Intermittent binge-like ethanol exposure during adolescence attenuates the febrile response by reducing brown adipose tissue thermogenesis in rats.

Ethanol (EtOH) consumption is a primary health risk worldwide, which generally starts during adolescence in a binge pattern (i.e., the episodic consumption of high amounts). Binge EtOH consumption can lead to modifications of the innate and adaptive immune responses, including fever. The present study evaluated the febrile response that was induced by lipopolysaccharide (LPS) and prostaglandins E2 (PGE2) and the mechanisms of thermoregulation in adolescent rats that were exposed to EtOH in a binge-like pattern. Male Wistar rats were treated with an intraperitoneal (i.p.) injection of EtOH or saline on postnatal days (PND) 25, 26, 29, 30, 33, 34, 37, and 38. On PND 51, they received a pyrogenic challenge with LPS (i.p.) or PGE2 (intracerebroventricular) to induce a febrile response. Interscapular brown adipose tissue (BAT) mass and uncoupling protein (UCP) activity in isolated mitochondria were evaluated on PND 51. The rats were then subjected to cold challenges to analyze adaptive thermogenesis. Intermittent EtOH exposure during adolescence impaired the LPS- and PGE2-induced febrile response 12 days after the end of EtOH exposure. Ethanol exposure decreased interscapular BAT mass, oxygen consumption, and UCP activity in isolated mitochondria, resulting in an impairment in thermogenesis at 5 °C. No morphological changes in BAT were observed. These findings indicate that binge-like EtOH exposure during adolescence impairs thermoregulation by reducing BAT mass and function. This reduction may last for a prolonged period of time after the cessation of EtOH exposure and may affect both cold defenses and the febrile response during the development of infectious diseases.

Central and peripheral fat body mass have a protective effect on osteopenia or osteoporosis in adults and elderly?

UNLABELLED: This cross-sectional study involves randomly selected men aged 50 to 99 years and postmenopausal women. Either central fat mass or peripheral fat mass were associated to osteoporosis or osteopenia independently from fat-free body mass and other confounding factors. INTRODUCTION: Obesity and osteoporosis are public health problems that probably share common pathophysiological mechanisms. The question if body fat mass, central or peripheral, is protective or harmful for osteoporosis or osteopenia is not completely resolved. This study aims to investigate the association between osteoporosis or osteopenia, and fat body mass (central and peripheral) independently from fat-free body mass, in men aged 50 to 99 years old and postmenopausal women randomly selected in the community. METHODS: This is a cross-sectional investigation with a random sample of registered population in Niterói Family Doctor Program (FDP), State of Rio de Janeiro, Brazil. Bone mineral density (BMD) and fat-free mass were assessed by dual X-ray absorptiometry (DXA). RESULTS: There was statistically significant bivariate association between bone loss with gender, age, skin color, alcohol consumption at risk dose, use of thiazide, fat-free body mass, and fat body mass (central and peripheral). In the multiple analysis of fat-free body mass, central and peripheral fat body mass showed an independent and protective effect on the presence of osteoporosis or osteopenia (p value <0.001). CONCLUSION: Since both obesity and osteoporosis are public health problems worldwide, strategies aimed at preventing both conditions should be encouraged during aging.

Role of Angiotensin II type 1 receptor on renal NAD(P)H oxidase, oxidative stress and inflammation in nitric oxide inhibition induced-hypertension.

