Lesions caused by anisakid and capillariid in Cairina moschata raised on Marajó island, state of Pará, Brazil / [Lesões por anisakideos e capillariideos em Cairina moschata criados na Ilha de Marajó, estado do Pará, Brasil]

The Muscovy duck is a commercially important bird on the island of Marajó usually raised in a peculiar system that includes supplying fish viscera to the birds under semi-extensive farming conditions. This enables a risk of contamination and losses in the production of these birds, resulting from injuries caused by helminth infections, especially nematodes. The objective of this study was to evaluate the histopathological changes caused by nematodes of the genera: Eucoleus, Anisakis and Contracaecum. Thirty-three ducks with lesions in the esophagus and ventricle were analyzed. Histopathological exams showed a mild inflammatory infiltrate in the submucosa of the esophagus caused by the fixation of E. contortus and third stage larvae of Anisakis sp., and we recorded third stage larvae of Contracaecum sp. parasitizing the ventricle, this being the first record of this parasite in ducks in Brazil.(AU)

O pato doméstico é uma ave amplamente comercializada na Ilha de Marajó, com um peculiar manejo que inclui a oferta de vísceras de peixes aos animais em criações semiextensivas, propiciando, assim, risco de contaminação e perdas na produção dessas aves decorrentes de lesões oriundas de infecções por helmintos, especialmente os nematódeos. Nesse sentido, objetivou-se avaliar as alterações histopatológicas causadas por nematódeos dos gêneros: Eucoleus, Anisakis e Contracaecum. Foram analisados 33 patos, e três exemplares apresentaram lesões no esôfago e no ventrículo. Exames histopatológicos demonstraram discreto infiltrado inflamatório na submucosa do esôfago ocasionado pela fixação de E. contortus e larvas de terceiro estágio de Anisakis sp., bem como foram registradas larvas de terceiro estágio de Contracaecum sp. parasitando o ventrículo, sendo esse o primeiro registro desse parasito em patos no Brasil.(AU)

Efeito da suplementação parenteral extra de cobre e zinco sobre a resposta imunológica de vacas Nelore / Effects of parenteral over-supplementation of cooper and zinc on immune response of Nellore cows

O objetivo deste estudo foi avaliar o efeito da suplementação mineral injetável extra de cobre (Cu) e zinco (Zn) sobre a resposta imunológica de vacas Nelore no período pré-parto. Foram avaliadas 60 vacas prenhes, as quais foram divididas em dois tratamentos, por meio da distribuição aleatória em delineamento inteiramente ao acaso. Aos 75 dias antes do parto, as vacas do tratamento testemunha (T) receberam soro fisiológico como placebo e os animais suplementados (S) receberam mineral injetável via subcutânea (75mg de cobre e 250mg de zinco, em dose única). Foram realizadas três coletas de sangue, duas antes da data prevista para o parto (75 e 10 dias) e uma 30 dias após o parto. Os teores de Cu, Zn, ceruloplasmina, imunoglobulinas G (IgG) e M (IgM) foram analisados durante as três coletas. A atividade fagocitária foi avaliada aos 30 dias pós-parto. Os dados foram examinados mediante análise de variância, com o uso do pacote estatístico do SAS, e os dados individuais da atividade fagocitária pelo PROC GLM. Os dados de Cu, Zn, IgG e IgM foram analisados como medidas repetidas no tempo de coleta por meio do PROC MIXED, com o nível de significância de 5%. Os teores de Cu, Zn, IgM, IgG, ceruloplasmina e a atividade fagocitária das vacas não sofreram influência dos tratamentos (P>0,05). O fornecimento de Cu e Zn injetável, nas doses utilizadas, aos 75 dias antes do parto para vacas Nelore, em dietas suficientes, não alterou os teores de Cu, Zn, ceruloplasmina e a resposta imunológica até 30 dias após o parto.(AU)

