Chemical characterization of atmospheric particles and source apportionment in the vicinity of a steelmaking industry

The objective of this work was to provide a chemical characterization of atmospheric particles collected in the vicinity of a steelmaking industry and to identify the sources that affect PM10 levels. A total of 94 PM samples were collected in two sampling campaigns that occurred in February and June/July of 2011. PM2.5 and PM2.5-10 were analyzed for a total of 22 elements by Instrumental Neutron Activation Analysis and Particle Induced X-ray Emission. The concentrations of water soluble ions in PM10 were measured by Ion Chromatography and Indophenol-Blue Spectrophotometry. Positive Matrix Factorization receptor model was used to identify sources of particulate matter and to determine their mass contribution to PM10. Seven main groups of sources were identified: marine aerosol identified by Na and Cl (22%), steelmaking and sinter plant represented by As, Cr, Cu, Fe, Ni, Mn, Pb, Sb and Zn (11%), sinter plant stack identified by NH4(+), K and Pb (12%), an unidentified Br source (1.8%), secondary aerosol from coke making and blast furnace (19%), fugitive emissions from the handling of raw material, sinter plant and vehicles dust resuspension identified by Al, Ca, La, Si, Ti and V (14%) and sinter plant and blast furnace associated essentially with Fe and Mn (21%).

Acute kidney injury and progression of renal failure after fetal programming in the offspring of diabetic rats

BACKGROUND

Diseases of adulthood, such as diabetes and hypertension, may be related to changes during pregnancy, particularly in kidney. We hypothesized that acute kidney injury progresses more rapidly in cases of fetal programming.

METHODS

Diabetic dams' offspring were divided into: CC (controls, receiving vehicle); DC (diabetics, receiving vehicle); CA (controls receiving folic Acid solution, 250 mg/kg); and DA (diabetics receiving folic acid solution). Renal function tests, morphometry, gene, and protein expression of epithelial-mesenchymal transition (EMT) markers were analyzed by qPCR and immunohistochemistry, respectively.

RESULTS

Creatinine, urea, Bowman's space, and EMT markers were increased in CA and DA groups. TGF-β3, actin, and fibronectin expression was higher in CA and DA, with significant increase in DA compared to CA 2-mo offspring. There was higher expression level of TGF-β1, TGF-β3, fibronectin, and vimentin in the offspring of diabetic dams at 5 mo. Increases in TGF-β1 and TGF-β3 were more evident in the offspring of diabetic dams.

CONCLUSION

Fetal programming promotes remarkable changes in kidney morphology, and function in offspring and renal failure progression may be faster in younger offspring of diabetic dams subjected to an additional injury.

Gut Bacteria Products Prevent AKI Induced by Ischemia-Reperfusion

Short-chain fatty acids (SCFAs) are fermentation end products produced by the intestinal microbiota and have anti-inflammatory and histone deacetylase-inhibiting properties. Recently, a dual relationship between the intestine and kidneys has been unraveled. Therefore, we evaluated the role of SCFA in an AKI model in which the inflammatory process has a detrimental role. We observed that therapy with the three main SCFAs (acetate, propionate, and butyrate) improved renal dysfunction caused by injury. This protection was associated with low levels of local and systemic inflammation, oxidative cellular stress, cell infiltration/activation, and apoptosis. However, it was also associated with an increase in autophagy. Moreover, SCFAs inhibited histone deacetylase activity and modulated the expression levels of enzymes involved in chromatin modification. In vitro analyses showed that SCFAs modulated the inflammatory process, decreasing the maturation of dendritic cells and inhibiting the capacity of these cells to induce CD4(+) and CD8(+) T cell proliferation. Furthermore, SCFAs ameliorated the effects of hypoxia in kidney epithelial cells by improving mitochondrial biogenesis. Notably, mice treated with acetate-producing bacteria also had better outcomes after AKI. Thus, we demonstrate that SCFAs improve organ function and viability after an injury through modulation of the inflammatory process, most likely via epigenetic modification.

Effects of transcutaneous electrical nerve stimulation on fetal and placental development in an experimental model of placental insufficiency

OBJECTIVE

To elucidate the effects of transcutaneous electrical nerve stimulation (TENS) in pregnancies with placental insufficiency.

METHODS

Pregnant rats were subjected to uterine artery ligation and to TENS according to the following groups: ligated stimulated (LS); ligated non-stimulated (LN), control stimulated (CS); and control non-stimulated (CN). Fetal external measurements, such as crown-rump length (CRL), fronto-occipital distance (FOD), thoracic ventral-dorsal (TVDD) and abdominal ventral-dorsal (AVDD) distances were analyzed together with the area occupied by fetal internal organs. Glucose transporter 1 (GLUT-1) expression was evaluated by immunohistochemistry in fetal organs. Thickness of junctional, labyrinth and intermediate placental zones was analyzed by morphometric evaluation in HE-stained slides, and placental hypoxia-inducible factor 1 alfa expression was measured by real-time polymerase chain reaction.

RESULTS

In LN and CS groups compared to the CN group, CRL was reduced (27.51/28.95 versus 30.16 mm), as well as FOD (6.63/6.63 versus 7.36 mm), AVDD (7.38/8.00 versus 8.61 mm) and TVDD (6.46/6.87 versus 7.23 mm). Brain GLUT-1 expression was higher in LS (1.3%) and CS (1.8%). The area occupied by placental vessels in the labyrinth zone (29.67 ± 3.51 versus 20.83 ± 7.63) and intermediate zone (26.46 ± 10.21 versus 10.86 ± 8.94) was larger in the LS group than in the LN group.

CONCLUSIONS

Our results suggest a negative effect of TENS on placental development, thus compromising the maintenance of adequate blood flow to the fetus.

Levels and spatial distribution of airborne chemical elements in a heavy industrial area located in the north of Spain

The adverse health effects of airborne particles have been subjected to intense investigation in recent years; however, more studies on the chemical characterization of particles from pollution emissions are needed to (1) identify emission sources, (2) better understand the relative toxicity of particles, and (3) pinpoint more targeted emission control strategies and regulations. The main objective of this study was to assess the levels and spatial distribution of airborne chemical elements in a heavy industrial area located in the north of Spain. Instrumental and biomonitoring techniques were integrated and analytical methods for k0 instrumental neutron activation analysis and particle-induced x-ray emission were used to determine element content in aerosol filters and lichens. Results indicated that in general local industry contributed to the emissions of As, Sb, Cu, V, and Ni, which are associated with combustion processes. In addition, the steelwork emitted significant quantities of Fe and Mn and the cement factory was associated with Ca emissions. The spatial distribution of Zn and Al also indicated an important contribution of two industries located outside the studied area.

