Ts17, a Tityus serrulatus ß-toxin structurally related to α-scorpion toxins.

Ts17 was purified from the venom of the scorpion Tityus serrulatus, the most dangerous scorpion species in Brazil. The activity on Nav1.1-Nav1.7 channels was electrophysiologically characterized by patch-clamp technique. Ts17 amino acid sequence indicated high similarity to alpha-scorpion toxins; however, it presented beta-toxin activity, altering the kinetics of the Na+-channels. The most affected subtypes during activation (with and without prepulse) and inactivation phases were Nav1.2 and Nav1.5, respectively. For recovery from inactivation, the most affected voltage-gated sodium channel was Nav1.5. Circular dichroism spectra showed that Ts17 presents mainly ß-sheet and unordered structures at all analyzed pHs, and the maximum value of α-helix was found at pH 4.0 (13.3 %). Based on the results, Ts17 might be used as a template to develop a new cardiac drug. Key contribution Purification of Ts17 from Tityus serrulatus, electrophysiological characterization of Ts17 on voltage-gated sodium channel subtypes, ß-toxin classification.

Leishmania (L.) infantum BH401 strain induces classic renal lesions in dogs: Histological and confocal microscopy study.

Extracellular matrix (ECM) alterations in visceral leishmaniasis are related mainly to collagen deposition (fibropoiesis). In canine visceral leishmaniasis (CVL), an intense fibrosis associated to chronic inflammation in organs such as kidneys is described. However, renal fibropoiesis has not been described in natural or experimental infections with L. (L.) infantum. We aimed to characterize renal nephropathies by histology and confocal microscopy comparing renal lesions in dogs naturally and experimentally infected with L. (L.) infantum. Sixty-two mixed-breed symptomatic dogs naturally infected with L. (L.) infantum, sixteen beagles experimentally infected with two strains of L. infantum (eleven dogs with the BH400 strain and five dogs with the BH401 strain), and five uninfected beagles (controls) were used. Samples were stained with hematoxylin & eosin for routine histology. Congo red was used to visualize amyloid protein deposits, periodic acid-Schiff to identify glomerular basal membrane anomalies, Masson's trichrome for collagen deposits, and Jones' methenamine silver to reveal membranous glomerulonephropathy. Immunohistochemistry was used to identify Leishmania amastigotes, and confocal microscopy was used for macrophage characterization (L1/calprotectin and CD163 antigen receptors). The most common lesions were chronic glomerular and interstitial nephritis, which was found in all naturally infected dogs and dogs experimentally infected with L. infantum strain BH401 but not with the BH400 strain. Glomeruloesclerosis was the main lesion presented in all BH401 group. Morphometric analysis revealed positive correlation of renal glomeruli tufts with cellular expression of L1/calprotectin and CD163 antigens. Leishmania infantum strain BH401 shows pathogenicity that may be sufficient to induce classic chronic visceral renal leishmaniasis.

Electrophysiological characterization of Tityus obscurus ß toxin 1 (To1) on Na+-channel isoforms.

To1, previously named Tc49b, is a peptide neurotoxin isolated from venom of the scorpion Tityus obscurus that is responsible for lethal human poisoning cases in the Brazilian Amazonian region. Previously, To1 was shown to be lethal to mice and to change Na+ permeation in cerebellum granular neurons from rat brain. In addition, To1 did not affect Shaker B K+ channels. Based on sequence similarities, To1 was described as a ß-toxin. In the present work, To1 was purified from T. obscurus venom and submitted to an electrophysiological characterization in human and invertebrate NaV channels. The analysis of the electrophysiological experiments reveal that To1 enhances the open probability at more negative potentials of human NaV 1.3 and 1.6, of the insect channel BgNaV1 and of arachnid VdNaV1 channel. In addition, To1 reduces the peak of Na+ currents in some of the NaVs tested. These results support the classification of the To1 as a ß-toxin. A structure and functional comparison to other ß-toxins that share sequence similarity to To1 is also presented.

Subtype Specificity of ß-Toxin Tf1a from Tityus fasciolatus in Voltage Gated Sodium Channels.

