Advanced clinical parameters: A complementary hydroxyurea adherence evaluation in sickle cell anemia treatment.

OBJECTIVES: Given the complex pathology of sickle cell anemia (SCA) and low adherence to hydroxyurea (HU) treatment, there is a need to seek parameters that identify recent changes in patient status. The advanced clinical parameters (ACPs) allow an early analysis of hematopoiesis. We aimed to draw the demographic profile of non-adherent SCA patients and to verify the use of ACPs as a measure of HU treatment adherence. METHOD: In a cross-sectional study, we divided 83 SCA subjects treated with HU into Children (<12 years old) and adolescents/adults (≥12 years old). Their hemogram with the ACPs, electronic medical charts and pharmacy claim data were analyzed. RESULTS: Non-adherent ≥12 years old patients had significantly increased WBC, absolute neutrophil, lymphocyte, monocyte, and basophil counts, RBC, RET, RDW, and PLT, and significantly decreased MCV and MCH. Subjects in the adolescent/adult group with IG† ≥0.035 cells/mm3 had the RR for non-adherence increased by 4.6 times (p = .014), and the systemic immune inflammation index (SII) of non-adherent patients was also significantly higher (p = .042). CONCLUSION: IG† presents clinical utility in early identification of non-adherence to HU, especially when combined with other parameters, suggesting the evaluation of ACPs in laboratory routine, as they can be easily implemented.

Acute kidney injury associated with rhabdomyolysis in a patient with COVID-19 / Lesão renal aguda associada à rabdomiólise em um paciente com COVID-19

Abstract Rhabdomyolysis is defined as the breakdown of skeletal muscle leading to the release of muscle contents into the extracellular fluid. Patients with rhabdomyolysis can be asymptomatic or have myalgia symptoms, weakness, myoglobinuria with dark urine, significant electrolyte imbalance, and acute kidney injury. Here we describe a case on acute kidney injury associated to rhabdomyolysis in a patient with COVID-19.

Resumo A rabdomiólise é definida como a lise da musculatura esquelética levando à liberação do conteúdo muscular para o fluido extracelular. Pacientes com rabdomiólise podem ser assintomáticos ou apresentar sintomas de mialgia, fraqueza, mioglobinúria com urina escura, desequilíbrio eletrolítico significativo e lesão renal aguda. Aqui descrevemos um caso de lesão renal aguda associada à rabdomiólise em um paciente com COVID-19.

Comparative Genomics and Characterization of SARS-CoV-2 P.1 (Gamma) Variant of Concern From Amazonas, Brazil.

BACKGROUND: P.1 lineage (Gamma) was first described in the State of Amazonas, northern Brazil, in the end of 2020, and has emerged as a very important variant of concern (VOC) of SARS-CoV-2 worldwide. P.1 has been linked to increased infectivity, higher mortality, and immune evasion, leading to reinfections and potentially reduced efficacy of vaccines and neutralizing antibodies. METHODS: The samples of 276 patients from the State of Amazonas were sent to a central referral laboratory for sequencing by gold standard techniques, through Illumina MiSeq platform. Both global and regional phylogenetic analyses of the successfully sequenced genomes were conducted through maximum likelihood method. Multiple alignments were obtained including previously obtained unique human SARS-CoV-2 sequences. The evolutionary histories of spike and non-structural proteins from ORF1a of northern genomes were described and their molecular evolution was analyzed for detection of positive (FUBAR, FEL, and MEME) and negative (FEL and SLAC) selective pressures. To further evaluate the possible pathways of evolution leading to the emergence of P.1, we performed specific analysis for copy-choice recombination events. A global phylogenomic analysis with subsampled P.1 and B.1.1.28 genomes was applied to evaluate the relationship among samples. RESULTS: Forty-four samples from the State of Amazonas were successfully sequenced and confirmed as P.1 (Gamma) lineage. In addition to previously described P.1 characteristic mutations, we find evidence of continuous diversification of SARS-CoV-2, as rare and previously unseen P.1 mutations were detected in spike and non-structural protein from ORF1a. No evidence of recombination was found. Several sites were demonstrated to be under positive and negative selection, with various mutations identified mostly in P.1 lineage. According to the Pango assignment, phylogenomic analyses indicate all samples as belonging to the P.1 lineage. CONCLUSION: P.1 has shown continuous evolution after its emergence. The lack of clear evidence for recombination and the positive selection demonstrated for several sites suggest that this lineage emergence resulted mainly from strong evolutionary forces and progressive accumulation of a favorable signature set of mutations.

