Plaquetopenia grave em paciente etilista com infecção por vírus da imunodeficiência humana / Severe thrombocytopenia in an alcoholic patient with human immunodeficiency virus infection

A infecção por vírus da imunodeficiência humana e síndrome da imunodeficiência adquirida constituem importantes problemas de saúde pública em todo o mundo e a plaquetopenia tem sido um achado frequente nesse grupo populacional. Os mecanismos da citopenia são multifatoriais e ainda não estão completamente esclarecidos. Fatores que agravam a plaquetopenia incluem coinfecção por hepatite C e cirrose hepática. O objetivo desse relato é exemplificar o caso de um paciente com o vírus, cirrose alcoólica e plaquetopenia grave, abaixo de 5.000/mm3, corrigida com a administração de corticosteroide.

Infection with human immunodeficiency virus infection and acquired immunodeficiency syndrome is a serious public health issue worldwide, and thrombocytopenia has been a frequent finding among this group of patients. The mechanisms of this cytopenia are multifactorial and have not been completely understood. Factors that worsen thrombocytopenia include hepatitis C coinfection and hepatic cirrhosis. The aim of this report is to describe the case of an human immunodeficiency virus infection patient with alcoholic cirrhosis and severe thrombocytopenia, above 5,000/mm3, which was treated with corticosteroid use.

Evaluating methods for the isolation of marine-derived fungal strains and production of bioactive secondary metabolites

In the present investigation we evaluate methods for the isolation and growth of marine-derived fungal strains in artificial media for the production of secondary metabolites. Inoculation of marine macroorganisms fragments in Petri dishes proved to be the most convenient procedure for the isolation of the largest number of strains. Among the growth media used, 3% malt extract showed the best result for strains isolation and growth, and yielded the largest number of strains from marine macroorganisms. The percentage of strains isolated using each of the growth media which yielded cytotoxic and/or antibiotic extracts was in the range of 23-35%, regardless of the growth media used. Further investigation of extracts obtained from different marine-derived fungal strains yielded several bioactive secondary metabolites, among which (E)-4-methoxy-5-(3-methoxybut-1-enyl)-6-methyl-2H-pyran-2-one is a new metabolite isolated from the Penicillium paxilli strain Ma(G)K.

Aspectos clínicos da mucopolissacaridose tipo VI / Clinical aspects of mucopolysaccharidosis type VI

JUSTIFICATIVA E OBJETIVOS: Este estudo visou destacar os principais sinais clínicos para a suspeita diagnóstica da mucopolissacaridose do tipo VI (MPS VI). Desta feita, espera-se que os profissionais de saúde aprofundem seus conhecimentos relacionados ao tema e identifiquem precocemente os pacientes portadores desta síndrome, possibilitando um tratamento adequado e, consequentemente, minimizando sequelas. CONTEÚDO: Realizou-se uma pesquisa ao banco de dados do MedLine/PubMed e do Pediatrics (Journal of the American Academy of Pediatrics) com a palavra-chave "Maroteaux-Lamy" selecionando-se apenas os estudos de livre acesso. Foram encontrados 19 estudos nas bases de dados consultadas, no período de setembro de 2009 a fevereiro de 2010. CONCLUSÃO: A MPS VI é uma doença autossômica recessiva cuja etiologia relaciona-se à atividade deficiente da hidrolase lisossômica N-acetilgalactosamina 4-sulfatase, ou arilsulfatase B. A maioria dos pacientes apresenta os primeiros sinais da doença na infância (hepatoesplenomegalia, face infiltrada e alterações na coluna). Com a sua evolução, os pacientes passam a apresentar alterações em vários órgãos e tecidos, que podem incluir: retardo de crescimento; contraturas flexionais de dedos, joelhos ou ombros; alterações cardiovasculares (estenose de valvas, regurgitação e cardiomegalia); alterações oculares (opacificação de córnea, glaucoma e papiledema com atrofia ótica); alterações neurológicas (hidrocefalia e compressão medular) e síndrome da apneia obstrutiva do sono. As complicações cardiorrespiratórias são progressivas e podem levar o paciente ao óbito, sendo imprescindível a identificação precoce da doença e instituição de terapêutica adequada.

BACKGROUND AND OBJECTIVES: This study aims to highlight the main clinical criteria for suspected diagnosis of mucopolysaccharidosis type VI (MPS VI). Consequently, we hope that the health professionals learn a little more about MPS VI and can identify patients with the syndrome in time to make appropriate treatment and thus minimize sequels. CONTENTS: We searched the database of MedLine/PubMed and Pediatrics (Journal of the American Academy of Pediatrics) with the keyword "Maroteaux-Lamy" by selecting only the open access studys. We found 19 studys in the databases consulted in the period of September 2009 to February 2010. CONCLUSION: MPS VI is an autosomal recessive disease whose etiology is related to deficiency of lysosomal hydrolase N-acetylgalactosamine 4-sulfatase, or arylsulfatase B. Most patients show early signs of disease in childhood (hepatosplenomegaly, facial infiltration and changes in column). With the evolution of the disease the patients started to show abnormalities in many organs and tissues, which may include: growth retardation; inflectional contractures of the fingers, knees or shoulders; cardiovascular disorders (stenosis, valve regurgitation and cardiomegaly); eyes (opacification cornea, glaucoma, and papilledema with optic atrophy); neurological disorders (hydrocephalus and spinal cord compression) and syndrome of obstructive sleep apnea. Cardiorespiratory complications are progressive and can lead the patient to death; due to this fact is essential early identification of disease and institution of therapy.