The effects of the Brazilian regulatory inspection programme on nuclear medicine facilities.

This paper aims to demonstrate the importance of the regulatory inspections carried out by the Brazilian regulatory body in the area of nuclear medicine. The main aspects observed during the inspections are presented as well as the time evolution of the non-compliances, according to their occurrence by type. We also evaluate factors concerning the working of the nuclear medicine facility responsible for solving the non-compliances. The results suggest a decrease of occurrence of non-compliances with time that can be related to the strictness of the inspections and the awareness of the personnel in the nuclear medicine facilities. An analysis of radiation dose exposure levels for the professionals involved in nuclear medicine was carried out; although dose values are below regulatory dose limits, their occurrence is not decreasing satisfactorily. Results indicate the need for staff training and commitment of the responsible nuclear medicine facility staff to the radiological protection procedures. Our results also emphasise the importance of continuous coercive actions to improve the level of radiological protection in nuclear medicine facilities in compliance with the standards established by the national regulatory authority and international recommendations.

Type I primary neuropathic amyloidosis (Andrade, portuguese).

The authors present a review of 21 cases with the diagnosis of type I amyloid neuropathy based on epidemiological data, clinical evolution and histopathological findings. They call attention to the possibility of cranial nerves involvement (hyposmia, diplopia, masseterian hypotrophy, peripheral facial paralysis, hypoacusis, dysphonia, laryngeal paralysis, dysphagia, and trapezium muscle hypotrophy), to the severeness of the digestive symptoms, to the precocity of the autonomic disorders, and to the rather high incidence (6 cases) of heart involvement. The electromyography showed anterior horn involvement in 3 cases. The electrocardiography showed repolarization disorders in 11 cases, left ventricular overload in 6 cases and atrioventricular block in 5 cases. The serum proteins electrophoresis showed frequent abnormalities, but no typical curve could be obtained. The barium-contrasted X-rays of the gastrointestinal tract showed no anatomical lesions, but functional abnormalities (hypo or hypermotility) were found in 14 examination. The Schilling test showed impairment of vitamin B12 absorption in 50% of the cases. However, with the concomitant administration of intrinsic factor (3 cases) there was improvement of it absorption. This proves that the gastric mucosa plays an important role in the disease malabsorption. The test with labeled-triolein showed slow absorption in 2 cases and steatorrhea in 3 (6 tests). For the confirmation of the amyloid deposits, the best histopathological procedure was nerve biopsy. In men, when the nerve biopsy was negative, testicular biopsy has shown to be a good option.

[Caring for the cancer patient: how can nurses face this challenge?]. / Assistir o paciente oncológico: como as enfermeiras poderão enfrentar este desafio?

This paper presents a report of the experience the authors had in taking care of 103 hospitalized oncology patients based on a particular framework. They reflect upon the nursing care provided to those patients, and also emphasizing patient's statements regarding their lived experience.

Heart involvement in hepatolenticular degeneration.

The case of a 10-year-old boy with a mild abdominal form of hepatolenticular degeneration, showing clinical, laboratory and histological manifestations of heart involvement is reported. The microscopical examination of myocardial fragments collected by intracavitary puncture biopsy, using hematoxylin-eosine and the histochemical method with rubeanic acid, showed a medium degree of myocardial damage and the presence of copper deposition in the tissue. Copper concentration on a myocardial biopsy fragment was almost 10 times the normal heart content. Comments are made on the relationship of the clinical, laboratory and pathological findings with the degree of copper storage on the myocardium.

[Determination of thermal requirements of Stomoxys calcitrans (L.) (Diptera, Muscidae), under laboratory conditions]. / Determinação das exigências térmicas de Stomoxys calcitrans (L.) (Diptera, Muscidae), em condições de laboratório.