Performance assessment of the single photon emission microscope: high spatial resolution SPECT imaging of small animal organs

The single photon emission microscope (SPEM) is an instrument developed to obtain high spatial resolution single photon emission computed tomography (SPECT) images of small structures inside the mouse brain. SPEM consists of two independent imaging devices, which combine a multipinhole collimator, a high-resolution, thallium-doped cesium iodide [CsI(Tl)] columnar scintillator, a demagnifying/intensifier tube, and an electron-multiplying charge-coupling device (CCD). Collimators have 300- and 450-µm diameter pinholes on tungsten slabs, in hexagonal arrays of 19 and 7 holes. Projection data are acquired in a photon-counting strategy, where CCD frames are stored at 50 frames per second, with a radius of rotation of 35 mm and magnification factor of one. The image reconstruction software tool is based on the maximum likelihood algorithm. Our aim was to evaluate the spatial resolution and sensitivity attainable with the seven-pinhole imaging device, together with the linearity for quantification on the tomographic images, and to test the instrument in obtaining tomographic images of different mouse organs. A spatial resolution better than 500 µm and a sensitivity of 21.6 counts·s^-1·MBq^-1 were reached, as well as a correlation coefficient between activity and intensity better than 0.99, when imaging ^99mTc sources. Images of the thyroid, heart, lungs, and bones of mice were registered using ^99mTc-labeled radiopharmaceuticals in times appropriate for routine preclinical experimentation of <1 h per projection data set. Detailed experimental protocols and images of the aforementioned organs are shown. We plan to extend the instrument's field of view to fix larger animals and to combine data from both detectors to reduce the acquisition time or applied activity.

Comparison of the total length and areas of upper central incisors between males and females using computer-assisted morphometry

The determination of measurements of teeth facilitates various procedures in dentistry. The purpose of this study was to evaluate the total length and the area of the non-extracted upper central incisors (UCI). Periapical radiographies of 42 UCI were placed over a lighted box. The outlines of the teeth and the pulp cavity were traced onto sheets and then measured using an image analyzer. The area of the upper left central incisor tooth (tooth 21) was statistically significantly larger in males than in females (p = 0.02). The total length of the right UCI was similar to that of the left one. This study demonstrates that computer-assisted morphometry is an important tool for the evaluation of the total length and areas of teeth and their pulp cavities. The significantly larger area of tooth 21 in males compared to females has anthropomorphic and clinical implications.

Exercise training improves cardiovascular autonomic activity and attenuates renal damage in spontaneously hypertensive rats

Experiments were performed to determine the influence of exercise training by swimming on cardiovascular autonomic control and renal morphology in spontaneously hypertensive rats (SHR) and Wystar-Kyoto (WKY) rats. Sedentary normotensive (SN), trained normotensive (TN), sedentary hypertensive (SH), and trained hypertensive (TH) rats were included in this study. Arterial pressure (AP), heart rate (HR), means of power spectral analysis of HR (HRV) and systolic AP variability (SAPV) were recorded in baseline conditions. Following, the HR baroreflex and autonomic tonus control were assessed. At the end, all animals were euthanized and their kidneys were excised to evaluate renal damage. Resting bradycardia was observed in TH and TN rats compared with their respective sedentary animals (p < 0.05). Exercise training attenuated AP in TH vs. SH (p < 0.001). The LF component of HRV and SAPV were lower in TH than SH (p < 0.05). The LF/HF relation was lower in TH than SH and SN (p < 0.05). TN and TH rats showed a sympathetic tonus reduction in comparison to SN and SH rats (p < 0.001). The TH presented an increased vagal tonus compared to SH (p < 0.05). Exercise training improved baroreflex control of HR in TH group versus SH (p < 0.05). The TH showed a lower number of sclerotic glomeruli compared to SH (p < 0.005). The exercise training decrease the glomerular indexes in TN and TH (p < 0.05). Further analysis showed a significant correlation between sympathetic nervous activity and AP levels (p < 0.05). A positive association was also found between sympathetic nervous activity and glomerular index (p < 0.05). Therefore, the exercise training reduces AP and attenuates renal damage. In addition, the attenuation of renal injury was associated with lower sympathetic activity. These findings strongly suggest that exercise training may be a therapeutic tool for improving structure and renal function in hypertensive individuals. Key pointsEndurance training.Decrease of the sympathetic activity.Attenuation of renal injury.Decrease of blood pressure in SHR.

Adipose tissue-derived stem cell treatment prevents renal disease progression

Adipose tissue-derived stem cells (ASCs) are an attractive source of stem cells with regenerative properties that are similar to those of bone marrow stem cells. Here, we analyze the role of ASCs in reducing the progression of kidney fibrosis. Progressive renal fibrosis was achieved by unilateral clamping of the renal pedicle in mice for 1 h; after that, the kidney was reperfused immediately. Four hours after the surgery, 2 × 10(5) ASCs were intraperitoneally administered, and mice were followed for 24 h posttreatment and then at some other time interval for the next 6 weeks. Also, animals were treated with 2 × 10(5) ASCs at 6 weeks after reperfusion and sacrificed 4 weeks later to study their effect when interstitial fibrosis is already present. At 24 h after reperfusion, ASC-treated animals showed reduced renal dysfunction and enhanced regenerative tubular processes. Renal mRNA expression of IL-6 and TNF was decreased in ASC-treated animals, whereas IL-4, IL-10, and HO-1 expression increased despite a lack of ASCs in the kidneys as determined by SRY analysis. As expected, untreated kidneys shrank at 6 weeks, whereas the kidneys of ASC-treated animals remained normal in size, showed less collagen deposition, and decreased staining for FSP-1, type I collagen, and Hypoxyprobe. The renal protection seen in ASC-treated animals was followed by reduced serum levels of TNF-α, KC, RANTES, and IL-1α. Surprisingly, treatment with ASCs at 6 weeks, when animals already showed installed fibrosis, demonstrated amelioration of functional parameters, with less tissue fibrosis observed and reduced mRNA expression of type I collagen and vimentin. ASC therapy can improve functional parameters and reduce progression of renal fibrosis at early and later times after injury, mostly due to early modulation of the inflammatory response and to less hypoxia, thereby reducing the epithelial-mesenchymal transition.