Acute kidney injury associated with rhabdomyolysis in a patient with COVID-19.

Rhabdomyolysis is defined as the breakdown of skeletal muscle leading to the release of muscle contents into the extracellular fluid. Patients with rhabdomyolysis can be asymptomatic or have myalgia symptoms, weakness, myoglobinuria with dark urine, significant electrolyte imbalance, and acute kidney injury. Here we describe a case on acute kidney injury associated to rhabdomyolysis in a patient with COVID-19.

Perfil laboratorial liquórico de pacientes com meningite atendidos em um hospital da região metropolitana de Porto Alegre/RS ­ Brasil / Cerebrospinal fluid laboratory profile of patients with meningitis attended to in a hospital in the metropolitan region of Porto Alegre/RS - Brazil

Introdução: Considerado um material nobre em laboratório clínico, o líquor (LCR) se assemelha a um ultrafiltrado de plasma e tem como principais funções o fornecimento de nutrientes essenciais ao cérebro e proteção mecânica. Os setores rotineiramente envolvidos na análise laboratorial do LCR são a bioquímica, a microbiologia e a citologia. Objetivo: Avaliar os principais agentes etiológicos associados à ocorrência de meningites e identificar as alterações laboratoriais mais prevalentes nas amostras liquóricas analisadas em laboratório de um hospital da região metropolitana de Porto Alegre. Métodos: Estudo transversal retrospectivo (01/2013 a 12/2017) em banco de dados. Resultados: Foi observada maior ocorrência de meningites bacterianas (35,53%), seguida por infecções virais (26,31%), fúngicas (25%) e parasitárias (13,16%). Os principais agentes infecciosos identificados foram Cryptococcus sp (n=18), Herpes Simples Vírus I e II (n=12), Toxoplasma gondii (n=10) e Streptococcus pneumoniae (n=9), e as principais alterações laboratoriais estiveram associadas à hiperproteinorraquia e à elevação no número de leucócitos. Nas meningites bacterianas, observaram-se hipoglicorraquia, hiperproteinorraquia e importante elevação de lactato desidrogenase (LDH); as fúngicas apresentaram discreta diminuição na glicorraquia e LDH moderadamente elevado, enquanto os agentes virais e parasitários apresentaram maior alteração na dosagem de proteínas (hiperproteinorraquia). Conclusão: Com perfil predominantemente masculino e adulto, a identificação de casos infecciosos na análise laboratorial liquórica representou 8,32% do total das análises, sendo as meningites bacterianas as mais prevalentes, podendo ser laboratorialmente reconhecidas por alterações bioquímicas e celulares. Os achados possibilitam o conhecimento epidemiológico e laboratorial, podendo embasar estudos posteriores.

Introduction: Considered a noble material in the clinical laboratory, CSF is similar to a plasma ultrafiltrate and its main functions are the supply of essential nutrients to the brain and mechanical protection. The sectors routinely involved in the laboratory analysis of CSF are biochemistry, microbiology and cytology. Objective: To evaluate the main etiological agents associated with the occurrence of meningitis and to identify the most prevalent alterations in CSF samples analyzed in the laboratory of a hospital in the metropolitan region of Porto Alegre. Methods: A retrospective cross-sectional study (01/2013 to 12/2017) in a database. Results: A higher occurrence of bacterial meningitis (35.53%) was observed, followed by viral (26.31%), fungal (25%) and parasitic (13.16%) infections. The main infectious agents identified were Cryptococcus sp (n=18), Herpes Simplex Virus I and II (n=12), Toxoplasma gondii (n=10) and Streptococcus pneumoniae (n=9) and the main laboratory alterations were associated with hyperproteinorrhachia and elevation in the number of leukocytes. In bacterial meningitis, hypoglycorrhachia, hyperproteinorrhachia and a significant increase in lactate dehydrogenase (LDH) relawere observed; fungal meningitis showed a slight decrease in glycorrhachia and moderately high LDH, while viral and parasitic agents showed greater change in protein level (hyperproteinorrhachia). Conclusion: With a predominantly male and adult profile, the identification of infectious cases in the CSF laboratory analysis represented 8.32% of the total analyses, with bacterial meningitis being the most prevalent, which can be recognized by biochemical and cellular alterations through laboratory testing. The findings allow for epidemiological and laboratory knowledge, which may support further studies.

