Neuroendocrine pathways at risk? Simvastatin induces inter and transgenerational disruption in the keystone amphipod Gammarus locusta.

The primary focus of environmental toxicological studies is to address the direct effects of chemicals on exposed organisms (parental generation - F0), mostly overlooking effects on subsequent non-exposed generations (F1 and F2 - intergenerational and F3 transgenerational, respectively). Here, we addressed the effects of simvastatin (SIM), one of the most widely prescribed human pharmaceuticals for the primary treatment of hypercholesterolemia, using the keystone crustacean Gammarus locusta. We demonstrate that SIM, at environmentally relevant concentrations, has significant inter and transgenerational (F1 and F3) effects in key signaling pathways involved in crustaceans' neuroendocrine regulation (Ecdysteroids, Catecholamines, NO/cGMP/PKG, GABAergic and Cholinergic signaling pathways), concomitantly with changes in apical endpoints, such as depressed reproduction and growth. These findings are an essential step to improve hazard and risk assessment of biological active compounds, such as SIM, and highlight the importance of studying the transgenerational effects of environmental chemicals in animals' neuroendocrine regulation.

Transgenerational inheritance of chemical-induced signature: A case study with simvastatin.

The hypothesis that exposure to certain environmental chemicals during early life stages may disrupt reproduction across multiple non-exposed generations has significant implications for understanding disease etiology and adverse outcomes. We demonstrate here reproductive multi and transgenerational effects, at environmentally relevant levels, of one of the most prescribed human pharmaceuticals, simvastatin, in a keystone species, the amphipod Gammarus locusta. The transgenerational findings has major implications for hazard and risk assessment of pharmaceuticals and other contaminants of emerging concern given that transgenerational effects of environmental chemicals are not addressed in current hazard and risk assessment schemes. Considering that the mevalonate synthesis, one of the key metabolic pathways targeted by simvastatin, is highly conserved among metazoans, these results may also shed light on the potential transgenerational effects of simvastatin on other animals, including humans.

Homophily around specialized foraging underlies dolphin social preferences.

Individuals often associate socially with those who behave the same way. This principle, homophily, could structure populations into distinct social groups. We tested this hypothesis in a bottlenose dolphin population that appeared to be clustered around a specialized foraging tactic involving cooperation with net-casting fishermen, but in which other potential drivers of such social structure have never been assessed. We measured and controlled for the contribution of sex, age, genetic relatedness, home range and foraging tactics on social associations to test for homophily effects. Dolphins tended to group with others having similar home ranges and frequency of using the specialized foraging tactic, but not other traits. Such social preferences were particularly clear when dolphins were not foraging, showing that homophily extends beyond simply participating in a specific tactic. Combined, these findings highlight the need to account for multiple drivers of group formation across behavioural contexts to determine true social affiliations. We suggest that homophily around behavioural specialization can be a major driver of social patterns, with implications for other social processes. If homophily based on specialized tactics underlies animal social structures more widely, then it may be important in modulating opportunities for social learning, and therefore influence patterns of cultural transmission.

A randomized double-blind clinical trial of the effect of non-absorbable oral polymyxin on infants with severe infectious diarrhea.

The present study evaluated the effect of non-absorbable oral polymyxin on the duodenal microflora and clinical outcome of infants with severe infectious diarrhea. Polymyxin was chosen because classic enteropathogenic Escherichia coli was more sensitive to this antibiotic. Twenty-five infants were randomly assigned to a 7-day treatment with oral polymyxin (2.5 mg/kg in 4 daily doses) or placebo. Duodenal and stool cultures were performed before and after the treatment. Five patients were excluded during the study because of introduction of parental antibiotic therapy due to clinical sepsis (N = 3) or rapid clinical improvement (N = 2). In the polymyxin group, small bowel bacterial overgrowth occurred in 61.5% of the cases (8/13) before treatment and in 76.9% (10/13) after treatment. In the placebo group these values were 71.4% (5/7) and 57.1% (4/7), respectively. By the 7th day, clinical cure was observed in 84.6% of the cases (11/13) in the polymyxin group and in 71.4% (5/7) in the placebo group (P = 0.587). Considering all 25 patients included in the study, clinical cure occurred on the 7th day in 12/14 cases (85.7%) in the polymyxin group and 6/11 cases (54.5%) in the placebo group (P = 0.102). Clinical sepsis occurred in 3/11 (27.3%) of the patients in the placebo group and in none (0/14) in the polymyxin group (P = 0.071). Oral polymyxin was not effective in reducing bacterial overgrowth or in improving the clinical outcome of infants hospitalized with severe infectious diarrhea. Taking into account the small sample size, the rate of cure on the 7th day and the rate of clinical sepsis, further studies with greater number of patients are necessary to evaluate these questions.

