Contributions to the knowledge of amphibians and reptiles from Volta Grande do Xingu, northern Brazil / Contribuições para o conhecimento de anfíbios e répteis da Volta Grande do Xingu, norte do Brasil

The region of Volta Grande do Xingu River, in the state of Pará, presents several kinds of land use ranging from extensive cattle farming to agroforestry, and deforestation. Currently, the Belo Monte Hydroelectric Power Plant affects the region. We present a checklist of amphibians and reptiles of the region and discuss information regarding the spatial distribution of the assemblies based on results of Environmental Programmes conducted in the area. We listed 109 amphibian (Anura, Caudata, and Gymnophiona) and 150 reptile (Squamata, Testudines, and Crocodylia) species. The regional species richness is still considered underestimated, considering the taxonomic uncertainty, complexity and cryptic diversity of various species, as observed in other regions of the Amazon biome. Efforts for scientific collection and studies related to integrative taxonomy are needed to elucidate uncertainties and increase levels of knowledge of the local diversity.

A região da Volta Grande no Rio Xingu, localizada no estado do Pará, apresenta várias frentes de exploração que vão desde a criação animal até área de cultivo, resultando no desmatamento de fragmentos florestais. Atualmente a região está sendo impactada pela implantação da Usina Hidrelétrica de Belo Monte. A partir de dados obtidos através dos Programas de Monitoramento Ambiental realizados na área de influência da UHE Belo Monte, apresentamos uma listagem das espécies de anfíbios e répteis, com comentários sobre a distribuição espacial das assembleias. Foram catalogados 109 espécies de anfíbios (Anura, Caudata e Gymnophiona) e 150 de répteis (Squamata, Testudines e Crocodylia). Considerando as incertezas taxonômicas, a complexidade e a diversidade críptica de várias espécies, a riqueza regional ainda continua subestimada, assim como observado em outras regiões da Amazônia. Esforços direcionados ao aproveitamento científico e estudos que contemplem a taxonomia integrativa são necessários para elucidar as incertezas e aumentar o nível de conhecimento sobre a diversidade da região.

Abordagem cognitiva da compreensão leitora: implicações para a educação e prática clínica / Cognitive view of reading compreehension

A importância da compreensão leitora é indiscutível e as publicações nacionais sobre o tema ainda ocorrem em número modesto, tendo em vista o desempenho dos brasileiros em termos desta habilidade. Este artigo apresenta a abordagem cognitiva da compreensão leitora. Enquanto que esta abordagem considera a participação de funções cognitivas de baixo e alto nível neste processo, de forma semelhante a outras teorias, delas se diferencia pela ênfase nas funções executivas e pelo detalhamento do processo de compreensão. Além disso, considera o standard de coerência do leitor como modulador desse processo. O modelo é apresentado e discutido em termos de suas implicações para a prática clínica e para a educação

The importance of reading comprehension is indisputable. National publications on the subject still occur in very modest numbers, given the restriction shown by Brazilians in terms of this skill. This paper presents the cognitive view of reading comprehension. While this theory considers the participation of cognitive functions of lower and higher level in reading comprehension, similarly to other theoretical models, it is distinguished by an emphasis on the executive functions and by the attempt to detail the process of comprehension. It also considers the reader's standard of coherence as a modulator of this process. The model is presented and discussed in terms of its implications for clinical practice and education

Morphometric and quantitative analysis of theafferent renal artery variation

The kidney is a retroperitoneal organ that weight from 125 to 170 g in the adult men and 115to 155 g in adult women. Irrigation kidney is characterized by the presence of large anatomical variability thatmay be influenced by ethnic and to a lesser extent by gender. Among the variations, there may be the presenceof an accessory renal artery that is projected into the upper or lower end of the kidney. This research aimsto observe the incidence of anatomical variations of the afferent renal artery and quantify both right and leftkidney weight.Materials and Methods:We analyzed kidney weights and accessory renal artery variations in48 adult kidneys of both genders obtained from Institute of Anatomy of the University of Severino Sombra.Subsequently, we compared the mean weights of kidneys in order to ascertain whether there was significantdiscrepancy between the left and the right kidney. For this, we performed the Student t test considering aP < 0.05.Results:The mean weight of the right kidney was 140.4 ± 22.6 g and the left was 148.8 ± 20.5 g.In 40% of right kidneys was observed anatomic variation with the presence of accessory renal artery. To the leftkidney was observed a variation of 35%.Conclusion:We found that the accessory renal artery, when present,was more closely related to the end of the kidney especially in the right kidney.

