Post-treatment of anaerobic effluents in constructed wetland systems.

This papers describes the behaviour of wetlands as a post-treatment unit for anaerobically treated sewage for the removal of organic matter, suspended solids, nutrients (nitrogen and phosphorus) and faecal coliforms. Raw sewage was treated in a UASB reactor with a retention time of 5 h and the effluent was used in four units of wetlands with coarse sand as the medium and operated with different hydraulic loads. Three of the units had emerging macrophytes (Juncus sp), whereas the fourth one was operated as a control unit without plants. During the 12 months of operation, the organic material removal efficiency (measured as COD) was in the range of 79 to 85%, whereas suspended solids removal varied from 48 to 71%. Faecal coliform removal was very high (99.99%); phosphorus was also efficiently removed (average efficiency of 90% for the lowest hydraulic load), but nitrogen removal was only partial (45 to 70% for ammonia and 47 to 70% for TKN). The experimental results clearly show the technical feasibility of using wetlands for treatment of municipal sewage after a pre-treatment in the UASB reactor.

Detection of antibodies against hepatitis A virus in eluates of blood spotted on filter-paper: a pilot study in Rio de Janeiro, Brazil.

The validity of blood spotted on to filter-paper (BSOFP) eluates for the detection of antibodies against hepatitis A virus (HAV) was investigated in 718 individuals (children and adults) during a field study in a small area in Rio de Janeiro State, Brazil. Serum samples were considered the 'gold standard'. BSOFP eluates were analyzed by 2 different techniques: microplate competitive enzyme-linked immunosorbent assay (ELISA) of the whole study group and microparticle enzyme immune assay (MEIA) of a subsample of 59 individuals. For BSOFP eluates by ELISA, sensitivity and specificity were 89.6% (95% CI: 84.7-93.1) and 97.5% (95% CI: 95.6-98.7), respectively. For a seroprevalence of anti-HAV antibodies of 32%, the positive predictive value was 94.5% (95% CI: 90.3-97.0) and the negative predictive value was 95.2% (95% CI: 92.8-96.8). The test efficiency was 95.0% (95% CI: 93.1-96.4). Similar results were found for BSOFP eluates by MEIA. Agreement between the 2 techniques used for BSOFP (ELISA and MEIA) was also high (kappa = 0.93). These results encourage the more widespread application of BSOFP as a means of surveillance for large-scale epidemiological studies for hepatitis A.

[Study of true precocious puberty in girls using clinical, laboratorial and imaging techniques]. / Estudo clínico, laboratorial e por métodos de imagem da puberdade precoce verdadeira em meninas.

This paper reviews the clinical findings, pituitary gonadotrophin reserve, plasma estradiol and androgens, radiological findings and pelvic ultrasound appearance in 17 girls with true precocious puberty (PP), and attempts to asses the value of these tests diagnosis in the clinical management of such patients and better understanding of the pathogenesis of this disorder. As noted in other series, acceleration of growth is one of the earliest features of PP and at the time of diagnosis bone age can be already significantly advanced. In 3 (18%) patients intracranial abnormalities were present. Ultrasound examination showed changes similar to those seen during normal puberty. To conclude, the introduction of high-resolution methods (CT scan and RM) and techniques for ultrasound examination have greatly simplified the clinical investigation of female precocious puberty.

Antigeno de histocompatibilidade H-Y (seu papel na diferenciacao gonadica). / Histocompatibility antigen H-Y (its role in gonadal differentiation)

Os autores fazem breve referencia aos estudos iniciais sobre a provavel vinculacao entre o antigeno de histocompatibilidade H-Y e o determinismo para a diferenciacao gonadica, a partir dos quais foi elaborado o conceito de que no cromosoma Y deve situar-se o complexo genico responsavel pela producao do antigeno e consequente diferenciacao testicular. Passam em revista numerosas publicacoes que parecem fortalecer essa hipotese. Mostram, no entanto, a seguir, como a progressao das pesquisas sobre o problema conduziram a verificacao de eventos de explicacao mais dificil, como, por exemplo, possiveis variacoes na expressividade do antigeno H-Y em presenca de um cromossoma Y aparentemente normal e, de outro lado, expressividade do antigeno (com diferenciacao de estrutura testicular) na ausencia de cromossoma Y. Sao abordadas, ao final, varias hipoteses sobre a etiopatogenia dessas condicoes

Hiperplasia supra-renal congenita. Efeito do tratamento sobre o crescimento estatural e a secrecao de somatotropina. / Congenital adrenal hyperplasia. The effect of the treatment of stature growth and somatotropina secretion

Os autores apresentam oito casos de pacientes com sindrome adrenogenital por hiperplasia suprarenal congenita devida a deficiencia de 21-hidroxilase tratados com corticosteroides. Analisam o efeito do tratamento sobre o desenvolvimento estatural e sobre os niveis serivos de hormonio do crescimento, discutindo os resultados em face dos possiveis mecanismos fisiopatologicos em causa

Exsanguineo-transfusao em septicemia eficacia terapeutica relacionada com um escore para indicacao do metodo. / Whole blood exchange transfusion in septicemia - therapeutic efficiency related to an score system for indication of the method

Os autores analisam, apos comparacao dos resultados, a eficacia da exsanguineo-transfusao (EST), na diminuicao da mortalidade em 32 pacientes com septicemia, divididos em dois grupos (retrospectivo e prospectivo). Analisam, baseados nessas observacoes, um metodo padronizado (escore) para determinacao do melhor momento de realizacao da EST, em casos graves de septicemia, refratarios aos cuidados suportivos e tratamento antimicrobiano habituais. No final, apresentam algumas proposicoes para padronizacao dos criterios de indicacao de EST(s) nesses casos de septicemia