[Psychosis Associated with Herbal Products: Iatrogenic Delusional Disorder]. / Psicose Associada a Produtos de Ervanária: Perturbação Delirante Orgânica de Carácter Iatrogénico.

Metabolic, toxic or structural brain changes may present as psychotic symptoms. Organic delusional disorders are characterized by the presence of delusional ideas with evidence of brain dysfunction. Iatrogenesis may be a cause of this dysfunction. We present a case of neuropsychiatric symptoms, including delusional disorder, secondary to the use of herbal products. The patient's perception regarding the safety of natural products might result in an omission to report their use during clinical history taking, and thus its use should be actively questioned.

Sintomas psicóticos podem constituir a forma de apresentação de alterações estruturais, metabólicas ou tóxicas. As perturbações delirantes orgânicas são caraterizadas pela presença de ideias delirantes com evidência de disfunção cerebral. A iatrogenia pode ser uma causa desta disfunção. Apresentamos um caso de sintomas neuropsiquiátricos, incluindo perturbação delirante, secundária ao uso de produtos de ervanária. A noção de inocuidade associada a estes produtos origina que o consumo dos mesmos não seja referido espontaneamente pelo doente na recolha da história clínica, pelo que a sua utilização deve ser ativamente questionada.

COVID-19 Suicide Survivors-A Hidden Grieving Population.

Present time has been dominated by the COVID-19 pandemic. People are grieving several non-death related situations: the loss of a job, of a status, of a role, of their life. Restrictive measures and uncertainty about the future makes individuals vulnerable to feelings of hopelessness and helplessness. Mental health support has been hindered and teams are reinventing themselves to reach people in need. Nevertheless, decompensation of previous psychiatric disorders, increasing levels of depression and anxiety, economical handicaps and fear of the infection, are prompting several cases of COVID-19 related suicides worldwide. Every suicide affects between 5 and 80 individuals, which are known as suicide survivors. Suicide grief is particularly challenging, with rates of complicated grief as high as 40%. Suicide survivors are at increased risk of developing depression, anxiety disorders and of suicidal behaviors. Moreover, feelings of guilt and shame, as well as social stigma, are major obstacles for them to reach form help. This article aims to review the existing literature on COVID-19 related suicides, complicated grief in suicide survivors and highlight modifiable risk factors for both conditions, as well as propose some public health measures to reduce the impact of the pandemic context on self-inflicted harm and its consequences on families, friends and the community. Obstacles to access to mental health support need to be overcome through the use of technology. Technicians should actively approach populations more vulnerable to develop suicidal ideation. Social media have the obligation to provide accurate an non-sensationalistic information. Families and friends should maintain social proximity, despite the need for physical distancing. When a suicide death occurs, police forces and health staff should be prepared to share the news with the family using an empathic and humane approach and providing psychological support. Funerals, memorials and other services should be held as much as possible. Closer contacts should be signalized and closely followed in order to detect the need for specific interventions. Help seeking behaviors should be promoted. Additionally, people should be educated on suicide and its impacts, in order to reduce stigma.

Núcleos ampliados de saúde da família e atenção básica no Brasil: uma revisão bibliográfica no período de 2008 a 2014 / Expanded nuclei of family health and basic care in Brazil: a bibliographic review from 2008 to 2014

Este estudo discorre sobre os Núcleos Ampliados de Saúde da Família e Atenção Básica (NASF), na Atenção Básica no Brasil, por meio de Revisão Bibliográfica, e seleção de artigos disponíveis no Portal Regional da Biblioteca Virtual em Saúde (BVS) publicados de 2008 a 2014. O ano de 2008 demarca a instituição desse Programa pelo Ministério da Saúde e a delimitação da análise dos artigos até o ano de 2014. Esta pesquisa teve por objetivo identificar, analisar e classificar a produção disseminada pelos profissionais inseridos nos NASfs, para isso adotamos parte da metodologia desenvolvida no âmbito da OPAS (2003) priorizando os itens de classificação denominados "áreas temáticas" e "categorias de análises das características dos estudos". Os resultados corroboram a importância dos NASF na Atenção Básica e destacam a preocupação dos membros das equipes atuantes nesses núcleos com questões subjetivas e objetivas ligadas à práxis profissional. A produção analisada frequentemente demonstrou associação com os seguintes temas: descontentamento com a infraestrutura; reformulação do processo de trabalho; excesso de demanda; adoecimentos e afastamentos, fragmentação do processo de trabalho e de cuidado, dificuldades na atuação multidisciplinar dentre outros. Temáticas cujo enfrentamento demandam ações de capacitação continuada, fixação dos trabalhadores nas equipes e fortalecimento da gestão