Induction of heme oxygenase-1 can halt and even reverse renal tubule-interstitial fibrosis

Background

The tubule-interstitial fibrosis is the hallmark of progressive renal disease and is strongly associated with inflammation of this compartment. Heme-oxygenase-1 (HO-1) is a cytoprotective molecule that has been shown to be beneficial in various models of renal injury. However, the role of HO-1 in reversing an established renal scar has not yet been addressed.

Aim

We explored the ability of HO-1 to halt and reverse the establishment of fibrosis in an experimental model of chronic renal disease.

Methods

Sprague-Dawley male rats were subjected to unilateral ureteral obstruction (UUO) and divided into two groups: non-treated and Hemin-treated. To study the prevention of fibrosis, animals were pre-treated with Hemin at days -2 and -1 prior to UUO. To investigate whether HO-1 could reverse established fibrosis, Hemin therapy was given at days 6 and 7 post-surgery. After 7 and/or 14 days, animals were sacrificed and blood, urine and kidney tissue samples were collected for analyses. Renal function was determined by assessing the serum creatinine, inulin clearance, proteinuria/creatininuria ratio and extent of albuminuria. Arterial blood pressure was measured and fibrosis was quantified by Picrosirius staining. Gene and protein expression of pro-inflammatory and pro-fibrotic molecules, as well as HO-1 were performed.

Results

Pre-treatment with Hemin upregulated HO-1 expression and significantly reduced proteinuria, albuminuria, inflammation and pro-fibrotic protein and gene expressions in animals subjected to UUO. Interestingly, the delayed treatment with Hemin was also able to reduce renal dysfunction and to decrease the expression of pro-inflammatory molecules, all in association with significantly reduced levels of fibrosis-related molecules and collagen deposition. Finally, TGF-β protein production was significantly lower in Hemin-treated animals.

Conclusion

Treatment with Hemin was able both to prevent the progression of fibrosis and to reverse an established renal scar. Modulation of inflammation appears to be the major mechanism behind HO-1 cytoprotection.

Minimal change disease: a variant of lupus nephritis

Some patients with systemic lupus erythematosus (SLE) present with nephrotic syndrome due to minimal change disease (MCD). Histopathological diagnosis of patients with SLE and nephrotic-range proteinuria has shown that these patients present with diffuse proliferative glomerulonephritis and membranous glomerulonephritis, World Health Organization (WHO) classes IV and V, respectively, more frequently than the other classes. In the present study, we reported a case of nephrotic syndrome and renal biopsy-proven MCD associated with SLE. A complete remission occurred after steroid treatment, which was followed by a relapse 15 months later with a concomitant reactivation of SLE. A second biopsy showed WHO class IIb lupus nephritis. Prednisone treatment was restarted, and the patient went into complete remission again. The association of MCD and SLE may not be a coincidence, and MCD should be considered as an associated SLE nephropathy.

Effect of hydrogen sulfide on growth of sulfate reducing bacteria

A culture of sulfate reducing bacteria (SRB) growing on lactate and sulfate was incubated at different pH values in the range of 5.8-7.0. The effect of pH on growth rate was determined in this pH range; the highest growth rate was observed at pH 6.7. Hydrogen sulfide produced from sulfate reduction was found to have a direct and reversible toxicity effect on the SRB. A hydrogen sulfide Concentration of 547 mg/L (16.1 mM) completely inhibited the culture growth. Comparison between acetic acid and hydrogen sulfide inhibition is presented and the concomitant inhibition kinetics are mathematically described.

Renal disorders involved in the pathophysiology of urinary excretion of a-1 microglobulin in patients with glomerulopathies

AIMS

The protein alpha1-microglobulin (alpha1-microg) is filtered by the glomeruli and fully reabsorbed by the proximal tubules, and tubulointerstitial injury compromises its reabsorption. The aim of this study was to determine which functional, morphological and inflammatory renal disorders associated with tubulointerstitial damage interfere with urinary excretion of alpha1-microg in patients with glomerulopathies.

PATIENTS AND METHODS

38 patients (33.6 +/- 11.3 years) with primary or secondary glomerulopathies diagnosed by renal biopsies were studied. The urinary fractional excretion of alpha1-microg (FEalpha1-microg), the urinary monocyte chemoattractant protein-1/urinary creatinine (UMCP-1) index and 24-h proteinuria were determined. In the cortex of renal biopsies, the number of macrophages/104 microm2 of glomerular tuft (GT) and tubulointerstitial (TI) areas, the relative interstitial area (RCIA), and the relative interstitial fibrosis area (CIF) were measured. Results are reported as median and range and the Spearman non-parametric test was used to determine the correlations.

RESULTS

FEalpha1-microg was 0.165% (0.008% - 14,790.0%) in patients with glomerulopathies and 0.065% (0.010% - 0.150%) in the control group (p < 0.05; Mann-Whitney U-Test). FEalpha1-microg was correlated with creatinine clearance (r = -0.4396; p = 0.0358), UMCP-1 index (r = 0.5978; p < 0.0001), number of macrophages/TI area (r = 0.5634; p = 0.0034) and RCIA (r = 0.7436; p < 0.0001). However, FEa1-microg was not correlated with proteinuria (r = 0.1465; p = 0.5153) or with CIF (r = 0.0039; p = 0.98).

CONCLUSIONS

renal MCP-1 and the expansion and number of macrophages of the tubulointerstitial area participate in the increase of urinary excretion of alpha1-microg in patients with glomerulopathies. Although proteinuria and interstitial fibrosis have not been associated with this effect, the present study does not exclude some of these disorders in the pathophysiology of urinary excretion of alpha1-microg.

High airborne PM2.5 chlorine concentrations link to diabetes surge in Portugal

Since 1995 airborne particles have been sampled near Lisbon and analysed by PIXE at ITN. On the Summer of 2004 extremely high concentrations of 14 microg/m(3) of chlorine in PM2.5 were determined in a week average sample. Later in 2004 and in 2005 similar events occurred. A 12 year database of PIXE data on airborne elemental concentrations (1995 to 2006) compiled on 2007 was then analysed for PM2.5 chlorine concentrations above 1 microg/m(3), and showed that the number of this type of events per year is increasing since 1995 up until the present. A quest for time coincident abnormal health data reports was carried out and revealed a 30% raise in diabetes mellitus incidence from 2003 to 2004 followed by a 20% raise from 2004 to 2005. After a first short publication at the XIth Int. PIXE Conference in 2007 (Reis et al., 2007a) the problem remained live. Taking into account new insights into the problem, recently published data, and biomonitoring data that were previously not considered, it was possible to establish a highly probable link between the abnormally high values of PM2.5 chlorine measured in the Lisbon area and the surge in diabetes mellitus incidence in Portugal in 2004 and 2005. Data, reasoning, possible mechanisms and conclusions regarding this link are reported in the present paper.

