Manejo del cáncer de mama en tiempos de pandemia COVID-19: experiencia local / Management of breast cancer in COVID-19 pandemic: a local experience

La pandemia por COVID-19 ha generado un estancamiento mundial en la atención y resolución de todas las patologías graves y crónicas, debido al colapso de los sistemas de salud, a la dificultad de consulta, dada por la disminución de movilidad de las personas, por las cuarentenas establecidas y también por el temor de los pacientes al contagio en los centros de salud. Los enfermos oncológicos han visto canceladas sus atenciones, suspendidos o postergado sus tratamientos y diferidas sus cirugías. Esto no ha sido ajeno a las pacientes con cáncer de mama. En el presente trabajo, se reporta la experiencia de una Unidad de Patología Mamaria de un hospital público de Santiago de Chile y de las acciones realizadas para mantener la continuidad de atención en una comuna con una alta tasa de infección por SARS-CoV-2.

The COVID-19 pandemic has generated a global stagnation in the care and medical treatment of serious and chronic illnesses due to the collapse of the health systems, the difficulty of consulting due to decreased mobility caused by forced quarantines and also because of the fear of infection when attending a health center. Cancer patients have had their medical appointments canceled, their treatments suspended or postponed, and their surgeries delayed. Breast cancer patients have not been the exception. We report the experience of a Breast Pathology Unit of a public hospital in Santiago of Chile, and the actions carried out to maintain continuity of care in a community with a high infection rate of SARS-CoV-2.

Ateneo general de la residencia: Apostando a un buen envejecer: experiencias y conceptualizaciones acerca del trabajo en espacios preventivo-promocionales / General athenaeum of the residence: Betting on a good aging: experiences and conceptualizations about work in preventive-promotional spaces

Primer parte del Ateneo, realizado por la Residencia de Psicopedagogía del Área Programática del Hospital Penna, Ciudad de Buenos Aires, donde se abordan diferentes aspectos sobre el proceso de envejecer, partiendo de reflexiones en torno a sentirse viejo, y sobre factores sociales, culturales y económicos que impactan en esta población y en su lugar en la sociedad. Se realiza un breve recorrido sobre las formas de nombrar al adulto mayor a lo largo de la historia, y específicamente en Argentina; y se analizan los duelos y cambios que se atraviesan en esta etapa, y las representaciones en torno al envejecer.

Validación de recursos humanos pre-profesionales para la detección de biofilm en niños en edad escolar / Validation of preprofessional resources for detecting biofilm in schoolchildren

Objetivo: Estimar la concordancia para la detección de biofilm dental entre recursos humanos que participan de programas de educación para la salud con diferente nivel de formación profesional. Métodos: Se seleccionó en forma intencionada un grupo deestudiantes de los primeros años de la carrera de odontología que participan como ayudantes en el curso Educación para la Salud (n= 8) (Grupo A). Los examinadores de referencia fueron odontólogos/docentes universitarios que desarrollan acciones sistemáticas de educación para la salud en escuelas públicas de Ciudad Autónoma de Buenos Aires (C.A.B.A.) (n= 2) (Grupo B). Se examinaron 67 escolares (edades 7 a 9 años) previo consentimiento informado de los responsables legales y el asentimiento de los niños/as. Los diagnósticos se realizaron bajo condiciones estandarizadas en la sede escolar. Los pares de examinadores determinaron en cada escolar la presencia de biofilm dental, primero a simple vista y luego con solución reveladora (Índice de O`Leary, 1970). La concordancia se valoró utilizando el coeficiente de correlación intraclase para valores absolutos. La fuerza del grado de acuerdo se valoró según Landis y Koch, 1977. Resultados: El coeficiente de correlación intraclase fue: 1) para el índice de placa visible: medidas individuales = 0,71 IC95 por ciento [0,56-0,81]; promedios = 0,83 IC95 por ciento [0,71-0,90] b) para el índice de O´Leary: medidas individuales = 0,62 IC95 por ciento [0,44-0,75]; promedios = 0,77 IC95 por ciento [0,61-0,86]. Conclusión: los examinadores del Grupo A (recursos humanos pre-reprofesionales) respecto del Grupo B (recursos humanos profesionales) alcanzaron un grado considerable de concordancia para la detección de placa a simple vista y un grado moderado de concordancia para la detección de placa con solución reveladora.