Scorpion venoms are a complex mixture of components. Among them the most important are peptides, which presents the capacity to interact and modulate several ion channel subtypes, including voltage-gated sodium channels (NaV). Screening the activity of scorpion toxins on different subtypes of NaV reveals the scope of modulatory activity and, in most cases, low channel selectivity. Until now there are approximately 60 scorpion toxins experimentally assayed on NaV channels. However, the molecular bases of interaction between scorpion toxins and NaV channels are not fully elucidated. The activity description of new scorpion toxins is crucial to enhance the predictive strength of the structural⁻function correlations of these NaV modulatory molecules. In the present work a new scorpion toxin (Tf1a) was purified from Tityus fasciolatus venom by RP-HPLC, and characterized using electrophysiological experiments on different types of voltage-gated sodium channels. Tf1a was able to modify the normal function of NaV tested, showing to be a typical ß-NaScTx. Tf1a also demonstrated an unusual capability to alter the kinetics of NaV1.5.

To4, the first Tityus obscurus ß-toxin fully electrophysiologically characterized on human sodium channel isoforms.

Many scorpion toxins that act on sodium channels (NaScTxs) have been characterized till date. These toxins may act modulating the inactivation or the activation of sodium channels and are named α- or ß-types, respectively. Some venom toxins from Tityus obscurus (Buthidae), a scorpion widely distributed in the Brazilian Amazon, have been partially characterized in previous studies; however, little information about their electrophysiological role on sodium ion channels has been published. In the present study, we describe the purification, identification and electrophysiological characterization of a NaScTx, which was first described as Tc54 and further fully sequenced and renamed To4. This toxin shows a marked ß-type effect on different sodium channel subtypes (hNav1.1-hNav1.7) at low concentrations, and has more pronounced activity on hNav1.1, hNav1.2 and hNav1.4. By comparing To4 primary structure with other Tityus ß-toxins which have already been electrophysiologically tested, it is possible to establish some key amino acid residues for the sodium channel activity. Thus, To4 is the first toxin from T. obscurus fully electrophysiologically characterized on different human sodium channel isoforms.

Rats treated with Hypericum perforatum during pregnancy generate offspring with behavioral changes in adulthood

Abstract Drugs used in the treatment of depression can cross the placenta giving rise to questions regarding the effects these drugs exert on the fetus. Hypericum perforatum L., Hypericaceae, is a natural product used to treat depression. However, information about its toxicity and the occurrence of alterations in the central nervous system development of the offspring is scarce. This work assessed the behavior of adult male rats born from mothers treated with Hypericum extract during gestation and analyzed the fluorescence of the extract in different organs of mothers and fetuses. Male pups were divided into three treated groups, corresponding to the administration of the Hypericum extract to mothers at the dose levels of 36 mg/kg, 72 mg/kg and 144 mg/kg, and one control group in which the mothers received distilled water. At 90 days of age, the offspring underwent the following tests: rotarod, pentobarbital-induced sleep time, elevated plus maze, hole-board and forced swimming test. The observed fluorescence indicated the presence of the extract in all tissues analyzed. The obtained results suggest lasting changes in the performances displayed in the CNS, depression and anxiety tests, indicating that the use of Hypericum during gestation could interfere with the behavioral development of the offspring reducing anxiety and depression when they become adults. We suggest that these alterations are associated with the reprogramming of the brain regions related to changes in emotional reactivity.

Characteristics of Patients with Smear-Negative Pulmonary Tuberculosis (TB) in a Region with High TB and HIV Prevalence.

INTRODUCTION: Smear-negative pulmonary TB (SNPT) represents 30-60% of all pulmonary TB cases. The mortality of these patients can reach 25% in populations with high prevalence of HIV infection, and 10-20% of TB transmission at the population level are attributable to SNPT cases. METHODS: We conducted a retrospective study to evaluate epidemiological, clinical, and radiological characteristics of patients with SNPT and to compare these with patients who were diagnosed as having smear-positive pulmonary TB (SPPT). All adult patients (≥ 18 years old) with a positive culture for Mycobacterium tuberculosis, and a diagnosis of pulmonary TB were included in the study. RESULTS: 198 patients met the inclusion criteria (positive culture for Mycobacterium tuberculosis) and were included in the analysis. Of these patients, 69 (34.8%) were smear positive (SPPT) and 129 (65.2%) were smear negative (SNPT). In univariate analysis, cough, dyspnea, and hemoptysis were less frequent in SNPT patients in comparison with SPPT patients. In a multivariate model, having no cough and no radiographic pattern typical of TB were the characteristics independently associated with a diagnosis of SNPT. CONCLUSIONS: We found a very high prevalence of SNPT among patients with TB in a setting with high TB and HIV prevalence. The absence of cough in the presence of other symptoms suggestive of TB, and having no radiographic pattern typical of TB where independent predictors of SNPT.

