The combination of atorvastatin and ethanol is not more hepatotoxic to rats than the administration of each drug alone.

Animal studies and premarketing clinical trials have revealed hepatotoxicity of statins, primarily minor elevations in serum alanine aminotransferase levels. The combined chronic use of medicines and eventual ethanol abuse are common and may present a synergistic action regarding liver injury. Our objective was to study the effect of the chronic use of atorvastatin associated with acute ethanol administration on the liver in a rat model. One group of rats was treated daily for 5 days a week for 2 months with 0.8 mg/kg atorvastatin by gavage. At the end of the treatment the livers were perfused with 72 mM ethanol for 60 min. Control groups (at least 4 animals in each group) consisted of a group of 2-month-old male Wistar EPM-1 rats exposed to 10% ethanol (v/v) ad libitum replacing water for 2 months, followed by perfusion of the liver with 61 nM atorvastatin for 60 min, and a group of animals without chronic ethanol treatment whose livers were perfused with atorvastatin and/or ethanol. The combination of atorvastatin with ethanol did not increase the release of injury marker enzymes (alanine aminotransferase, aspartate aminotransferase, and lactic dehydrogenase) from the liver and no change in liver function markers (bromosulfophthalein clearance, and oxygen consumption) was observed. Our results suggest that the combination of atorvastatin with ethanol is not more hepatotoxic than the separate use of each substance.

Infection due to Roseomonas spp: a case report

ABSTRACT Male patient, 68 years old, immunocompromised, presented himself with fever and malaise for 15 days. At his hospitalization, peripheral blood and Schilley catheter blood cultures were collected, in addition to computed tomography that showed the presence of a peri-pancreatic collection. The material was drained and the samples were sent to the laboratory. Blood culture was positive for pink coconuts identified by mass spectrometry as Roseomonas spp. with the diagnosis of Bloodstream Infection being closed.

Marsh deer (Blastocerus dichotomus) reintroduction in the Jataí Ecological Station (Luís Antônio, SP): spatial preferences.

Throughout the latter half of the twentieth century, wildlife habitat destruction and species extinctions have greatly increased. As the number of endangered species grows, the use of reintroduction as a conservation tool against species extinction increases. This study focuses on a 16-month study on marsh deer reintroduced in the Jataí Ecological Station. The animals were radio tagged and tracked daily between December 1998 and April 2000. Displacement activity and spatial preferences were monitored by triangulation. The animals wandered the floodplains inside the protected area and also a floodplain that is part of privately owned property on the western edge of the Jataí Ecological Station. During the study, most of the reintroduced marsh deer preferred the private floodplain area more than the floodplains inside the protected area. This preference revealed the ecological importance of the area and the necessity of its incorporation into the Jataí Ecological Station.

Peripheral dopaminergic blockade for the treatment of diabetic orthostatic hypotension.

This study was designed to evaluate the effects of domperidone, a peripheral dopaminergic antagonist, in diabetic patients with symptomatic orthostatic hypotension. Nine patients were admitted to the hospital, placed on a diet containing 150 mEq sodium, and studied for periods of 4 hours, on different days, in the following conditions: (1) supine position, (2) upright posture (UP), (3) UP after 10 mg domperidone, intravenously in bolus, and (4) UP after 3 days of domperidone, 30 mg orally. Before domperidone the mean blood pressure observed in supine position of 132 +/- 37/75 +/- 6 mm Hg fell to 75 +/- 22/57 +/- 13 mm Hg after 2 hours in UP. Acute domperidone did not change the blood pressure response to UP. After 3 days of oral domperidone and in UP for 2 hours, the mean blood pressure value of 89 +/- 21/61 +/- 8 mm Hg was higher than that before domperidone (p less than 0.05), with relief of symptoms in all patients. This blood pressure response to UP has been maintained in six patients who completed 6 months of therapy. No differences were observed in plasma renin activity, aldosterone, sodium, and potassium and in 4-hour urinary excretion of aldosterone, epinephrine, norepinephrine, and dopamine, determined during the UP tests. Administration of domperidone for 3 days reduced the falls in creatinine clearance and the urinary excretion of sodium and potassium induced by UP but did not alter the blood pressure and aldosterone dose-response curves to angiotensin II. Although the mechanism of action is not defined, it is concluded that domperidone is effective for the treatment of orthostatic hypotension in patients with diabetes.

