Metastatic Crohn's disease despite infliximab therapy.

Metastatic Crohn's disease is a rare extraintestinal manifestation of Crohn's disease. It is characterized by polymorphic skin lesions formed by non-caseating granulomas located on anatomical sites distant from the gastrointestinal tract. We report a rare case of metastatic Crohn's disease, simultaneously displaying multiple clinically heterogeneous cutaneous lesions, in a patient with previously diagnosed Crohn's disease in remission due to anti-TNF-α use. This case highlights the need for high clinical suspicion and early biopsy in the setting of a patient with Crohn's disease and persistent skin lesions, even under biologic therapy. Furthermore, it reinforces the need of monitoring of the serum level of infliximab, increasing the dose in case it is low or undetectable.

O brincar para o desenvolvimento do esquema corporal, orientação espacial e temporal: análise de uma intervenção / Play for the development of body schema and spatial and temporal orientation: analysis of an intervention

[{"text": "Introdução: A infância é uma fase significativa do desenvolvimento humano, na qual se desenvolvem\r\nvárias aptidões, ocorrendo evoluções na aprendizagem. O ato de brincar é uma atividade do cotidiano das crianças e aperfeiçoa as habilidades cognitivas, sociais, emocionais e psicomotoras. Objetivo: Avaliar os resultados de uma intervenção para uma criança com atraso no desenvolvimento do esquema corporal, da orientação espacial e da orientação temporal. Método: Este estudo adotou o design quase-experimental do tipo pré e pós-teste. Foi aplicada a Escala de Desenvolvimento Motor (EDM) em uma criança de quatro anos. A partir dos resultados da EDM, foi elaborado um plano de intervenção com brincadeiras que estimulassem as aquisições acima citadas. A concretização do plano de intervenção teve duração de dois meses, sendo a criança avaliada antes e no término da intervenção. O Método Jacobson e Truax foi adotado para análise dos dados e verificação da ocorrência de mudanças confiáveis e clinicamente significativas. Resultados: A criança obteve mudança confiável nos três itens avaliados. Em relação à significância clínica, na organização espacial a criança mudou seu status clínico, passando para a população funcional. No esquema corporal, a criança permaneceu na população disfuncional, e na organização temporal apresentou-se na faixa de incerteza. Conclusão: Os resultados demonstraram mudanças positivas e confiáveis nos itens avaliados, confirmando um efeito positivo do brincar enquanto recurso terapêutico ocupacional presente no\r\nprograma de intervenção elaborado. Ressalta-se a importância da realização de novos estudos com maior número de participantes para novos dados e descobertas sobre a utilização do brincar em intervenções no desenvolvimento de aquisições psicomotoras.", "_i": "pt"}, {"text": "Introduction: Childhood is a significant stage in human development in which many skills are developed\r\ninfluencing learning progress. Play is an activity of children's daily lives that enhances cognitive, social, emotional, and psychomotor abilities. Objective: evaluate the results of an intervention for a child with delayed development of body schema and spatial and temporal orientation. Method: This study adopted the semi-experimental design type of pre and post-test. The Motor Development Scale (MDS) was applied in a four-year-old child. From the MDS results, an intervention plan was prepared concerning games that stimulate the previously mentioned acquisitions. The implementation of the plan lasted two months and the child was evaluated before and at the end of the intervention. The JT method was adopted for data analysis and verification of significant and reliable clinical changes. Results: The child achieved significant change in the three items assessed. In terms of clinical significance, the child changed status on spatial organization, becoming part of the functional population. Body schema remained in the dysfunctional population and the child's temporal orientation was in the range of uncertainty. Conclusion: The results showed positive and reliable changes in the evaluated items, confirming the positive effect of play as an occupational therapeutic resource present in the developmental intervention program. It emphasizes the importance of conducting further studies with a larger number of participants for new data and findings on the use of play in interventions into psychomotor development.", "_i": "en"}]

A New Paradigm in Gallstones Diseases and Marked Elevation of Transaminases: An Observational Study

