Marginal Adaptation and Quality of Interfaces in Lithium Disilicate Crowns - Influence of Manufacturing and Cementation Techniques.

PURPOSE: To evaluate the cement line thickness and the interface quality in milled or injected lithium disilicate ceramic restorations and their influence on marginal adaptation using different cement types and different adhesive cementation techniques. METHODS AND MATERIALS: Sixty-four bovine teeth were prepared for full crown restoration (7.0±0.5 mm in height, 8.0 mm in cervical diameter, and 4.2 mm in incisal diameter) and were divided into two groups: CAD/CAM automation technology, IPS e.max CAD (CAD), and isostatic injection by heat technology, IPS e.max Press (PRESS). RelyX ARC (ARC) and RelyX U200 resin cements were used as luting agents in two activation methods: initial self-activation and light pre-activation for one second (tack-cure). Next, the specimens were stored in distilled water at 23°C ± 2°C for 72 hours. The cement line thickness was measured in micrometers, and the interface quality received scores according to the characteristics and sealing aspects. The evaluations were performed with an optical microscope, and scanning electron microscope images were presented to demonstrate the various features found in the cement line. For the cement line thickness, data were analyzed with three-way analysis of variance (ANOVA) and the Games-Howell test (α=0.05). For the variable interface quality, the data were analyzed with the Mann-Whitney U-test, the Kruskal-Wallis test, and multiple comparisons nonparametric Dunn test (α=0.05). RESULTS: The ANOVA presented statistical differences among the ceramic restoration manufacturing methods as well as a significant interaction between the manufacturing methods and types of cement (p<0.05). The U200 presented lower cement line thickness values when compared to the ARC with both cementation techniques (p<0.05). With regard to the interface quality, the Mann-Whitney U-test and the Kruskal-Wallis test demonstrated statistical differences between the ceramic restoration manufacturing methods and cementation techniques. The PRESS ceramics obtained lower scores than did the CAD ceramics when using ARC cement (p<0.05). CONCLUSIONS: Milled restorations cemented with self-adhesive resin cement resulted in a thinner cement line that is statistically different from that of CAD or pressed ceramics cemented with resin cement with adhesive application. No difference between one-second tack-cure and self-activation was noted.

Effects of the herbicide atrazine in neotropical catfish (Rhamdia quelen).

The exposure to a world-wide used herbicide atrazine (ATZ) (96h exposure to 2, 10, and 100µgL(-1)), was investigated on the freshwater fish Rhamdia quelen through a multi biomarker approach. Liver histopathology revealed leukocyte infiltration, hepatocyte vacuolization like steatosis and necrosis areas, leading to raised lesion index levels in all tested concentrations. The increase of free melanomacrophage numbers was observed. Gill filaments revealed considerable loss of the microridges on pavement cells at 10 and 100µgL(-1) of ATZ, and a significantly increased of chloride cell (CC) number and density on apical surface area at 100µgL(-1) of ATZ. CAT, GST, GPx, and GR activities were inhibited by all tested concentrations. GSH levels were reduced in individuals exposed to 100µgL(-1). Osmoregulatory function was also disturbed. We observed an increase of plasma magnesium concentrations at 10µgL(-1). Additionally the inhibition of branchial carbonic anhydrase activity was observed at 100µgL(-1). In the kidney, carbonic anhydrase activity decreased only in the group exposed to 2µgL(-1). These results suggest that ATZ, represents a potential ecotoxicological hazard and can be hepatotoxic and nephrotoxic even low concentrations. The current study was the first to show the nephrotoxic effect of ATZ in fish. Besides, in Brazil, the environmental protection agency (CONAMA) establishes that the maximum allowed level of dissolved ATZ in water is 2µgL(-1), but the present results showed that this concentration may cause histopathological, biochemical and physiological changes in R. quelen.

Risks of waterborne copper exposure to a cultivated freshwater Neotropical catfish (Rhamdia quelen).