Determination of erythrocyte uroporphyrinogen I synthetase activity in chronic renal failure.

To obtain some information on porphyrin metabolism in uraemic patients, the activity of erythrocyte uroporphyrinogen I synthetase was measured in patients with chronic renal failure. The results indicate a decreased enzymatic activity which is not due to urea interference, in the hemolysates of these patients.

Comparison of methods for urinary albumin determination in patients with type 1 diabetes.

We tested the correlation of the albumin-to-creatinine ratio (A/C) in an early-morning urine sample, measured with a commercial kit (DCA 2000), with the conventional immunoturbidimetric determination in the laboratory and with overnight albumin excretion rate (reference method). Fifty-five type 1 diabetic adolescents had their first-morning urine collected on the 1st and 8th day of the period. Urinary albumin and creatinine were determined immediately using the DCA 2000 kit. Samples were also stored for laboratory analysis. To evaluate the correlation between early-morning urinary A/C ratio and overnight albumin excretion rate, 16 subjects had a timed overnight urine collection. A/C ratios determined with the DCA 2000 kit and by the laboratory method were 13.1 +/- 20.5 and 20.4 +/- 46.3 mg/g, respectively. A/C results by both methods proved to be strongly correlated (r = 0.98, P<0.001). DCA 2000-determined A/C showed 50% sensitivity and 100% specificity when compared to the reference method. Spot urinary A/C of the subset of 16 subjects significantly correlated with their overnight albumin excretion rate (r = 0.98, P<0.001). Intraindividual variation ranged from 17 to 32% and from 9 to 63% for A/C and overnight albumin excretion rate, respectively. In conclusion, an early-morning specimen should be used instead of timed overnight urine and the A/C ratio is an accurate, reliable and easily determined parameter for the screening of diabetic nephropathy. Immediate measurement of the A/C ratio is feasible using the DCA 2000 kit. Intraindividual variability indicates the need for repeated determinations to confirm microalbuminuria and the diagnosis of incipient diabetic nephropathy.

[Simultaneous determination of 4 anticonvulsant drugs by high pressure liquid chromatography (HPLC)]. / Determinação simultânea de quatro anticonvulsivantes por cromatografia líquida de alta pressão (HPLC).

We describe a sensitive and precise method for the simultaneous high pressure liquid-chromatography determination of phenobarbital, diphenylhydantoin, primidone, and carbamazepine in serum. The drugs are extracted into chloroform, dried and dissolved in the mobile phase. The drugs are eluted from a reverse-phase column with methanol/water and detected by their absorption at 214 nm. Concentrations are estimated from their peak heights. The results, when compared with those by enzyme-immunoassay, gave correlation coefficients of 0.990 for phenobarbital, 0.993 for diphenylhydantoin, 0.992 for primidone and 0.994 for carbamazepine.

Third graders' understanding of core political concepts (law, nation-state, government) before and after teaching.

A curriculum of about 22 hr distributed over 3 months on some core political notions (law, the main Italian political offices, the state) was implemented in an Italian 3rd-grade class of 23 children. Another class of 20 children formed the comparison group. The workings of the executive system were exemplified by explaining the running of the school (which in Italy is state-run). Children's learning and retention of these notions were tested twice, 1 month and 10 months after the end of the curriculum. At pre-test, before implementation of the curriculum, the majority of the children did not have a concept of the political domain: They did not know of parliament and government, hardly distinguished between the law and other types of rules, and did not know that teachers, policemen, and judges are public servants. At post- and delayed post-test, most of the children in the experimental group had mastered the concepts, performing significantly better than the comparison group. Thus, the development of political understanding appears to be due to the acquisition of relevant domain-specific knowledge rather than the emergence of across-the-board logic ability.

