Indicadores bioquímico e hormonal de vacas leiteiras mestiças sadias e doentes durante o final da gestação e o início da lactação / Biochemical and hormonal indicators from healthy and sickly crossbred dairy cows during late pregnancy and early lactation

Objetivou-se identificar alguns indicadores bioquímicos e hormonais durante o final da gestação e início da lactação de vacas leiteiras sadias, quando comparadas com as que apresentaram algum tipo de transtorno clínico ao longo do experimento. Para tanto, utilizou-se 39 vacas mestiças (holandês x Gir), distribuídas em dois grupos, o primeiro (G1) com 22 animais hígidos e o segundo (G2) com 17 vacas que apresentaram algumas enfermidades (retenção de placenta, endometrite, mastite, pododermatite e distocia materna). O delineamento experimental ocorreu a partir das coletas realizadas nos períodos -60, -40, -20, -10 dias antes do parto, 0 (dia do parto), e +10, +20, +40, +60 dias pós-parto. Analisou-se os metabólitos energéticos (glicose, frutosamina, AGNEs e β-hidroxibutirato), hormonais (insulina e cortisol), proteicos (proteína total, albumina, globulina e ureia) e minerais (CaT, P, Mg, K, Na e Cl). As variáveis estudadas foram interpretadas por meio de análise de variância ao nível de 5% de probabilidade. Analisando o perfil energético, verificou-se uma maior mobilização no G2 durante o periparto, por meio dos menores valores de frutosamina e glicose, além das concentrações superiores de AGNEs e β-hidroxibutirato. O comportamento dos hormônios insulina e cortisol foi similar, observando apenas efeito de momento, cujos maiores concentrações ocorreram no dia do parto. O perfil proteico revelou, pela proteína total apenas efeito de momento, em que seus menores valores foram verificados no dia do parto, contudo, a albumina do G2 foi inferior ao G1 em todos os momentos, já as globulinas do G2 foram superiores ao grupo das vacas hígidas e a ureia apresentou concentrações maiores no G1. Com relação aos minerais o cálcio total, magnésio e cloro apontaram níveis inferiores desde o período inicial das coletas no grupo G2. Conclui-se, que esses metabólitos estudados sinalizaram precocemente a deficiência nutricional durante o final da gestação, repercutindo no período de transição, e comprometendo o mecanismo de adaptação das vacas, com isso aumentando os riscos para maior ocorrência de enfermidades.(AU)

This study aimed to identify some biochemical and hormonal indicators during late pregnancy and early lactation from healthy dairy cows crossbred compared with those who had some type of clinical disorder throughout the experiment. Therefore, we used 39 Crossbred dairy cows (Holstein x Gyr), divided into two groups, the first (G1) with 22 healthy animals and the second (G2) with 17 cows showed some disease (retained placenta, endometritis, mastitis, foot rot and maternal dystocia). The experiment took place from collections made in the period -60, -40, -20, -10 days before delivery, 0 (parturition day), and +10, +20, +40, +60 days postpartum. We analyzed energy metabolites (glucose, fructosamine, NEFA and β-hydroxybutyrate), hormone (insulin and cortisol), protein (total protein, albumin, globulin and urea) and minerals (CaT, P, Mg, K, Na and Cl). The variables studied were interpreted by analysis of variance at 5% probability. Analyzing the energetic profile, there was a greater mobilization in G2 during childbirth, through the lower fructosamine and glucose values, besides higher concentrations of Agnes and β-hydroxybutyrate. The behavior of the hormones insulin and cortisol was similar, noting only effect of time, whose higher levels occurred on the day of delivery. The protein profile revealed by total protein only time effect in their lowest values were recorded on the day of delivery, however, albumin G2 was lower than the G1 at all times, since the G2 globulin were higher than the group of otherwise healthy cows and urea showed higher concentrations in G1. With respect to the total mineral calcium, magnesium and chlorine showed lower levels from the initial period of the collections in G2. It follows that these metabolites studied early signal nutritional deficiency during late pregnancy, reflecting the transition period, and compromising the adjustment mechanism for cows, thereby increasing the risks to higher incidence of disease.(AU)