As it is the case in all animal food production systems, it is often necessary to treat farmed fish for diseases and parasites. Quite frequently, fish farmers still rely on the aggressive use of copper to control bacterial infections and infestations by ecto-parasites, and to manage the spread of diseases. The susceptibility of the neotropical fish Rhamdia quelen to copper was here evaluated at different waterborne copper concentrations (2, 7 or 11 µg Cu L(-1)) for 96 h, through a multi biomarkers approach. Liver histopathological findings revealed leukocyte infiltration, hepatocyte vacuolization and areas of necrosis, causing raised levels of lesions upon exposure to 7 and 11 µg Cu L(-1). Decreased occurrence of free melano-macrophages and increased densities of melano-macrophage centers were noted upon exposure to 11 µg Cu L(-1). Gills showed damages on their secondary lamellae already at 2 µg Cu L(-1); hypertrophy and loss of the microridges of pavement cells at 7 and 11 µg L(-1), and increased in chloride cell (CC) apical surface area (4.9-fold) and in CC density (1.5-fold) at 11 µg Cu L(-1). In the liver, catalase (CAT), glutathione peroxidase activities (GPx) and glutathione concentration (GSH) remained unchanged, compared to the control group. However, there was inhibition of 7-ethoxyresorufin-O-deethylase (EROD) at all copper concentrations tested. Glutathione reductase activity (GR) was reduced and levels of lipid peroxidation (LPO) were increased at 11 µg Cu L(-1). Glutathione S-transferase activity (GST) at 7 µg Cu L(-1) and superoxide dismutase activity (SOD) at both 7 and 11 µg Cu L(-1) were reduced. However, copper exposure did not alter brain and muscle acetylcholinesterase (AChE) activity. Osmoregulatory function was also disturbed, in agreement with the above-mentioned changes noted in the gills, as detected by plasma osmolality reduction in the group exposed to 11 µg Cu L(-1), and plasma chloride reduction at 2 µg Cu L(-1). These concentrations also, coherently, lead to inhibition of branchial carbonic anhydrase activity. In the kidney, increased carbonic anhydrase activity was measured in the groups exposed to 2 and 7 µg Cu L(-1). When these effects are compared to data available in the literature for other freshwater fish, also for 96 h of exposure, R. quelen appears as a relatively sensitive species. In addition, the concentrations employed here were quite low in comparison to levels used for disease control in real culture practices (ranging from 4 µg Cu L(-1) used against bacteria to 6000 µg Cu L(-1) against fungal infections). We can conclude that the concentrations frequently employed in aquaculture are in fact not safe enough for this species. Such data are essential for the questioning and establishment of new policies to the sector.

An assessment of acute biomarker responses in the demersal catfish Cathorops spixii after the Vicuña oil spill in a harbour estuarine area in Southern Brazil.

The Vicuña oil tanker exploded in Paranaguá Bay (South of Brazil), during methanol unloading operations in front of Paranaguá Harbour, on November 15th, 2004, releasing a large amount of bunker oil and methanol. Two weeks after the accident, the acute effects of the Vicuña Oil Spill (VOS) were evaluated in the demersal catfish Cathorops spixii, comparing a contaminated (at the spill site) and a reference site inside the Bay. Data were compared to previous measurements, taken before the accident, in the same species, from the same sites. The physiological biomarkers were the ones that best reflected acute effects of the spill: plasma osmolality, chloride, calcium, magnesium, and potassium. Morphological (liver and gill histopathology) and genetic (piscine micronucleus and DNA strand breaks) biomarkers revealed that damage was already present in fishes from both reference and contaminated sites inside the Bay. Thus, the reference site is not devoid of contamination, as water circulation tends to spread the contaminants released into other areas of the Bay. Acute field surveys of oil spill effects in harbour areas with a long history of contamination should thus be viewed with caution, and whenever possible previous evaluations should be considered for proper appraisal of biomarker sensitivity, especially in mobile bioindicators such as fish.

Multibiomarker assessment of three Brazilian estuaries using oysters as bioindicators.

Oysters have been largely employed as bioindicators of environmental quality in biomonitoring studies. Crassostrea rhizophorae was selected to evaluate the health status of three estuarine areas impacted by anthropogenic activities along the Brazilian coast, in three estuarine complexes, ranging in latitude from 7 to 25 degrees S. In each estuary three sites were sampled in Winter and in Summer: a site considered as reference, and two sites next to contamination sources. Condition index was similar at all sites and estuaries, with the highest values found for Itamaracá oysters in Summer. Necrosis, hyperplasia, mucocyte hypertrophy and fusion of ordinary filaments were the main histopathological lesions observed. Muscle cholinesterase activity was overall similar, but with a strong seasonal effect. Inhibition or activation of branchial total ATPase and Na,K-ATPase activities at the contaminated sites was observed. The health status of these estuarine areas is quite similar, and the combined use of biomarkers is recommended.