AIMS: Activation of the renin-angiotensin system (RAS), renal oxidative stress and inflammation are constantly present in experimental hypertension. Nitric oxide (NO) inhibition with N(w)-nitro-L-arginine methyl ester (L-NAME) has previously been reported to produce hypertension, increased expression of Angiotensin II (Ang II) and renal dysfunction. The use of Losartan, an Ang II type 1 receptor (AT1R) antagonist has proven to be effective reducing hypertension and renal damage; however, the mechanism by which AT1R blockade reduced kidney injury and normalizes blood pressure in this experimental model is still complete unknown. The current study was designed to test the hypothesis that AT1R activation promotes renal NAD(P)H oxidase up-regulation, oxidative stress and cytokine production during L-NAME induced-hypertension. MAIN METHODS: Male Sprague-Dawley rats were distributed in three groups: L-NAME, receiving 70 mg/100ml of L-NAME, L-NAME+Los, receiving 70 mg/100ml of L-NAME and 40 mg/kg/day of Losartan; and Controls, receiving water instead of L-NAME or L-NAME and Losartan. KEY FINDINGS: After two weeks, L-NAME induced high blood pressure, renal overexpression of AT1R, NAD(P)H oxidase sub-units gp91, p22 and p47, increased levels of oxidative stress, interleukin-6 (IL-6) and interleukin-17 (IL-17). Also, we found increased renal accumulation of lymphocytes and macrophages. Losartan treatment abolished the renal expression of gp91, p22, p47, oxidative stress and reduced NF-κB activation and IL-6 expression. SIGNIFICANCE: These findings indicate that NO induced-hypertension is associated with up-regulation of NADPH oxidase, oxidative stress production and overexpression of key inflammatory mediators. These events are associated with up-regulation of AT1R, as evidenced by their reversal with AT1R blocker treatment.

Genetic diversity of spineless Cereus jamacaru accessions using morphological and molecular markers.

This is the first study to examine the genetic diversity of mandacaru cactus (Cereus jamacaru P. DC.). Plants of spineless mandacaru are commonly found in gardens and parks of urban areas in northeastern Brazil. In addition to exploring their ornamental potential, morphological, and genetic characterization may contribute to the development of plant materials that can be used as a source of macromolecules of potential economic interest. The goal of this study was to estimate the genetic variability of spineless mandacaru accessions using random amplified polymorphic DNA (RAPD) and inter-simple sequence repeat (ISSR) molecular markers, and to characterize their morphology. Ten samples of newly emitted shoots with differentiated areolas and ribs were collected from each accession from the Cactaceous Germplasm Collection of Embrapa Agroindústria Tropical, in Fortaleza, CE. Shoot shape and aspects of spine primordia (presence, location, grouping, and size of spines) were evaluated. The morphological analysis showed that the spineless mandacaru presented spine primordia. Twenty-six RAPD and 15 ISSR primers were polymorphic. A total of 262 markers were obtained, 129 of which were polymorphic. The average polymorphism of ISSR markers was higher than that of RAPD markers. The dendrograms for both analyses showed differentiation between accessions. Nevertheless, the molecular markers detected higher levels of diversity and a different pattern of diversity than those found using morphological markers. The molecular results revealed significant genetic variability both within and between groups.

A possible role of a cerebral energy gene in alcoholism.

We examined a possible relationship between genes responsible for energy metabolism of the brain and addictive behavior in an animal model. We used non-inbred, Swiss mice exposed to a three-bottle free-choice model [water, 5% (v/v) ethanol, and 10% (v/v) ethanol] over a 16-week period, consisting of four phases: acquisition, withdrawal, reexposure, and quinine-adulteration. The mice were then behaviorally classified into three groups: loss-of-control-drinker (preference for ethanol and high levels of consumption during all phases, N = 6), heavy-drinker (preference for ethanol and high levels of consumption during acquisition and reduction during quinine-adulteration, N = 7), and light-drinker (preference for water during all phases, N = 10). Another group only received tap water (ethanol-naive control mice, N = 9). Further analysis using quantitative real-time PCR showed that in mice behaviorally classified as loss-of-control-drinkers, there was a significant inverse correlation between transcript levels of the Hadh gene and those of other energy metabolism genes in the nucleus of the amygdala, suggesting that this pathway may contribute to ethanol consumption in these mice. We conclude that cerebral energy metabolism is involved with ethanol addiction, meriting further study.

Myricitrin, a nitric oxide and protein kinase C inhibitor, exerts antipsychotic-like effects in animal models.

