Quality control in the different stages of producing red blood cell concentrate from dogs / Controle de qualidade nas diferentes etapas de produção do concentrado de hemácias em cães

The objective of this study was to perform a quality control assessment of red blood cells after standardization of the blood production stages. For this purpose, separation of the blood components to obtain red blood cells, the storage of the blood packets and an evaluation of blood quality were performed. The mean (± SD) volume, globular volume, hemoglobin and hemolysis percentage of the red blood cell concentrate were 299.77±30.08mL, 60.87±2.60%, 20.57±0.93g/DL and 0.09±0.07%, respectively. The means (± SD) of the volume, globular volume, total hemoglobin percentage of hemolysis and hemoglobin per unit of packed red blood cells after the storage period (8.83±6.73 days) were 57.55±3.01%, 20.30±0.89 0, 20±0.12%, and 60.90±7.65. The red blood cell packets were within the parameters of quality control established by Health Ministry legislation in humans and allow us to conclude that the standardization of blood production stages involves the selection of donors until the end of storage and is necessary to produce quality red blood cells. Quality control aims to find possible flaws in the procedures to be repaired, increasing transfusion safety.(AU)

O objetivo deste estudo foi realizar o controle de qualidade do concentrado de hemácias após a padronização das etapas de produção do sangue. Para isso, realizou-se separação de hemocomponentes para obtenção de concentrado de hemácias, armazenamento das bolsas de sangue e avaliação da qualidade delas. Os valores médios (± DP) do volume, do volume globular, da hemoglobina e do percentual de hemólise do concentrado de hemácias foram: 299,77±30,08mL, 60,87±2,60%, 20,57±0,93g/DL e 0,09±0,07%, respectivamente. Os valores médios (± DP) do volume globular, da hemoglobina total percentual de hemólise e da hemoglobina por unidade de concentrado de hemácias após o período de armazenamento (8,83±6,73 dias) foram: 57,55±3,01%, 20,30±0,89 0,20±0,12%, 60,90±7,65. As bolsas de concentrado de hemácias ficaram dentro dos parâmetros de controle de qualidade estabelecidos pela legislação do Ministério da Saúde em humanos e possibilitaram concluir que a padronização das etapas de produção do sangue envolve desde a seleção de doadores até o final do armazenamento e é necessária para produzir concentrado de hemácias com qualidade. O controle de qualidade visa encontrar possíveis falhas nos procedimentos para que estas possam ser reparadas, aumentando, assim, a segurança transfusional.(AU)

The Epidemiological Importance of Bats in the Transmission of Rabies to Dogs and Cats in the State of São Paulo, Brazil, Between 2005 and 2014.

In Brazil, rabies control in dogs and cats was pioneered by the state of São Paulo with the adoption of the Pan American Health Organization recommendations for prophylaxis and control, which led to a reduction in rabies cases from 1994 onwards. As a result of these measures, the rabies virus (RABV) genetic lineage associated with dogs has not been found in the state since 1998, and all the cases in domestic animals reported since then have been caused by bat-associated lineages of RABV. In the light of this, this study sought to investigate rabies cases in dogs and cats in the state of São Paulo between 2005 and 2014 and identify the associated transmission cycles by characterizing the RABV lineages responsible for these cases. Nine samples from dogs (n = 5) and from cats (n = 4) were collected between 2005 and 2014. The tenth animal, a rabid cat, was analysed by a different laboratory. The N gene nucleotide sequences obtained were analysed with the neighbor-joining algorithm and Kimura 2-parameter model using the MEGA 6 program. Phylogenetic analysis revealed that the genetic lineages identified in all the samples were those circulating in Brazilian bats. The findings of this study demonstrate that bats play an important role in the transmission of rabies to domestic animals in São Paulo state and that emphasis should be placed on the implementation of public policies to support surveillance of chiropterans for rabies.

Anterior and posterior complexes: a step towards improving neurosonographic screening of midline and cortical anomalies.