This study deals with the Expanded Nuclei of Family Health and Basic Care (NASF), in Primary Care in Brazil, through a Bibliographic Review, and selection of articles available in the Regional Portal of the Virtual Health Library (VHL) published in 2008 to 2014. The year 2008 demarcates the institution of this Program by the Ministry of Health and the delimitation of the analysis of the articles until the year 2014.The aim of this research was to identify, analyze and classify the production disseminated by the professionals included in the NASfs. For this purpose, we adopted part of the methodology developed within PAHO (2003), prioritizing the classification items called "thematic areas" and " of studies ".The results corroborate the importance of NASF in Primary Care and highlight the concern of the members of the teams working in these nuclei with subjective and objective questions related to professional praxis.The production analyzed frequently showed association with the following themes: discontent with the infrastructure; reformulation of the work process; excess demand; illnesses and withdrawals, fragmentation of the work and care process, difficulties in multidisciplinary action, among others. Thematic areas whose confrontation demand continuous training actions, fixation of the workers in the teams and strengthening of the management

Effects of PI3K and FSH on steroidogenesis, viability and embryo development of the cumulus-oocyte complex after in vitro culture.

The purpose of this study was to evaluate the effects of FSH and PI3K on the nuclear maturation, viability, steroidogenesis and embryo development of bovine cumulus-oocyte complexes (COCs). Oocyte maturation was achieved with MIV B, MIV B+100 µM LY294002, MIV B+10 ng/mL follicle stimulating hormone (FSH), or MIV B+10 ng/mL FSH+100 µM LY294002 treatments for 22-24 h. After the cultured COCs were denuded, oocytes were separated into those that extruded polar bodies (mature) and those that did not, and real-time polymerase chain reaction (PCR) for BAX, BCL2, LHR, FSHR, CYP11A1, CYP19A1 and HSD17B1 genes was performed. The culture medium was collected to determine the levels of 17ß-estradiol (E2) and progesterone (P4). The trypan blue test was used to study COC viability, and embryo development was evaluated. FSH increased nuclear maturation and PI3K blocked the maturation but did not influence oocyte viability. BAX and BCL2 expression levels in the cumulus cells were only affected by FSH, and the BAX levels decreased after treatment with LY294002. FSH increased the levels of E2 and P4, however inhibition of PI3K decreased E2 levels. MIV B enhanced levels of LHR, FSHR, CYP11A1, CYP19A1 and HSD17B1, whereas LY294002 inhibited the expression levels of all genes. MIV B+FSH decreased the expression levels of all genes except CYP11A1. LY294002 did not demonstrate any effects in the presence of FSH. Embryo development was significantly decreased when the MIV B+FSH medium was used. In conclusion, FSH controls the steroidogenesis, viability and gene expression in COCs. PI3K plays essential roles in nuclear maturation, steroidogenesis and embryo development.

Insulin influences developmental competence of bovine oocytes cultured in α-MEM plus follicle-simulating hormone.

The aim of this study was to evaluate the dose-response effect of insulin, plus follicle-simulating hormone (FSH) at a fixed concentration, in a serum-free defined culture medium (DCM) on the in vitro maturation of bovine cumulus-oocyte complexes (COCs). For oocyte nuclear maturation, the expression levels of GDF9, GLUT1, PRDX1 and HSP70.1 transcripts related to oocyte and embryo developmental competence were analysed. For in vitro maturation (IVM), cumulus-oocyte complexes from slaughterhouse ovaries were distributed into four groups based on insulin concentration added to serum-free DCM, which was composed of alpha minimum essential medium (α-MEM), as basal medium: (1) DCM control: 0 ng/ml; (2) DCM1: 1 ng/ml; (3) DCM10: 10 ng/ml; and (4) DCM100: 100 ng/ml. After IVM, the nuclear status of a sample of oocytes was analysed and the other oocytes were submitted for in vitro fertilization (IVF) and in vitro culture (IVC). Different concentrations of insulin did not affect significantly the nuclear maturation and cleavage rate (72 h post-insemination) across all groups. Blastocyst rate (192 h post-insemination) did not differ in DCM control (24.3%), DCM1 (27.0%) and DCM10 (26.3%) groups, but the DCM100 (36.1%) group showed a greater blastocyst rate (P 0.05) was observed at the different insulin concentrations. The results indicated that insulin added to DCM influenced levels of transcripts related to cellular stress (HSP70-1 and PRDX1) and oocyte competence (GDF9) in bovine oocytes and at higher concentrations enhanced blastocyst production.