A randomized double-blind clinical trial of the effect of non-absorbable oral polymyxin on infants with severe infectious diarrhea

The present study evaluated the effect of non-absorbable oral polymyxin on the duodenal microflora and clinical outcome of infants with severe infectious diarrhea. Polymyxin was chosen because classic enteropathogenic Escherichia coli was more sensitive to this antibiotic. Twenty-five infants were randomly assigned to a 7-day treatment with oral polymyxin (2.5 mg/kg in 4 daily doses) or placebo. Duodenal and stool cultures were performed before and after the treatment. Five patients were excluded during the study because of introduction of parental antibiotic therapy due to clinical sepsis (N = 3) or rapid clinical improvement (N = 2). In the polymyxin group, small bowel bacterial overgrowth occurred in 61.5 percent of the cases (8/13) before treatment and in 76.9 percent (10/13) after treatment. In the placebo group these values were 71.4 percent (5/7) and 57.1 percent (4/7), respectively. By the 7th day, clinical cure was observed in 84.6 percent of the cases (11/13) in the polymyxin group and in 71.4 percent (5/7) in the placebo group (P = 0.587). Considering all 25 patients included in the study, clinical cure occurred on the 7th day in 12/14 cases (85.7 percent) in the polymyxin group and 6/11 cases (54.5 percent) in the placebo group (P = 0.102). Clinical sepsis occurred in 3/11 (27.3 percent) of the patients in the placebo group and in none (0/14) in the polymyxin group (P = 0.071). Oral polymyxin was not effective in reducing bacterial overgrowth or in improving the clinical outcome of infants hospitalized with severe infectious diarrhea. Taking into account the small sample size, the rate of cure on the 7th day and the rate of clinical sepsis, further studies with greater number of patients are necessary to evaluate these questions.

Phenotypic plasticity in Passiflora suberosa L.(Passifloraceae): induction and reversion of two morphs by variation in light intensity.

Leaf morphology may vary considerably even within a branch of Passiflora suberosa plants. Leaves are of a typical green type in shaded areas, but in open fields turn into violet, and apparently have greater thickness and trichome density. The proximate causes and the adaptive meaning, if any, for the existence of the violet morph are still unknown. By cultivating P. suberosa clones under two light regimes (total and partial exposure to sunlight), we consecutively induced (first year) and then reversed (second year) the appearance of the violet morph. We evaluated the corresponding changes in morpho-anatomic and chemical leaf characteristics. Plants that were grown under partial sunlight had a greater size and did not alter their green color, but those grown under total sunlight changed into violet, were smaller in size and their leaves were tougher, thicker, and had a greater number of trichomes. The violet morph had increased anthocyanins and phenolic derivatives. It also showed cellular hypertrophy, a greater number of cell layers in the mesophyll, and a lignified pericycle. Since these morphs are interchangeable by changing light conditions, we inferred that they are not determined by genotypic diversity, but are mainly a result of a physiological response to light stress, and thus part of P. suberosa phenotypic plasticity.

Phenotypic plasticity in Passiflora suberosa L.(Passifloraceae): induction and reversion of two morphs by variation in light intensity / Plasticidade fenotípica em Passiflora suberosa L. (Passifloraceae): indução e reversão de duas formas pela variação na intensidade luminosa