Myricitrin is a nitric oxide (NO) and protein kinase C (PKC) inhibitor that has central nervous system activity, including anxiolytic-like action. Nitric oxide inhibitors blocked the behavioral effects of apomorphine, suggesting an antipsychotic-like effect. Furthermore, PKC inhibition reduced psychotic symptoms in acute mania patients and blocked amphetamine-induced hyperlocomotion, suggesting a potential antipsychotic-like effect. The present study evaluated the effects of myricitrin in animal models that assess antipsychotic-like effects (apomorphine-induced stereotypy and climbing and the paw test) and extrapyramidal side effects (catalepsy test and paw test). Olanzapine was used as a positive control. 7-Nitroindazole (7-NI), a NOS inhibitor, and l-arginine, a NO precursor, were used to evaluate nitrergic modulation, and tamoxifen was used to test the effect of PKC inhibition. In mice, myricitrin dose-dependently and olanzapine blocked the stereotypy and climbing induced by apomorphine at doses that did not induce catalepsy. 7-Nitroindazole also blocked apomorphine-induced stereotypy and climbing, which were reversed by l-arginine pretreatment. l-arginine only attenuated the effects of myricitrin on apomorphine's effects. Tamoxifen also blocked apomorphine-induced stereotypy and climbing. In the paw test in rats, myricitrin and olanzapine increased hindlimb retraction time at doses that did not affect forelimb reaction time, whereas haloperidol affected both parameters at the same dose. Myricitrin did not induce catalepsy in the bar test. Tamoxifen did not affect hindlimb retraction time or forelimb retraction time, whereas 7-NI significantly increased hindlimb reaction time. Thus, myricitrin exhibited an antipsychotic-like profile at doses that did not induce catalepsy, and this effect may be related to nitrergic action.

Estrutura e celularidade de meniscos frescos de coelhos (Oryctolagus cuniculus) preservados em glicerina / Structure and cellularity of the fresh menisci (Oryctolagus cuniculus) of rabbits and the menisci preserved in glycerin

No presente estudo foi avaliada a arquitetura tecidual, a população celular, assim como a integridade e a distribuição dos tipos celulares em meniscos frescos de coelhos e preservados em glicerina 98 por cento. Foram analisados meniscos mediais de coelhos recém abatidos, que foram distribuídos em três grupos: o grupo MF (n=7), composto por meniscos frescos, correspondeu ao grupo controle; o grupo MG (n=7), composto por meniscos preservados em glicerina 98 por cento, por 30 dias, e o grupo MR (n=7), por meniscos preservados em glicerina 98 por cento e reidratados em NaCl 0,9 por cento, por 12 horas. Em todos os meniscos foram identificados e quantificados os diferentes tipos celulares: fibroblastos/fibrócitos e condrócitos. A população celular foi estatisticamente semelhante nos três grupos de meniscos, sendo que os meniscos preservados, grupos MG e MR, apresentaram menor intensidade de coloração e retração das fibras colágenas, diminuição de volume e maior intensidade de coloração dos núcleos (condensação da cromatina), em relação aos meniscos frescos (MF), caracterizando o fenômeno de lise celular. A matriz fibrocartilaginosa dos meniscos preservados revelou- se bem preservada mantendo a arquitetura tecidual dos meniscos. Conclui-se que a glicerina 98 por cento é uma opção de meio de preservação para meniscos objetivando aloenxerto, com matriz colágena desvitalizada.

In the present study was evaluated the tissue architecture, the percentage of cellular population, as well as viability and distribution of cells in fresh menisci of rabbits and preserved in 98 percent glycerin. Were analyzed medial menisci of rabbits freshly slaughtered, which were distributed into three groups: the MF group (n=7), composed of fresh menisci, corresponded to the control group; the MG group (n=7), composed by menisci preserved in 98 percent glycerin, for 30 days, and the MR group (n=7) by menisci preserved in 98 percent glycerin and rehydrated in NaCl 0.9 percent for 12 hours. In all menisci were identified and quantified the different cell types: fibroblasts/fibrocytes and condrocytes. The cell population percentage was statistically similar in all groups. All menisci preserved in the MG and MR groups showed a lower intensity of color and shrinkage of collagen fibers, reduced volume and higher intensity of staining of nucleus (chromatin condensation), as compared to fresh menisci (MF), featuring the phenomenon of cell lysis. The cartilaginous matrix of preserved menisci proved to be well preserved because the tissue architecture was maintained. It was concluded that 98 percent glycerin is an optional preservation mean for meniscal allografts with a devitalized collagenous matrix.

