Traditional red cell indices are not suggestive of iron deficiency in children with chronic kidney disease

Background. Iron deficiency (ID) contributes significantly to the chronic anaemia seen in chronic kidney disease (CKD). The use of traditional red cell indices such as mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and red cell distribution width (RCDW) in screening for ID has been recommended, because they are inexpensive and widely available, especially in low-income settings.Objectives. To determine the prevalence of anaemia and ID, and the role of traditional red cell indices in screening for ID in children with CKD.Methods. A sample of 130 children (aged 5 - 18 years) with various stages of CKD was recruited. Blood samples were taken and assessed for traditional red cell indices (MCV, MCH, MCHC and RCDW), serum haemoglobin, creatinine, C-reactive protein, iron, transferrin,transferrin saturation (TSAT) and ferritin.Results. The mean (standard deviation) age was 10.7 (3.6) years, with a male-to-female ratio of 1.8:1. There was a high prevalence (32%) of anaemia among the patients. The median TSAT and ferritin were 19 (range 13 - 26)% and 50 (28 - 102) ng/mL, respectively. The prevalence of ID and ID with anaemia (IDA) was 43% and 11%, respectively. The majority of the patients (110/130; 85%) were iron deplete, and serum ferritin and RCDW were found to be independent predictors for anaemia, ID and IDA. There was no significant difference in the traditional red cell indices in iron-deplete and iron-replete patients.Conclusion. The routine use of traditional red cell indices alone in screening for ID in children with CKD should be discouraged

Hematological and biochemical characteristics during the transport of dog snapper Lutjanus jocu (Perciformes: Lutjanidae)

The objective of this study was to evaluate stress responses in dog snapper (Lutjanus jocu) during transport by evaluating their hematological and biochemical responses. Twenty-five wild dog snapper specimens were used in the experiment (220 ± 68 g and 24.5 ± 2.5 cm total length). Blood samples were collected prior to transport (control), and fish were placed in two transport boxes, one with anesthetic and one without anesthetic. Immediately after transport and after 24 h, blood was collected from the fish that underwent each treatment (with anesthetic and without anesthetic). Biochemical and hematological results demonstrated the inefficiency of benzocaine as a stress reliever during handling and transport. Biochemical parameters revealed the effects of stress during transport, and after 24 h, glucose levels and hematological parameters (hemoglobin, erythrocytes, leukocytes, neutrophils and MCH) showed a tendency to return to control levels. This study is the first to report stress response measurements of hematological and biochemical indicators in dog snapper, representing an important basis for the planning of future experiments involving the transport and handling of this fish species.(AU)

O objetivo desde estudo foi avaliar as repostas de estresse em dentão (Lutjanus jocu) durante o procedimento de transporte, através de respostas hematológicas e bioquímicas. Vinte e cinco exemplares selvagens de dentão foram utilizados no experimento (220 ± 68 g e 24.5 ± 2.5 cm de comprimento total). Foram realizadas coletas de sangue previamente ao transporte (controle), e os demais peixes foram acondicionados em duas caixas de transporte, uma com anestésico e outra sem anestésico. Imediatamente após o transporte e após 24 h, houve coleta de sangue para cada tratamento (com anestésico e sem anestésico). Os resultados bioquímicos e hematológicos apontam a ineficiência da benzocaína como mitigador do estresse durante o manuseio e transporte. Os parâmetros bioquímicos foram capazes de detectar o efeito do estresse durante o transporte, e após 24 h os níveis de glicose e alguns parâmetros hematológicos (hemoglobina, eritrócitos, leucócitos, neutrófilos e MCH) demonstraram uma tendência de retorno aos níveis do controle. Este trabalho é o primeiro a informar os níveis de resposta basal e de estresse para indicadores hematológicos e bioquímicos em dentão, representando uma base importante para o planejamento de futuras experiências com transporte e manejo dessa espécie.(AU)

Temperature affects the hypoxia tolerance of neotropical Cichlid Geophagus brasiliensis

