RESUMEN

Hepatocellular carcinoma (HCC) is the most common primary tumor of the liver and the fifth most common cancer in the world. The lungs, bone, and lymph nodes are frequent sites of metastasis of HCC. The purpose of the present study is show that metastases, although rare, must be among the differential diagnosis of skin lesions and that a diagnostic research based on these findings can be conducted. The authors report a rare case of metastatic hepatocellular injury to the scalp and skull treated by a radical surgical approach. Excision of the lesion in the scalp was performed "en bloc." The tumor was supplied by the frontal branch of the superficial temporal artery. There are few case reports of metastatic HCC to scalp and skull; treatment of these lesions should be individualized in order to control symptoms, improve quality of life, and promote an increase in survival.

RESUMEN

Low-energy penetrating nail injury to the brain is an extremely rare neurosurgical emergency. The most common cause of nail gun injury is work related accidents; other causes result from accidental firing of a nail gun, suicide attempts by firing nail guns into the brain, and bomb blasts containing pieces of nails. Neurosurgical treatment performed by craniotomy still seems to be the safest one; there are reports of complications such as subdural hematoma and intraparenchymal hemorrhages following the blind removal of foreign bodies leading to suggestions that all penetrating foreign bodies should be removed under direct vision. We report a rarely described neurosurgical approach for removal of a penetrating nail from the brain and skull without evidence of associated hematoma and other brain lesions.

RESUMEN

BACKGROUND: The objective of this study was to evaluate renal function and to explore the relationship between some risk factors in kidney donors 12.37 ± 7.60 years after donation. PATIENTS AND METHODS: In a cross-sectional study conducted in a transplant unit, 77 nephrectomized subjects were assessed ≥5 years after donation to evaluate their renal function and the presence or absence of hypertension, dyslipidemia, and microalbuminuria. RESULTS: Twenty donors had an estimated glomerular filtration rate of <60 mL/min/1.73 m(2). Nine donors showed urinary albumin excretion of >20 µg/min (11.68%). Subjects with an EGFR of <60 mL/min were predominantly male and hypertensive and showed higher body mass index (BMI), higher uric acid, higher total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C), and logarithm of triglycerides/HDL-C (log TG/HDL-C) ratios than donors with an EGFR of >60 mL/min. Hypertensive donors were older and had higher BMI, higher UA serum values, higher TC/HDL-C and log TG/HDL-C ratios and microalbuminuria than nonhypertensive donors (P < .005). A multivariate analysis was conducted and, after final adjustment, a filtration rate of <60 mL/min was 3.05 times higher in men than women, increased 10% for each 1-unit increase in BMI and was positively associated with log (TG/HDL-C). The frequency of hypertension increased by 10% for each 1-unit increase in BMI and was positively associated with microalbuminuria. CONCLUSION: In this sample of kidney donors from a single transplant unit, ≥5 years after donation, male sex and high BMI were positively associated with the presence of kidney failure.

Asunto(s)

Hipertensión/complicaciones , Trasplante de Riñón , Donadores Vivos , Insuficiencia Renal/complicaciones , Albuminuria/complicaciones , Índice de Masa Corporal , Brasil , HDL-Colesterol/sangre , Estudios Transversales , Femenino , Tasa de Filtración Glomerular , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Triglicéridos/sangre

