Genetic parameters and genotype-environment interactions for skeleton deformities and growth traits at different ages on gilthead seabream (Sparus aurata L.) in four Spanish regions.

One of the most important problems of fish aquaculture is the high incidence of fish deformities, which are mainly skeletal. In this study, genetic parameters on gilthead seabream (Sparus aurata L.) for skeleton deformities at different ages (179, 269, 389, 539 and 689 days) and their correlations with growth traits were estimated, as were as their genotype × environment interactions (G × E) at harvesting age. A total of 4093 offspring from the mass spawning of three industrial broodstocks belonging to the PROGENSA(®) breeding programme were mixed and on-grown by different production systems in four Spanish regions: Canary Islands (tanks and cage), Andalusia (estuary), Catalonia (cage) and Murcia (cage). Parental assignment was inferred using the standardized SMsa1 microsatellite multiplex PCR. From three broodstocks, 139 breeders contributed to the spawn and a total of 297 full-sibling families (52 paternal and 53 maternal half-sibling families) were represented. Heritabilities at different ages were medium for growth traits (0.16-0.48) and vertebral deformities (0.16-0.41), and low for any type of deformity (0.07-0.26), head deformities (0.00-0.05) and lack of operculum (0.06-0.11). The genetic correlations between growth and deformity traits were medium and positive, suggesting that to avoid increasing deformities they should be taken into account in breeding programmes when growth is selected. The G × E interactions among the different facilities were weak for length and deformity and strong for growth rate during this period. These results highlight the potential for the gilthead seabream industry to reduce the prevalence of deformities by genetic improvement tools.

Case report of hepatic mucormycosis after liver transplantation: successful treatment with liposomal amphotericin B followed by posaconazole sequential therapy.

Mucormycosis is a rare but emerging fungal infection complicating solid organ transplantation (SOT), with a cumulative incidence of around 2% during the first year after SOT. The associated mortality rate is high, and surgical debridement is frequently required as part of the treatment along with antifungal therapy based mostly on amphotericin B formulations, We describe here an unusual case of hepatic mucormycosis in a liver transplant recipient that was successfully treated with clinical therapy based on liposomal amphotericin B followed by posaconazole, without surgical resection.

Composición en ácidos grasos de alimentos de alto consumo por la población escolar de la región Metropolitana de Chile, incluyendo contenido en ácidos grasos trans / Fatty acid profile of high consumption foods by school population of the region Metropolitan of Chile, including trans fatty acid content

La población escolar chilena ha mostrado un notable cambio en sus hábitos alimentarios, incorporando a su dieta alimentos con alto aporte de grasa que podrían explicar los altos índices de obesidad que hoy se tienen. Gran parte de estos alimentos utilizan grasas industrializadas con alto contenido en ácidos grasos saturados (AGS) y que potencialmente podrían contener ácidos grasos trans (AGT) provenientes de la hidrogenación parcial de aceites o contenidos en forma natural en materias grasas de animales rumiantes.El objetivo de esta investigación fue determinar el perfil de ácidos grasos, incluyendo los AGT, de aquellos alimentos de mayor consumo por la población escolar de la Región Metropolitana de Chile. Se aplicó una encuesta alimentaria a 203 escolares de la Región Metropolitana de Chile , con preguntas de frecuencia y preferencia de consumo de diferentes tipos de alimentos. De acuerdo a esta encuesta se seleccionaron diez tipos de alimentos diferentes a los que se les determinó el contenido de grasa y su perfil en ácidos grasos, incluyendo AGT ,medidos por Cromatografía Gas Liquido, según Norma UNE 5509. Se realizó tres muestreos, se trabajo con muestras compuestas por cinco envases individuales y los análisis se realizaron en duplicado. Se encontró que gran parte de los alimentos analizados presentaron bajos contenidos de AGT (<1 %), sin embargo algunos de ellos presentaron un notable aporte de AGS, lo que hace que ellos tengan una baja relación AGPI/AGS y por ende baja calidad nutricional de su grasa. La escasa presencia de AGT encontrados en los alimentos analizados es posible debido a la disminución en el uso de materias grasas hidrogenadas, fruto de las recomendaciones de la OPS/OMS que están siendo acogidas en nuestro país.

