Avaliação da resposta ao tratamento combinado em pacientes com Hepatite Crônica C / Assessing response to combined treatment in patients with Chronic Hepatitis C

Atualmente, a terapêutica da Hepatite Crônica C (HCV) baseia-se na combinação de interferon peguilado e ribavirina. O sucesso terapêutico é alcançado em cerca de 40 a 80 %, a depender de fatores do hospedeiro e virais (AU)

Melhor escore de avaliação para hepatocarcinoma / Best score for the evaluation of hepatocellular carcinoma

O hepatocarcinoma é uma das complicações mais freqüente e temida da cirrose hepática, independentemente da etiologia. O tratamento requer escolha cuidadosa, uma vez que a função hepática na cirrose encontra-se prejudicada. É o 4º câncer mais prevalente no mundo e possui alta morbidade e mortalidade (AU)

Avaliação da resposta ao tratamento combinado em pacientes com Hepatite Crônica C

Atualmente, a terapêutica da Hepatite Crônica C (HCV) baseia-se na combinação de interferon peguilado e ribavirina. O sucesso terapêutico é alcançado em cerca de 40 a 80 %, a depender de fatores do hospedeiro e virais

Melhor escore de avaliação para hepatocarcinoma

O hepatocarcinoma é uma das complicações mais freqüente e temida da cirrose hepática, independentemente da etiologia. O tratamento requer escolha cuidadosa, uma vez que a função hepática na cirrose encontra-se prejudicada. É o 4º câncer mais prevalente no mundo e possui alta morbidade e mortalidade

A contribution to the establishment of reference values for total mercury levels in hair and fish in amazonia.

Studies on mercury levels in the Amazonian Region have typically lacked background or reference parameters. A sectional study on Hg concentration in hair and fish was conducted, together with an assessment of the prevalence of signs and symptoms related to Hg poisoning, in four communities in the Amazon Basin not impacted by gold mining, located either by a river course (Santana do Ituqui and Caxiuanã) or by a lake (Aldeia do Lago Grande and Vila do Tabatinga). Mercury determinations in hair and fish were made by flameless atomic absorption spectrophotometry. Mean total Hg in hair was 4.33 microg/g (0.40-11.60 microg/g) in 321 individuals from Santana do Ituqui, 3.98 microg/g (0.40-11.76 microg/g) for 316 persons in Aldeia do Lago Grande, 5.46 microg/g (0.37-49.85 microg/g) for 504 individuals from Vila do Tabatinga and 8.58 microg/g (0.61-45.59 microg/g) for 203 inhabitants from Caxiuanã. Fish consumption was very high in all those communities but no signs or symptoms associated with Hg poisoning were found. Mean Hg concentration in fish varied from 0.006 to 2.529 microg/g for carnivores and from 0.008 to 0.871 microg/g for noncarnivores. These values suggest that further studies including a larger number of communities would eventually lead to values of "normal" Hg concentration in the Amazonian Region quite above the limits suggested by the World Health Organization.

Health effects of residential exposure to aluminum plant air pollution.

In this study, the authors evaluated the relative risk of residential exposure to air pollution from an aluminum plant. The authors used government-compiled data to compare hospital admissions in 1997 for selected respiratory diseases for 2 communities in Brazil. One community, Ouro Preto, was located near an aluminum plant, and the other, Diamantina, was located far from any source of industrial air pollution. The relative risk of hospital admissions for selected respiratory diseases was 4.11 (95% confidence interval = 2.96, 5.70). The risk was highest among individuals between 30 and 39 yr of age (relative risk = 11.70; 95% confidence interval = 1.52, 89.96). Admissions per thousand residents were highest for individuals under 10 yr of age and for individuals older than 70 yr of age. The authors assessed exposure with environmental measurements. Dust deposition was collected in the residences of participants (n = 36 in each location), and the dust was analyzed for aluminum, manganese, magnesium, and calcium content. There were significantly different (p < .05) levels of aluminum in the 2 communities; the highest quantities were found near the aluminum plant. Measurements from independent studies indicated that both 24-hr maximum values and annual mean concentrations of suspended particulate matter exceeded the average of international standards in Ouro Preto (i.e., aluminum plant area). These results suggested that exposure to greater air pollution in the aluminum plant area (i.e., Ouro Preto, Brazil) versus the control area resulted in statistically significant health effects in those individuals who resided in Ouro Preto.

