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Se describe el caso de un paciente de 70 años que consultó por cefalea súbita, tipo trueno, sin alteración del estado de consciencia, acompañada de dolor torácico de una hora de evolución y de baja intensidad. A su ingreso fue enfocado como cefalea en trueno, que es clasificada, en cuanto a la atención, como bandera roja. La medición de troponina fue negativa y una tomografía de cráneo fue leída como normal. Desde el ingreso presentaba signos vitales normales, cuando iba a ser dado de alta se torna hipotenso (completamente asintomático) y por su síntoma cardinal (cefalea), que se asoció a dolor torácico leve y no anginoso, se solicitó angiotomografía toracoabdominal, con la que se demostró aneurisma disecante de la aorta. Con la presentación de este caso, se busca resaltar la importancia en el servicio de urgencias de la asociación de la cefalea tipo trueno, con condiciones vasculares como la disección aórtica.

We describe the case of a 70-year-old patient, who seeks medical advice due to sudden, thunder headache, without alteration of the state of consciousness, accompanied by chest pain of 1 hour of evolution and of low intensity. Upon his admission, the patient was treated as a thunderclap headache, which is considered a red flag. His troponin was negative, and his head tomography was interpreted as normal. From admission he had normal vital signs, but when he was going to be discharged, he became hypotensive (completely asymptomatic) and due to his cardinal symptom (headache) that was asso-ciated with mild non-anginal chest pain, a thoracoabdominal angioCT was requested, with which dissecting aneurysm of the aorta was evidenced. With the presentation of this case, we seek to highlight the importance of the association of thunder-type headache with possible vascular conditions such as aortic dissection in the emergency department.

Descrevemos o caso de uma paciente de 70 anos que consultou por quadro de cefaleia súbita, tipo trovão, sem alteração do estado de consciência, acompanhada de dor torácica de uma hora de evolução e de baixa intensidade. Na admissão, foi tratado como cefaleia em trovoada, que é classificada, em termos de atenção, como bandeira vermelha. A me-dição da troponina foi negativa e uma tomografia de crânio foi lida como normal. Desde a admissão apresentava sinais vitais normais, quando ia receber alta ficou hipotenso (totalmente assintomático) e devido ao seu sintoma cardinal (cefaleia), que se associou a dores torácicas ligeiras e não anginosas, foi solicitada angiografia toracoabdominal, com cujo aneurisma dissecante da aorta foi demonstrado. Com a apresentação deste caso, o objetivo é destacar a importância no pronto-socorro da associação da cefaleia do tipo trovão com afecções vasculares como a dissecção da aorta.

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Este trabalho teve como objetivo avaliar o efeito da substituição da farinha e do óleo de peixe pelo concentrado proteico de soja e óleo de soja, na sobrevivência, no crescimento e na composição corporal dos camarões (Litopenaeus vannamei) produzidos em sistema de bioflocos (BFT). Foram formuladas cinco dietas, isoproteicas e isoenergéticas, com diferentes níveis de substituição da farinha e do óleo de peixe por concentrado proteico de soja e óleo de soja, sendo os tratamentos designados como: 0% (sem substituição), 25%, 50%, 75% e 100%. As rações foram elaboradas para conter aproximadamente 35% de proteína e 8% de lipídios. O experimento foi conduzido durante 49 dias, com juvenis com peso inicial de 2,93±0,83g, em sistema de bioflocos (BFT). Não foram encontradas diferenças significativas entre os tratamentos até 75% de substituição para as variáveis de ganho de peso, conversão alimentar e sobrevivência. O tratamento de 100% de substituição apresentou menor taxa de crescimento específico. O presente resultado sugere que, nas dietas para camarões criados em sistema bioflocos, a farinha e o óleo de peixe possam ser substituídos em até 75% por concentrado proteico de soja e óleo de soja, sem prejudicar o desenvolvimento dos animais.(AU)