Norepinephrine stimulates progesterone production in highly estrogenic bovine granulosa cells cultured under serum-free, chemically defined conditions.

BACKGROUND: Since noradrenergic innervation was described in the ovarian follicle, the actions of the intraovarian catecholaminergic system have been the focus of a variety of studies. We aimed to determine the gonadotropin-independent effects of the catecholamine norepinephrine (NE) in the steroid hormone profile of a serum-free granulosa cell (GC) culture system in the context of follicular development and dominance. METHODS: Primary bovine GCs were cultivated in a serum-free, chemically defined culture system supplemented with 0.1% polyvinyl alcohol. The culture features were assessed by hormone measurements and ultrastructural characteristics of GCs. RESULTS: GCs produced increasing amounts of estradiol and pregnenolone for 144h and maintained ultrastructural features of healthy steroidogenic cells. Progesterone production was also detected, although it significantly increased only after 96h of culture. There was a highly significant positive correlation between estradiol and pregnenolone production in high E2-producing cultures. The effects of NE were further evaluated in a dose-response study. The highest tested concentration of NE (10 (-7) M) resulted in a significant increase in progesterone production, but not in estradiol or pregnenolone production. The specificity of NE effects on progesterone production was further investigated by incubating GCs with propranolol (10 (-8) M), a non-selective beta-adrenergic antagonist. CONCLUSIONS: The present culture system represents a robust model to study the impact of intrafollicular factors, such as catecholamines, in ovarian steroidogenesis and follicular development. The results of noradrenergic effects in the steroidogenesis of GC have implications on physiological follicular fate and on certain pathological ovarian conditions such as cyst formation and anovulation.

Regulation of steroidogenesis by atrial natriuretic peptide (ANP) in the rat testis: differential involvement of GC-A and C receptors.

Previous studies have established a stimulatory effect of natriuretic peptides (NP) on testosterone production in mouse Leydig cells as intense as that of LH. Chronic administration of ANP in mice, on the other side, reduced testosterone levels. So, the understanding of the role of ANP on testicular steroidogenesis has been impaired by discrepant findings. The aim of the present study was to clarify the physiological role of ANP in the rat testis steroidogenesis using a model that preserves the interactions between testis cells and a medium devoid of any circulating factors that could interfere with testosterone production. First, ANP was immunolocalized in the interstitial compartment of the rat testis, mainly in Leydig cells. We also determined the presence of ANP and both GC-A (guanylyl cyclase A) and C receptors by real-time PCR in testis. Perfusion in vitro of testis with ANP (1 and 3x10(-7)M) stimulated testosterone production in a time- and dose-dependent manner. On the other side, testosterone secretion induced by LH was blunted by ANP. Similar effect was obtained using the specific C receptor ligand, cANF, indicating the involvement of C receptor in such response. In conclusion, ANP stimulated testosterone production in the rat testis perfused in vitro but decreased testosterone production LH-induced, effect that seems to involve C receptor. To this extent, our results suggest the existence of a local and complex peptidergic system in the rat testis, involving ANP and its receptors that could importantly modulate the androgen biosynthesis.

Traffic and catalytic converter - related atmospheric contamination in the metropolitan region of the city of Rio de Janeiro, Brazil.

In this work, 24-h PM10 samples were collected in Rio de Janeiro, Brazil, and analysed for trace elements (Cd, Ce, Cu, La, Mo, Ni, Pb, Pd, Rh, Sb and Sn). The sampling was carried out at five locations (Bonsucesso; Centro, downtown city; Copacabana; Nova Iguaçu and Sumaré) with different traffic densities and anthropogenic activities. An analytical method based on the EPA method for the determination of trace elements in airborne particulate matter (PM), using ultrasonic-assisted extraction and inductively coupled plasma mass spectrometry (ICP-MS) was applied. Our results suggest that vehicular traffic is the most important source of environmental pollution at the studied sites. The presence of Mo, Pd and Rh in the analysed filters reflects an additional source of pollution caused by the erosion and deterioration of automotive catalytic converters.

