Transcriptomic and clinical heterogeneity of metastatic disease timing within metastatic castration-sensitive prostate cancer.

BACKGROUND: Metastatic castration-sensitive prostate cancer (mCSPC) is commonly classified into high- and low-volume subgroups which have demonstrated differential biology, prognosis, and response to therapy. Timing of metastasis has similarly demonstrated differences in clinical outcomes; however, less is known about any underlying biologic differences between these disease states. Herein, we aim to compare transcriptomic differences between synchronous and metachronous mCSPC and identify any differential responses to therapy. PATIENTS AND METHODS: We performed an international multi-institutional retrospective review of men with mCSPC who completed RNA expression profiling evaluation of their primary tumor. Patients were stratified according to disease timing (synchronous versus metachronous). The primary endpoint was to identify differences in transcriptomic profiles between disease timing. The median transcriptomic scores between groups were compared with the Mann-Whitney U test. Secondary analyses included determining clinical and transcriptomic variables associated with overall survival (OS) from the time of metastasis. Survival analysis was carried out with the Kaplan-Meier method and multivariable Cox regression. RESULTS: A total of 252 patients were included with a median follow-up of 39.6 months. Patients with synchronous disease experienced worse 5-year OS (39% versus 79%; P < 0.01) and demonstrated lower median androgen receptor (AR) activity (11.78 versus 12.64; P < 0.01) and hallmark androgen response (HAR; 3.15 versus 3.32; P < 0.01). Multivariable Cox regression identified only high-volume disease [hazard ratio (HR) = 4.97, 95% confidence interval (CI) 2.71-9.10; P < 0.01] and HAR score (HR = 0.51, 95% CI 0.28-0.88; P = 0.02) significantly associated with OS. Finally, patients with synchronous (HR = 0.47, 95% CI 0.30-0.72; P < 0.01) but not metachronous (HR = 1.37, 95% CI 0.50-3.92; P = 0.56) disease were found to have better OS with AR and non-AR combination therapy as compared with monotherapy (P value for interaction = 0.05). CONCLUSIONS: We have demonstrated a potential biologic difference between metastatic timing of mCSPC. Specifically, for patients with low-volume disease, those with metachronous low-volume disease have a more hormone-dependent transcriptional profile and exhibit a better prognosis than synchronous low-volume disease.

Infusion of Life: patient perceptions of expressive therapy during chemotherapy sessions.

Through a quanti-qualitative study, we observed the effects of group expressive therapy (ET) sessions on patients' feelings and sense of well-being, as part of the Infusion of Life project. This project is part of a broader programme to improve integral care, developed by an interdisciplinary team headed by a medical doctor who is also an artist and expert in ET. We offered 48 group ET sessions to a total of 253 outpatients with cancer or autoimmune disorders receiving venous infusions in the chemotherapy room of University Hospital Antonio Pedro, Rio de Janeiro, Brazil. The qualitative analysis showed that the programme was a pleasant way to spend time, revived their sense of humour, relieved symptoms, provided meaningful experiences, improved their relationships with staff, enabled expression of their feelings, stimulated them to be creative, improved coping resources and reorganisation of the psyche, and renewed their perspective on life. Family and spirituality were major sources of support. Expressive therapy was shown to be flexible and applicable in small spaces, using recycled materials, even with patients with restrained movements; it can also offer great benefits with relatively small investments if a qualified team is in charge of planning, executing, and auditing the work.

Follow-up of the development of femoral degeneration lesions in broilers / Seguimiento del desarrollo de lesiones por degeneración en pollos de engorde

A study was carried out in the experimental facilities of FMVZ/UNESP-Botucatu, with the aim of following-up the development and the incidence of femoral degeneration (FD). A total of 305 one-day-old male broilers were housed in six pens of 5m² each. Histological analyses of femur head collected when broilers were 0, 7, 14, 21, 28, 35, and 42 days of age were carried out. At 42 days of age, 30 birds were taken to the experimental processing plant of FMVZ for leg gross examination. Ten legs per FD score where selected, and histologically analyzed to determine the most probable age at the beginning of the lesions, and to standardize femoral degeneration lesion scores. The histological results showed that cell architecture started to disorganize at 21 days of age in the resting and proliferation zones, and that angiogenesis increased, invading the joint cartilage, The gross lesion indexes due to femoral degeneration were 22.5 percent, 42.5%, and 65% at 28, 35, and 42 days of age, respectively.

