RESUMEN
Myocardial ischemia may occur during an exercise session in cardiac rehabilitation programs. However, it has not been established whether it is elicited when exercise prescription is based on heart rate corresponding to the anaerobic threshold as measured by cardiopulmonary exercise testing. Our objective was to determine the incidence of myocardial ischemia in cardiac rehabilitation programs according to myocardial perfusion SPECT in exercise programs based on the anaerobic threshold. Thirty-nine patients (35 men and 4 women) diagnosed with coronary artery disease by coronary angiography and stress technetium-99m-sestamibi gated SPECT associated with a baseline cardiopulmonary exercise test were assessed. Ages ranged from 45 to 75 years. A second cardiopulmonary exercise test determined training intensity at the anaerobic threshold. Repeat gated-SPECT was obtained after a third cardiopulmonary exercise test at the prescribed workload and heart rate. Myocardial perfusion images were analyzed using a score system of 6.4 at rest, 13.9 at peak stress, and 10.7 during the prescribed exercise (P < 0.05). The presence of myocardial ischemia during exercise was defined as a difference > or = 2 between the summed stress score and summed rest score. Accordingly, 25 (64%) patients were classified as ischemic and 14 (36%) as nonischemic. MIBI-SPECT showed myocardial ischemia during exercise within the anaerobic threshold. The 64% prevalence of ischemia observed in the study should not be looked on as representative of the whole population of patients undergoing exercise programs. Changes in patient care and exercise programs were implemented as a result of our finding of ischemia during the prescribed exercise.
Asunto(s)
Umbral Anaerobio/fisiología , Prueba de Esfuerzo/efectos adversos , Frecuencia Cardíaca/fisiología , Isquemia Miocárdica/etiología , Anciano , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/rehabilitación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/diagnóstico por imagen , Isquemia Miocárdica/fisiopatología , Radiofármacos , Factores de Riesgo , Tecnecio Tc 99m Sestamibi , Tomografía Computarizada de Emisión de Fotón ÚnicoRESUMEN
Myocardial ischemia may occur during an exercise session in cardiac rehabilitation programs. However, it has not been established whether it is elicited when exercise prescription is based on heart rate corresponding to the anaerobic threshold as measured by cardiopulmonary exercise testing. Our objective was to determine the incidence of myocardial ischemia in cardiac rehabilitation programs according to myocardial perfusion SPECT in exercise programs based on the anaerobic threshold. Thirty-nine patients (35 men and 4 women) diagnosed with coronary artery disease by coronary angiography and stress technetium-99m-sestamibi gated SPECT associated with a baseline cardiopulmonary exercise test were assessed. Ages ranged from 45 to 75 years. A second cardiopulmonary exercise test determined training intensity at the anaerobic threshold. Repeat gated-SPECT was obtained after a third cardiopulmonary exercise test at the prescribed workload and heart rate. Myocardial perfusion images were analyzed using a score system of 6.4 at rest, 13.9 at peak stress, and 10.7 during the prescribed exercise (P < 0.05). The presence of myocardial ischemia during exercise was defined as a difference ≥2 between the summed stress score and summed rest score. Accordingly, 25 (64 percent) patients were classified as ischemic and 14 (36 percent) as nonischemic. MIBI-SPECT showed myocardial ischemia during exercise within the anaerobic threshold. The 64 percent prevalence of ischemia observed in the study should not be looked on as representative of the whole population of patients undergoing exercise programs. Changes in patient care and exercise programs were implemented as a result of our finding of ischemia during the prescribed exercise.