The aim of this study was to evaluate the effect of extra injectable mineral supplementation of copper (Cu) and zinc (Zn) on the immune response of Nellore cows in pre-partum period. Sixty pregnant cows were randomly distributed in a completely randomized design in two treatments. In the control treatment (T), cows received saline as placebo, and supplemented treatment (S) received mineral injection (75mg copper and 250mg of zinc, single dose) subcutaneously, 75 days prior to parturition. Blood was sampled three times, two before the expected date of parturition (75 and 10 days) and another at 30 days postpartum. Analyses were performed for Cu, Zn, ceruloplasmin, immunoglobulin G (IgG) and M (IgM) in the three periods and the phagocytic activity in the last period (30 days postpartum). The experimental data were subjected to analysis of variance using the statistical package SAS, being that the individual data phagocytic activity were analyzed by PROC GLM, and the Cu, Zn, IgG and IgM were analyzed as repeated measures in the time, using the PROC MIXED, with the significance level of 5%. The Cu, Zn, IgM, IgG, ceruloplasmin and the phagocytic activity of the cows were not affected by treatments (P>0.05). The supply of injectable Cu and Zn, at the doses used, 75 days before parturition to Nellore cows in sufficient diets, did not alter the serum contents of Cu, Zn, ceruloplasmin and the immune response up to 30 days after parturition.(AU)

Assessment of indicators of vitamin A status in non-cirrhotic chronic hepatitis C patients

Subjects with chronic liver disease are susceptible to hypovitaminosis A due to several factors. Therefore, identifying patients with vitamin deficiency and a requirement for vitamin supplementation is important. Most studies assessing vitamin A in the context of hepatic disorders are conducted using cirrhotic patients. A cross-sectional study was conducted in 43 non-cirrhotic patients with chronic hepatitis C to evaluate markers of vitamin A status represented by serum retinol, liver retinol, and serum retinol-binding protein levels. We also performed the relative dose-response test, which provides an indirect estimate of hepatic vitamin A reserves. These vitamin A indicators were assessed according to the stage of liver fibrosis using the METAVIR score and the body mass index. The sample study was predominantly composed of male subjects (63%) with mild liver fibrosis (F1). The relative dose-response test was <20% in all subjects, indicating vitamin A sufficiency. Overweight or obese patients had higher serum retinol levels than those with a normal body mass index (2.6 and 1.9 µmol/L, respectively; P<0.01). Subjects with moderate liver fibrosis (F2) showed lower levels of serum retinol (1.9 vs 2.5 µmol/L, P=0.01) and retinol-binding protein levels compared with those with mild fibrosis (F1) (46.3 vs 67.7 µg/mL, P<0.01). These results suggested an effect of being overweight on serum retinol levels. Furthermore, more advanced stages of liver fibrosis were related to a decrease in serum vitamin A levels.

Avaliação do processo de reestruturação da assistência farmacêutica no município de Aracaju-SE / Assessment of the restructuring of pharmaceutical services in the city of Aracaju (SE, Brazil)

O objetivo do estudo é avaliar o efeito da reestruturação da Assistência Farmacêutica (AssistFar) no município de Aracaju-SE. Foi realizado um estudo retrospectivo longitudinal, de fevereiro a junho de 2011. Para avaliação da Assistência Farmacêutica foi utilizado um banco de dados documental, gerado pelo "Sistema de Controle de Administração de Materiais" e aplicaram-se os indicadores do Instrumento de Auto-Avaliação para o Planejamento da Assistência Farmacêutica (IAPAF) do ?Planejar é Preciso?, que aborda tópicos de acordo com o ?Ciclo da Assistência Farmacêutica?. A aplicação do instrumento foi realizada em três momentos na prática da AssistFar no município de Aracaju. Para análise de cada indicador levou-se em consideração os níveis de qualidade classificados de 1 a 3, sendo o nível 3 o melhor estágio. A maioria dos resultados evidenciou o fortalecimento da gestão após a criação de procedimentos e a inclusão de estratégias de monitoramento dos indicadores de avaliação no plano municipal de saúde. As etapas de institucionalização dos serviços perante a gestão foram as que apresentaram os melhores resultados. Enquanto que a etapa de prescrição foi considerada a mais crítica do processo. Os dados mostram que a falta de ações de desenvolvimento da AssistFar contribuíram para a presença de resultados insatisfatórios, principalmente nas etapas de prescrição e dispensação, sinalizando a necessidade de elaborar uma estratégia de gestão que vise sua reformulação. Neste cenário, é preciso incorporar às equipes de saúde mais farmacêuticos que atuem em todas as etapas da AssistFar, promovendo uma gestão racional de medicamentos...