Leaf morphology may vary considerably even within a branch of Passiflora suberosa plants. Leaves are of a typical green type in shaded areas, but in open fields turn into violet, and apparently have greater thickness and trichome density. The proximate causes and the adaptive meaning, if any, for the existence of the violet morph are still unknown. By cultivating P. suberosa clones under two light regimes (total and partial exposure to sunlight), we consecutively induced (first year) and then reversed (second year) the appearance of the violet morph. We evaluated the corresponding changes in morpho-anatomic and chemical leaf characteristics. Plants that were grown under partial sunlight had a greater size and did not alter their green color, but those grown under total sunlight changed into violet, were smaller in size and their leaves were tougher, thicker, and had a greater number of trichomes. The violet morph had increased anthocyanins and phenolic derivatives. It also showed cellular hypertrophy, a greater number of cell layers in the mesophyll, and a lignified pericycle. Since these morphs are interchangeable by changing light conditions, we inferred that they are not determined by genotypic diversity, but are mainly a result of a physiological response to light stress, and thus part of P. suberosa phenotypic plasticity.

A morfologia das folhas de Passiflora suberosa pode variar consideravelmente mesmo dentro dos ramos de um dado espécime. P. suberosa ocorre tipicamente em áreas sombreadas e as folhas são verdes. Porém, em áreas abertas, onde há maior incidência de luz solar, as folhas são de coloração roxa, aparentemente mais duras e com grande densidade de tricomas. As possíveis causas e o significado adaptativo da manifestação destas características ainda são desconhecidas. Com base no cultivo de clones de P. suberosa sob dois regimes de luz solar (incidência total e parcial), nós consecutivamente induzimos (primeiro ano) e então revertemos (segundo ano) o aparecimento da forma roxa. As mudanças nas características morfológicas e químicas das formas verde e roxa foram avaliadas. As plantas que foram cultivadas sob incidência parcial de luz solar apresentaram maior tamanho dos ramos e não alteraram a cor verde das folhas. As plantas que foram cultivadas sob incidência total dos raios solares apresentaram coloração roxa, maior dureza, espessura e pilosidade. A forma roxa apresentou alto teor de antocianinas e derivados fenólicos. As plantas exibiram hipertrofia celular, maior número de camadas celulares no mesofilo e lignificação do periciclo. Considerando que as formas são intercambiáveis perante a mudança na intensidade luminosa, nós inferimos que elas não resultam da diversidade genotípica, mas sim de uma resposta fisiológica ao estresse luminoso e, dessa forma, parte da plasticidade fenotípica de P. suberosa.

Constituents from leaves of Quillaja brasiliensis.

A new abietane diterpene, the 19-O-beta-D-glucopyranoside of 16-hydroxylambertic acid was isolated from the leaves of Quillaja brasiliensis together with a known prosapogenin (3-O-beta-D-glucuronopyranosyl-quillaic acid), quercetin, and rutin. The new compound was identified by chemical and spectroscopic methods.

[Study of preoperative risk factors for bacteriobilia in patients with acute calculosis cholecystitis]. / Estudos dos fatores de risco pré-operatórios para bacteriobilia em doentes portadores de colecistite aguda calculosa.

OBJECTIVE: to determine an association between the preoperative clinical status and the result of bile and gallbladder wall cultures. MATERIAL AND METHODS: 28 variables regarding history, physical examination and labatorial assessment in 38 patients with acute calculosis cholecystitis submitted to urgency surgery were prospectively studied during a 19-month period, between November 1995 and May 1997. Cultures for aerobic and anaerobic agents from both the gallbladder wall and the bile were performed, in three different culture media (BACTEC 9240, BHI and HEMOBAC). RESULTS: bacteria were isolated in at least one culture medium, in 68.2% of the patients. At univariate analysis, five preoperative factors were identified as predictors of bactibilia: over 55 years of age, a greater than 0.4 degrees C difference in the axillary-rectal temperature, a greater than 12.000 cels/m3 blood leukocyte count, a greater than 75% neutrophil percentage and a greater than 4% rod neutrophil percentage. Owing to the small sample size, statistical significance of the series could not be noted by logistic regression, although a trend to preoperative determination could be observed in 98% of the subjects with positive culture, by means of the model based on age and percentage of rod neutrophil. By analyzing predictive factors jointly, it was noted that patients with more than one predictive factor have a significantly greater possibility to yielding positive culture when compared to those with up to one predictive factor for bactibilia. CONCLUSIONS: We concluded that, in patients with acute calculosis cholecystitis, bactibilia may be predicted yet at the preoperative period, by using simple and easily obtained data.