Utilidad de la resonancia magnética en el diagnóstico de lesiones musculares de localización atípica / Usefulness of magnetic resonance imaging in the diagnosis of atypical location muscle lesions

En el presente los desgarros musculares son una causa muy frecuente de lesión en la práctica deportiva. Según los estudios actuales, un 30% de las lesiones en atletas afecta los músculos, siendo particularmente comunes a nivel de los isquiotibiales, el recto anterior de los cuádriceps, los gemelos y los aductores. El diagnóstico se realiza en forma sencilla mediante un estudio ecográfico. Sin embargo, existe un número importante de lesiones musculares de localización profunda e infrecuente, que pueden pasar inadvertidas en la ecografía y que causan largos períodos de inactividad para el deportista. La resonancia magnética (RM), por su resolución anatómica y capacidad multiplanar, es el método de elección para el estudio de este tipo de afecciones, ya que permite descartar otras patologías de similar presentación clínica y realizar un diagnóstico específico. En este artículo describimos los desgarros musculares de localización inusual, particularmente los de localización pelviana, evaluando también la pared torácica, abdominal y miembros superiores e inferiores. En todos los casos, se usaron equipos de alto campo 1.5 y 3 Tesla.

Muscle injuries are currently particularly frequent among people who participate in sports. Current studies show that 30% of injuries in athletes affect muscles, with hamstrings, quadriceps, gastrocnemius, and adductors being particularly prevalent. The diagnosis is easily made with an ultrasound study. However, there are a significant number of muscle injuries, considered uncommon, that may be not be detected by ultrasound, mainly because of their depth, and could be responsible for long periods of inactivity for the sportsman. Magnetic resonance imaging (MRI), with a better anatomical resolution and multiplanar capability, is the method of choice for detecting the precise location and severity of the injury and can establish their severity. The aim of this article is to review muscle tears of unusual location, particularly in the pelvic area, but also evaluating the chest wall, abdomen, and upper and lower limbs. All patients were evaluated by 3 and 1.5 Tesla MRI units.

Neuralgia del trigémino: estudio funcional mediante tensor de difusión de alta densidad como herramienta diagnóstica / Trigeminal Neuralgia: functional study using high density diffusion tensor imaging as a diagnostic tool

Objetivo: El objetivo del presente artículo es demostrar la alteración de la fracción de anisotropía (FA) en la neuralgia esencial del trigémino (NET). Materiales y métodos: Se evaluaron 10 pacientes con diagnóstico de neuralgia esencial del trigémino mediante secuencias de tensor de difusión de alta densidad e imágenes anatómicas 3D en un resonador de alto campo 3 Tesla. En todos los casos se localizaron los nervios. Las imágenes obtenidas se posprocesaron para realizar la tractografía y medir la FA en 20 nervios. Resultados: Se correlacionaron los hallazgos patológicos entre la medición de la FA y la clínica de los pacientes. De los 10 casos, 6 presentaron compresión neurovascular de lado con neuralgia y un valor de FA descendido con respecto al contralateral en rango normal; mientras que 2 mostraron compresión neurovascular bilateral, pero solo descenso del valor de FA del lado afectado clínicamente. En los otros 2 pacientes no se determinó compresión neurovascular, aunque en el lado con manifestación clínica neurálgica la FA se encontraba descendida. Conclusión: La realización de la difusión anisotrópica de alta densidad y la medición de la FA pueden ser una herramienta en la evaluación de la neuralgia esencial del trigémino, ya que es un método reproducible y seguro que permite estudiar la función del nervio.