Evaluation of fixative solutions for ultrastructural analysis of brown spider Loxosceles intermedia (araneae: sicariidae) tissues

In view of the widely varying compositions of fixative solutions used for studying spiders, five different fixative formulas were tested for fixing male brown-spider (Loxosceles intermedia) gonad tissues. The brown spider represents a public health problem in Curitiba (Paraná State, Brazil). Morphological study of its gonads may aid in understanding the reproductive strategies of this species, and possibly in developing a reproduction control program. The fixatives tested contained glutaraldehyde alone or combined with paraformaldehyde, and the buffers cacodylate or phosphate, with or without the addition of sucrose or sodium chloride as osmolytes. Those containing 2.5 percent glutaraldehyde and 2 percent paraformaldehyde in 100 mM phosphate buffer with 200 mM sucrose, or in 200 mM sodium cacodylate, satisfactorily preserved mitochondria, the Golgi apparatus, and the membranes in general. These formulas were nearly isosmotic (439 mOsm/kg H2O and 455 mOsm/kg H2O respectively) to brown spider hemolymph (478 mOsm/kg H2O). With respective to the fixative agents, a glutaraldehyde-paraformaldehyde combination resulted in optimal fixation of Loxosceles intermedia cells. For other species of spiders, hemolymph osmolality should be considered, but the fixative formulas cited above would also probably yield good results.

Dada a variabilidade na composição de soluções fixadoras utilizadas em aranhas, cinco diferentes fixadores foram elaborados para a análise ultra-estrutural dos tecidos da aranha marrom Loxosceles intermedia. A aranha marrom representa um problema de saúde pública na cidade de Curitiba, e o estudo morfológico de suas gônadas pode auxiliar na compreensão de suas estratégias reprodutivas e, possivelmente, no desenvolvimento de um programa de controle da sua população. As fórmulas usadas continham glutaraldeído com ou sem paraformaldeído, tampão cacodilato ou fosfato, e NaCl ou sacarose como osmólitos. As soluções fixadoras compostas por 2.5 por cento glutaraldeído e 2 por cento paraformaldeído, em tampão fosfato com adição de sacarose ou em 200 mM cacodilato de sódio, preservaram bem estruturas como mitocôndrias, aparelho de Golgi e membranas em geral. Os tampões são praticamente isosmóticos (439 mOsm/kg H2O e 455 mOsm/kg H2O, respectivamente) à hemolinfa da aranha marrom (478 mOsm/kg H2O). Ainda, com relação aos agentes fixadores, a combinação do glutaraldeído e paraformaldeído levou a uma melhor preservação das células. Para outras espécies de aranhas, a osmolalidade da hemolinfa deve ser medida e considerada, mas as fórmulas acima citadas podem ser testadas, com chance de sucesso.

Evaluation of fixative solutions for ultrastructural analysis of brown spider Loxosceles intermedia (Araneae: Sicariidae) tissues.

In view of the widely varying compositions of fixative solutions used for studying spiders, five different fixative formulas were tested for fixing male brown-spider (Loxosceles intermedia) gonad tissues. The brown spider represents a public health problem in Curitiba (Paraná State, Brazil). Morphological study of its gonads may aid in understanding the reproductive strategies of this species, and possibly in developing a reproduction control program. The fixatives tested contained glutaraldehyde alone or combined with paraformaldehyde, and the buffers cacodylate or phosphate, with or without the addition of sucrose or sodium chloride as osmolytes. Those containing 2.5% glutaraldehyde and 2% paraformaldehyde in 100 mM phosphate buffer with 200 mM sucrose, or in 200 mM sodium cacodylate, satisfactorily preserved mitochondria, the Golgi apparatus, and the membranes in general. These formulas were nearly isosmotic (439 mOsm/kg H2O and 455 mOsm/kg H2O respectively) to brown spider hemolymph (478 mOsm/kg H2O). With respective to the fixative agents, a glutaraldehyde-paraformaldehyde combination resulted in optimal fixation of Loxosceles intermedia cells. For other species of spiders, hemolymph osmolality should be considered, but the fixative formulas cited above would also probably yield good results.