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Umbral Anaerobio/fisiología , Prueba de Esfuerzo/efectos adversos , Frecuencia Cardíaca/fisiología , Isquemia Miocárdica/etiología , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/rehabilitación , Isquemia Miocárdica/fisiopatología , Isquemia Miocárdica , Radiofármacos , Factores de Riesgo , Tomografía Computarizada de Emisión de Fotón ÚnicoAsunto(s)
Rechazo de Injerto/inmunología , Trasplante de Riñón/inmunología , Glicoproteínas de Membrana/análisis , Serina Endopeptidasas/análisis , Adolescente , Adulto , Biopsia con Aguja/métodos , Cadáver , Proteína Ligando Fas , Femenino , Rechazo de Injerto/sangre , Rechazo de Injerto/patología , Granzimas , Humanos , Trasplante de Riñón/patología , Masculino , Glicoproteínas de Membrana/sangre , Persona de Mediana Edad , Perforina , Proteínas Citotóxicas Formadoras de Poros , Serina Endopeptidasas/sangre , Donantes de TejidosAsunto(s)
Corazón/diagnóstico por imagen , Fallo Renal Crónico/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Diálisis Renal , Huesos/diagnóstico por imagen , Calcinosis/diagnóstico por imagen , Femenino , Humanos , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Cintigrafía , Medronato de Tecnecio Tc 99m , Uremia/diagnóstico por imagenRESUMEN
The effects of hypothyroidism on oligodendroglial differentiation and myelination are for the first time studied by immunohistochemical localization of an early oligodendroglial marker, the 2'3'cyclic nucleotide 3'phosphodiesterase (E.C. 3.1.4.37-CNPase), in developing rats. Two groups received methimazol; one during gestation (H) and another postnatally (PN). One H sub-group received thyroxine after birth (T). We observed a delay in CNPase expression followed by a decrease in the number of CNPase immunoreactive fibers in both H and PN groups. The T sub-group was not different from controls. Furthermore, the immunoreactive fibers, in mature hypothyroid animals, showed a continuous pattern of staining in contrast with a discontinuous one in controls. Myelinogenesis is a highly regulated timed event. CNPase links myelin related proteins to the cytoskeleton also interacting with membrane lipids during extension and wrapping of the oligodendroglial process around the axon (ensheathment phase). In mature myelinated fiber the CNPase is absent from compact myelin sheath, being located only in the inner and outer loops and in paranodal loops. Thus, our data suggest a disorder in myelin compaction and point once more to the post-natal period as critical for the mechanisms that are thyroid hormone regulated in myelinogenesis.
Asunto(s)
2',3'-Nucleótido Cíclico Fosfodiesterasas/análisis , Encéfalo/anomalías , Encéfalo/enzimología , Hipotiroidismo Congénito , Hipotiroidismo/metabolismo , Vaina de Mielina/enzimología , Animales , Antitiroideos , Encéfalo/patología , Femenino , Hipotiroidismo/inducido químicamente , Hipotiroidismo/patología , Inmunohistoquímica , Metimazol , Vaina de Mielina/patología , Oligodendroglía/enzimología , Oligodendroglía/patología , Embarazo , Efectos Tardíos de la Exposición Prenatal , Ratas , Ratas Wistar , Tiroxina/farmacologíaAsunto(s)
Quimiocinas/genética , Rechazo de Injerto/inmunología , Supervivencia de Injerto/inmunología , Trasplante de Corazón/inmunología , Animales , Ciclosporina/uso terapéutico , Regulación de la Expresión Génica/efectos de los fármacos , Regulación de la Expresión Génica/inmunología , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Trasplante Homólogo , Trasplante IsogénicoRESUMEN
A few family studies have evaluated HLA antigens in Alport's syndrome; however, there are no large population studies. In the present report, we studied 40 unrelated white patients with Alport's syndrome seen at the Unit of Renal Transplantation, Faculty of Medicine of Ribeirão Preto, São Paulo, Brazil. HLA-A, -B, -DR and -DQ antigens were typed using a complement-dependent microlymphocytotoxicity assay. A control white population (N = 403) from the same geographical area was also typed for HLA antigens. Although the frequencies of HLA-A and -B antigens of patients were not statistically different from controls, the frequency of HLA-DR2 antigen observed in patients (65%) was significantly increased in relation to controls (26%; P < 0.001). The relative risk and etiologic fraction for HLA-DR2 antigen were 5.2 and 0.525, respectively. Although few immunological abnormalities have been shown in Alport's syndrome, in this report we emphasize the association of HLA molecules and Alport's syndrome. Besides the well-known inherited molecular defects encoded by type IV collagen genes in Alport's syndrome, the major histocompatibility alleles may be in linkage disequilibrium with these defective collagen genes.