The Chilean school population has shown remarkable changes in their eating habits, incorporating high fat content foods to their diet, which could explain the current high obesity rates. A great proportion of these foods uses industrial fats whit high content of saturated fatty acids (SFA) and potentially contains trans fatty acids (TFA) as a result of partial oil hydrogenation or as a natural form in ruminant animals fat. The purpose of this investigation was to determine fatty acid profile, including trans fatty acids, from food consumed by the Metropolitan Region school population. A food consumption survey was applied to 203 Metropolitan Region of Chile school-children, which consisted of questions about food consumption frequency and consumer preferences. Based on the results, ten types of food products were selected. Fat content, fatty acids profile, including trans fatty acid, were determinate by GLC according to the UNE 5509 Norm. Each analysis was carried out in duplicate and three samplings were performed. It was found that a great percentage of the analyzed foods showed low TFA content (<1%). However, some of them presented remarkable saturated fatty acids content, generating a PUFA/SFA ratio with poor fat nutritional quality. The low TFA concentration found in the food may be explained by a decrease in the use of hydrogenated fats, following PAHO/WHO recommendation, which are being applied in Chile.

Evaluation of the quality and treatability of leachate produced at a landfill connected to an urban waste composting and recovery plant at Alhendin (Granada, Spain).

The leachate produced at a landfill adjoining an urban waste composting and recovery plant at Alhendin (Granada, Spain) was sampled for a period of more than 3 years from February 2003 until July 2006. The main pollutant parameters (COD, BOD(5), solids, nitrogen, main anions and cations, pH, Eh and conductivity) were analysed with the aim of selecting the most effective treatment for the leachate. The results obtained showed high concentrations of different pollutants with COD and BOD(5) values up to 74,133 mg/L and 39,000 mg/L respectively. Seasonal changes in leachate composition were mainly attributed to differences in rainfall, temperatures, and evaporation rates. Our study classified the Alhendin landfill leachate as a partially stabilized leachate because of: (i) its management strategies (storage at artificial ponds and recirculation); (ii) the coexistence in the landfill of active and closed cells with wastes of different ages and at different decomposition phases. The leachate quality data obtained was statistically evaluated using various statistical tools. A good correlation was found between many of the parameters analysed, some of which also showed good linear regressions. Principal component analysis allowed the reduction of most of the parameters analysed to four components: Component 1 (K(+), Mg(2 +), FTS, VDS, VTS, Na(+) and Cl(-)), component 2 (BOD(5)), component 3 (TDS, TS, FDS and conductivity) and component 4 (pH, FSS, Eh and VSS). The results obtained are valuable for the selection of the best leachate treatment option. A combination of a physicochemical treatment and a fixed film biological system is recommended for this leachate.

[Fatty acid profile of high consumption foods by school population of the region Metropolitan of Chile, including trans fatty acid content]. / Composición en ácidos grasos de alimentos de alto consumo por la población escolar de la región Metropolitana de Chile, incluyendo contenido en ácidos grasos trans.

The Chilean school population has shown remarkable changes in their eating habits, incorporating high fat content foods to their diet, which could explain the current high obesity rates. A great proportion of these foods uses industrial fats whit high content of saturated fatty acids (SFA) and potentially contains trans fatty acids (TFA) as a result of partial oil hydrogenation or as a natural form in ruminant animals fat. The purpose of this investigation was to determine fatty acid profile, including trans fatty acids, from food consumed by the Metropolitan Region school population. A food consumption survey was applied to 203 Metropolitan Region of Chile school-children, which consisted of questions about food consumption frequency and consumer preferences. Based on the results, ten types of food products were selected. Fat content, fatty acids profile, including trans fatty acid, were determinate by GLC according to the UNE 5509 Norm. Each analysis was carried out in duplicate and three samplings were performed. It was found that a great percentage of the analyzed foods showed low TFA content (<1%). However, some of them presented remarkable saturated fatty acids content, generating a PUFA/SFA ratio with poor fat nutritional quality. The low TFA concentration found in the food may be explained by a decrease in the use of hydrogenated fats, following PAHO/WHO recommendation, which are being applied in Chile.