Objective: The objective of this article is to demonstrate the alteration of the anisotropy factor (FA) in essential trigeminal neuralgia. Materials and methods: Ten patients with essential trigeminal neuralgia were studied with sequences of high density diffusion tensor and anatomic 3D images with a high-field 3 Tesla resonator. The nerves were located in all cases studied. The obtained images were post-processed to perform tractography and FA was measured in 20 nerves. Results: There was correlation of pathological findings between measuring FA and clinical presentation of the patients. Six of the ten patients studied with neurovascular compression at the neuralgia side had decreased FA values compared to contralateral normal range. Two of the ten patients showed bilateral neurovascular compression, but only abnormal values of FA were found at the clinically affected side. In the remaining two patients no neurovascular compression was determined; however the FA was lower at the clinical manifestation neuralgic side. Conclusión: The performing of high density anisotropic diffusion and the measurement of the FA may be useful in the evaluation of Trigeminal neuralgia, since it is a safe and reproducible method that allows the study of nerve function.

Achados bioquímicos, eletrolíticos e hormonais de cabras acometidas com toxemia da prenhez / Biochemical, electrolytic and hormonal findings in goats affected with pregnancy toxemia

A abrangência dos estudos sobre a toxemia da prenhez (TP) tem sido constante e inovadora em alguns conceitos, porém o estudo dos casos clínicos naturais em cabras é inexistente no Brasil. Diante disso, realizou-se análise das alterações clínicas, do perfil bioquímico, eletrolítico e hormonal com o objetivo de compreender a fisiopatogenia da enfermidade. Foram avaliadas 22 cabras atendidas na Clínica de Bovinos, Campus Garanhuns/UFRPE, diagnosticadas com TP, no período de 2007 a 2012. Realizou-se exame clínico e coleta de sangue e urina, para análise do perfil bioquímico e hormonal. Acentuadas alterações clínicas foram observadas, como decúbito, apatia, dispneia, aumento da temperatura corpórea, mucosas congestas, vasos episclerais injetados, desidratação, anorexia, hipomotilidade ou atonia ruminal, edema nos membros. Os resultados laboratoriais revelaram valores elevados para ureia, creatinina, ácidos graxos não esterificados (AGNE), β-hidroxibutirato, amilase e cortisol, enquanto as variáveis: proteína total, albumina, cálcio total, cálcio ionizado, fósforo, a relação cálcio e fósforo, sódio e insulina encontraram-se diminuídos. Outros parâmetros bioquímicos e eletrolíticos, como frutosamina, globulina, cloro, potássio e magnésio mantiveram-se dentro da faixa de normalidade. Quanto a glicemia, foram constatados três condições nas cabras com TP, normoglicêmicas (50%), hiperglicêmicas (27,28%) e hipoglicêmicas (22,72%). Dos 17 (77,27%) animais que obtiveram alta 10 (58,82%) eram normoglicêmicos. Vieram a óbito 22,8 % (5/22), no qual 60% (3/5) delas estavam hiperglicêmicas. A média de nascimento por cabra foi superior a duas crias. Verificou-se existir associação fortemente positiva dos AGNE's com a albumina (r=0,60), fraca com o β-hidroxibutirato (r=0,10) e glicose (r=0,03). Porém, existiu relação fortemente negativa dos AGNE's com a insulina (r= -0,70), moderada com o cortisol (r= -0,52) e amilase (r= -0,30). Marcadas alterações clínicas e metabólicas ...