OBJECTIVE: To describe the anatomical structures that form the anterior (AC) and posterior (PC) complexes of the fetal brain and to categorize their anomalies in fetuses with cerebral abnormalities. METHODS: We analyzed retrospectively volume datasets from 100 normal fetuses between 20 and 30 weeks' gestation. On the axial transventricular plane, our analysis of the AC included the interhemispheric fissure (IHF), the callosal sulcus (CS), the genu of the corpus callosum (CC), the cavum septi pellucidi (CSP) and the anterior horns (AH) of the lateral ventricles. The PC included the splenium of the CC, the medial wall of the lateral ventricles, the CS and the parieto-occipital fissure (POF). We then categorized AC/PC findings in 32 fetuses with agenesis of the septi pellucidi, schizencephaly, callosal dysgenesis, cortical malformation and hypoxic-ischemic brain injury. RESULTS: The structures forming the AC and PC were visible in 100% and 92%, respectively, of normal cases. In the AC, the CSP was square-shaped in 73% of cases and it was triangular in 27%; the AH was comma-shaped in 92% of cases and triangular in the remainder. In the PC, the splenium of the CC interrupted and bridged the midline and was delimited posteriorly by the CS and the IHF. The POF was visible posteriorly. We categorized AC and PC abnormalities according to the main deviation from normality in their anatomical structures. The AC was abnormal in 30/32 cases and the PC was abnormal in 16/32 cases. In the two cases with normal AC, the PC was abnormal. CONCLUSION: Normal appearance of AC and PC seems to be a strong indicator of fetal central nervous system normality. Morphological abnormalities in both complexes are robust markers of midline defects, but not exclusively so. The majority of fetuses with cortical malformations showed a defect in the AC.

A case report and literature overview: Abiotrophia defectiva aortic valve endocarditis in developing countries.

A fatal case of aortic valve endocarditis due to Abiotrophia defectiva was reported in Brazil. An overview of cases of endocarditis and other human infections related to A. defectiva in developing countries was also accomplished.

Haplotype distribution of five nuclear genes based on network genealogies and Bayesian inference indicates that Trypanosoma cruzi hybrid strains are polyphyletic.

Chagas disease is still a major public health problem in Latin America. Its causative agent, Trypanosoma cruzi, can be typed into three major groups, T. cruzi I, T. cruzi II and hybrids. These groups each have specific genetic characteristics and epidemiological distributions. Several highly virulent strains are found in the hybrid group; their origin is still a matter of debate. The null hypothesis is that the hybrids are of polyphyletic origin, evolving independently from various hybridization events. The alternative hypothesis is that all extant hybrid strains originated from a single hybridization event. We sequenced both alleles of genes encoding EF-1alpha, actin and SSU rDNA of 26 T. cruzi strains and DHFR-TS and TR of 12 strains. This information was used for network genealogy analysis and Bayesian phylogenies. We found T. cruzi I and T. cruzi II to be monophyletic and that all hybrids had different combinations of T. cruzi I and T. cruzi II haplotypes plus hybrid-specific haplotypes. Bootstrap values (networks) and posterior probabilities (Bayesian phylogenies) of clades supporting the monophyly of hybrids were far below the 95% confidence interval, indicating that the hybrid group is polyphyletic. We hypothesize that T. cruzi I and T. cruzi II are two different species and that the hybrids are extant representatives of independent events of genome hybridization, which sporadically have sufficient fitness to impact on the epidemiology of Chagas disease.

Contagem de reticulócitos de cães saudáveis ou anêmicos pela citometria de fluxo / Count of reticulocyte counts of healthy or anemic dogs by flow cytometry

Compararam-se os resultados da contagem de reticulócitos pela microscopia de luz e pelo método da citometria de fluxo em 25 cães saudáveis (controle), 60 cães com anemia regenerativa e 40 com anemia arregenerativa. Houve diferença nas contagens absolutas obtidas pela microscopia de luz e pela citometria de fluxo nos três grupos estudados. A contagem de reticulócitos foi mais alta pela citometria de fluxo que a contagem pela microscopia de luz, mostrando ser um método mais sensível, simples e seguro para a quantificação de reticulócitos.

