Rosácea extra-facial: desafío diagnóstico / Extra-facial rosacea: a diagnostic challenge

A rosácea é uma dermatose comum, com variedade de manifestações clínicas, porém muitas vezes subdiagnosticada, principalmente nas suas formas atípicas. Sua patogênese não é bem definida e envolve inflamação e hiperatividade vascular. Seu diagnóstico é essencialmente clínico, sendo o examehistopatológico útil para excluir outras dermatoses. Relatamos um caso incomum de rosácea, acometendo apenas as orelhas, com excelente resposta à tetraciclina (AU)

Rosacea is a common skin disease with a variety of clinical manifestations, but often under diagnosed, especially in atypical forms. Its pathogenesis is not fully understood, but is clearly related to vascular hyperactivity and inflammation. Its diagnosis is essentially clinical and a histopathological examination is useful to exclude other types of dermatosis. We report an unusual case of rosacea, affecting only the ears, with an excellent response to tetracycline (AU)

Rosácea extra-facial: desafío diagnóstico / Extra-facial rosacea: a diagnostic challenge

A rosácea é uma dermatose comum, com variedade de manifestações clínicas, porém muitas vezes subdiagnosticada, principalmente nas suas formasatípicas. Sua patogênese não é bem definida e envolve inflamação e hiperatividade vascular. Seu diagnóstico é essencialmente clínico, sendo o exame histopatológico útil para excluir outras dermatoses. Relatamos um caso incomum de rosácea, acometendo apenas as orelhas, com excelente resposta à tetraciclina (AU)

Rosacea is a common skin disease with a variety of clinical manifestations, but often under diagnosed, especially in atypical forms. Its pathogenesis is not fully understood, but is clearly related to vascular hyperactivity and inflammation. Its diagnosis is essentially clinical and a histopathological examination is useful to exclude other types of dermatosis. We report an unusual case of rosacea, affecting only the ears, with an excellent response to tetracycline (AU)

Estudo comparativo entre aplicação de ATAa 90% e fenol a 88% com a técnica de CROSSnas cicatrizes da acne / Chemical reconstruction of skin scars with 90% trichloroacetic acid or 88% phenol: a comparative study

Introdução: Acne é uma doença comum que afeta a unidade pilosebácea e produz várias sequelas cosméticas, como as cicatrizes. Pacientes e métodos: Este estudo foi realizado para se avaliar o benefício do tratamento das cicatrizes de acne utilizando a técnica de “CROSS”(reconstrução química de cicatrizes de acne) e para se comparar o uso de duas substâncias nesta técnica- o ácido tricloroacetico (ATA) a 90% e o fenola 88% . Foram tratadas cicatrizes de acne em oito pacientes, aplicando-se as substâncias químicas nas cicatrizes. Foram utilizados aplicadores de madeira para aplicar fenol a 88% nas cicatrizes da hemiface direita e ATA a 90% nas cicatrizes da hemiface esquerda. O procedimento foi repetido emintervalos mensais em um total de cinco meses. Resultados: Foi observado que a sensação de queimação que ocorre no momento da aplicação das substâncias é mais intensa quando se usa ATA. Oeritema que surge no local da aplicação é mais é mais evidente e duradouro com uso de ATA. A reepitelização da pele tratada é mais demorada comATA. A maior parte dos pacientes mostrou melhores resultados cosméticos na hemiface onde foi usado o fenol a 88%.Discussão: Neste estudo, a técnica de “CROSS” teve bons resultados, mas foi necessário um longo tempo para que se produzisse resultados clínicosvisíveis. Quando as duas substâncias foram comparadas, o fenol a 88% se mostrou mais satisfatório do que o ATA, pois ocasionou menos dor, tevemelhores resultados cosméticos e reepitelização mais rápida (AU)

Introduction: Acne is a comon disease that affects the pilosebaceous unit and produces many cosmetic sequels, like scarring. Patients and methods: This study has been performed to evaluate the benefit of treating depressed acne scars with CROSS ( chemical reconstruction of skin scars ) technique versus 90% trichloroacetic acid (90% TCA) and 88% phenol. Acne scars in eight patients were treated by applying the chemical substances directly to the scars. We used wooden applicators to apply 88% phenol to the scars of the right hemiface and 90% TCA to the scars of the left hemiface. The procedure was repeated at monthly intervals for a total of five treatments. Results: The burning sensation that occurs at the time of application of both substances was more intense when using TCA. The erythema area that surges at the site of application is more evident and lasts longer with TCA. The reepithelization of the skin treated was slower with TCA. The majority of patients showed best cosmetic results at the hemiface where 88% phenol has been used. Discussion: In this study, the CROSS technique had good results but it required long time to produce clinical visible results. When both substances were compared, 88% phenol seemed to be more satisfactory than 90% TCA since it produced less pain, showed best cosmetic results and had faster reepithelization. (AU)

Low-frequency noise effects on the parotid gland of the Wistar rat.