Progesterona plasmática e fertilidade de fêmeas caprinas submetidas à sincronização do estro com prostaglandina F2α / Plasmatic progesterone and fertility of goats submitted at estrus synchronization with Prostaglandin F2α

Avaliou-se a resposta ao protocolo de sincronização do estro com duas doses de prostaglandina F2a (22,5µg) intervaladas de 10 dias, por meio da mensuração da concentração de progesterona plasmática, bem como a taxa de concepção das cabras após a inseminação artificial, de acordo com as diferentes respostas obtidas. Utilizaram-se 23 fêmeas e dois reprodutores da raça Toggenburg. A mensuração da progesterona plasmática foi realizada no dia da primeira aplicação de PGF2a (D0), no D5, no dia da segunda aplicação de PGF2a (D10), no D15, no D20 e no D33. A resposta positiva à PGF2α foi determinada pela queda da concentração de progesterona a valores abaixo de 1,5ng/mL, mensurada nos dias cinco e 15. As fêmeas foram distribuídas em três grupos. O grupo I foi composto por fêmeas que responderam às duas aplicações; o grupo II por fêmeas que não responderam à primeira aplicação e responderam à segunda aplicação; e o grupo III por fêmeas que responderam à primeira aplicação e não responderam à segunda aplicação, foram inseminadas e não conceberam. A presença de um corpo lúteo funcional, no momento das aplicações, determinou a resposta ao protocolo. As diferentes respostas das fêmeas ao protocolo, grupo I e II, não influenciaram as taxas de concepção.

Plasmatic progesterone concentrations were evaluated during the synchronization protocol with two doses of 22.5µg of Prostaglandin F2α, 10-day interval, and the conception rate of females in accordance to the reply to the protocol. Twenty-three female goats and two sexually mature Toggenburg bucks were used. Blood was sampled on day 0 (1st PGF2α injection), and on the following days 5, 10 (2nd PGF2α injection), 15, 20, and 33. The positive reply to the PGF2α was determined when the progesterone concentrations fell to values below 1.5ng/mL at days 5 and 15. The females were divided in three groups: Group I: females that responded to the two PGF2α applications; Group II: females that responded only to the second application; Group III: females that responded the first application, did not respond to the second application, were inseminated but did not conceive. The presence of a functional corpus luteum at the moment of the applications determined the reply to the protocol. There was no difference in the conception rates between females that responded to the two PGF2α applications or responded only to the second application.

5-HT1A autoreceptor modulation of locomotor activity induced by nitric oxide in the rat dorsal raphe nucleus

The dorsal raphe nucleus (DRN) is the origin of ascending serotonergic projections and is considered to be an important component of the brain circuit that mediates anxiety- and depression-related behaviors. A large fraction of DRN serotonin-positive neurons contain nitric oxide (NO). Disruption of NO-mediated neurotransmission in the DRN by NO synthase inhibitors produces anxiolytic- and antidepressant-like effects in rats and also induces nonspecific interference with locomotor activity. We investigated the involvement of the 5-HT1A autoreceptor in the locomotor effects induced by NO in the DRN of male Wistar rats (280-310 g, N = 9-10 per group). The NO donor 3-morpholinosylnomine hydrochloride (SIN-1, 150, and 300 nmol) and the NO scavenger S-3-carboxy-4-hydroxyphenylglycine (carboxy-PTIO, 0.1-3.0 nmol) were injected into the DRN of rats immediately before they were exposed to the open field for 10 min. To evaluate the involvement of the 5-HT1A receptor and the N-methyl-D-aspartate (NMDA) glutamate receptor in the locomotor effects of NO, animals were pretreated with the 5-HT1A receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT, 8 nmol), the 5-HT1A receptor antagonist N-(2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl)-N-2-pyridinyl-cyclohexanecarboxamide maleate (WAY-100635, 0.37 nmol), and the NMDA receptor antagonist DL-2-amino-7-phosphonoheptanoic acid (AP7, 1 nmol), followed by microinjection of SIN-1 into the DRN. SIN-1 increased the distance traveled (mean ± SEM) in the open-field test (4431 ± 306.1 cm; F7,63 = 2.44, P = 0.028) and this effect was blocked by previous 8-OH-DPAT (2885 ± 490.4 cm) or AP7 (3335 ± 283.5 cm) administration (P < 0.05, Duncan test). These results indicate that 5-HT1A receptor activation and/or facilitation of glutamate neurotransmission can modulate the locomotor effects induced by NO in the DRN.