Se realizó un estudio en las instalaciones experimentales de FMVZ/UNESP-Botucatu, con el objetivo de seguir el desarrollo y la incidencia de degeneración femoral (DF) en pollos. Se utilizaron 305 polluelos de un día, machos, distribuidos en seis corrales de 5m² cada uno. Se analizaron cortes histológicos de cabezas de fémur recolectadas a los 0, 7, 14, 21, 28, 35 y 42 días de edad. A los 40 días de edad, se llevaron 30 aves al Matadero Experimental de FMVZ, para análisis macroscópico de las piernas. Se escogieron 10 muslos por escore de DF, y se analizaron histológicamente para determinar la edad más probable del inicio de la lesión y estandarizar los escores de lesión por degeneración femoral. Los resultados histológicos indicaron que a los 21 días ocurre el inicio de la desorganización celular en la zona de reposo y de proliferación, además del aumento de la angiogénesis, invadiendo el cartílago articular. Microscópicamente, el índice de lesión por degeneración femoral fue del 22.5 por ciento, 42.5% y 65% a los 28, 35 y 42 días de edad, respectivamente.

Femur mineral density of broilers with femoral degeneration fed high nutritional density diets / Densidad mineral del fémur de pollos de engorde con degeneración femoral alimentados con dietas de alta densidad nutricional

A study was carried out in the experimental facilities of FMVZ/UNESP-Botucatu, with the aim of following-up the development and the incidence of femoral degeneration (FD). A total of 305 one-day-old male broilers were housed in six pens of 5m² each. A completely randomized experimental design, with 3 treatments (T1traditional nutritional density diet; T2high nutritional density diet) of 3 replicates each was applied. Femoral head of the broilers were submitted to gross examination at 0, 7, 14, 21, 28, 35, and 42 days of aged. At 42 days of age, 60 birds (30 per treatment) were submitted to the Veterinary Hospital of FMVZ to determine bone mineral density by radiography. Birds were then sacrificed for gross examination of the legs, and FD scoring. Five legs per treatment within each FD score were submitted to computed tomography for femur head integrity and bone mineral density. Treatments did not influence FD incidence, and the first gross FD lesions appeared when birds were 28 days old. It was concluded that radiographic optical densitometry and computed tomography are efficient methods to evaluate femoral degeneration, and both techniques expressed the same profile. In addition, using radiographic optical densitometry and computed tomography, these results also allowed us to establish bone mineral density value ranges within each gross FD score. These finding may provide an excellent non-invasive tool to describe femoral degeneration.

Se realizó un estudio en las instalaciones experimentales de FMVZ/UNESP-Botucatu, con el objetivo de seguir el desarrollo y la incidencia de degeneración femoral en pollos. Se utilizaron 305 polluelos de un día, machos, distribuidos en seis corrales de 5m² cada uno. Se adoptó un delineamiento experimental totalmente al azar, con dos tratamientos de 3 repeticiones cada uno. Se alimentaron las aves del T1 con dietas con densidad nutricional convencional, mientras el T2 consistió de una dieta con alta densidad nutricional. Se realizaron análisis macroscópicos de la cabeza del fémur de aves de 0, 7, 14, 21, 28, 35 y 42 días de edad. A los 42 días de edad, se llevaron 60 aves (30 por tratamiento) al Hospital Veterinario de FMVZ, para hacer radiografías para el análisis de la densidad mineral ósea. Posteriormente, se sacrificaron los pollos para el análisis macroscópico de las piernas y se atribuyeron puntajes para DF. Se seleccionaron cinco muslos por tratamiento dentro de cada puntaje de DF, que fueron sometidas a tomografía para evaluación de la integridad y de la densidad ósea de la cabeza del fémur. Los tratamientos no tuvieron influencia en la incidencia de DF, y a partir de los 28 días de vida, las aves presentaron lesiones macroscópicas. Se estableció que la densitometría ósea y la tomografía son métodos eficaces para evaluar la DF, además que ambos expresan el mismo perfil. Por otra parte, se encontraron intervalos de valores para densidad mineral ósea obtenida por densitometría óptica radiográfica y por tomografía en función de los puntajes macroscópicos de DF. Esos hallazgos son una importante herramienta no invasiva para la caracterización de degeneración femoral.