Collagenofibrotic glomerulopathy: three case reports in Brazil

Background

We are reporting the first Collagenofibrotic Glomerulopathy (CG) in South America. So, this collagen type III glomerulopathy is not limited to Japan but may be found throughout the world.

Case Reports

We describe three patients that presented some factors in common, such as sex, age and the presence of non-nephrotic proteinuria associated with microscopic hematuria. The findings with the immunofluorescence microscopy, of immunoglobulins, and components of the complement were usually negative. The picrosyrius staining showed the presence of reddish material in the mesangium, when it was seen under standard microscopy; however, when it was seen with birefringence, it became greenish under polarized light, showed the collagen found in this area of the glomerulus. The identification of CG was made through electronic microscopic scanning, and curved and disorganized fibers were found.

Conclusion

These cases are the first from South America to be reported, and they are about an idiopathic renal disease that is not related to any specific races or locations. The reports contribute to a better understanding of this disease, which although not so prevalent, should be considered as an importantly differential diagnostic of cases of proteinuria.

Early modulation of inflammation by mesenchymal stem cell after acute kidney injury

Therapy with stem cells has showed to be promising for acute kidney injury (AKI), although how it works is still controversial. Modulation of the inflammatory response is one possible mechanism. Most of published data relies on early time and whether the protection is still maintained after that is not known. Here, we analyzed whether immune modulation continues after 24 h of reperfusion. MSC were obtained from male Wistar rats. After 3-5 passages, cells were screened for CD73, CD90, CD44, CD45, CD29 and CD 31. In addition, MSC were submitted to differentiation in adipocyte and in osteocyte. AKI was induced by bilaterally clamping of renal pedicles for 60 min. Six hours after injury, MSC (2 x 10(5) cells) were administered intravenously. MSC-treated animals presented the lowest serum creatinine compared to non-treated animals (24 h: 1.3+/-0.21 vs. 3.23+/-0.89 mg/dl, p<0.05). The improvement in renal function was followed by a lower expression of IL-1b, IL-6 and TNF-alpha and higher expression of IL-4 and IL-10. However, 48 h after reperfusion, this cytokine profile has changed. The decrease in Th1 cytokines was less evident and IL-6 was markedly up regulated. PCNA analysis showed that regeneration occurs faster in kidney tissues of MSC-treated animals than in controls at 24 h. And also ratio of Bcl-2/Bad was higher at treated animals after 24 and 48 h. Our data demonstrated that the immunomodulatory effects of MSC occur at very early time point, changing the inflammation profile toward a Th2 profile.

Morphological characterization of the false vocal cords as larynx-associated lymphoid tissue

The lymphoid follicles (LF) found in the false vocal cords (FVC) protect the upper air tracts, similar to the lymphoid tissue associated to the respiratory mucosas. However, studies that characterize the phenotype of cells like larynx-associated lymphoid tissue (LALT) are lacking. We analyzed the FVC of autopsied adults according to morphometric and immunohistochemical criteria and defined their possible role as LALT. We analyzed 249 FVC. Primary antibodies, CD68+ macrophages, CD20+, CD3+, and FDC+ were used for the evaluation of inflammatory cell phenotypes. In 40.6% of the cases, there was an inflammatory reaction. In 42.2% of the cases, LF were identified in the submucosa. In 17.3% of the cases, neither LF nor mononuclear cells were identified in the FVC, and these patients were from an older age group (p=0.013). A significant increase in the number of all LF cell phenotypes was observed in patients with pulmonary inflammation; the difference in both T- and B-lymphocytes was statistically significant (p=0.010). The morphological findings of LF suggest a probable participation of the FVC in the protection of the larynx and lungs, and similarity to LALT.

Placental morphometrical and histopathology changes in the different clinical presentations of Hypertensive Syndromes in Pregnancy

OBJECTIVE

Even though there are clinical studies emphasizing the diagnosis and the perinatal intercurrent diseases of the Hypertensive Syndromes in Pregnancy, few of these studies establish the clinical forms of the specific hypertensive syndromes with the associated morphological placental alterations. The lack of studies on placental morphology and the etiopathogenesis of the different clinical standards for HSP, together with the need to objectively characterize these morphological placental lesions justify this study.

STUDY DESIGN

A retrospective study was carried out with 91 placentas examined throughout the period from 2000 to 2003. All placentas from patients presenting HSP in this period were included in the study. These were classified according to features well established by the literature such as laboratory and clinical criteria into: gestational hypertension (GH), chronic hypertension (CH), pre-eclampsia (PE) and pre-eclampsia superimposed on chronic hypertension (PSCH).

RESULTS

The number of knots presented a positive correlation with the length of time and severity of the hypertension during gestation (Spearman correlation: 0.253; P = 0.0158). The fibrin deposit was greater in all HSP groups but the pattern of distribution changes in the most severe cases from perivillous to intravillous as in the PSCH group (P = 0.002). There was no statistically significant difference in the area of the stem vessel walls among the groups. The cases with PE and CH presented a larger number of terminal villi vessels (P < 0.001).

CONCLUSION

This report suggests, that although they could be different types of hypertension or an evaluation of the same disease, the final pathway that leads to microscopic lesions in the placenta is the same, with only different intensity due to the severity of the disease.

Mesenchymal stem cells ameliorate tissue damages triggered by renal ischemia and reperfusion injury

BACKGROUND

Ischemia and reperfusion injury (I/R) is the major cause of acute renal failure (ARF) with high mortality rates. Because alternative therapies are needed, we investigated the use of stem cell therapy to modulate inflammation in a renal I/R model.

METHODS

To study kidney I/R injury, we clamped bilateral pedicles for 60 minutes. Mesenchymal stem cells (MSC), which had been isolated and cultivated in plastic flasks, were administered to mice 6 hours after injury. Real-time polymerase chain reaction was used to quantify interleukin (IL)-4 and IL-1beta mRNAs. Proliferative nuclear cell antigen (PCNA) was used to calculate tubular regeneration.

RESULTS

Administration of MSC attenuated renal injury; serum creatinine and plasma urea levels were significantly reduced 24 hours after reperfusion. PCNA immunohistochemistry showed that regeneration occurred faster in renal tissues of animals that received MSC than in tissues of control animals. Analyses of cytokine expression in renal tissue demonstrated a greater level of anti-inflammatory cytokines in MSC-treated animals.