Studies on pregnancy toxemia (PT) have been constant and innovative with regard to some concepts. However, no studies have been carried out on natural clinical cases in Brazil. Thus, the aim of the present study was to perform an analysis of clinical, biochemical, electrolytic and hormonal findings in goats with PT to gain an understanding of the physiopathology of this metabolic disease. Twenty-two goats with a diagnosis of PT were analyzed at the Bovine Clinic of the Federal Rural University of Pernambuco (Garanhuns Campus, Brazil) between 2007 and 2012. Clinical exams were performed and both blood and urine were collected for the biochemical and hormonal analyses. Accentuated clinical changes were found, such as decubitus, apathy, dyspnea, increased body temperature, congested mucous membranes, dilated episcleral vessels, dehydration, anorexia, ruminal stasis and edema in the limbs. The laboratory findings revealed high concentrations of urea, creatinine, non-esterified fatty acids, β-hydroxybutyrate, amylase and cortisol as well as reductions in total proteins, albumin, total calcium, ionized calcium, phosphorus the calcium to phosphorus ratio, sodium and insulin. Fructosamine, globulin, chlorine, potassium and magnesium were within the range of normality. Regarding blood sugar, 50% of the goats were within the normal range, 27.28% were hyperglycemic and 22.72% were hypoglycemic; among the 17 animals (77.27%) discharged with life, ten (58.82%) had normal blood sugar levels. Five goats (22.8%) died, 60% (3/5) of which were hyperglycemic. The mean birth rate per goat was more than two offspring. Non-esterified fatty acids were strongly associated with albumin (r = 0.60) and weakly associated with both β-hydroxybutyrate (r=0.10) and glucose (r=0.03). Moreover, non-esterified fatty acids were negatively associated with insulin (r= -0.70; strong association), cortisol (r= -0.52; moderate association) and amylase (r= -0.30; moderate association)...

Identificación prequirúrgica de pares craneales en tumores de la base del cráneo mediante la técnica de tensor de difusión / Diffusion tensor technique as a preoperative identification of cranial nerves in skull base tumors

Objetivo: El objetivo de este trabajo es demostrar la utilidad de las técnicas de tensor de difusión de alta densidad (DTI 32 direcciones) para visualizar el trayecto de los pares craneales antes de la cirugía en pacientes con patología tumoral de la base del cráneo. Materiales y métodos: Se estudiaron 26 pacientes con patología tumoral de la base del cráneo con secuencias de tensor de difusión de alta densidad. Los resultados imagenológicos fueron correlacionados con los hallazgos intraoperatorios. Resultados: En todos los pacientes estudiados fue posible la identificación prequirúrgica del recorrido de los nervios involucrados por las lesiones de la base del cráneo y también hubo una correlación entre los datos obtenidos mediante las imágenes y los hallazgos intraoperatorios. Conclusión: La visualización del recorrido de los nervios craneales mediante la difusión de alta densidad demostró ser segura y reproducible para identificar los pares y su recorrido...

Objective: The objective of this work is to demonstrate the usefulness of high density diffusion tensor imaging techniques (HD-DTI 32 directions), to visualize the course of the cranial nerves prior to surgery in patients with skull base tumor disease.Materials and methods: Twenty-six patients with skull base tumor disease were studied with sequences of high density diffusion tensor imaging. The imaging results were correlated with the intra-operative fi ndings.Results: Pre-surgical identifi cation of the course of the nerves affected by the injuries of the skull base was possible in all the studied patients, with the imaging results correlating with the intraoperative fi ndings.Conclusion: The visualization of the course of the cranial nerves with high density diffusion tensor imaging was shown to be safe and reproducible for the identifi cation of cranial nerves and their course...

Indicadores bioquímicos e hormonais de casos naturais de toxemia da prenhez em ovelhas / Biochemical and hormonal indicators of natural cases of pregnancy toxaemia of in sheep

Toxemia da prenhez é considerada um transtor-acordo com a resolução clínica dos animais, alta hospitano metabólico de grande impacto econômico na produção lar (G1) e aqueles que morreram (G2). A manifestação cli-de ovinos, porém as particularidades de repercussão sis-nica da doença foi observada no período do pré-parto em têmicas deste distúrbio ainda são pouco esclarecedoras. O 100 por cento dos animais, destes 66,2 por cento (n=51) receberam alta presente estudo teve por objetivo avaliar o perfil bioquí-clínica e 33,8 por cento (n=26) morreram. Dos casos de toxemia mico e hormonal de 77 ovelhas com diagnóstico clínico de da prenhez estudados havia gestação múltipla em 55,8 por cento. toxemia da penhez e comparar os achados laboratoriais de Dentre os parâmetros estudados, cortisol, uréia, AST e CK estavam mais elevados no G2 em relação ao G1 com diferenças significativas (P0,05). Não ocorreram alterações nas taxas de colesterol e triglicerídios. Houve redução nos índices da insulina, não havendo diferenças entre G1 e G2 (P>0,05). Todas as ovelhas apresentaram cetonúria e acidúria.

