Clinical Impact of Surgical Complications in Kidney Transplant Recipients in a Reference Hospital in Salvador, Bahia, Brazil.

BACKGROUND: Renal transplantation is the treatment of choice for patients with stage V chronic kidney disease, which does not have contraindications to the procedure and is more cost-effective than dialysis treatments and provides better survival and quality of life. OBJECTIVE: The objective of this study was to evaluate the incidence of postoperative complications in kidney transplant recipients in a reference hospital. METHODOLOGY: This was a descriptive and retrospective study involving the analysis of patient records during hospitalization and outpatient treatment. We analyzed the demographics, clinical indicators, surgical techniques, and postoperative complications. RESULTS: In the analysis of 147 transplantations, there was a higher incidence of transplantation in female recipients, average age of 37 years with a predominance of cadaveric transplantation. Of all pretransplantation comorbidities, hypertension was the most frequent. The overall incidence of surgical complications was 29.9%, with an incidence of vascular complications of 12.7%, 13.4% of surgical site complications, 8.2% of urologic complications, and 3% of hemorrhagic complications. DISCUSSION: Vascular complications are serious complications and are associated with increased risk of graft loss (relative risk, 8.4), particularly arterial thrombosis. Patients with ureteral anastomosis using Lich-Gregoir technique showed lower urologic complications compared with patients with anastomosis by Leadbetter-Politano technique. CONCLUSION: Surgical complications have different clinical effects, depending on their category. The vascular complications are associated with graft lost.

[Combination of 5-fluorocytosine and amphotericin B in the treatment of chromomycosis]. / Associação de 5-fluorocitosina e anfotericina B no tratamento da cromomicose.

The authors discuss the problem of resistance of chromomycosis to 5-fluorocytosine (5-FC), observed in a previous study in 7 patients initially treated with the drug and subsequently treated with 5-FC associated with other medicaments. All the associations, including that with amphotericin B, failed to overcome resistance. Experiments in mice and "in vitro" show a synergism between 5-FC and amphotericin B against "C. albicans", "C. neoformans" and "Fonsecaeae pedrosoi" already confirmed in human subjects infected with the above mentioned fungi. Resistance to 5-FC seems to be irreversible, as shown in previous experiments. The mechanism of action of the drugs on the fungi is discussed, as well as the fact that amphothericin B prevents the development of resistance to 5-FC. Results obtained with the use of the above association in 5 cases of chromomycosis are presented; all the patients had old and well established lesions, and in three cases these lesions were large and disseminated, conditions probably associated with the development of resistance to 5-FC used alone. The drugs were given in small doses, inferior to those usually recommended. The good therapeutic results seem to confirm the synergism observed in laboratory trials. Four cases were discharged as cured and one abandoned treatment for personal reasons. The association seems to act more rapidly than 5-FC alone. Tolerance was excellent in all cases.

Photosensitization of lymphoblastoid cells with phthalocyanines at different saturating incubation times.

Photodynamic therapy of cancer is a promising treatment based on the tumor-specific accumulation of photosensitizers followed by irradiation with visible light which induces tumor cell death. The effect of different preincubation times on the photosensitization efficiency of the phthalocyanines AlPc and AlPcS4 was investigated in lymphoblastoid CCRF-CEM cells under conditions that allow maximal uptake of the sensitizers. First, the time course for the uptake of AlPcS4 and AlPc by CCRF-CEM cells and by the pheochromocytoma PC12 cells was compared. The uptake of AlPcS4 by CCRF-CEM cells was not significantly different after 6 h or 24 h incubation, but the photosensitization efficiency of the phthalocyanine was much higher when a 24 h preincubation period was used, with a fluence rate of 5 mW/cm2. However, for a fluence rate of 10 mW/cm2, the photosensitization efficiency of AlPcS4 was almost completely independent of the preincubation time (6 h vs. 24 h) with the phthalocyanine. When the cells were preincubated with 1 micromol/L AlPc for 10 min or 6 h, which allows the same accumulation of sensitizer by the cells, no significant effect of the incubation time on the photodynamic inactivation of CCRF-CEM cells was observed, with fluence rates of 5 mW/cm2 or 10 mW/cm2, for different light doses. Confocal fluorescence microscopy studies did not reveal differences in the localization of the phthalocyanines after maximal uptake was reached. The results show that the preincubation time with AlPcS4, after the maximal uptake is reached, affects cell growth to an extent depending on the fluence rate used, and this effect was not due to a major redistribution of the sensitizer during incubation. However, this was not observed when AlPc was used.

Six years' experience in treatment of chromomycosis with 5-fluorocytosine,.

Twenty-three patients with chromomycosis were treated with oral 5-fluorocytosine for periods ranging from 2 to 67 months. Sixteen were considered cured, after 3 consecutive monthly controls showing healing of the lesions and absence of fungi in mycologic and histopathologic examinations of biopsy specimens. Seven, in spite of initial clinical improvement, showed resistance to treatment. Associated treatment with amphotericin B, calciferol or thiabendazole failed to help patients resistant to 5-fluorocytosine. Resistance seems to occur especially in those with long-standing lesions or widespread involvement.

Retinoides em dermatologia e oncologia. / Retinoids in dermatology and oncology

Os retinoides sao uma nova classe de medicamentos, derivados da vitamina A, com menor toxicidade e efeito terapeutico mais especifico que a propria vitamina. Diversos retinoides tem sido estudados experimentalmente e em ensaios clinicos, sobretudo nas dermatoses caracterizadas por hiperceratinizacao. Os principais compostos atualmente em estudo sao: a) etretinato ou RO 10-9359, particularmente eficaz na psoriase e em genodermatoses ceratinicas; b) isotretinoina ou RO 4 - 3780, bastante ativa no tratamento da acne juvenil, inclusive formas cisticas graves; e c) motretinida ou RO 11 - 1430, usado em aplicacao local na acne, tao eficaz e melhor tolerado que o acido retinoico. Os retinoides parecem tambem constituir-se em novo recurso para o tratamento e a profilaxia de neoplasias epiteliais

Acidic proteinases from resting cotyledons of cowpea (Vigna unguiculata)

Copwpea (Vigna unguiculata) seed cotyledons contain acidic hemoglobinase activity that can be inhibited by the aspartic acid proteinase specific inhibitor pepstatin. Two of these proteinases were isolated by affinity and ion exchange chromatography. Their relative molecular weights were 69,000 and 45,000 as calculated by gel filtration chromatography