Avaliação das fibras colágenas de meniscos frescos e preservados em glicerina: estudo experimental em coelhos (Oryctolagus cuniculus) / Evaluation of the collagen fibers of the fresh meniscus and the meniscuses preserved in glycerine: experimental study in rabbits (Oryctolagus cuniculus)

No presente estudo foi avaliado o efeito da glicerina 98 por cento sobre as fibras colágenas, arquitetura tecidual e o tamanho de meniscos mediais de coelhos da raça Nova Zelândia. Os meniscos foram separados em três grupos: (1) Grupo MF com meniscos frescos (grupo controle), (2) Grupo MG com meniscos preservados em glicerina 98 por cento por 30 dias, e (3) Grupo MR com meniscos preservados em glicerina 98 por cento por 30 dias e reidratados em NaCl 0,9 por cento, por 12 horas. Os cortes histológicos foram corados com sirius red para identificação dos tipos de colágenos e observados em microscópio de luz polarizada, avaliando-se a concentração total de colágeno Tipo I e III e a disposição das fibras. Os meniscos frescos apresentaram significativamente maior concentração de fibras colágenas Tipo I e menor concentração de fibras colágenas Tipo III que os meniscos preservados (MG e MR); isto ocorreu devido à perda de água e conseqüente redução do tamanho dos meniscos e retração das fibras colágenas dos meniscos dos Grupos MG e MR; isto pode ter feito com que as fibras Tipo I, mais espessas e em maior quantidade, se tornassem mais evidentes do que as fibras colágenas Tipo III, que são mais delgadas e frágeis (fibrilas). Nos três grupos estudados, as fibras colágenas apresentaram-se de forma circunferencial, interpostas por fibras orientadas radialmente. Entretanto, nos grupos tratados (MG e MR) foi observado, em pequenas áreas, leve desorganização das fibras colágenas, o que correspondeu a 42,8 por cento e 14,3 por cento dos meniscos, respectivamente. O grupo de meniscos em glicerina apresentou redução significativa (p<0,05) no tamanho em relação ao Grupo MF. No Grupo MR, 85,7 por cento dos meniscos retornaram ao seu tamanho inicial após a reidratação. A glicerina 98 por cento é eficaz na preservação de meniscos, mantendo o tamanho, a arquitetura estrutural, a integridade e percentagem do colágeno dos meniscos preservados semelhante à de...

In the present study was evaluated the effect of 98 percent glycerin on the collagen fibers, tissue architecture and size of medial meniscuses of New Zealand rabbits. The animals were separated into three groups: (1) Group MF of fresh meniscus, (2) Group MG of meniscus preserved in glycerin for 30 days, and (3) Group MR of meniscus preserved in glycerin for 30 days and rehydrated in NaCl 0.9 percent for 12 hours. Histological sections were stained with sirius red for identification of collagen types, which were examined with a polarized light microscope. The total collagen concentration and the fiber arrangement were evaluated. Group MF presented higher Type I collagen concentration and lower Type III collagen concentration when compared with Group MG and MR. This fact is due to the water loss and consequent reduction in size and subsequent retraction of the collagen fibers of the meniscus from these groups, caused by dehydration. This may have occurred because those Type I fibers, thicker and in larger quantities, become more evident than Type III collagen fibers, which are more slender and fragile (fibrils). In the three groups studied, the collagen fibers presented themselves in a circumference form, interposed by radially oriented fibers. All of the meniscuses from Group MF presented fibers arranged obliquely, while in the treated groups, a slight disorganization of collagen fibers could be observed in some areas, what corresponds to 42.8 percent and 14.3 percent of the meniscuses, respectively. The MG group presented a significant decrease (p<0.05) in size if compared with the MF group. In the MR group, 85.7 percent of the meniscuses went back to the original size after rehydratation. The 98 percent glycerin is effective in preserving the meniscus, following rehydratation, maintaining size, structural architecture, integrity and percentage of collagen of the meniscus preserved similar to the fresh one.

Avaliação das fibras colágenas de meniscos frescos e preservados em glicerina: estudo experimental em coelhos (Oryctolagus cuniculus) / Evaluation of the collagen fibers of the fresh meniscus and the meniscuses preserved in glycerine: experimental study in rabbits (Oryctolagus cuniculus)