Adapting EVIAVE methodology as a planning and decision-making tool in Venezuela.

Landfills in Venezuela have serious problems regarding their location, design and operation. In fact, basic waste disposal is one of the main weaknesses of the municipal waste management in this country. The Venezuelan Ministry of Environment and Renewable Resources has studied and identified the negative impacts of operating landfills, but no program has been implemented to determine the cause-effect relation of these impacts or to design strategies to counteract with the serious environmental and health risks generated. This paper describes how EVIAVE methodology can be successfully used for landfill diagnosis, and shows how this type of landfill diagnosis was applied in Venezuela. For our research study, we carried out both a quantitative and qualitative evaluation of the environmental problems generated by 22 landfills in Venezuela. Our study was based on the following environmental indexes: Landfill Environment, Environmental Risk, Environmental Value, and Probability of Contamination. For the purposes of our study, it was first necessary to adapt EVIAVE to the legal system and social context in Venezuela. The results obtained confirmed the applicability of this methodology to Venezuelan landfills. EVIAVE was found to be an effective planning tool that provided crucial information for the development of action plans, which would improve landfill operation, and help make decisions pertaining to their closure, sealing and eventual recovery.

FDTD chiral brain tissue model for specific absorption rate determination under radiation from mobile phones at 900 and 1800 MHz.

A new electrodynamics model formed by chiral bioplasma, which represents the human head inner structure and makes it possible to analyse its behaviour when it is irradiated by a microwave electromagnetic field from cellular phones, is presented. The finite-difference time-domain (FDTD) numeric technique is used, which allows simulation of the electromagnetic fields, deduced with Maxwell's equations, and allows us to simulate the specific absorption rate (SAR). The results show the SAR behaviour as a function of the input power and the chirality factor. In considering the chiral brain tissue in the proposed human head model, the two more important conclusions of our work are the following: (a) the absorption of the electromagnetic fields from cellular phones is stronger, so the SAR coefficient is higher than that using the classical model, when values of the chiral factor are of order of 1; (b) "inverse skin effect" shows up at 1800 MHz, with respect to a 900 MHz source.

Coagulation-flocculation pretreatment of a partially stabilized leachate from a sanitary landfill site at Alhendin (Granada, Southern Spain).

Leachate recirculation, biological, and physicochemical treatment processes are used to treat leachate landfill, but all treatment technologies seem to need a combination of two or more methods to obtain an effluent with suitable properties to eliminate environmental problems. In spite of the considerable literature focused on the coagulation-flocculation applied to landfill leachate before biological treatments, most investigations are developed to study different operating variables as leachate characteristics, type, and concentrations of chemical products applied. Two ferric coagulants (ferric chloride and Ferriclar), two aluminum coagulants (PAX-18 and SAL-8.2), an organic coagulant and flocculant (Chemifloc PA-15), several anionic flocculant (Chemifloc A05.L, A10.L, A20L, and A30.L), and a non-ionic flocculant (Chemifloc N01) were used in jar-test experiments to determine the best conditions for the removal of chemical oxygen demand (COD) and total solids (TS) from a partially stabilized leachate collected at a sanitary landfill site at Alhendín (Granada, Southern Spain). The organic coagulant-flocculant PA-15 showed highest (17%) COD and TS removal efficiencies at a concentration of 2 mL/L. All combinations of coagulants and flocculants enhanced the COD removal efficiency. The best results (more than 25% COD removal) were obtained with a combination of ferric or aluminum-based salts in combination with high molecular weight flocculants.

Solid industrial wastes and their management in Asegra (Granada, Spain).