The objective of this work was to evaluate the effect of the substitution of fishmeal and fish oil with soy protein concentrate and soybean oil on survival, growth and body composition of shrimp (Litopenaeus vannamei) produced in biofloc system (BFT). Five diets were formulated to be isoproteic and isoenergetic with different levels of substitution of fishmeal and fish oil with soy protein concentrate and soybean oil. The treatments were named as: 0% (without substitution), 25%, 50%, 75% and 100%. The diets were formulated to contain approximately 35% protein and 8% lipids. The experiment was conducted for 49 days, with juveniles with initial weight of (2.93±0.83g) in a biofloc system (BFT). No significant differences were found between treatments up to 75% of substitution for the variables of weight gain, feed conversion ratio, and survival. The 100% substitution treatment showed a lower specific growth rate. The present study suggests fish meal and fish oil can be substituted in up to 75% for soy protein concentrate and soybean oil, without harming the development of the shrimps when reared in biofloc system.(AU)

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Este trabalho teve como objetivo avaliar o efeito da substituição da farinha e do óleo de peixe pelo concentrado proteico de soja e óleo de soja, na sobrevivência, no crescimento e na composição corporal dos camarões (Litopenaeus vannamei) produzidos em sistema de bioflocos (BFT). Foram formuladas cinco dietas, isoproteicas e isoenergéticas, com diferentes níveis de substituição da farinha e do óleo de peixe por concentrado proteico de soja e óleo de soja, sendo os tratamentos designados como: 0% (sem substituição), 25%, 50%, 75% e 100%. As rações foram elaboradas para conter aproximadamente 35% de proteína e 8% de lipídios. O experimento foi conduzido durante 49 dias, com juvenis com peso inicial de 2,93±0,83g, em sistema de bioflocos (BFT). Não foram encontradas diferenças significativas entre os tratamentos até 75% de substituição para as variáveis de ganho de peso, conversão alimentar e sobrevivência. O tratamento de 100% de substituição apresentou menor taxa de crescimento específico. O presente resultado sugere que, nas dietas para camarões criados em sistema bioflocos, a farinha e o óleo de peixe possam ser substituídos em até 75% por concentrado proteico de soja e óleo de soja, sem prejudicar o desenvolvimento dos animais.(AU)

The objective of this work was to evaluate the effect of the substitution of fishmeal and fish oil with soy protein concentrate and soybean oil on survival, growth and body composition of shrimp (Litopenaeus vannamei) produced in biofloc system (BFT). Five diets were formulated to be isoproteic and isoenergetic with different levels of substitution of fishmeal and fish oil with soy protein concentrate and soybean oil. The treatments were named as: 0% (without substitution), 25%, 50%, 75% and 100%. The diets were formulated to contain approximately 35% protein and 8% lipids. The experiment was conducted for 49 days, with juveniles with initial weight of (2.93±0.83g) in a biofloc system (BFT). No significant differences were found between treatments up to 75% of substitution for the variables of weight gain, feed conversion ratio, and survival. The 100% substitution treatment showed a lower specific growth rate. The present study suggests fish meal and fish oil can be substituted in up to 75% for soy protein concentrate and soybean oil, without harming the development of the shrimps when reared in biofloc system.(AU)

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A acne é uma doença de pele extremamente comum. Sua patogênese é multifatorial, incluindo hiperqueratinização folicular, hiperplasia sebácea, hipercolonização bacteriana. A Propionibacterium acnes possui um papel relevante na resposta inflamatória da patogênese da acne. Os antibióticos representam uma das classes de medicamentos utilizadas no tratamento da acne. No entanto, as reações adversas causadas por esses fármacos tornam o tratamento desagradável, além de casos relatados de resistência bacteriana. Por esse motivo, o uso de produtos naturais tem sido destaque na área de dermatologia. O presente trabalho visou avaliar "in vitro" os possíveis efeitos antimicrobianos do óleo essencial de Rosmarinus officinalis e da tintura de própolis sobre cepa de Propionibacterium acnes (ATCC 1969). O óleo essencial foi extraído pela técnica de hidrodestilação e obteve-se a tintura de própolis por maceração. O ensaio antimicrobiano foi realizado pela técnica da diluição em tubos. O óleo foi testado em diferentes concentrações, variando de 16% a 0,0625% e a tintura de 10% a 0,072312%. Pode-se verificar que o óleo essencial de Rosmarinus officinalis L. não apresentou atividade antibacteriana contra a cepa de Propionibacterium acnes. A tintura de própolis teve ação em várias concentrações, sendo a concentração inibitória mínima de 0,625%.

