[Clinical response to inhalation and oral antibiotics in patients with bronchiectasis]. / Avaliação da resposta clínica ao uso de antibióticos por via oral e via inalatória em pacientes portadores de bronquiectasias.

INTRODUCTION: The aim of this technique was to achieve high concentration of the antibiotic that excedeed the minimal inhibitory concentration (MIC) of the microbial load present in the sputum. METHOD: To evaluate the bronchiectasis patients with pictures of infectious exacerbations response to the treatment with antibiotic by oral way (roxitromicin 300 mg/day for 21 days) and in cases of failure of this schema the use of antibiotic by inhalatory way (gentamicin 80 mg/2 times day for 21 days), 28 patients were evaluated a special ambulatory, some signs and respiratory symptoms according to the "Cotes modified scale" (sputum, cough, bronchospasm and dyspnea). STATISTICAL ANALYSIS: We used: Kappa concordant test and McNemar test for discordation in the evaluation of the degree of signal and respiratory symptoms, Wilcoxon test for periods without infection, Fisher test for the collaterals effects presented, G of Cochran test for the personal history analysis. RESULTS: The personal history did not influence the evolution of bronchopulmonary infeccion, the evaluated signs and symptoms had significant improvement except dyspnea that stayed the same in 80% of the cases. DISCUSSION: The group that had used the antibiotics schema by inhalatory way after oral scheme failure had a significant longer period without bronchopulmonary infection but with superior collateral effects without clinicals repercussions. CONCLUSION: The use of inhalatory antibiotic in infectious exacerbations in patients with bronchiectasis was better than the oral way.

Avaliaçäo da resposta clínica ao uso de antibióticos por via oral e via inalatória em pacientes portadores de bronquiectasias / Evaluation of clinical response in the antibiotics use by inhalatory and oral ways in patients with bronchiectasis

Objetivo. A base desta técnica foi obter alta concentração do antibiótico que excedia a concentração mínima inibitória (MIC) para a carga bacteriana presente no escarro. Método. Para avaliar a resposta de pacientes portadores de bronquiectasis em quadros de exacerbações infecciosas ao tratamento com antibiótico por via oral (roxitromicina 300 mg/dia por 21 dias) e nos casos de fracasso deste esquema uso de antibiótico por via inalatória (gentamicina 80 mg/2 vezes dia por 21 dias), foram avaliados em 28 pacientes atendidos noambulatório da especialidade, alguns sinais e sintomas respiratórios de acordo com a escala de Cotes modificada (secreção brônquica, tosse, broncoespasmo e dispnéia). Análise Estatística. Utilizamos o seguinte tratamento estatístico: teste de concordância Kappa e teste de McNemar para a discordância na avaliação dos graus de sinais e sintomas respiratórios, teste exato de Fischer para os efeitos colaterais apresentados, teste G de Cochran para análise dos antecedentes pessoais. Resultados. Observamos que a presença dos antecedentes pessoais não influenciaram a evolução da infecção brocopulmonar, houve melhora significante nos sinais e sintomas avaliados excetuando-se a dispnéia que permaneceu inalterada em 80 por cento dos casos. Discussão. O grupo que fez de esquema antibiótico por via inalatória após fracasso do esquema via oral foi beneficiado com período médio sem infecção brocopulmonar significantemente superior, embora a presença de efeitos colaterais tenha sido superior neste grupo, porém sem repercussão clínica. Conclusão. O controle de quadros de exacerbação infecciosa em portadores de bronquiectasias foi melhor com o antibiótico por via inalatória do que por via oral.

[Effect of dopamine in dopaminergic doses on pulmonary circulation of dogs in normoxia and hypoxia]. / Efeitos da dopamina em doses dopaminérgicas sobre a circulação pulmonar de cães em normóxia e hipóxia.

PURPOSE: To study if dopamine in dopaminergic doses (1.5 and 4.0 micrograms/kg/min) had some effect on the pulmonary vasoconstriction mechanism, and if in those doses the drug had some action on systemic and pulmonary hemodynamic variables, as well as in the pulmonary gas exchange. METHODS: Seventeen normal mongrel dogs, anesthetized and paralized under mechanical ventilation were submitted to two different gas mixtures: room air (F1O2 = 0.2093 -10 dogs) and hypoxic mixture (F1O2 = 0.125 -7 dogs). Dopamine was infused in both groups during 15 min in the two doses 1.5 and 4.0 micrograms/km/min, separated by a period of 30 min. RESULTS: Pulmonary hemodynamics and gas exchange variables after infusion of dopamine at 1.5 and 4.0 micrograms/km/min in dogs in normoxia and hypoxia. [table: see text] CONCLUSION: Dopamine in the used doses had no action on the pulmonary circulation and on the hypoxic pulmonary vasoconstriction mechanism; pulmonary gas exchange was not affected by dopamine in both doses during normoxia and hypoxia; in the experimental model there was no evidence of dopaminergic receptors in the pulmonary vessels.

[Pathological alterations in pulmonary fat embolism caused by oleic acid. Experimental study in dogs (author's transl)]. / Anatomia patológica na embolia gordurosa pulmonar provocada por ácido oleico. Estudo experimental em cães.