Neutrophils phagocytosing fungal hyphae in urinary sediment / Neutrófilos fagocitando hifas no sedimento urinário

Abstract The Phagocytosis of fungal structures by neutrophils is a well-documented function of these immune cells. However, neutrophil phagocytosis of hyphal structures in the urine sediment is not usually observed during routine sample evaluation. This is a case of hyphal phagocytosis by neutrophils in the urine of a kidney allograft recipient patient.

Resumo A fagocitose de estruturas fúngicas por neutrófilos é uma função bem documentada destas células imunes. No entanto, a fagocitose de hifas por neutrófilos no sedimento urinário não é normalmente observada durante avaliação de rotina de amostras. Este é um caso de fagocitose de hifas por neutrófilos na urina de um paciente receptor de aloenxerto renal.

Predominance of the SARS-CoV-2 Lineage P.1 and Its Sublineage P.1.2 in Patients from the Metropolitan Region of Porto Alegre, Southern Brazil in March 2021.

Almost a year after the COVID-19 pandemic had begun, new lineages (B.1.1.7, B.1.351, P.1, and B.1.617.2) associated with enhanced transmissibility, immunity evasion, and mortality were identified in the United Kingdom, South Africa, and Brazil. The previous most prevalent lineages in the state of Rio Grande do Sul (RS, Southern Brazil), B.1.1.28 and B.1.1.33, were rapidly replaced by P.1 and P.2, two B.1.1.28-derived lineages harboring the E484K mutation. To perform a genomic characterization from the metropolitan region of Porto Alegre, we sequenced viral samples to: (i) identify the prevalence of SARS-CoV-2 lineages in the region, the state, and bordering countries/regions; (ii) characterize the mutation spectra; (iii) hypothesize viral dispersal routes by using phylogenetic and phylogeographic approaches. We found that 96.4% of the samples belonged to the P.1 lineage and approximately 20% of them were assigned as the novel P.1.2, a P.1-derived sublineage harboring signature substitutions recently described in other Brazilian states and foreign countries. Moreover, sequences from this study were allocated in distinct branches of the P.1 phylogeny, suggesting multiple introductions in RS and placing this state as a potential diffusion core of P.1-derived clades and the emergence of P.1.2. It is uncertain whether the emergence of P.1.2 and other P.1 clades is related to clinical or epidemiological consequences. However, the clear signs of molecular diversity from the recently introduced P.1 warrant further genomic surveillance.

Population-based prevalence surveys during the Covid-19 pandemic: A systematic review.

Population-based prevalence surveys of Covid-19 contribute to establish the burden of infection, the role of asymptomatic and mild infections in transmission, and allow more precise decisions about reopen policies. We performed a systematic review to evaluate qualitative aspects of these studies, assessing their reliability and compiling practices that can influence the methodological quality. We searched MEDLINE, EMBASE, bioRxiv and medRxiv, and included cross-sectional studies using molecular and/or serological tests to estimate the prevalence of Covid-19 in the general population. Survey quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. A correspondence analysis correlated methodological parameters of each study to identify patterns related to higher, intermediate and lower risks of bias. The available data described 37 surveys from 19 countries. The majority were from Europe and America, used antibody testing, and reached highly heterogeneous sample sizes and prevalence estimates. Minority communities were disproportionately affected by Covid-19. Important risk of bias was detected in four domains: sample size, data analysis with sufficient coverage, measurements in standard way and response rate. The correspondence analysis showed few consistent patterns for high risk of bias. Intermediate risk of bias was related to American and European studies, municipal and regional initiatives, blood samples and prevalence >1%. Low risk of bias was related to Asian studies, nationwide initiatives, reverse-transcriptase polymerase chain reaction tests and prevalence <1%. We identified methodological standards applied worldwide in Covid-19 prevalence surveys, which may assist researchers with the planning, execution and reporting of future population-based surveys.

Neutrophils phagocytosing fungal hyphae in urinary sediment.

