J. Rodrigues da Silva

Alterações da função ventilatória na blastomicose pulmonar: correlação radiológica e espirográfica

Ten cases of pulmonary form of Lutz disease (South American blastomycosis) were studied in correlation of chest X-ray and spirometry. All of them showed the classic radiologic signs of nodular lesions, patchy infiltrations, fibrosis and emphysema. Four cases showed insufficiency of ventilatory function, probably derived from obstructive lesions; however, two other cases with X-ray signs of emphysema did not show spirometric abnormality. The authors emphasize the necessity of more investigation on lung function tests in a larger number of cases of pulmonary blastomycosis to establish definite conclusions in this unexplored field.

Influence of Compound 16.842 on hookworm infections

Compound 16.842 was tried with three different groups of patients in order to evaluate its tolerancy, and efficacy as well, with a view of using the drug in mass campaigns against hookworm. Group I, used for a preliminary trial, consisted of 38 patients attending an out-patient clinic, and living either in the out-skirts or in the various urban areas of the city of Rio de Janeiro, including some inmates of an orphanage. Group II, a field trial, was carried out in two farms, where the drug was administered both to the positive cases (124) and to the rest of the population (nearly 90%). Group III, a field trial was also carried out in a small town where nearly 40% of the total population was treated with the Compound. Tolerability was considered rather satisfactory, mainly among the patients receiving two single doses (50-150mg), according to the age, 4 - 6 weeks apart). These results suggest that 2-4 courses of therapy within a shorter span of time should be the ideal for a mass treatment campaign. Efficacy varied from 26.6% to 76.2% parasitological cure in the various groups, with a wide range of variation also in the percent of mean reduction of eggs for hookworm. The drug showed also some effect against Ascaris lumbricoides giving cure rates between 10,5% and 35.7% in the various groups, with a percentage reduction in mean egg counts of 27% to 83.3% according to the various groups. It was concluded that Compound 16.842 possesses a marked effect on hookworm and a mild effect on A. lumbricoides. The findings indicate the need for more accurate studies to determine the most efficient schedules of treatment and the real value of the drug, as compared to other antihelminthics against the two parasites under study.

Experiências terapêuticas com a alfa-6-deoxi-5-oxitetraciclina (doxiclina): um nôvo antibiótico de largo espectro

The authors present their experiences with doxycycline in the treatmend of 54 patients, 16 of them with different infectious diseases, 18 Staphylococcus aureus carriers and 20 Streptococcus beta haemolyticus carriers. The drug was given in a single oral dose for several days according to the degree of severity of the disease; tolerance to the drug was good. Doxycycline was very effective in the treatment of Staphylococcus aureus and Streptococcus beta haemolyticus infections.

Inquérito hematológico em 100 crianças da Fundação Romão de Mattos Duarte, Estado da Guananabara

The authors present the results of haematologic studies carried out in 100 children living in an orfhanage in Rio de Janeiro, Guanabara State; 96 children presented the typical blood picture of anemia, 79% of them of the microcitic type, 2% macrocitic e 15% normocromic; in most of the cases serum total protein ivas telow 6,5 g%; the sedimentation rate was increased in 45 children. In 38 children white cells ranged from 10.000 to 20.000 per mm3; eosinophilia was jrequent (89%), in 44% of them eosinophil countings were 11 to 20% and in 15% were 21 to 50% and always related to the presence of intestinal nematodes, specially Strongyloides stercoralis, Trichuris trichiura and hookworms.

Biópsia per-oral do intestino delgado em 150 casos de diferentes enteroparasitoses

The authors describe some types of capsules used in their experiences and point out the value of small intestine biopsy to the study of intestinal pathology. Six different types of capsules were tried. Hystopathological findings in 150 patients infected with different enteroparasites are described. Giardia lamblia was found in the mucosa in 16 out of 50 cases of parasitism by the protozoa; in 11.1% of the cases of schistosomiasis and 1,8% of those of strongyloidiasis parasites were seen in the mucosa. A case is described of a patient with Giardia lamblia and kala-azar; leishmanias were seen in the corion. Some other hysthological changes, considered as non specific, need more detailed studies in order to give valuable conclusions; atrophy of villi, e.g., was found in 27 cases infected by Strongyloides stercoralis, 5 of them exclusively infected by this helminth.