The objective of the study was to evaluate the effect of the restructuring of Pharmaceutical Services (AssistFar) in the city of Aracaju (capital of Sergipe, Brazil). We conducted a retrospective, longitudinal survey, from February to June 2011. A document database generated by the "Materials Management Control System" was analyzed, to assess the pharmaceutical services, by applying the indicators of the Self-Assessment Instrument for Pharmaceutical Services Planning (IAPAF) that are defined in the government-proposed" Planning is Necessary" method, which covers topics referring to the various steps in the "Cycle of Pharmaceutical Services". This instrument was applied to three stages in the practice of AssistFar in the city of Aracaju, within the study period. For each indicator, the quality of each step was graded from 1 to 3, level 3 being the best. Most results showed a strengthening of management after the establishment of procedures and inclusion of strategies for monitoring the quality indicators, for the municipal health plan. Steps towards the institutionalization of management services showedthe best results. In contrast, the step of prescription was considered the most critical of the Cycle. The data showed that the lack of AssistFar development actions contributed to the unsatisfactory results, especially in the steps of prescribing and dispensing, signaling the need to develop a management strategy that aims to recast it. In this scenario, it will be necessary to involve the health teams, plus the pharmacists, in the work at all stages of AssistFar, promoting the rational management of medicines...

Desempenho bioeconômico de sistemas intensivos de cria e de ciclo completo por meio de simulação / Bioeconomic performance of intensive breeding systems and of full-cycle by way of simulation

Foram simulados quatro sistemas de produção de bovinos de corte a partir de dados zootécnicos e econômicos de uma fazenda de ciclo completo situada no município de Corinto, região central de Minas Gerais. Utilizou-se o programa de simulação bioeconômica Embrapec. Os sistemas simulados foram: ciclo completo com uso de cruzamento industrial (CompCRUZA), ciclo completo exclusivamente com zebuíno (CompZEBU), ciclo de cria com uso de cruzamento industrial (CriaCRUZA), ciclo de cria exclusivamente com zebuíno (CriaZEBU). No sistema com cruzamento industrial, os animais eram vendidos logo após a desmama, com oito meses (CriaCRUZA), ou abatidos aos 13 meses (CompCRUZA). No sistema com rebanho zebu, os animais eram também vendidos à desmama (CriaZEBU) ou abatidos aos 24 meses (CompZEBU). As bezerras foram recriadas, e uma parcela (15%), descartada para a venda. A quantidade de animais em um rebanho estabilizado foi 13,1% e 10,7% menor nos sistemas cruzados, completo e cria, respectivamente; porém a quantidade (kg) de carcaça vendida/ha (49,9 para CriaCRUZA e 118,1 para CompCRUZA) e a taxa de desfrute (24,4%) foram em média 15,3% maior que zebuínos. A taxa interna de retorno e o valor presente líquido foram superiores para os sistemas que adotaram o cruzamento de zebuínos com raças europeias, CriaCRUZA (17,2% e R$ 10.151.896,54) e CompCRUZA (18,9% e R$ 11.749.329,42). Quando comparados os sistemas de produção, os que utilizaram ciclo completo, o CompCRUZA (18,9% e R$ 11.749.329,42) e CompZEBU (16,2% e R$ 9.568.293,51), foram em média 18,7% maiores que os de cria, quando comparados com o mesmo grupo genético, CriaCRUZA (17,2% e R$ 10.151.896,54) e CriaZEBU (14,6% e R$ 7.955.230,38). Todos os sistemas de produção simulados foram economicamente viáveis, sendo que o sistema de produção CompCRUZA foi que apresentou maior viabilidade econômica e com melhores indicadores zootécnicos.