Estudos dos fatores de risco pré-operatórios para bacteriobilia em doentes portadores de colecistite aguda calculosa / Study of preoperative risk factors for bactibilia in patients with calculosis acute cholecystitis

OBJETIVO: Determinar uma associaçäo entre o quadro clínico pré-operatório e os resultados das culturas de bile e da parece vesicular. CASUISTICA E METODOS: Foram estudadas 28 variáveis considerando-se história clínica, exame físico e investigaçäo laboratorial em 38 doentes portadores de colecistite aguda calculosa, submetidos à cirurgia de urgência. Este estudo prospectivo foi realizado em 19 meses, entre novembro de 1995 a maio de 1997. Foram realizadas culturas para agentes anaeróbios e aeróbios, em três diferentes meios de cultura (BACTEC 9240, BHI e HEMOBAC). RESULTADOS: Foram isoladas bactérias em pelo menos um meio de cultura em 68,2 por cento dos doentes. Pela anßlise univariada, foram identificadas cinco variáveis pré-operatórias como preditivas de bacteriobilia: idade acima de 55 anos, temperatura diferencial axilo-retal maior do que 0,4 C, leucocitose acima de 12000 cels/mmÝ, neutrofilia acima de 75 por cento e neutrófilos bastonetes acima de 4 por cento. Devido ao pequeno tamanho da amostra, näo pôde ser observada significância estatística por regressäo logística, embora pudesse ser observada em 98 por cento uma tendência para determinaçäo pré-operatória dos indivíduos com cultura positiva por meio do modelo baseado na idade e porcentagem de neutrófilos bastonetes. Pela análise em conjunto dos fatores preditivos, pôde-se observar que doentes com mais de um fator preditivo têm uma possibilidade significantemente maior para cultura positiva, quando comparado com aqueles com fator preditivo de bacteriobilia. CONCLUSAO: Conclui-se, portanto, que pela utilizaçäo de dados facilmente disponíveis em doentes com colecistite aguda calculosa, a bacteriobilia pode ser previsível no pré-operatório,

In vitro antimicrobial activity of linezolid tested against vancomycin-resistant enterococci isolated in Brazilian hospitals.

The emergence of vancomycin-resistant enterococci (VRE) has been described recently in Brazil. This is in contrast to the USA and Europe, where the VRE appeared in the late 1980s. The progressive increase in VRE isolation poses important problems in the antimicrobial therapy of nosocomial infections. Treatment options and effective antimicrobial agents for VRE are often limited and the possibility of transfer of vancomycin genes to other Gram-positive microorganisms continues. In the search for antimicrobial agents for multiresistant Gram-positive cocci, compounds such as linezolid and quinupristin/dalfopristin have been evaluated. The present study was conducted to evaluate the in vitro activity of the oxazolidinone linezolid and 10 other antimicrobial agents, including quinupristin-dalfopristin, against multiresistant enterococci isolated in Brazilian hospitals. Thirty-three vancomycin resistant isolates (17 Enterococcus faecium and 16 E. faecalis), were analyzed. Strains were isolated from patients at São Paulo Hospital, Oswaldo Cruz Hospital, Hospital do Servidor Público Estadual, Santa Marcelina Hospital, Santa Casa de Misericórdia de São Paulo, and Hospital de Clínicas do Paraná. The samples were tested by a broth microdilution method following the National Committee for Clinical Laboratory Standards (NCCLS) recommendations. All isolates were molecular typed using pulsed-field gel electrophoresis (PFGE). Linezolid was the most active compound against these multiresistant enterococci, showing 100% inhibition at the susceptible breakpoints. Quinupristin/dalfopristin and teicoplanin showed poor activity against both species. The molecular typing results suggest that there has been interhospital spread of vancomycin resistant E. faecium and E. faecalis among Brazilian hospitals. The results of this study indicate that linezolid is an appropriate therapeutic option for the treatment of vancomycin-resistant enterococci infections in Brazil.