Objective: The aim of this study was to measure inter-observer agreement in the assessment of dental biofilm between subjectsparticipating in health education programs with different levels of professional training. METHODS: In order to perform thisvalidation procedure, a group of undergraduate students in the initial years of the career of dentistry engaged as teaching assistants for aHealth Education Course (n=8) was intentionally recruited (GROUP A). Freshmen dental graduates / teaching assistants whodevelop systematic health educational activities in public schools (n=2). 67 children (ages 7 to 9) were considered reference examiners(GROUP B). Clinical examinations were performed among 67 schoolchildren (ages 7 to 9 years old). Informed consent of children´slegal guardians and assent of children themselves as for participation in the study were obtained. At first, examiners set into pairs,assessed dental biofilm presence/absence in each child visually (Visual Plaque Index). The same procedure was repeated after applyingdisclosing solution (O´Leary Index). The intraclass correlation index (ICI) was used to establish interobserver agreement whereas theLandis-Koch criteria was used to interpret the results. RESULTS: The intraclass correlation index was 1) Visual Plaque Index:individual measures = 0,71 IC95% [0,56-0,81]; average measures = 0,83 IC95% [0,71-0,90] b) O´Leary Index: individualmeasures = 0,62 IC95% [0,44-0,75]; average measures = 0,77 IC95% [0,61-0,86]. CONCLUSION: examiners fromGROUP A (undergraduate students) respect to those from GROUP B (graduates) reached a substantial agreement in the assessment ofdental biofilm visually and a moderate degree of agreement in the assessment of dental biofilm using disclosing solution.

Structural properties of lipid reconstructs and lipid composition of normotensive and hypertensive rat vascular smooth muscle cell membranes

Multiple cell membrane alterations have been reported to be the cause of various forms of hypertension. The present study focuses on the lipid portion of the membranes, characterizing the microviscosity of membranes reconstituted with lipids extracted from the aorta and mesenteric arteries of spontaneously hypertensive (SHR) and normotensive control rat strains (WKY and NWR). Membrane-incorporated phospholipid spin labels were used to monitor the bilayer structure at different depths. The packing of lipids extracted from both aorta and mesenteric arteries of normotensive and hypertensive rats was similar. Lipid extract analysis showed similar phospholipid composition for all membranes. However, cholesterol content was lower in SHR arteries than in normotensive animal arteries. These findings contrast with the fact that the SHR aorta is hyporeactive while the SHR mesenteric artery is hyperreactive to vasopressor agents when compared to the vessels of normotensive animal strains. Hence, factors other than microviscosity of bulk lipids contribute to the vascular smooth muscle reactivity and hypertension of SHR. The excess cholesterol in the arteries of normotensive animal strains apparently is not dissolved in bulk lipids and is not directly related to vascular reactivity since it is present in both the aorta and mesenteric arteries. The lower cholesterol concentrations in SHR arteries may in fact result from metabolic differences due to the hypertensive state or to genes that co-segregate with those that determine hypertension during the process of strain selection.

Analysis of the feeding habits of the swallow-tailed hummingbird, Eupetomena macroura (Gmelin, 1788), in an urban park in southeastern Brazil / Análise do comportamento alimentar do beija-flor tesourão, Eupetomena macroura (Gmelin, 1788), em um parque urbano localizado na região sudeste do Brasil

