PSX-A-23 Late-Breaking: Supplementation of Nerve Growth Factor (β-NGF) in the maturation medium and efficiency of in vitro embryo production in cattle

The aim of this study was to evaluate the supplementation of Nerve Growth Factor (β-NGF) in the maturation medium in in vitro embryo production routines. Antral follicles were aspirated from ovaries of cows obtained from slaughterhouses and then oocytes were selected for quality (grades I and II) for in vitro maturation and subjected to 4 successive in vitro embryo production routines (IVEP). Supplementation of 100 ng of β-NGF was performed in the oocyte maturation medium 22 hours before in vitro fertilization. 48 hours after fertilization of the oocytes, an analysis was made of their cleavage rate by counting blastomeres with the aid of a stereoscopic microscope (cleavage rate = number of embryos / number of initial oocytes). Seven days after fertilization, the blastocyst rate was determined through the relation to the number of oocytes that started cleavage and reached this stage of development (blastocyst rate = number of blastocyst / number of oocytes that started cleavage). To verify the existence of a difference between the supplemented and the non-supplemented groups, the paired T test was applied, using the Excel / Action software (Microsoft). In vitro embryo production routines supplemented with β-NGF in the maturation medium had, on average, a higher cleavage rate (P = 0.0072) and a higher blastocyst rate (P = 0.0033) compared to non-supplemented routines with β-NGF. In this study was demonstrated that Nerve Growth Factor supplementation in the maturation medium improves the efficiency of in vitro embryo production in cattle, and this protein has a probable action in the oocyte maturation process.

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Multiple metals and agricultural use affects oxidative stress biomarkers in freshwater Aegla crabs

Metals and agrochemicals are among the main aquatic contaminants, being able to trigger oxidative stress in exposed organisms. The objective of this work was to evaluate the correlation between the level of oxidative stress biomarkers in Aegla crabs (Crustacea, Anomura) with (i) the set of metals present in the streams sediment and (ii) with land uses of three hydrographic basins. The study was carried out in streams (≤ 2nd order) of hydrographic basins in southern Brazil (Basins of Rio Suzana, Rio Ligeirinho-Leãozinho and Rio Dourado). In these streams were quantified the land uses and Cu, Cr, Cd, Fe, Mn and Zn concentrations in the sediment. The enzymes Catalase (CAT) and Glutathione Reductase (GR), as well as the level of membrane lipid peroxidation (TBARS), were analyzed in adult females. The PCA analysis showed that the distribution of metals was different between the basins. Cd, Cr and Fe were correlated positively with CAT and negatively with TBARS and GR. The Dourado basin had the lowest concentrations of these three metals and the highest levels of TBARS. However, in Dourado basin there is predominance of agriculture land use, and TBARS was positively correlated with agricultural land use. Besides in Dourado basin, GR activity was higher than in the others basins, indicating a compensatory response in relation to CAT inhibition. The basins of Suzana and Ligeirinho-Leãozinho rivers had lower TBARS values, which may be due to the induction of CAT in response to metals accumulated in sediment. In summary, this work indicates that in the basins with a higher concentration of toxic metals there is an adaptive response of CAT induction, which reduces TBARS in Aegla. On the other hand, in the basin with lower metallic contamination, TBARS occurrence was primarily influenced by agricultural land use.

Selected sperm traits are simultaneously altered after scrotal heat stress and play specific roles in in vitro fertilization and embryonic development

Improvements in the estimation of male fertility indicators require advances in laboratory tests for sperm assessment. The aims of the present work were (1) to apply a multivariate analysis to examine sperm set of alterations and interactions and (2) to evaluate the importance of sperm parameters on the outcome of standard IVF and embryonic development. Bulls (n = 3) were subjected to scrotal insulation, and ejaculates were collected before (preinsulation = Day 0) and through 56 days (Days 7, 14, 21, 28, 35, 42, 49, and 56) of the experimental period. Sperm head morphometry and chromatin variables were assessed by a computational image analysis, and IVF was performed. Scrotal heat stress induced alterations in all evaluated sperm head features, as well as cleavage and blastocyst rates. A principal component analysis revealed three main components (factors) that represented almost 89% of the cumulative variance. In addition, an association of factor scores with cleavage (factor 1) and blastocyst (factor 3) rates was observed. In conclusion, several sperm traits were simultaneously altered as a result of a thermal insult. These sperm traits likely play specific roles in IVF and embryonic development.