Counts of reticulocytes using both the light microscopy and flow cytometry (FC) methods in 25 healthy control dogs, 60 dogs with regenerative anemia, and 40 dogs with non-regenerative anemia were compared. The absolute counts were submitted to the paired t-Student test, which determined significant differences (P<0.0001) between those methods in the three studied groups. Counts of retyculocytes were higher under flow cytometry, which proved to be a more sensitive method. Flow cytometry is a simple and reliable method for the quantification of reticulocytes.

[Quantitative volumetric analysis of the hippocampus, amygdala and entorhinal cortex: normative database for the adult Portuguese population]. / Análisis volumétrico mesiotemporal: valores normativos del hipocampo, la amígdala y el córtex entorrinal en la población adulta portuguesa.

INTRODUCTION: Atrophy of the hippocampus, amygdala and entorhinal cortex can be found in neurodegenerative diseases, head trauma and epilepsy and are expressed by means of volume reductions. The ability to detect these changes quantitatively depends on accurate comparisons with normative databases. AIM: To present standard magnetic resonance imaging (MRI) volumes of the mesio-temporal lobe structures and an objective statistical methodology for contrasting pathological states. SUBJECTS AND METHODS: Volumes of the right and left hippocampi, amygdalae and entorhinal cortex were measured from MRI in 34 right-handed healthy volunteers, aged 19-52 years. Data were normalized for the individual variation in total intracranial volume. Reproducibility was confirmed by intra/inter-observer tests. The statistical analyses included asymmetry comparisons, correlations between volumes and tests to assess the influence of age, gender and general morphometry (body mass index and height). For each volume, we further defined a normative interval by means of 99% confidence ellipses, accordingly to Hotteling's method. RESULTS: Right-left asymmetry in the volumes of the hippocampus and entorhinal cortex was a normal finding. Structures located in the right hemisphere were larger than the left by a small but statistically significant amount. No asymmetry was found in the amygdala. There was no correlation in-between these volumes. Gender differences were exclusively noted in the absolute amygdala volumes (male > female) but were eliminated by the normalization procedure. No effect of age or morphometry was seen in the absolute or normalized volumes (except for a milder correlation between hippocampal volumes and height). Confidence ellipses were built for every structure and provided a precise reading of the data. Particularly, it allowed for a clear distinction of pathological asymmetries and bilateral cases. CONCLUSION: These normative volumes serve as a reference for the assessment of pathologic groups within similar age-range. The use of a single graphic representation simplifies the clinical interpretation and enhances the precision of the results.

Análisis volumétrico mesiotemporal: valores normativos del hipocampo, la amígdala y el córtex entorrinal en la población adulta portuguesa / Quantitative volumetric analysis of the hippocampus, amygdala and entorhinal cortex: normative database for the adult portuguese population