Psychiatric presentation of Hashimoto's encephalopathy.

INTRODUCTION: Hashimoto's encephalopathy is an unusual condition that is associated with Hashimoto's thyroiditis. Myoclonus, epileptic seizures, dementia, and disturbances of consciousness are the most common features. CASE REPORT: We present an atypical case of Hashimoto's encephalopathy in a 33-year-old woman who presented with several brief and acute psychotic episodes. After treatment with steroids, there was an improvement in the patient's psychiatric symptoms and electroencephalogram, and antithyroglobulin antibody titers returned to normal levels. CONCLUSIONS: It is our opinion that Hashimoto's encephalopathy should be considered in the differential diagnosis of atypical psychosis, especially because this is a treatable syndrome. This is particularly important in patients with a previous history of thyroid disease, despite current normal thyroid function.

Efeitos da endotelina-1 sobre a esteroidogênese e o crescimento celular em cultura de células da granulosa de bovinos / Endothelin-1 effects on steroidogenesis and cellular growth of bovine granulosa cells culture

Além do controle neuroendócrino do eixo hipotalâmico-hipofisáriogonadal existem fatores autócrinos e parácrinos que controlam o crescimento, seleção e ovulação nos mamíferos. Estes fatores ainda não estão bem estabelecidos. Objetivando analisar as variações nas concentrações plasmáticas da endotelina-1 em um ciclo estral bovino e seus efeitos sobre o cultivo de células da granulosa, foram analisadas amostras plasmáticas de 5 dias (0, 1, 3, 7 e 13) de um ciclo estral, tendo como base o dia da ovulação (dia 0) e 3 horas (8, 13 e 16) do 14º dia do ciclo. As variações nas concentrações plasmáticas de endotelina-1 não foram significativas para os dias assim como para as horas do dia analisado. Células da granulosa obtidas de folículos antrais foram cultivadas durante 48 horas com diferentes concentrações de endotelina. Os resultados demonstraram que a endotelina atua de maneira dosedependente estimulando a produção de progesterona e inibindo o crescimento celular.

Besides the neuroendocrine control of the hypotalamic-hypophisarygonodal axis there are autocrines and paracrines factors that control the growth, selection and ovulation in the mammals. These factors are not well established yet. Aiming to analyze the variations in the endotelin-1plasmatic concentrations in a bovine estral cycle and their effects on the culture of granulosa cells, plasma samples of 5 days (0,1,3,7 and 13) from an estral cycle have been analyzed, having as basis the ovulation day (day 0) and 3 hours (8,13,16) of the fourteenth day of the cycle. The variations in the endothelin-1 concentrations were not significant for the days as well as for the hours of the analyzed day. Granulosa cells obtained from antral follicles were cultivated during 24 hours with different concentrations of endothelin. The results demonstrated that the endothelin-1 acts in a dose-dependent manner stimulating the production of progesterone and inhibiting the cellular growth.

Concentrações de FSH, LH, estradiol, progesterona e histamina no soro, no fluido peritoneal e no fluido folicular de mulheres com e sem endometriose / FSH, LH, estradiol, progesterone, and histamine concentrations in serum, peritoneal fluid and follicular fluid of women with and without endometriosis