Oxygen and temperature are the most limiting factors in aquatic environments. Several species are exposed to variations of these factors in water because of physical, chemical and biological processes. The objective of this study was to evaluate the metabolic profile and the tolerance to the hypoxia of Geophagus brasiliensis exposed to changes in temperature and oxygen availability. The fish were exposed to 20 and 90% of oxygen saturation combined with different temperatures (20°, 24° and 28° C) for 8 h. Hepatic and muscular glycogen, as well as the activities of lactate dehydrogenase (LDH), malate dehydrogenase (MDH), citrate synthase (CS) and their ratios were evaluated. Both glycogen and MDH activity showed a significant difference in the liver. While CS showed increased activity only in the heart. The increase in LDH activity in the white muscle shows the importance of the anaerobic pathway as energy source in this tissue. The MDH / LDH ratio increased in all tissues, while CS / LDH increased in the liver and decreased in the heart. Based on the results of the present study it may be concluded that this species used the anaerobic metabolism as the main strategy for hypoxia tolerance.(AU)

O oxigênio e a temperatura são os fatores mais limitantes em ambientes aquáticos. Várias espécies são expostas a variações destes fatores na água como resultado de processos físicos, químicos e biológicos. O estudo objetivou avaliar o perfil metabólico e a tolerância à hipóxia de Geophagus brasiliensis expostos a alterações na temperatura e disponibilidade de oxigênio. Os peixes foram expostos a 20% e 90% de saturação de oxigênio combinadas com diferentes temperaturas (20 ° C, 24 ° C e 28 ° C) durante 8h. Foram avaliados o glicogénio hepático e muscular, assim como as atividades das enzimas lactato desidrogenase (LDH), malato desidrogenase (MDH), citrato sintase (CS) e suas razões. Tanto o glicogênio quanto a atividade da MDH apresentaram diferença significativa no fígado. Enquanto a CS apresentou aumento de sua atividade apenas no coração. O aumento da atividade LDH no músculo branco mostra a importância da via anaeróbia como fonte de energia neste tecido. A razão MDH/LDH aumentou em todos os tecidos, enquanto CS/LDH apresentou aumento no fígado e diminuição no coração. Os resultados obtidos permitem concluir que esta espécie utilizou o metabolismo anaeróbio como principal estratégia de tolerância à hipóxia.(AU)

Acute copper toxicity in juvenile fat snook Centropomus parallelus (Teleostei: Centropomidae) in sea water

Three experiments were designed to assess the accumulation and acute toxicity of copper (Cu) in juvenile fat snook Centropomus parallelus. The first experiment was performed to determine the 96-h lethal concentration (LC50) of Cu. The second experiment was designed to assess the effects of sublethal concentrations of Cu (0.47 and 0.94 mg/L), while the third one allowed us to test the recovery capacity of fish exposed to the sublethal concentrations Cu and kept in sea water without Cu addition. The LC50 value for Cu was found to be 1.88 mg/L Cu. Fish exposed to the sublethal concentrations of Cu showed a significant accumulation of Cu in gills at 96 h respect to the control ones (0.43 µg/g Cu). No significant difference was observed in the accumulation of Cu in gills between fish exposed to 0.47 mg/L (1.09 µg/g Cu) and 0.94 mg/L (1.26 µg/g Cu). Exposure (24 and 96 h) to the sublethal concentrations of Cu tested induced DNA damage in the erythrocytes. The results show that acute exposure to sublethal concentrations induces Cu accumulation and DNA damage in fish, these effects being recovered after 240 h in sea water without Cu addition.

Três experimentos foram realizados para avaliar o acúmulo e toxicidade aguda do cobre (Cu) em juvenis de robalo-peva Centropomus parallelus. O primeiro experimento foi realizado para determinar a concentração letal (96h-CL50) de Cu. O segundo experimento foi realizado para avaliar os efeitos de concentrações subletais de Cu (0,47 e 0,94 mg/L), enquanto o terceiro permitiu testar a capacidade de recuperação dos peixes expostos a concentrações subletais do Cu e posteriormente mantidos em água do mar sem acréscimo de Cu. O valor de LC50 encontrado para o Cu foi de 1,88 mg/L. Os peixes expostos as concentrações subletais de Cu mostraram um acúmulo significativo nas brânquias em relação ao controle em 96 h de exposição (0,43 µg/g Cu). Nenhuma diferença significativa foi observada entre os peixes expostos a 0,47 mg/L de Cu (1,09 µg/g) e 0,94 mg/L de Cu (1,26 µg/g). A exposição (24 e 96 h) para as concentrações subletais de Cu induziram danos no DNA. Os resultados mostram que a exposição aguda a concentrações subletais induz o acúmulo de Cu e danos ao DNA nas brânquias dos peixes, onde estes efeitos são recuperados após 240 h em água do mar sem adição de Cu.