Ionic regulation in aglomerular tropical estuarine pufferfishes submitted to sea water dilution.

Two common tropical estuarine pufferfishes were used in this study. The main species was Sphoeroides testudineus Linnaeus, 1758, a very abundant species in the estuaries of Paranaguá Bay (Paraná, Brazil), found in waters of salinity between 0 per thousand (tidal creeks) and 34 per thousand (tidal plains). The second species was S. greeleyi Gilbert, 1900, a species limited in distribution to an area of higher salinity ( approximately 30 per thousand) than S. testudineus. The present work thus aimed at evaluating the capacity of ionic regulation of both species of pufferfishes when submitted to salinity decrease, relating the results with both species' distribution in nature. Ion regulation curves for sodium (Na(+)), chloride (Cl(-)), and magnesium (Mg(2+)) ions after 6 h and 15 days of exposure of the abundant S. testudineus to the salinities of 30 per thousand, 20 per thousand, 10 per thousand, and 5 per thousand were elaborated, as well as for Cl(-) and Mg(2+) after 6 h and 15 days of exposure of both species to the extreme salinities of 35 per thousand and 5 per thousand. Both species kept their plasma Cl(-) ( approximately 120-160 mM), and Mg(2+) ( approximately 1.3 mM) concentrations stable, as did S. testudineus for Na(+) ( approximately 130 mM). Na(+) (measured only for S. testudineus) and Cl(-) were either hyper-regulated (in 5 per thousand) or kept iso-ionic ( approximately 7-10 per thousand), but more often hypo-regulated (20-35 per thousand). In contrast, Mg(2+) was strongly hypo-regulated in all salinities. According to their distribution records in nature, S. greeleyi was less able to tolerate strong sea water dilution, showing mortality after 5 days in 5 per thousand water. These estuarine pufferfishes are thus efficient regulators of plasma ionic concentrations in diluted sea water, as expected from their occupation of estuaries. The experiments have supported the distribution records of both species in the estuarine complex and resident estuarine species were thus characterized with respect to their osmoregulatory capacities.

[Tuberculosis associated with AIDS: the situation in a Northeastern region of Brazil]. / Tuberculose associada à AIDS: situação de região do Nordeste brasileiro.

INTRODUCTION: The main aspects of the HIV and Mycobacterium tuberculosis coinfection in the adult patients attended by the main reference hospital for infectious diseases in the State of Ceará, Brazil, responsible for the notification of 89.3% of the cases registered in the state between 1986 and 1992 were investigated. METHODOLOGY: Data were collected from the case histories of patients of more than 15 years of age with a diagnosis of AIDS, attended in a state reference hospital in Northeastern Brazil. The analysis of the data obeys the criteria of the Ministry of Health for the definition of this disease. RESULTS: Tuberculosis had been present in 30.6% of the patients studied (151/493) and it was diagnosed by the first year after the AIDS diagnosis in 76.8% of the cases. The proportion of AIDS cases with tuberculosis is significantly greater (p = 0.032) among men (94.7%) than among women (88.3%). An increased linear trend in the proportion of cases with tuberculosis was noticed in the AIDS cases according to the decrease in level of schooling (p < 0.001). The direct baciloscopy of the sputum although considered a high priority exam, was made in only 72.9% of the patients, presenting positive results in 28.3% of these. The extrapulmonary form was detected in 23.9% of the cases and, among those, the miliary form in 25% and the meningitis in 16.7%. These results differ in a significant way (p < 0.001 for all) from the cases with tuberculosis without HIV infection in adults registered in the state in 1992 (9.8% extrapulmonary, 7.2% miliary and 3.3% meningitis). In most cases, death occurred in the presence of tuberculosis (52.3%), and only 10.6% managed to recover from the tuberculosis. CONCLUSIONS: The premature development of tuberculosis in AIDS patients, the presence of a high percentage of extrapulmonary forms and the high lethality are indicator that the prevention and control measures of these two pathologies cannot be considered separately in this State.