Introducción. La atrofia selectiva del hipocampo, la amígdala y el córtex entorrinal se puede detectar en enfermedades neurodegenerativas, traumatismo y epilepsia. La magnitud de la lesión se puede cuantificar mediante técnicas volumétricas y comparando con valores de individuos sanos. Objetivo. Determinar los volúmenes normativos de las estructuras mesio temporales y proponer la metodología estadística objetiva para el análisis de casos patológicos. Sujetos y métodos. Las cuantificaciones de los volúmenes delos hipocampos, los complejos amigdalinos y las cortezas entorrinales se realizaron a partir de los exámenes de resonancia magnética de 34 individuos sanos, diestros y con edades entre 19 y 52años. Los valores se normalizaron para las diferencias del volumen intracraneal de cada individuo. Se realizaron tests intra/interobservador para determinar la reproducibilidad. Los análisis estadísticos incluyeron las comparaciones de asimetrías, correlaciones entre volúmenes y test para cotejar la influencia de la edad, el sexo y la morfometría general (índice de la masa corporal y la altura).Para cada estatura definimos un intervalo normativo según el método de Hotteling de elipses de confianza (99%). Resultados. Los volúmenes del hipocampo y del córtex entorrinal derechos son mayores que los volúmenes izquierdos. El valor de la asimetría es pequeño, pero significativo. Los volúmenes de la amígdala no mostraron asimetrías. No se verificaron correlaciones entre volúmenes de estructuras diferentes. Las diferencias relacionadas con el sexo apenas existen en los volúmenes absolutos de la amígdala (hombre >mujer). Sin embargo, tras la normalización, esas diferencias se eliminan. No se comprobó ningún efecto de la edad o la morfometría (a excepción de una correlación moderada entre la altura y los volúmenes del hipocampo). Las elipses de confianza de los valores normales proporcionaron una lectura precisa de los datos. En particular, permiten valorar con seguridad las asimetrías patológicas y los casos con lesión bilateral. Conclusión. Estos valores normativos sirven de referencia para los estudios de casos patológicos a partir del momento en que se incluyen en el mismo grupo de edad. El uso de una representación gráfica única basada en las elipses de confianza al 99% simplifica la interpretación clínica y mejora la precisión de los resultados (AU)

Introduction. Atrophy of the hippocampus, amygdala and entorhinal cortex can be found in neurodegenerative diseases, head trauma and epilepsy and are expressed by means of volume reductions. The ability to detect these changes quantitatively depends on accurate comparisons with normative databases. Aim. To present standard magnetic resonance imaging (MRI) volumes of the mesio-temporal lobe structures and an objective statistical methodology for contrasting pathological states. Subjects and methods. Volumes of the right and left hippocampi, amygdalae and entorhinal cortex were measured from MRI in 34 right-handed healthy volunteers, aged 19-52 years. Data were normalized for the individual variation in total intracranial volume. Reproducibility was confirmed by intra/inter-observer tests. The statistical analyses included asymmetry comparisons, correlations between volumes and tests to assess the influence of age, gender and general morphometry (body mass index and height). For each volume, we further defined a normative interval by means of 99%confidence ellipses, accordingly to Hoteling's method. Results. Right-left asymmetry in the volumes of the hippocampus and entorhinal cortex was a normal finding. Structures located in the right hemisphere were larger than the left by a small but statistically significant amount. No asymmetry was found in the amygdala. There was no correlation in-between these volumes. Gender differences were exclusively noted in the absolute amygdala volumes (male > female) but were eliminated by the normalization procedure. No effect of age or morphometry was seen in the absolute or normalized volumes (except for a milder correlation between hippocampal volumes and height). Confidence ellipses were built for every structure and provided a precise reading of the data. Particularly, it allowed for a clear distinction of pathological asymmetries and bilateral cases. Conclusion. These normative volumes serve as a reference for the assessment of pathologic groups within similar age-range. The use of a single graphic representation simplifies the clinical interpretation and enhances the precision of the results (AU)

Apparent diffusion coefficient mapping of the hippocampus and the amygdala in pharmaco-resistant temporal lobe epilepsy.