OBJETIVOS: relatos da literatura mostram que não há dados conclusivos sobre a associação entre a endometriose e as concentrações de hormônios envolvidos no controle da reprodução. Este estudo foi realizado para determinar as concentrações de FSH, LH, estradiol (E), progesterona (P) e histamina (Hi) no soro, no fluido peritoneal e no fluido folicular de mulheres com e sem endometriose. MÉTODOS: a extensão da doença foi estadiada de acordo com a American Fertility Society classification (1997). Para a coleta de soro e de fluido peritoneal foram selecionadas 28 mulheres com endometriose submetidas à laparoscopia diagnóstica (18 mulheres inférteis com endometriose I-II e dez mulheres inférteis com endometriose III-IV). Para o grupo controle, foram selecionadas 21 mulheres férteis submetidas à laparoscopia para esterilização tubárea. O fluido folicular foi obtido de 39 mulheres inférteis submetidas a fertilização in vitro (21 mulheres com endometriose e 18 mulheres sem endometriose). RESULTADOS: as concentrações de FSH e LH no soro, no fluido peritoneal e no fluido folicular não diferiram significativamente entre os grupos. As concentrações de E e P no fluido peritoneal foram significativamente mais baixas em mulheres inférteis com endometriose (E: 154,2±15,3 para estágios I-II e 89,3±9,8 ng/mL para estágios III-IV; P: 11,2±1,5 para estágios I-II e 7,6±0,8 ng/mL para estágios III-IV) em comparação com mulheres controle (E: 289,1±30,1; P: 32,8±4,1 ng/mL) (Testes de Kruskal-Wallis/Dunn; p<0,05). No soro, as concentrações de E e P seguiram o mesmo padrão. No fluido folicular, as concentrações de E e Hi foram significativamente mais baixas em mulheres com endometriose (E: 97,4±11,1 ng/mL; Hi: 6,6±0,9 ng/mL) em comparação com mulheres sem endometriose (E: 237,5±28,5 pg/mL; Hi: 13,8±1,3 ng/mL), enquanto os níveis de P não revelaram diferença significativa entre os grupos (teste t de Student; p<0,05). CONCLUSÕES: nossos resultados indicam disfunção...

PURPOSE: literature reports show that there are no conclusive data about the association between endometriosis and the concentrations of hormones involved in the control of reproduction. Thus, the present study was undertaken to determine FSH, LH, estradiol (E), progesterone (P), and histamine (Hi) concentrations in serum, peritoneal fluid and follicular fluid of women with and without endometriosis. METHODS: the extent of the disease was staged according to the revised American Fertility Society classification (1997). For the collection of serum and peritoneal fluid, 28 women with endometriosis undergoing diagnostic laparoscopy were selected (18 infertile women with endometriosis I-II and ten infertile women with endometriosis III-IV). For the control group, 21 fertile women undergoing laparoscopy for tubal sterilization were selected. Follicular fluid was obtained from 39 infertile women undergoing in vitro fertilization (21 women with endometriosis and 18 women without endometriosis). RESULTS: FSH and LH levels in serum, peritoneal fluid and follicular fluid did not differ significantly between groups. On the other hand, E and P concentrations in the peritoneal fluid were significantly lower in infertile women with endometriosis (E: 154.2±15.3 for stages I-II and 89.3 ng/mL±9.8 ng/mL for stages III-IV; P: 11.2±1.5 for stages I-II and 7.6 ng/mL±0.8 for stages III-IV) in comparison with control women (E: 289.1 ng/mL±30.1; P: 32.8±4.1 ng/mL) (Kruskal-Wallis/Dunn tests; p<0.05). In serum, estradiol and progesterone concentrations followed the same pattern. In the follicular fluid, E and Hi concentrations were significantly lower in women with endometriosis (E: 97.4±11.1 pg/mL; Hi: 6.6±0.9 ng/mL) in comparison to women without endometriosis (E: 237.5±28.5 pg/mL; Hi: 13.8±1.3 ng/mL) (Student t-test; p<0.05), while progesterone levels revealed no significant difference between groups. CONCLUSIONS: our results indicate ovary dysfunction in...

Concentration and emission sources of airborne metals in particulate matter in the industrial district of Médio Paraíba, state of Rio de Janeiro, Brazil.

Total suspended particles and 12 airborne metals were determined in 4 sampling sites in the industrial region of Médio Paraíba, Brazil. The geometrical means for the four sampling locals were (in units of microg/m3): 65.9 in Barra Mansa, 57.3 in Jardim Paraíba (Volta Redonda), 41.7 in Resende, and 48.9 in Volta Grande (Volta Redonda). These values are lower than levels previously determined in urban and industrial locals of the Metropolitan Area of Rio de Janeiro. For metals, the higher concentrations were obtained for Ca, Zn, Al, Fe, and Mg. Ca, Zn, and Al levels are higher than those determined in other industrial areas. These three metals are used in steel manufacturing, the main economical activity of the region. Enrichment factors for Zn, Cu, Cd, and Pb are higher than 10, suggesting an industrial input. Statistical analysis show a high correlation among Ca, Mg, Zn, Cr, Al, Mn, and Fe, all of them used as raw materials in steel manufacturing and/or accumulated as industrial blast furnace slag and steelworks slag.