CONCLUSION

These results showed an antiinflammatory pattern in MSC-treated animals, demonstrating the potential of MSC to modulate I/R, leading to earlier regeneration of damaged renal tissue.

Cushing's disease in a 5-month infant due to a basophilic microadenoma of the pituitary gland

We report a female patient who developed severe Cushing's disease during the fifth month of life due to a basophilic pituitary adenoma Histological findings showed a basophilic microadenoma of the pituitary gland, leading to the diagnosis of Cushing's disease. The infant died because of untreatable septic shock. The importance of the present report resides in the age of the child at diagnosis, and that it was the necropsy finding of microadenoma which clarified the cause of the Cushing's syndrome, since it was not diagnosed during life. Cushing's disease is most often diagnosed in children older than 7 years, and our patient was only 5 months old when we detected the pituitary adenoma, the earliest case diagnosed so far. Cushing's syndrome in pediatric patients has been rarely reported and most cases are due to functioning adrenal tumors, usually a malignant carcinoma but occasionally a benign adenoma. The present case shows that the pituitary of these patients should be investigated with important implications in terms of therapeutic approaches, such as pituitary radiotherapy, which can cure the patient when treatment is started very soon.

Histopathologic changes in human true vocal folds: a postmortem study

Several articles describe the gross pathology alterations of the true vocal cords (TVC), but the histopathology descriptions in adults are rare in the literature and are normally associated with neoplasia. The aim of this study is to identify the TVC morphological lesions in adult autopsies. This was a cross-sectional study of 266 adults' larynxes consecutively autopsied from 1993 to 2003. Histochemical and immunohistochemical methods were used for morphological analysis. Considering the morphological analysis, 97 TVC (36.5%) were considered normal. The following lesions were found in the TVC: thickening of the basal membrane of the TVC in 81 patients (30.5%), inflammatory reaction in 66 patients (24.8%), hemorrhage in 19 patients (7.1%), and ulceration in 3 patients (1.1%). Our study demonstrated that the TVC microscopic lesions are frequent, present different morphological patterns, and showed different causes from what had been described until nowadays by the literature. Despite this difference in the morphological pattern, we were able to identify a common lesion pathway for ethiological different diseases.

Approaching PM(2.5) and PM(2.5-10) source apportionment by mass balance analysis, principal component analysis and particle size distribution

A chemical characterization was carried out for PM(2.5) and PM(2.5-10) samples collected in a suburban area and the concentrations of 12 elements were determined in 8 size segregated fractions using a Berner Impactor. Two main objectives were proposed in this work: 1) to test for closure among chemical and gravimetric measurements of PM(2.5) and PM(2.5-10) and 2) evaluate the performance of Multilinear Regression Analysis (MLRA) and Mass Balance Analysis (MBA) in the determination of source contribution to Particulate Matter (PM) concentrations. The fraction unaccounted for by chemical analysis comprised on average 17% and 34% of gravimetric PM(2.5) and PM(2.5-10), respectively. The lack of closure in PM(2.5) and PM(2.5-10) mass (i.e., constituent concentrations not adding up to gravimetrically measured) could partly result from the presence of water associated with particles and errors in the estimation of unmeasured species. MLRA and MBA showed very similar results for the temporal variation of the source contributions. However, quantitatively important discrepancies could be observed, principally due to the lack of mass closure in PM(2.5) and PM(2.5-10). Both methods indicated that the major PM(2.5) aerosol mass contributors included secondary aerosol and vehicle exhaust. In the coarse fraction, marine and mineral aerosol contributions were predominant.

Description of microscopic lesions of vestibular folds of autopsied adults and their relationship with cause of death and underlying disease

The increase in invasive methods currently applied to diagnosis airway upper tract infection leads to a possible increase in vestibular folds (VF) lesions. Besides, VF importance in the prevention of the organism against infection pathogens had been stressed and few studies had addressed the microscopic lesions of the VF in autopsied patients because there is no routine VF examination in the postmortem exam.

Aim

The aim of this study is morphological microscopic analyses of the VF from autopsied patients and its correlation with basic disease and cause of death.

Study design

transversal cohort.

Material and Method

We studied 82 larynges collected during the autopsy exam and performed the Hematoxylin -eosin method for morphological analyses.

Results

From the 82 vestibular folds analyzed we observe that 42 (51%) showed an inflammatory reaction. In fifteen (18.3%) vestibular folds we found lymphoid follicular hyperplasia, in eleven (13.4%) diffuse inflammatory infiltrate and in sixteen (19.5%) acute inflammatory reactions. Circulatory diseases were the most frequently underlying diseases found, 31 (37.8%) and from these 20 (67.8%) presented associated vestibular folds inflammatory reaction. The infection diseases were the most frequently cause of death among the patients with inflammatory reaction of the VF.

Conclusion

Besides the anatomic function, VF seem to have a immunological function preventing lower airway infections. Our study demonstrated inflammatory PV reactions in patients with infections diseases as cause of death; this finding could be a consequence of the sepses that leads the patient to death or a different way used by the organism to prevent infection.

Gravimetric and chemical features of airborne PM 10 AND PM 2.5 in mainland Portugal

This paper describes concentration amounts of arsenic (As), particulate mercury (Hg), nickel (Ni) and lead (Pb) in PM(10) and PM(2.5), collected since 1993 by the Technological and Nuclear Institute (ITN) at different locations in mainland Portugal, featuring urban, industrial and rural environments, and a control as well. Most results were obtained in the vicinity of coal- and oil-fired power plants. Airborne mass concentrations were determined by gravimetry. As and Hg concentrations were obtained through instrumental neutron activation analysis (INAA), and Ni and Pb concentrations through proton-induced X-ray emission (PIXE). Comparison with the EU (European Union) and the US EPA (United States Environmental Protection Agency) directives for Ambient Air has been carried out, even though the sampling protocols herein--set within the framework of ITN's R&D projects and/or monitoring contracts--were not consistent with the former regulations. Taking this into account, 1) the EU daily limit for PM(10) was exceeded a few times in all sites except the control, even if the number of times was still inferior to the allowed one; 2) the EU annual mean for PM(10) was exceeded at one site; 3) the EPA daily limit for PM(2.5) was exceeded one time at three sites; 4) the EPA annual mean for PM(2.5) was exceeded at most sites; 5) the inner-Lisbon site approached or exceeded the legislated PMs; 6) Pb levels stayed far below the EU limit value; and 7) concentrations of As, Ni and Hg were also far less than the reference values adopted by EU. In every location, Ni appeared more concentrated in PM(2.5) than in coarser particles, and its levels were not that different from site to site, excluding the control. The highest As and Hg concentrations were found in the neighbourhood of the coal-fired, utility power plants. The results may be viewed as a "worst-case scenario" of atmospheric pollution, since they have been obtained in busy urban-industrial areas and/or near major power-generation and waste-incineration facilities.