Pharmacological Alternatives for the Treatment of Neurodegenerative Disorders: Wasp and Bee Venoms and Their Components as New Neuroactive Tools.

Neurodegenerative diseases are relentlessly progressive, severely impacting affected patients, families and society as a whole. Increased life expectancy has made these diseases more common worldwide. Unfortunately, available drugs have insufficient therapeutic effects on many subtypes of these intractable diseases, and adverse effects hamper continued treatment. Wasp and bee venoms and their components are potential means of managing or reducing these effects and provide new alternatives for the control of neurodegenerative diseases. These venoms and their components are well-known and irrefutable sources of neuroprotectors or neuromodulators. In this respect, the present study reviews our current understanding of the mechanisms of action and future prospects regarding the use of new drugs derived from wasp and bee venom in the treatment of major neurodegenerative disorders, including Alzheimer's Disease, Parkinson's Disease, Epilepsy, Multiple Sclerosis and Amyotrophic Lateral Sclerosis.

Behavioural and neurotoxic effects of ayahuasca infusion (Banisteriopsis caapi and Psychotria viridis) in female Wistar rat.

Ayahuasca, a psychoactive beverage used by indigenous and religious groups, is generally prepared by the coction of Psychotria viridis and Banisteriopsis caapi plants containing N,N-dimethyltryptamine (DMT) and ß-carboline alkaloids, respectively. To investigate the acute toxicity of ayahuasca, the infusion was administered by gavage to female Wistar rats at doses of 30X and 50X the dose taken during a religious ritual, and the animals observed for 14 days. Behavioural functions were investigated one hour after dosing at 15X and 30X using the open field, elevated plus maze, and forced swimming tests. Neuronal activation (c-fos marked neurons) and toxicity (Fluoro-Jade B and Nissl/Cresyl staining) were investigated in the dorsal raphe nuclei (DRN), amygdaloid nucleus, and hippocampal formation brain areas of rats treated with a 30X ayahuasca dose. The actual lethal oral dose in female Wistar rats could not be determined in this study, but was shown to be higher than the 50X (which corresponds to 15.1mg/kg bw DMT). The ayahuasca and fluoxetine treated groups showed a significant decrease in locomotion in the open field and elevated plus-maze tests compared to controls. In the forced swimming test, ayahuasca treated animals swam more than controls, a behaviour that was not significant in the fluoxetine group. Treated animals showed higher neuronal activation in all brain areas involved in serotoninergic neurotransmission. Although this led to some brain injury, no permanent damage was detected. These results suggest that ayahuasca has antidepressant properties in Wistar female at high doses, an effect that should be further investigated.

First report of the characterization of the pathophysiological mechanisms caused by the freshwater catfish Pimelodus maculatus (order: Siluriformes).

Injuries caused by aquatic animals in Brazil in most cases are provoked by marine and freshwater catfish. Pimelodus maculatus is a freshwater catfish very common in Brazilian basins that causes frequent accidents mainly amongst fishermen, and whose venom characteristics and pathological mechanisms of the venom are poorly known. In the present study for the first time, we have characterized the main pathophysiological mechanisms associated with the clinical manifestation (pain, local inflammation and edema) of the envenomations caused by P. maculatus crude venom. It was estimated that the crude venom of one P. maculatus stinger contains approximately 100 µg of protein, likely the quantity involved in the envenomation. P. maculatus crude venom induced marked nociceptive and edematogenic effects and caused vascular permeability alterations at doses from 30 to 100 µg/animal. Additionally, P. maculatus crude venom caused a decrease in the contraction force in in situ frog heart, did not cause hemorrhage or alterations in clotting times (prothrombin time and activated partial thromboplastin time), but induced significant changes in the levels of CK and its isoenzyme CK-MB in mice. In the present work, we present a correlation between the effects obtained experimentally and the main symptoms observed in the human accidents provoked by P. maculatus.