Acne is an extremely common skin disease. The pathogenesis of acne is multifactorial, including follicular hyperkeratinization, sebaceous hyperplasia and hypercolonization of bacteria. The Propionibacterium acnes has an important role in the inflammatory response of the pathogenesis of acne. Antibiotics are one of the drugs used in the treatment of acne. However, the adverse reactions caused by these drugs turn the treatment unpleasant, besides the existence of cases of bacterial resistance. For this reason, the use of natural products has been prominent in the dermatology area. This work intended to perform an in vitro evaluation of the possible antimicrobial effects of the essential oil of Rosmarinus officinalis and propolis tincture on the Propionibacterium acnes (ATCC 1969) strain. The essential oil was extracted by hydrodistillation, and the propolis tincture was obtained by maceration. The antimicrobial test was conducted by the tube dilution technique. The oil was tested in different concentrations varying between 16% and 0.0625%, and the tincture, between 10% and 0.072312%. We verified that the essential oil of Rosmarinus officinalis has no effects against the Propionibacterium acnes strain. The propolis tincture showed some action in several concentrations, being the minimal inhibitory concentration: 0.625%.

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INTRODUCTION: Oral lichen planus (OLP) is a relatively common inflammatory disease with a wide range of clinical forms. Its pathogenesis has not been fully elucidated although it is known to be mediated by lymphocytes with the participation of cytokines and other inflammatory cells, including type I and type II dermal dendrocytes (DD) (factor XIIIa+ DD and CD34+ DD, respectively). OBJECTIVES: To describe the presence and tissue distribution of these cells, through immunohistochemistry, in 23 specimens from patients with clinical and histopathological criteria of OLP. RESULTS: Factor XIIIa+ DD were mainly located in the superficial dermis (p < 0.0001) as opposed to the deep submucosa. These cells were abundant throughout the dermal-epidermal junction and closely related to lymphocyte infiltration. Moreover, factor XIIIa+ DD were also found in the epithelium and deep dermis. CD34+ DD were distributed mostly to the deep dermis directly below the lymphocyte infiltrate with few cells in the subepithelial region. CONCLUSIONS: DD were present in OLP, with distinct tissue distributions. Factor XIIIa+ DD were predominant in the superficial dermis while CD34+ DD could be found mostly in the deep dermis. These findings suggest that DD, and those positive for factor XIIIa+ in particular in view of their ability to express intercellular adhesion molecule-1 (ICAM-1) and tumor necrosis factor alpha (TNF-alpha), may play an important role in pathogenesis of OLP.

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Muscle fatigue can be a limiting factor to determine index as the electromyographic fatigue threshold (EMGFT) due the alterations in motivation and disconfots. This way, the purpose of this study was to identify the right biceps brachii and left biceps brachii obtained from repetitive elbow flexions at each 100% of total time. Nine healthy subjects performed the exercise named biceps curl until exhaustion with 25%, 35%, and 45%0 of one repetition maximum, in three different days. EMG amplitude (root mean square--RMS) was obtained for concentric contractions during these load levels and correlated with time to determine the slope values for each load and them determine the EMGFT. The EMGFT was obtained within of each 10% of total time and they were compared by analysis of variance. The results showed a progressive increase in RMS with time, for both muscles in all loads, characterizing the muscle fatigue process, and for the EMGFT values ware not found predominantly significant differences between the execution time, as well as between muscles (right biceps x left biceps). This protocol allowed to identify the EMGFT to both muscles during the biceps curl, which was similar at different percentage of total time, indicating the possibility to reduce the length of the contraction test without the need to maintain the contraction until exhaustion. Further studies are needed to evaluate the applicability of this method to determining the effects on performance.

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The purpose of this study was to identify the Electromyographic Fatigue Threshold (EMGFT) of the biceps brachii muscle bilaterally during the elbow flexion in tests performed in different times. 30 second test, 1 minute test and fatiguing test, in concentric (CC) and eccentric (EC) phases. Nine healthy young men performed the elbow flexion with loads corresponding at 25%, 35% and 45% of the one repetition maximum (1-RM) in separate days. The results indicated that the test applied for the biceps brachii muscle during elbow flexion induced a progressive increment of EMG activity with time indicating muscle fatigue and allowed the identification of the EMGFT. The three tests presented no difference of EMGFT between CC and EC phases bilaterally.