RESUMEN

RESUMO A utilização de plantas medicinais para o tratamento de doenças tropicais como a malária na Amazônia Central é de suma importância, principalmente em locais onde o sistema único de saúde não se encontra presente como na maioria das comunidades ribeirinhas desta região. Sendo assim, investigar e resgatar o conhecimento popular a respeito de plantas medicinais utilizadas no tratamento de malária e males associados pelos moradores da comunidade Julião situada na Reserva de Desenvolvimento Sustentável do Tupé, Manaus-AM, torna-se importante no registro de como as populações locais se previnem e tratam essa doença tão prevalente e perigosa na região. O trabalho foi conduzido na forma de oficinas participativas, segregadas por gênero e complementadas com entrevistas semiestruturadas aliadas à técnica da turnê-guiada nos quintais e floresta adjacente à comunidade. Foram calculados os índices de diversidade de Shannon-Wiener, equitabilidade e concordância quanto ao uso principal (CUP). A partir da colaboração efetiva de 13 comunitários foram registradas 62 espécies vegetais pertencentes a 53 gêneros e 34 famílias botânicas que resultaram em índice de diversidade (H’) de 1,62 decits e equitabilidade de 0,9. As famílias mais representativas foram: Fabaceae (7 espécies), Asteraceae e Lamiaceae (4 espécies cada) e Solanaceae e Rutaceae (3 espécies cada). Vale destacar que 16 espécies (25,8%) foram citadas para tratamento de malária e males associados pela primeira vez em estudos etnobotânicos realizados na América Latina.

---

ABSTRACT The use of medicinal plants in order to treat tropical diseases such as malaria is of extreme importance, particularly in places where the public health system is not present as in most coastal communities of the Amazonia region. That being stated, investigating and rediscovering the popular knowledge of medicinal plants used to treat malaria and its associated diseases by the residents of the Julião community, located in RDS Tupé, Manaus-AM, becomes relevant in recording how local populations prevent and treat this disease so prevalent and dangerous in this region. In order to carry out this study, it was implemented an ethnobotanical survey through workshops organized in categories and semi-structured interviews as well as guided tours by residents of the community in their backyards and nearby forest areas. The Shannon-Wiener diversity indicators were calculated, measuring equitability and concurrence regarding its main use (CUP). From the effective collaboration of 13 community members, 62 plant species belonging to 53 types and 34 botanic families were observed,which resulted in a diversity index (H ‘) and equitability of 1.62 decits 0.9. The most significant botanical families shown in the survey were: Fabaceae (7 species), Asteraceae (4 species), Lamiaceae (4 species), Solanaceae (3 species) and Rubiaceae (3 species). It is worth to highlight that 16 species (25.8%) were mentioned for malaria treatment and associated diseases, for the first time in ethnobotanical studies conducted in Latin America.

Asunto(s)

Humanos , Etnobotánica/métodos , Investigación Participativa Basada en la Comunidad/métodos , Malaria/diagnóstico , Medicina Tradicional , Plantas Medicinales/anatomía & histología , Enfermedades Desatendidas/clasificación

RESUMEN

Metastasis of squamous cell carcinoma of the uterine cervix on the scalp has been reported only six times in the literature; however, we found no reports of metastasis on the scalp associated with skull and brain invasion. We present an exceptionally rare case with good evolution after neurosurgical resection.

Asunto(s)

Neoplasias Encefálicas/secundario , Carcinoma de Células Escamosas/patología , Cuero Cabelludo/patología , Neoplasias Cutáneas/secundario , Neoplasias Craneales/secundario , Neoplasias del Cuello Uterino/patología , Neoplasias Encefálicas/cirugía , Femenino , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Procedimientos Neuroquirúrgicos , Neoplasias Cutáneas/cirugía , Neoplasias Craneales/cirugía , Resultado del Tratamiento