Prepubertal administration of estradiol valerate disrupts cyclicity and leads to cystic ovarian morphology during adult life in the rat: role of sympathetic innervation.

Administration of estradiol valerate (EV) to adult rats leads to anovulation and cystic ovarian morphology. Sympathetic ovarian nerve denervation (SONX) overcomes this disruption. In this study, we determined whether EV administration to juvenile rats prevents achievement of reproductive competence, disrupts cyclicity, and whether this programming is facilitated via activation of the sympathetic nerve input to the ovary. Prepubertal rats were administered 2 mg EV in corn oil or corn oil alone. One half of the animals from each group underwent SONX on d 71 of life. Rats were euthanized on d 91 for determination of serum gonadotropins, progesterone, Delta4 androstenedione, and estradiol concentrations, ovarian norepinephrine (NE), and 3beta-hydroxysteroid dehydrogenase (3beta-HSD) activities and ovarian dynamics. Results revealed that EV administration during juvenile period advanced pubertal onset, suppressed circulating LH, FSH, and Delta4 androstenedione, increased ovarian NE, estradiol, and 3beta-HSD activities, disrupted ovarian dynamics evidenced as absent corpus luteum and presence of ovarian cysts and culminated in anovulation. SONX restored cyclicity in these animals, normalized LH, estradiol, ovarian 3beta-HSD activities, and ovarian dynamics as evidenced by the disappearance of ovarian cysts and appearance of corpus luteum and restored corpus luteum function. These findings provide evidence that EV exposure during juvenile life leads to long-lasting deleterious reproductive consequences via activation of the sympathetic ovarian nerve.

Efeito das drogas anti-retrovirais sobre as taxas de fertilidade de ratas Wistar / Effects of antiretroviral drugs on fertility of Wistar rats

Objetivo: avaliar os efeitos de drogas anti-retrovirais isoladas e em associação sobre as taxas de fertilidade em ratas prenhes expostas a estes fármacos, bem como o efeito perinatal nas crias. Métodos: foram utilizadas ratas fêmeas prenhes adultas da raça Wistar, pesando inicialmente entre 200 e 230 g. Foram testadas a azidotimidina (AZT), lamivudina (3TC) e nelfinavir (NFV), cujas dosagens foram padronizadas em 10 vezes a dose normalmente utilizada em gestantes, proporcionalmente ao peso dos animais. No total foram avaliados sete grupos, incluindo o controle. O início da experimentação foi o dia zero da prenhez e as cesarianas foram realizadas com 21 dias de prenhez. Para o cálculo das taxas de fertilidade, avaliaram-se o número de fetos vivos e mortos, sítios de implantação e número de corpos lúteos. Utilizaram-se o teste t de Student e Mann-Whitney para a análise estatística. Resultados: não houve alterações significativas nas taxas de perdas pré-implantação e da eficiência de implantação de ratas tratadas com anti-retrovirais isolados e em associação. No entanto, houve aumento significativo nas taxas de perdas pós-implantação (grupo controle: 7,6 por cento; grupos medicamentos: de 20,2 a 26,7 por cento), redução significativa nas taxas de viabilidade fetal (grupo controle: 92,4 por cento; grupos medicamentos: de 73,3 a 79,8 por cento) e redução significativa no número de fetos por ninhada (grupo controle: 14,7, grupos medicamentos: de 11,1 a 12,7). Observou-se também que houve redução do peso materno e dos fetos nos grupos tratados com 3TC, AZT + 3TC e AZT + 3TC + NFV. Conclusão: com a utilização de doses elevadas de medicamentos anti-retrovirais na presente casuística, efeitos importantes sobre a fertilidade foram encontrados, o que sinaliza para a necessidade de se pesquisarem outros fármacos anti-retrovirais com menor potencial histotóxico e que possam, com segurança, ser utilizados por gestantes portadoras da infecção pelo vírus da imunodeficiência humana

Identification of bacteria in drinking and purified water during the monitoring of a typical water purification system.