ABSTRACT Background. In clinical practice, it is assumed that a severe rise in transaminases is caused by ischemic, viral or toxic hepatitis. Nevertheless, cases of biliary obstruction have increasingly been associated with significant hypertransaminemia. With this study, we sought to determine the true etiology of marked rise in transaminases levels, in the context of an emergency department. Material and methods. We retrospectively identified all patients admitted to the emergency unit at Centro Hospitalar e Universitário de Coimbra between 1st January 2010 and 31st December 2010, displaying an increase of at least one of the transaminases by more than 15 times. All patient records were analyzed in order to determine the cause of hypertransaminemia. Results. We analyzed 273 patients - 146 males, mean age 65.1 ± 19.4 years. The most frequently etiology found for marked hypertransaminemia was pancreaticobiliary acute disease (n = 142;39.4%), mostly lithiasic (n = 113;79.6%), followed by malignancy (n = 74;20.6%), ischemic hepatitis (n = 61;17.0%), acute primary hepatocellular disease (n = 50;13.9%) and muscle damage (n = 23;6.4%). We were not able to determine a diagnosis for 10 cases. There were 27 cases of recurrence in the lithiasic pancreaticobiliary pathology group. Recurrence was more frequent in the group of patients who had not been submitted to early cholecystectomy after the first episode of biliary obstruction (p = 0.014). The etiology of hypertransaminemia varied according to age, cholestasis and glutamic-pyruvic transaminase values. Conclusion. Pancreaticobiliary lithiasis is the main cause of marked hypertransaminemia. Hence, it must be considered when dealing with such situations. Not performing cholecystectomy early on, after the first episode of biliary obstruction, may lead to recurrence.

A New Paradigm in Gallstones Diseases and Marked Elevation of Transaminases: An Observational Study.

BACKGROUND: In clinical practice, it is assumed that a severe rise in transaminases is caused by ischemic, viral or toxic hepatitis. Nevertheless, cases of biliary obstruction have increasingly been associated with significant hypertransaminemia. With this study, we sought to determine the true etiology of marked rise in transaminases levels, in the context of an emergency department. MATERIAL AND METHODS: We retrospectively identified all patients admitted to the emergency unit at Centro Hospitalar e Universitário de Coimbra between 1st January 2010 and 31st December 2010, displaying an increase of at least one of the transaminases by more than 15 times. All patient records were analyzed in order to determine the cause of hypertransaminemia. RESULTS: We analyzed 273 patients - 146 males, mean age 65.1 ± 19.4 years. The most frequently etiology found for marked hypertransaminemia was pancreaticobiliary acute disease (n = 142;39.4%), mostly lithiasic (n = 113;79.6%), followed by malignancy (n = 74;20.6%), ischemic hepatitis (n = 61;17.0%), acute primary hepatocellular disease (n = 50;13.9%) and muscle damage (n = 23;6.4%). We were not able to determine a diagnosis for 10 cases. There were 27 cases of recurrence in the lithiasic pancreaticobiliary pathology group. Recurrence was more frequent in the group of patients who had not been submitted to early cholecystectomy after the first episode of biliary obstruction (p = 0.014). The etiology of hypertransaminemia varied according to age, cholestasis and glutamic-pyruvic transaminase values. CONCLUSION: Pancreaticobiliary lithiasis is the main cause of marked hypertransaminemia. Hence, it must be considered when dealing with such situations. Not performing cholecystectomy early on, after the first episode of biliary obstruction, may lead to recurrence.

Metastatic Crohn's disease despite infliximab therapy

Abstract Metastatic Crohn's disease is a rare extraintestinal manifestation of Crohn's disease. It is characterized by polymorphic skin lesions formed by non-caseating granulomas located on anatomical sites distant from the gastrointestinal tract. We report a rare case of metastatic Crohn's disease, simultaneously displaying multiple clinically heterogeneous cutaneous lesions, in a patient with previously diagnosed Crohn's disease in remission due to anti-TNF-α use. This case highlights the need for high clinical suspicion and early biopsy in the setting of a patient with Crohn's disease and persistent skin lesions, even under biologic therapy. Furthermore, it reinforces the need of monitoring of the serum level of infliximab, increasing the dose in case it is low or undetectable.