Four alternative systems of production from zootechnical and economic beef cattle data were simulated from an existing full-cycle farm located in Corinto, state of Minas Gerais, Brazil. The systems simulated were: full-cycle with the use of crossbreed cattle (CompCRUZA), full cycle, exclusively with zebu cattle (CompZEBU), rearing cycle with the use of crossbreed cattle (CriaCRUZA) and rearing cycle with zebu cattle (CriaZEBU). The crossbreeding system animals were sold immediately after weaning with 8 months (CriaCRUZA) or slaughtered with 13 months (CompCRUZA). The zebu cattle system animals were also sold after weaning (CriaZEBU) or slaughtered with 24 months (CompZEBU). The female calves were reared and 15% were destined for sale. The data was simulated on the bioeconomic software "Embrapec". The number of animals in the stabilized herd was lower in cross-systems, but the amount (kg) of carcass sold/ha (49.9 for CriaCRUZA and 118.1 for CompCRUZA) and offtake rate (24.4%) were superior to zebu cattle. The internal rate of return and net present value was higher for systems that have adopted the crossing system (taurine x zebu cattle), CriaCRUZA (17.2% and R$ 10,151,896.54) and CompCRUZA (18.9% and R$ 11,749,329.42). When comparing the production systems, those using full-cycle, the CompCRUZA and CompZEBU (16.2% and R$ 9,568,293.51), were more profitable than rearing systems, when compared with the same genetic group, CriaCRUZA and CriaZEBU (14.6% to R$ 7,955,230.38. All production systems simulated were financially feasible, but the production systemCompCRUZA showed the highest economic viability and better zootechnical indicators.

Pesquisa de anticorpos anti-Brucella abortus e anti-Brucella ovis em ovinos no município de Uberlândia, MG / Research of Brucella abortus and Brucella ovis antibodies in sheep of Uberlândia county, MG, Brazil

The first epidemiologic inquiry to Brucella abortus (B. abortus) and Brucella ovis (B. ovis) was carried out in sheep from Uberlândia county, MG. A total of 334 blood serum samples of sheep from both sexes and different ages and breeds were collected in 12 farms. An epidemiologic questionnaire was applied for each farm. Tests for B. abortus and B. ovis antibodies were Buffered Acidified Antigen and Complement Fixation, respectively. None of the sheep was reactive to B. abortus and B. ovis; however, the adoption of sanitary measures is important to avoid the introduction of infections caused by these bacteria.

Scanning electron microscopic evaluation of the successful sterilization of Lucilia cuprina (Wiedemann) utilized in maggot debridement therapy (mdt)

In Malaysia, maggot debridement therapy (MDT) utilizes maggots of Lucilia cuprina (Wiedemann) to debride necrotic tissue from wound surface, reduce bacterial infection and therefore, enhance wound healing process. To evaluate the sterility of the sterile maggots produced after sterilization process before delivering onto patient wounds. Sterility of sterile maggots is crucial in ensuring the safe usage of MDT and patient’s health. Eggs of L. cuprina collected from a laboratory colony were divided into treated group (sterilized) and control group (non-sterilized). Treated group underwent sterilization while eggs from control group were allowed to hatch without sterilization. Sodium hypochlorite and formaldehyde were the main disinfectants used in this sterilization process. Scanning electron microscope (SEM) was used to examine and ascertain the sterility of sterile maggots. SEM results showed that all sterilized L. cuprina eggs and maggots achieved sterility and all were cleared from bacterial contamination. In contrast, all non-sterilized eggs and maggots were found to be colonized by microorganisms. Sterilization method employed to sterilize eggs and maggots used in Malaysia MDT was proven successful and MDT is safe to be used as wound management tools.

Evaluación de osteoporosis y ateroesclerosis carotídea en relación a enfermedad cerebrovascular oclusiva / Assessment of correlation between occlusive cerebrovascular disease and osteoporosis and carotid atherosclerosis

Objetivo: Determinar la asociación existente entre las manifestaciones ateroescleróticas carotídeas y la osteoporosis, en pacientes con enfermedad cerebrovascular oclusiva (ECVO). Método: Estudiamos 115 pacientes con diagnóstico clínico tomográfico de ECVO desde junio 2007 a junio 2009, a los que se les realizó ultrasonido Doppler color carotídeo y densitometría de columna lumbosacra y caderas. Resultados: No hallamos correlación entre el valor de la densidad mineral ósea (DMO) y la magnitud del daño aterosclerótico carotídeo; encontramos correlación moderada positiva entre el índice de masa corporal y la DMO. La mayoría de los factores de riesgo se asociaron con incremento del grosor íntima media, índice aterogénico aumentado y baja prevalencia de estenosis significativa, así como osteopenia densito-métrica, siendo el envejecimiento y la hipertensión los factores predominantes. Conclusiones: La osteoporosis y las manifestaciones ateroescleróticas carotídeas en la ECVO no guardan relación, más allá de la presencia de factores de riesgo en común.