The aim of this work was to observe and describe the feeding habits and available food resources of the swallow-tailed hummingbird, Eupetomena macroura. The study was carried out in a municipal park located in the city of Taubaté, in the state of São Paulo. The observations took place between December 2003 and October 2004, recording the following variables: 1) the plant species visited for feeding and territorial defense; 2) the kinds of food resources; and 3) the kinds of flight to procure and obtain food. E. macroura visited 12 plant species. For territorial defense, Mangifera indica was the most visited, whereas Malvaviscus arboreus was most visited for feeding. The foliage was the plant part that received the most frequent visits. In order to obtain nectar, the only species visited was M. arboreus; to obtain arthropods, the species most visited were Mangifera indica and Hymenaea stilbocarpa. In the dry season, the hummingbirds visited flowers, whereas in the rainy season they visited leaves to acquire food. The arthropod groups most frequently found on leafy branches were Homoptera and Psocoptera. Finally, the results of the type of flight analysis showed that flight used to capture food was more often observed than were flights to search for food. In conclusion, these observations suggest that E. macroura shows plasticity in feeding behavior, which can help it to persist in urban areas.

O objetivo deste trabalho foi observar e descrever o hábito alimentar do Beija-flor Tesourão, Eupetomena macroura. O estudo foi realizado em um parque municipal, situado na cidade de Taubaté, Estado de São Paulo. As observações ocorreram entre dezembro de 2003 e outubro de 2004, período em que foram observadas as seguintes variáveis: 1) as espécies de plantas visitadas para alimentação e defesa territorial; 2) o tipo de recurso alimentar; e 3) a freqüência de vôo para busca e obtenção de alimento. Foram registradas 12 espécies de plantas visitadas pelo E. macroura, visto que Mangifera indica e Malvaviscus arboreus foram as mais utilizadas para defesa territorial e para alimentação, respectivamente. O maior índice de flores visitadas foi observada para Malvaviscus arboreus. Mangifera indica e Hymenaea stilbocarpa foram as espécies que apresentaram maior freqüência de visita em folhas e ramos. Na estação seca, o beija-flor tesourão visitou flores para obtenção de alimento, já na estação úmida a maior parte do alimento foi adquirida entre folhas e ramos. Quando analisados as folhas e ramos visitados pelos indivíduos quanto à presença de artrópodes, os resultados obtidos indicaram que os grupos mais abundantes foram Homoptera e Psocoptera. Finalmente, pela análise do tipo de vôo, observou-se que o vôo que representa captura de alimento foi mais vezes observado do que aquele que é utilizado para procura de alimento. Os resultados sugerem uma flexibilidade trófica do E. macroura, fato que pode auxiliar na permanência da espécie em áreas urbanas.

Muerte fetal: realidad en Chile entre 1995-2004 / Fetal death: reality in Chile between 1995-2004

Objective: to know the late fetal mortality rate (LFMR) in Chile between 1995 and 2004. Methods: descriptive study analyzing the fetal deaths occurred in Chile in the period 1995-2004. Results: the LFMR in the period studied was 4,4 /1000newborns (NB). The LFMR in 2004 was 3.7/1000NB and the most prevalent etiologies were: gestational pathologies (49 percent), ovular pathologies (21.7 percent), intrauterine hypoxia (12.8 percent), congenital malformations (6.5 percent), maternal pathology not related with pregnancy (4.2 percent) and undetermined cause (3.7 percent). Conclusions: The LFMR and the frequency of the etiologies of fetal deaths found in our study were important to plan the prevention strategies of perinathology.

The effect of milk on plasmatic and tissue levels of macrolides: in vivo study in rats

The ingestion of milk with drugs, particularly some antibiotics, is frequently recommended in order to decrease possible gastrointestinal discomfort. The objective of this sutdy was to assess the interference of milk in the absorption and tissue levels of macroline antibiotics (erythromycin, clarithromycin, roxithromycin and azithromycin). Forty female rats received surgically-implanted PVC sponges on their backs. One week later, granulomatous tissue was observed and the animals were divided into eight groups, which received erythromycin, clarithromycin, roxithromycin and azithromycin with and without milk. One hour after administration of antibiotic, the animals were sacrificed. The serum and tissue samples were submitted to microbiological assay with Micrococcus luteus ATCC 9341, in order to determine drug concentration. Milk did not cause any reduction in the serum and tissue levels of azithromycin and clarithromycin (p>0.05, t-test). However, ingestion of milk reduced by approximately 28.7% the roxithromycin (p<0.0001, t-test) and by 34.1% the rythromycin (p<0.0001, t-test) serum concentrations. Similar effects were observed on tissue levels. Milk ingestion caused a reduction of approximately 20.8% in the roxithromycin (p<0.0001, t-test) and 40% in the erythromycin (p<0.0001, t-test) tissue levels. We concluded that erythromycin and roxithromycin should be not administered with milk