Análise de uma intervenção dirigida ao desenvolvimento da coordenação motora fina, global e do equilíbrio / Analysis of an intervention directed to the development of balance and gross and fine motor coordination

Introdução: As aquisições motoras das crianças evoluem de acordo com a idade e com a influência contínua de fatores intrínsecos e extrínsecos, os quais provocam variações de uma criança para outra e tornam único o curso do desenvolvimento. Objetivo: Elaborar uma intervenção para uma criança com atraso na coordenação motora fina, global e no equilíbrio e analisar o impacto no desenvolvimento. Método: Design quase-experimental do tipo pré e pós-teste. O instrumento utilizado foi a Escala de Desenvolvimento Motor aplicada em uma criança de 4 anos. A partir dos resultados obtidos na avaliação foi elaborado um plano de intervenção composto por atividades dirigidas que estimulassem as aquisições acima citadas. A concretização do plano de intervenção teve duração de 2 meses, sendo a criança avaliada antes e ao término da intervenção para verificar se houve ganho nas aquisições estimuladas. O Método JT foi adotado para análise dos dados e verificação de ocorrência de mudanças positivas confiáveis e clinicamente relevantes. Resultados: Os resultados obtidos no presente estudo demonstram que ocorreram mudanças positivas confiáveis nos itens psicomotores que passaram por estimulação. Conclusão: Infere-se que a intervenção proposta teve um efeito positivo sobre o desenvolvimento da criança. Com isso, o estudo contribui para melhoria no cuidado oferecido a crianças com atrasos no desenvolvimento psicomotor, ilustrando possibilidades de estratégias e atividades. Também possibilita o reconhecimento da ação do terapeuta ocupacional como um dos profissionais que compõe a equipe multidisciplinar voltada à intervenção precoce.

Representações oociais do amor no rock Brasileiro dos anos 80 / Reresentaciones sociales del amor en el rock Brasileño de los años 80 / Social repreentaations of love in Brazilian rock from the 1980s

O objetivo do presente trabalho foi descrever e analisar as Representações Sociais de amor no rock brasileiro dos anos 80. Foram consultados 222 LPs gravados e lançados entre 1981 e 1990, todos pertencentes ao rock brasileiro dos Anos 80. De um corpus inicial composto por 2.074 gravações, obtivemos 999 letras que faziam referência a relacionamentos amorosos (48,16% do total). Dois procedimentos de análise foram utilizados: (a) Análise lexical (software ALCESTE) do corpus formado pelas 999 letras; e (b) análise de conteúdo de uma amostra (Eₒ= 5%) de 286 letras que fazem parte desse corpus. Identificamos na análise lexical duas classes (Paisagem e Vou te dizer) que permitiram a articulação dos 09 conjuntos temáticos resultantes da Análise de conteúdo (Na pele, A paisagem, Ela, A luz, As sombras do amor, Só, Movimentos, No coração, Na cabeça). Identificamos tal articulação como o princípio organizador das Representações Sociais do amor no corpus analisado...

El objetivo del presente trabajo fue describir y analizar las Representaciones Sociales del amor en el rock brasileño de los años 80. Fueron consultados 222 discos grabados y lanzados entre 1981 y 1990, todos pertenecientes al rock brasileño. Desde un corpus inicial compuesto por 2.074 grabaciones, obtuvimos 999 letras que hacían referencia a relacionamientos amorosos (48,16% del total). Dos procedimientos de análisis fueron utilizados: (a) Análisis lexical (software ALCESTE) del corpus formado por las 999 letras; y (b) Análisis de contenido de una muestra (Eₒ= 5%) de 286 letras. Identificamos en el análisis lexical dos clases (Paisagem y Vou te dizer) que permitieron la articulación de los 09 conjuntos temáticos resultantes del análisis de contenido (Na pele, A paisagem, Ela, A luz, As sombras do amor, Só, Movimentos, No coração, Na cabeça). Identificamos tal articulación como el principio organizador de las Representaciones Sociales en el corpus analizado...