BACKGROUND AND PURPOSE: The purpose of this study is to determine whether interictal apparent diffusion coefficients (ADC) provide a robust means for detecting amygdalo-hippocampal abnormalities in adult patients with localization-related chronic temporal lobe epilepsy (TLE) undergoing presurgical evaluation. METHODS: Fifty-five patients and 20 age-matched controls were studied with hippocampal and amygdala ADC maps (HADC and AMYADC), volumes (HCVOL, AMYVOL), T2 relaxometry (HCT2, AMYT2), and hippocampal N-acetylaspartate to choline and creatine/phosphocreatine ratios (HCSI). Mean values and 99% confidence ellipses were computed for the groups. Individual ADC mapping was compared with electroencephalography (EEG) data and further correlated with the quantitative MR measures and with the age at onset and duration of TLE. Moreover, we evaluated the association and the predictive value of HADC and AMYADC with respect to the surgical outcome in a subgroup of patients (n = 21) operated on the side of maximal EEG lateralization and with MR imaging criteria for hippocampal sclerosis, 71% of which became seizure-free. RESULTS: In controls, there was no relation between ADC values and age, sex, or right-left asymmetries. In TLE groups with right (n = 29) or left epileptogenic foci (n = 26), group comparisons showed that ADC mapping detected changes ipsilateral to the focus in the hippocampus (P < .01) and the amygdala (P < .05), accordingly with the volumes, T2 maps, and HCSI. Significant Pearson correlations (2-tailed) were obtained between ADC maps and the volume of the hippocampus (r = -0.64) and of the amygdala (r = -0.55; both P < .01), T2 (r = 0.70, r = 0.29; both P < .01), but not with HCSI. Individual ADC analysis showed ipsilateral pathology in 82% of cases (hippocampus) and 35% (amygdala) and included a moderate association between ipsilateral HADC and AMYADC (r = 0.54; P < .01). Bilateral abnormalities were found in 7% (hippocampus) and 5% (amygdala) of cases. Except for HCSI and the amygdala data, there were significant correlations between the asymmetry indices and the duration of epilepsy (HADC: r = 0.42; HCT2: r = 0.50; HCVOL: r = 0.35; all P < .01). Age at onset was associated only with ipsilateral HADC (r = 0.35; P < .01) and HCVOL and HCT2 (both P < .05). The association with postsurgical successes was characteristic of HADC (Fisher exact test, 2-tailed: P =.031; Spearman correlation: r(s) = -0.75; P = .0002), but not AMYADC. The predictive value regarding a favorable outcome was 0.87 (odds ratio 26; 95% confidence interval 2.33-38.86). As determined by regression models, both larger ipsilateral HADCs and asymmetry indices predicted surgical success. CONCLUSION: Interictal ADC mapping lateralizes efficiently the lesion side in accordance with the EEG data and might be used to study the differential regional aspects of mesio-temporal sclerosis. HADC--not AMYADC--maps discriminate favorably postoperative outcome and can be added to the multidisciplinary evaluation workout of pharmacoresistant TLE patients.

Tratamento de insuficiência cardíaca com benazepril em cães com cardiomiopatia dilatada e endocardiose / Treatment of congestive heart failure with benazepril in dogs with dilated cardiomyopathy and endocardiosis

Foram avaliados os efeitos clínicos do benazepril, um inibidor da enzima de conversão da angiotensina de ação prolongada, em cães com insuficiência cardíaca congestiva (ICC) secundária à endocardiose de mitral ou cardiomiopatia dilatada. O medicamento foi administrado na dose de 0,25 a 0,5mg/kg/dia. Diuréticos, digitálicos e fármacos antiarrítmicos froam usados de acordo com a necessidade de cada paciente. Exames físico, radiográfico e eletrocardiográfico foram realizados nos dias 0, 7, 28 e 56. A gasometria arterial e a bioquímica sérica foram avaliadas nos dias 0 e 56. Os sinais de dispnéia e o estado geral dos pacientes melhoraram em todos os cães após o início do tratamento. Houve diminuição na frequência da tosse e não houve alterações no eletrocardiograma, exceto pela diminuição na amplitude e na duração da onda P. Nenhum efeito colateral foi observado. Conclui-se que o benazepril é um inibidor da enzima de conversão da angiotensina, eficaz e bem tolerado no tratamento da ICC no cão.

Assessment of the preferred scout sagittal orientation for temporal lobe imaging with magnetic resonance.