Metabolic profile of serum and follicular fluid from postpartum dairy cows during summer and winter

This study was designed to monitor the biochemical profiles of serum and follicular fluid (FF) of postpartum dairy cows during the summer (n=30) and winter (n=30). Blood and FF (follicles ≥ 9 mm) were obtained from Girolando cows at 30, 45, 60, 75 and 90 days postpartum. The samples were collected and analysed to determine glucose, total cholesterol (TC), triglyceride (TG), urea, sodium (Na), potassium (K) and calcium (Ca) levels. Throughout the study, the following clinical variables were measured: rectal temperature (RT), respiratory rate (RR) and body condition score (BCS). In addition, the temperature humidity index (THI) was calculated for each season. During the summer season, THI was higher, BCS decreased, there was an increase in RT, and glucose, urea, Na and K serum levels were decreased (P<0.05). The levels of TC, TG, urea, K and Ca in follicular fluid increased (P<0.05). Positive correlations (P<0.05) were observed between the serum and FF levels for glucose (r=0.29), TC (r=0.24) and Ca (r=0.30). Therefore, the biochemical profile of serum and FF of dairy cows under summer heat-stress conditions demonstrates marked changes that may impair fertility during lactation.

Ovarian activity and oocyte quality associated with the biochemical profile of serum and follicular fluid from Girolando dairy cows postpartum

This study was designed to evaluate the influence of heat stress (HS) on the metabolic profile of serum and follicular fluid (FF), ovarian follicle development, and oocyte quality of Girolando dairy cows. Oocytes, blood, and FF (follicles ≥9mm) samples were obtained at 30, 45, 60, 75, and 90 days postpartum in the summer and winter seasons. During transvaginal follicular aspiration, rectal temperature (RT), body condition score (BCS), number of ovarian follicles, and quality of oocytes were recorded. The ambient air temperature (AT) and relative humidity (RH) were also recorded to calculate the temperature humidity index (THI). Glucose, total cholesterol (TC), triglycerides (TG), urea, sodium (Na), potassium (K), and calcium (Ca) concentrations were determined using serum and FF samples. The RT, THI, and BCS loss were greater (P<0.01) in the summer; however, glucose, Na, and K serum concentrations decreased in the same season (P<0.05). Degenerated oocytes were positively associated (P<0.05) with THI (r=0.14) and AT (r=0.13), and negatively associated with glucose (r=-0.12) and K (r=-0.11) serum concentrations. HS induces metabolic changes, which compromise the number of ovarian follicles and the follicular environment, thus resulting in morphologically damaged oocytes.

Multicentre study of nitrate reductase assay for rapid detection of rifampicin-resistant M. tuberculosis

SETTING

Four regional laboratories belonging to the Mycobacteria Reference Laboratory of São Paulo State, Brazil.

OBJECTIVE

To evaluate the nitrate reductase assay (NRA) for rifampicin (RMP) susceptibility testing of Mycobacterium tuberculosis directly from clinical sputum samples of patients with pulmonary tuberculosis (TB).

DESIGN

Performance of the NRA for detection of M.tuberculosis susceptibility to RMP was evaluated with 210 clinical sputum samples received by the participating laboratories during 2005 and 2006 and compared with the results of the direct proportion method.

RESULTS

Susceptibility tests performed using the NRA and the direct proportion method showed 204 susceptible isolates and six isolates resistant to RMP by both methods. NRA sensitivity and specificity for RMP was 100%. The NRA results of susceptibility tests against RMP were available in 15 days for 87% of the samples. The results showed that NRA may yield a rapid answer in determining resistance for the majority of sputum samples with smear results reported as 3+ and 2+.