No presente estudo foi avaliado o efeito da glicerina 98 por cento sobre as fibras colágenas, arquitetura tecidual e o tamanho de meniscos mediais de coelhos da raça Nova Zelândia. Os meniscos foram separados em três grupos: (1) Grupo MF com meniscos frescos (grupo controle), (2) Grupo MG com meniscos preservados em glicerina 98 por cento por 30 dias, e (3) Grupo MR com meniscos preservados em glicerina 98 por cento por 30 dias e reidratados em NaCl 0,9 por cento, por 12 horas. Os cortes histológicos foram corados com sirius red para identificação dos tipos de colágenos e observados em microscópio de luz polarizada, avaliando-se a concentração total de colágeno Tipo I e III e a disposição das fibras. Os meniscos frescos apresentaram significativamente maior concentração de fibras colágenas Tipo I e menor concentração de fibras colágenas Tipo III que os meniscos preservados (MG e MR); isto ocorreu devido à perda de água e conseqüente redução do tamanho dos meniscos e retração das fibras colágenas dos meniscos dos Grupos MG e MR; isto pode ter feito com que as fibras Tipo I, mais espessas e em maior quantidade, se tornassem mais evidentes do que as fibras colágenas Tipo III, que são mais delgadas e frágeis (fibrilas). Nos três grupos estudados, as fibras colágenas apresentaram-se de forma circunferencial, interpostas por fibras orientadas radialmente. Entretanto, nos grupos tratados (MG e MR) foi observado, em pequenas áreas, leve desorganização das fibras colágenas, o que correspondeu a 42,8 por cento e 14,3 por cento dos meniscos, respectivamente. O grupo de meniscos em glicerina apresentou redução significativa (p<0,05) no tamanho em relação ao Grupo MF. No Grupo MR, 85,7 por cento dos meniscos retornaram ao seu tamanho inicial após a reidratação. A glicerina 98 por cento é eficaz na preservação de meniscos, mantendo o tamanho, a arquitetura estrutural, a integridade e percentagem do colágeno dos meniscos preservados semelhante à de ...(AU)

In the present study was evaluated the effect of 98 percent glycerin on the collagen fibers, tissue architecture and size of medial meniscuses of New Zealand rabbits. The animals were separated into three groups: (1) Group MF of fresh meniscus, (2) Group MG of meniscus preserved in glycerin for 30 days, and (3) Group MR of meniscus preserved in glycerin for 30 days and rehydrated in NaCl 0.9 percent for 12 hours. Histological sections were stained with sirius red for identification of collagen types, which were examined with a polarized light microscope. The total collagen concentration and the fiber arrangement were evaluated. Group MF presented higher Type I collagen concentration and lower Type III collagen concentration when compared with Group MG and MR. This fact is due to the water loss and consequent reduction in size and subsequent retraction of the collagen fibers of the meniscus from these groups, caused by dehydration. This may have occurred because those Type I fibers, thicker and in larger quantities, become more evident than Type III collagen fibers, which are more slender and fragile (fibrils). In the three groups studied, the collagen fibers presented themselves in a circumference form, interposed by radially oriented fibers. All of the meniscuses from Group MF presented fibers arranged obliquely, while in the treated groups, a slight disorganization of collagen fibers could be observed in some areas, what corresponds to 42.8 percent and 14.3 percent of the meniscuses, respectively. The MG group presented a significant decrease (p<0.05) in size if compared with the MF group. In the MR group, 85.7 percent of the meniscuses went back to the original size after rehydratation. The 98 percent glycerin is effective in preserving the meniscus, following rehydratation, maintaining size, structural architecture, integrity and percentage of collagen of the meniscus preserved similar to the fresh one.(AU)

Estrutura e celularidade de meniscos frescos de coelhos (Oryctolagus cuniculus) preservados em glicerina / Structure and cellularity of the fresh menisci (Oryctolagus cuniculus) of rabbits and the menisci preserved in glycerin