Efeito do sistema de criação sobre o desempenho e rendimento de carcaça de frangos de corte tipo colonial / Effect of production system on performance and carcass yield of free range broiler chickens

Foram utilizados 1600 pintos de corte de um dia de idade, distribuídos em delineamento, em blocos ao acaso, com esquema fatorial 4Î2 (quatro linhagens, sendo uma delas comercial (Ross-308) e as demais específicas para a produção colonial (Caipirinha, Pescoço Pelado e Paraíso Pedrês) e dois sistemas de criação (confinado e com acesso a piquete), com quatro repetições de 50 aves cada. A ração não continha promotores químicos de crescimento e produtos de origem animal. Avaliaram-se o ganho de peso, o consumo de ração, a conversão alimentar, a mortalidade e os rendimentos de carcaça e das partes (peito, pernas, asas e dorso) aos 56, 63, 70, 77 e 84 dias de idade. O comprimento e a porcentagem (em relação ao peso vivo) dos intestinos e o peso e a porcentagem (em relação ao peso vivo) do fígado, moela e pâncreas foram avaliados aos 84 dias de idade. Houve efeito (P<0,05) da linhagem para as características de desempenho e da linhagem e do sexo para rendimentos da carcaça e das partes, assim como para as características do sistema digestório (P<0,05). O sistema de criação não influenciou as características avaliadas.

One thousand and six hundred day-old-chicks were randomly assigned to a 4Î2 factorial design (4 strains and 2 production systems) with 4 replicates of 50 birds each. A commercial strain Ross and three strains (Caipirinha, Pescoço Pelado and Paraíso Pedrês) for free range chicken production systems were used. The production systems were confined and semi-confined supplemented with grass paddock (3m²/bird). The diets did not contain chemical growth promoters and animal by products. Weight gain, feed consumption, feed conversion, mortality and carcass yield and parts were evaluated at 56, 63, 70, 77 and 84 days. Length and percentage of gut, liver, gizzard and spleen were evaluated at 84 days. Differences (P<0.05) among strains for performance, carcass yield and parts and gut characteristics and no differences (P>0.05) among production systems were observed.

Desempenho e qualidade da carne de frangos de corte alimentados com diferentes níveis de sorgo em substituicão ao milho / Effects on performance and meat quality of replacing corn with sorghum in a broiler diet

Avaliaram-se o desempenho e a qualidade da carne de frangos de corte alimentados com diferentes níveis de sorgo, do cultivar SAARA, com 0,49g/kg de tanino, em substituicão ao milho. Os 2600 pintos sexados de um dia de idade, da linhagem Ross 308, foram distribuídos em delineamento inteiramente ao acaso, com esquema fatorial 5 2 (cinco níveis de sorgo - 0, 25, 50, 75 e 100 por cento e dois sexos), e quatro repeticões de 65 aves por unidade experimental. Não houve efeito (P>0,05) da substituicão do milho pelo sorgo sobre as características de desempenho, de rendimentos de carcaca, carne de peito e pernas, de composicão química e sensoriais. O pH observado nas carnes de peito e pernas foi maior para os machos (P<0,05), e houve diminuicão do pH à medida que se aumentaram os níveis de substituicão. Os machos apresentaram os maiores valores nas medidas de comprimento, largura e espessura do filé. Na carne do peito dos machos, ocorreu maior perda de peso por cozimento e forca de cisalhamento (P<0,05). Observou-se diminuicão (P<0,05) dos valores de a (vermelho) e b (amarelo) e aumento de L (luminosidade) à medida que aumentaram os níveis de substituicão.

Efeito da idade da matriz sobre o desempenho e rendimento de carcaça de frangos de corte / Effect of broiler breeder age on performance and carcass yield of broiler chickens

Avaliou-se efeito da idade da matriz sobre as características de desempenho, rendimento de carcaça e partes de frangos de corte, criados até 49 dias de idade. Foram utilizados 3600 pintos de um dia, oriundos de ovos de matrizes da linhagem Ross 308, distribuídos segundo um delineamento experimental inteiramente ao acaso, em esquema fatorial 5I2, com cinco idades de matrizes (29, 41, 58, 68 e 98 semanas) e dois sexos, com quatro repetições de 90 aves cada. Aos 21, 28, 35, 42 e 49 dias de idade, cinco frangos por parcela foram amostrados e abatidos após jejum alimentar de oito horas, para avaliação do rendimento de carcaça e partes. A idade da matriz influenciou (P<0,05) o desempenho das aves na fase inicial de criação (1 a 21 dias); os frangos oriundos de matrizes com 29 semanas de idade apresentaram menor rendimento. A idade da matriz não afetou (P>0,05) o rendimento de carcaça nas idades avaliadas. Os frangos oriundos de matrizes com 29 semanas apresentaram melhor rendimento de peito que aqueles de matrizes com 58 semanas. O sexo influenciou (P<0,05) tanto o desempenho quanto o rendimento de carcaça e partes dos frangos de corte.

sTNFRI and sTNFRII synthesis by fine-needle aspiration biopsy sample cultures is significantly associated with acute rejection in kidney transplantation.