The Phagocytosis of fungal structures by neutrophils is a well-documented function of these immune cells. However, neutrophil phagocytosis of hyphal structures in the urine sediment is not usually observed during routine sample evaluation. This is a case of hyphal phagocytosis by neutrophils in the urine of a kidney allograft recipient patient.

Urine Sediment Findings and the Immune Response to Pathologies in Fungal Urinary Tract Infections Caused by Candida spp.

Fungi are pathogenic agents that can also cause disseminated infections involving the kidneys. Besides Candida, other agents like Cryptococcus spp. can cause urinary tract infection (UTI), as well as other non-yeast fungi, especially among immunocompromised patients. The detection and identification of fungi in urine samples (by microscopy and culture) plays an essential role in the diagnosis of fungal UTI. However, variable cutoff definitions and unreliable culture techniques may skew analysis of the incidence and outcome of candiduria. The sediment analysis plays a key role in the identification of fungal UTI because both yeasts and pseudohyphae are easily identified and can be used as a clinical sign of fungal UTI but should not be overinterpreted. Indeed, urine markers of the immune response (leukocytes), urine barriers of tissue protection (epithelial cells), and urine markers of kidney disease (urinary casts) can be found in urine samples. This work explores the manifestations associated with the fungal UTI from the urinalysis perspective, namely the urinary findings and clinical picture of patients with fungal UTI caused by Candida spp., aspects associated with the immune response, and the future perspectives of urinalysis in the diagnosis of this clinical condition.

Insuficiência renal aguda em pacientes com COVID-19 / Acute kidney injury in patients with COVID-19

Apesar de inicialmente terem surgido como agentes etiológicos de resfriados comuns, os coronavírus se tornaram uma ameaça global no século XXI, provocando síndromes respiratórias com alto poder de transmissão e contribuindo para quadros graves que podem levar à morte. Além dos coronavírus que emergiram no século XXI, quatro outros coronavírus humanos são mundialmente endêmicos e atualmente representam até 30% das infecções do trato respiratório superior em adultos. A pandemia atual de Síndrome Respiratória Aguda Grave causada por SARS-CoV-2, denominada COVID-19, vem aumentando sua casuística de forma importante, causando o colapso dos sistemas de saúde. Além dos danos ao sistema respiratório, a insuficiência renal aguda (IRA) é uma importante complicação da COVID-19, ocorrendo em 0,5%-7% dos casos e em 2,9%-23% dos pacientes em Unidade de Terapia Intensiva (UTI). Até o momento não se conhecem os mecanismos relacionados à etiologia da IRA associada à COVID-19. Nesta revisão são apresentadas algumas informações associadas à COVID-19 como histórico, manifestações clínicas e laboratoriais, à IRA (especialmente em pacientes internados em UTI) e enfatizando as alterações evidenciadas no exame de urina em pacientes com COVID-19.

Although they initially emerged as etiologic agents of common colds, coronaviruses became a global threat in the 21st century, causing respiratory syndromes with high transmission power and contributing to serious conditions that can lead to death. In addition to the coronaviruses that emerged in the 21st century, four other human coronaviruses are globally endemic and currently account for up to 30% of upper respiratory tract infections in adults. The current pandemic of Severe Acute Respiratory Syndrome caused by SARS-CoV-2, called COVID-19, has been increasing its casuistry significantly, and causing the collapse of health systems. In addition to damage to the respiratory system, acute kidney injury (AKI) is an important complication of COVID-19, occurring in 0.5-7% of cases and in 2.9-23% of patients in the Intensive Care Unit (ICU). So far, the mechanisms related to the etiology of AKI associated with COVID-19 are not known. In this review, some information associated with COVID-19 is presented, such as history, clinical and laboratory manifestations, AKI (especially in ICU patients), and emphasizing the changes evidenced in the urine test in patients with COVID-19.

Blue-green discoloration of urine and false nephrotic range proteinuria at dipstick urinalysis.

A 32 year-old woman presented to the emergency department with symptoms of urinary tract infection. Over the past 2 days, she reported the use of a medication whose active compounds were methenamine (120 mg) + methylthioninium chloride (20 mg). A collected urine sample had a strong blue-green discoloration. Uroculture was negative and dipstick urinalysis revealed the following results: SG 1.015, pH  7, Albumin 3+, Bilirubin 2+ and Haemoglobin 2+. Urine microscopic analysis revealed 5-6 squamous epithelial cells/high power field (HPF), 5-6 leukocytes/HPF and 7-8 erythrocytes/HPF. No bacteria, cellular casts, or renal tubular epithelial cells were present in the urine sample. The most remarkable feature of the urine sediment was that some cells (squamous epithelial cells, macrophages, leukocytes and erythrocytes) were strongly stained in blue. The albuminuria measured by dipstick shows 3+ (300 mg/dL), but in turbidimetric method the urine protein concentration was 18 mg/dL, showing an important interference of methylene blue on the dipstick albumin area.