No presente estudo foi avaliada a arquitetura tecidual, a população celular, assim como a integridade e a distribuição dos tipos celulares em meniscos frescos de coelhos e preservados em glicerina 98 por cento. Foram analisados meniscos mediais de coelhos recém abatidos, que foram distribuídos em três grupos: o grupo MF (n=7), composto por meniscos frescos, correspondeu ao grupo controle; o grupo MG (n=7), composto por meniscos preservados em glicerina 98 por cento, por 30 dias, e o grupo MR (n=7), por meniscos preservados em glicerina 98 por cento e reidratados em NaCl 0,9 por cento, por 12 horas. Em todos os meniscos foram identificados e quantificados os diferentes tipos celulares: fibroblastos/fibrócitos e condrócitos. A população celular foi estatisticamente semelhante nos três grupos de meniscos, sendo que os meniscos preservados, grupos MG e MR, apresentaram menor intensidade de coloração e retração das fibras colágenas, diminuição de volume e maior intensidade de coloração dos núcleos (condensação da cromatina), em relação aos meniscos frescos (MF), caracterizando o fenômeno de lise celular. A matriz fibrocartilaginosa dos meniscos preservados revelou- se bem preservada mantendo a arquitetura tecidual dos meniscos. Conclui-se que a glicerina 98 por cento é uma opção de meio de preservação para meniscos objetivando aloenxerto, com matriz colágena desvitalizada.(AU)

In the present study was evaluated the tissue architecture, the percentage of cellular population, as well as viability and distribution of cells in fresh menisci of rabbits and preserved in 98 percent glycerin. Were analyzed medial menisci of rabbits freshly slaughtered, which were distributed into three groups: the MF group (n=7), composed of fresh menisci, corresponded to the control group; the MG group (n=7), composed by menisci preserved in 98 percent glycerin, for 30 days, and the MR group (n=7) by menisci preserved in 98 percent glycerin and rehydrated in NaCl 0.9 percent for 12 hours. In all menisci were identified and quantified the different cell types: fibroblasts/fibrocytes and condrocytes. The cell population percentage was statistically similar in all groups. All menisci preserved in the MG and MR groups showed a lower intensity of color and shrinkage of collagen fibers, reduced volume and higher intensity of staining of nucleus (chromatin condensation), as compared to fresh menisci (MF), featuring the phenomenon of cell lysis. The cartilaginous matrix of preserved menisci proved to be well preserved because the tissue architecture was maintained. It was concluded that 98 percent glycerin is an optional preservation mean for meniscal allografts with a devitalized collagenous matrix.(AU)

A surgical device for radiofrequency ablation of large liver tumors.

Radiofrequency ablation has become an accepted treatment option of patients with primary and metastatic liver tumors. We propose an ablation electrode array consisting of 4-8 blade shaped electrodes arranged in a circular geometry for the treatment of large liver tumors. We developed a 3D code based on the finite difference method for evaluating the effect of different numbers of electrodes (4, 6 and 8) and electrode distance on lesion size. The configuration with six electrodes can ablate a volume of 70 x 70 x 40 mm(3) in approximately 5 min, with tissue temperature above 50 degrees C throughout the treatment volume. We then performed an experimental study in polyacrylamide gel in order to validate the theoretical results. The average temperature error between the simulation and the experiment was 3.8% at the center of the electrode array. This study shows that the proposed device potentially allows more rapid treatment of large tumors than current radiofrequency ablation devices.

[Iron status, malnutrition and acute phase response in HIV-positive patients]. / Resposta de fase aguda, subnutrição e estado nutricional do ferro em adultos com AIDS.

Nutritional status and some iron metabolism parameters of acute phase response (APR) positive and APR-negative AIDS patients were studied. Twenty-nine AIDS patients were submitted to 24h food intake recall, anthropometry, and albumin, C-reactive protein (CRP), hemoglobin, ferritin, and total iron binding capacity (TIBC) measurements. Infection plus serum CRP > 7 mg/dl were criteria for APR presence. Protein-energy malnutrition (PEM) was ascertained by body mass index (BMI) lower than 18.5 kg/m2 and height-creatinine index (HCI < 70%). PEM (77.8 vs 40%) and pulmonary tuberculosis (44. 4 vs 9.5%) were more frequent in APR-positive patients, which also had lower serum albumin (3.7 +/- 0.9 vs 4.3 +/- 0.9 g/dl), TIBC (165. 8 +/- 110.7 vs 265.9 +/- 74.6 mg/dl) and blood hemoglobin (10.5 +/- 1. 8 vs 12.6 +/- 2.3g/dl). Iron intake was similar between groups; however, serum ferritin levels (median, range) were higher among APR-positive (568, 45.3-1814 vs 246, 18.4-1577 ng/ml) patients. HIV-positive adults with systemic response to invading pathogens showed worse nutritional status than those APR-negative. In APR-positive AIDS patients, anemia appears to be unrelated to recent iron intake.