Objective: To determine the association between carotid atherosclerotic manifestations and osteoporosis in patients with occlusive cerebrovascular disease (OCVD). Method: From June 2007 to June 2009 115 patients with clinical tomographic diagnosis of ECVO, who underwent carotid artery-Color Doppler Ultrasound exams as well as lumbar spine and hip bone densitometry, were studied. Results: No correlation between the value of bone mineral density (BMD) and the magnitude of carotid atherosclerotic damage was observed. There was a moderate positive correlation between Body Mass Index (BMI) and BMD. Most risk factors were associated with increased intima media thickness, increased atherogenic index, low rates of significant stenosis, and densitometric osteopenia, with aging and hypertension as predominant factors. Conclusions: Despite the presence of shared risk factors, no correlation between osteoporosis and atherosclerotic manifestations in the carotid artery in OCVD was observed.

Qualidade microbiológica de queijo-coalho comercializado em Aracaju, SE / Microbial quality of “coalho” cheese commercialized in Aracaju, SE

Determinou-se a ocorrência de Staphylococcus aureus, Salmonella spp. e de microrganismos indicadores de contaminação fecal em queijos-coalho comercializados em 15 pontos de venda do Mercado Central de Aracaju, SE, durante quatro meses. Dezesseis amostras (26,7 por cento) foram positivas para Salmonella spp. e 28 (46,7 por cento) positivas para estafilococos coagulase positiva. Quanto à contaminação por coliformes totais, 56 (93,3 por cento) das amostras apresentaram valores entre 8,0 x10² e 1,23 x10(4)NMP/g, e de 2,72 x10² a 1,12 x10³NMP/g para coliformes termotolerantes. Estes valores não atenderam à legislação brasileira para queijo-coalho e as amostras analizadas podem ser classificadas como impróprios ao consumo humano.

The occurrence of Staphylococcus aureus, Salmonella spp., and microorganisms indicators of fecal contamination in "coalho"cheese commercialized in 15 retail store at the Central Market of Aracaju, SE during four months was determined. Sixteen samples (26.7 percent) were positive for Salmonella spp. and 28 (46.7 percent) for coagulase positive staphylococci. In relation to contamination by total coliforms, 56 samples (93.3 percent) presented values from 8.0 x10² to 1.23 x10(4)NMP/g; and for thermal tolerant coliforms, from 2.72 x10² to 1.12 x10³NMP/g. These values are not acceptable for the Brazilian legislation for "coalho" cheese. This indicates that the analyzed products were inappropriate to the human consumption.

Hepatitis B virus genotype E detected in Brazil in an African patient who is a frequent traveler

Genotype E of hepatitis B virus (HBV) has not been described in Brazil and is found mainly in Africa. Genotype A is the most prevalent in Brazil, and genotypes B, C, D, and F have already been reported. We report here an HBV genotype E-infected patient and some characterization of surface (S) protein, DNA polymerase (P) and precore/core (preC/C) coding regions based on the viral genome. The patient is a 31-year-old black man with chronic hepatitis B who was born and raised in Angola. He has been followed by a hepatologist in São Paulo, Brazil, since November 2003, and he is a frequent traveler to Latin America, Africa, and Europe. In 2003, he was diagnosed with HBV infection and started treatment with lamivudine with the later addition of adefovir dipivoxil. No known risk factor was identified. Serologically, he is HBsAg and anti-HBe positive, but HBeAg and anti-HBs negative. DNA sequence analysis of the S/P region confirmed that this patient is infected with genotype E, subtype ayw4. The preC/C region showed G1896A and G1899A mutations but no mutations in the basal core promoter. Nucleotide substitutions common in genotype E were also observed (C1772, T1858 and A1757). Although this is not an autochthonous case and there is no evidence of further spread, the description of this case in Brazil highlights the current risk of viral genotypes spreading with unprecedented speed due to constant travel around the world.

