Doce de leite ( revisão) / Candy of milk (review)

O doce de leite é um produto resultante da cocção do leite com açúcar até a concentração e caramelização desejada. É comercializado principalmente no Brasil e na Argentina, mas, seu consumo está em expansão na Europa e nos Estados Unidos. Trata-se de um produto com elevado teor de proteínas e altamente energético. O produto apresenta coloração escura e sabor peculiar devido à várias reações que ocorrem durante o processo, como por exemplo, a Reação de Maillard que está relacionada com a intensidade do tratamento térmico. Um problema que afeta o doce de leite é o aparecimento de ôarenosidadeö, que aparece devido á baixa umidade do produto entre outros fatores e provoca a sensação de aspereza quando colocado na boca. O objetivo desta revisão foi o de trazer informações sobre o doce de leite, no que se refere a sua composição, reações e problemas que podem ocorrer durante sue processamento e armazenamento.

Pathogenetic factors of acute schistosomiasis mansoni: correlation of worm burden, IgE, blood eosinophilia and intensity of clinical manifestations.

A clinical study of 34 previously healthy young patients simultaneously infected in an endemic area of schistosomiasis mansoni is presented, emphasizing the initial phase of the infection. Its intensity was established according to the occurrence, intensity, and duration of the signs and symptoms in order to investigate the possible correlations between the worm burden (estimated by the number of eggs in faeces), the blood eosinophilia and specific levels of IgE (estimated by the area of immediate intradermal reaction), with the clinical manifestations. A significant but low-level association was found between the worm burden and morbidity, suggesting that multiple factors, besides worm burden itself, may contribute to the pathogenesis of the disease.

[The Queixadinha Project: morbidity and control of schistosomiasis in an endemic area in the northeast of Minas Gerais, Brazil]. / O Projeto Queixadinha: a morbidade e o controle da esquistossomose em área endêmica no nordeste de Minas Gerais, Brasil.

In an endemic area for schistosomiasis in the northeast of the state of Minas Gerais in Brazil 516 individuals have been submitted to clinical and laboratory examination, ultrasonography of the abdomen and dopplerecocardiography in order to define the morbidity of schistosomiasis before and after treatment. A high prevalence of schistosomiasis (66.3%) and of severe disease (9.5% with palpable spleens) were recorded. Ultrasonography classified liver periportal fibrosis as light (19.4%), moderate (27.6%) and intense (6.8%), and 46.0% presented no periportal fibrosis. Twenty one out of the 53 individuals (39.6%) with palpable spleens did not present liver fibrosis on ultrasound. Periportal lymph nodes were described in 33.8% of the population and anti-KLH antibodies were found in the serum of 40.7%. Urinary alterations compatible with the glomerulopathy of schistosomiasis were observed in 4.5% of the population, and 11.7% of the individuals examined by dopplerecocardiography had pulmonary hypertension. Twelve months after treatment for schistosomiasis the prevalence of the disease dropped from 66.3% to 25.0%. In Queixadinha, a profile of the morbidity of schistosomiasis has just been established.

Secondary cutaneous manifestations of acute schistosomiasis mansoni.

The secondary cutaneous manifestations of the initial phase of schistosomiasis mansoni were studied in 34 patients who had been infected simultaneously in the same location. Sixteen of the patients developed angioedema and/or urticaria, generally of short duration and of mild intensity and usually about 30 days post-infection. There was no apparent association between the occurrence of these skin manifestations and the patients' worm burdens, blood eosinophilias or areas of immediate reaction to an intradermal inoculation with worm antigen. Other factors, particularly host immunological reactivity, are thought to be important elements in the genesis of the manifestations.

Pulmonary manifestations in the initial phase of schistosomiasis mansoni.

The clinical and radiological pulmonary manifestations in the initial phase of schistosomiasis mansoni were studied in thirty previously healthy individuals who were simultaneously infected. The findings were compared with those concerning a control group and related to possible pathogenetic factors. The respiratory manifestations were of light or of moderate intensity, the dry cough being the most common symptom. The significant radiological alterations were: thickening of bronchial walls and beaded micronodulation, predominantly localized in the lower pulmonary fields. It was observed significant association between wheezing and IgE levels, estimated by the area of immediate intradermal reaction, as well as between the number of blood eosinophils and the occurrence of radiological changes. Moreover, there was correlation between the worm burden and the presence of wheezing, thoracic pain and beaded micronodulation. Thus, the clinical and radiological pulmonary manifestations described are significant part of the initial phase of schistosomiasis mansoni and present the worm burden, eosinophilia and levels of IgE as probable pathogenetic factors.

