[Cryptococcosis in children in the State of Pará, Brazil]. / Criptococose em crianças no Estado do Pará, Brasil.

We report 19 cases of cryptococcosis in children, diagnosed in Belém, PA. In nine patients the variety of the etiologic agent was studied and identified as Cryptococcus neoformans var. gattii. The average age of these patients was 7.8 years (range, 5-13 years) There were 5 girls and 4 boys (ratio, 1.25:1). Amphotericin B treatment (associated with fluconazole 3 or fluocytosine 1) was given but five (56%) of these patients died in the following three months. The existence of highly endemic areas of infection by var. gattii in Pará, Brazil and the severity of the disease due to this fungal variety are commented.

[Evaluation of 3 therapeutic schedules with N-methyl-glucamine antimonate in the treatment of visceral leishmaniasis in the state of Para, Brazil]. / Avaliação de três esquemas terapêuticos com o antimoniato de N-metil-glucamina no tratamento da leishmaniose visceral no estado do Pará, Brasil.

We have evaluated, in a retrospective manner, three chemotherapeutic schemes with meglumine antomoniate (Glucantime) use in the treatment of 43 autochthonous cases of visceral leishmaniasis in children in the age-group of 1-12 years old, during the period 1985-1990. Of the 43 cases, 28 (group A) were treated with 40mg/SbV/kg given IV at intervals of 48 hours, in courses of 15 applications (scheme I); 8 (group B) were treated with 40 mg/SbV/kg given IV daily during 15 days (scheme II), and 7 (group C) were treated with 20 mg/SbV/kg given IV daily during 15 days (scheme III). With the criteria for cure based essentially on clinical examination, we admitted that the scheme III would be the preferred for these reasons: a) it produces the same cure-rate as those schemes which use double this dosage, b) in relation to positive results it is less expensive, c) the scheme can be used for more extended periods, with less risk of toxic effects, and d) there has till now been no evidence of the development of resistance to treatment using this scheme, at least in our particular area of study (Pará).

Effects of naloxone infusion in patients with septic shock and renal failure: a limited experience.

Septic shock is frequently associated with acute renal failure. Management of these patients becomes complicated if either the renal or systemic hemodynamic derangement cannot be corrected. Although previously large doses of furosemide and naloxone infusion have been used separately in managing these patients, the combination of both agents has not been employed. We therefore report our limited experience with this combined treatment in 5 patients with septic shock, of which 4 had acute renal failure.