Expression of neuronal nitric oxide synthase in the hippocampal formation in affective disorders

Hippocampal output is increased in affective disorders and is mediated by increased glutamatergic input via N-methyl-D-aspartate (NMDA) receptor and moderated by antidepressant treatment. Activation of NMDA receptors by glutamate evokes the release of nitric oxide (NO) by the activation of neuronal nitric oxide synthase (nNOS). The human hippocampus contains a high density of NMDA receptors and nNOS-expressing neurons suggesting the existence of an NMDA-NO transduction pathway which can be involved in the pathogenesis of affective disorders. We tested the hypothesis that nNOS expression is increased in the human hippocampus from affectively ill patients. Immunocytochemistry was used to demonstrate nNOS-expressing neurons in sections obtained from the Stanley Consortium postmortem brain collection from patients with major depression (MD, N = 15), bipolar disorder (BD, N = 15), and schizophrenia (N = 15) and from controls (N = 15). nNOS-immunoreactive (nNOS-IR) and Nissl-stained neurons were counted in entorhinal cortex, hippocampal CA1, CA2, CA3, and CA4 subfields, and subiculum. The numbers of Nissl-stained neurons were very similar in different diagnostic groups and correlated significantly with the number of nNOS-IR neurons. Both the MD and the BD groups had greater number of nNOS-IR neurons/400 µm² in CA1 (mean ± SEM: MD = 9.2 ± 0.6 and BD = 8.4 ± 0.6) and subiculum (BD = 6.7 ± 0.4) when compared to control group (6.6 ± 0.5) and this was significantly more marked in samples from the right hemisphere. These changes were specific to affective disorders since no changes were seen in the schizophrenic group (6.7 ± 0.8). The results support the current view of the NMDA-NO pathway as a target for the pathophysiology of affective disorders and antidepressant drug development.

Ginkgo biloba leaf extract (EGb 761) enhances catalepsy induced by haloperidol and L-nitroarginine in mice

Ginkgo biloba extract EGb 761 has been reported to have therapeutic effects which have been attributed to anti-oxidant and free radical-scavenging activities, including a direct action on nitric oxide production. L G-nitro-arginine (L-NOARG), a nitric oxide synthase inhibitor, and haloperidol, a drug that blocks dopamine receptors, are both known to induce catalepsy in rodents. Nitric oxide has been shown to influence dopaminergic transmission in the striatum. The purpose of the present study was to evaluate the effect of the extract obtained from leaves of Ginkgo biloba tree EGb 761 on catalepsy induced by haloperidol or by L-NOARG. Albino Swiss mice (35-45 g, N = 8-12) received by gavage a single or repeated oral dose (twice a day for 4 days) of EGb 761 followed by ip injection of haloperidol or L-NOARG. After the treatments, the animals were submitted to behavioral evaluation using the catalepsy test. Acute treatment with 80 mg/kg EGb did not modify the catalepsy induced by L-NOARG but, the dose of 40 mg/kg significantly enhanced haloperidol-induced catalepsy measured at the 10th min of the test. After repeated treatment with 80 mg/kg EGb 761, a significant increase in the cataleptic effect produced by both haloperidol and L-NOARG was observed. These data show that repeated EGb 761 administration increases the effects of drugs that modify motor behavior in mice. Since the catalepsy test has predictive value regarding extrapyramidal effects, the possibility of pharmacological interactions between haloperidol and Ginkgo biloba extracts should be further investigated in clinical studies.

Hypomagnesemia in critically ill cancer patients: a prospective study of predictive factors

Hypomagnesemia is the most common electrolyte disturbance seen upon admission to the intensive care unit (ICU). Reliable predictors of its occurrence are not described. The objective of this prospective study was to determine factors predictive of hypomagnesemia upon admission to the ICU. In a single tertiary cancer center, 226 patients with different diagnoses upon entering were studied. Hypomagnesemia was defined by serum levels <1.5 mg/dl. Demographic data, type of cancer, cause of admission, previous history of arrhythmia, cardiovascular disease, renal failure, drug administration (particularly diuretics, antiarrhythmics, chemotherapy and platinum compounds), previous nutrition intake and presence of hypovolemia were recorded for each patient. Blood was collected for determination of serum magnesium, potassium, sodium, calcium, phosphorus, blood urea nitrogen and creatinine levels. Upon admission, 103 (45.6 percent) patients had hypomagnesemia and 123 (54.4 percent) had normomagnesemia. A normal dietary habit prior to ICU admission was associated with normal Mg levels (P = 0.007) and higher average levels of serum Mg (P = 0.002). Postoperative patients (N = 182) had lower levels of serum Mg (0.60 ± 0.14 mmol/l compared with 0.66 ± 0.17 mmol/l, P = 0.006). A stepwise multiple linear regression disclosed that only normal dietary habits (OR = 0.45; CI = 0.26-0.79) and the fact of being a postoperative patient (OR = 2.42; CI = 1.17-4.98) were significantly correlated with serum Mg levels (overall model probability = 0.001). These findings should be used to identify patients at risk for such disturbance, even in other critically ill populations

