Modulation of reactive oxygen levels and gene expression in sensitive and resistant tumoral cells by C-phyocyanin.

In this work we investigated the possible cellular changes induced by C-phycocyanin (C-PC) in erythroleukemic cells with (K562-Lucena and FEPS) and without (K562) the multidrug resistance (MDR) phenotype. The reactive oxygen levels (ROS) (evaluated by fluorimetry) were increased relative to the control in K562 and K562-Lucena cells treated with 100 µg/mL and were not increased in FEPS cells. The expression of the following genes related to resistance was evaluated by real-time PCR: COX2, ALOX5, ABCB1 and ABCC1. Treatment with 100 µg/mL of C-PC increased COX2 and ABCB1 expression in K562-Lucena cells and reduced expression of ALOX5 in K562-Lucena and FEPS cells. ROS levels appear to be involved in biological responses to C-PC in K562 and K562-Lucena cells, although expression of the genes studied here was only modified by C-PC in the K562-Lucena cell line. Thus, it is possible to suggest that C-PC modulates the expression of COX2 and ABCB1 for the K562-Lucena in a ROS-dependent manner and the expression of ALOX5 for the FEPS in a ROS-independent manner; however, more studies are needed to elucidate these mechanisms.

Imiquimod en el tratamiento de la infección vulvar por virus de papiloma humano / Imiquimod in the treatment of vulvar infection by human papilloma virus

Determinar la eficacia de imiquimod como tratamiento médico de la infección vulvar por VPH. Estudio descriptivo, prospectivo, longitudinal en el que 30 pacientes con verrugas genitales recibieron imiquimod crema al 5 por ciento interdiario por 12 semanas. Se evaluó el área de aplicación semanalmente por un mes y se realizó vulvoscopia a los 3, 6 y 12 meses después del tratamiento. La edad promedio de las pacientes fue 27,7 ± 6,5 años. Las lesiones más frecuentes fueron exofíticas, 30 por ciento estaban ubicadas en horquilla y 30 por ciento eran multifocales. A los tres y seis meses del tratamiento, se obtuvo una mejoría total del 96,7 por ciento y 3,3 por ciento de persistencia (P<0,001) Al año de seguimiento 83,3 por ciento se curaron, 13,3 por ciento recurrieron y en 3,3 por ciento persistió la lesión (P<0,001). El 66,7 por ciento de las pacientes presentaron efectos colaterales leves durante el tratamiento, predominaron el dolor (26,7 por ciento) y el ardor (23,3 por ciento). La diferencia entre la proporción de sintomáticas y asintomáticas fue estadísticamente significativa. Ninguna suspendió la terapia. Para el mes de culminado el tratamiento, el 73,3 por ciento no manifestó síntomas (P=0,0003). Las variables epidemiológicas y las características de las lesiones no afectaron el resultado. El imiquimod es eficaz en el tratamiento de la infección vulvar por VPH, con efectos adversos leves tolerados por las pacientes, con tasas de curación elevada y de recurrencia y persistencia bajas

To determine the efficacy of imiquimod as medical treatment of infection by HPV vulvar. Descriptive, prospective, longitudinal study in which 30 patients with genital warts received imiquimod cream 5 percent every 48 hours, for 12 weeks. The area of application was assessed weekly for a month and a vulvoscopia was made at 3, 6 and 12 months after treatment. The average age of the patients was 27.7 ± 6.5 years. The most common injuries were exophytics, 30 percent were located in fork and 30 percent were multifocal. At three and six months of treatment, obtained a total improvement of 96.7 per cent and 3.3 per cent of persistence (P<0.001) and after one year of follow up 83.3 percent were cured, there were 13.3 percent of recurrence and in 3.3 percent injury persisted (P<0.001). 66.7 percent of the patients had mild side effects during treatment, pain (26.7 percent) and the burning predominated (23.3 percent). The difference between the proportion of symptomatic and asymptomatic was statistically significant. No patient discontinued therapy. For the month of completed treatment, 73.3 percent said not symptoms (P=0.0003). Epidemiological variables and characteristics of the injury did not affect the result. The imiquimod is effective in the treatment of vulvar infection by HPV, with mild adverse effects tolerated by patients, with low recurrence and persistence and high cure rates

Profile of cancer patients treated at the emergency room of a tertiary cancer care centre in southern Brazil.

The number of cancer care visits in the emergency department for evaluation and treatment has been steadily increasing. Cancer patients represent a challenge for the emergency team because they may have acute symptoms of still undiagnosed malignancy, vague symptoms related to the disease or complications of cancer treatment, all of which can be either mild or potentially life-threatening. The Santo Antonio Hospital is a public institution located in the city of Blumenau (SC, southern Brazil), which serves as a reference centre for cancer care patients for a population of over a million and a half. The objective of this research was to describe the epidemiological profile of the oncologic population who were treated at the emergency department of this hospital, during a period of over six months, starting on April 1st , 2011 to October 31st of the same year. There were 1,051 oncologic visits during this period, with the age ranging from 19 to 89 years. The greater demand for care was sought by patients with urological, breast, upper and lower gastrointestinal tract and lung cancer. The three major complaints of the consultations were pain, respiratory and gastrointestinal symptoms. The visits occurred mainly during daytime mostly on Mondays and Tuesdays. The improvement of primary care services and efficiency of oncology clinics in meeting the high demand for appointments is extremely important, in order to prevent unnecessary visits to the emergency department.