Bacteremia após a colangiopancreatografia retrógrada endoscópica, com e sem procedimento terapêutico: frequência, fatores associados e significado clínico / Bacteremia after endoscopic retrograde cholangiopancreatography with or without therapeutic procedure: frequency, associated factors and clinical manifestations

Objetivo. O objetivo do presente estudo foi avaliar a freqüência, os fatores associados e a manifestaçöes clínica de bacteremia em pacientes submetidos à colangiopancreatografia retrógrada endoscópica (CPRE), associada ou näo Ó realizaçäo de procedimento terapêutico. Casuística. Foram analisadas prospectivamente 46 colangiopancreatografias retrógradas endoscópicas (CPREs) realizadas em 42 pacientes. Os pacientes foram divididos em três subgrupos na dependência da utilizaçäo de antibióticos, da presença de obstruçäo do ducto biliar e/ou pancreático e da realizaçäo de procedimentos terapêuticos. Método. A pesquisa de bacteremia foi realizada mediante coleta de hemoculturas seriadas antes e após a CPRE. Foram utilizados, como meio para as hemoculturas, frascos tipo Bactec, capazes de receber maiores volumes de sangue e com resinas para adsorçäo de antibioóticos. A análise de positividade das hemoculturas foi realizada no sistema Bactec 9240Ô, e a identificaçäo das bactrérias, por meio de rotina do Laboratório Central da instituiçäo e com o sistema autoScan/Microscan. Resultados. Foi detectada bacteremia após sete exames; entretanto, em dois os microrganismos isolados foram considerados contaminantes. Em cinco exames ocorreu bacteremia verdadeira (freqüência, 10,9 por cento). Foram identificados os microrganismos: Streptococcus viridans, Corynebacterium sp., Enterobacter cloacae, Klebsiella oxytoca e Enterobacter aerogenes. Os episódios de bacteremia foram detectados com maior freqüência nas hemoculturas realizadas imediatamente após os exames (p<0,05), e foram restrito aos pacientes que näo estavan utilizando antibióticos (p=0,0192). Näo houve manifestaçäo clínica dos episódios de bacteremia. Conclusöes. Concluiu-se que os episódios de bacteremia ocorreram exclusivamente nos pacientes que näo estavam utilizando antibiótico e foram transitórios e completamente assintomáticos.

Exertional rhabdomyolysis and exercise intolerance revealing dystrophinopathies.

Exercise intolerance associated with myalgias, muscle cramps or myoglobinuria may be associated with a dystrophinopathy. A search for abnormal dystrophin expression (using immunohistochemistry, immunoblot and DNA analysis) was carried out in a series of 15 patients. They were selected because they presented exercise intolerance, negative biochemical tests (lipid, glycogen and mitochondrial metabolism) and abnormal immunohistochemistry with at least one anti-dystrophin antibody (anti-Dys 1, rod domain; anti-Dys 2, C terminus; anti-Dys 3, N terminus). Lack of anti-Dys 1 immunoreactivity was seen in three patients and abnormal immunoreactivity with all three anti-dystrophin antibodies in two. Immunoblot confirmed the dystrophinopathy in these five patients only, and multiplex polymerase chain reaction DNA analysis revealed a deletion in the dystrophin gene in two of these patients, affecting the proximal part of the rod domain in one and the distal part of this domain in the other. The clinical, biological and histopathological features of the five patients reported here, together with the previous cases reported in the literature, are described and reveal that exercise intolerance associated with dystrophinopathy displays characteristic clinical, biological and immunohistochemical features and defines a new dystrophinopathy phenotype. The absence of staining in the rod domain provides a secure diagnosis of this syndrome. Dystrophinopathy is one etiology of idiopathic myoglobinuria, requiring genetic counseling.

Significância clínica, epidemiologia e microbiologia das bacteremias por estafilococos coagulase-negativos em hospital de ensino / Clinical significance, epidemiology and microbiology of coagulase-negative staphylococcal nosocomial bacteremia at a teaching hospital

Os estafilococos coagulase-negativos (ECN) sao importantes agentes etiológicos das bacteremias hospitalares e freqüentemente considerados como contaminantes de hemoculturas. No período de outubro de 1990 a setembro de 1992, foram estudadas 300 hemoculturas positivas para ECN no Hospital Sao Paulo, sendo 141 bacteremias consideradas de origem hospitalar. Com o objetivo de diferenciar as bacteremias hospitalares verdadeiras das contaminantes por ECN, foram definidos critérios clínicos e microbiológicos. Apenas 20,6 por cento das bacteremias hospitalares por ECN foram consideradas como verdadeiras. A maior freqüência de recém-nascidos internados na unidade de terapia intensiva neonatal, a presença de cateter intravascular e a utilizaçao de nutriçao parenteral foram achados significativos. Nao houve diferença significante quanto a resistência a oxacilina e produçao de SLIME entre os ECN isolados das bacteremias verdadeiras e contaminantes. O critério clínico e a positividade da hemocultura até 48 horas após a incubaçao, utilizados em nossa definiçao, foram úteis para caracterizar as bacteremias verdadeiras por ECN.