This article aims at describing and analyzing the social representations of love within brazilian rock from the 1980s. 222 brazilian rock LPs recorded and released between 1981 and 1990 were analyzed. From an initial corpus consisting of 2074 recordings, 999 lyrics made reference to love relationship (48,16 % of total). Two analysis procedures were used: 1) Lexical Analysis (using the software ALCESTE) of the corpus (999 lyrics) and, 2) Content Analysis of a sample (Eₒ= 5%) of 286 lyrics that are part of this corpus. In the Lexical Analysis it was possible to identify two classes (Paisagem and Vou te dizer) that allowed the articulation of the 09 thematic groups resulting from Content Analysis (Na pele, A paisagem, Ela, A luz, As sombras do amor, Só, Movimentos, No coração, Na cabeça). This articulation was identified as the organizing principle of Social Representation of love in the corpus analyzed...

REPRESENTAÇÕES SOCIAIS DO AMOR NO ROCK BRASILEIRO DOS ANOS 80 / REPRESENTACIONES SOCIALES DEL AMOR EN EL ROCK BRASILEÑO DE LOS AÑOS 80 / SOCIAL REPRESENTATIONS OF LOVE IN BRAZILIAN ROCK FROM THE 1980S

O objetivo do presente trabalho foi descrever e analisar as Representações Sociais de amor no rock brasileiro dos anos 80. Foram consultados 222 LPs gravados e lançados entre 1981 e 1990, todos pertencentes ao rock brasileiro dos Anos 80. De um corpus inicial composto por 2.074 gravações, obtivemos 999 letras que faziam referência a relacionamentos amorosos (48,16% do total). Dois procedimentos de análise foram utilizados: (a) Análise lexical (software ALCESTE) do corpus formado pelas 999 letras; e (b) análise de conteúdo de uma amostra (Eₒ= 5%) de 286 letras que fazem parte desse corpus. Identificamos na análise lexical duas classes (Paisagem e Vou te dizer) que permitiram a articulação dos 09 conjuntos temáticos resultantes da Análise de conteúdo (Na pele, A paisagem, Ela, A luz, As sombras do amor, Só, Movimentos, No coração, Na cabeça). Identificamos tal articulação como o princípio organizador das Representações Sociais do amor no corpus analisado.(AU)

El objetivo del presente trabajo fue describir y analizar las Representaciones Sociales del amor en el rock brasileño de los años 80. Fueron consultados 222 discos grabados y lanzados entre 1981 y 1990, todos pertenecientes al rock brasileño. Desde un corpus inicial compuesto por 2.074 grabaciones, obtuvimos 999 letras que hacían referencia a relacionamientos amorosos (48,16% del total). Dos procedimientos de análisis fueron utilizados: (a) Análisis lexical (software ALCESTE) del corpus formado por las 999 letras; y (b) Análisis de contenido de una muestra (Eₒ= 5%) de 286 letras. Identificamos en el análisis lexical dos clases (Paisagem y Vou te dizer) que permitieron la articulación de los 09 conjuntos temáticos resultantes del análisis de contenido (Na pele, A paisagem, Ela, A luz, As sombras do amor, Só, Movimentos, No coração, Na cabeça). Identificamos tal articulación como el principio organizador de las Representaciones Sociales en el corpus analizado.(AU)

This article aims at describing and analyzing the social representations of love within brazilian rock from the 1980s. 222 brazilian rock LPs recorded and released between 1981 and 1990 were analyzed. From an initial corpus consisting of 2074 recordings, 999 lyrics made reference to love relationship (48,16 % of total). Two analysis procedures were used: 1) Lexical Analysis (using the software ALCESTE) of the corpus (999 lyrics) and, 2) Content Analysis of a sample (Eₒ= 5%) of 286 lyrics that are part of this corpus. In the Lexical Analysis it was possible to identify two classes (Paisagem and Vou te dizer) that allowed the articulation of the 09 thematic groups resulting from Content Analysis (Na pele, A paisagem, Ela, A luz, As sombras do amor, Só, Movimentos, No coração, Na cabeça). This articulation was identified as the organizing principle of Social Representation of love in the corpus analyzed. .(AU)

Conscious sedation with inhaled 50% nitrous oxide/oxygen premix in photodynamic therapy sessions for vulvar lichen sclerosus treatment.