Seroprevalência da infecçäo pelo HIV-1 em gestantes atendidas no IMIP, Recife - Brasil / Seroprevalence of HIV infection among pregnant women attending in the IMIP, Recife-Brasil

The number of HIV infected heterosexual has been steadily increasing in Brazil. This fact was followed by a decline on the ratio of male/female HIV infection every year. We have examined the seroprevalence of HIV infection among pregnant women attending an antenatal clinic in the Instituto Materno Infantil de Pernambuco (IMIP) at Recife, North-eastern Brazil. This study was performae as an anonymous sentinel surveillance. The collected blood samples were tested for HIV infection by two different types of ELISA, and if positive, further analysis by IIA was submitted. The subjects were arranged in four age groups with the respective proportion: group l (<15 years)-0.9 per cent, group II (15 to 20 years)-31.6 per cent, group III (21 to 34 years)-61.7 per cent and group IV (>35 years)- 5,8 per cent. It was found an HIV-1 seroprevalence of 0.1 per cent (95 per cent confidence interval, -0.l to + 0,3) This percentage represents one single HIV positive woman included in age group III. his low HIV infection seroprevalence is suitable with a low risk population (pregnant women) in a low prevalence area. However, we became concerned with the great propottion of pregnant woman under 21 years (32,5 per cent) and with the implications of how to reinforce effectively HIV preventions of how to reinforce effectively HIV prevention strategies to this population

Stroke study group. Preliminary results. Early intensive care improves functional outcome.

Early and intensive care seems to positively affect outcome in stroke patients. A standardized protocol, costly adjusted to our reality and suitable for application by non-specialist at Emergency Room, proved effective, reflecting in diagnosis reliability, reducing time for beginning therapy, leading to low mortality rates and better functional outcomes at discharge.

Malnutrition among children of adolescent mothers in a squatter community of Recife, Brazil.

In a study of 357 first time mothers in a squatter community of Recife it was found that 1 in 10 were less than 15 years old and 60 per cent less than 20 at the time of their first delivery. Two groups of mothers were distinguished, viz. adolescent mothers with a mean (SD) age at first delivery of 16.7 (0.78) years and older mothers with a mean (SD) age at first delivery of 25 (0.79). More than a third were living in common-law union. Of the adolescent mothers only 58 per cent were living with the child's father. A further 23 per cent had received financial support from their own parents during the pregnancy. The rest were expelled from home. The adolescent mothers were generally worse off with a per capita income generally half of that of older mothers. About a quarter of all children studied were below the 10th centile of NCHS standards (23 per cent by weight/age; 28 per cent by height/age). The undernourished first born was 2.5 times more likely to have an adolescent mother, four times more likely to be in a household with low income, and two times more likely to have an illiterate mother as compared to the first borns who remain well nourished. The implications of these findings for urban primary health care programmes are further discussed.

Inadequate immunity to measles in children vaccinated at an early age: effect of revaccination.

This report describes a follow-up serological study of 79 Brazilian children who, because of their young age, had failed to develop protective levels of immunity after vaccination against measles. There was serological evidence that infection with wild virus had occurred at a rate of about 17% per annum. Approximately 1(1/2) years after the initial vaccination, 46% of the uninfected children maintained very low levels of neutralizing antibody, but did not have a measurable haemagglutination-inhibition titre. Revaccination did not elicit an IgM response in most children, but stimulated anti-measles IgG production in all of them. In 36% of the children, the IgG titres fell again within three months to levels that may permit reinfection. If it is assumed that some of the persistent titres can be attributed to wild virus infection, the actual effect of revaccination would have been to immunize no more than 60% of the susceptible group. The results suggest that early administration of measles vaccine may produce a cohort of children with inadequate immunity who cannot be fully immunized by revaccination. The implications of these findings for measles immunization programmes are discussed.

[Lipoma of the corpus callosum. Report of a case associated with callosum agenesia]. / Lipoma do corpo caloso. Registro de um caso associado com agenesia calosa.

A case of callosal lipoma with radiologic, angiographic and CT comprovation is discussed under actual knowledge of metabolic and clinical aspect of lipomas. The authors also make considerations about surroundings and genetic factors which would play a role acting especifically with chemical biotrophism on developing cells, affecting the genesis of corpus callosum and altering the functional structure of cells affected.