The authors studied the pathological aspects of the lungs in an experimental study made in dogs submitted to fat embolism. The histological aspects were of hemorrhagic edema when the lungs were fixed in the classical way as well when they were fixed inflated. The alveolar microatelectasias were only seen in lungs fixed in the classical way but not were seen in lungs fixed when inflated.

[Pulmonary ultrastructural changes in dogs following experimental hemorrhagic shock (author's transl)]. / Alterações da ultraestrutura pulmonar provocadas pelo choque hemorrágico. estudo experimental em cães.

The authors have studied the ultrastructure of the lung in dogs following experimental hemorrhagic shock. They found intra-alveolar edema, red cells in the alveolar sac, disappearance of the substance of the lamellated osmiophilic bodies and cellular degeneration. Correlation among these alterations and increase of capillary permeability as well as consumption of surfactant secretion were established.

[Sensitivity and specificity of the passive hemagglutination reaction applied to titration of herpes antibodies]. / Sensibilité et spécificité de la réaction d'hémagglutination passive appliquée au titrage des anticorps herpétiques

52 human sera were checked for herpes virus hominis type 1 antibodies by passive hemagglutination, complement fixation, neutralization tests and plaque reduction in presence of complement. A good correlation was observed among the results obtained by the passive hemagglutination test and the plaque reduction in presence of complement. The rapidity of the indirect hemagglutination test and the sensitivity of the reaction are in favour of its routine use.

[Virus infections in man during immunodepression (author's transl)]. / Les infections virales au cours de l'immunodépression en pathologie humaine

The authors review virus infections observed in patients undergoing immunosuppressive treatment. The herpes virus, in particular the cytomegalovirus, are the most important cause. However, the role of the virus itself in an unfavourable course is variously assessed. The mechanism of the virus infection is discussed, whether primary infection, exogenous or endogenous re-infection. The latter seems to be the most frequent, at least in the case of the herpes viruses.

Lymphocyte transformation test in uveal pathology.

Comparative studies of skin tests and in vitro lymphocyte transformation tests were found to be fruitful with the following antigens: tuberculin and PPD, Streptococcus, vaccine and protein M of Streptococcus, candidin, herpes antigen, Brucella antigen, antigen from autologous saliva. Three types of response occur: (1) positive skin test with syndromic ocular reaction and positive LTT: the diagnosis of hypersensitivity is certain; (2) positive skin test without syndromic reaction but positive LTT in vitro; less sensitive than the in vivo test but enhancing the value of the latter; the diagnosis is presumptive, and (3) skin test positive or negative and LTT negative: indicates that the in vitro test is less sensitive than the in vivo one. Practical interest of this comparison stems from those cases in whom skin testings is contra-indicated because it is considered to be dangerous (macular choroiditis, Eales' disease). Specific desensitization treatment was carried out on most of the cases and seemed to be effective in several of them.

Humoral and cellular immunity to retinal antigens in guinea pigs.

Cellular and humoral immunity was studied in pigmented guinea pigs after one injection in the two hind footpads of extract of bovine retina or crude suspensions of rod outer segments (ROS) with complete Freund's adjuvant. In vitro macrophage migration inhibition experiments showed that the antigens which give rise to cellular immunity are mainly located in the pigment epithelium-photoreceptor layers and are devoid of species specificity. With the complement fixation method, the evolution of serum antibodies in anti-ROS guinea pigs was compared with clinical and histological data during the course of the ocular disease. Antibodies appeared in the 2nd week, slighly before the lesions, reaching their maximum level at the 4th week and decreased pari passu with the clinical ocular inflammation, while choroidal cellular infiltration and retinal alterations persisted for several months. Attempts to transfer the disease passively with concentrated serum from enucleated donors were successful. The immune sera were injected locally by different routes. Repeated subconjunctival injections - the less traumatic way - induced severe chorio-retinal lesions.

[Experimental herpetic infection in rabbits combined with immunodepression (author's transl)]. / Infection herpétique expérimentale du lapin et immunodépression

The immunologic response to herpesvirus infection have been studied in rabbits receiving azathioprine before, after or simultaneously with the infection. The part of humoral depression in the complications following human kidney graft and the meaning of the viral antibodies rises in these patients are discussed.

Renal transplantation and viral infections. II. Results of follow-up studies.

13 renal transplant recipeints were submitted to virological survey over a period of about 10 months following transplantation. They were compared to a group of individuals who underwent no transplantation : 7 patients on chronic hemodialysis and 10 healthy blood donors. The renal transplant recipients, showed rises in titer of antibodies against various viral antigens. Nevertheless, no other viral elimination but that of cytomegalovirus and herpes simplex virus was detected in them. Renal trnasplant recipients show significantly more often rises in virus antibody titers than the other individuals, when time of survey is taken into account. Some of these rises appeared to be simultaneous. Their mechanism is under debate : analysis of special cases and observation of associated immunohematological abnormalities are strongly suggesting that in some situations, rises in titer of viral antibodies may occur without infection.