Asunto(s)
Antígeno HLA-DR2/sangre , Nefritis Hereditaria/inmunología , Adolescente , Adulto , Niño , Femenino , Humanos , Complejo Mayor de Histocompatibilidad/inmunología , Masculino , Persona de Mediana Edad , Factores de RiesgoRESUMEN
A few studies have evaluated HLA antigens in Alport's syndrome; however, there are no large population studies. In the present report, we studied 40 unrelated white patients with Alport's syndrome seen at the Unit of Renal Transplantation, Faculty of Medicine of Ribeirao Preto, Sao Paulo, Brazil. HLA-A, -B, -DR and -DQ antigens were typed using a complement-dependent microlymphocytotoxicity assay. A control white populations (N=403) from the same geographical area was also typed for HLA antigens. Although the frequencies of HLA-A and -B antigens of patients were not statistically different from controls, the frequency of HLA-DR2 antigen observed in patients (65 percent) was significantly increased in relation to controls (26 percent; P<0.001). The relative risk and etiologic fraction for HLA-DR2 antigen were 5.2 and 0.525, respectively. Although few immunological abnormalities have been shown in Alport's syndrome, in this report we emphasize the association of HLA molecules and Alport's syndrome. Besides the well-known inherited molecular defects encoded by tyope IV collagen genes in Alport's syndrome, the major histocompatibility alleles may be in linkage disequilibrium with these defective collagen genes.
Asunto(s)
Adulto , Persona de Mediana Edad , Femenino , Humanos , Niño , Adolescente , Antígenos HLA/sangre , Nefritis Hereditaria/inmunología , Complejo Mayor de Histocompatibilidad/inmunología , Factores de RiesgoRESUMEN
O objetivo do trabalho foi verificar a prevalência de candidíase em transplantados renais. Foram avaliados os prontuários dos pacientes transplantados no Hospital das Clínicas de Ribeirão Preto de fevereiro de 1968 a fevereiro de 1995. Nesse período foram transplantados 620 pacientes. Destes, 87 apresentaram 107 episódios de candidíase. Locais mais acometidos: trato urinário com 55 episódios, trato respiratório com 28, e trato gastrointestinal com 16. O agente etiológico mais freqüente foi C. albicans com 65 casos seguido de C. tropicalis com 12 e C. glabrata com 11 casos. As infecções do trato urinário mostraram incidência maior (61,7%) nos primeiros 6 meses. A maioria se apresentou clínicamente como infecção bacteriana. No trato respiratório, as infecções foram caracterizadas por recuperação do agente no escarro. No trato gastrointestinal, 9/16 episódios foram esofágicos, com epigastralgia, dor retroesternal, às vezes acompanhados de candidíase oral ou odinofagia. Nos outros episódios o agente foi recuperado nas fezes com quadro clínico de gastroenterite. Nas infecções dos tratos urinário e respiratório, houve associação da candidíase com antibioticoterapia prévia (76% e 67% respectivamente), além de infecções bacterianas concomitantes (34% e 64% respectivamente). As infecções por Candida sp tiveram prevalência geral em torno de 14,5%. A localização predominante foi no trato urinário e, em seguida, nos tratos respiratório e gastrointestinal, apresentando alto índice de associação com antibioticoterapia prévia e infecções bacterianas.
The medical records of 620 patients submitted to renal transplant from February 1968 to February 1995 were surveyed for Candida infection. Of these, 87 presented 107 episodes of candidiasis. In 42.9% the infection appeared up to 6 months after the transplant. The most frequent involved sites were: urinary tract, respiratory tract, and gastrointestinal tract. The most frequent etiological agents were: C. albicans, C. tropicalis and C. glabrata. Most urinary tract infections occurred in the first 6 months (61.7%) and manifested clinically as a bacterial infection. In the respiratory tract infections were characterized by isolation of the agent in sputum. In the gastrointestinal infections, 9/16 episodes were esophageal. There were 3 deaths directly related to Candidiasis (one pulmonary and 2 disseminated cases). In the urinary tract, and respiratory tract infections there was association of candidiasis with previous antibiotic treatment (76% and 67%, respectively), and with concomitant bacterial infections (34% and 64%, respectively). The overall prevalence of Candida infections was 14.5%. The predominant location was in the urinary tract (51.0%), followed by the respiratory (26.0%) and gastrointestinal tract (15.0%), with a high rate of association with previous antibiotic treatment and bacterial infections.