Thickening of the amnion basement membrane and its relationship to placental inflammatory lesions and fetal and maternal disorders

OBJECTIVE

The aim of this study is the morphological and morphometric analysis of the basement membrane amniotic epithelium of the chorionic plate to establish possible correlation between the basement membrane amniotic epithelium thickening and maternal and fetal disorders.

STUDY DESIGN

Ninety-one placentas of infants delivered in Medical Hospital School were studied with hematoxylin-eosin (H&E) and Periodic Acid Schiff (PAS) methods, morphometric and ultrastructural analysis.

RESULTS

Of the 91 placentas analyzed, 17 (18.6%) were normal with regard to placental morphology, fetal and maternal history. Basement membrane amniotic epithelium thickening was significantly greater in the cases associated with chorioamnionitis (P=0.013), villitis (P=0.040), maternal hypertension syndromes during pregnancy (P=0.027) and stillborn (P=0.040) babies. The electron microscopic examination of the basement membrane amniotic epithelium identified a structural alteration and edema of the dense lamina.

CONCLUSION

Thickening of the basement membrane amniotic epithelium was associated with morphologic placental abnormalities and/or fetal or maternal disorders. Thickening of the basement membrane amniotic epithelium was identified away from the site of placental inflammation, possibly being a consequence of cytokines, supporting more than a local effect. This could be a new insight into the pathogenesis of fetal and maternal complications associated with inflammatory placental lesions.

Organomercurial removal from vaccine production wastewaters in a supported liquid membrane bioreactor

Vaccine production effluents are strongly polluted with thiomersal, a highly toxic organomercurial compound, for which there is presently no remediation technology available. This work describes a new remediation process based on the extraction of thiomersal from the wastewater to a biological compartment, where it is degraded by a microbial strain. The selective extraction of thiomersal is achieved by using an ionic liquid immobilized in a porous membrane. In the biological compartment, thiomersal is degraded to metallic mercury, under aerobic conditions, by a Pseudomonas putida strain. The utilization of ionic liquids in supported liquid membranes for thiomersal transport, and the kinetics of thiomersal biodegradation by a Pseudomonas putida strain are presented and discussed.

An evaluation of olive-tree bark for the biological monitoring of airborne trace-elements at ground level

There is a need to start looking into the possibility of tree bark for biomonitoring. Bark from olive trees (Olea europaea Linn.) has been collected over an area in northwestern Portugal, featuring a blend of rural lands, industrial towns and coastal environments. Samples were analysed through INAA and PIXE for their elemental contents. Results from both techniques were reconciled and then compared with an extensive database on 46 trace elements in Parmelia spp. thalli from the same sites and mostly from the very bark substrates. Distribution-free, nonparametric statistics show that, despite signal magnitude, variation patterns of bark and lichen concentrations follow one another in a most significant way. Selected elements in bark also correlate to a superior extent. As far as this investigation goes, there is no reason whatsoever for discarding bark as an alternative to lower epiphytes.

Calibration of lichen transplants considering faint memory effects

Biomonitoring, among other purposes, can be used as a tool to study the dispersion of trace elements through the atmosphere and back to the earth's surface again. In this sense it has been used for more than 20 years now. Yet, the calibration of biomonitors elemental contents against other atmospheric element dispersion variables like deposition or airborne concentration is still an open subject. The knowledge of a calibration nevertheless represents a qualitative improvement upon the use of biomonitors. Biomonitors elemental contents are usually assumed to depend in a linear way on the average values of atmospheric element dispersion variables, thus a linear regression is assumed to provide a good calibration. In this work: the element dispersion variables like deposition or airborne concentration will be referred in general as availability variables due to reasons that will be clarified; an uptake experiment using transplants of lichen Parmelia sulcata carried out in Portugal during a 2-year period (1994/1996) is described; and new concepts and calibration methods are presented. Lichen and aerosol samples were analysed by nuclear analytical techniques PIXE and INAA, and total deposition dry residue samples were analysed by ICP-MS. A database of roughly 70,000 values was thus created and biomonitor calibration carried out considering that biomonitors are not mechanical instruments but that they rather describe their exposure with a non-perfect memory. Data shows that surveying lichens four times within 1 year, with a period of 3 months in between sampling campaigns, allows the recovery of availability mean, maxima and standard deviation for many elements.

A comparative study for results obtained using biomonitors and PM10 collectors in Sado Estuary

In 1996 a program was started, financed by the Environmental Ministry of Portugal and IAEA, aiming to study the inorganic atmospheric pollutant dispersion in Sado Estuary. Gent PM10 air samplers were used for air particulate matter sampling. Three sampling sites were chosen, forming a triangle around the fuel power station of Setúbal. Transplants of Parmelia sulcata Taylor were suspended in nylon bags within a rectangle 15 km wide and 25 km long on a 2.5 x 2.5 km grid. Two sets of four transplants were hung in each of the 47 locations, one set facing the wind and the other set opposing the wind. The transplants were suspended in December 1997 for a 1-year period; every 3 months, one transplant of each set was collected. Both lichen transplants and PM10 filters were analysed by INAA and PIXE. A comparative study of results obtained for the two sampling procedures is presented in this work.

In situ corrosion control in industrial water systems

The main objective of this study was to evaluate the efficacy of a biocide and a corrosion inhibitor against the corrosion of a circulating pipe in a cooling tower. Isothiazolone was tested as the industrial biocide. The results showed that the biocide by itself or combined with a dispersant was not efficient to control corrosion in the industrial system. Corrosion rates of 0.324 mm/year were recorded in both the presence and absence of the biocide. Corrosion control was successfully accomplished by using a corrosion inhibitor. In the latter case the maximum corrosion rate of 0.024 mm/year were obtained.