RESUMEN

Fluctuation analysis has great potential to contribute to pulmonary clinical science and practice. We evaluated the relationship between asthma and the respiratory impedance recurrence period density entropy (RPDEnZrs) and the variability (SDZrs). A non-invasive and simple protocol for assessing respiratory mechanics during spontaneous breathing was used in a group of 74 subjects with various levels of airway obstruction. Airway obstruction resulted in a reduction in the RPDEnZrs that was significantly correlated with both spirometric indices of airway obstruction (R = 0.48, p < 0.0001) and mean respiratory impedance (R = -0.83, p < 0.0001). These results suggest that the impedance pattern becomes less complex in asthmatic patients, which may explain the reduction in respiratory systems' adaptability to daily life activities. Preliminary evaluations indicate that RPDEnZrs may contribute to the asthma diagnosis, presenting accuracies of 82 and 87 % in patients with moderate and severe airway obstruction, respectively. On the other hand, SDZrs increased with obstruction (p < 0.0001) and was inversely correlated with spirometric indices of obstruction (R = -0.42, p = 0.0003) and directly associated with mean impedance (R = 0.88, p < 0.0001). This analysis contributes to elucidate previous studies and identified respiratory changes in patients with moderate and severe obstruction with an adequate accuracy (85 and 87 %, respectively).

Asunto(s)

Obstrucción de las Vías Aéreas/fisiopatología , Asma/fisiopatología , Pruebas de Función Respiratoria/métodos , Procesamiento de Señales Asistido por Computador , Adulto , Anciano , Análisis de Varianza , Entropía , Humanos , Persona de Mediana Edad , Oscilometría , Curva ROC , Mecánica Respiratoria/fisiología

RESUMEN

The trigeminal artery is an anastomosis between the embryonic precursors of the vertebrobasilar and carotid systems, and may persist into adult life. The association of the persistent primitive trigeminal artery (PTA) with cerebral aneurysm is well documented in the literature and, in general, aneurysms are located in the anterior circulation. We describe a patient who presented with a panencephalic Fisher III subarachnoid hemorrhage due to rupture of an intracranial aneurysm. Digital arteriography showed a saccular aneurysm in the middle third of the basilar artery, adjacent to the junction with a persistent trigeminal artery. She was submitted to endovascular treatment with embolization of the basilar artery aneurysm with coils. Aneurysms at the PTA junction with the basilar artery are rare. This paper describes a case of PTA associated with an aneurysm in the basilar artery at PTA junction and briefly reviews the literature.

Asunto(s)

Arteria Basilar/anomalías , Arterias Carótidas/anomalías , Aneurisma Intracraneal/diagnóstico por imagen , Hemorragia Subaracnoidea/diagnóstico por imagen , Arteria Basilar/diagnóstico por imagen , Arterias Carótidas/diagnóstico por imagen , Angiografía Cerebral , Femenino , Humanos , Persona de Mediana Edad , Hemorragia Subaracnoidea/etiología

RESUMEN

INTRODUCTION: Arteriovenous fistulas (AVF) are rare vascular lesions of the brain that differ from arteriovenous malformations as they present a direct connection between artery and vein, without interposition of the nidus. They are fed by one or more arterial branches, with a single draining vein. Clinically they can be revealed through cerebral hemorrhage, convulsive crisis, neurological deficit, heart failure in neonates and infants, headache, bruit, or intracranial hypertension symptoms. PATIENT AND METHODS: A 30-year-old patient was found unconscious on a public street, presenting a generalized tonic-clonic convulsive crisis. At admission, she presented with ocular proptosis, conjunctival hyperemia and bilateral jugular turgescence. The cranial computed tomography showed diffuse subarachnoid hemorrhage, and the cerebral angiography evidenced a giant intracranial pial AVF with high flow supplied by 2 branches of the left anterior cerebral artery.The patient underwent endovascular treatment in 2 sessions, using a mixture of histoacryl and lipiodol for complete occlusion of the lesion. She was discharged after a month, alert, devoid of motor deficit, and the ocular proptosis and the conjunctival hyperemia had decreased. CONCLUSION: AVFs are rare vascular lesions that require prompt treatment. The endovascular treatment must be considered, especially when the lesions are deep and the risks of neurological deficit associated with the surgery are high. Endoscopic intervention represents an effective and safe option for the treatment of this type of lesion.