ASEGRA is an industrial area in Granada (Spain) with important waste management problems. In order to properly manage and control waste production in industry, one must know the quantity, type, and composition of industrial wastes, as well as the management practices of the companies involved. In our study, questionnaires were used to collect data regarding methods of waste management used in 170 of the 230 businesses in the area of study. The majority of these companies in ASEGRA are small or medium-size, and belong to the service sector, transport, and distribution. This was naturally a conditioning factor in both the type and management of the wastes generated. It was observed that paper and cardboard, plastic, wood, and metals were the most common types of waste, mainly generated from packaging (49% of the total volume), as well as material used in containers and for wrapping products. Serious problems were observed in the management of these wastes. In most cases they were disposed of by dumping, and very rarely did businesses resort to reuse, recycling or valorization. Smaller companies encountered greater difficulties when it came to effective waste management. The most frequent solution for the disposal of wastes in the area was dumping.

Environmental diagnosis methodology for municipal waste landfills.

A large number of countries are involved in a process of transformation with regard to the management of municipal solid waste. This process is a consequence of environmental requirements that occasionally materialise in legislation, such as the European Council Directive 31/99/EC on waste release in the European Union. In some cases, the remediation of old landfills can be carried out in compliance with environmental requirements; in other cases, it is necessary to proceed with the closure of the landfill and to assimilate it into its own environment. In both cases, it is necessary to undertake a diagnosis and characterisation of the impacted areas in order to develop an adequate action plan. This study presents a new methodology by which environmental diagnosis of landfill sites may be carried out. The methodology involves the formulation of a series of environmental indeces which provide information concerning the potential environmental problems of the landfills and the particular impact on different environmental elements, as well as information related to location, design and operation. On the basis of these results, it would be possible to draw up action plans for the remediation or closure of the landfill site. By applying the methodology to several landfills in a specific area, it would be possible to prioritize the order of actions required.

Detection of Soybean Rust caused by Phakopsora pachyrhizi in Northwestern Argentina.

Asian soybean rust, caused by Phakopsora pachyrhizi, is regarded as one of the most destructive diseases of soybean (Glycine max (L.) Merr.). In Argentina, it was first detected in the province of Misiones in the northeast near Paraguay and Brazil during the 2001-02 growing season (2). The following season, it also was found in the neighboring province of Corrientes. However, it did not reach major soybean production areas in northern Argentina until the end of the 2003-04 season. During April 2004, as soybean crops were nearing maturity, the disease was found throughout the region of northwestern Argentina, which includes the provinces of Tucumán, Salta, Jujuy, Catamarca, and Santiago del Estero, where approximately 6% of the soybean crop of Argentina is produced. During February and March, the area had a severe drought and above average temperatures, but in April, rainfall was abundant, particularly during the first half of the month. Soybean rust was first observed on 16 April in several locations of the departments (counties) of Moreno and Jiménez in the province of Santiago del Estero, and the following week in the departments of Alberdi, Burruyacú, Cruz Alta, Famaillá, La Cocha, and Leales in the province of Tucumán, in the department of Santa Rosa in the province of Catamarca, and in the departments of Anta, Metán, Rosario de la Frontera, and San Martín in the province of Salta. In those fields where the disease was detected, nearly all plants showed symptoms. Affected crops were mostly in growth stages R7 to R8, except for a few fields that had been planted late and were in a late R5 stage. Yield losses as much as 28% and premature defoliation occurred in these fields only. Disease severity, measured as percentage of affected leaf area, ranged from 45 to 50% in untreated fields and 0.9 to 39% in fungicide-treated fields. Leaf lesions were reddish brown, irregularly shaped, and were more abundant on the abaxial surface. Under the dissecting microscope, uredinia were observed as erumpent pustules with a conspicuous central pore. Masses of urediniospores were expelled through the pore and covered the pustules. Urediniospores were hyaline to pale yellow-brown, sub globose to ovoid, with finely echinulate, hyaline walls, and an average size of 27.8 × 18.5 µm. Because there are two morphologically similar species of Phakopsora that infect soybean, P. pachyrhizi (the Asian species) and P. meibomiae (the New World species), a molecular differentiation was carried out using the polymerase chain reaction (PCR) assay described by Frederick et al. (1). DNA extracted from 37 samples from different locations was amplified with specific primers for both species of Phakopsora and specific primers for P. pachyrhizi and for P. meibomiae. Twenty-eight samples amplified with the two species primers and with the P. pachyrhizi primer. None of the samples amplified with the P. meibomiae primer. Specimens have been deposited at Instituto Miguel Lillo, Tucumán, Argentina. These results confirmed the presence of P. pachyrhizi in the provinces of Catamarca, Tucumán, Salta, and Santiago del Estero, Argentina. References: (1) R. D. Frederick et al. Phytopathology 92:217, 2002. (2) R. L. Rossi. Plant Dis. 87:102, 2003.