[Clinical significance, epidemiology and microbiology of coagulase-negative staphylococcal nosocomial bacteremia at a teaching hospital]. / Significância clínica, epidemiologia e microbiologia das bacteremias por estafilococos coagulase-negativos em hospital de Ensino.

Coagulase-negative staphylococci (CNS) are an important cause of nosocomial bacteremia and they are frequently considered as contaminants of blood-cultures. From October 1990 to September 1992, 300 positive blood-cultures for CNS at the Hospital São Paulo were studied and 141 CNS bacteremias were characterized as nosocomial bacteremias. Clinical and microbiological criteria were defined to differentiate between true CNS bacteremia and contaminated cultures. Only 20.6% of the CNS nosocomial bacteremia were considered as true bacteremia. Most of the CNS true nosocomial bacteremia were detected among newborns admitted to the neonatal intensive care unit; the presence of intravascular catheter and parenteral nutrition were significant findings. We did not detect significant difference between true nosocomial bacteremia and contaminated cultures regarding to resistance to oxacillin and SLIME production. The clinical criteria and the positivity of the blood-cultures up to 48 hours after incubation, utilized in our definitions, were useful parameters to characterize the CNS true nosocomial bacteremia.

[Bacteremia after endoscopic retrograde cholangiopancreatography with and without therapeutic procedure: frequency, associated factors and clinical significance]. / Bacteremia após a colangiopancreatografia retrógrada endoscópica, com e sem procedimento terapêutico: freqüência, fatores associados e significado clínico.

PURPOSE: To determine the frequency, associate factors and clinical features of bacteremia in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), with or without therapeutic procedures. METHODS: Prospectively, 42 consecutives patients undergoing 46 endoscopic retrograde cholangiopancreatographies (ERCPs) from August to December 1994 were analyzed. The search for bacteremia was done by drawing 6 blood samples for cultures from peripheral blood. Two blood samples were collected before the ERCP and 4 of them after. The bottles used for cultures were Bactec bottles. The bottles were incubated in the Bactec 9240 system, and eventual bacteria detect were identificated by the manual routine of the laboratory and also with the autoScan/Microscan system. RESULTS: All blood cultures obtained before the ERCPs were negatives. Bacteremia were detected after 7 endoscopic procedures. In two episodes of bacteremia, the microorganism identified (Staphylococcus epidermidis) was considered to be a contaminant. The other 5 episodes of bacteremia were considered true bacteremia (frequency- 10.9%), and the microorganisms identified were: Streptococcus viridans, Corynebacterium sp., Enterobacter cloacae, Klebsiello oxytoca and Enterobacter aerogenes. This episodes were more frequent in the blood cultures obtained immediately after the ERCPs (p < 0.05), and occurred exclusively in the patients who were not receiving antibiotics (p = 0.0192). Clinical manifestation of the episodes of bacteremia were not detected. CONCLUSION: The episodes of bacteremia occurred exclusively in the patients who were not receiving antibiotics, were transient and completely no symptomatic.

Borderline--tuberculoid leprosy: clinical and immunological heterogeneity.