Gastro-intestinal manifestations of the initial phase of schistosomiasis mansoni.

Clinical gastro-intestinal manifestations were studied in 34 patients in the initial phase of schistosomiasis mansoni. The patients, all men, were of similar age and in similar nutritional condition and had been infected simultaneously at the same transmission site. Most (85%) showed some gastro-intestinal sign or symptom, generally of light or moderate intensity; 56% had liquid or pasty diarrhoea, 41% abdominal pain, 29% hepatomegaly, 21% dysentery, 15% anorexia, 12% pain on colon palpation and 9% nausea and/or vomiting. High worm burden was associated with blood in faeces but apparently not with any other clinical manifestation. There was no apparent association between any clinical manifestation and peripheral-blood eosinophil counts or titres of IgE specific for Schistosoma mansoni (evaluated by the area of immediate intradermal reaction to injected adult worm antigen). The absence of association between worm burden and nearly all the clinical gastro-intestinal manifestations strengthens the concept that factors other than worm burden, such as host reactivity, constitute important pathogenetic elements in the initial phase of schistosomiasis mansoni.

[Environmental and social determinants in schistosomiasis mansoni in Ravena, Minas Gerais, Brazil]. / Determinantes ambientais e sociais da esquistossomose mansoni em Ravena, Minas Gerais, Brasil.

This study identified the role of biological and social determinants in the transmission of schistosomiasis mansoni in Ravena, Minas Gerais, Brazil, in 1980. This data was used to characterize the clinical and epidemiological profiles of the endemic desease in the population, allowing for the determination of the efficacy of the potable water supply and the specific treatment of those infected with S. mansoni. The district contains three locations, Ravenopolis, Ravena and Lavapes, where the prevalence of the endemic disease was, 20.1%, 42.6% and 63.9%, respectively. The prevalence in the district was statistically higher in men. The age brackets that displayed differences by gender were 10-14 and 15-19 years. Severity of infection was statistically different among individuals within the 10-14 year bracket in ali three locations, and in the 15-19 year bracket among individuals from Ravenopolis and Ravena. The hepatointestinal form was associated with age, and individuals under 15 years of age presented risk of infection 8.85 times higher than adults. Multivariable analysis of the factors involved in transmission of the disease showed that Lavapes was independently associated with infection. In that area, poor sanitary conditions and the proximity of houses to streams infested with S. marsoni cercariae facilitated infection of neighborhood women while performing domestic activities, as well as men digging sand from the streams for construction. These results show the focal nature of transmission of the endemic requiring specific intervention for effective control of disease.

Hemocultures from chronic Chagasic patients using EDTA or heparin as anticoagulants.

Hemoculture tests, a method for the detection of Trypanosoma cruzi, were used to investigate the effects of the anticoagulants heparin or EDTA on the parasite growth in culture medium (liver infusion tryptose, LIT). Hemocultures from 13 patients with positive serology for chronic Chagas' disease performed in parallel with both anticoagulants resulted in a total of seven (54%) positive hemocultures, three positive with blood samples collected with EDTA (23%), two with heparin (15%) and two with both anticoagulants (15%). There was no significant difference between the number of positive tubes in blood samples collected with either heparin (11%) or with EDTA (13%), an indication that heparin does not block the growth of T. cruzi. However, the simultaneous use of both anticoagulants may improve the positivity index of the hemocultures.

Hemocultures from chronic chagasic patients using EDTA or heparin as anticoagulants

Hemoculture tests, a method for the detection of Trypanosoma cruzi, wre used to investigate the effects of the anticoagulants heparin or EDTA on the parasite growth in culture medium (liver infusion tryptose, LIT). Hemocultures from 13 patients with positive serology for chronic Chagas' disease performed in parallel with both anticoagulants resulted in a total of seven (54%) positive hemocultures, three positive with blood samples collected with EDTA (23%), two with heparin (15%) and two with both anticoagulants (15%). There was no significant difference between the number of positive tubes in blood samples collected with either heparin (11%) or with EDTA (13%), an indication that heparin does not block the growth of T. cruzi. However, the simultaneous use of both anticoagulants may improve the positivity index of the hemocultures