[Teicoplanin and vancomycin susceptibility in Staphylococcus aureus and coagulase-negative staphylococci]. / Avaliação da sensibilidade à teicoplanina e vancomicina, em Staphylococcus aureus e estafilococos coagulase negativos.

Members of the genera Staphylococcus are the most common pathogens found in the hospital environment and they are acquiring resistance to multiple drugs. PURPOSE--To evaluate the in vitro activity of teicoplanin and vancomycin against 195 strains of staphylococci isolated from in-patients. METHODS--One hundred strains of Staphylococcus aureus (50% methicillin-resistant) and 95 strains of coagulase-negative staphylococci (46.3% strains methicillin-resistant) were tested by the agar dilution and the disk diffusion techniques. RESULTS--All strains (100%) were susceptible to vancomycin, S. aureus strains presented MIC90 of 0.5 microgram/mL whereas strains of coagulase-negative staphylococci showed MIC90 of 1.0 microgram/mL. For teicoplanin, 98.5% of the strains were susceptible. MIC90 values were 0.5 microgram/mL for S. aureus strains, 2.0 micrograms/mL for coagulase-negative methicillin-susceptible staphylococci strains and 8.0 micrograms/mL for coagulase-negative methicillin-resistant staphylococci strains. CONCLUSION--From the microbiological point of view, the results showed a high potential for both drugs as therapeutic agents in staphylococcal infections due to multiresistant strains of hospital origin.

[Physiopathology of the short bowel: apropos of 2 cases]. / Fisiopatologia do intestino curto: a propósito de dois casos.

A 54 years old white woman and a 38 years old white man with short-bowel disease are reported. Both of them were submitted to surgical procedures for urinary oxalate calculi. They presented malabsorption syndrome with steatorrhea and severe malnutrition. The patients received parenteral nutrition. The woman had also cholelithiasis and acute pancreatitis. The clinical and laboratory data are presented and the pathophysiology of short-bowel disease with emphasis on bile salts depletion, the effect of bile salts on colon oxalate absorption, and intestinal loss of water is commented. The management of short-bowel disease and the use of cholesteramine and the supplementary diet is discussed.

Erythrocyte insulin receptor: normalization of binding data for the average cell age by the red cell creatine determination in obese, diabetic and acromegalic patients.

Insulin binding studies performed in erythrocytes (RBC) have been employed in clinical studies assessing the status of insulin receptors at target cell tissues. However, some authors challenged this assumption on the basis of some discrepancies described in comparative studies of other cell types, probably related to populations of different cell age affecting insulin binding to RBC. We evaluated insulin binding to RBC in normal males (n = 10), non-obese diabetic males (n = 13), normal females (n = 15), obese (n = 11) and acromegalic females (n = 5), before and after correction of insulin binding data for creatine concentration in the RBC as a procedure of correction for age, since a negative correlation was described between creatine content and RBC age which also correlates inversely with % insulin binding. Insulin binding in all three groups of patients was not statistically different from corresponding values for normal males and females respectively before correction of data for creatine, but significantly reduced values were found after adjustment for creatine in accordance with published data concerning monocytes. In conclusions, the procedure of correcting insulin binding in erythrocytes by the creatine content in RBC is potentially useful for clinical investigations, since the influence of RBC age is excluded.

Insulin resistance in acromegaly: evaluation by studies of insulin binding to erythrocytes.

Insulin binding to erythrocytes (RBC) was evaluated in 10 acromegalic patients (6 females and 4 males) in comparison to 22 normal subjects (12 females and 10 males) in an attempt to study the insulin resistance of acromegaly. Basal glucose from all acromegalic patients were within the normal range but incremental glucose and insulin curves, respectively, on oGTT were significantly increased in the acromegalic patients suggesting an insulin resistant state. Basal growth hormone concentrations were elevated in all acromegalic patients, but no correlation was observed between insulin and GH levels. The insulin binding studies in the acromegalic patients showed a decreased binding due to a reduction in the receptor number per cell but with no alterations in the affinity state. Correction of data for creatine, as a procedure of normalization of binding data for a standardized RBC cell age, enhanced the reduction of insulin binding of the acromegalic patients in comparison to controls in consequence to the younger population of acromegalic RBC as indicated by their increased creatine concentrations. In conclusion, the insulin resistant state in acromegalics observed in our study is accompanied by a decrease in the insulin binding to the RBC receptor due to a reduction of the receptor concentration as mediated by the compensatory hyperinsulinemia.