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The aim of the present study was to assess the spectral behavior of the erector spinae muscle during isometric contractions performed before and after a dynamic manual load-lifting test carried out by the trunk in order to determine the capacity of muscle to perform this task. Nine healthy female students participated in the experiment. Their average age, height, and body mass (+/- SD) were 20 +/- 1 years, 1.6 +/- 0.03 m, and 53 +/- 4 kg, respectively. The development of muscle fatigue was assessed by spectral analysis (median frequency) and root mean square with time. The test consisted of repeated bending movements from the trunk, starting from a 45 masculine angle of flexion, with the application of approximately 15, 25 and 50% of maximum individual load, to the stand up position. The protocol used proved to be more reliable with loads exceeding 50% of the maximum for the identification of muscle fatigue by electromyography as a function of time. Most of the volunteers showed an increase in root mean square versus time on both the right (N = 7) and the left (N = 6) side, indicating a tendency to become fatigued. With respect to the changes in median frequency of the electromyographic signal, the loads used in this study had no significant effect on either the right or the left side of the erector spinae muscle at this frequency, suggesting that a higher amount and percentage of loads would produce more substantial results in the study of isotonic contractions.

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The aim of the present study was to assess the spectral behavior of the erector spinae muscle during isometric contractions performed before and after a dynamic manual load-lifting test carried out by the trunk in order to determine the capacity of muscle to perform this task. Nine healthy female students participated in the experiment. Their average age, height, and body mass (± SD) were 20 ± 1 years, 1.6 ± 0.03 m, and 53 ± 4 kg, respectively. The development of muscle fatigue was assessed by spectral analysis (median frequency) and root mean square with time. The test consisted of repeated bending movements from the trunk, starting from a 45º angle of flexion, with the application of approximately 15, 25 and 50 percent of maximum individual load, to the stand up position. The protocol used proved to be more reliable with loads exceeding 50 percent of the maximum for the identification of muscle fatigue by electromyography as a function of time. Most of the volunteers showed an increase in root mean square versus time on both the right (N = 7) and the left (N = 6) side, indicating a tendency to become fatigued. With respect to the changes in median frequency of the electromyographic signal, the loads used in this study had no significant effect on either the right or the left side of the erector spinae muscle at this frequency, suggesting that a higher amount and percentage of loads would produce more substantial results in the study of isotonic contractions.

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AIMS: The aim of this study is to demonstrate the incidence of spastic tetraparesis (ST) in meningitis patients in the paediatric ICU, together with the associated variables, and establish comparisons with the existing literature. PATIENTS AND METHODS: We reviewed the medical records of patients who presented symptoms of meningitis and required hospital treatment in the Paediatric ICU at the Hospital de Clínicas de Porto Alegre, between January 1985 and June 2001. In addition to the diagnosis of meningitis and the incidence of ST as a complication, we also examined the aetiological agent, sex, age at the moment of hospital admittance, length of time spent in hospital and treatment given in each case. RESULTS AND DISCUSSION. An incidence of 15.1% was found for cerebral palsy in the 112 cases of bacterial meningitis that were followed up clinically. In the patients with ST, the time spent in hospital was longer, and the frequency of seizures, intracranial hypertension and the protein concentration levels in CSF were higher (p<0.05).

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Changes in responsiveness of the vas deferens and urinary bladder to bradykinin (BK) receptor agonists (Tyr8-BK and des-Arg9-BK), substance P (SP), and endothelin-1 (ET-1) were assessed 8 weeks after streptozotocin (STZ)-induced diabetes. Preparations from control or STZ-treated (60 mg/kg i.p.) male rats were tested for contractile and neurogenic twitch potentiating (TP, in VD only) effects of all four agonists (1 nM to 0.3 or 3 microM). In diabetic VD, contractile effects of Tyr8-BK, des-Arg9-BK, and SP were enhanced, but ET-1 effects were unchanged. In contrast, TP by des-Arg9-BK was unaffected, that by Tyr8-BK was decreased, and those by SP and ET-1 were increased. In diabetic UB, only contractions to des-Arg9-BK and SP were enhanced. Following insulin replacement (human, 1-3 U/day s.c.), starting 1 week after STZ, TP induced by Tyr8-BK and des-Arg9-BK in VD were further inhibited, but all other changes in both preparations were reversed at least partially. Insulin treatment of nondiabetic rats, however, also affected VD (but not UB) responsiveness, such that contractions to Tyr8-BK and TP by ET-1 were increased, but TP by Tyr8-BK was decreased. Thus, STZ-induced type I diabetes causes important alterations in responsiveness of non-vascular smooth muscle tissues of the rat to BK, SP, and ET-1. Long term insulin replacement, at doses normalising glycaemia, effectively reversed most changes in VD or UB responsiveness, but it is unclear if this is truly due to blocking of STZ-induced changes, since the treatment also affected responsiveness of nondiabetic tissues.