Effect of beta 1, 3 glucan in stress responses of the pencilfish (Nannostomus trifasciatus) during transport within the rio Negro basin

We investigated the use of beta 1,3 glucan as an imunostimulant during a transport experiment to determine the effects upon the stress response of the pencilfish (Nannostomus trifasciatus). Pencilfish were fed for seven days with different concentrations of beta 1,3 glucan: 0.0% (control); 0.01%; 0.1% and 0.5% of beta 1,3 glucan per kg of feed-1. Fish were then transported for 24 hours by boat from Barcelos to Manaus. The highest dose of beta 1,3 glucan in the food increased Na+ influx after 12 hours of transport and 0.1 and 0.5% beta 1,3 glucan maintained the flux of both ions close to zero at 24 hours. All doses of beta 1,3 glucan reduced K+ loss significantly in the beginning of the transport, but after 12 to 24 hours did not. No significant differences in whole body cortisol or survival were observed. Our results indicate that pencilfish had ionic alterations during transport from Barcelos to Manaus. The lack of significant differences in whole body cortisol and survival rate in addition to the maintenance of Na+ and K+ balance during transport reinforce the positive effects of beta 1,3 glucan immunostimulant on fish homeostasis. Therefore, we recommend its addition to food prior to transport...

O objetivo deste trabalho foi verificar se o imunoestimulante beta 1,3 glicano, adicionado à ração fornecida dias antes do transporte, pode minimizar algumas respostas de estresse do peixe lápis (Nannostomus trifasciatus) capturado na natureza. Estes peixes foram alimentados por sete dias com diferentes concentrações de beta 1,3 glicano: 0,0% (controle); 0,01 %; 0,1% e 0,5 % de beta 1,3 glicano.kg de ração-1. Após este período, as caçapas foram transportadas via barco de Barcelos para Manaus, com duração de 24 horas. Nos peixes alimentados com a maior concentração de beta 1,3 glicano na ração foi verificado aumento no influxo de Na+ após 12 horas de transporte e nos peixes alimentados com 0,1 e 0,5% de beta 1,3 glicano, o fluxo destes íons foi mantido próximo de zero no final de 24 horas de transporte. Todas as doses de beta 1,3 glicano reduziram significativamente a perda de K+ no início do transporte, mas, após 12 horas até o final do transporte houve efeito significativo no efluxo de K+. Não foram verificadas diferenças significativas entre tratamentos ou tempos de amostragem para os níveis de cortisol corpóreo. A taxa de sobrevivência não diferiu ao final do experimento. Nossos resultados indicam que o transporte entre Barcelos e Manaus promoveu alterações iônicas no peixe-lápis e a ausência de diferenças significativas no cortisol corpóreo e na taxa de sobrevivência aliada, à manutenção do equilíbrio de sódio e potássio durante o transporte, reforça o efeito positivo do imunoestimulante beta 1,3 glicano na homeostase dos peixes e sua adição à ração é recomendada...

Perfil epidemiológico dos pacientes atendidos na clínica de ortopedia da Universidade Paulista / Epidemiological profile of patients served at the clinic orthopedics of the University Paulista