Comparison of the effectiveness of initial combined antiretroviral therapy with nelfinavir or efavirenz at a university-based outpatient service in Brazil

Since there are some concerns about the effectiveness of highly active antiretroviral therapy in developing countries, we compared the initial combination antiretroviral therapy with zidovudine and lamivudine plus either nelfinavir or efavirenz at a university-based outpatient service in Brazil. This was a retrospective comparative cohort study carried out in a tertiary level hospital. A total of 194 patients receiving either nelfinavir or efavirenz were identified through our electronic database search, but only 126 patients met the inclusion criteria. Patients were included if they were older than 18 years old, naive for antiretroviral therapy, and had at least 1 follow-up visit after starting the antiretroviral regimen. Fifty-one of the included patients were receiving a nelfinavir-based regimen and 75 an efavirenz-based regimen as outpatients. Antiretroviral therapy was prescribed to all patients according to current guidelines. By intention-to-treat (missing/switch = failure), after a 12-month period, 65 percent of the patients in the efavirenz group reached a viral load <400 copies/mL compared to 41 percent of the patients in the nelfinavir group (P = 0.01). The mean CD4 cell count increase after a 12-month period was also greater in the efavirenz group (195 x 10(6) cells/L) than in the nelfinavir group (119 x 10(6) cells/L; P = 0.002). The efavirenz-based regimen was superior compared to the nelfinavir-based regimen. The low response rate in the nelfinavir group might be partially explained by the difficulty of using a regimen requiring a higher patient compliance (12 vs 3 pills a day) in a developing country.

Effect of the intracerebroventricular administration of GR 113808, a selective 5-HT4 antagonist, on water intake during hyperosmolarity and hypovolemia

We demonstrate here that acute third ventricle injections of GR 113808, a highly selective 5-HT4 antagonist, decrease water intake induced by a previous salt load while potentiating drinking elicited by hypovolemia induced by previous subcutaneous administration of polyethylene glycol in male Wistar rats (200 + or - 20 g). At the dose of 160 nmol/rat, third ventricle injections of GR 113808 induced a significant reduction of water intake in salt-loaded animals after 120 min as compared to salt-loaded animals receiving third ventricle injections of saline (salt load + GR = 3.44 + or - 0.41 ml, N = 12; salt load + saline = 5.74 + or - 0.40 ml, N = 9). At the dose of 80 nmol/rat, GR 113808 significantly enhanced water intake in hypovolemic animals after 120 min as compared to hypovolemic animals receiving third ventricle injections of saline (hypovol + GR = 4.01 + or - 0.27 ml, N = 8; hypovol + saline = 2.41 + or - 0.23 ml, N = 12). We suggest that central 5-HT4 receptors may exert a positive drive on water intake due to hyperosmolarity and a negative input on drinking provoked by hypovolemia.

Enfermedad de Creutzfeldt-Jakob en Venezuela: informe de 10 casos y revisión de la literatura / The Creutzfeldt-Jakob disease in Venezuela: report of 10 cases and revition of the literature

La enfermedad de Creutzfeldt-Jakob (ECJ) es una encefalopatía espongiforme transmisible infrecuente y de amplia distribución mundial. Su incidencia en Venezuela es desconocida y sólo 5 casos previos han sido publicados. Se presentan en este informe 10 casos estudiados en los últimos 27 años. La confirmación del diagnóstico fue realizada mediante el estudio histológico y estructural de muestras del cerebro y/o cerebelo, obtenidas por biopsia en 3 casos y por autopsia en 7. El promedio de edad fue de 60,1 años. El intervalo entre el inicio de los síntomas y muerte fue de 4,5 meses. Todos los pacientes presentaron un síndrome demencial rápidamente progresivo asociado a signos piramidales y extrapiramidales, mioclonos y cambios en el electroencefalograma. El examen histológico reveló en todos los casos degeneración espongiosa, astrogliosis y pérdida neuronal en la sustancia gris de la corteza cerebral, núcleos basales y cerebelo. Desde el punto de vista estructural, las áreas afectadas en 4 casos estudiados mostraron vacuolización extensa del neurópilo, degeneración neuronal y prolongaciones astrogliales con numerosos filamentos intermedios. Ningún caso tenía antecedente familiar ni causa iatrogénica probable de la enfermedad. Se plantea la posibilidad de un subregistro de la ECJ en Venezuela y la importancia epidemiológica que tiene el conocimiento de esta entidad clínico-patológica en el diagnóstico diferencial de los diferentes tipos de trastornos demenciales