Oblique magnetic resonance imaging of the temporal lobe (tilted orientation) requires a stable reference line with minimum variability. In the clinical setting, where several observers carry out examination of the patients, there is a need to assure minimum inter-observer variability, in order to obtain comparable tilted anatomical planes. This is particularly relevant when performing quantitative imaging (qMRI) of the hippocampus, amygdala and para-hippocampal cortices. In this study, eight experienced observers tested the stability of four sagittal reference lines by manually tracing the posterior commissure-obex (PC-OB) line, the line tangential to the anterior surface of the pons at its most convex point and the lines orthogonal to the main axis of both hippocampi, in ten exams of healthy subjects. The stability of the tracing was assessed by comparing the inter-observer variability expressed by the variances of the measurements. The observers' performance was assessed by comparing the precision of the tracing for each line. We tested the results statistically using Bartlett's test (analysis of the variances of the four lines) followed by Fischer-Snedecor (in order to compare the two lines that had the smallest variance). The PC-OB line and the line tangential to the anterior surface of the pons had smaller inter-observer variances than the orthogonal lines (p < 0.01). In addition, the variance of the PC-OB line was smaller than that of the line tangential to the pons (p < 0.01). There were no significant intra-observer differences in the precision of tracing of any of the lines. We show quantitatively that the PC-OB line is the scout reference that yields the smallest inter-observer variance. Thus, this line should be preferred to improve the reproducibility of temporal lobe imaging while performing tilted coronal and axial sequences, to make quantitative assessments of the hippocampus, amygdala and para-hippocampal cortices.

Lung tissue mechanics in the early stages of induced paracoccidioidomycosis in rats

Pulmonary dysfunction represents the most important cause of death in patients with paracoccidioidomycosis (PBM). In order to investigate the functional changes of the lungs in the early stages of PBM, a model of benign disease was developed by intratracheal challenge of 12-week old isogenic Wistar rats with 1 x 10(6) yeast forms of Paracoccidioides brasiliensis. Animals were studied 30 and 60 days after infection, when fully developed granulomas were demonstrable in the lungs. Measurements of airway reistance, lung elastance and tissue hysteresis were made during sinusoidal deformations (100 breaths/min, tidal volume = 2 ml) with direct measurement of alveolar pressure using the alveolar capsule technique. Infection caused a significant increase in hysteresis (infected: 1.69, N = 13; control: 1.13, N=12,P = 0.024, ANOVA), with no alterations in airway resitance or lung elastance. Histopathological analysis revealed the presence of fully developed granulomas located in the axial compartment of the lung interstitial space. These results suggest that alterations of tissue mechanics represent an early event in experimental PBM.

Pulmonary emphysema induced by passive smoking: an experimental study in rats

We describe a short time model for inducing experimental emphysema in rats chronic tobacco smoke inhalation. Three groups of male Wistar rats (6 months old) were studied: controls (N = 8), rats intoxicated for 45 days (s-45, N = 7) or for 90 days (s-90, N = 8). The exposed animals were intoxicated 3 times a day (10 cigarettes per exposure period), 5 days a week. Pulmonary damage was assessed by means of functional tests and quantitative pathological examination of the airways and lung parenchyma. The s-45 and s-90 animals were similar in terms of functional residual capacity (FRC) corrected for body weight (FRC/kg) but both groups of smoking rats exhibited significantly higher FRC/kg values than the controls (s-45=6.33; s-90=6.46; controls=3.78;P<0.05). When the two groups of smoking rats were pooled together and compared to controls, they showed decreased lung elastance (1.6 vs 2.19; P = 0.046) and increased mean linear intercept (Lm) (85.14 vs 66.44; P = 0.025). The s-90 animals presented higher inflammation and muscular hypertrophy at the level of the axial bronchus than the controls (P<0.05). When smoking groups were pooled and compared to controls, they presented significantly higher inflammation at the lateral level (P = 0.028), as well as airway secretory hyperplasia (P = 0.024) and smooth muscle hypertrophy ( P = 0.005) at the axial level. Due to its simplicity, low cost and short duration, this technique may be a useful model to obtain new information about airspace remodeling due to chronic tobacco consumption.

Lung tissue mechanics in the early stages of induced paracoccidioidomycosis in rats.