Mechanism of charged pollutants removal in an ion exchange membrane bioreactor: drinking water denitrification

The mechanism of anionic pollutant removal in an ion exchange membrane bioreactor (IEMB) was studied for drinking water denitrification. This hybrid process combines continuous ion exchange transport (Donnan dialysis) of nitrate and its simultaneous bioreduction to gaseous nitrogen. A nonporous mono-anion permselective membrane precludes direct contact between the polluted water and the denitrifying culture and prevents secondary pollution of the treated water with dissolved nutrients and metabolic products. Complete denitrification may be achieved without accumulation of NO3(-) and NO2(-) ions in the biocompartment. Focus was given to the effect of the concentration of co-ions, counterions, and ethanol on the IEMB performance. The nitrate overall mass transfer coefficient in this hybrid process was found to be 2.8 times higher compared to that in a pure Donnan dialysis process without denitrification. Furthermore, by adjusting the ratio of co-ions between the biocompartment and the polluted water compartment, the magnitude and direction of each individual anion flux can be easily regulated, allowing for flexible process operation and control. Synthetic groundwater containing 135-350 mg NO3(-) L(-1) was treated in the IEMB system. A surface denitrification rate of 33 g NO3(-) per square meter of membrane per day was obtained at a nitrate loading rate of 360 g NO3(-) m(-3)d(-1), resulting in a nitrate removal efficiency of 85%.

Magnesium deficiency improves glucose homeostasis in the rat: studies in vivo and in isolated islets in vitro

The serum mineral levels, glucose disappearance rate (kg), total area under the glucose (DeltaG) and insulin (DeltaI) curves, and static insulin secretion were compared among rats fed a Mg-deficient diet for 6 (DF-6) or 11 (DF-11) weeks, and rats fed a control diet for the same periods (CO-6 and CO-11 groups). No change in glucose homeostasis was observed among DF-6, CO-6 and CO-11 rats. DF-11 rats showed an elevated kg and a reduced DeltaG and DeltaI. For evaluating the effect of supplementation, rats fed a control or Mg-deficient diet for 6 weeks were then fed a Mg- supplemented diet for 5 weeks (SCO and SDF groups respectively). The serum Mg levels in SDF rats were similar to those in CO-11 and SCO rats, but higher than in the DF-11 group. SDF rats showed similar kg, DeltaG and DeltaI compared with the CO-11 and SCO groups. However, a significantly lower kg and higher DeltaG and DeltaI were observed in SDF compared with DF-11 rats. Basal and 8.3 mmol glucose/l-stimulated insulin secretion by islets from DF-11 rats were higher than by islets from CO-11 rats. These results indicate that moderate Mg depletion for a long period may increase the secretion and sensitivity to insulin, while Mg supplementation in formerly Mg-deficient rats may prevent the increase in sensitivity and secretion of insulin.

Two-dimensional fluorometry coupled with artificial neural networks: a novel method for on-line monitoring of complex biological processes

The use of two-dimensional scanning fluorometry as an on-line, noninvasive, in situ bioreactor monitoring technique is extended to complex bioprocesses using mixed cultures, with particular attention to biofilm systems. Using the example of spectra subtraction, it is demonstrated that established methods for fluorescence data analysis have a limited capability of utilizing overall fluorometric information. Artificial neural networks (ANNs) are introduced as a novel nonlinear and nonmechanistic technique for interpreting the highly complex fluorescence maps. It is shown that ANNs are able to infer process performance parameters in a pattern recognition approach, based on the entire fluorescence "fingerprint" of the biological system. The studies were carried out using an extractive membrane bioreactor (EMB) for the degradation of chlorinated organic compounds, operating with mixed cultures. Model pollutants em- ployed were 1,2-dichloroethane, 3-chloro-4-methylaniline, and p-toluidine.

Magnesium deficiency modulates the insulin signaling pathway in liver but not muscle of rats

Altered insulin secretion and sensitivity have been observed in Mg-deficient animals. However, the effects of Mg deficiency and supplementation on intracellular signaling events triggered by insulin are unknown. Therefore, we studied the early steps of insulin action in muscle and liver of rats fed Mg-deficient (DF-6, DF-11) or control (CO-6, CO-11) diets for 6 or 11 wk, respectively, and Mg-deficient or control diets for 6 wk, followed by Mg supplementation for 5 wk (SDF and SCO groups, respectively). There were no differences in the glucose disappearance rate (K(itt)) or insulin signaling between CO-6 and DF-6 rats. Between the two groups of rats fed for 11 wk, the DF-11 group had a significantly greater K(itt). SDF and SCO rats had K(itt) that did not differ from CO-11 rats, but that were significantly lower than in DF-11 rats. In the latter rats, insulin receptor and insulin receptor substrate-1 protein and phosphorylation levels were elevated in liver and there was a greater association between the insulin receptor substrate-1 and p85 subunit of phosphatidyl-inositol 3-kinase compared with CO-11 rats. There were no differences in the early steps of insulin action in SDF and control rats. These results suggest that the normal insulin sensitivity maintained by Mg supplementation and the increased insulin sensitivity produced by a long period of Mg deprivation may result, at least in part, from alterations in or maintenance of the early molecular steps of insulin action in hepatic tissue.

[Occurrence of encephalic and cardiac cysticercosis (Cysticercus cellulosae) in necropsy]

OBJECTIVE

To review the incidence and pathologic findings of cysticercosis diagnosed at autopsies, with emphasis on the most common organs affected.

METHODS

Reports of 1.596 autopsies performed between 1974 and 1997 at a school hospital in Uberaba, MG, Brazil were studied. The following data were obtained: age, sex, ethnic group, body mass index, and the site of the cysticercosis.

RESULTS

The study found diagnosis of cysticercosis in 53 autopsies (3.3%). The average age of patients with cysticercosis was 50 (range: 15 to 86 years); 62.3% were male, and 64.1% Caucasian. The most affected organs were: brain (79.2%), heart (22.6%), skeletal muscle (11.3%), and other organs (5.7%). No statistical differences were found comparing age, gender, ethnic group, and body mass index of the affected and the non-affected patients. In two cases of neurocysticercosis the lesions were located in the ventromedial nucleus of the hypothalamus.