Asunto(s)

Fístula Arteriovenosa/cirugía , Venas Cerebrales/anomalías , Procedimientos Endovasculares/métodos , Enfermedades Arteriales Intracraneales/cirugía , Procedimientos Neuroquirúrgicos/métodos , Adulto , Fístula Arteriovenosa/complicaciones , Angiografía Cerebral , Venas Cerebrales/cirugía , Femenino , Humanos , Enfermedades Arteriales Intracraneales/complicaciones , Microcirugia/métodos , Hemorragia Subaracnoidea/etiología , Resultado del Tratamiento

RESUMEN

OBJECTIVE: the aim of this report is to warn that sodium valproate used during pregnancy can produce craniosynostosis in the newborn, particularly trigonocephaly. METHOD: we describe a case of trigonocephaly in a six month-old girl, daughter of a young non-smoker couple, whose mother had used phenobarbital 100 mg daily and sodium valproate 500 mg twice daily during the whole pregnancy. We also review current literature about this topic. RESULT: bone sclerosis over the metopic suture was confirmed during surgery. Bibliographical review yields previous reports on valproate teratogenicity, mainly determining metopic suture craniosynostosis. CONCLUSION: sodium valproate used during pregnancy can produce craniosynostosis by teratogenic effect, specially trigonocephaly (premature fusion of metopic suture).

Asunto(s)

Anticonvulsivantes/efectos adversos , Suturas Craneales , Craneosinostosis/inducido químicamente , Efectos Tardíos de la Exposición Prenatal , Ácido Valproico/efectos adversos , Adulto , Suturas Craneales/diagnóstico por imagen , Craneosinostosis/diagnóstico por imagen , Femenino , Humanos , Lactante , Fenobarbital/efectos adversos , Embarazo , Tomografía Computarizada por Rayos X/métodos

RESUMEN

OBJECTIVE: The study aimed to investigate an outbreak caused by Enterobacter cloacae in a neonate intensive care unit. DESIGN: A descriptive study of an outbreak of sepsis in high-risk neonates was used. SETTING: The study was set in a tertiary care university teaching hospital. PATIENTS: The patients were 11 neonates infected with Enterobacter cloacae whose symptoms and signs of sepsis developed during a 16-hour period. All but one neonate received parenteral nutrition. Isolates from blood cultures, in-use parenteral nutrition solutions, and control aliquots of parenteral nutrition solution were typed by pulsed-field gel electrophoresis. RESULTS: Enterobacter cloacae was found in the refrigerated aliquots of parenteral nutrition solution, in blood cultures from infected newborns, and from in-use parenteral nutrition solutions. All these strains of Enterobacter cloacae had the same antibiotic susceptibility pattern and the same genomic DNA profile. The strain isolated from the one patient who did not receive parenteral nutrition presented a different susceptibility profile and genotype. CONCLUSION: The source of the nosocomial sepsis was the parenteral nutrition solution in 10 neonates. This contamination apparently occurred during preparation of the parenteral solution.

Asunto(s)

Enterobacter cloacae/aislamiento & purificación , Infecciones por Enterobacteriaceae/etiología , Nutrición Parenteral Total/efectos adversos , Choque Séptico/etiología , Brotes de Enfermedades , Electroforesis en Gel de Campo Pulsado , Enterobacter cloacae/genética , Infecciones por Enterobacteriaceae/epidemiología , Infecciones por Enterobacteriaceae/microbiología , Femenino , Genoma Bacteriano , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Masculino , Pruebas de Sensibilidad Microbiana , Factores de Riesgo , Choque Séptico/microbiología