Lipoma do corpo caloso: registro de um caso associado com agenesia calosa. / Lipoma of corpus callosum: report of a case associated with callosum agemesia

Registro de um caso de lipoma caloso com comprovacao radiologica, angiografica cerebral e pela tomografia computorizada. Os achados sao discutidos bem como as recentes aquisicoes sobre os aspectos metabolicos dos lipomas. Os autores julgam ser valido especular sobre fator ou fatores ambientais ou ate geneticos mutacionais, atuando com biotropismo quimico especifico sobre as celulas em desenvolvimento afetando a formacao do corpo caloso e alterando a estrutura funcional das celulas afetadas

Comportamento antropometrico do desnutrido grave submetido a tratamento intra-hospitalar com dois tipos de dietas. Estudo de 200 casos. / Anthropometric behavior of the severe malnourished patient submitted to intrahospital treatment with 2 types of diet. Study of 200 cases

Estudo antropometrico de 200 criancas desnutridas graves hospitalizadas para tratamento foi realizado. Na admissao, os pacientes foram classificados segundo os criterios de Gomez. O estudo dos deficits de pesolidade, alturalidade e peso/altura, alem da analise da evolucao do estado nutricional pela adequacao peso/altura e estudo do ganho de peso foram valorizados.Evidenciou-se que aos 45 dias de internamento, a classificacao do estado nutricional atraves dos criterios de Gomez e de Macias diferiu significativamente, permanecendo os pacientes na mesma condicao nutricional inicial quando aferidos por Gomez e verificando-se uma melhoria do estado nutricional com os criterios de Macias, sendo estes considerados mais sensiveis para a avaliacao do estado nutricional atual. Todavia, foi reconhecido que os criterios de Macias sao muito exigentes para serem utilizados para alta de pacientes internados, uma vez que para serem atingidos impoem uma permanencia hospitalar mais prolongada. A analise do ganho de peso demonstrou que a mudanca no esquema dietetico nao alterou os padroes de recuperacao em dois grupos estudados

[Progressive occlusive disease of the cerebral arteries associated with Down's syndrome: considerations on the etiopathogenesis]. / Doença oclusiva progressiva das arterias cerebrais associada a síndrome de Down: considerações sobre a etiopatogenia.

The case of a 5 years old child with association of "moyamoya" and Down syndrome with permeability of internal carotid, of medial and anterior cerebral arteries is reported. The authors postulate the possibility of a microcirculatory disorder in view of the distal lesion including the action of any distribution of the alterations.

Desnutricao e hospital. I - Prevalencia de desnutricao proteico-calorica em pacientes hospitalizados. / Malnutrition and hospital. I - Prevalence of protein-calorie malnutrition in hospitalized patients

Da analise realizada em 2.025 pacientes hospitalizados, verificou-se que 2/3 dos pacientes sofrem de algum grau de desnutricao; que o sexo masculino predominou no grupo total; que a idade prevelente para a hospitalizacao e de um a quatro anos: que, excecao feita para a categoria de particulares, onde prevaleceu o grupo de normais, entre os previdenciarios houve nitida predominancia de desnutridos; que houve uma tendencia a um grau de DPC mais avancado nas familias de maior tamanho, assim como nos casos que apresentavam maior numero de hipoteses diagnosticas na admissao.A omissao de registro do diagnostico de DPC no prontuario foi considerada, em 80% dos casos, falta importante a ser corrigida face as implicacoes que a DPC traz no processo de hospitalizacao

Desnutricao e hospital. II - Tempo de permanencia e criterios de alta para desnutridos. / Malnutrition and hospital.II - Length of stay and discharge criteria for malnourished children

Os AA. analisam o comportamento de 200 criancas portadoras de DPC de II e III graus, com patologia associada, submetidas a tratamento intra-hospitalar mediante a utilizacao de criterios de alta diferentes. Evidenciam que a permanencia hospitalar esta na razao direta dos criterios de alta empregados e apos discutirem acerca dos parametros antropometricos bioquimicos, hematologicos, etc., recomendam como criterios mais objetivos e de valor pratico os seguintes: cura da patologia associada a DPC, adaptacao a dieta normal para a idade e ganho de peso progressivo, pelo menos durante uma semana. Os criterios acima permitiram uma permanencia media de 47 dias

Desnutricao e hospital. III - Custos do tratamento do desnutrido grave a nivel hospitalar. / Malnutrition and hospital.III - Treatment costs of the severe malnourished infant in the hospital

Valendo-se da experiencia adquirida com o tratamento de 200 criancas portadoras de Desnutricao Proteico Calorica (DPC); os autores fazem uma estimativa dos custos da hospitalizacao e tentam extrapolar os resultados para a possibilidade de cobertura da populacao desnutrida da cidade do Recife. O numero reduzido de leitos, o longo tempo de permanencia exigido para recuperacao dos pacientes, levando a um baixo rendimento e custo muito elevados dos leitos, torna impossivel este tipo de assistencia e fortalece a ideia de que a solucao so podera ser encontrada em programas extra-hospitalares