Frogeye Leaf Spot of Soybean Caused by Cercospora sojina in Northwestern Argentina.

Frogeye leaf spot of soybean (Glycine max (L.) Merr.), caused by Cercospora sojina Hara, was first detected during the 1997-98 growing season at low incidence and severity (<1% of the leaf diseased) levels in the provinces of Tucumán, Salta, Jujuy, Catamarca, and Santiago del Estero in northwestern Argentina. During the 1998-1999 growing season, disease incidence increased and disease severity grew to 10% of the leaf surface diseased on highly susceptible cultivars in a few locations. An outbreak of frogeye leaf spot occurred throughout northwestern Argentina during the 1999-2000 growing season. Frogeye leaf spot was severe on susceptible cultivars in the provinces of Salta, Santiago del Estero and Catamarca with the greatest intensity in the northeastern part of the Province of Tucumán. Symptoms on leaves were circular lesions that ranged in size from 1 to 5 mm, were reddish-brown to gray or tan, and were bordered by a narrow, reddish-brown to purple margin. Conidiophores and conidia of C. sojina developed on the abaxial leaf surface (1,2). Severely diseased leaves were desiccated and dropped during the R6 stage of growth. Lesions also developed on stems, pods, and seeds. Field surveys indicated that this disease reduced the yields of the highly susceptible cultivars Anta 82 RR, Coker 6738, and A 6445 RG by 48, 34, and 25%, respectively. C. sojina was cultured from diseased tissue on PDA acidified with 0.2% lactic acid and maintained on V-8 juice agar amended with streptomycin sulfate (100 mg/l). Conidia were elongated, dark, 38 to 62 × 5 to 9 µm, with 2 to 6 septa, and borne on dark conidiophores with 1 to 4 septa. Pathogenicity tests were conducted on seedlings of the susceptible cultivars A 6445 RG and Coker 6738 and on the resistant cultivars A 8000 RG and Shulka. Seedlings were inoculated at the V3 growth stage by spraying the leaves with a conidial suspension (4 × 104 conidia/ml) using a hand-held atomizer. Control plants were sprayed with sterile distilled water. Plants were placed in a moist chamber at 26°C for 2 days and then transferred to a greenhouse bench where they were kept at 25 to 30°C. Symptoms identical to those observed in the field became visible after 7 to 10 days. Ratings were made 14 days after inoculation by estimating the percentage of leaf area affected using a standard area diagram. Lesions covered 60 to 65% of the leaf area of susceptible cultivars, but less than 2% on resistant cultivars. Control plants remained healthy. C. sojina was reisolated from lesions on leaves of susceptible plants. Above-average rainfall and high relative humidity in northwestern Argentina during the first three months of 2000 may have encouraged the severe outbreak of frogeye leaf spot of soybean. The outbreak was aggravated by the widespread use of notillage systems in the region and the large hectarage planted with susceptible cultivars. References: (1) S.G. Lehman J. Agric. Res. 36:811-833, 1928. (2) D. V. Philips and J. T. Yorinori. 1989. Frogeye leaf spot. Pages 19-21 in: Compendium of Soybean Diseases, 3rd ed. APS Press, St. Paul, MN.

[Pulmonary vein stenosis. Report of 2 cases and review of the literature]. / Estenose das veias pulmonares. Apresentação de dois casos e revisão da literatura.