Megavejiga fetal en el segundo trimestre: síndrome de Berdon- un signo fácil, un diagnóstico difícil / Fetal megabladder in the second trimester: Berdon syndrome a simple sign, a difficult diagnosis

El diagnóstico de megavejiga en el embarazo es infrecuente más aun si se trata de un feto femenino. Este hecho nos permite delimitar bastante las alternativas diagnósticas, dentro de un espectro bastante heterogénico. El síndrome Megavejiga-Microcolon Hipoperistalsis Intestinal(MMIHS) es una patología de muy mal pronóstico que asocia megavejiga y alteraciones intestinales severas. Es por esto que es importante tenerla presente, para poder dar a los padres una información fidedigna y certera en cuanto al pronóstico. Presentamos 2 casos de nuestro servicio en el período 1998-2003. Se comentan los aspectos diagnósticos, terapéuticos y la evolución.

Uso racional de medicamentos: ¿qué conocen losmédicos residentes sobre los fármacos de uso corriente? / Rational drug use: what do resident surgeons know about common medicines?

Introducción: el uso irracional de los medicamentos constituye un riesgo inadmisible para los pacientes y un continuo derroche de recursos. De los diversos factores que contribuyen a esta realidad,el hábito de prescripción de los médicos es uno de los más frecuentes. La prescripción es un proceso razonado que exige el uso de información actualizada e independiente sobre los medicamentos. Objetivo: conocer la información que tienen los médicos residentes ded pediatría y medicina interna sobre medicamentos de uso frecuente. Material y método: en diciembre de 2002 se encuestaron en forma personal y anónima, 69 médicos residentes (38 de pediatría y 31 de medicina interna). Se evaluó el conocimiento sobre nombre genérico, dosis, efectos adversos y contraindicaciones absolutas de medicamentos de uso frecuente en cada una de las disciplinas. Las respuestas fueron catalogadas como verdaderas o falsas usando un estándar elaborado por los autores. Resultados: los porcentajes de respuestas verdaderas entre los residentes de pediatría fueron: genérico 82 por ciento, dosis 42 por ciento, efectos adversos comunes 16 por ciento, efectos adversos graves 16 por ciento y contraindicaciones 32 por ciento. Entre los residentes de medicina interna: genérico 89 por ciento, dosis 53 por ciento, efectos adversos comunes 16 por ciento, efectos adversos graves 45 por ciento y contraindicaciones 46 por ciento. Se observó una proporción mayor de respuestas verdaderas estadísticamente significativa, entre resideentes de medicina interna en relación a las dosis, efectos adversos graves y contraindicaciones. Conclusiones: una elevada proporción de los residentes encuestados no tiene conocimientos suficientes en relación a las dosis, los efectos adversos y las contraindicaciones de estos medicamentos de uso frecuente. Esto constituye un factor determinante en la prescripción irracional de los medicamentos. Es necesario fortalecer la formación continua en farmacología y terapéutica de los médicos residentes para revertir este problema.