[Urinary citrate determination in normal persons and in patients with recurrent urinary calculi]. / Dosagem de citrato urinário em indivíduos adultos normais e em pacientes com calculose urinária recidivante.

The presence of citric acid in urine and its ability to bind calcium ions forming a soluble complex are well recognized and has led to the suggestion that citric acid may play an important role in preventing renal calcium stone disease. In this study the 24-hour urinary excretion was measured with a specific enzymatic method in 48 normal subjects and in a group of 46 non selected patients with recurrent urolithiasis. Hypocitraturia was detected in 18/46 patients (39.1%) and was the unique metabolic abnormality in 6 (13%).

[Rice bran in the treatment of idiopathic hypercalciuria in patients with urinary calculosis]. / Farelo de arroz no tratamento da hipercalciúria idiopática em pacientes portadores de calculose urinária.

Ten patients with recurrent nephrolithiasis and hypercalciuria were given rice bran during 60 days. Hypercalciuria was reduced in all patients in an average of 40%. Urinary magnesium was reduced in 28% and oxalate excretion was increased in 28%. The rate of decrease of urinary calcium was 65% in the absorptive type and 33% in the renal type of hypercalciuria.

The combination of atorvastatin and ethanol is not more hepatotoxic to rats than the administration of each drug alone

Animal studies and premarketing clinical trials have revealed hepatotoxicity of statins, primarily minor elevations in serum alanine aminotransferase levels. The combined chronic use of medicines and eventual ethanol abuse are common and may present a synergistic action regarding liver injury. Our objective was to study the effect of the chronic use of atorvastatin associated with acute ethanol administration on the liver in a rat model. One group of rats was treated daily for 5 days a week for 2 months with 0.8 mg/kg atorvastatin by gavage. At the end of the treatment the livers were perfused with 72 mM ethanol for 60 min. Control groups (at least 4 animals in each group) consisted of a group of 2-month-old male Wistar EPM-1 rats exposed to 10 percent ethanol (v/v) ad libitum replacing water for 2 months, followed by perfusion of the liver with 61 nM atorvastatin for 60 min, and a group of animals without chronic ethanol treatment whose livers were perfused with atorvastatin and/or ethanol. The combination of atorvastatin with ethanol did not increase the release of injury marker enzymes (alanine aminotransferase, aspartate aminotransferase, and lactic dehydrogenase) from the liver and no change in liver function markers (bromosulfophthalein clearance, and oxygen consumption) was observed. Our results suggest that the combination of atorvastatin with ethanol is not more hepatotoxic than the separate use of each substance.

Marsh deer (Blastocerus Dichotomus) reintroduction in the Jataí Ecological Station (Luís Antônio, SP): spatial preferences

A destruição dos habitats naturais e a extinção de espécies têm crescido muito a partir da última metade do século XX. Nesse contexto, o aumento do número de espécies ameaçadas tem proporcionado maior uso da reintrodução como estratégia de conservação no combate à atual taxa de extinção. O presente trabalho focaliza um estudo de 16 meses realizado com cervos-do-pantanal reintroduzidos na Estação Ecológica de Jataí. Os animais foram marcados com rádio-colares e monitorados diariamente entre dezembro de 1998 e abril de 2000, tendo suas atividades de deslocamento e uso do espaço acompanhadas por triangulação. Os animais exploraram várzeas dentro da unidade de conservação e também uma área de várzea pertencente a uma propriedade particular localizada na fronteira oeste da estação. Durante o período de estudo, a maioria dos cervos reintroduzidos utilizou a área de várzea particular mais intensivamente que as várzeas da unidade de conservação. A preferência demonstrada por essa área confirmou sua importância ecológica, evidenciando a necessidade de proteção por meio de sua incorporação aos limites da Estação Ecológica de Jataí. .