Electrodiffusive transport of Mg across renal membrane vesicles of the rainbow trout Oncorhynchus mykiss.

The mechanism of tubular Mg transport was investigated in membrane vesicles (MV) of trout kidneys prepared by differential centrifugation with sucrose. MV consisted largely of brush-border membranes, as indicated by high enrichments of brush-border membrane enzymes. Although measured transport of 28 Mg included a binding component, most membrane transport was into or out of an osmotically active space. There was no evidence for amiloride-sensitive Na/Mg exchange, nor was Mg uptake affected by the carboxyl group reagents trimethyloxonium tetrafluoroborate, glycine methyl ester.HCl-1-ethyl-3- (3-dimethyl-aminopropyl)carbodiimide, and N,N'-dicyclohexyl carbodiimide or the Ca channel modulators D-600, verapamil, diltiazem, and BAY K 8644. However, Mg uptake increased in the presence of inside-negative voltages generated by inward gradients of the permeant anions NO3, SCN, and Cl or by outward gradients of K (plus valinomycin). Alkaline-earth cations displayed the selectivity sequence VII (Mg > Ca > Sr > Ba) for cis-inhibition of 28 Mg uptake. Mg efflux was trans-inhibited by La and Gd, and Mg uptake was cis-inhibited by Mn. The sulfhydryl group reagents p- chloromercuribenzoic acid and p-chloromercuriphenylsulfonate stimulated Mg uptake and efflux. These results reveal an electrodiffusive pathway for Mg transport in trout renal MV.

Neuroendocrine control of osmotic regulation in the freshwater shrimp Macrobrachium olfersii (Wiegmann) (Crustacea, decapoda): free amino acid concentrations in the hemolymph.

The participation of neuroendocrine factors present within the central nervous system in the regulation of hemolymph free amino acid (FAA) concentrations was examined in the freshwater shrimp Macrobrachium olfersii. Test shrimps were injected intramuscularly with homogenates prepared from the eyestalks (ES), ventral nerve cord (VNC), supraesophageal (SEG), or thoracic ganglia (TG) of donor shrimps previously exposed for 6 hr to a high-salinity medium (HSM, 21% salinity). After injection of the homogenate, the shrimps were maintained for up to 6 hr in either freshwater (FW) or HSM. Hemolymph was sampled by cardiac puncture and prepared for reverse phase HPLC, derivatizing the FAA with phenylisothiocyanate. An FAA profile was determined and the [FAA]:[Cl-] ratios for the four FAA present in highest concentration (Gly, Arg, Ala, and Pro for ES and VNC experiments; Glu, Leu, Ala, and Val for SEG and TG experiments) were obtained. Nonparametric analyses revealed specific, notable effects resulting from homogenate injection, e.g., ES homogenate increased [Pro]/[Cl-] ratios in FW-exposed shrimps; SEG homogenate increased [Glu]/[Cl-] and [Val]/[Cl-] ratios in HSM-exposed shrimps; and TG homogenate increased [FAA]/[Cl-] ratios for Glu, Leu, Ala, and Val in HSM-exposed shrimps. Total FAA concentrations decreased after exposure of the shrimps to HSM but were increased by the injection of ES homogenate in FW-exposed shrimps and by TG homogenate in HSM-exposed shrimps. The total [FAA]/[Cl-] ratio was also increased by TG homogenate in HSM-exposed animals. There were no clear effects on [Cl-] alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Na-D-glucose cotransport in renal brush-border membrane vesicles of an early teleost (Oncorhynchus mykiss).

Brush-border membrane vesicles (BBMV) enriched with alkaline phosphatase (8.1-fold) and gamma-glutamyl transpeptidase (11.5-fold) were prepared from the rainbow trout kidney. D-[3H]glucose uptake was stimulated by inward Na gradients but not by K, choline, Li, N-methyl-D-glucamine, or mannitol gradients. Na-dependent glucose uptake displayed overshoot in voltage-polarized vesicles (VPV; negative inside) but not in short-circuited vesicles (SCV). Recognition of carbons 2 and 3 of the glucopyranose ring was essential for glucose uptake. Phlorizin inhibited Na-dependent D-glucose uptake with an inhibition constant of 11.4 microM. The Michaelis-Menten constant of glucose was 0.58 mM in VPV and increased to 1.49 mM in SCV, whereas that for sodium was 193 mM in VPV and similar in SCV. Maximum velocity of Na was reduced in SCV. The Hill coefficient was 1 for both Na and glucose in VPV and SCV. Our studies indicate a single Na-D-glucose cotransporter that transports Na and glucose with a 1:1 stoichiometry and voltage-dependent kinetics. The transporter shares functional properties with both mammalian transporters SGLT1 and SGLT2.