RESUMEN

INTRODUCTION: Knowledge accumulation is overfilling the thematic content of medical graduation. Medical Schools must be alert to define a minimal content related with the most frequent disturbs. We intent to suggest topics for the minimal content, to the program of Neurology in medical graduation. METHOD: 1. To identify the places where young doctors are working outside the School Hospital (SH): we analysed the answers of the letters sent to 6415 resident - doctors (RD) in São Paulo's State and we made personal interview with 201 RD. 2. To verify the most frequent neuropsychiatric disturbs (ND) in the population: we made the analysis of the patient's diagnostic records in emergency room of three institutions: Municipal of Taubaté-SP, Municipal of São José dos Campos-SP and Faculty of Medicine of São Paulo Santa Casa de Misericórdia. RESULTS: 1. The RD are young and, outside the SH, they work in other emergency services. 2. The most frequent diagnosis in institutions were listed: alcoholism, cerebrovascular disease, coma, cranial trauma, dementia, dizziness, epilepsy, facial paralysis, faint, headache, hemiplegia or paraplegia, meningitis, others paralysis, periferical neuropathy and psychiatric disorders. CONCLUSIONS: Those diagnostics most frequent are relevant topics of the programmatic content to the program of Neurology in medical graduation.

Asunto(s)

Curriculum , Educación de Pregrado en Medicina , Enfermedades del Sistema Nervioso/epidemiología , Neurología/educación , Brasil/epidemiología , Femenino , Humanos , Masculino , Enfermedades del Sistema Nervioso/diagnóstico

RESUMEN

Rates of glucose synthesis from several substrates were examined in renal tubule fragments from hyperthyroid rats. A hyperthyroid state was induced by daily intraperitoneal injections of thyroxine (T4) (100 microg/100 g body weight) for 14 days. At the end of the experimental period, plasma triiodothyronine and T4 levels were six and eight times higher, respectively, than initial values. Hyperthyroid rats gained less weight and had lower blood glucose despite an increased food intake. In both control and hyperthyroid rats, rates of glucose production by renal tubule fragments were higher with glutamine and glycerol than with lactate, alanine, or glutamate. T4 treatment induced a significant increase in the de novo glucose synthesis from all substrates, except glutamine. The highest percent increase was obtained with alanine (64%), compared with 31-40% for glutamate, lactate, and glycerol. The T4 treatment induced increase in glucose synthesis by renal tubule fragments suggests that renal gluconeogenesis contributes to enhance glucose production in hyperthyroidism.

Asunto(s)

Glucosa/biosíntesis , Hipertiroidismo/metabolismo , Túbulos Renales/metabolismo , Animales , Gluconeogénesis , Hipertiroidismo/etiología , Técnicas In Vitro , Masculino , Ratas , Ratas Wistar , Tiroxina/farmacología

RESUMEN

During 1993 and 1994, a recycling program on Standard Precautions was conducted for the nursing personnel at the Women's Health Centre (CAISM). In 1995, an evaluation was obtained through direct observation of these sectors regarding the adoption of these measures, the adequate use, access and availability of gloves and boxes for the disposal of perforating, sharp material. Sixty observations and 232 procedures were reported. One hundred sixty four procedures (71%) adopted these measures and 68 procedures (29%) did not. It was evident that the need to wash hands and not to use needles twice should be emphasized.

Asunto(s)

Adhesión a Directriz , Enfermería/normas , Precauciones Universales

RESUMEN

The occurrence of alterations was verified in some parameters of the asymptomatic individuals' renal function infected by the virus of the human immunodeficiency (HIV). Forty seven individuals were studied, taking place renal functional tests, as: creatinine clearance, clearance of free water, clearance osmolar, reabsorption tubular proximal and distal of sodium and potassium and urinary pH. The results revealed significant differences (p < 0.05) in the urinary pH, larger in the group with HIV (6.36 +/- 0.41), that in the controls (6.02 +/- 0.41); in the clearance of free water, that indicated reabsorption of larger water in the group with HIV (1.00 +/- 0.64 ml/min) and in the clearance osmolar, that was 2.00 +/- 0.83 ml/min in the group with HIV and 1.57 +/- 0.48 ml/min. The remaining of the indicators of renal function was not shown statistically different between an and other group. It was ended that those differences are significant, in spite of the absolute values they be inside of the normality, because could be associated to late evolutionary alterations of the disease, such as the increase of the frequency of infections of the urinary treatment and the dilution hyponatremia. More studies are necessary for if they confirm those hypotheses.