Monitoring human cytomegalovirus viral load in peripheral blood leukocytes of renal transplant recipients by a simple limiting dilution-PCR assay

To assess the clinical relevance of a semi-quantitative measurement of human cytomegalovirus (HCMV) DNA in renal transplant recipients within the typical clinical context of a developing country where virtually 100 per cent of both receptors and donors are seropositive for this virus, we have undertaken HCMV DNA quantification using a simple, semi-quantitative, limiting dilution polymerase chain reaction (PCR). We evaluated this assay prospectively in 52 renal transplant patients from whom a total of 495 serial blood samples were collected. The samples scored HCMV positive by qualitative PCR had the levels of HCMV DNA determined by end-point dilution-PCR. All patients were HCMV DNA positive during the monitoring period and a diagnosis of symptomatic infection was made for 4 of 52 patients. In symptomatic patients the geometric mean of the highest level of HCMV DNAemia was 152,000 copies per 106 leukocytes, while for the asymptomatic group this value was 12,050. Symptomatic patients showed high, protracted HCMV DNA levels, whereas asymptomatic patients demonstrated intermittent low or moderate levels. Using a cut-off value of 100,000 copies per 106 leukocytes, the limiting dilution assay had sensitivity of 100 per cent, specificity of 92 per cent, a positive predictive value of 43 per cent and a negative predictive value of 100 per cent for HCMV disease. In this patient group, there was universal HCMV infection but relatively infrequent symptomatic HCMV disease. The two patient groups were readily distinguished by monitoring with the limiting dilution assay, an extremely simple technology immediately applicable in any clinical laboratory with PCR capability.

Frequency of cholelithiasis in alcoholics

In order to determine the frequency of biliary lithiasis in alcoholic patients without signs of hepatic cirrhosis, we submitted 106 male alcoholics (mean age, 42.2 + or - 11.2 years) to ultrasound examination of the biliary system. Cholelithiasis was present in 6 (5.6 percent). We did not observe any association between the quantity of ethanol consumed and/ or the time of consumption and the presence of cholelithiasis. There was no significant difference between the frequency of cholelithiasis in these patients and that found in autopsies carried out on 716 male patients (6 percent) at the Hospital de Clínicas, Universidade Federal de Uberlândia, during the period 1982 to 1993. thus, we conclude that in the cases we examined, alcoholism did not represent a risk factor for biliary lithogenesis

Roedores silvestres como modelos experimentais da esquistossomose mansonica: Akodon arviculoides (Rodentia: Cricetidae) / Wild rodents as experimental models of schistosomiasis mansoni: Akodon arviculoides (Rodentia: Cricetidae)

A infeccao experimental do A. arviculoides atraves de diferentes vias de penetracao das cercarias de Schistosoma mansoni (transcutanea e subcutanea) foi estudada pela cinetica de eliminacao de ovos nas fezes, pela recuperacao dos vermes adultos (no sistema porta e nos vasos mesentericos) e pelo oograma quantitativo. Demonstrou-se que a infeccao do A. arviculoides assemelha-se a dos camundongos albinos que serviram de controle, quanto a eficacia das vias de penetracao, ao habitat dos vermes adultos e ao oograma. Esses resultados sugerem que se avaliem outros aspectos da relacao parasito-hospedeiro para que o A. arviculoides possa ser indicado como modelo experimental alternativo, nos estudos sobre a esquistossomose.