Topical congenital pulmonary vein stenosis is a uncommon defect, both isolated or associated to other cardiac abnormalities. Only the localization of the lesions seems to affect the survival, because 60% of survival cases has unilateral stenosis; the severity of associated cardiac lesions become the prognosis poor. We describe two cases: 1st case, a 43 days old boy presented with heart failure and convulsion and had a diagnosis of pulmonary hypertension, atrial septal defect and tricuspid regurgitation, without pulmonary abnormalities. He had recurrent pulmonary infections and a cerebral ischemia in the following months, and died at 15 months of age for sepsis. Autopsy revealed stenosis and atresia in all pulmonary veins, with venous and arterial hypertension. There was also aortic hypoplasia and aortic and tricuspid valves indifferentiation; 2nd case, a 7 days old girl had a diagnosis of aortic coarctation and atrial and ventricular septal defects. Surgical corrections, at 38 and 46 days old, firstly of the aortic coarctation and after for the septal defects, disclosed and relief a supra-valvar mitral stenosis, but she remained on heavy respiratory insufficiency. At 6 months old, she returned to the hospital with dyspnea and cianosis, heart failure and hemoptisis; a sepsis developed and she died. At autopsy, there were severe pulmonary vein stenosis on the left and in the superior right veins, with pulmonary hypertension and hemorrhage.

Duración de la evolución pre-terapia y pronóstico en meningitis bacteriana aguda en el niño menor / Duration of the pre-therapy and prognostic evolution in acute bacterial meningitis in little child

Se ha informado sobre retraso en el diagnóstico de meningitis bacteriana (MB) y el consiguiente impedimento para el tratamiento oportuno en nuestra población infantil. La duración de la enfermedad previa al tratamiento (DEPT), definida como las horas de fiebre (HF) o número de consultas (NC) por el mismo síndrome febril previos al diagnóstico clínico de MB, podría influir en la evlución de la enfermedad en niños. Para examinar si ha habido cambios de la DEPT en los últimos años, revisamos los casos MB del primer estudio, egresados del Hospital Roberto del Río durante 1978-90 (G1)(N=186) y los comparamos con 105 casos egresados del mismo hospital durante 1978-90 (G2). También utilizamos en segundo grupo para probar la hipótesis que el diagnóstico de MB hecho después de las primeras 24 hrs está asociado a mal pronóstico medido como muerte o secuelas al alta de los pacientes. La letalidad fue 25,8 por ciento y 8,6 por ciento en G1 y G2. respectivamente (OR= 3.7; 95 por ciento CI= 1,5, 9,2; p= 0,002). El riesgo de DEPT más larga fue mayor en G1, con punto de corte en las primeras 12 hrs del síndrome febril (OR= 3,34; 95 por ciento CI= 1,29, 8,87; p= 0,01) y también cuando el número de consultas necesarias fue de 3 o más (OR= 2,77; 95 por ciento CI= 0,96, 8,29; p= 0,06). El riesgo de muerte o secuelas graves al alta, apareció con punto de corte de la DEPT en 24 hrs sólo en G2 (OR= 3,5; 95 por ciento CI= 1,0, 15,6; p= 0,025). Igualmente, el NC >1 se asoció a mayor riesgo en (OR= 5,56; 95 por ciento CI= 1,1, 37,7; p= 0,01). En este segundo grupo, la combinación de DEPT >24 hrs y NC= 1, mostró la razón de riesgos más alta de las observadas (OR= 8,92; 95 por ciento CI= 1,1, 193; p= 0,01). Estos resultados sugieren que el diagnóstico precoz (< 24 hrs) puede influenciar la evolución de la MB en niños

[Infective endocarditis associated with pregnancy]. / Endocardite infecciosa relacionada à gravidez.