Asunto(s)

Infecciones por VIH/fisiopatología , Riñón/fisiopatología , Adulto , Recuento de Linfocito CD4 , Femenino , Infecciones por VIH/inmunología , Humanos , Concentración de Iones de Hidrógeno , Masculino , Persona de Mediana Edad , Orina/química , Agua/metabolismo

RESUMEN

Verificou-se a ocorrência de alterações em alguns parâmetros da função renal de indivíduos infectados pelo virus da imunodeficiência humana (HIV), assintomáticos. Foram estudados 47 indivíduos, realizando-se provas funcionais renais: depuração de creatinina endógena, depuração de água livre, depuração osmolar, reabsorção tubular proximal e distal de sódio, excreção fracional de sódio e potássio e pH urinário. Os resultados revelaram diferenças significantes (p < 0,05) no pH urinário, maior no grupo HIV (6,36 ± 0,41), do que nos controles (6,02 ± 0,41); na depuração de água livre, que indicou reabsorção de água maior no grupo HIV (1,00 ± 0,64ml/min), do que nos controles (0,53 ± 0,48ml/min) e na depuração osmolar, que foi 2,00 ± 0,83ml/min no grupo HIV e 1,57 ± 0,48ml/min nos controles. O restante dos indicadores de função renal estudados não se mostraram diferentes estatisticamente entre um e outro grupo. Concluiu-se que essas diferenças são significativas, apesar de os valores absolutos estarem dentro da normalidade, pois podem estar associadas a alterações evolutivas tardias da doença, tais como o aumento na frequência de infecções do trato urinário e a hiponatremia dilucional. Mais estudos são necessários para se confirmarem essas hipóteses.

---

The occurrence of alterations was verified in some parameters of the asymptomatic individuals' renal function infected by the virus of the human immunodeficiency (HIV). Forty seven individuals were studied, taking place renal functional tests, as: creatinine clearance, clearance of free water, clearance osmolar, reabsorption tubular proximal and distal of sodium and potassium and urinary pH. The results revealed significant differences (p < 0.05) in the urinary pH, larger in the group with HIV (6.36 +/- 0.41), that in the controls (6.02 +/- 0.41); in the clearance of free water, that indicated reabsorption of larger water in the group with HIV (1.00 +/- 0.64 ml/min) and in the clearance osmolar, that was 2.00 +/- 0.83 ml/min in the group with HIV and 1.57 +/- 0.48 ml/min. The remaining of the indicators of renal function was not shown statistically different between an and other group. It was ended that those differences are significant, in spite of the absolute values they be inside of the normality, because could be associated to late evolutionary alterations of the disease, such as the increase of the frequency of infections of the urinary treatment and the dilution hyponatremia. More studies are necessary for if they confirm those hypotheses.

Asunto(s)

Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infecciones por VIH/fisiopatología , Riñón/fisiopatología , Agua/metabolismo , Concentración de Iones de Hidrógeno , Infecciones por VIH/inmunología , Orina/química

RESUMEN

Foi avaliada a função renal de 11 pacientes com leishmaniose cutâneo-mucosa tratados com antimonial pentavalente na dose de 40mg SbV/kg/dia aplicada de 12/12 horas, em esquema contínuo, durante trinta dias. No estudo, um paciente apresentou insuficiência renal reversível e dois desenvolveram alterações enzimáticas hepáticas e eletrocardiográficas sendo o esquema terapêutico interrompido. Nos demais pacientes observou-se efeitos nefrotóxicos tais como diminuição da taxa de filtração glomerular, diminuição da capacidade de concentração urinária, avaliada por um jejum hídrico de 16 horas e aumento na fração de excreção de sódio. No exame do sedimento urinário observou-se um aumento no número de leucócitos e cilindros. Os resultados encontrados neste estudo sugerem que o tratamento com antimonial pentavalente na dose de 40mg SbV/kg/dia foi menos tolerado em virtude de seus efeitos tóxicos, não parecendo apresentar índice de cura superior ao esquema atualmente preconizado de 20mg SbV/kg/dia.