Stereoselectivity of the anxiolytic effect of propranolol microinjected into the dorsal midbrain central gray

In a previous study we have shown that microinjection of d,I-propranolol into the dorsal midbrain central gray of the rat causes an anxiolytic effect in the elevated plus-maze model which is lilkely to be mediated by endogenous 5-hydroxytryptamine. In the present experiment, the effects of 1- and d,1-propranolol were compared under the same experimental conditions. Both the I-isomer and the racemic mixture increased the percentage of open arm entries without affecting the total number of entries into either open or enclosed arms of the maze, thus reproducing the selective anxiolytic effect previously described. The doses of 5 nmol 1-propanolol and 10 nmol d,1-propranolol caused anxiolytic effects of comparable magnitude, while the doses of 2,5 nmol of the former and 5 nmol of the latter were ineffective. Therefore, the 1-isomer was nearly twice as potent as the racemic mixture, thus being responsible for the pharmacological activity observed. These results are compatible with the proposal that propranol blocks stereospecific autoreceptors in serotonergic nerve endings that inhibit neurotransmitter release

Antyphospholipid antibodies in syphilis

1. An enzyme-linked immunosorbent assay was used to determine the phospholipid specificity of antibodies in sera from 35 syphilis patients. 2. Based on the cross-reaction obtained aginst a mixture of cardiolipin, phosphatidylcholine and holesterol that is standard for flocculation tests according to the Venereal Disease Research Laboratory (CECON, Säo Paulo, Brazil), all 35 patients tested positive for antibodies of the IgG class whereas 13 (37%) also had IgM antibodies for the same mixture of lipids. IgG antibodies to cardiolipin were demonstrated in 2 patients (6%) and IgM antibodies in 5 (15%). Significant levels of IgG anti-phosphatidylcholine were detected in 3 patients (9%) and IgM antibodies in 4(11%). IgG anti-phosphatidylethanolamine antibodies were found in 1 patient (3%) and IgM antibodies in 3(9%). Antibody binding to cardiolipin plus cholesterol or cardiolipin plus phosphatidycholine was as effective as when the standard mixture of all 3 lipids was used. 3. A comparison with serum from systemic lupus erythematosus patients and inhibition studies using liposomes o cardiolipin or the mixture of 3 lipids suggests that there are at least 3 groups of anticardiolipin antibodies

Bloqueio do plexo braquial por via axilar: pode o bloqueio motor antecipar a analgesia efetiva? / Brachial plexus block by axillary approach: can motor block anticipate effective analgesia?

Estudou-se em 20 pacientes, estado físico ASA I ou II, sem comprometimento neurológico de membro superior, submetidos à técnica perivascular axilar de Winnie, utilizando bupivacaína a 0,3%, com volume calculado em funçäo da altura do paciente em centímetros (h x 25). A punçäo realizou-se com uma só agulha e fixada após o seu correto posicionamento. Após a injeçäo foram avaliadas a cada dois minutos as funçöes motoras dos grupos musculares correspondentes a cada um dos principais nervos do membro superior: extensäo do antebraço para o radial, flexäo do antebraço para o músculo-cutâneo; flexäo palmar do punho para o mediano e abduçäo/aduçäo dos dedos para o ulnar. Classificaram-se os resultados em quatro graus; MO =normal, M1 = sensaçäo subjetiva de dificuldade motora, M2 = dificuldade objetiva (visual) do movimento e M3 = incapacidade motora (relaxamento). Paralelamente, a cada cinco minutos, observaram-se as variaçöes na sensibilidade, classificadas em três graus: SO = normal, S1 = parestesias (formigamento); S2 = analgesia efetiva, pelo teste do pinçamento. Classificaram-se os resultados mostraram que a instalaçäo de M1, de M2 e de S1 precedem de forma significativa (p <0,01) a instalaçäo de S2 nas áreas dos nervos radial, ulnar e mediano. Para o músculo-cutâneo o fato näo se repetiu. A comparaçäo do número de ocorrências de M1, M2, M3 e S1 com o número de ocorrências de S2 foi semelhante nas áreas dos nervos radial, ulnar e mediano. Apenas M3 foi täo freqüente quanto S2 para o nervo músculo-cutâneo. Concluiu-se que (1) há, efetivamente, um bloqueio insuficiente ou tardio do nervo músculo-cutâneo nas técnicas axilares do bloqueio do plexo braquial; (2) que a sensaçäo subjetiva de peso, a dificuldade motora e o aparecimento de parestesias antecedem de forma significativa a analgesia completa, nas áreas dos nervos radial, mediano e ulnar, pelo que constituem sinais precoces de bloqueio efetivo e (3) que as mesmas sensaçöes e dificuldades näo servem para antecipar a efetividade de bloqueio para o nervo músculo-cutâneo