A leucine-supplemented diet improved protein content of skeletal muscle in young tumor-bearing rats

Cancer cachexia induces host protein wastage but the mechanisms are poorly understood. Branched-chain amino acids play a regulatory role in the modulation of both protein synthesis and degradation in host tissues. Leucine, an important amino acid in skeletal muscle, is higher oxidized in tumor-bearing animals. A leucine-supplemented diet was used to analyze the effects of Walker 256 tumor growth on body composition in young weanling Wistar rats divided into two main dietary groups: normal diet (N, 18 percent protein) and leucine-rich diet (L, 15 percent protein plus 3 percent leucine), which were further subdivided into control (N or L) or tumor-bearing (W or LW) subgroups. After 12 days, the animals were sacrificed and their carcass analyzed. The tumor-bearing groups showed a decrease in body weight and fat content. Lean carcass mass was lower in the W and LW groups (W = 19.9 ± 0.6, LW = 23.1 ± 1.0 g vs N = 29.4 ± 1.3, L = 28.1 ± 1.9 g, P < 0.05). Tumor weight was similar in both tumor-bearing groups fed either diet. Western blot analysis showed that myosin protein content in gastrocnemius muscle was reduced in tumor-bearing animals (W = 0.234 ± 0.033 vs LW = 0.598 ± 0.036, N = 0.623 ± 0.062, L = 0.697 ± 0.065 arbitrary intensity, P < 0.05). Despite accelerated tumor growth, LW animals exhibited a smaller reduction in lean carcass mass and muscle myosin maintenance, suggesting that excess leucine in the diet could counteract, at least in part, the high host protein wasting in weanling tumor-bearing rats.

Valores hematológicos e bioquímicos de grupos de papagaios-de-cara-roxa (Amazona brasiliensis)

O artigo não apresenta resumo.

Estudo sobre triatomíneos e reservatórios silvestres de Trypanosoma cruzi no Estado do Paraná, Sul do Brasil: resultados preliminares / Triatomids and forest reservoirs of Trypanosoma cruzi in the state of Paraná, southern Brazil: preliminary results

Em localidades da zona rural de cinco municípios da região noroeste do Paraná adultos e ninfas de Triatoma sordida foram capturados em 21 (41,2%) de 51 unidades domiciliares pesquisadas. Foram capturados 154 exemplares de T. sordida e 2 Panstrongylus megistus. De 135 exemplares examinados 58 (43,0%) apresentavam o Trypanosoma tipo cruzi. Constatou-se também a infecção em 57,1% (4/7) dos gambás (Didelphis sp) examinados. O peridomicílio apresentou-se mais infestado que o intradomicílio, sendo a casa de madeira abandonada a construção mais freqüente (34,7% do total investigado) e com maior taxa de infestação (53,9%). Os dados mostram um elevado índice de infestação da zona rural por espécies secundárias de triatomíneos com altas taxas de infecção por flagelados do tipo T. cruzi, em uma área endêmica para a doença de Chagas já em fase de vigilância epidemiológica.

In the rural area of five municipalities of the Northeast of the State of Paraná, Brazil, 154 adults or nymphs of Triatoma sordida and 2 Panstrongylus megistus were captured in 21 (41.2%) of 51 dwellings at the peridomestic sites. Trypanosoma cruzi-like organisms were found in 58 out of the 135 (43.0%) triatomids. Moreover, it was also found in the blood of 4/7 opossum (Didelphis sp). The triatomine infestation was more prevalent in the peridomicile than inside house. The forsaken wooden house presented the highest level of infestation (53.8%). Although the rural area of the Northeast of the State of Paraná is considered under epidemiologic surveillance it still presents a high level of peridomestic infestation by triatomids highly infected with T. cruzi-like organisms.

Glycosphingolipid antigens from Leishmania (L.) amazonensis amastigotes. Binding of antiglycosphingolipid monoclonal antibodies in vitro and in vivo