Evaluation of postpartum behaviour in rats treated with Hypericum perforatum during gestation

Gestational depression is detrimental to the health of the mother and the offspring and contributes to the appearance of depressive and anxiety symptoms during the postnatal period. Traditional antidepressants have undesirable side effects when utilised during gestation, but Hypericum perforatum has been characterised as an efficient and safe antidepressant that prevents the recurrence of symptoms. This study verified the effects of Hypericum perforatum on the behaviour of Wistar rats that were treated during gestation and evaluated 10 and 60 days post-treatment. Pregnant Wistar rats were divided into four groups of ten animals each: one control group that received distilled water and three treatment groups that were treated orally with 36, 72 or 144 mg/kg Hypericum perforatum extract. At 10 and 60 days after parturition and post-treatment, the rats were submitted to the holeboard, the tail suspension, and the forced swim tests. The animals treated with 144 mg/kg Hypericum perforatum exhibited greater head-dipping activity in the hole-board test and reduced immobility in the tail suspension and forced swim tests, suggesting less anxiety and depression 10 and 60 days post-treatment.The results indicated that treating rats with Hypericum perforatum during the gestational period decreased depressive behaviour and anxiety 10 and 60 days post-treatment.

Three new species of Proceratophrys Miranda-Ribeiro 1920 from Brazilian Cerrado (Anura, Odontophrynidae).

Based on the analyses of specimens collected at several areas in the Cerrado domain from Central Brazil and others housed in scientific collections and on specimens collected at the type-locality, herein we describe three new species belonging to the P. cristiceps group: Proceratophrys bagnoi sp. nov., from UHE Serra da Mesa power plant (13°49'47.5"S, 48°19'17"W; 570 m a.s.l.; WGS84 datum), Municipality of Minaçu, State of Goiás; Proceratophrys branti sp. nov., from Jalapão, Municipality of Mateiros (05o15'25"S, 48o12'00"W; 109 m a.s.l.; WGS84 datum), State of Tocantins; and Proceratophrys dibernardoi sp. nov., Municipality of Mineiros (17o33'52"S, 52o33'20"W; 803 m a.s.l.; WGS84 datum), State of Goiás. The diversity of Proceratophrys in Brazilian Cerrado is still underscored and several species will be described in the following years.

Updated neuronal scaling rules for the brains of Glires (rodents/lagomorphs).

Brain size scales as different functions of its number of neurons across mammalian orders such as rodents, primates, and insectivores. In rodents, we have previously shown that, across a sample of 6 species, from mouse to capybara, the cerebral cortex, cerebellum and the remaining brain structures increase in size faster than they gain neurons, with an accompanying decrease in neuronal density in these structures [Herculano-Houzel et al.: Proc Natl Acad Sci USA 2006;103:12138-12143]. Important remaining questions are whether such neuronal scaling rules within an order apply equally to all pertaining species, and whether they extend to closely related taxa. Here, we examine whether 4 other species of Rodentia, as well as the closely related rabbit (Lagomorpha), conform to the scaling rules identified previously for rodents. We report the updated neuronal scaling rules obtained for the average values of each species in a way that is directly comparable to the scaling rules that apply to primates [Gabi et al.: Brain Behav Evol 2010;76:32-44], and examine whether the scaling relationships are affected when phylogenetic relatedness in the dataset is accounted for. We have found that the brains of the spiny rat, squirrel, prairie dog and rabbit conform to the neuronal scaling rules that apply to the previous sample of rodents. The conformity to the previous rules of the new set of species, which includes the rabbit, suggests that the cellular scaling rules we have identified apply to rodents in general, and probably to Glires as a whole (rodents/lagomorphs), with one notable exception: the naked mole-rat brain is apparently an outlier, with only about half of the neurons expected from its brain size in its cerebral cortex and cerebellum.

Suppression of allergic inflammatory response in the skin of alloxan-diabetic rats: relationship with reduced local mast cell numbers.

BACKGROUND: Diabetic patients are refractory to allergic inflammatory diseases. In this study, the influence of alloxan-induced diabetes on allergic skin inflammation was investigated. METHODS: Diabetes was induced by intravenous injection of alloxan into male Wistar rats, and the analyses were performed 21 days later. Animals were actively sensitized with a mixture of aluminium hydroxide plus ovalbumin and challenged intradermally with ovalbumin on day 14. RESULTS: Diabetic sensitized rats exhibited a less pronounced antigen-induced protein extravasation in the dorsal skin when compared with normal animals. Also, fragments of the dorsal subcutaneous tissue from diabetic sensitized rats showed a reduction in histamine release after stimulation with antigen in vitrowhen compared with fragments obtained from nondiabetic sensitized rats. Optical microscopy analysis revealed that the dorsal skin of diabetic rats showed a marked reduction in dermis thickness, as compared with that seen in normal animals. A significant decrease in the number of skin mast cells was also noted, a phenomenon that paralleled with the reduction in the expression of extracellular matrix components laminin, fibronectin and collagen. Administration of insulin into diabetic rats restored basal mast cell numbers as well as the levels of laminin, fibronectin and collagen. CONCLUSIONS: Our findings show that alloxan diabetes induces downregulation of the skin allergic inflammatory response in rats, and this was correlated with reduction in local mast cell numbers and expression of extracellular matrix components. Lastly, these alterations were reversed with insulin treatment.