Photodynamic therapy has been described as an effective therapeutic option in selected cases of anogenital lichen sclerosus that are refractory to first-line treatments. However, procedure-related pain is a limiting factor in patient adherence to treatment. The authors report the case of a 75-year-old woman with highly symptomatic vulvar lichen sclerosus, successfully treated with photodynamic therapy. An inhaled 50% nitrous oxide/oxygen premix was administered during sessions, producing a pain-relieving, anxiolytic, and sedative effect without loss of consciousness. This ready-to-use gas mixture may be a well-tolerated and accepted alternative to classical anesthetics in Photodynamic therapy, facilitating patients' adherence to illumination of pain-prone areas.

Conscious sedation with inhaled 50% nitrous oxide/oxygen premix in photodynamic therapy sessions for vulvar lichen sclerosus treatment

Photodynamic therapy has been described as an effective therapeutic option in selected cases of anogenital lichen sclerosus that are refractory to first-line treatments. However, procedure-related pain is a limiting factor in patient adherence to treatment. The authors report the case of a 75-year-old woman with highly symptomatic vulvar lichen sclerosus, successfully treated with photodynamic therapy. An inhaled 50% nitrous oxide/oxygen premix was administered during sessions, producing a pain-relieving, anxiolytic, and sedative effect without loss of consciousness. This ready-to-use gas mixture may be a well-tolerated and accepted alternative to classical anesthetics in Photodynamic therapy, facilitating patients' adherence to illumination of pain-prone areas.

[Nutritional status and food intake of continuous peritoneal dialysis patients with and without secondary hyperparathyroidism]. / Estado nutricional e ingestão alimentar de pacientes em diálise peritoneal contínua com e sem hiperparatireoidismo secundário.

INTRODUCTION: Secondary hyperparathyroidism (SHPT) is a common and early complication in chronic kidney disease (CKD) patients. Studies have suggested that high levels of parathyroid hormone (PTH) may have deleterious effects on the nutritional status of patients with CKD. Thus, the aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. OBJECTIVE: The aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. METHODS: 74 patients were evaluated, including adults and seniors, divided into two groups according to PTH levels. In group 1 (n = 18) levels of PTH higher than 300 pg/mL and in group 2 less than or equal to 300 pg/mL. The nutritional status of patients was assessed by anthropometry, biochemical and subjective global assessment (SGA). Food intake was measured by food record for 3 days. We also collected clinical data, such as calcium and serum phosphorus, and the presence of inflammation was assessed by measuring C-reactive protein ultra-sensitive (CRP US). RESULTS: The average age of the population studied was 54.97 ± 17.06 years, with predominance of adult patients (58.1%) and females (56.8%). The time of CPD expressed in median was 17 months (7.75-33). Through ASG, it was shown a prevalence of 36.5% of the population undernourished. In the analysis of difference between the groups in relation to anthropometry, biochemical indicators and ASG as well as food intake, there were no differences between the groups. CONCLUSION: There were no differences in nutritional status and dietary intake between patients with and without SHPT.

Estado nutricional e ingestão alimentar de pacientes em diálise peritoneal contínua com e sem hiperparatireoidismo secundário / Nutritional status and food intake of continuous peritoneal dialysis patients with and without secondary hyperparathyroidism

INTRODUÇÃO: O hiperparatireoidismo secundário (HPT2) é uma complicação comum e precoce em pacientes com doença renal crônica (DRC). Estudos têm sugerido que os altos níveis de paratormônio (PTH) podem exercer efeitos deletérios no estado nutricional de pacientes com DRC. Assim, o objetivo deste estudo foi comparar o estado nutricional de pacientes com DRC em diálise peritoneal contínua (DPC) com e sem HPT2. OBJETIVO: O objetivo deste estudo é comparar o estado nutricional de pacientes com DRC em diálise peritoneal contínua (DPC) com e sem HPTS. MÉTODOS: Foram avaliados 74 pacientes, entre adultos e idosos, divididos em dois grupos, de acordo com os níveis de PTH. No grupo 1 (n = 18) os níveis de PTH eram maiores do que 300 pg/mL e, no grupo 2, menores ou iguais a 300 pg/mL. O estado nutricional dos pacientes foi avaliado através da antropometria, exames bioquímicos e avaliação subjetiva global (ASG). O consumo alimentar foi avaliado através do registro alimentar de 3 dias. Foram coletados também dados clínicos, como cálcio e fósforo séricos, e a presença de inflamação foi avaliada através da dosagem de proteína C reativa ultrassensível (PCR US). RESULTADOS: A média de idade da população estudada foi de 54,97 ± 17,06 anos, com predominância de pacientes adultos (58,1%) e do sexo feminino (56,8%). O tempo de DPC expresso em mediana foi de 17 meses (7,75-33). Através da ASG, demonstrou-se prevalência de 36,5% de desnutridos na população. Na análise de diferença entre os grupos, em relação à antropometria, indicadores bioquímicos e ASG, bem como ingestão alimentar, não foram evidenciadas diferenças entre os grupos estudados. CONCLUSÃO: Não houve diferenças no estado nutricional e na ingestão alimentar entre os pacientes com e sem HPT2.