Specific glycosphingolipid antigens of Leishmania (L.) amazonensis amastigotes reactive with the monoclonal antibodies (MoAbs) ST-3, ST-4 and ST-5 were isolated, and their structure was partially elucidated by negative ion fast atom bombardment mass spectrometry. The glycan moieties of five antigens presented linear sequences of hexoses and N-acetylhexosamines ranging from four to six sugar residues, and the ceramide moieties were found to be composed by a sphingosine d18:1 and fatty acids 24:1 or 16:0. Affinities of the three monoclonal antibodies to amastigote glycosphingolipid antigens were also analyzed by ELISA. MoAb ST-3 reacted equally well with all glycosphingolipid antigens tested, whereas ST-4 and ST-5 presented higher affinities to glycosphingolipids with longer carbohydrate chains, with five or more sugar units (slow migrating bands on HPTLC). Macrophages isolated from footpad lesions of BALB/c mice infected with Leishmania (L.) amazonensis were incubated with MoAb ST-3 and, by indirect immunofluorescence, labeling was only detected on the parasite, whereas no fluorescence was observed on the surface of the infected macrophages, indicating that these glycosphingolipid antigens are not acquired from the host cell but synthesized by the amastigote. Intravenous administration of 125I-labeled ST-3 antibody to infected BALB/c mice showed that MoAb ST-3 accumulated significantly in the footpad lesions in comparison to blood and other tissues.

Isolation and possible composition of glucosylceramides from Paracoccidioides brasiliensis

Twelve different species of neutral monohexosyl ceramides (CMHs) and two species of neutral monohexosyl ceramides were isolated form mycelium and yeast forms of Paracoccidioides brasiliensis, respectively, by a combination of ion-exchange chromatography, HPLC, and HPTLC. The glucosylceramides did not react with sera from patients with paracoccidioidomycosis (PCM). Carbohydrate analysis indicated that CMHs contain glucose. Analysis of (1)H-NMR and mass spectrometry data suggest that the structure of the CMHs is Glcpbeta1(Cer (mycelium forms present 12 different ceramides and yeast forms present 2 different ceramides). The composition of the lipid moieties was analyzed by negative fast atom bombardment mass spectrometry. No glycosphingolipid other than glucosylceramide was detected in P. brasiliensis.

Psiquiatria de interconsulta no hospital geral: comunicaçäo inicial de uma experiência / Interconsultation Psychiatry in general hospital: initial communication of an experience

A psiquiatria de interconsulta atende os pacientes com sintomas psíquicos no hospital geral, aproximando a Psiquiatria das outras especialidades médicas. Esse trabalho documenta a implantaçao de um serviço de consultoria psiquiátrica no Hospital Universitário da Universidade de Sao Paulo (HU-USP), em seus primeiros seis meses. Objetivo. Aplicaçao do diagnóstico multiaxial do Manual Estatístico e Diagnóstico, da Associaçao Psiquiátrica Americana, 3( ediçao revisada (DSM-III-R, 1987), aos pacientes internados no HU-USP. Casuística e Método. Foram atendidos 60 casos, mediante pedido de consulta, aplicando-se entrevista estruturada baseada no Present State Examination, 9( ediçao, a pacientes maiores de 17 anos e nao-intubados ou comatosos. Resultados. Houve predominância, nos diagnósticos de eixo I, de síndromes mentais orgânicas, transtornos depressivos e ansiosos, o que reproduz dados de literatura. No eixo II, houve uma percentagem significativa de deficientes mentais em relaçao à literatura internacional. Dos transtornos de personalidade, a maior incidência foi dos distúrbios de personalidade tipo borderline e dependente. No eixo III, acharam causas orgânicas diversas, refletindo, provavelmente, a casuística hospitalar. No eixo IV, os pacientes com estressores em grau severo apontaram a internaçao, complicaçoes clínicas, notícia da doença e tentativas suicidas como fatores mais estressantes. No eixo V, mais da metade da amostra apresentava prejuízos severos na adaptaçao ao hospital. Conclusoes. Discutem-se as licoes provenientes desse trabalho, que apontam para o ganho em qualidade de atendimento com a introduçao de um serviço de interconsulta psiquiátrica em um hospital geral, bem como de abrangência das informaçoes que nos possibilita o diagnóstico multiaxial desses pacientes, úteis para médicos de todas as especilidades.