Mercury exposures in riverside Amazon communities in Pará, Brazil.

Cross-sectional studies were conducted in three riverside communities in the state of Pará in the Amazon Region of Brazil. Two of these communities, Brasília Legal and São Luís do Tapajós, are located in a watershed exposed to mercury pollution from artisanal gold mining, and the third, Santana do Ituqui, is outside this area. The studies were based upon a community census and included all persons volunteering for participation in each community. All participants were surveyed by questionnaire for health history, occupation, residence, and diet. Clinical evaluations were also done on each subject, along with collection of blood, urine, feces, and hair. Fish samples were collected to represent the most frequently consumed species. Mercury was measured in hair and fish. Although no signs or symptoms of overt mercury intoxication were observed, persons in Brasília Legal and São Luís do Tapajós had higher levels of mercury in hair than residents of Santana de Ituqui, located out of the risk area. Levels of mercury in fish were below Brazilian health guidance limits, but the high rates of fish consumption among these populations raise concerns for the possible effects of chronic exposure, especially among young children and women of childbearing age.

A program for the control of indoor pollution by metallic mercury.

The objective of this study was to develop an educational program for preventing metallic mercury emissions due to the burning of mercury-gold amalgams inside houses. The main participants were adolescents from a school in the city of Poconé, State of Mato Grosso. The program was developed in five stages, including discussions of the methods and exhibition of slides showing people working in activities including the garimpos, planning activities as dramatizations, making posters and preparing a screenplay for the production of a video, discussing how to prevent indoor burning of gold-mercury amalgams, and a final evaluation of the adolescents about what they had learned during the program. The evaluation of the impact was done through a comparison of correct answers from a questionnaire before and after the development of the educational activities and by means of a comparison of urinary mercury in school students and a group of residents (women) at three different times: before the program (2.30 microgram/L), 6 months after (2.90 microgram/L), and 11 months after (1.49 microgram/L).

[Diagnosis of health conditions in a pan-mining community in the Tapajós River Basin, Itaituba, Par , Brazil, 1992]. / Diagnóstico das condições de saúde de uma comunidade garimpeira na regiõ o do Rio Tapajós, Itaituba, Pará, Brasil, 1992.

The purpose of this article is to describe health conditions in a pan-mining community, in particular the interaction of mercury contamination with other health problems. This study was carried out in a panning mine located on Rato Creek, a tributary of the Tapajó s River Basin in the municipality of Itaituba, State of Par The study population consisted of 223 individuals. An epidemiological questionnaire was applied, medical treatment was given, and biological specimens were collected. Testing of fecal samples showed that 96.1% of the individuals had parasites and 66.4% were anemic. Prevalence of hepatitis B virus was 85.0%, and 11 individuals (6.0%) were virus carriers (HBsAg positive). Of 186 patients tested for malaria, 65 individuals (35.0%) had the infection, of whom 34 (52.3%) were asymptomatic. Prevalence of syphillis was 41.6%. Urine mercury levels were measured in 173 individuals. Some 16 (9.2%) of those tested had mercury levels between 10 and 19 ug/l, while 9 patients (5.2%) had levels above 20 ug/l. An overview of general health conditions showed a combination of problems in individuals, who lacked adequate diagnosis, in addition to a high level of self-medication, given the absence of health facilities. In addition, these individuals are threatened by critical levels of mercury contamination. In conclusion, this article gives a general overview of health conditions in these pan-mining communities, demonstrating the multicausal nature of health conditions in the Amazon region, a fact which should be considered when planning appropriate strategies for clinical treatment.

Inherited lysozyme deficiency in rabbits. The absence of a primary isozyme of lysozyme as the cause of the condition.