[Clinical and laboratory renal alterations in patients with acquired immunodeficiency syndrome in relation to anatomopathological findings]. / Alterações renais clínico-laboratoriais em pacientes com a síndrome da imunodeficiência adquirida em relação aos achados anatomopatológicos.

Clinical as well as renal anatomopathological data of 119 patients with acquired immunodeficiency syndrome from the Hospital of the Faculty of Medicine of Triângulo Mineiro, Uberaba, MG, Brazil, were studied. Mean age was 33 +/- 10.4 years (range 18 to 67 years). White (59%) and male (80%) individuals predominated. Ninety percent of patients came from Uberaba or neighborhood. There were 59 (50%) heterosexual, 25 (21%) homosexual, 17 (14%) bisexual and 18 (15%) unknown. Forty three percent were drug abusers. Fourteen (12.2%) of patients had serum creatinine higher than 3mg/dl, ten days before death, 64% of them showed acute tubular necrosis. Seventy one (61%) patients presented hyponatremia and 8 (7%) had hypernatremia. Hypokalemia was detected in 28 (24%) and hyperkalemia in 8 (7%) patients. Twenty four hours urinary protein was detected in 12 patients, 7 of them presenting more than 1g/24h. Two patients showed segmentar focal glomerulosclerosis, one of them with 24h urinary protein level of 5.5 g and serum creatinine 1.5 mg/dl and no edema. The most (56%) patients had tubulointerstitial nephritis. Clinical, laboratory and types of renal disorders in patients with acquired immunodeficiency syndrome are variable. The glomerular diseases were relatively scarce however, tubulointerstitial lesions are quite frequent, mainly interstitial nephritis and acute tubular necrosis. Not always an anatomoclinical correlation could be observed, because many times the electrolyte disorders were frequently observed only functionally.

Nutritional assessment of vitamin E in malnourished patients with AIDS.

Malnourished patients with acquired immunodeficiency syndrome (AIDS) may have low serum levels and reduced intake of alpha-tocopherol, mainly in the presence of acute-phase response. The aims of this study were to compare intake and serum levels of alpha-tocopherol between malnourished (MN) and non-malnourished (NMN) AIDS patients and to correlate alpha-tocopherol intake and serum levels. Undernutrition was defined as having a body mass index lower than 18. 5 kg/m(2) or a height-creatinine index lower than 70%. A semiquantitative food frequency questionnaire assessed alpha-tocopherol intake. High-performance liquid chromatography determined vitamin serum levels. The patients were divided into MN (n = 14) and NMN (n = 15) groups. There were no statistical differences in relation to clinical findings between MN and NMN, respectively, including moniliasis (7/14 versus 4/15), neurocryptoccocosis and neurotoxoplasmosis (6/14 versus 6/15), pulmonary tuberculosis (4/14 versus 2/15), and fever (1/14 versus 3/15). MN and NMN groups had similar peripheral blood CD(4) levels (111.4+/-87.1 versus 124.4+/-90.9 cells/mm(3)), and both groups had similar and adequate alpha-tocopherol intake (MN = 50.0+/-11.0 versus NMN = 47.2+/-16.5 mg) and serum levels (MN = 17.8+/-7.2 versus NMN = 19.8+/-6.3 micromol/L). Vitamin E intake and serum levels did not show a significant correlation (r = -0.22, P 0.05). Protein-energy nutrition status and acute-phase response were not factors determining vitamin status among AIDS patients.

[Mefloquine in the treatment of cutaneous leishmaniasis in an endemic area of Leishmania (Viannia) braziliensis]. / Mefloquina no tratamento da leishmaniose cutânea em uma área endêmica de Leishmania (Viannia) braziliensis.

The aim of this study was to evaluate the efficacy of mefloquine in the treatment of skin leishmaniasis in patients infected with Leishmania (Viannia) braziliensis at an endemic region. Mefloquine is an oral drug effective against malaria with a prolonged half-life, less toxicity and easier administration than pentavalent antimonials. At Corte de Pedra in the Southern litoral of Bahia State, two randomized groups of ten patients with leishmaniasis were treated. The first group was treated with oral mefloquine, 250 mg per day in a single dose for six days and repeated three weeks later. The second group received meglumine antimoniate (Glucantime), 20 mg/kg daily administered intravenously for 20 days. Only one patient in the group treated with mefloquine showed evidence of clinical success. During treatment, one patient with four lesions developed a new lesion. The other three patients with clinical leismaniasis did not show evidence of clinical success after nine weeks of treatment. The group treated with Glucantime showed evident clinical improvement of the skin lesions.