---

The renal function of eleven patients with mucocutaneous leishmaniasis was analyzed in a prospective study realized at the School Hospital of University of Brasília. The patients were treated with doses of 40 mg/kg/day of pentavalent antimony (Sb V), in a continuous scheme during thirty days. In this study three patients were excluded, one patient with reversible renal failure and two patients with hepatic and cardiac malfunctions. In the other eight patients, severe nephrotoxic effects were observed, like reduction of glomerular filtration rate, reduction of the urinary concentration capacity, evaluated by a sixteen hours hydric fasting and an increase of sodium fractional excretion. An increase in the number of leucocytes and cylinders were observed at the urinary sediment exam. Finally, the results shows that the treatment with pentavalent antimony in doses of 40 mg Sb/kg/day was less tolerated on account of its renal toxic effects. This scheme seems not be superior than the currently preconized scheme of 20 mg of Sb V/kg/day during 30 days.

Asunto(s)

Adolescente , Adulto , Animales , Humanos , Persona de Mediana Edad , Antimonio/administración & dosificación , Antimonio/efectos adversos , Antiprotozoarios/administración & dosificación , Antiprotozoarios/efectos adversos , Compuestos Organometálicos/administración & dosificación , Leishmania braziliensis , Leishmaniasis Mucocutánea/tratamiento farmacológico , Meglumina/administración & dosificación , Meglumina/efectos adversos , Riñón/efectos de los fármacos , Compuestos Organometálicos/efectos adversos , Evaluación de Medicamentos , Tolerancia a Medicamentos , Leishmaniasis Mucocutánea/fisiopatología , Estudios Prospectivos , Riñón/fisiopatología , Factores de Tiempo

RESUMEN

The renal function of eleven patients with mucocutaneous leishmaniasis was analyzed in a prospective study realized at the School Hospital of University of Brasília. The patients were treated with doses of 40 mg/kg/day of pentavalent antimony (Sb V), in a continuous scheme during thirty days. In this study three patients were excluded, one patient with reversible renal failure and two patients with hepatic and cardiac malfunctions. In the other eight patients, severe nephrotoxic effects were observed, like reduction of glomerular filtration rate, reduction of the urinary concentration capacity, evaluated by a sixteen hours hydric fasting and an increase of sodium fractional excretion. An increase in the number of leucocytes and cylinders were observed at the urinary sediment exam. Finally, the results shows that the treatment with pentavalent antimony in doses of 40 mg Sb/kg/day was less tolerated on account of its renal toxic effects. This scheme seems not be superior than the currently preconized scheme of 20 mg of Sb V/kg/day during 30 days.

Asunto(s)

Antimonio/administración & dosificación , Antimonio/efectos adversos , Antiprotozoarios/administración & dosificación , Antiprotozoarios/efectos adversos , Riñón/efectos de los fármacos , Leishmania braziliensis , Leishmaniasis Mucocutánea/tratamiento farmacológico , Meglumina/administración & dosificación , Meglumina/efectos adversos , Compuestos Organometálicos/administración & dosificación , Compuestos Organometálicos/efectos adversos , Adolescente , Adulto , Animales , Evaluación de Medicamentos , Tolerancia a Medicamentos , Humanos , Riñón/fisiopatología , Leishmaniasis Mucocutánea/fisiopatología , Antimoniato de Meglumina , Persona de Mediana Edad , Estudios Prospectivos , Factores de Tiempo