Toxemia of pregnancy is a metabolic disorder with considerable economic impact on the production of sheep. However, the particularities of the systemic repercussion of the disorder have not yet been fully clarified. The aim of the present study was to assess the biochemical and hormonal profile of 77 ewes with a clinical diagnosis of toxemia of pregnancy and to compare the laboratory findings based on the clinical outcome: discharge (G1) or death (G2). The clinical manifestation of the disease was observed in the pre-birth period in 100 percent of the ewes, from which 66.2 percent (n=51) were discharged and 33.8 percent (n=26) died. A total of 55,8 percent of the cases were of multiple pregnancies.. Considering the parameters analyzed, cortisol, urea, AST and CK were significantly higher in G2 in comparison to G1 (p<0.05). An increase was found in the concentration of plasma glucose, fructosamine, albumin, creatinine, ß-hydroxybutyrate, non-esterified fatty acids and L-lactate, with no statistically significant differences between groups (p>0.05). No changes were found in cholesterol or triglycerides. A reduction in insulin levels was found, with no statistically significant difference between groups (p>0.05). All ewes exhibited ketonuria and aciduria.

Linfossarcoma em bovinos no Agreste Meridional de Pernambuco / Lymphosarcoma in cattle from the hinterland of Pernambuco state

Neste trabalho são descritos os sinais clínicos, patologia clínica e patologia de 24 bovinos com leucose bovina enzoótica atendidos na Clínica de Bovinos de Garanhuns da Universidade Federal Rural de Pernambuco. Esses casos representaram 0,5 por cento de 4.758 bovinos atendidos entre os anos de 2000 e 2010. A doença afetou 22 (91,7 por cento) fêmeas e dois machos. Vinte e um animais (87,5 por cento) eram de raças leiteras (seis Holandês, 13 Girolando, um Jersey e um Pardo Suíça) e três (12,5 por cento) eram da raça Nelore. Vinte e três animais (95,8 por cento) tinham idade entre 3 e 8 anos e um era mais jovem. Todos eram criados em regime de confinamento ou semi-confinamento. Clinicamente todos os animais apresentaram aumento dos linfonodos superficias. Outros sinais frequentes foram hiporexia, diminuição da produção de leite, emagrecimento progressivo, escore corporal baixo, desidratação, hipomotilidade dos pré-estômagos e fezes alteradas e em pouca quantidade. Com menor frequência foram observados exoftalmia, dispneia e aumento de volume do útero. No leucograma foi constatada leucocitose média de 34.082/µL, com linfocitose de 21.814/µL e neutrofilia de 10.906/µL. Treze animais foram necropsiados e os demais foram enviados pelos proprietários para o abate. Dos treze animais abatidos todos apresentaram lesões nos linfonodos superficiais, seis nos linfonodos mesentéricos, seis no intestino, três no abomaso, um no coração, um no fígado, um no rúmen, um no útero e um no rim. Diante da importância desta enfermidade e dos prejuízos causados pela mesma é necessário alertar produtores sobre os cuidados a serem tomados durante a aquisição de animais, assim como da necessidade de implantar medidas que evitem a difusão da doença entre as fazendas.