BACKGROUND: Long-term low-frequency noise (LFN) (

Disfunción endotelial en la hipertensión pulmonar / Endothelial dysfunction in pulmonary hypertension

No disponible

Geographic distribution of hepatitis C virus genotypes in Brazil.

Brazil is a country of continental dimension with a population of different ethnic backgrounds. Thus, a wide variation in the frequencies of hepatitis C virus (HCV) genotypes is expected to occur. To address this point, 1,688 sequential samples from chronic HCV patients were analyzed. HCV-RNA was amplified by the RT-PCR from blood samples collected from 1995 to 2000 at different laboratories located in different cities from all Brazilian States. Samples were collected in tubes containing a gel separator, centrifuged in the site of collection and sent by express mail in a refrigerated container to Laboratório Bioquímico Jardim Paulista, São Paulo, SP, Brazil. HCV-RNA was extracted from serum and submitted to RT and nested PCR using standard procedures. Nested PCR products were submitted to cycle sequencing reactions without prior purification. Sequences were analyzed for genotype determination and the following frequencies were found: 64.9% (1,095) for genotype 1, 4.6% (78) for genotype 2, 30.2% (510) for genotype 3, 0.2% (3) for genotype 4, and 0.1% (2) for genotype 5. The frequencies of HCV genotypes were statistically different among Brazilian regions (P = 0.00017). In all regions, genotype 1 was the most frequent (51.7 to 74.1%), reaching the highest value in the North; genotype 2 was more prevalent in the Center-West region (11.4%), especially in Mato Grosso State (25.8%), while genotype 3 was more common in the South (43.2%). Genotypes 4 and 5 were rarely found and only in the Southeast, in São Paulo State. The present data indicate the need for careful epidemiological surveys throughout Brazil since knowing the frequency and distribution of the genotypes would provide key information for understanding the spread of HCV.

Geographic distribution of hepatitis C virus genotypes in Brazil

Brazil is a country of continental dimension with a population of different ethnic backgrounds. Thus, a wide variation in the frequencies of hepatitis C virus (HCV) genotypes is expected to occur. To address this point, 1,688 sequential samples from chronic HCV patients were analyzed. HCV-RNA was amplified by the RT-PCR from blood samples collected from 1995 to 2000 at different laboratories located in different cities from all Brazilian States. Samples were collected in tubes containing a gel separator, centrifuged in the site of collection and sent by express mail in a refrigerated container to Laboratório Bioquímico Jardim Paulista, São Paulo, SP, Brazil. HCV- RNA was extracted from serum and submitted to RT and nested PCR using standard procedures. Nested PCR products were submitted to cycle sequencing reactions without prior purification. Sequences were analyzed for genotype determination and the following frequencies were found: 64.9 percent (1,095) for genotype 1, 4.6 percent (78) for genotype 2, 30.2 percent (510) for genotype 3, 0.2 percent (3) for genotype 4, and 0.1 percent (2) for genotype 5. The frequencies of HCV genotypes were statistically different among Brazilian regions (P = 0.00017). In all regions, genotype 1 was the most frequent (51.7 to 74.1 percent), reaching the highest value in the North; genotype 2 was more prevalent in the Center-West region (11.4 percent), especially in Mato Grosso State (25.8 percent), while genotype 3 was more common in the South (43.2 percent). Genotypes 4 and 5 were rarely found and only in the Southeast, in São Paulo State. The present data indicate the need for careful epidemiological surveys throughout Brazil since knowing the frequency and distribution of the genotypes would provide key information for understanding the spread of HCV.

Crystallization, preliminary X-ray analysis and molecular-replacement solution of haemoglobin-II from the fish matrinxã (Brycon cephalus).