Buoyant density of neutrophils in patients with juvenile rheumatoid arthritis

A densidade de neutrófilos polimorfonucleares (PMN) está diminuída em doenças difusas do colágeno, provavelmente devido a interaçoes com imunocomplexos, complemento ou outros mediadoes solúveis. Conseqüentemente, as suspensoes de linfócitos obtidas de pacientes com doenças do colágeno, mediante centrifugaçao de leucócitos do sangue periférico em gradiente de densidade de Ficoll-Hypaque (FH), d = 1,076, estao "contaminadas" com PMN. Estudamos 30 crianças com artrite reumatóide juvenil (ARJ) e encontramos aumento significante (p<0,01) no número de PMN nas suspensoes celulares de interfase FH em relaçao aos controles normais, apenas para a forma poliarticular. Esta diferença foi ainda maior quando se comparou a proporçao entre linfócitos e PMN. O soro de pacientes com ARJ poliarticular induziu in vitro diminuiçao da densidade de PMN de indivíduos normais. A diferença encontrada na densidade de PMN entre as formas pauci e poliarticular da ARJ pode estar relacionada a mecanismos fisiopatológicos distintos envolvidos em cada uma das formas dessa doença

Epithelial transport of magnesium in the kidney of fish.

That the kidneys of marine fish have powerful renal mechanisms for the excretion of magnesium (Mg) from the body has been known since the early 1930s, but it took another 40 years before the first renal Mg transport model was suggested by Natochin and Gusev. Since rates of net renal sodium (Na) reabsorption were closely correlated with rates of net renal Mg secretion in scorpion fish, Natochin and Gusev proposed tubular Na/Mg exchange transport. However, confirmation of Na/Mg exchange in other fish kidneys has been elusive. Detailed renal clearance studies in sea water rainbow trout have shown that bladder reabsorption of Na and water, the process which concentrates Mg in the bladder, accounts for much of Natochin's original observation. Nevertheless, studies of isolated perfused proximal tubules of the flounder and killifish do show inverse relationships between the concentrations of Na and Mg in the tubule lumen, consistent with Na/Mg exchange. Unfortunately, large paracellular Na permeabilities in renal proximal tubules do not clarify whether paracellular Na fluxes of Na/Mg exchange transport across the brush border membrane are responsible for generating inverse concentrations of Na and Mg in the tubule lumen. These uncertainties have led the authors to their present use of brush border membrane vesicles to look for evidence of Na/Mg exchange transport.

Involvement of the central nervous system in neuroendocrine mediation of osmotic and ionic regulation in the freshwater shrimp Macrobrachium olfersii (Crustacea, Decapoda).

The presence of putative neurofactors within the central nervous system, i.e., the eyestalks (ES), ventral nerve cord (VNC), and supra-esophageal (SEG) and thoracic ganglia (TG), which are involved in osmotic and ionic regulation, was investigated in the euryhaline, freshwater shrimp, Macrobrachium olfersii. Homogenates were prepared from shrimps exposed for 6 hr to a high salinity medium (HSM, 21/1000 S) and were injected into shrimps subsequently maintained for 1, 3, or 6 hr in freshwater (FW, 0/1000 S) or HSM. Osmolality and sodium, chloride, and calcium concentrations were determined in single hemolymph samples removed at each time interval. Heart rates and wet weights were measured before and after experimental treatments. Exposure to HSM increased [Na+] and [Cl-] and heart rate. Injection of ES homogenate increased osmolality, [Na+] and [Cl-], and wet weight in shrimps maintained in FW; VNC homogenate also increased hemolymph [Cl-] in shrimps maintained in FW after injection, but reduced heart rate in shrimps subsequently exposed to HSM. Injection of TG homogenate reduced heart rate to a lesser extent in shrimps maintained in FW. Hemolymph [Ca2+] was not altered by homogenate injection. The exposure period of 6 hr to HSM appears to result in the accumulation of factors within the central nervous system that regulate the osmotic and ionic concentrations of the hemolymph, in addition to exerting antidiuretic and cardio-depressor actions. The coordinated action of these factors is intimately involved in the hyporegulatory processes that permit the survival of M. olfersii in media of elevated salinity.