BACKGROUND: Previously we reported that cultures of fine-needle aspiration biopsy (FNAB) samples synthesize different cytokine pattern depending on the alloimmune response towards the kidney graft. However, we failed to find a clear picture for growth factors implicated in early T-cell activation (interferon-gamma, interleukin [IL]-4, IL-12), although we observed that interleukin-1 receptor antagonist (IL-1ra) was associated with absence of acute rejection. We have now studied tumor necrosis factor-alpha (TNF-alpha) and its two soluble receptors, sTNFRI and sTNFRII, IL-1beta and soluble IL-1 receptor II (sIL-1RII), and leukemia inhibitory factor (LIF), all potential modulators of T-cell activation. METHODS: Sixty-six cadaver kidney transplants (KTX) were divided into four groups: group 1, day 7 after KTX, stable (n=30); group 2, day 7 after KTX, 8+/-4.5 days before acute rejection (n=12); group 3, first day of acute rejection (n=17); and group 4, day 14 after KTX, stable (n=32). Patients from groups 1 and 4 remained rejection-free for the first 6 months. All rejection episodes were confirmed by core renal biopsy. FNAB samples were cultured according to our published methodology, and culture supernatants were collected at 48 hr and analyzed by ELISA for IL-1beta, sIL-1RII, TNF-alpha, sTNFRI, sTNFRII, and LIF. Serum levels for sIL-1RII, sTNFRI, and sTNFRII were also measured. RESULTS: FNAB cultures from groups 1 and 4 synthesized significantly lower amounts of sTNFRI and sTNFRII than those from either groups 2 or 3. Both sTNFRI and sTNFRII reached high positive and negative predictive values for acute rejection. IL-1beta and sIL-1RII were synthesized by all groups but without differences. No trace of LIF and TNF-alpha was found. sTNFRII was significantly higher in serum from group 3. CONCLUSIONS: Both TNF receptors were positively associated with acute rejection and were good predictors of impending acute rejection. The ratio of sIL-1RII over IL-1 (together with IL-1ra that we previously measured in FNAB cultures) suggests that IL-1 actions may be inhibited with current immunosuppression early after transplantation.

Microemulsion cyclosporin formulation, in contrast to the old formulation, widens the T lymphocyte subsets differences between stable and acute rejection of kidney transplants.

BACKGROUND: The new cyclosporin (CsA) formulation, Neoral, has different pharmacokinetics compared with Sandimmune (SIM). Larger area under the curve (AUC) values with equivalent trough blood values are reached when Neoral is administered at equivalent doses to SIM. Previously, we showed a great diagnostic reliability when using cytofluorometric analysis from fine-needle aspiration biopsy (FNAB) samples. We investigated possible changes brought about by Neoral on lymphocyte subsets and the repercussions on the activation score cut-off for acute rejection, defined under SIM treatment. METHODS: Of 63 patients that received SIM, 40 remained rejection-free and 23 suffered one episode of rejection. Of 52 patients that received Neoral, 38 remained rejection-free. Peripheral blood lymphocytes (PBL) and lymphocytes from FNAB taken on days 7 and 14 post-transplantation and on the first day of acute rejection were analysed by flow cytometry. RESULTS: Trough blood CsA levels were not different between SIM and Neoral treatments. Among rejection-free patients, a significant down-regulation of CD3DR and of CD8DR expression on both graft-infiltrating lymphocytes (GIL) and PBL, and significant up-regulation of naïve T cells on GIL were observed with Neoral. These changes were followed by a significant down-regulation of the activation score with Neoral. Conversely, within the acute rejection group, the activation score was significantly higher with Neoral than with SIM. The activation score performed equally well in Neoral transplants compared with what we had reported with SIM. CONCLUSIONS: Our study indicates that Neoral elicits stronger immunosuppressive effects in stable patients, which eventually should translate into better clinical efficiency. However, when acute rejection supervenes, the treatment breakthrough seems stronger with Neoral. Cytofluorometric studies from FNAB samples showed that diagnostic reliability was maintained at a high level under Neoral therapy.