Lysozyme from normal and genetically lysozyme-deficient rabbits was extracted from three types of tissue: leukocytic (bone marrow), lymphoepithelial (thymus and appendix), and gastrointestinal (colon). Extracts were analyzed by electrophoretic, chromatographic, and kinetic techniques. Identification of at least two isozymes of rabbit lysozyme was made with these techniques. The distribution of the isozymes was tissue specific. Leukocytic and gastrointestinal isozymes were clearly distinguished, and a possible lymphoepithelial isozyme that resembled the gastrointestinal isozyme electrophoretically and chromatographically but not kinetically was identified. Mutant, lysozyme-deficient rabbits lacked completely a detectable leukocytic isozyme but had gastrointestinal and lymphoepithelial isozyme(s) indistinguishable from those of normal rabbits. By electrophoretic methods, the mutant rabbits were demonstrated to lack a protein band corresponding to that of the leukocytic isozyme of lysozyme from normal rabbits. These observations considered collectively were interpreted as evidence that at least two primary isozymes of lysozyme are present in rabbits and that inherited lysozyme deficiency in rabbits is caused by the absence of a single primary isozyme.

Lysozyme activity in female genital tissues of normal and genetically lysozyme-deficient rabbits.

The internal genitalia of female normal rabbits and mutant lysozyme-deficient rabbits, which lack genetically the leukocytic isozyme of lysozyme, were assayed for lysozyme activity. The ovaries, uteri, and vaginas of the lysozyme-deficient rabbits had less than 20% of the lysozyme activity of normals. The oviducts, and in particular the caudal portions of the oviducts, had lysozyme activities up to 71% of the levels in normals. These observations suggest that the lysozymes of oviduct and leukocytes of rabbits are under the control of different genes.

Secretion of colonic isozyme of lysozyme in association with cecotrophy of rabbits.

The relation between the rabbit gastrointestinal (colonic) isozyme of lysozyme and the unique circadial coprophagic behavior of rabbits, termed "cecotrophy," was investigated. We found that lysozyme activity was very low in all segments of the rabbit gastrointestinal tract proximal to the fusus coli. However, the distal or nonsacculated colon, located distal to the fusus coli, had very high lysozyme activity throughout. It was determined, furthermore, that the lysozyme in the wall of the nonsacculated colon was secreted circadially into the colonic lumen in association with the circadial production of soft feces that were destined for reingestion by cecotrophy. The colonic lysozyme, therefore, was transferred to the stomach. These observations suggest that rabbit colonic lysozyme may have a possible function in the upper gastrointestinal tract and be analogous to ruminant abomasal-duodenal lysozyme.

Lysozyme activity in gastrointestinal and lymphoreticular tissues of rabbits genetically deficient in lysozyme.

Lysozyme activities in gastrointestinal and lymphoreticular tissues and in macrophage culture products of normal and genetically lysozyme-deficient rabbits were measured and compared. The supernatants of homogenates of 18 gastrointestinal and lymphoreticular tissues were assayed for lysozyme. In the gastrointestinal tract, there were no major differences in lysozyme activities between the two groups of rabbits. Ascending colon and orad gastrointestinal tissues had low activities, whereas descending colon and rectum had very high lysozyme activities in both types of rabbits. In the lymphoreticular tissues, lysozyme-deficient rabbits had graded lysozyme deficiencies: slight or no deficiency was present in thymus, partial deficiency in gut-associated lymphoid tissues, and near total deficiencies in secondary lymphoid tissues and bone marrow. Both macrophage culture cells and fluids from lysozyme-deficient rabbits were completely deficient in lysozyme. The results indicate that in the lysozyme-deficient rabbits there is tissue-specific lysozyme activity expressed and when considered along with other observations suggest that the lysozyme-deficient condition may be due to a deficiency of an isozyme or isozymes of lysozyme.

Inheritance of lysozyme deficiency in rabbits.

The phenotypes of 273 offspring of 56 matings of various genotypes of lysozyme-deficient and normal New Zealand white rabbits were analyzed. It was determined that lysozyme deficiency of rabbits is inherited as an autosomal recessive with complete penetrance. The symbol ld is suggested for the gene for lysozyme deficiency. Further studies on the nature of the condition revealed that the lysozyme deficiency was not due to a lysozyme that was cold labile, or to a lysozyme that was so tightly bound it was unavailable for enzymatic assay, or to a lysozyme with a variant pH optimum. It was demonstrated, however, that the pH profile of the lysozyme remaining in the ld/ld rabbits was different from that found in normal rabbits.