Mefloquine in the treatment of cutaneous leishmaniasis.

Three cases of cutaneous leishmaniasis were treated orally with a mefloquine dose of 4.2 mg/kg/day for six days in the Teaching Hospital of the Faculdade de Medicina do Triângulo Mineiro, Uberaba, MG, Brazil. Three weeks later a new series was repeated. No patient was cured.

[Measurement of the volume of the skin ulcer in cutaneous leishmaniasis]. / Medida do volume da úlcera cutânea na leishmaniose tegumentar.

Skin ulcers by Leishmania (Viannia) braziliensis are often deep and irregular and are difficult to measure by just the skin surface transverse and longitudinal diameters. The proposal is to mould the cavity, after local asepsis with fresh water plus soap, with a gelatinous plastic which contains silence, potassium alginate, calcium sulphate, magnesium oxide commercialized under the name of jeltrate (Dentsply Laboratory), by solving 9.5g of jeltrate in 20ml of fresh water and applying the gel on the ulcer which solidifies in 5 minutes. This mould is then filled with a self polymerising acrylic and its volume measured either by weight (by using an analytical balance)-technique 1-or by water displacement by applying Archimeds'principle-technique 2. We show data in a field trial before and after 20 days treatment in 20 patients using three different schedules as follows: 7 received pentamidine isethionate, 7 patients received aminosidine sulphate and 6 received meglumine antimoniate. The results point out that there was a uniform reduction of ulcer volume occurred during this period in the three groups, in both technique. Regarding the therapeutic schedules we are sure that there was a significant statistical difference between the three schedules using the T Student Test, which showed that aminostdine sulphate produced a better volume reduction of the ulcer than the other drugs. Serial moulds reflect clinical billing and are a permanent record. We conclude that the measure of the volume of the skin ulceration can be useful in the therapeutic evaluation, as a practical and cheap procedure, and may be used in field trials.

[Psoriasis in HIV positive patients]. / Psoríase em pacientes HIV positivo.

Two patients with the acquired immunodeficiency syndrome (AIDS) developed psoriasis, one of them presenting the more severe form and the other one the milder form of the disease, were treated with zidovudine per oral via, 200mg 3 times a day. In the first case the therapeutical response was complete. No lesion was verified in the patient after 9 months under maintenance schedule. In the second case, despite the response being clear, after 6 months of treatment, the patient still presented furfuraceous scalings at limbs ever under the medication schedule.

[Comparative study of meglumine antimoniate, pentamidine isethionate and aminosidine sulfate in the treatment of primary skin lesions caused by Leishmania (Viannia) braziliensis]. / Estudo comparativo entre antimoniato de meglumina, isotianato de pentamidina e sulfato de aminosidine, no tratamento de lesões cutâneas primárias causadas por Leishmania (Viannia) braziliensis.

With the aim of comparing the therapeutic efficacy, tolerability and toxicity of meglumine antimoniate, aminosidine sulphate and pentamidine isethionate, a field study was conducted on randomized treatment of patients with primary cutaneous leishmaniasis due to Leishmania (Viannia) braziliensis (L(V)b), in Corte de Pedra, BA, from October 1992 up to January 1993. Forty six patients were treated and distributed into three groups, two with 15 and one with 16 subjects. All patients were submitted to clinical examination, histopathological and immunological investigations, as diagnostic criterium. All patients were treated by intramuscular route. Group 1 received pentamidine 4 mg/kg/every 2 days, for 8 applications; Group 2 received aminosidine 20 mg/kg/day, for 20 days, and Group 3 received meglumine 10 mg Sbv/kg/day, for 20 days. Failure of therapy was defined as ulceration of the skin lesion four months after treatment. Such failure occurred in five cases as follows: two cases in patients of group 1 one case in patients of group 2, and two cases in group 3, after the first year of follow up. In the evaluation after three years we reviewed fifteen patients, five in each group; except for one in Group 3, all of them were cured. Statistical significance of the results between the three schedules used was not verified.