Klebsiella pneumoniae ESBL forming spheroplasts in the fresh and unstained urine sediment. / Klebsiella pneumoniae ESBL formando esferoplastos em sedimento urinário a fresco sem coloração.

A 60 year-old man was submitted to kidney transplantation in 2013 due to chronic renal insufficiency caused by hypertension. He had recurrent episodes of urinary tract infection and came to the hospital due to a 4 day-long fever, abdominal pain, burning urination and nausea. Routine urinalysis revealed a picture of infection (> 50 leucocytes/high power field associated to massive bacteriuria). The urine sediment revealed elongated like elements with an enlarged part in the middle of the structure body.

Klebsiella pneumoniae ESBL formando esferoplastos em sedimento urinário a fresco sem coloração / Klebsiella pneumoniae ESBL forming spheroplasts in the fresh and unstained urine sediment

Resumo Um homem de 60 anos de idade foi submetido a transplante renal em 2013 devido à insuficiência renal crônica causada por hipertensão. Ele teve episódios recorrentes de infecção do trato urinário e veio para o hospital devido a 4 dias de febre, dor abdominal, ardência para urinar e náusea. Análise do sedimento urinário revelou um quadro de infecção (> 50 leucócitos/campo de grande aumento associado à bacteriúria maciça). O sedimento urinário revelou elementos alongados com um alargamento na parte central do corpo da estrutura.

Abstract A 60 year-old man was submitted to kidney transplantation in 2013 due to chronic renal insufficiency caused by hypertension. He had recurrent episodes of urinary tract infection and came to the hospital due to a 4 day-long fever, abdominal pain, burning urination and nausea. Routine urinalysis revealed a picture of infection (> 50 leucocytes/high power field associated to massive bacteriuria). The urine sediment revealed elongated like elements with an enlarged part in the middle of the structure body.

Hypovitaminosis D in patients with cystic fibrosis: a cross-section study in South Brazil.

INTRODUCTION: Cystic fibrosis (CF) patients have a susceptibility to vitamin D deficiency because of nutrient malabsorption. OBJECTIVES: To evaluate the prevalence of hypovitaminosis D in CF patients and the factors associated with serum 25-hydroxyvitamin D levels. METHODS: We evaluated the prevalence of vitamin D deficiency defined as 25-hydroxyvitamin D <30 ng/mL, as suggested recently by the Cystic Fibrosis Foundation, and factors associated with its serum levels. Patients with confirmed CF were included. Nutritional status and hospital admissions were evaluated. Serum C-reactive protein, calcium, phosphate, magnesium, albumin, 25-hydroxyvitamin D and parathyroid hormone levels were measured. Lung function was evaluated by spirometry, and clinical and chest radiographic scores were assessed. Statistical significance level was set at P < 0.05. RESULTS: Fifty-nine patients were included. Prevalence of hypovitaminosis D was 61%. Patients with pancreatic insufficiency had a trend to have higher vitamin D levels. Sixteen patients had severe lung disease with percentage of forced expiratory volume in 1 s predicted below 40%. After multivariate analysis, body mass index and hospitalization in the last month remained significantly associated with serum vitamin D levels. CONCLUSIONS: Vitamin D insufficiency is still a problem in CF patients, even in those receiving supplementation.

Association between a frequent variant of the FTO gene and anthropometric phenotypes in Brazilian children.