T lymphocyte subsets and cytokine production by graft-infiltrating cells in FSGS recurrence post-transplantation.

BACKGROUND: Focal segmental glomerulosclerosis (FSGS) aetiology remains undefined although a derangement of lymphocytes and monocytes macrophages, at least, has been strongly suspected. We report the graft-infiltrating phenotypes and their cytokine production in a case of FSGS recurrence post-transplantation. METHODS: The kidney transplant recipient suffered immediate FSGS recurrence. Aspiration biopsies were done at the first and second week post-surgery and were analysed by flow cytometry. The cytokine analysis was done on aspiration sample culture supernatants and serum by enzyme-linked immunosorbent assay. RESULTS: High expression of CD3CD69, CD3CD71 and CD4CD29 was found on infiltrating lymphocytes. Biopsy cultures pointed to a Th0/Th1 pattern of cytokine production as well as significant synthesis of transforming growth factor-beta1. Interestingly, monocyte chemokines were absent. CONCLUSION: We report evidence of intragraft lymphocyte activation in the early days of FSGS recurrence. Aspiration biopsy cultures showed failure of cyclosporin A to inhibit interleukin-2 (IL-2) production by infiltrating lymphocytes. If our findings are confirmed in similar patients, a trial with anti-IL-2-receptor antibody could be warranted.

Analysis of fine-needle aspiration biopsies by flow cytometry in kidney transplant patients.

BACKGROUND: Peripheral blood lymphocyte (PBL) analysis by flow cytometry has been inconsistently reported as an adjunctive method for diagnosing acute kidney transplant rejection. However, there is good evidence that lymphocytes infiltrating renal grafts differ from those found at the peripheral level. We hypothesized that the study of aspiration biopsy samples in conjunction with PBL by flow cytometry would enable us to diagnose acute rejection crisis reliably. METHODS: Lymphocytes from PBL and aspiration biopsies of kidney transplant patients were analyzed. Fifty-one stable patients, rejection-free for the first 6 months, were studied on day 7 and day 30 after transplantation and were compared with 32 patients with 40 acute rejection episodes. RESULTS: Significant differences were observed for several lymphocyte subpopulations on aspiration biopsy samples comparing stable patients with rejection patients. In contrast, PBL analysis was not helpful in differentiating the two groups of patients. By combining the expression of several activation markers inside the graft with CD3DR and CD3CD25 aspiration biopsy to peripheral blood ratios, we obtained very good values for sensitivity and specificity-83.9% and 90.5%, respectively. The positive predictive value for rejection among dysfunctional grafts reached 85.8%. CONCLUSIONS: Flow cytometry study of aspiration biopsy samples of kidney transplant patients is a reliable and powerful method to diagnose acute rejection episodes, although it is needed to consider several lymphocyte phenotypes; cytofluorometric analysis of PBL is important because it provides graft-infiltrating cell to peripheral blood lymphocyte ratios. This safe and rapid test may significantly improve the management of kidney transplant patients.

Monocytes-macrophages and cytokines/chemokines in fine-needle aspiration biopsy cultures: enhanced interleukin-1 receptor antagonist synthesis in rejection-free kidney transplant patients.

BACKGROUND: Monocytes-macrophages are found within kidney allografts during the first days after surgery, where they perform "housekeeping" tasks, participate in postreperfusion injury, and act as antigen-presenting cells, as well as become involved in the effector phase of acute rejection. They also seem to play a prominent role in chronic rejection. We quantified their presence in fine-needle aspiration biopsies and studied the growth factors that, we hypothesized, would mark the different implications of the presence of monocytes-macrophages. METHODS: Fine-needle aspiration biopsies were obtained from 56 adult renal transplants and analyzed for CD14+ using the alkaline phosphatase-anti-alkaline phosphatase procedure. Thirty-three patients were studied on the production of interleukin (IL)-1 receptor antagonist (IL-1ra), IL-6, IL-8, macrophage colony-stimulating factor, monocyte chemotactic protein 1, and macrophage inflammatory protein 1alpha by aspiration biopsies cultures using enzyme-linked immunosorbent assay techniques. RESULTS: CD14+ cells were present at significantly higher numbers in steroid-resistant acute rejections but also during the first days after surgery, especially if acute tubular necrosis was present. We found a significantly higher production of IL-1ra by rejection-free patients compared with acutely rejecting patients, and this difference was already established on day 7 after surgery (10+/-10.5 days before rejection). CONCLUSIONS: Monocytes-macrophages are present at higher numbers in aspiration biopsies of kidney transplant patients suffering either acute tubular necrosis or steroid-resistant rejections, but they are present during the first days after transplant in stable patients, too. The production of IL-1ra is significantly up-regulated in stable patients, which suggests that monocytes-macrophages may constitute an early key factor in the down-regulation of the anti-allograft immune response.