BACKGROUND: A typical purification system that provides purified water which meets ionic and organic chemical standards, must be protected from microbial proliferation to minimize cross-contamination for use in cleaning and preparations in pharmaceutical industries and in health environments. METHODOLOGY: Samples of water were taken directly from the public distribution water tank at twelve different stages of a typical purification system were analyzed for the identification of isolated bacteria. Two miniature kits were used: (i) identification system (api 20 NE, Bio-Mérieux) for non-enteric and non-fermenting gram-negative rods; and (ii) identification system (BBL crystal, Becton and Dickson) for enteric and non-fermenting gram-negative rods. The efficiency of the chemical sanitizers used in the stages of the system, over the isolated and identified bacteria in the sampling water, was evaluated by the minimum inhibitory concentration (MIC) method. RESULTS: The 78 isolated colonies were identified as the following bacteria genera: Pseudomonas, Flavobacterium and Acinetobacter. According to the miniature kits used in the identification, there was a prevalence of isolation of P. aeruginosa 32.05%, P. picketti (Ralstonia picketti) 23.08%, P. vesiculares 12.82%,P. diminuta 11.54%, F. aureum 6.42%, P. fluorescens 5.13%, A. lwoffi 2.56%, P. putida 2.56%, P. alcaligenes 1.28%, P. paucimobilis 1.28%, and F. multivorum 1.28%. CONCLUSIONS: We found that research was required for the identification of gram-negative non-fermenting bacteria, which were isolated from drinking water and water purification systems, since Pseudomonas genera represents opportunistic pathogens which disperse and adhere easily to surfaces, forming a biofilm which interferes with the cleaning and disinfection procedures in hospital and industrial environments.

[Corticoid resistant nephrotic syndrome]. / Síndroma nefrótico corticorresistente.

The authors present a case report on a eighteenth months old male white, who was admitted at the Nephrology Unit with nephrotic syndrome--first episode. Considering the age of the patient, the laboratorial results and the negative result of the immunologic study, the first diagnostic hypothesis was the minimal lesions nephrotic syndrome and was initiated treatment with corticosteroid in the dosis of 60 mg per square meter, per day. The generalized oedema and the massive proteinuria persisted although the corticosteroid and additional therapy. At the sixth week the renal biopsy revealed membranous glomerulonephropathy with mesangial deposits of IgG, IgA, IgM, C3, C4, C1q, compatible with an immunologic disease and suggestive of lupus nephritis. Then, was initiated the therapeutic protocol with 6 menstrual pulses of intravenous cyclophosphmide. After the 4th pulse of cyclophosphamide the proteinuria was negative, and the patient remains in clinical and laboratorial remission since the end of the 6 pulses, and after 14 months of follow-up.

Imunorreatividade para endotelina-1 no plasma e fluido folicular de eqüinos e bovinos / Endothelin-1 immunoreactive in the plasma and follicular fluid of horses and cattle

endotelina-1, um peptídeo isolado recentemente, tem sido observada em diferentes tecidos e está envolvida em várias funçöes reprodutivas. Propusemo-nos a determinar as concentraçöes da endotelina-1 por radioimunoensaio no plasma de eqüinos e bovinos e no fluido folicular de eqüinos. Foram testados 2 tipos de inibidores de degradaçäo protéica no plasma e fluido folicular. A imunorreatividade média foi de 47,5 por cento, a dose mínima detectável foi de 1 pg/tubo e o coeficiente de variaçäo inter e intra-ensaio foi de 2,36 por cento e 7,26 por cento, respectivamente. O paralelismo entre a curva padräo e as curvas determinadas com diferentes volumes de plasma e fluido folicular valida o radioimunoensaio de endotelina-1 para estas espécies. Segundo nosso conhecimento, este é o primeiro relato de literatura que detecta por radioimunoensaio a endotelina-1 no plasma e fluido folicular de eqüinos e plasma de bovinos. Os resultados do presente trabalho sugerem a utilizaçäo do método de radioimunoensaio utilizando-se kits comerciais para a determinaçäo das concentraçöes da endotelina-1 no plasma de eqüinos e bovinos e fluido folicular de eqüinos, pelo fato de este apresentar alta sensibilidade, precisäo e reprodutibilidade, podendo assim ser utilizado no estudo de múltiplas funçöes da endotelina-1 nestas espécies animais e, em especial, no sistema endócrino-reprodutivo