Malária quiescente: aplicação do método de imunofluorescência em dois casos

The authors, after a brief revieiw of the literature, present two cases of neurosyphilitic inpatients who had blood induced malaria with two different strains of P. falciparum from endemic areas of Goias. The fluorescent antibody levels always showed high leveis even before the innoculation and remained so during the patency of the infection

Infecções post-transfusionais por Plasmodium falciparum

The authors make a brief revision about the duration of P. falciparum infection. Cases are mentioned in which the period lasted up to three years under a latent form. They refer to the risk that this fact represents in blood transfusions and finally relate three cases in which they believed that this fact had occurred and which could have serious consequences 1. By the possibility of spreading a strain of P. falciparum resistant to the different anti-malarials. 2. By the fact that the blood transfusions are generaily made in patients with various debilitating conditions. 3. By the difficulty which technicians face when making a transfusion in detecting whether the parasite is resistant or not in asymptomatic cases. 4. By relatively significant diffusion of strains of resistant P. falciparum in various parts of the national territory

Esplenoportografia em pacientes com hepatoesplenomegalia acompanhada de infecção malárica

Foi praticada a esplenoportografia em 10 pacientes portadores de malaria, sendo a infeccao causada pelo P. falciparum em 5 casos, pelo P. vivax em 3 casos e pela associacao de ambos os plasmodios em outros 2 casos. Em 2 desses 10 casos, havia associacao da malaria com a esquistossomose mansoni. Os resultados obtidos demonstraram: 1) tortuosidade da veia esplenica em 4 casos. Este fato e explicado pela hepatoesplenomegalia, restringindo a distância entre os hilos dos dois orgaos e portanto causando uma retracao da veia esplenica em seu sentido longitudinal; 2) discreta pobreza das ramificacoes portais intrahepalicas, representada pela ausencia ou deficiencia de contrastacao dos ramos aicotomicos portais mais finos. Esta imagem foi encontrada em 7 casos, e pode ser explicada pela vasoconstriccao das ramificacoes portais, relatadas por Skirrow em Macacus rhesus infectados pelo P. knowlesi (19, 20). Outra explicacao mais simplista para este fato esta relacionada com a grande diluicao do contraste ao atingir os ramos portais mais finos, tendo em vista a ampliacao do leito vascular, em virtude da grande hepatoesplenomegalia - sendo de nocar-se que a hepatomegalia era proeminente em 6 dos casos; 3) o hepatograma, alem dos aspectos mencionados, mostrou um aumento apreciavel e universal do figado em 6 casos cujos limites podiam ser apreciados em todos os sentidos, contrastando de certo modo com o hepatograma de esquistossomose hepatoesplenica, em que predominam alteracoes vasculares intrahepaticas, com aspectos sugestivos de peripileflebite esquistossomotica. Parece que esses resultados nao foram influenciados pela especie do plasmodio em causa, isto e, o falciparum ou o vivax. Nove dos dez pacientes foram submetidos a puncao biopsia hepatica, sendo que as alteracoes histopatologicas observadas foram bastante discretas, estando portanto em acordo com as pequenas modificacoes evidenciadas no esplenoportograma. Apenas em um dos dois casos de esquistossomose mansoni associada, na qual foi praticada a biopsia, havia fibrose interlobular com a presenca de granuloma esquistcssomotico. Neste mesmo caso, a esplenoportografia demonstrou imagens de ncoformacao vascular em torno dos ramos dicotomicos do sistema porta intrahepatico, com seu aspecto musgoso descrito por Bogliolo, considerado caracteristico da esquistossomose mansoni.

A new and practical viscerotome

An instrument consisting of a sheath-like tube 22 1/2 cm. long with a rod or trocar and attached cutting blade is described. It may be used to obtain fragments of non hollow organs, 7mm wide by five to ten centimeters long, to substitute the classic viscerotome. No failures have occurred in viscerotomies of the liver so far. The greatest advantage of this instrument is its relatively small size. Its more practical use is to overcome the difficulties which may hamper the use of the classical viscerotome. This is very important as the need arose to reorganize the network of viscerotomy service. In some areas or countries where no complete autopsies can be performed, biopsy samples have been reduced to such a small size that no practical Information has been received in the last few years. The difficulties of performing an autopsy prevents the obtention of useful vathological data on several diseases affecting the population, even among putients dying in hospitais. The viscerotomy is also the practical solution for this problem.