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The present study investigated hind paw oedema mediated by bradykinin B(1) and B(2) receptors in streptozotocin-diabetic rats. Paw oedema induced by intraplantar (i.pl.) injection of bradykinin or the selective bradykinin B(2) receptor agonist, Tyrosine(8)-bradykinin ([Tyr(8)]bradykinin) (both 3 nmol/paw), was significantly reduced at 4 weeks after streptozotocin treatment (34 +/- 8% and 40 +/- 7%). At 6 weeks after streptozotocin, when paw oedema caused by substance P or prostaglandin E(2) (both 10 nmol/paw) was unchanged, inhibition of bradykinin B(2) receptor-mediated oedema was maximal (66 +/- 6% and 72 +/ -2%, for bradykinin and [Tyr(8)]bradykinin, respectively). The selective bradykinin B(1) receptor agonist, [des-Arg(9)]bradykinin (100 nmol/paw), induced only slight paw oedema in non-diabetic controls. Responses to [des-Arg(9)]bradykinin were markedly enhanced 8 weeks after streptozotocin (from 0.09 +/- 0.01 to 0.38 +/- 0.05 ml), less so at 10 weeks (0.22 +/- 0.03 ml), and returning to basal values at 12 weeks (0.11 +/- 0.03 ml). Treatment with insulin protamine zinc (1-3 U/day/7 weeks, s.c.) did not reverse the inhibition of responses to [Tyr(8)]bradykinin or the potentiation of responses to [des-Arg(9)]bradykinin seen at 8 weeks. Thus, streptozotocin-induced diabetes induces long-lasting alterations in oedematogenic responsiveness to kinins in the rat, characterized by marked reduction of oedema involving activation of bradykinin B(2) receptors, associated with enhancement of bradykinin B(1) receptor-mediated oedema.

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We have examined the responsiveness of strips of rabbit gallbladder (RGB) to endothelin (ET) receptor agonists, and its susceptibility to blockade by selective antagonists. Endothelin-1 (ET-1; 0.1-100.0 nM) caused graded tonic contractions with a CK50 (concentration causing response equivalent to 50% of KCl 80 mM) of 3.4 nM and EH (response to highest concentration) of 186 +/- 22, being 40-fold less potent than cholecystokinin-8 (CCK-8), 103-fold more potent than carbachol, but equipotent to ET-3, sarafotoxin S6c (S6c) and IRL 1620. The selective ETA receptor antagonists BQ-123 (3 microM) and A-127722-5 (0.3 microM) did not block responses to ET-1, but BQ-123 depressed responses to 30-100 nM ET-3 by about 35%. The ETB receptor antagonist BQ-788 (1 microM) shifted the curve to S6c by only fivefold. In rabbit aorta and at these same concentrations, BQ-123 and A-127722-5 markedly shifted (> or = 100-fold) the curve for ET-1-induced contraction, whereas BQ-788 shifted that for S6c 40-fold. Higher concentrations of all three antagonists contracted the RGB. Thus, although RGB responses to ETs and selective ETB receptor agonists seem to be largely mediated via ET, receptors, they are remarkably insensitive to blockade by both selective ETA and ETB receptor antagonists, as previously reported in the guinea pig gallbladder. Finally, through yet unknown mechanisms, high concentrations of ET receptor antagonists induce marked RGB contractions. It remains to be seen whether this finding is predictive of adverse biliary tract side-effects of such drugs in the clinic.