CONCLUSION

Both the overall incidence of cysticercosis and the incidence of cardiac cysticercosis were greater in the study than in other autopsy series from the same geographic areas. In two cases there was an association between hypothalamic cysticercosis and obesity

Glucose metabolism and kinetics of phosphorus removal by the fermentative bacterium Microlunatus phosphovorus

Phosphorus and carbon metabolism in Microlunatus phosphovorus was investigated by using a batch reactor to study the kinetics of uptake and release of extracellular compounds, in combination with (31)P and (13)C nuclear magnetic resonance (NMR) to characterize intracellular pools and to trace the fate of carbon substrates through the anaerobic and aerobic cycles. The organism was subjected to repetitive anaerobic and aerobic cycles to induce phosphorus release and uptake in a sequential batch reactor; an ultrafiltration membrane module was required since cell suspensions did not sediment. M. phosphovorus fermented glucose to acetate via an Embden-Meyerhof pathway but was unable to grow under anaerobic conditions. A remarkable time shift was observed between the uptake of glucose and excretion of acetate, resulting in an intracellular accumulation of acetate. The acetate produced was oxidized in the subsequent aerobic stage. Very high phosphorus release and uptake rates were measured, 3.34 mmol g of cell(-1) h(-1) and 1.56 mmol g of cell(-1) h(-1), respectively, values only comparable with those determined in activated sludge. In the aerobic period, growth was strictly dependent on the availability of external phosphate. Natural abundance (13)C NMR showed the presence of reserves of glutamate and trehalose in cell suspensions. Unexpectedly, [1-(13)C]glucose was not significantly channeled to the synthesis of internal reserves in the anaerobic phase, and acetate was not during the aerobic stage, although the glutamate pool became labeled via the exchange with intermediates of the tricarboxylic acid cycle at the level of glutamate dehydrogenase. The intracellular pool of glutamate increased under anaerobic conditions and decreased during the aerobic period. The contribution of M. phosphovorus for phosphorus removal in wastewater treatment plants is discussed on the basis of the metabolic features disclosed by this study.

Distribution in Portugal of some pollutants in the lichen Parmelia sulcata

During the months of July and August 1993 a lichen (Parmelia sulcata Taylor) collection campaign was held in Portugal where samples were obtained from olive tree bark at 228 sites, following a grid of 10 x 10 km along the Atlantic coast and 50 x 50 km in the interior of the country. The samples were analysed by instrumental neutron activation analysis and proton induced X-ray emission techniques. Concentration data patterns for the pollutants As, Cr, Hg, Ni, Pb, S, Sb, Se, and V were obtained for the whole country surface by making use of an extinction rule of 1/r(3), preventing any cut-off distance from being artificially introduced. Some pollution sources were identified: (1) oil-powered plants on the Lisbon-Setúbal axis (V, Ni), (2) coal-power plants in Porto and Sines (S, Se), (3) traffic in the northern area and the Lisbon-Setúbal axis (Pb), (4) a chemical industry south of Porto (Hg, As), and (5) soil influence (Cr, Sb). Arsenic and chromium results largely exceed, in a few areas, the concentrations acceptable to plants, and in a few spots also Hg, Ni, and Pb data.

Environmental assessment in an industrial area of Portugal

The region of Lisbon and south of Lisbon (Sado estuary) is densely industrialized, and, therefore, air pollution should be studied in a more detailed scale there. The topography of the Sado estuary region and the predominant wind direction from the northwest contribute to the influence in this region of the industries located in the north. The region selected includes a fuel-fired power station. Transplants of the lichen Parmelia sulcata Taylor were suspended in nylon bags within a rectangle 15 km wide and 25 km long on a grid 2.5 km x 2.5 km, centered in the power station. In each of the 47 sites, 2 sets of 4 transplants each were hung. Care was taken (1) in covering the two sets with a polyethylene roof to prevent leaching of elements in the lichen, (2) in building a hanging system that could rotate according to the wind direction, and (3) in orienting one set toward the wind and the other set opposite the wind. For a 1-yr period and every 3 mo, one transplant of each set is collected. In this work, the results of the first campaign (after 3 mo suspension) obtained by instrumental neutron activation analysis and proton-induced X-ray emission are shown. Some elemental contents are mapped and discussed.

Protein deficiency and nutritional recovery modulate insulin secretion and the early steps of insulin action in rats

Maternal malnutrition was shown to affect early growth and leads to permanent alterations in insulin secretion and sensitivity of offspring. In addition, epidemiological studies showed an association between low birth weight and glucose intolerance in adult life. To understand these interactions better, we investigated the insulin secretion by isolated islets and the early events related to insulin action in the hind-limb muscle of adult rats fed a diet of 17% protein (control) or 6% protein [low (LP) protein] during fetal life, suckling and after weaning, and in rats receiving 6% protein during fetal life and suckling followed by a 17% protein diet after weaning (recovered). The basal and maximal insulin secretion by islets from rats fed LP diet and the basal release by islets from recovered rats were significantly lower than that of control rats. The dose-response curves to glucose of islets from LP and recovered groups were shifted to the right compared to control islets, with the half-maximal response (EC50) occurring at 16.9 +/- 1.3, 12.4 +/- 0.5 and 8.4 +/- 0.1 mmol/L, respectively. The levels of insulin receptor, as well as insulin receptor substrate-1 and phosphorylation and the association between insulin receptor substrate-1 and phosphatidylinositol 3-kinase were greater in rats fed a LP diet than in control rats. In recovered rats, these variables were not significantly different from those of the other two groups. These results suggest that glucose homeostasis is maintained in LP and recovered rats by an increased sensitivity to insulin as a result of alterations in the early steps of the insulin signal transduction pathway.

[Candidiasis in kidney transplant patients]

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.

Use of ciprofloxacin as a prophylactic agent in urinary tract infections in renal transplant recipients

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.

Relationship between Chagas' disease immunoreactivity in pericardial fluid and survival of children

Pericardial fluid (PF) obtained at autopsy has been used for the study of fluid pericardium proteins in noninfectious and infectious diseases such as Chagas' disease. The aim of the present study was to determine the immunoreactivity to Chagas' disease in PF obtained at autopsy from children in an endemic area. A total of 251 autopsy records were surveyed from the files of the Medical School of Uberaba, Brazil, of children ranging in age from stillborn to 14 yr who had died between 1968 and 1992. The reactions for Chagas' disease (immunofluorescence, complement fixation, and hemagglutination) applied to PF were recorded. Thirty-four children (13.5%) showed positive reactions to Chagas' disease. The frequency of immunoreactivity was significantly related to age-group distribution (chi 2 = 13.4; P < 0.005). Children with negative PF tests who had died between 1 and 60 days of age presented a median survival time of 13 days; positive children presented a median survival time of 4 days (Z = 2.1; P = 0.02). These data indicate that the prevalence of Chagas' disease is high among pregnant women in southern Brazil. In addition, they also suggest that "antitrypanosome antibodies" detected in PF may be 1 of the indicators of age of infant death and may possibly play a role in the course of the disease in children born from mothers with Chagas' disease.