The authors analysed some immunological criteria in leprosy patients diagnosed as borderline tuberculoid by the presentation of different grades of skin lesions as well as different grades of nerve involvement. Only 50% of the patients presented a single skin lesion and 58% had none or only one affected nerve. Nineteen patients (39.6%) showed a positive lepromin reaction (induration > or = 5 mm). Patients with a positive skin test had a greater number of skin lesions when compared with patients with a negative lepromin test. Fifty-seven percent of the patients were found to be positive using a lymphoproliferation test (LTT) in response to Mycobacterium leprae antigens. Positive LTT results did not correlate with the number of skin lesions, but patients unresponsive to LTT had a lesser extent of nerve involvement. Four out of 18 patients (22%) released high IFN gamma levels in PBMC culture stimulated by M. leprae. (mean U/ml +/- SD = 142 +/- 72). All of these 4 patients presented only one skin lesion, although three of them had more than one affected nerve. Nineteen out of 21 patients (90.5%) showed no anti-PGL-1 antibodies in their serum. The low levels of anti-PGL-1 antibodies among these patients confirmed their tuberculoid background even in those with multiple skin lesions. These findings seem to attribute an important role to IFN gamma in restraining the spreading of the infection in the skin, but IFN gamma may have an opposite effect on the nerves. The potential pathological effects of IFN gamma during the delayed type of hypersensitivity can be related to its ability to synergise with other inflammatory cytokines such as TNF alpha, IL-1 beta, and others.

Haploidentical cord blood transplant contaminated with maternal T cells in a patient with advanced leukaemia.

Myeloablative treatment followed by lymphohaematopoietic reconstitution with stem cells from umbilical cord blood (UCB) can cure children with leukaemia. The clinical experience of UCB transplantation with HLA 2- and 3-antigen mismatched siblings is rather limited and there are no reports of such patient being given UCB significantly contaminated with maternal T lymphocytes. In this study, we report our experience in treating a child with chronic myeloid leukaemia in blast crisis who was transplanted using UCB cells from mismatched sibling donor containing a significant number of maternal T cells. The patient received 1.17 x 10(8) nucleated cells/kg after conditioning with Ara-C, busulphan, TBI and cyclophosphamide. GVHD prophylaxis was with cyclosporine and an anti-CD25 monoclonal antibody. Although engraftment was somewhat slow it was complete as documented by cytogenetic analysis and DNA studies. Results of minimal residual disease monitoring by RT-PCR for the hybrid BCR/ABL gene showed no evidence of leukaemic mRNA post-transplant. Acute GVHD, skin only, developed on day +14 but promptly responded to low-dose steroids. The technique used for UCB collection may have cell contamination found. In spite of these potential disadvantages: advanced disease, HLA antigen disparate donor and significant maternal T cell contamination, the transplant was successful and at a follow-up of 14 months the child is well with no evidence of chronic GVHD. Immune naivety of cord blood and lack of immunological reactivity of maternal T cells in this context may have played a significant role in the outcome of this case.

Estudo comparativo de técnicas de detecçäo de amostras de Staphylococcus aureus resistentes à meticilina / Comparison of screening methods for detection of methicillin-resistant Staphylococcus aureus strains

Foi realizado um estudo comparativo entre diferentes métodos disponíveis, incluindo técnicas tradicionais e avançadas, para a detecçäo de amostras de Staphylococcus aureus resistentes à meticilina (MRSA), enfatizando-se aspectos como: sensibilidade, rapidez, custos e aplicabilidade como procedimentos de rotina em microbiologia clínica. Foram utilizadas 12 amostras de S. aureus selecionadas entre linhagens isoladas de pacientes internos no Hospital Universitário "Lauro Wanderley" (HU/UFPb), comparando-se as seguintes técnicas: a)Método de difusäo em discos, b)Triagem em agar incorporado de NaCl e oxacilina, c)Sistema automatizado Microscan, d)Sistem E-Test de determinaçäo da CIM e)Sistema Crystal MRSA ID. Os resultados demonstraram que as amostras testadas puderam ser identificadas como MRSA havendo vantagens e desvantagens nos métodos avaliados quando utilizados em situaçöes específicas, considerando-se as facilidades de interpretaçäo, custos e acurácia de cada teste

Normative data for a brief neuropsychological screening battery. Multicenter AIDS Cohort Study.

This study reports normative data for a group of 733 homosexual/bisexual men stratified by age (range 25 to 54 years) and by education on the following six neuropsychological tests: (1) Digit Span (WAIS-R), (2) Rey Auditory Verbal Learning Test, (3) Symbol Digit Modalities Test, (4) Controlled Oral Word Association Test, (5) Grooved Pegboard, and (6) The Trail Making Test. Analysis demonstrates that both age and education are important determinants of performance for several of these measures.