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Endothelins (ETs) potently contract guinea pig gallbladder (GPGB) via endothelin-A and -B (ETA and ETB) receptors. This study assesses the possible participation of eicosanoids in the mediation of responses of the GPGB (Krebs' solution, 37 degrees C, 0.5 g load) triggered through each receptor type. Indomethacin (INDO; 5.6 microM) shifted the curve to endothelin-1 (ET-1) (0.1-100 nM) to the right, enhancing the CK50 (concentration causing 50% of response to KCl 80 mM) from 0.9 to 6.8 nM and reducing its EH (response to 100 nM) from 170 +/- 13 to 123 +/- 9 (% of response to 80mM KCl). INDO strongly depressed responses to sarafotoxin S6c (S6c; control CK50 0.9 nM), reducing its EH from 108 +/- 5 to 21 +/- 4. Neither BQ-123 nor BQ-788 (1 microM) changed responses to ET-1, but each markedly reduced responsiveness to ET-3 (control: CK50 of 9.7 nM and EH of 153 +/- 14; BQ-123: approximately = 100 nM and 44 +/- 12; BQ-788 approximately = 100 nM and 65 +/- 18). In the presence of BQ-123, INDO further depressed responses to ET-3 (EH 26 +/- 6), whereas in the presence of BQ-788, such responses were strongly enhanced (EH 126 +/- 9). These findings strongly suggest that contractions of GPGB caused via ETB receptors are mediated to a large extent by contractile eicosanoids, whereas those caused (at least by ET-3) via ETA receptors are limited by relaxant eicosanoids. The cellular sources and nature of the eicosanoids released by ETs remain to be established.

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Objetivos: Comparar la eficacia de distintas técnicas de analgesia y sedación durante la raquicentesis en niños. Diseño: Estudio clínico prospectivo, randomizado. Material y método: Cuarenta y siete niños que consultaron en el DEP del CHPR y requirieron raquicentesis diagnostica, recibieron preparación sicológica previa y crema EMLA tópica. Se los dividió luego mediante la randomización en 4 protocolos diferentes: un grupo no recibió ninguna otra medida preparatoria para la raquicentesis; un segundo grupo recibió midazolam i/v; un tercer grupo recibió lidocaína s/c y al cuarto grupo se le administró midazolam i/v y lidocaína s/c. Resultados: La utilización de lidocaína no tuvo incidencia como procedimiento analgésico (p=0.6); la utilización de midazolam solo mejoró la respuesta pero las diferencias no fueron significativas (p =0.2); la asociación midazolam-lidocaína mejoró considerablemente la respuesta, pero las diferencias tampoco fueron estadísticamente significativas(p=0.08). Conclusión: No parece justificado el uso de lidocaína s/c para raquicentesis si se utilizó previamente preparación sicológica y crema EMLA. La asociación de midazolam y lidocaína parece mejorar la tolerancia al dolor provocado por la maniobra pero se requiere ampliar la muestra para confirmarlo (p=0.08). No se registraron efectos adversos con los protocolos de analgesia-sedación utilizados por lo que estos resultan seguros(AU)

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Objetivos: Comparar la eficacia de distintas técnicas de analgesia y sedación durante la raquicentesis en niños. Diseño: Estudio clínico prospectivo, randomizado. Material y método: Cuarenta y siete niños que consultaron en el DEP del CHPR y requirieron raquicentesis diagnostica, recibieron "preparación sicológica" previa y crema EMLA tópica. Se los dividió luego mediante la randomización en 4 protocolos diferentes: un grupo no recibió ninguna otra medida preparatoria para la raquicentesis; un segundo grupo recibió midazolam i/v; un tercer grupo recibió lidocaína s/c y al cuarto grupo se le administró midazolam i/v y lidocaína s/c. Resultados: La utilización de lidocaína no tuvo incidencia como procedimiento analgésico (p=0.6); la utilización de midazolam solo mejoró la respuesta pero las diferencias no fueron significativas (p =0.2); la asociación midazolam-lidocaína mejoró considerablemente la respuesta, pero las diferencias tampoco fueron estadísticamente significativas(p=0.08). Conclusión: No parece justificado el uso de lidocaína s/c para raquicentesis si se utilizó previamente "preparación sicológica" y crema EMLA. La asociación de midazolam y lidocaína parece mejorar la tolerancia al dolor provocado por la maniobra pero se requiere ampliar la muestra para confirmarlo (p=0.08). No se registraron efectos adversos con los protocolos de analgesia-sedación utilizados por lo que estos resultan seguros