Pulmonary dysfunction represents the most important cause of death in patients with paracoccidioidomycosis (PBM). In order to investigate the functional changes of the lungs in the early stages of PBM, a model of benign disease was developed by intratracheal challenge of 12-week old isogenic Wistar rats with 1 x 10(6) yeast forms of Paracoccidioides brasiliensis. Animals were studied 30 and 60 days after infection, when fully developed granulomas were demonstrable in the lungs. Measurements of airway resistance, lung elastance and tissue hysteresis were made during sinusoidal deformations (100 breaths/min, tidal volume = 2 ml) with direct measurement of alveolar pressure using the alveolar capsule technique. Infection caused a significant increase in hysteresis (infected: 1.69, N = 13; control: 1.13, N = 12, P = 0.024, ANOVA), with no alterations in airway resistance or lung elastance. Histopathological analysis revealed the presence of fully developed granulomas located in the axial compartment of the lung interstitial space. These results suggest that alterations of tissue mechanics represent an early event in experimental PBM.

Pulmonary emphysema induced by passive smoking: an experimental study in rats.

We describe a short time model for inducing experimental emphysema in rats by chronic tobacco smoke inhalation. Three groups of male Wistar rats (6 months old) were studied: controls (N = 8), rats intoxicated for 45 days (s-45, N = 7) or for 90 days (s-90, N = 8). The exposed animals were intoxicated 3 times a day (10 cigarettes per exposure period), 5 days a week. Pulmonary damage was assessed by means of functional tests and quantitative pathological examination of the airways and lung parenchyma. The s-45 and s-90 animals were similar in terms of functional residual capacity (FRC) corrected for body weight (FRC/kg) but both groups of smoking rats exhibited significantly higher FRC/kg values than the controls (s-45 = 6.33; s-90 = 6.46; controls = 3.78; P < 0.05). When the two groups of smoking rats were pooled together and compared to controls, they showed decreased lung elastance (1.6 vs 2.19; P = 0.046) and increased mean linear intercept (Lm) (85.14 vs 66.44; P = 0.025). The s-90 animals presented higher inflammation and muscular hypertrophy at the level of the axial bronchus than the controls (P < 0.05). When smoking groups were pooled and compared to controls, they presented significantly higher inflammation at the lateral level (P = 0.028), as well as airway secretory hyperplasia (P = 0.024) and smooth muscle hypertrophy (P = 0.005) at the axial level. Due to its simplicity, low cost and short duration, this technique may be a useful model to obtain new information about airspace remodeling due to chronic tobacco consumption.

Respiratory mechanics and lung morphometry in severe pancreatitis-associated acute lung injury in rats.

OBJECTIVE: To develop and study an experimental model for severe pancreatitis-associated lung injury. DESIGN: Prospective, randomized, controlled trial. SETTING: University pulmonary laboratory. SUBJECTS: Seventy-eight male Wistar rats. INTERVENTIONS: Pancreatitis was induced by taurocholate injection into the pancreatic duct. Data were compared with data from sham-operated animals. MEASUREMENTS AND MAIN RESULTS: Pulmonary mechanical measurements were performed in anesthetized and mechanically ventilated rats. Alveolar pressure was obtained by the alveolar capsule technique. Lungs were fixed at functional residual capacity by immersion in liquid nitrogen and were submitted to morphometric studies. Dynamic pulmonary elastance was found to be increased in the acute pancreatitis group (2.25 +/- 0.21 vs. 1.62 +/- 0.10 cm H2O/mL [p < .05]). Morphometric signs of distal airway contraction and vasoconstriction were observed. Increased intraalveolar edema rate (55.6 +/- 12.7% vs. 22.6 +/- 9.6% [p < .001]) was detected in the animals with acute pancreatitis. A high degree of pulmonary unevenness and polymorphonuclear infiltration were also detected in the lungs of the acute pancreatitis animals. CONCLUSIONS: In this severe pancreatitis-associated lung injury model, the mechanical and morphologic alterations were similar to those alterations observed in the adult respiratory distress syndrome. This model may prove to be a useful tool to investigate mechanisms and mediators of the respiratory failure induced by acute pancreatitis and other forms of adult respiratory distress syndrome.