Asunto(s)
Femenino , Humanos , Masculino , Candidiasis/epidemiología , Infección Hospitalaria/epidemiología , Trasplante de Riñón , Brasil/epidemiología , Causas de Muerte , Candida/aislamiento & purificación , Candidiasis/microbiología , Infección Hospitalaria/microbiología , Infecciones Bacterianas/epidemiología , Prevalencia , Estudios Retrospectivos , Factores de Tiempo , Trasplante de Riñón/mortalidad , Trasplante de Riñón/estadística & datos numéricosRESUMEN
The most common form of bacterial infection in renal transplant recipients is urinary tract infection (UTI), and some studies have shown that prophylaxis can reduce this incidence. In the present investigation we evaluated 80 patients submitted to renal transplantation at the Renal Transplant Unit of the University Hospital of Ribeirao Preto, SP. The study was prospective, double blind and randomized. The patients were divided into two groups, one receiving placebo and the other ciprofloxacin at the dose of 250 mg twice a day for the first 10 d and 250 mg/d for 6 months after transplantation. Of the 41 patients who received ciprofloxacin 28 completed the study, and of the 39 patients who received placebo 30 completed the study. The largest number of UTI occurred in the placebo group, with a significant difference from the ciprofloxacin group during the first month after surgery (p < 0.05). In the group treated with ciprofloxacin, only 6/40 patients (15%) developed UTI, as opposed to 19/39 (48.7%) for the placebo group. The total number of infectious episodes was higher in the placebo group (26) than in the ciprofloxacin group (12). The medication was well tolerated throughout the study period.
Asunto(s)
Antiinfecciosos/uso terapéutico , Ciprofloxacina/uso terapéutico , Trasplante de Riñón , Infecciones Urinarias/prevención & control , Administración Oral , Adulto , Antiinfecciosos/administración & dosificación , Antiinfecciosos/efectos adversos , Bacteriuria/prevención & control , Brasil , Candidiasis/etiología , Candidiasis/prevención & control , Causas de Muerte , Quimioprevención , Ciprofloxacina/administración & dosificación , Ciprofloxacina/efectos adversos , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Placebos , Estudios Prospectivos , Infecciones Urinarias/etiologíaRESUMEN
The medical records of 620 patients submitted to renal transplant from February 1968 to February 1995 were surveyed for Candida infection. Of these, 87 presented 107 episodes of candidiasis. In 42.9% the infection appeared up to 6 months after the transplant. The most frequent involved sites were: urinary tract, respiratory tract, and gastrointestinal tract. The most frequent etiological agents were: C. albicans, C. tropicalis and C. glabrata. Most urinary tract infections occurred in the first 6 months (61.7%) and manifested clinically as a bacterial infection. In the respiratory tract infections were characterized by isolation of the agent in sputum. In the gastrointestinal infections, 9/16 episodes were esophageal. There were 3 deaths directly related to Candidiasis (one pulmonary and 2 disseminated cases). In the urinary tract, and respiratory tract infections there was association of candidiasis with previous antibiotic treatment (76% and 67%, respectively), and with concomitant bacterial infections (34% and 64%, respectively). The overall prevalence of Candida infections was 14.5%. The predominant location was in the urinary tract (51.0%), followed by the respiratory (26.0%) and gastrointestinal tract (15.0%), with a high rate of association with previous antibiotic treatment and bacterial infections.
Asunto(s)
Candidiasis/epidemiología , Infección Hospitalaria/epidemiología , Trasplante de Riñón , Infecciones Bacterianas/epidemiología , Brasil/epidemiología , Candida/aislamiento & purificación , Candidiasis/microbiología , Causas de Muerte , Infección Hospitalaria/microbiología , Femenino , Humanos , Trasplante de Riñón/mortalidad , Trasplante de Riñón/estadística & datos numéricos , Masculino , Prevalencia , Estudios Retrospectivos , Factores de TiempoRESUMEN
A reabilitaçäo cardíaca é o processo de desenvolvimento e manutençäo de nível desejável de atividade física, social e psicológica após o início da doença coronária sintomática. Trata-se de terapêutica multidisciplinar para patologia multifatorial. Os maiores objetivos säo: melhora da capacidade funcional e da qualidade de vida, mudança de hábitos após evento coronário, com modificaçäo dos fatores de risco e reduçäo dos índices de mortalidade. Säo discutidos os vários efeitos do treinamento físico, clusive sobre a qualidade de vida de homens e mulheres, os tipos de exercício apropriados, conforme o tipo de doença cardiovascular, bem como a estratificaçäo quanto ao risco para atividade física após evento coronário. finalmente, säo apresentadas as indicaçöes e contra-indicaçöes atuais da reabilitaçäo cardíaca.