Haemoglobins constitute a set of proteins with interesting structural and functional properties, especially when the two large animal groups reptiles and fishes are focused on. Here, the crystallization and preliminary X-ray analysis of haemoglobin-II from the South American fish matrinxã (Brycon cephalus) is reported. X-ray diffraction data have been collected to 3.0 A resolution using synchrotron radiation (LNLS). Crystals were determined to belong to space group P2(1) and preliminary structural analysis revealed the presence of two tetramers in the asymmetric unit. The structure was determined using the standard molecular-replacement technique.

[The occurrence of hepatitis B and delta virus infection within seven Amerindian ethnic groups in the Brazilian western Amazon]. / Ocorrência da infecção pelo vírus da hepatite B (VHB) e delta (VHD) em sete grupos indígenas do Estado do Amazonas.

HBV and HDV infections are a major health problem in the Amazon. This study evaluates the prevalence of these viruses within Indians groups, measuring the frequency of serological markers. The prevalence of past infection was 54.5% and HBsAg was found in 9.7%. An important variation of those markers was detected between villages, inclusively within the same ethnic group. None showed evidence of an acute infection. All HBeAg reactive were Apurinã, living in the same village and three of them from the same family. The prevalence of anti-HDT was 13.4% in HBsAg positive individuals. The authors observed high prevalence of HBV and HDV infection with the following pattern: low degree of infectivity, marked transmission in early ages, intra-familial dissemination, and lack of importance of vertical transmission. However, the results suggest that these viruses were not yet introduced effectively in some of the studied groups.

The polymorphism at codon 54 of the FABP2 gene increases fat absorption in human intestinal explants.

Based on titration microcalorimetry and Caco-2 cell line transfection studies, it has been suggested that the A54T of the FABP2 gene plays a significant role in the assimilation of dietary fatty acids. However, reports were divergent with regard to the in vivo interaction between this polymorphism and postprandial lipemia. We therefore determined the influence of this intestinal fatty acid-binding protein polymorphism on intestinal fat transport using the human jejunal organ culture model, thus avoiding the interference of various circulating factors capable of metabolizing in vivo postprandial lipids. Analysis of DNA samples from 32 fetal intestines revealed 22 homozygotes for the wild-type Ala-54/Ala-54 genotype (0.83) and 10 heterozygotes for the polymorphic Thr-54/Ala-54 genotype (0.17). The Thr-encoding allele was associated with increased secretion of newly esterified triglycerides, augmented de novo apolipoprotein B synthesis, and elevated chylomicron output. On the other hand, no alterations were found in very low density lipoprotein and high density lipoprotein production, apolipoprotein A-I biogenesis, or microsomal triglyceride transfer protein mass and activity. Similarly, the alanine to threonine substitution at residue 54 did not result in changes in brush border hydrolytic activities (sucrase, glucoamylase, lactase, and alkaline phosphatase) or in glucose uptake or oxidation. Our data clearly document that the A54T polymorphism of FABP2 specifically influences small intestinal lipid absorption without modifying glucose uptake or metabolism. It is proposed that, in the absence of confounding factors such as environmental and genetic variables, the FABP2 polymorphism has an important effect on postprandial lipids in vivo, potentially influencing plasma levels of lipids and atherogenesis.

Ocorrência da infecção pelo vírus da hepatite B (VHB) e delta (VHD) em sete grupos indígenas do Estado do Amazonas / The occurrence of hepatitis B and delta virus infection within seven Amerindian ethnic groups in the Brazilian western Amazon

HBV and HDV infections are a major health problem in the Amazon. This study evaluates the prevalence of these viruses within Indians groups, measuring the frequency of serological markers. The prevalence of past infection was 54.5% and HBsAg was found in 9.7%. An important variation of those markers was detected between villages, inclusively within the same ethnic group. None showed evidence of an acute infection. All HBeAg reactive were Apurinã, living in the same village and three of them from the same family. The prevalence of anti-HDT was 13.4% in HBsAg positive individuals. The authors observed high prevalence of HBV and HDV infection with the following pattern: low degree of infectivity, marked transmission in early ages, intra-familial dissemination, and lack of importance of vertical transmission. However, the results suggest that these viruses were not yet introduced effectively in some of the studied groups.