Neonatal capsaicin treatment decreases airway and pulmonary tissue responsiveness to methacholine.

We studied the effects of selective depletion of neurokinins in sensory nerve fibers by capsaicin treatment on the airway and pulmonary tissue responses to methacholine. Dose-response curves to aerosolized methacholine were performed on anesthetized and mechanically ventilated Wistar rats. Capsaicin (50 mg/kg sc) was administered to 2-day-old rats, and the animals were studied after 12 wk. The response to each dose of methacholine was determined by measuring changes in airway resistance (R(aw)), dynamic pulmonary elastance (Edyn), and pulmonary tissue resistance (Rtis). We calculated sensitivity (Kx) as the concentration of methacholine required for a one-half maximal response and reactivity as the relationship between the maximum response and Kx. Capsaicin treatment resulted in significantly greater values of Kx and lower values of reactivity for R(aw), Edyn, and Rtis compared with control rats. Morphometric analysis of airways showed similar values of the area occupied by smooth muscle but a significantly lower (P < 0.02) area of airway epithelium in capsaicin-treated rats. Our results suggest that methacholine requires capsaicin-sensitive nerves for part of its airway and lung tissue effects.

[The low quality of home-made oral rehydration solution in Salvador, Bahia (Brazil)]. / A baixa qualidade do soro caseiro em Salvador, Brasil.

In 1988 a nation-wide campaign aiming to inform the Brazilian population about preparation and use of simple sugar/salt oral rehydration solution (ORS) was carried out. The campaign was massively shown by the media. This preliminary study assessed the quality of ORS prepared by 23 mothers of in-patient children from a pediatric hospital in Salvador, State of Bahia. Fourteen (60.9%) among the 23 mothers prepared solutions containing Na concentrations ranging from 30 to 80 mmol/L which is recommended by the World Health Organization. Eleven (47.8%) solutions contained glucose within the recommended range of 30 to 112 mmoI/L Only 6 (26%) out of the 23 mothers prepared ORS with simultaneously adequate Na and glucose concentrations. However, just 3 (13%) out of these 6 ORS also presented balanced electrolyte concentrations. Potential iatrogenicity due to high concentrations of Na and glucose was found in 30.4% and 43.5% of the solutions, respectively. These data raise serious concerns about the quality of home-made sugar/salt ORS, and therefore about its use as a safe agent in a campaign of diarrhoeal diseases control.

Midazolam e pressäo intra-ocular / Midazolam and intraocular pressure

Quatorze pacientes de ambos os sexos, com idade variando de 27 a 76 anos, submetidos a cirurgias intra-oculares, receberam midazolam por via venosa, na dose de 0,07 mg.kg elevado a menos um, com o objetivo de se verificar sua açäo na pressäo intra-ocular (PIO). Nenhuma medicaçäo pré-anestésica foi administrada. A primeira medida foi efeuada assim que o paciente chegou ao centro cirúrgico; a segunda medida, cinco minutos após a administraçäo de midazolam. Houve queda da PIO, com significância estatística (p < 0,05). Portanto, para diminuir a PIO durante cirurgias intra-oculares, recomenda-se o midazolam por via venosa na dose de 0,07 mg.kg elevado a menos um

Avaliacao clinica da bupivacaina pesada a 0,5% na raquianestesia. / Clinical evaluation of heavy bupivacaine 0.5% in spinal anesthesia

Os autores apresentaram os resultados obtidos em 50 pacientes submetidos a cirurgias infra-umbilicais. Os pacientes foram anestesiados com a tecnica da raquianestesia em uma solucao de bupivacaina a 0,5% na dose de 20 mg do agente anestesico. A qualidade do bloqueio foi considerada boa, com bom relaxamento muscular e uma duracao media de anestesia de 2 horas e 34 minutos. Na casuistica presente a raquianestesia efetuada com a bupivacaina hiperbarica a 0,5% foi isenta de complicacoes