The article reports epidemiological data, clinical signs, and laboratory and pathological findings in 24 cattle with enzootic bovine leukosis observed in the Clinic of Garanhuns, at the Federal Rural University of Pernambuco. The 24 cases represented 0.5 percent of 4,758 cattle examined from 2000 to 2010. The disease affected 22 (91.7 percent) females and two males. Twenty one of the animals were dairy (six Holstein, 13 girolando, one Brown Swiss and one Jersey), and three were for meat production (Nelore). Twenty three animals were 3-8 years of age and one was younger. All were raised in confinement or semi-confinement. All animals showed enlarged superficial lymph nodes. Other frequent clinical signs were hyporexia, decreased milk production, progressive weight loss, dehydration, hypomotility of the fore stomachs, and altered scant feces. Exophthalmia, dyspnea, and enlarged uterus were observed with less frequency. Leukocytosis (mean of 34,082 leukocytes/µL) with lymphocytosis (21,814 lymphocytes/µL) and neutrophilia (10,906lymphocytes/µL) was observed in the white blood count. Thirteen bovines were necropsied and 11 were slaughtered. Gross lesions were observed on the superficial lymph nodes of all animals necropsied. Six had lesions in the mesenteric lymph nodes, six in the gut, three in the abomasum, two in the uterus, one in the heart, one in the rumen, one in heart, and one in the liver. Due to the importance of enzootic bovine leukosis it is necessary for the farmers to introduce animals free of the disease and to establish a strict health policy for its control.

Evento adverso y salud pública: [editorial] / Adverse event and public health: [editorial]

La salud pública es entendida como una acción política generada a partir de esfuerzos colectivos e individuales del estado y la comunidad, basados en la promoción de la salud, los sistemas de salud y la evaluación de políticas intersectoriales. A ello se suma que la promoción de la salud debe insertarse en la dinámica del desarrollo humano generando resultados favorables bajo la óptica de los fenómenos de globalización y los efectos de las políticas sanitarias dependientes del mercado que influyen en la calidad de prestación de los servicios de salud.

Calidad de vida en pacientes post evento cerebrovascular isquémico en dos hospitales de la ciudad de Barranquilla (Colombia) / Quality of life in patients post ischaemic cerebrovascular event in two hospitals of Barranquilla (Colombia)

Objetivo: Valorar la calidad de vida relacionada con la salud a través del instrumento SF-36 en sujetos que padecieron enfermedad cerebro-vascular y relacionar estas determinaciones con características sociodemográficas. Materiales y métodos: Estudio descriptivo donde participaron 41 pacientes egresados del Hospital Universidad del Norte y Cari de Alta Complejidad con diagnóstico de ECV isquémico en el año 2007. Se utilizaron 2 instrumentos: Short Form Health Survey (SF-36) y una encuesta sobre características sociodemográficas. Se tabularon los datos en Epi-info V2002 y se aplicaron técnicas de análisis descriptivas. Resultados: Se encontró un mayor compromiso de la función física, promedio de 24.2, en su mayoría presentaban limitaciones. El rol físico, la vitalidad y la salud mental presentaron rangos bajos cerca de (0), que indican malas condiciones de salud. El dolor corporal y la función social con mejores condiciones presentan una media de 67.5 y 69.5. En la salud en general y en el rol emocional existe un balance entre los datos obtenidos, media de 52.8 y 53.6, respectivamente. Conclusiones: La función física fue el ítem más afectado en ambos sexos; presentó rangos cercanos al 0 dentro del cuestionario SF-36. Las dimensiones referidas al dolor corporal y función social mostraron mejores condiciones en relación a las otras; la mayoría de estos pacientes cuentan con el apoyo de familiares para realizar su autocuidado. A medida que se avanzaba en la estructura de edad se revisó el comportamiento de las dimensiones de función física, rol físico y salud mental; se encontró que las dos primeras fueron las más afectadas. Los hombres obtuvieron mejores resultados, superando a las mujeres en casi la totalidad de los ítems evaluadosen el tesd de calidad de vida...