RESUMEN

Gluconeogenic activity and kinetic parameters of glucose metabolism were estimated during the different phases of prolonged food deprivation in quails. Gluconeogenic activity, estimated from the rate of increase of incorporation of H14CO-3 into circulating glucose, was significantly higher in fasted quails than in fed birds, whatever the period of food deprivation. However, gluconeogenic activity during phase II, although higher than in the fed state, was significantly lower than in quails fasted for 2 days (phase I) or in those on the final (phase III) period of starvation. Gluconeogenic activity did not differ significantly in birds from phases I and III. Rates of glucose replacement, estimated with [6-3H]-glucose, were very high (20.5 mg.kg-1.min-1) in fed quails and were markedly reduced (to about 42% of fed values) by fasting, no difference being observed between quails fasted for 2 and 5 days. Because of the poor condition of the birds, glucose replacement rates could not be measured during phase III. The present data are the first to provide direct evidence for the changes in gluconeogenesis which occur during prolonged food deprivation.

Asunto(s)

Coturnix/metabolismo , Ayuno/metabolismo , Gluconeogénesis/fisiología , Glucosa/metabolismo , Adaptación Fisiológica/fisiología , Anestesia General , Animales , Bicarbonatos/metabolismo , Privación de Alimentos/fisiología , Cinética , Masculino

RESUMEN

After up to 21 days without food, adult male quails (Coturnix coturnix japonica) lost about 45% of the initial body weight (100-150 g). As in naturally fast-adapted and larger birds, three phases were identified during prolonged fasting in quails. Phase I lasted 2-3 days and was characterized by a rapid decrease in the rate of body weight loss and high fat mobilization. Phase II was longer and characterized by a slow and steady decline in the rates of body weight loss and of nitrogen excretion. The third (critical) period was marked by an abrupt increase in the rates of body weight loss and of nitrogen excretion. Despite their small size, the duration of phase II in quails was relatively long, a clear advantage for the study of the relationships between the several metabolic events that occur during this crucial adaptative period. Also, the beginning of phase III could be precisely determined. Changes in blood glucose, plasma FFA and triacylglycerols levels, as well as in liver and carcass lipid content were similar to those found in other species of birds. Therefore, quails seem to be a suitable model to investigate the biochemical mechanisms involved in the metabolic adjustments to prolonged food deprivation in non fasting-adapted birds.

Asunto(s)

Adaptación Fisiológica/fisiología , Coturnix/metabolismo , Ayuno/metabolismo , Aminoácidos/sangre , Animales , Glucemia/metabolismo , Peso Corporal/fisiología , Carbohidratos de la Dieta/metabolismo , Proteínas en la Dieta/metabolismo , Ácidos Grasos no Esterificados/sangre , Metabolismo de los Lípidos , Lípidos/sangre , Hígado/metabolismo , Masculino , Nitrógeno/orina , Triglicéridos/sangre

RESUMEN

The effect of an 8 hour-period of water deprivation on fluid and electrolyte renal excretion was investigated in male Wistar rats infected with the strain Sao Felipe (12SF) of Trypanosoma cruzi, in comparison with age and sex matched non-infected controls. The median percent reductions in the urinary flow (-40 per cent v -63 per cent) and excretion of sodium (-57 per cent v - 79 per cent) were smaller in chagasic than in control rats, respectively. So, chagasic rats excereted more than controls. On the other hand, the median percent decrement in the clearance of creatinine was higher in chagasic (-51 per cent) than in controls (-39 per cent). Thus, chagasic rats showed some disturbed renal hydroelectrolytic responses to water deprivation, expressed by smaller conservation, or higher excretion of water and sodium in association with smallerglotmerular filtration rate. This fact denoted an elevation in the fractional excretion of sodium and water.

Asunto(s)

Animales , Masculino , Ratas , Enfermedad de Chagas/fisiopatología , Privación de Agua/fisiología , Desequilibrio Hidroelectrolítico/fisiopatología , Enfermedad Crónica , Ratas Wistar