Asunto(s)
Enfermedades Cardiovasculares/rehabilitación , Rehabilitación , Terapia por Ejercicio , Calidad de VidaRESUMEN
O crescente número de transplantes cardíacos em nosso país e as limitaçöes funcionais, psicológicas e sociais após a cirurgia justificam a inclusäo desse grupo especial de pacientes em programa de reabilitaçäo cardiovascular, com abrangência multidisciplinar. Idealmente, o programa deve iniciar no período pré-transplante, pois estudos recentes demonstram que o tratamento farmacológico da insuficiência cardíaca avançada, isoladamente, näo reduz os sintomas como fadiga e dispnéia ao exercício. Váriosutores têm reportado melhora das respostas hemodinâmicas e respiratórias ao esforço com programas supervisionados de exercícios regulares e de moderada intensidade. Particularidades como a denervaçäo do coraçäo do doador, que resulta em taquicardia de repouso e insuficiência cronotrópica, assim como a disfunçäo diastólica säo fatores presentes e que limitam as adaptaçöes periféricas ao treinamento físico. Os benefícios descritos ocorrem a partir de oito semanas, destacando-se os aumentos entre 30 por cet e 40 por cento do consumo máximo de oxigênio e entre 30 por cento e 35 por cento na capacidade de exercício. Melhora da qualidade de vida e estabilidade psicológica também säo relatadas após período de 3 a 6 meses e o apoio e o envolvimento familiar säo imprescindíveis. A terapia imunossupressora, particularemente os corticosteróides, os episódios de rejeiçäo aguda e infecçöes säo fatores que interferem negativamente nos resultados funcionais e psicológicos, daí a necessidade de seguimento clínico coníno e frequente durante todo o processo de reabilitaçäo.
Asunto(s)
Terapia por Ejercicio , Trasplante de Corazón , Calidad de Vida , Ejercicio Físico , RehabilitaciónAsunto(s)
Presión Sanguínea/efectos de los fármacos , Ciclosporina/farmacología , Circulación Esplácnica/efectos de los fármacos , Acetilcolina/farmacología , Análisis de Varianza , Animales , Técnicas In Vitro , Masculino , Nitroprusiato/farmacología , Fenilefrina/farmacología , Ratas , Ratas Wistar , Circulación Esplácnica/fisiologíaRESUMEN
Between January 1968 and December 1992, 136 kidney transplants were performed in the University Hospital of Ribeirão Preto, with women of childbearing age (14 to 40 years) as receptors. From this population, 19 patients became pregnant at least once after transplantation, and 2 were transplanted inadvertently during the first trimester of their pregnancies. There was a total of 25 pregnancies and 27 offspring. The mean age at the time of conception was 28.6 years (23 to 41 years), with a mean interval of 3.5 years from transplant to conception (< 1 to 16 years). All patients continued their immunosuppressive regimens during the entire pregnancy, but only 5 of 25 were taking cyclosporine. There were two miscarriages (8%) and two therapeutic abortions (8%); of those that passed the 20th week of pregnancy, the mean gestation time at delivery was 35 weeks (range, 28 to 38 weeks) with an incidence of prematurity (gestation < 37 weeks) of 67%, and their offspring weighed from 670 to 3,100 g (mean, 2,236 g), presenting a very high incidence of low birthweight (64%). There was one stillborn and one neonatal death. The most common complications that occurred during pregnancy were infections (especially urinary tract and vaginal mycotic infections) followed by hypertension. The obstetric complications were distributed as follows: premature rupture of membranes in 27%, fetal distress in 24%, preterm labor in 24%, and oligohydramnios in 10%. Lower segment cesarean section was necessary in 16 of 21 cases (76%), and all were for obstetric reasons. One patient died during the puerperium because of sepsis.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Países en Desarrollo , Fallo Renal Crónico/cirugía , Trasplante de Riñón , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo/epidemiología , Embarazo , Adolescente , Adulto , Brasil/epidemiología , Cesárea/estadística & datos numéricos , Femenino , Humanos , Inmunosupresores/uso terapéutico , Incidencia , Recién Nacido de Bajo Peso , Recién Nacido , Fallo Renal Crónico/epidemiología , Complicaciones del Embarazo/cirugía , Estudios RetrospectivosRESUMEN
We report two cases of acute renal failure in renal transplant patients using cyclosporine-A (CsA) after the introduction of angiotensin-converting enzyme inhibitor (ACEI) to control arterial hypertension. They had no renal artery stenosis or acute rejection. Both patients presented severe acute tubular necrosis (ATN), which subsided after discontinuation of the ACEI. Synergistic toxic effect of ACEI and CsA on the renal tubules might explain ATN in these two cases.