Influence of dietary lysine levels and arginine:lysine ratios on performance of broilers exposed to heat or cold stress during the period of three to six weeks of age.

Four trials of identical experimental design were conducted to determine the effects of temperature, dietary Lys level, and dietary Arg:Lys ratios on performance and carcass yield of male broilers. Birds of a commercial strain were grown from 21 to 42 d of age in wire-floored finishing batteries placed in environmental chambers. The chambers were programmed to provide either a constant thermoneutral temperature (21.1 C), a constant cold temperature (15.5 C), or a cycling hot diurnal temperature (25.5 to 33.3 C). Within each environment there was a factorial arrangement of three Lys levels (1.0, 1.1, and 1.2%) with four Arg:Lys ratios (1.1:1, 1.2:1, 1.3:1, and 1.4:1). Environmental temperature significantly influenced virtually every characteristic examined. Hot cyclic temperatures reduced weight gain, feed intake, and breast meat yield, and increased feed conversion, dressing percentage, leg quarter yield, and abdominal fat content. The cold environment promoted increased feed intake and mortality. Ascites and cardiomyopathy were the leading causes of death under cold exposure and thermoneutral conditions, whereas complications arising from heat exposure were the main cause of death under hot cyclic conditions. Levels of Lys affected leg quarter yield and abdominal fat content over all environments but increased breast meat yield only under cold conditions. Increasing Arg:Lys ratios improved feed conversion and dressing percentage and reduced abdominal fat content; it could not be determined whether these responses were consistent with Arg per se or were due to a nonspecific N response. As increasing Lys levels or Arg:Lys ratios did not improve weight gain, increase breast meat yield, or attenuate adverse effects due to heat or cold exposure, it is concluded that the levels of Lys and Arg suggested for 21 to 42 d by the NRC are adequate for birds of this age under the environmental conditions encountered.

Efeito da linhagem sobre o rendimento de carcaça de frangos de corte / Effect of strain of broiler chickens on carcass yield

O objetivo do experimento foi determinar o efeito da linhagem sobre o rendimento de carcaça e das partes da carcaça. Aos 49 dias de idade foi retirada uma amostra de 18 machos e 18 fêmeas de cada uma das quatro linhagens comparadas, para abate após um período de jejum de oito horas. A linhagem afetou o ganho de peso (P<0,05) no período de um a 49 dias, mas näo (P>0,05) o consumo de raçäo e a conversäo alimentar. A linhagem afetou (P<0,05) as percentagens de carcaça eviscerada (sem cabeça, pescoço e patas), peito e patas, mas näo teve efeito (P>0,05) sobre as percentagens de coxas, sobre-coxas, dorso, asas, gordura abdominal, cabeça e pescoço. As fêmeas apresentaram maiores (P<0,05) percentagens de carcaça eviscerada, peito e gordura abdominal; os machos foram superiores em coxas, patas e cabeça. As demais características estudadas näo foram afetadas (P>0,05) pelo sexo das aves

Tratamento das gastroenterocolites agudas. / Treatment of acute gastroenterocolitis

Foram estudadas 101 criancas com diagnostico de gastroenterocolite aguda internadas no Hospital e Maternidade Chacara Flora, no periodo de junho de 1982 a junho de 1983. Verificou-se que 62 (61%) criancas tinham menos de seis meses de idade; 48(47%) eram eutroficas/desnutridas proteico-caloricas grau I(DPC), 42(41%) apresentaram DPC grau II e 11(10%) DPC grau III. Oitenta e oito (87%) apresentaram historia de diarreia, anterior a internacao, menor do que sete dias. Sessenta e oito (67%) criancas ficaram menos de sete dias internadas. As restantes apresentaram alguma patologia associada, obrigando-as a permanecer internadas por um periodo mais prolongado. Quanto ao tratamento, os resultados sugerem que a manutencao do estado hidrico e nutricional foi vital para o restabelecimento do quadro clinico