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The receptors mediating guinea pig gall bladder (GPGB) contractions induced by endothelin-1 (ET-1) and related peptides were characterized using various ET receptor antagonists. As all ET-receptor agonists used, except sarafotoxin S6c (SRTX), failed to induce a clear-cut maximal response at the highest concentration tested (i.e. 100 nM), their potencies are expressed in terms of a CK50 (i.e. the concentration causing 50% of the response to 80 mM KCl). ET-1 (CK50 0.8 nM) was equipotent to ET-2 and SRTX (selective ET(B) receptor agonist), but more potent than ET-3 (5-fold) or IRL 1620 (selective ET(B) receptor agonist). BQ-123 (0.3 microM, peptidic ET(A) receptor antagonist) did not alter responses to ET-1, ET-3 or SRTX. BQ-788 (1 microM, peptidic ET(B) receptor antagonist) reduced the potency of ET-3 (9-fold at the CK50 level) and SRTX ( > 20-fold), but not ET-1. SRTX responses were unaffected by RES-701-1 (3 microM, peptidic ET(B) receptor antagonist). The combination BQ-123 (0.3 microM) plus BQ-788 (1 microM) did not modify responses to ET-1, inhibited SRTX responses similarly to BQ-788 alone and abolished ET-3 responses. Bosentan (1 microM, non-peptidic ET(A)/ET(B) receptor antagonist) reduced the potency of ET-1 (15-fold). ET-3 (9-fold) and SRTX (4-fold). In rat aorta, the antagonists blocked ET-1-induced contractions (BQ-123 and bosentan) or SRTX-induced endothelium-dependent relaxations (BQ-788, RES-701-1 and bosentan). Thus, the GPGB expresses both ET(A) and ET(B) receptors. As BQ-123 only blocked responses to ET-3 in the presence of BQ-788, there appears to be cross-talk between both receptor types. Also, the binding sites of ET-1 and ET-3 on the ET(A) receptor may not coincide entirely, as BQ-123, even in presence of BQ-788, did not affect ET-1-induced contractions.

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Day-care attendance accounts for an increased frequency of acute respiratory infections (ARI), in numbers of both episodes and hospitalizations. In addition to day-care exposure, risk factors include age, siblings, and crowding. The purpose of this study was to investigate a possible association between duration of day-care exposure and ARI. A cross-sectional study was carried out to compared ARI rates for children exposed to day care and children cared for at home. Children with at least one parent working in a hospital were sampled from the hospital-run day-care center and those cared for at home. An acute respiratory infection was defined as the presence of two or more signs or symptoms in the previous two weeks. Children exposed to the day-care center for 12 to 50 hours a week had a three to five times greater risk of developing ARI than those staying at home. This risk was assessed independently, taking socioeconomic status, age, and number of siblings into account. Risk of respiratory illness and day-care attendance has been described elsewhere, but this study presents original findings related to duration of exposure. With a view towards reducing risk of ARI, improvements should be made in institutional day-care centers in Brazil, where family day care is still not available.

RESUMO

The value of the Apgar score as an index of birth asphyxia has been recently questioned. The purpose of the present study is to evaluate the relationship between cord blood pH and Apgar score in term newborn infants.A cross-sectional study involving 76 term newborn infants was performed from March through September 1995 at the Obstetric Unit of Hospital de Clínicas de Porto Alegre. The blood samples were obtained from umbilical cord artery and vein at the moment of delivery. Infants were divided in three different groups according to the Apgar score: Group A (n=60): >or=7 at one and five minutes; Group B (n=13): < 7 at one minute and >or=7 at five minutes; Group C (n=3): < 7 at one and five minutes. The frequency of acidemia in Group A was 18.3% (11 newborn infants) considering arterial pH < 7.20 and 5% considering arterial pH or= 7.20 and nine (56.2%) had arterial pH > 7.10. None of the newborn infants in Group C had arterial pH > 7.10. The sensitivity and specificity values for Apgar score less than 7 at one minute for detection of fetal acidemia were, respectively, 54.1% and 94.1%. This study confirms a poor correlation between Apgar score and umbilical blood cord pH, even in a term newborn, and emphasizes the importance of obtaining umbilical cord pH to consider the diagnosis of perinatal asphyxia.

Assuntos