Mamografia digital: perspectiva atual e aplicações futuras / Digital mammography: current view and future applications

Na mamografia digital, os processos de aquisição da imagem, demonstração e armazenamento são separados, o que leva à otimização de cada uma dessas etapas. A radiação transmitida através da mama é absorvida por um detector eletrônico, em resposta fiel a uma ampla variedade de intensidades. Uma vez que esta informação é armazenada, ela pode ser demonstrada usando técnicas computadorizadas de imagem, permitindo variações de brilho e contraste e ampliação, sem a necessidade de exposições radiológicas adicionais para a paciente. Neste artigo, o estado atual da tecnologia em mamografia digital e dados sobre testes clínicos que dão suporte ao uso dessa tecnologia são revistos. Além disso, algumas aplicações potencialmente utilizáveis que estão sendo desenvolvidas com a mamografia digital são descritas.

In digital mammography, imaging acquisition, display and storage processes are separated and individually optimized. Radiation transmitted through the breast is absorbed by an electronic detector with an accurate response over a wide range of intensities. Once these data are stored, they can be displayed by means of computer image-processing techniques to allow arbitrary settings of image brightness, contrast and magnification, without the need for further radiological exposure of the patient. In this article, the current state of the art in technology for digital mammography and clinical trials data supporting the use of this technology are reviewed. In addition, several potentially useful applications, currently under development with digital mammography, are described.

Comprometimento da resposta inflamatória em ratos diabéticos: envolvimento de mastócitos e componentes da matriz extracelular / The engagement of the inflammatory reply in diabetic rats: envolvement of mast cells and extracellular matrix components

A incidência da diabetes vem aumentando a cada ano em todo o mundo. As doenças de ordem alérgica também são encontradas cada vez mais freqüentemente na população com o passar dos tempos. Contudo, quando se avalia a ocorrência simultânea de ambas em um mesmo indivíduo, detecta-se uma incidência bastante reduzida. Com base nestas observações, tivemos como objetivo no presente trabalho avaliar a influência do estado diabético induzido por aloxana sobre a resposta cutânea alérgica em ratos, com ênfase sobre a população de mastócitos e de componentes da matriz extracelular. Ratos Wistar foram tornados diabéticos pela injeção de aloxana e as análises foram feitas 21 dias após. A sensibilização com ovoalbumina e hidróxido de alumínio foi realizada 7 dias após a indução da diabetes e a análise após 14 dias. Os resultados mostraram que: (1) ratos diabéticos ativamente sensibilizados apresentaram menor extravasamento protéico na pele; (2) fragmentos da pele de ratos diabéticos e sensibilizados, quando estimulados por antígeno in vitro apresentaram menor secreção de histamina em comparação com os de animais apenas sensibilizados; (3) a derme de animais diabéticos moostrou redução de espessura (cerca de 30por cento) quando comparada àquela dos animais normais; (4) a densidade de mastócitos da pele dorsal de ratos diabéticos foi inferior à de ratos normais; (5) ratos diabéticos apresentaram menor expressão de laminina e de fibronectina na matriz extracelular presente na derme dorsal comparativamente aos ratos normais; (6) o tratamento dos animais diabéticos com insulina foi capaz de reverter a diminuição da espessura da derme, da densidade mastocitária, como também da expressão das proteínas da matriz extracelular. Em conclusão, nossos resultados indicam que ratos tornados diabéticos pela injeção de aloxana apresentaram-se menos reativos à estimulação antigênica cutânea, em comparação aos animais não diabéticos sensibilizados, fenômeno este que ocorreu em paralelo à reduç...

