial meningitis, 134 of which tuberculous meningitis (4.5 per cent). 40.2 per cent were individuals of age 0-4 years, 52.3 per cent over 14 years and 7.5 per cent of unknown age. Tuberculous meningitis was clinically suspected in 51.5 per cent of the cases, while in the remaining cases (48.5 per cent) it was detected mainly because of the routine investigation of mycobacteria in CSF. Considering that the laboratory does not always receive a request to analyze M. tuberculosis in CSF and that, in terms of public health, tuberculosis is still an important problem, a careful study of mycobacteria in suspect cases of meningitis is recommended.

Distribuicao de oftalmologistas nas diferentes mesorregioes, estados do Brasil e cidades brasileiras mais populosas e respectivos indices de oftalmologistas por numero de habitantes e oftalmologistas por numero de medicos. / Distribution of ophtalmologists in the different regions and states of Brazil and the most populous cites and the respective register of ophthalmologists by number of inhabitants and ophthalmologists by number of physicians

Foi realizado um levantamento do numero de oftalmologista existentes no Brasil que comparado com a populacao nos forneceu o indice de oftalmologistas por numero de habitantes no Brasil,em todos os estados e territorios, em suas mesorregioes e nas 10 cidades mais populosas do pais.Procedeu-se ainda um levantamento do numero de medicos e a relacao medico/oftalmologista para cada estado da federacao. Para uma populacao estimada de 128.302.000 habitantes, o Brasil possui 4.896 oftalmologistas perfazendo uma proporcao de 1:26.205 habitantes, muito proximo do ideal preconizado pelos orgaos internacionais de saude de 1:20.000 habitantes. Porem, podemos observar diferenca significante nessa proporcao quando analisamos isoladamente cada estado, suas mesorregioes e cidades mais populosas do Brasil. Notamos assim, regioes brasileiras como a Hileia Paraense, com uma populacao de quase 700.000 habitantes para nenhum oftalmologista, ao passo que na cidade de Porto Alegre (RS) encontramos uma relacao de aproximadamente 1 oftalmologista para 5.000 habitantes

Distribuicao dos oftalmologistas nas diferentes regioes e municipos do estado de Sao Paulo e respectivos indices oftalmologistas por numero de habitantes e de oftalmologistas por numero total de medicos. / Distribution of ophthalmologists in the different regions and municipalities of Sao Paulo State (Brazil) and the respective ratio of ophthalmologists by the number of inhabitants and ophthalmologists by the total number of physicians

No presente trabalho, procedeu-se ao estudo do numero de oftalmologistas numero total de medicos, porcentagem de oftalmologistas em relacao ao numero de medicos populacao geral e indice de oftalmologista por numero de habitantes, para cada municipio e regiao do Estado de Sao Paulo. O Estado de Sao Paulo possui 1.583 oftalmologistas e uma populacao estimada para 1983 de 28 milhoes de habitantes, isto representa um indice oftalmologista/numero de habitantes de 1:17.687. Esse indice, existente em praticamente todas as regioes do Estado, e muito proximo ao indice de 1: 20.000 sugerido por Orgaos Internacionais de Saude. Encontramos 439 municipios sem oftalmologistas residentes o que pode indicar uma distribuicao irregular de oftalmologistas no Estado de Sao Paulo

A formacao do psiquiatra brasileiro. / The education of the Brazilian psychiatrist

A autora trabalha com o conceito de modelo ideal do psiquiatra, necessariamente associado ao processo educativo proposto. Em seguida, tece consideracoes criticas a expressao "realidade brasileira", categoria classificatoria excessivamente globalizante e insatisfatoria quando se pretende uma analise mais profunda da questao. Prefedo referir-se a formacao do psiquiatra capacitado a trabalhar com os pobres, aponta distorcoes na formacao do especialista e na expectativa da clientela. Finalmente, enfatiza a necessidade do psiquiatra de assumir uma atitude ativa, alicercada no conhecimento de sua comunidade e nas normas de sua propria sub-cultura profissional