BACKGROUND: Our goal was to analyze the association of the fat mass and obesity- associated (FTO) gene rs9939609 variant (T/A) with the anthropometric and dietary intake phenotypes related to obesity in Brazilian children. METHODS: We analyzed the association of this single nucleotide polymorphism (SNP) with phenotypes related to the accumulation of body mass in a cohort of 348 children followed from the time of birth until 8 years old and then replicated the main findings in an independent schoolchildren sample (n = 615). RESULTS: At the age of 4, we observed a significant association between the A/A genotype and a higher mean BMI Z-score (P = 0.036). At the age of 8, the A/A individuals still presented with a higher BMI Z-score (P = 0.011) and with marginal differences in the volume of subcutaneous fat (P = 0.048). We replicated these findings in the schoolchildren sample, which showed that those with at least one copy of the A allele presented with a higher BMI Z-score (P = 0.029) and volume of subcutaneous fat (P = 0.016). CONCLUSION: Our results indicate that this FTO variant is associated with increased body mass and subcutaneous fat in Brazilian children beginning at the age of 4.

Caloric restriction increases hippocampal glutamate uptake and glutamine synthetase activity in Wistar rats.

Recent studies indicate that caloric restriction (CR) protects the central nervous system from several pathological conditions. The impairment of astroglial cell function, including glutamate uptake, glutamine synthetase (GS) activity and S100B secretion, may contribute to the progression of neurological disorders. The present study aimed to evaluate hippocampal astrocytic changes in response to CR diet, measuring astroglial parameters, such as glutamate uptake, GS activity and the immunocontent of GFAP and S100B. Blood biochemical parameters were also analyzed. Rats (60-day old) were fed ad libitum or on CR diets for 12 weeks. CR-fed rats showed approximately 16% less body weight gain than control rats. The CR diet was able to induce a significant increase in glutamate uptake (23%) and in GS activity (26%). There were no statistically significant differences in the immunocontent of either GFAP or S100B. In summary, the present study indicates that CR also modulates astrocyte functions by increasing glutamate uptake and GS activity, suggesting that CR might exert its neuroprotective effects against brain illness by modulation of astrocytic functions.

Naturally occurring compounds affect glutamatergic neurotransmission in rat brain.

Natural products, including those derived from plants, have largely contributed to the development of therapeutic drugs. Glutamate is the main excitatory neurotransmitter in the central nervous system and it is also considered a nociceptive neurotransmitter, by acting on peripheral nervous system. For this reason, in this study we investigated the effects of the hydroalcoholic extracts from Drymis winteri (polygodial and drimanial), Phyllanthus (rutin and quercetine), Jathopha elliptica (jatrophone), Hedyosmum brasiliense (13HDS), Ocotea suaveolens (Tormentic acid), Protium kleinii (alphabeta-amyrin), Citrus paradise (naringin), soybean (genistein) and Crataeva nurvala (lupeol), described as having antinociceptive effects, on glutamatergic transmission parameters, such as [(3)H]glutamate binding, [(3)H]glutamate uptake by synaptic vesicles and astrocyte cultures, and synaptosomal [(3)H]glutamate release. All the glutamatergic parameters were affected by one or more of these compounds. Specifically, drimanial and polygodial presented more broad and profound effects, requiring more investigation on their mechanisms. The putative central side effects of these compounds, via the glutamatergic system, are discussed.

Effects of maternal protein malnutrition on oxidative markers in the young rat cortex and cerebellum.

Malnutrition affects a large number of children worldwide. Inadequate nutrition during pre- and postnatal period may alter brain development resulting in biochemical, physiological and anatomical changes which in turn could cause behavioral abnormalities. The impairment of the central nervous system following protein deficit have been extensively studied and this deprivation produces deleterious effects upon cerebral structures. The aim of this study was to identify oxidative parameters present in the developing brain as consequence of maternal protein malnutrition. Female Wistar rats were fed a normal protein diet (25% casein) or low protein diet (8% casein) from the time of conception up to 21 days after the parturition. In addition, the diets were supplemented or not with l-methionine. Cortex and cerebellum were removed from offspring to determine the activity of antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and the levels of lipoperoxidation (TBARS). Our findings demonstrated heterogeneity in response to protein restriction. The levels of lipoperoxidation were increased in the cerebellum of malnourished offspring. Methionine supplementation caused an increase in lipoperoxidation in both brain structures. CAT activity was decreased in the cerebellum of the offspring supplemented with methionine whereas the cerebellum of malnourished pups with or not methionine supplementation showed a decrease in SOD activity. The activity of SOD in the cortex did not differ among groups. CAT activity, however, was increased in the cortex of malnourished pups supplemented or not with methionine. Thus, these results provide clues to the knowledge of malnutrition effects upon the brain.