Immunochemical characterization of carbohydrate antigens from fungi, protozoa and mammals by monoclonal antibodies directed to glycan epitopes

Cell surface carbohydrates constitute the major antigenic determinants of fungi and protozoa. Glycoconjugates also represent a large variety of antigens or markers present in mammals such as histo-blood groups ABO, differentiation and heterophile antigens, among others. This article focuses on the general properties of glycoconjugate antigens and production and characterization of the anti-carbohydrate monoclonal antibodies (MoAbs). It describes the specificity and some properties of monoclonal antibodies directed against carbohydrate epitopes present in tumor-associated glycoproteins, in clycosaminoglycans of higher eukaryotes and in glycolipid antigens of protozoa and fungi. The epitopes recognized by the anti-carbohydrate MoAbs range from one sugar unit up to ten sugar units. Although most anti-carbohydrate MoAbs are directed predominantly toward terminal sugar residues, a few MoAbs are also reactive with internal sugar residues. The fine structure of the carbohydrate epitopes has been chemically defined by [H]NMR, GC/MS of alditol acetates of partially permethylated compounds, FAB/MS, degradation with exoglycosidases and inhibition with different methyl-glycosides and oligosaccharides.

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

Use of ampicilin plus ranitidine for Helicobacter pylori gastritis

Helicobacter pylori (formerly Campylobacter pylori) is now recognized as an etiological factor in gastritis and duodenal ulcers and probably also gastric ulcers. Eradication of the bacteria is fundamental to avoid ulcer relapse. Although bismuth salts have been shown to be effective for treatment, they are not commercially available in Brazil. We report an attempt to treat patients with Helicobacter pylori-associated gastritis with ampicilin (1000 mg twice daily for one month) and compare the results with the conventional treatment used in Brazil (ranitidine, 300 mg daily for one month) and with a combination of the two drugs. We studied 44 patients with histologically confirmed gastritis and with Helicobacter pylori, who were examined at the beginning and after one month of treatment. Ampicilin associated with ranitidine was better than ampicilin or ranitidine alone for the treatment of gastritis. Although ampicilin may be more efficient in patients with lower acid output we did not find a statistically significant difference between these two groups (ampicilin vs drug combination), perhaps owing to the small number of patients studied. When ampicilin was with ranitidine there was 25% normalization of the histological picture of the gastric mucosa. We conclude that ampicilin in combination with ranitidine may be a useful treatment for Helicobacter pylori-associated gastritis

Evaluación del valor nutricional de leches de soya preparadas a partir de granos de soya tratados con microondas / Evaluation of the nutritive value of soybean milk prepared with microwave-treated soybeans

Se prepararon extractos acuosos de soya a partir de granos previamente sometidos a microondas, para la inactivación casi completa de la lipoxigenasa. Las leches de soya así obtenidas se evaluaron nutricionalmente. Todas las leches sometidas a estudio presentaron menor contenido de proteína, lípidos, ceniza y sólidos totales, en comparación con el alimento control, preparado a partir de granos no tratados por microondas. La leche obtenida de granos de soya con 8.7% de humedad inicial, irradiados con microondas durante 240 segundos, acusó el mejor puntaje químico de aminoácidos esenciales y la mayor disponibilidad aparente de metionina y PER. La inactivación completa de la actividad inhibidora de la tripsina se obtuvo en la leche preparada a partir de granos de soya con 56.8% de humedad, tratados por microondas durante 180 segundos. Por otro lado, la leche obtenida de granos de soya con 38.8% de humedad, irradiados con microondas durante 180 segundos, resultó ser la de mayor digestibilidad de la proteína in vitro

Campylobacter pylori in dyspeptic patients

The presence of Campylobacter pylori in gastric mucosa of patients with dyspeptic complaints has been described. The association of the symptoms and endoscopic and histopathologic alterations with the presence of the bacterium still remains unknown. 117 patients were studied with respect to dyspeptic symptoms, endoscopic and histopathologic examinations, microbiological analysis and urease test to detect Campylobacter pylori. Campylobacter pylori was found in 77 per cent of all patients. Of these 36.8 per cent had normal gastric mucosa and 84.7 per cent presented gastritis. There was no association between the symptoms, the endoscopic and histological findings.