The biology of immature stages of Stomoxys calcitrans (L.) was studied in the laboratory under four constant temperatures. The study was carried out in biological incubators at 20, 25, 30 and 35 degrees C; 65 +/- 10% relative humidity and 14 hours of photophase. The most favorable temperature for developing eggs, larval and pupal was 25 degrees C, while 35 degrees C proved to be harmful for a normal developing of S. calcitrans in larval stage. The incubation periods for egg were 69.90, 42.58, 26.10, 21.78 hours and 2.91, 1.77, 1.08, 0.90 days at 20, 25, 30, 35 degrees C, respectively. The larval stage was 18.40, 11.63, 8.55 days and, the pupal stage, 8.60, 4.54, 3.60 days at 20, 25, 30 degrees C, respectively.. Threshold temperatures for males were a little higher than for females, however, this difference was lesser than 1 decree C. On the other hand, the quantity of energy (GD) for developing females was a little higher than for males.

Osteoarthropathy of hepatolenticular degeneration.

Ninety-six joints of 25 patients with hepatolenticular degeneration have been studied by means of scintigraphs with technetium (99mTc), a method which can disclose early synovial inflammation and postinflammatory articular degeneration. Signs of synovitis were found in 22 joints of 10 patients (40%) and degenerative changes were present in 15 joints of eight patients (32%). Eleven patients complained of joint pains; in four of them they were the presenting symptom. The radiological study showed osteoporosis in 22 patients (88%); flexion deformity was found in two cases, anomalous osteophytes in two, and signs of growth arrest, features of rheumatoid arthritis and aseptic necrosis in one case each. The pathogenesis of osteoarticular changes in Wilson's disease is discussed.

Determinaçao das exigências térmicas de Stomoxys calcitrans (L.) (Diptera, Muscidae), em condiçöes de laboratório / Determination of thermal requirements of Stomoxys calcitrans (L.) (Diptera, Muscidae), under laboratory conditions

Determination of thermal requirements of Stomoxys calcitrans (L.) (Diptera, Muscidae), under laboratory conditions - The biology immature stage of Stomoxys calcitrans (L.) was studied in the laboratory under four constant temperature. The study was carried out in biological incubators at 20, 25, 30 and 35-C; 65 ñ 10% relative humidity and 14 hours of photophase. The most favorable temperature for developing eggs, larval and pupal was 25-C, while 35-C proved to be harmful for a normal developing of S. calcitrans in larval stage. The incubation periods for egg were 69.90, 42.58, 26.10, 21.78 hours and 2.91, 1.77, 1.08, 0.90 days at 20, 25, 30, 35-C, respectively . The larval stage was 18.40, 11.63, 8.55 days and, the pupal stage, 8.60, 4.54, 3.60 days at 20, 25, 30-C, respectively. Threshold temperatures for males were a little higher than for females, however, this difference was lesser than 1-C. On the other hand, the quantity of energy (GD) for developing females was a little higher than for males. No difference was observed between the two methods used for calculating the above mentioned biological parameters of S. calcitrans

Acao antimicrobiana local da associacao anfotericina B e cloridrato de tetraciclina em pacientes portadoras de leucorreia de diferentes etiologias. / Local antimicrobial action of the association of amphotericin B and tetracyclin in patients with leukorrhea of different etiologies

O objetivo do presente estudo e avaliar a eficacia da associacao de cloridrato de tetraciclina 100 mg e anfotericina B 50 mg na forma de creme vaginal em pacientes portadoras de corrimento vaginal. Neste sentido selecionamos no ambulatorio de ginecologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (Servico do Prof. Carlos Alberto Salvatore), 40 pacientes, cujas idades variaram de 18 a 56 anos (media etaria 31 anos) com corrimento de aspecto inespecifico; 28 destas apresentaram dispareunia; 23 prurido; 22 ardor e disuria.A estas pacientes foi administrada esta associacao sob a forma de creme vaginal, um aplicador por dia, durante sete dias. Nas pacientes que permaneciam com qualquer sintoma, apos este intervalo, o tratamento era prolongado por mais sete dias. Antes do inicio do tratamento e sete dias apos o termino, foram realizados os seguintes exames: exame a fresco com hidroxido de potassio a 10% coloracao de Gram, Giemsa e Papanicolaou para detectar-se flora Gram-negativa, Candida, Trichomonas, Mycoplasma, Chlamydia, Neisseria e Hemophilus