Artoplastias totais do quadril com prótese PCA (Porous Coated Anatomic) / Total HIP arthroplasty with PCA (Porous Coated Anatomic) prosthesis

Foram realizadas 27 artroplastias totais do quadril nos anos de 1988 e 1993, com próteses do quadril PCA (Anatômica com revestimento poroso) em 26 pacientes. O tempo médio de seguimento foi de nove anos. Foram excluídos desta avaliação sete quadris: um devido a infecção profunda precoce, dois referentes a pacientes falecidos de causa não relacionada a operação e quatro em que os pacientes não foram localizados para a presente avaliação. A idade média no tempo da operação foi de 53 anos. O diagnóstico pré-operatório foi de osteoartrite primária em nove pacientes, osteoartrite secundária em sete pacientes e artrite inflamatória em quatro pacientes. Os pacientes foram avaliados do ponto de vista clínico, radiográfico e subjetivo. As radiografias foram estudadas em relação a ocorrência de osteólise, migração ou afrouxamento da taça, desgaste do polietileno, desprendimento de contas, afundamento ou afrouxamento da hasta femoral, reabsorção proximal do fêmur, reação periosteal, hipertrofia cortical e pedestal. Os resultados clínicos foram bons em 17 quadris (85 por cento). Três quadris apresentaram maus resultados (15 por cento) devido a migração e soltura da taça em dois casos e desgaste do polietileno em um caso. Houve concordância entre os resultados clínicos e subjetivos. Entretanto algumas alterações radiográficas observadas não se relacionaram com maus resultados.

Estudo comparativo do tratamento de ferimento de colon de coelho com reparo seroso da parede de jejunum e sutura primária / Comparative study of colon wound treatment of rabbits using serosal repair of jejunal wall and primary suture

Os animais foram submetidos a procedimento operatório sob anestesia geral para a produção de dois ferimentos padronizados em colo não preparado, usando instrumento desenvolvido para esta finalidade. O primeiro ferimento foi produzido a 2 cm do ceco e o segundo 20 cm eqüidistante deste, no sentido caudal. Estes ferimentos foram reparados obedecendo a resultado de sorteio que determinou a técnica a ser usada, se com o lado seroso da parede de jejuno ou por sutura primária. Nas duas técnicas foram usados pontos separados de fio monofilamentar de poliglecaprone 4-0 , sendo que o animal serviu de controle para si mesmo. Realizou-se eutanásia no 7º P.O. para os animais do sub-grupo A e no 30º P.O. para os animais do sub-grupo B para avaliação macroscópica e microscópica. O experimento demonstrou que é viável o uso do lado seroso da parede de jejuno para reparar ferimento em colo não preparado e apresentou resultados com tendências a serem superiores aos da sutura primária , não dual de Maringá.

Drenagem pós operatória após artroplastia total do joelho / Postoperative drain following total knee replacement

Os autores compraram o volume de drenagem pós-operatória entre o 1º e o 2º dias em 33 pacientes submetidos à artroplastia total do joelho entre setembro de 1995 e junho de 1996. Observam que 84 por cento da drenagem ocorrem nas primeiras 24 horas e somente 16 por cento no 2º dia (estatisticamente significativo, p<0,05). Concluem pela utilizaçao do dreno por somente 24 horas, correlacionando o risco de sua permanência prolongada com os problemas de sua retirada precoce.

Pancreatite aguda: etiopatogenia, fisiopatologia e tratamento / Acute pancreatitis: etiopathogeny, pathophysiology and treatment

Com o objetivo de verificar os progressos na etiopatogenia e fisiopatologia da pancreatite aguda e as tendências atuais em seu tratamento, apresentamos uma revisäo de trabalhos publicados recentemente sobre esses temas. Em 60 a 80 por cento dos casos, a pancreatite aguda está associada à litíase biliar ou ao consumo de etanol. Entretanto, a cada dia novos fatores säo associados a essa doença. Os mecanismos fisiopatológicos responsáveis pelo seu desencadeamento näo estäo bem determinados. Várias teorias säo propostas. A mais recente associa as lesöes pancreáticas à liberaçäo de radicais livres de oxigênio provenientes do metabolismo celular. Näo há um tratamento específico para a pancreatite aguda. Nos casos leves, as primeiras medidas terapeuticas säo a suspensäo da ingesta oral, analgesia e, se necessário, hidrataçäo venosa. Nos pacientes mais graves säo necessários cuidados intensivos. O tratamento cirúrgico precoce está indicado apenas em situaçöes de urgência. Tardiamente, a decisäo para tratamento cirúrgico deve ser baseada em dados clínicos, morfológicos e bacteriológicos.