Determinacao da proteina C-reativa na doenca reumatoide e no lupus eritematoso sistemico. Correlacoes com a velocidade de eritrossedimentacao e com a mucoproteina. / C-reactive protein determination in rheumatoid disease and systemic lupus erythematosus. Its correlation with the velocity of erythrosedimentation and micoprotein

A proteina C-reativa (PCR), a velocidade de eritrossedimentacao (VHS) e a mucoproteina (Muco) foram determinadas em 56 pacientes adultos: 34 com doenca reumatoide (DRe) e 22 com lupus eritematoso sistemico (LES). A PCR alcancou valores mais elevados na DRe ativa do que nos LES ativo, independente da presenca duma complicacao infecciosa. Verificamos na DRe um certo paralelismo nos achados da PCR com aqueles da VHS e da Muco, as quais traduzem, indistintamente, o grau de resposta inflamatoria, embora possam ter diferentes significados clinicos. No LES, observamos nitida diferenca entre os resultados obtidos no grupo com a doenca ativa sem infeccao daqueles com infeccao bacteriana associada principalmente em relacao aos niveis sericos de PCR. No entanto, em virtude do encontro de variaveis valores quantitativos (altos e baixos) nestas duas situacoes cli nicas, acreditamos ser temerario utilizar a PCR como elemento patognomico do diagnostico diferencial

Pneumonite intersticial e miastenia grave. Relato de caso com estudo anatomopatologico. / Intersticial pneumonite and myasthenia gravis. Report of a case with anatomopathologic study

Mulher com 39 anos de idade, com miastenia grave desenvolveu, cinco anos depois, fibrose pulmonar intersticial. Em virtude da ausencia de dados na literatura ate o presente momento, os autores tecem consideracoes a respeito desta rara associacao, chamando a atencao para existencia de anti-corpo anti-colageno I em ambas as doencas. Baseados neste fato os autores consideram esta associacao mais que uma mera coincidencia

Revisao do quadro de malaria por P.falciparum. / Review of the clinical aspects in patients with malaria due to P. falciparum

Pacientes portadores de infeccoes malarias causadas por Plasmodium falciparum, que haviam sido admitidos ao Hospital Barros Barreto para inclusao no Projeto Mefloquina, mas que, por diferentes motivos, foram excluidos do referido projeto tiveram seus quadros clinicos analisados a fim de que se verificasse a correlacao entre os respectivos quadros clinicos e a ocorrencia ou nao de antecendentes malaricos. Observou-se uma variacao muito grande dos sintomas e sinais, porem o numero e a intensidade das manifestacoes clinicas mostraram-se inversamente influenciados pela frequencia de exposicao aos plasmodios. As complicacoes surgidas durante o tratamento afetaram, principalmente, o sistema nervoso central, tendo um caso apenas evoluido para o obito

Estudo evolutivo da doenca mista do tecido conectivo. / Course of mixed connective tissue disease

A doenca mista do tecido conjuntivo (DMTC) descrita por Sharp em 1969, e caracterizada por uma superposicao clinica de lupus eritematoso sistemico (LES), miosite (PM-DM), esclerose sistemica progressiva(ESP) e artrite reumatoide (AR); presenca de altos titulos de anticorpos anti-RNP, ausencia de anticorpos anti-DNA-nativo, baixa frequencia de comprometimento renal e bom prognostico sob o uso de doses baixas de esteroides. Neste estudo, oito pacientes com esta doenca foram seguidos evolutivamente, durante tres anos, em relacao aos aspectos clinicos e laboratoriais. Os demais permanecem com quadro clinico de LES ou DMTC. Nenhum deles evoluiu para ESP. Os estudos laboratoriais nao mudaram significativamente. Os autores concluiram que a DMTC pode ser considerada como uma sindrome isolada no grupo das doencas difusas do tecido conectivo

Interacoes medicamentosas: nossa realidade. / Drug interaction: our reality

Com o proposito de verificar as interacoes medicamentosas mais frequentes em nosso meio, realizou-se o estudo de 1.200 prescricoes de pacientes internados em diversas clinicas de Curitiba no ano de 1981.Observou-se um total de 455 interacoes medicamentosas, sendo 156 (34,3%) de importancia clinica menor, 262 (57,6%) de importancia clinica relativa e 37 (8,1%) de importancia clinica maior. Existe, portanto, elevado indice de interacoes medicamentosas, grande parte das quais potencialmente prejudiciais aos pacientes