A infecção pelo VHB e VHD são importantes problemas de saúde na Amazônia. Este estudo avalia a prevalência da infecção por esses agentes em sete grupos indígenas do Estado do Amazonas. A taxa de infecção passada pelo VHB encontrada foi de 54,5% e a de portadores do AgHBs de 9,7%. Observa-se variação importante destes marcadores entre as aldeias, inclusive da mesma etnia. Não evidenciamos marcador de infecção aguda, os quatro AgHBe reativos eram todos Apurinã, da mesma aldeia, e três da mesma família. O VHD foi encontrado em 13,4% dos AgHBs reativos. O padrão de infecção pelo VHB e VHD encontrado possui as seguintes características: endemicidade elevada, baixo potencial de infectividade, transmissão marcada em idade precoce, provável transmissão familiar, e pouca importância da transmissão vertical. Entretanto, também sugere que esses vírus não tenham sido ainda introduzidos efetivamente em algumas das etnias estudadas

Determinants of lipid level variability in French-Canadian children with familial hypercholesterolemia.

The wide variability in the biochemical expression of familial hypercholesterolemia (FH) is only partly explained by mutational heterogeneity in the low density lipoprotein receptor (LDLR) gene. In the current study, we measured this biochemical variability in a group of children heterozygous for the >15-kb LDLR gene deletion (n=67) and examined the contribution of apolipoprotein (apo) E and B allelic variations to this phenotypic variability. Variances of total cholesterol (TC), LDL-C, and apoB concentrations and of the ratio of TC to high density lipoprotein cholesterol (HDL-C) were increased in FH subjects compared with controls. However, after taking the means into account, the coefficients of variation showed that the variability of LDL-C and apoB concentrations was smaller for FH than for controls and that the variability of TC and of the ratio TC to HDL-C was similar between both groups. The epsilon2/3 genotype was associated with lower mean TC, LDL-C, and apoB concentrations in FH. The magnitude of this effect was smaller in controls than in FH. Indeed, the percentages of total variance of TC, LDL-C, and apoB attributable to the apoE locus were 19.9%, 18.1%, and 11.8%, respectively, in FH cases and 5.9%, 7.4%, and 6.0%, respectively, in controls. We did not detect any effect of the apoB insertion/deletion polymorphism on lipid traits in FH children. However, in controls, we observed a strong interaction between apoE and apoB genotypes on apoB concentrations and on TC to HDL-C ratios. Our study reemphasizes the important role of apoE in lipid metabolism and illustrates that the effects of allelic variations on lipid traits are context dependent.

[Resistance of Plasmodium falciparum to 3 antimalarials in Turbo (Antioquia, Colombia), 1998]. / Resistencia de Plasmodium falciparum a tres fármacos antimaláricos en Turbo (Antioquia, Colombia), 1998.

In 1998 we determined in vivo and in vitro the frequency and the degree of resistance of Plasmodium falciparum to the three antimalarials (chloroquine, amodiaquine, and sulfadoxine/pyrimethamine) most utilized in the municipality of Turbo (in the area of Urabá, Antioquia, Colombia), in a sample representative of the population with malaria. We carried out clinical and parasitological analyses over a 14-day period using the standard test recommended by the World Health Organization. In vivo, P. falciparum showed resistance to chloroquine, amodiaquine, and sulfadoxine/pyrimethamine, with a frequency of 97%, 7%, and 13%, respectively. In vitro, the corresponding figures were 21%, 23%, and 9%, respectively. For chloroquine the level of agreement between the in vivo and in vitro results was 23%.

Human papillomavirus (HPV) study of 691 pathological specimens from Quebec by PCR-direct sequencing approach.

Human papillomaviruses (HPV) are etiological agents of cervical cancer. In order to address clinical demand for HPV detection and sequence typing, mostly in pre-cancerous cervical lesions, we applied our two-tier PCR-direct sequencing (PCR-DS) approach based on the use of both MY09/MY11 and GP5 + /GP6 + sets of primers. We tested 691 pathological specimens, all of which were biopsies, 75% of which were diagnosed histologically as cervical intraepithelial neoplasia (CIN) grades I-III. In total, 484 samples (70%) tested HPV-positive, yielding 531 HPV sequences from 47 HPV types, including two novel types. Four most frequently found HPV types accounted for 52.9% of all isolates: HPV6, 16, 11, and 31 (21.5%, 20.0%, 7.0%, and 4.5%, respectively). Some interesting results are the following: all currently known high-risk HPV (14 types) and low-risk HPV (6 types) were detected; HPV18 was not the 1st or 2nd but rather the 4th-5th most frequent high-risk HPV type; the highest detection rate for HPV (86%) among samples suspected to be HPV-infected was found in the youngest age group (0-10 years old), including 70% (44/63) "genital" HPV types; HPV types of undetermined cervical cancer risk represented 19% and of the total HPV isolates but were strongly increased in co-infections (36.5% of all isolates). To our knowledge, this is the largest sequencing-based study of HPV. The HPV types of unknown cancer risk, representing the majority of the known HPV types, 27 of the 47 types detected in this study, are not likely to play a major role in cervical cancer because their prevalence in CIN-I, II, and III declines from 16% to 8% to 2.5%. The two-tier PCR-DS method provides greater sensitivity than cycle sequencing using only one pair of primers. It could be used in a simple laboratory setting for quick and reliable typing of known and novel HPV from clinical specimens with fine sequence precision. It could also be applied to anti-cancer vaccine development.