Objective: To value the quality of life related to health through instrument SF - 36 in subjects that has suffered ischaemic stroke event and relate with sociodemographic determinants. Materials and methods: There was carried out a descriptive mixed study taking 41 patients of both sex who with drawed from the Hospital Universidad del Norte and Cari de Alta Complejidad diagnosed with Ischemic Cerebrovascular Accident. Two questionnaires were used to study population, the test Short Form Health Survey (SF-36), and a survey on socio-demographic characteristics. The tabulation of results was done in Epi info V2002. Results: It is possible to be demonstrated that there is a greater commitment of the physical function within the studied patients, with an average of 24,2, since many of them presented certain limitations and incapacities that prevented them to do their habitual activities. In the same way the physical Role, the vitality and the mental health are jeopardized, presenting ranks near 0 that indicate bad conditions of health with respect to the SF-36. Unlike the corporal pain and the social function, in which they respectively presented bet- ter conditions with an average of 67,5 and 69,5. In general health and the emotional role, there is an approximated balance between the collected data obtained, with an average of 52,8 and 53,6 respectively. Conclusions: The physical function was the most affected item in masculine as feminine, with ranks near 0 within questionnaire SF-36. On the other hand, the corporal pain and social function showed better conditions in both sorts, since the majority of these patients counts on the support of one or more relatives to do the ordinary activities...

The epidemiology of malaria in adults in a rural area of southern Mozambique

Background: Epidemiological studies of malaria in adults who live in malaria endemic areas are scarce. More attention to the natural history of malaria affecting adults is needed to understand the dynamics of malaria infection and its interaction with the immune system. The present study was undertaken to investigate the clinical; parasitological and haematological status of adults exposed to malaria; and to characterize parasites in these individuals who progressively acquire protective immunity. Methods: A cross-sectional survey of 249 adults was conducted in a malaria endemic area of Mozambique. Clinical; parasitological and haematological status of the study population was recorded. Sub-microscopic infections and multiplicity of infections were investigated using polymerase chain reaction (PCR) and restriction fragment length polymorphism of Plasmodium falciparum merozoite surface protein 2 (msp2). Results: Prevalence of P. falciparum infection by microscopy (14) and PCR (42) decreased progressively during adulthood; in parallel with an increase in the prevalence of sub-microscopic infections. Anaemia was only related to parasitaemia as detected by PCR. Multiplicity of infection decreased with age and was higher in subjects with high P. falciparum densities; highlighting density-dependent constraints upon the PCR technique. Conclusions: Adults of Manhica progressively develop non-sterile; protective immunity against P. falciparum malaria. The method of parasite detection has a significant effect on the observed natural history of malaria infections. A more sensitive definition of malaria in adults should be formulated; considering symptoms such as diarrhoea; shivering and headache; combined with the presence of parasitaemia

Carcinoma bronquioloalveolar. Consideraciones sobre 23 casos. / Bronchioloalveolar carcinoma. Study of 23 cases

Se estudiaron las principales caracteristicas clinicas e histopatologicas de 23 casos de carcinoma bronquioloalveolar que correspondieron al 4.8% de 466 tumores bronquiogeneticos. Este tumor es de diagnostico clinico dificil. Fue mas frecuente en la sexta decada de la vida; la localizacion multicentrica bilateral fue la mas comun, 78.2%. El habito de fumar no tuvo relacion con este tipo de tumor. El tipo histologico mas frecuente fue el secretor, 10 casos. Se discuten algunos aspectos de su histogenesis y se consideran las bases para el diagostico histologico de sus tres variedades: secretor, no secretor y poco diferenciado. Se senala la importancia de la microscopia electronica que permite determinar la presencia de moco y de otros marcadores histologicos como granulos electrodensos semejantes a los que hay en las celulas de Clara y otros elementos celulares como los que existen en los neumocitos tipo II. El muestreo extenso de cada especimen es indispensable en virtude de que puede haber en una misma lesion diferentes aspectos histopatologicos. Se senala la utilidad de los metodos citologicos y del estudio de especimenes de tejido pulmonar para el diagnostico de esta entidad oncologica pulmonar. Aunque la distribucion de las lesiones puede ser multicentrica bilateral o nodular solitaria, el diagnostico histologico puede corresponder a cualquiera de las variedades senaladas