Avaliaçäo de nitratos de açäo rápida através de dados clínicos e teste de esforço / Evaluation of rapid action of nitrates through clinical data and exercise test

Foram estudados os efeitos do dinitrato de isossorbitol e propatilnitrato, administrados por via sublingual, comparados aos do placebo, através da análise de dados clínicos e das respostas cardiovascular e eletrocardiográfica durante o teste de esforço, em 14 pacientes do sexo masculino portadores de aterosclerose e insuficiência coronária crônica. Todos apresentavam resposta positiva (isquêmica) ao teste de esforço máximo, em cicloergômetro, caracterizado por infradesnivelamento do segmento ST >=1,0mm, de morfologia horizontal e/ou descendente. A idade dos pacientes variou de 40 a 70 anos, sendo a média de 53,7 anos. A investigaçäo foi dividida em quatro fases: controle (A), durante a administraçäo de dinitrato de isossorbitol (B), propatilnitrato (C) e placebo (D), a intervalos de seis horas durante oito dias. Evidenciaram-se reduçöes näo significativas do número de crises anginosas, dos nitratos consumidos, das queixas de palpitaçäo e dispnéia nas fases B e C em relaçäo as fases A e D. O aparecimento de cefaléia foi maior (p<0,05) na fase B do que nas fases A, C e D. Durante o uso de ambos os nitratos foram observadas variaçöes näo significativas da freqüência cardíaca das pressöes arteriais e do duplo-produto, aumento do índice carga-tempo, do trabalho físico máximo (Tfm) e de suas relaçöes com a pressäo arterial sistólica (PAS) e o duplo-produto, sendo o aumento do Tfm e da relaçäo Tfm/PAS significativo na fase B (p<0,5)

Tratamento do queixo senil: descriçäo da técnica / Treatment of the senile chin: description of tecnic

Os autores däo relevante importância estética à correçäo do queixo senil. Destacam que na cirurgia do rejuvenescimento facial deve ser enfocado o posicionamento do queixo como refinamento do contorno facial. Fazem um recordatório anatômico da regiäo mentoniana. Descrevem o perfil do queixo senil com sua patogenia. Assinalam as mais freqüentes deformidades do contorno mentoniano. Utilizam material da clínica paraticular e do Serviço de Cirurgia Plástica da Policlínica Geral do Rio de Janeiro, com 11 pacientes portadores de mentos ptosados operados, associados à ritidoplastia, todos do sexo feminino e desdentados. Baseiam a sua técnica no trabalho de Ullôa (1972), que utiliza um "VY" invertido com ressecçäo de um triângulo tecidual. Usam o mesmo princípio, todavia conservando os tecidos e utilizando a base da pirâmide rebaixada, para encher a depressäo do sulco submentoniano que é sempre pronunciado no queixo senil

Infecciones respiratorias agudas en una poblacion infantil semi-rural. / Acute upper respiratory tract infections in a semi-rural children population

Se estudian las caracteristicas clinicas de ninos con infecciones agudas de vias respiratorias superiores en una poblacion semi-rural puntualizando los elementos que deben dar paso a un manejo mas racional y economico

Ausencia congenita de la apofisis odontoidea del axis con anomalias congenitas multiples y retraso psicomotor. / Congenital absence of the odontoid process of the axis with multiple congenital anomalies and psychomotor retardation

Se comunica un caso de retraso psicomotor y multiples anomalias congenitas y donde destaca la ausencia congenita de la apofisis odontoidea del axis