Eficacia de las maniobras de reposición canicular en el tratamiento del vértigo postural paroxístico benigno / Efficacy of canalicular replacement procedures in the treatment of benign paroxysmal postural vertigo

Se estudiaron 12 pacientes con diagnóstico de vértigo postural paroxístico benigno del canal semicircular posterior que cumplieran con los requisitos clínicos a éste y que tuvieran maniobra de Dix-Hallpike positiva, en el período comprendido entre octubre de 1999 y enero del año 2000. Todos los pacientes fueron de sexo femenino, con un promedio de edad de 46 años y de evolución de los síntomas de 20 meses. Nueve pacientes (75 por ciento) presentaban afección del canal semicircular del oído derecho y tres pacientes (25 por ciento) del lado izquierdo. Se practicaron las maniobras de reposición canalicular a la totalidad de los pacientes siendo necesario realizar una sesión en tres pacientes, dos sesiones a 8 pacientes y tres a un paciente, para la resolución completa de los síntomas y la negativización de la maniobra de Dix-Hallpike

[Hepatitis A and hepatitis B seroprevalence in 4 centers in Brazil]. / Soroprevalência para hepatite A e hepatite B em quatro centros no Brasil.

The prevalence of antibodies to hepatitis A and B virus was assessed in 3,653 subjects across four regions of Brazil. The anti-HAV and anti-HBc seroprevalence were 64.7% and 7.9%, respectively. The highest anti-HAV (92.8%) and anti-HBc (21.4%) rates were seen in the Northern region. In other regions, anti-HAV seroprevalence over 90% was only reached in the more elderly, indicating an intermediate endemicity and a significantly higher anti-HAV prevalence was seen in the low socioeconomic group between 1-30 years. With respect to anti-HBc seroprevalence an increase was seen in adolescents and there was a significantly higher anti-HBc prevalence in the lower socioeconomic group between 1-20 years. A 3.1% anti-HBc prevalence was seen in one-year-old infants, suggesting a vertical transmission. The major findings of this study indicate that the pre-adolescent and adolescent population in some Brazilian cities are at greatest risk from both hepatitis A and B infection, but for different reasons.

New method for automatic identification identification and typing of single and multiple superimposed human papillomavirus sequences.

This study of specimens of human papillomaviruses (HPV) through HPV-specific polymerase chain reaction (PCR), followed by direct sequencing, resulted in 11% (38/354) superimposed HPV sequences, signifying coinfection with more than one HPV type. To address the diagnostic problem that these superimposed ("degenerated," overlapping) sequences pose, the authors created a papillomavirus database in Microsoft Excel (Microsoft Corporation, Redmond, WA, U.S.A.) and Corel Quattro Pro 9 (Corel Corporation, Ottawa, Ontario, Canada) formats, retrievable from http://www2.crosswinds.net/ -crosswindswatson/index.html. This sequence database is simultaneously a search and comparison tool for quick (several seconds) typing of HPV from regular and "degenerated" sequencing results. Some of the advantages of the method are as follows: (1) superimposed HPV sequences that differ in length could be readily identified from a single input; (2) the search is restricted to the currently known 127 PV types, which speeds up the typing; (3) the most common HPV sequencing artifacts are included for quick detection; (4) there is no proprietary code and the database could be easily improved; (5) HPV sequence identification does not require internet connection; and (6) new HPV types could be easily detected. This method allowed resolution of all but 1 of 354 HPV-positive specimens. From 38 superimposed HPV sequences, this method identified one known HPV type (3 specimens), two HPV types (30 specimens) and three HPV types (4 specimens).