Objetivo - Os distúrbios do sistema músculo esquelético estão entre os mais acometidos na população em geral que procuram atendimento médico e que são encaminhados para a fisioterapia. O presente estudo pretende descrever o perfil dos pacientes atendidos na clínica de Fisioterapia aplicada à ortopedia e traumatologia da Universidade Paulista (UNIP). Métodos - Foi realizado o levantamento de 416 prontuários de pacientes atendidos no período de 2005 a 2009, deste total 145 foram excluídos por conterem dados incompletos e por serem de pacientes que só realizaram avaliação, foram incluídos 271 prontuários por conterem todos os dados e por terem realizado tratamento na clínica da UNIP. Foram analisados dados como sexo, faixa etária, diagnósticos, uso de medicamento e segmento acometido. Resultados - Observou-se que o sexo feminino foi o mais afetado (62,37%), numa faixa de idade entre 51 a 60 anos. O diagnóstico mais presente foi a osteoatrose seguido da lombociatalgia, sendo o joelho e a coluna lombar os segmentos mais acometidos. Conclusão - Este estudo demonstrou que os diagnósticos encontrados, a faixa etária e o sexo acometido coincidem com o que a literatura apresenta.

Objective - The system skeletal muscle disorders are among the most attacked in the general population seeking medical care that are shipped to the physiotherapy. This study aims to describe the profile of the patients met in physiotherapy clinic applied to orthopedics and traumatology of University Paulista (UNIP). Methods - It was held the lifting of 416 patient records served in the period 2005 to 2009, of this total 145 were excluded because they contain incomplete data and for patients who have only been included 271 assessment, patient records to contain all data and by carrying out treatment in the clinic of UNIP. Data were analysed as sex, age, diagnostics, drug usage and segment fell ill. Results - It was noted that the female was the more affected (62.37%), in a strip of age between 51 to 60 years. The diagnosis more gift was the osteoarthrosis followed by lombociatalgia, being the knee and lumbar spine more attacked segments. Conclusion - This study demonstrated that the diagnostics found, the age and sex fell ill coincide with what literature presents.

Phenotyping and genotyping methods applied to investigate the relatedness of Brazilian isolates of Enterobacter cloacae

In order to evaluate the resolving power of several typing methods to identify relatedness among Brazilian strains of Enterobacter cloacae, we selected twenty isolates from different patients on three wards of a University Hospital (Orthopedics, Nephrology, and Hematology). Traditional phenotyping methods applied to isolates included biotyping, antibiotic sensitivity, phage-typing, and O-serotyping. Plasmid profile analysis, ribotyping, and macrorestriction analysis by pulsed-field gel electrophoresis (PFGE) were used as genotyping methods. Sero- and phage-typing were not useful since the majority of isolates could not be subtyped by these methods. Biotyping, antibiogram and plasmid profile permitted us to classify the samples into different groups depending on the method used, and consequently were not reliable. Ribotyping and PFGE were significantly correlated with the clinical epidemiological analysis. PFGE did not type strains containing nonspecific DNase. Ribotyping was the most discriminative method for typing Brazilian isolates of E. cloacae

Detection of cytotoxic activity on Vero cells in clinical isolates of Serratia marcescens

Cytotoxin production was studied in 60 Serratia marcescens strains isolated from hospitalized patients. Association of cytotoxic activity with serotype, source of isolation and presence of plasmids was also evaluated. Thirteen of the 60 S. marcescens strains produced a cytotoxic effect of Vero cells. These strains were isolated from distinct clinical sources and classified into seven different serotypes (O1:H7; O4:NM; O10:NT; O19:NM; O6,14:H4; O6,14:NM and O6,14:H1). No relationship was observed between cytotoxic activity and clinical source or serotypes of the strains. Plasmids from five cytotoxin-producing S. marcescens strains were transferred to E. Coli K12/711. The transconjugants did not exhibit cytotoxicity, indicating that the cytotoxic effect is not plasmid-mediated among these strains. Although a cytotoxic activity was demonstrated in filtrates of some S. marcescens strains, further studies should be performed to assess the role of this toxin in pathogenesis.