PURPOSE: To report the intra-hospitalar and late follow-up of patients with infective endocarditis (IE) acquired in the pregnancy or puerperium. METHODS: Eleven patients, between 1984-1992 according to the beginning of the IE episode (fever and other signals) were studied. Patients were divided in two groups: IE of pregnancy (7 cases), and puerperal IE (4 cases). RESULTS: In the pregnancy IE group, mitral valve was affected in 6 (85%), and aortic valve in 1 (15%). During the course of the treatment, two patients had to be operated on, respectively, in the 24th and 28th week of the pregnancy. The 1st one had a successfully mitral valve replacement by a biological prosthesis but 48 h later she aborted, and the 2nd presented neurological complication (intracerebral hemorrhage) in the immediate post-operative period of a successfully mitral valve replacement by biological prosthesis. She was undergone to a cesarean but the fetus remained alive for 24 h only. If we look at the newborns (fetus), only 4 of them survived. Out of 3 fetal deaths, 2 had close association with mother cardiac surgeries. In the pregnant period acquired IE, 3 (47%) mothers died. In the puerperium group, 2 mitral valves and 2 aortic valves had IE. Two of them had to be operated on due to an important aortic regurgitation and cardiac failure. There were no deaths in this group. CONCLUSION: During pregnancy, IE showed a high morbi-mortality for mother and concept. The mother's neurological complications played a major role in the poor outcome during the pregnancy period.

[Endocarditis due to Mycobacterium chelonei in a valvular prosthesis]. / Endocardite por Mycobacterium chelonei em prótese valvar.

Male aged 40 year, with infective endocarditis in valvular prosthesis caused by Mycobacterium chelonei. This agent is unusual in this situation and rarely identified by the blood cultures.

[Infective endocarditis in patients with permanent pacemaker]. / Endocardite infecciosa em pacientes com marcapasso definitivo.

Five patients who had permanent pacemaker and infective endocarditis were analyzed. Diagnose was confirmed by a positive blood cultures in all patients and 2 of them had identifiable vegetation in the echocardiogram too. The etiologic agent was Staphylococcus aureus in 3, Staphylococcus epidermidis in 1 and Staphylococcus viridans in 1. Three patients were treated with antibiotics alone: one had no clinical conditions to be operated, one died before surgery and one had good response to antimicrobial therapy alone. Two patients were submitted to antibiotic therapy and surgical removal of the pacemaker system, without complications. It was concluded that the surgical removal of the pacemaker system, as soon as possible, is the choice's therapy.

[Myocardial infarction in infective endocarditis]. / Infarto do miocárdio na endocardite infecciosa.

Two patients with chronic valvular heart disease and myocardial infarction were assisted at our hospital. Both of them were febrile and only one had petechiae associated with signs of valvular involvement led to suspicion of infective endocarditis. Although blood cultures were negative, echocardiographic, surgical and anatomopathologic findings were compatible with infective endocarditis. They required cardiac surgery during the acute phase of the infection because they presented progressive hemodynamic deterioration and no satisfactory response to antimicrobial regimen too. One patient died at late follow-up (two weeks after the hospital discharge) and the other survived, but with signs of cardiac failure (class II of NYHA) one year after the procedure.

Correçäo cirúrgica dos tumores primários do coraçäo / Surgical correction of primary heart tumors

No período de 1962 a 1991, no Instituto Dante Pazzanese de Cardiologia, foram tratados cirurgicamente 52 pacientes portadores de tumores primários do coraçao. Dentre os tumores benignos, 43 eram mixomas, 5 fibromas, 1 fibroelastomapapilar, l rabdomioma e apenas 2 malignos (rabdomiossarcomas). A idade média foi de 4l,l anos; 33 pacientes eram do sexo feminino e l9 do masculino; 53,84 por cento apresentaram-se com insuficiência cardíaca congestiva, 19,2 por cento com dor precordial e/ou palpitaçoes e 17,3 por cento com taquiarritmias. A ressecçao completa do tumor foi possível em 50 pacientes e os 2 com tumores malignos foram apenas submetidos a biopsia. Todos os pacientes sobreviveram à cirurgia; entretanto, 3 pacientes foram a óbito no período hospitalar. Um paciente com mixoma apresentou recorrência três anos após e foi reoperado com sucesso. Temos em acompanhamento tardio 20 pacientes, que se encontram em classe funcional I (NYHA) e os resultados sao bastante satisfatórios.