INTRODUCTION: Secondary hyperparathyroidism (SHPT) is a common and early complication in chronic kidney disease (CKD) patients. Studies have suggested that high levels of parathyroid hormone (PTH) may have deleterious effects on the nutritional status of patients with CKD. Thus, the aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. OBJECTIVE: The aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. METHODS: 74 patients were evaluated, including adults and seniors, divided into two groups according to PTH levels. In group 1 (n = 18) levels of PTH higher than 300 pg/mL and in group 2 less than or equal to 300 pg/mL. The nutritional status of patients was assessed by anthropometry, biochemical and subjective global assessment (SGA). Food intake was measured by food record for 3 days. We also collected clinical data, such as calcium and serum phosphorus, and the presence of inflammation was assessed by measuring C-reactive protein ultra-sensitive (CRP US). RESULTS: The average age of the population studied was 54.97 ± 17.06 years, with predominance of adult patients (58.1%) and females (56.8%). The time of CPD expressed in median was 17 months (7.75-33). Through ASG, it was shown a prevalence of 36.5% of the population undernourished. In the analysis of difference between the groups in relation to anthropometry, biochemical indicators and ASG as well as food intake, there were no differences between the groups. CONCLUSION: There were no differences in nutritional status and dietary intake between patients with and without SHPT.

Desnutrição, inflamação e outros fatores de risco para doença cardiovascular em pacientes sob diálise peritoneal / Malnutrition, inflammation and other risk factors for cardiovascular diseases in patients undergoing peritoneal dialysis

OBJETIVO: Identificar a ocorrência de desnutrição, inflamação e outros fatores de risco para doença cardiovascular em pacientes sob diálise peritoneal. MÉTODOS: Estudo transversal, envolvendo 61 pacientes em duas unidades de diálise em Salvador (BA). O estado nutricional foi avaliado por meio da Avaliação Subjetiva Global. Realizou-se a dosagem de proteína C reativa ultrassensível para determinar inflamação. Foram estudados fatores de risco tradicionais para doença cardiovascular, como gênero, idade, etilismo, tabagismo, sedentarismo, hipertensão, diabetes, dislipidemia e hábitos alimentares e fatores não tradicionais, como alterações no metabolismo de cálcio, fósforo e anemia. RESULTADOS: Nessa população, 36,0 por cento dos pacientes encontravam-se desnutridos e 49,2 por cento com processo inflamatório. Desnutrição e inflamação foram evidenciadas em 21,3 por cento dos pacientes. O grupo de pacientes desnutridos apresentou níveis maiores de proteína C reativa ultrassensível do que o de pacientes com bom estado nutricional (p=0,04). A elevada ocorrência dos outros fatores risco para doença cardiovascular também foi observada na população. CONCLUSÃO: A desnutrição ainda é frequente nos pacientes sob diálise peritoneal, assim como a inflamação. Pacientes desnutridos apresentam maiores níveis séricos de proteína C reativa ultrassensível do que aqueles com bom estado nutricional. Observa-se que muitos dos fatores de risco evidenciados na população estudada são passíveis de terapêutica.