Nocardia infection in renal transplant recipient: diagnostic and therapeutic considerations

In the present report the authors discuss the diagnostic difficulties, therapeutic measures and the clinical course of Nocardia infection which occurred among renal transplant recipients at the University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo (UH-FRP), from 1968 to 1991. Among 500 individuals submitted to renal transplant, 9 patients developed Nocardiosis at varying times after transplant (two months to over two years). All the patients had pulmonary involvement and their most common symptoms were fever, cough and pleural pain. Dissemination of the process is common and three patients presented cutaneous abscesses, four CNS involvement and one had pericarditis due to Nocardia. The diagnostic is quite difficult since there is no specific clinical picture, concomitant infections are frequent and the microorganism presents slow growth in culture (ranging from four to forty days, in our experience). In this report, three cases were only diagnosed by necropsy. The treatment of choice is a combination of Sulfamethoxazole and Trimethoprim (SMX-TMP). In the present series, overall mortality was 77 (7 cases) and in five of the patients who died the diagnosis was late. All the patients who had CNS involvement died.

Fagotipagem e resistencia as drogas de amostras de Staphylococcus aureusmultiresistentes no HU/UFPB / Phage typing and drug resistence in multiple-antibiotic-resistant Staphylococcus aureus in a university hospital

Foi realizado um estudo epidemiologico de 38 amostras de Staphylococcus aureus isolados de pacientes internos no Hospital Universitario da UFPb. Em sua aioria, aslinhagens estudadas apresentaram multiresistencia as drogas, das quais 31,6% demonstraram resistencia a oxacilina (ORSA). A partir de testes de sensibilidade as drogas determinou-se o padrao de resistencia das amostras estudadas, com especial atençao as amostras ORSA nas quais foi detectada uma resistencia media de 75,0% a bateria de drogas utilizadas. As amostras foram submetidas a fagotipagem utilizando a RTD e100xRTD obtendo-se 22/38 (57,9%) de amostras tipaveis, sendo a maioria 11/22 (50,0%) caracterizada no grupo fagico III. No entanto,considerando o elevado numero de amostras nao tipaveis, e que coincidiu em grande parte dos casos com cepas de resistencia elevada, concluimos ser necessario a utilizaçao de tecnicas moleculares para melhor estabelecer a analise epidemiologica.

Meningencefalite por Pasteurella multocida: estudo clínico-laboratorial de um caso em lactente / Pasteurella multocida meningencephalitis: clinical and laboratory study of a case in a newborn infant

Os autores apresentam descriçäo clínico-laboratorial e evolutiva do caso de lactente com o diagnóstico de maningencefalite por Pasteurella multocida que apresentou na evoluçäo evoluçäo atraso neuromotor, manifestaçöes epilépticas, surdez neurossensorial e paresia crural a esquerda. Fazem também breve revisäo do papel deste agente etiológico na patologia humana. Ressaltam a importância da P. multocida em casos de meningites bacterianas, fazendo-se o diagnóstico laboratorial diferencial com o Haemophilus influenzae e Neisseria meningitidis em processos infecciosos conseqüentes a arranhadura ou mordida de animais e nas bacteremias ou septicemias em pacientes com hepatopatias crônicas ou em estados de imunodepressäo

Contraimunoeletroforese e hemaglutinacao passiva como metodos complementares para o estudo da infeccao meningococica. / Counterinmmunoelectrophoresis and passive hemagglutination as complementary methods in the study of meningococcal infection

Analisamos 108 casos de meningite bacteriana, atendidos no Hospital das Clinicas da FMRP-USP, atraves de bacterioscopia do sedimento do liquido cefalorraquiano (LCR) corado pelo Gram, cultura do LCR em agar-chocolate, contraimunoeletroforese (CIE) do LCR para pesquisa de polissacarides meningococicos A e C, de hemofilos tipo b e de pneumococo com soro polivalente, hemocultura e hemaglutinacao passiva (HP) para avaliar titulos de anticorpos antimeningococicos A e C no soro. Embora nem todos os testes tenham sido aplicados simultaneamente, foram diagnosticados 71 casos de meningites meningococicas (41 tipo A, 11 C, 2A e C e 18 nao tipadas), 9 por hemofilos tipo b, 6 por pneumococos, 2 por E. aerogenes, 1 por Streptococcus sp e 19 permaneceram sem diagnostico etiologico. Isoladamente, a HP revelou maior indice de positividade, enquanto que os metodos tradicionais (bacterioscopia e cultura do LCR) e a CIE forneceram resultados satisfatorios. A associacao de pelo menos dois desses metodos aumentou significantemente a porcentagem de identificacao dos casos de meningite meningococica