[Rheumatic manifestations of acquired immunodeficiency syndrome (AIDS)]. / Manifestações reumáticas na síndrome de imunodeficiência adquirida (AIDS).

120 AIDS patients (mean age 33 +/- 9 years, 108 males) were evaluated regarding rheumatic manifestations. According to CDC's classification, 18.3% belonged to group II, 28.3% to group III, and 53.4% to group IV. Arthralgia was present in 33 patients (27.5%), and in only 8 could be associated with infections other than HIV (5 cases of tuberculosis, 3 P. carinii, and 1 gonococcal infection). Incidence of arthralgia was equal in either sex. Arthritis was present in 8 patients, 2 of them with Reiter's syndrome. In 6 patients arthralgia was the first symptom (3 with arthritis) before AIDS diagnosis. There was a higher incidence of dry mouth, dry eyes, and muscular complaints in patients with arthralgia than in patients without arthralgia. Antinuclear antibodies and rheumatoid factor were absent in the serum of the patients studied. Arthritic manifestations possibly occur in AIDS, even in patients without other clinical manifestations, as a reactive state to HIV infection.

Delayed hypersensitivity skin tests in prognosis of human immunodeficiency virus infection.

Delayed hypersensitivity skin tests (DHST) with recall antigens were investigated as prognostic markers in five different approaches. In the first study, 42 acquired immunodeficiency syndrome (AIDS) patients (IVb, IVcl, IVd, and IVe; MMWR 35:334-339, 1986) 26 AIDS-related complex (ARC) patients (IVa and IVc2), and 98 asymptomatic patients (II and III) were evaluated with candidin, tricophytin, PPD and streptokinase-streptodornase. In the second study, 10 patients (II and III) were evaluated sequentially with the same antigens. In the third, 45 patients with at least two positive skin tests ("reactors") were followed for one year and evaluated every 6 months with the same antigens. In the fourth, 16 "reactors" were followed and evaluated every 3 months with the same antigens. We measured the interval from the time at which patients first presented with only one or no positive DHST until the development of ARC or AIDS. In the last study, the correlation between absolute number of CD4+ lymphocytes and the number of DHST was studied in 151 patients. We found that the decrease in reactiveness to DHST correlated directly with the progression to AIDS, demonstrating the usefulness of this simple procedure as a valid prognostic marker.

Evaluation of ketotifen in the prophylactic treatment of bronchial asthma in children.

The usefulness of ketotifen for reducing bronchial hypperreactivity, acting as a prophylactic drug, was studied in children with extrinsic asthma. In an open-label phase (phase A), 2.267 asthmatic children received ketotifen orally at a dosage of 1 mg twice daily for three months. Another study, double-blind, placebo-controlled (phase B), enrolled 75 children (38 ketotifen; 37 placebo); they received the same dosage of ketotifen or placebo for five months, after a one-month placebo baseline control period. A progressive improvement in the severity of asthmatic attacks was seen throughout the three-month period (phase A). At the end of the trial, the percentage of patients with moderate or intense attacks was reduced from 77% at baseline to 18%. Significant reductions were noted in the duration and frequency of asthma attacks at each monthly evaluation. The need for the use of symptomatic medication declined significantly during the 3-month trial. In the five-month, double-blind, placebo--controlled study (phase B), significant reduction in the frequency of dyspnea was noted at the end of the trial; in the placebo group, this frequency increased. This clinical observation was confirmed by the mean consumption of sympathomatic drugs during the five-month treatment period: it declined in the ketotifen--treated patients but increased in those who received placebo. The low incidence side effects attests to the safety of ketotifen in children. Our results demonstrate that ketotifen is both safe and effective for prophylactic use in asthmatic children.