OBJECTIVE: This study aimed to identify the occurrence of malnutrition, inflammation and other risk factors for cardiovascular diseases in patients undergoing peritoneal dialysis. METHODS: This is a crosssectional study comprising 61 patients from two dialysis units in Salvador (Bahia, Brazil). Nutritional status was determined by the global subjective assessment and inflammation by the ultra sensitive creactive protein levels. Traditional risk factors for cardiovascular diseases, such as gender, age, consumption of alcoholic beverages, smoking, inactivity, hypertension, diabetes, dyslipidemia and food habits, as well as nontraditional factors such as disturbed calcium and phosphorus metabolism and anemia, were investigated. RESULTS: Malnutrition was found in 36.0 percent of the patients in the population under study whereas inflammation was present in 49.2 percent of them. Patients with both malnutrition and inflammation were shown to comprise 21.3 percent of the sample. Ultra sensitive creactive protein levels were found to be higher (p=0.04) in malnourished patients than in those with good nutritional status. High rates of other risk factors for cardiovascular disease were also observed in this population. CONCLUSION: Malnutrition and inflammation are still common among patients undergoing peritoneal dialysis. Ultra sensitive creactive protein levels were found to be higher among malnourished patients than in well-nourished patients. Many of the risk factors found in the studied population are treatable.

Biochemical biomarkers in algae and marine pollution: a review.

Environmental pollution by organic compounds and metals became extensive as mining and industrial activities increased in the 19th century and have intensified since then. Environmental pollutants originating from diverse anthropogenic sources have been known to possess adverse values capable of degrading the ecological integrity of marine environment. The consequences of anthropogenic contamination of marine environments have been ignored or poorly characterized with the possible exception of coastal and estuarine waters close to sewage outlets. Monitoring the impact of pollutants on aquatic life forms is challenging due to the differential sensitivities of organisms to a given pollutant, and the inability to assess the long-term effects of persistent pollutants on the ecosystem as they are bio-accumulated at higher trophic levels. Marine microalgae are particularly promising indicator species for organic and inorganic pollutants since they are typically the most abundant life forms in aquatic environments and occupy the base of the food chain. We review the effects of pollutants on the cellular biochemistry of microalgae and the biochemical mechanisms that microalgae use to detoxify or modify pollutants. In addition, we evaluate the potential uses of microalgae as bioindicator species as an early sentinel in polluted sites.

Metabolites from algae with economical impact.

In order to survive in a highly competitive environment, freshwater or marine algae have to develop defense strategies that result in a tremendous diversity of compounds from different metabolic pathways. Recent trends in drug research from natural sources have shown that algae are promising organisms to furnish novel biochemically active compounds. The current review describes the main substances biosynthesized by algae with potential economic impact in food science, pharmaceutical industry and public health. Emphasis is given to fatty acids, steroids, carotenoids, polysaccharides, lectins, mycosporine-like amino acids, halogenated compounds, polyketides and toxins.

Oxidative stress in alcohol-induced rat parotid sialadenosis.

This study evaluated the effect of chronic ethanol consumption on the oxidative status of rat parotid and submandibular glands. To identify the endogenous response to ethanol ingestion, the activities of the antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were determined. In addition, the antioxidant alpha-tocopherol was supplied to the animals in order to estimate its action in ethanol-associated glandular damage. The thiobarbituric acid reactive substances (TBARS), and the protein carbonyl (PC) content, both markers of cellular oxidative stress on lipid and protein structures, respectively, were recorded. Animals subjected to alcohol ingestion showed a low body growth rate with concomitant enlargement of absolute and relative parotid wet weight, compared with pair-fed calorie-controlled rats. Parotid glands of ethanol-treated animals showed increased SOD and GPx activity, and alpha-tocopherol was able to reduce their activities to the control levels. TBARS and PC were enhanced after chronic ethanol treatment in rat parotids. Supplemental alpha-tocopherol suppressed the oxidative ethanol-induced damage in lipid without affecting induced protein oxidation. Submandibular glands revealed no alterations in the weight, enzymatic and oxidative parameters tested due to ethanol and/or alpha-tocopherol ingestion. These findings indicate the involvement of oxidative stress in parotid gland sialadenosis due to ethanol consumption and the capability of alpha-tocopherol to halt lipid damage, although this low-molecular antioxidant compound leads to neither increased glandular weight nor protein oxidation in ethanol-induced parotid alterations.