Asunto(s)
Enalapril/efectos adversos , Trasplante de Riñón , Necrosis Tubular Aguda/inducido químicamente , Ciclosporina/efectos adversos , Ciclosporina/uso terapéutico , Relación Dosis-Respuesta a Droga , Sinergismo Farmacológico , Enalapril/administración & dosificación , Enalapril/uso terapéutico , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Túbulos Renales/efectos de los fármacos , Masculino , Persona de Mediana EdadRESUMEN
Clinical and serological follow-up of 7 patients submitted to renal transplantation and presenting positive serological reactions to Chagas' disease before immunosuppression did not show significant changes in indirect immunofluorescence and complement fixation titres for Chagas' disease, or signs and symptoms indicating exacerbation of the disease during follow-up. In addition, 18 of 66 recipients of renal transplants considered to be non-chagasic before immunosuppression showed at least one positive result to the indirect immunofluorescence test for Chagas' disease during the study period. The results suggest that the immunosuppression state induced in chagasic patients submitted to renal transplant did not promoted exacerbation of the chronic infection in these patients and not interfere with the serological response of chronic chagasics, thus permitting the use of these serologic reactions for diagnostic purposes in these cases. However, the positive results of the indirect immunofluorescence test in non-chagasic patients indicate the need for judicious interpretation of the indirect immunofluorescence test for the diagnosis of Chagas' disease in renal transplanted patients.
Asunto(s)
Enfermedad de Chagas/diagnóstico , Huésped Inmunocomprometido/inmunología , Trasplante de Riñón/inmunología , Brasil/epidemiología , Enfermedad de Chagas/epidemiología , Pruebas de Fijación del Complemento , Técnica del Anticuerpo Fluorescente , Estudios de Seguimiento , Humanos , Terapia de Inmunosupresión , Fallo Renal Crónico/inmunología , Fallo Renal Crónico/cirugía , Trasplante de Riñón/estadística & datos numéricos , Estudios LongitudinalesRESUMEN
Two cases of acute Chagas' disease acquired after renal transplantation are reported. The two patients received the kidney from the same donor. The present paper confirms this form of transmission of Chagas' disease and reinforces the need to exclude kidney donors with Trypanosoma cruzi infection.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Persona de Mediana Edad , Enfermedad de Chagas/transmisión , Trasplante de Riñón , Enfermedad Aguda , Enfermedad de Chagas/sangreRESUMEN
In the present report the authors discuss the diagnostic difficulties, therapeutic measures and the clinical course of Nocardia infection which occurred among renal transplant recipients at the University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo (UH-FRP), from 1968 to 1991. Among 500 individuals submitted to renal transplant, 9 patients developed Nocardiosis at varying times after transplant (two months to over two years). All the patients had pulmonary involvement and their most common symptoms were fever, cough and pleural pain. Dissemination of the process is common and three patients presented cutaneous abscesses, four CNS involvement and one had pericarditis due to Nocardia. The diagnostic is quite difficult since there is no specific clinical picture, concomitant infections are frequent and the microorganism presents slow growth in culture (ranging from four to forty days, in our experience). In this report, three cases were only diagnosed by necropsy. The treatment of choice is a combination of Sulfamethoxazole and Trimethoprim (SMX-TMP). In the present series, overall mortality was 77 (7 cases) and in five of the patients who died the diagnosis was late. All the patients who had CNS involvement died.