CONCLUSION

The results demonstrate the feasibility of NRA for screening resistant strains in sputum samples from patients with pulmonary TB. NRA represents a rapid and low-cost alternative method that might be used in microbiological laboratories where resources are scarce.

Predictive index to differentiate invasive squamous cell carcinoma from preinvasive ocular surface lesions by impression cytology

BACKGROUND/AIMS

In the literature, no cytological features have been identified that reliably differentiate invasive squamous cell carcinoma (SCC) from preinvasive lesions in impression cytology (IC) samples. The aim was to identify cytological features related to malignancy and apply them in a quantitative model to determine an index score with the best predictive power to differentiate SCC from preinvasive ocular surface lesions by IC.

METHODS

39 patients with ocular surface epithelial lesions were enrolled. IC was obtained from all lesions before surgical excision. Specimens with atypical cells were evaluated regarding 11 cytological parameters based on the 2001 Bethesda system.

RESULTS

Histopathological diagnosis was pterygium in one case, actinic keratosis in nine cases, intraepithelial neoplasia in nine cases and SCC in 20 cases. Analysis of the receiver operating characteristic curve revealed that a predictive index score (cut-off point) > or =4.25 presented the best relationship between sensitivity and specificity in identifying SCC (sensitivity of 95%, specificity of 93%, positive predictive value of 95% and negative predictive value of 93%).

CONCLUSION

The scoring system model presented is suitable for clinical practice in differentiating SCC from preinvasive ocular surface lesions by IC and can be better evaluated with prospective use.

Multicentre evaluation of an automated BACTEC 960 system for susceptibility testing of Mycobacterium tuberculosis

SETTING

Three mycobacteria reference laboratories in the south-eastern part of Brazil.

OBJECTIVE

To evaluate the automated Mycobacteria Growth Indicator Tube (MGIT) for drug susceptibility testing of Mycobacterium tuberculosis.

DESIGN

Performance of the automated BACTEC MGIT 960 (M960) system for testing M. tuberculosis susceptibility to streptomycin (SM), isoniazid (INH), rifampicin (RMP) and ethambutol (EMB) was evaluated with 95 clinical isolates and compared to the results of the radiometric BACTEC 460TB (B460) system, the proportion method (PM), and the resistance ratio method (RRM). Judicial susceptibility profiles of 88 isolates were defined based on two or more concordant results among B460, PM and RRM, and used as a reference for comparison with M960 results.

RESULTS

Agreement rates between M960 and conventional methods were 95.2% with B460, 96.6% with the PM and 93.4% with the RRM. The lowest agreement rates were obtained for SM with the RRM and for EMB with B460. When comparing M960 with judicial susceptibility profiles, the agreement rate was 97.9%. The agreement rates obtained for INH and RMP were 99.2% and for SM and EMB they were 96.2% and 96.9%, respectively. The mean time to reporting the M960 results was 6.9 days.

CONCLUSION

M960 offers great improvements when compared to the proportion and resistance ratio methods and would benefit patient treatment.

Differentiation of Mycobacterium tuberculosis from other mycobacteria with rho-nitrobenzoic acid using MGIT960

SETTING

Mycobacteria growth in media with the addition of inhibitory substances has been used in species identification. Growth of the Mycobacterium tuberculosis complex (MTC) is inhibited by rho-nitrobenzoic acid (PNB), whereas non-tuberculous mycobacteria (NTM) are resistant.

OBJECTIVE

To develop a rapid PNB test using the automated BACTEC MGIT960 system and to evaluate its usefulness in the screening of mycobacterial isolates.

DESIGN

PNB tests were performed in 93 MTC strains and 61 NTM strains from the Instituto Adolfo Lutz Culture Collection. PNB was added to Löwenstein-Jensen (LJ) medium and to BACTEC MGIT960 medium.

RESULTS

The MTC strains were all PNB-susceptible, confirming the original identification. Among 10 NTM species, all were found to be resistant to PNB, except for one strain of M. kansasii and another of M. marinum. The median time to obtain presumptive identification of MTC by inhibition test in the BACTEC MGIT960 system was 6.3 days and for NTM it was 2.5 days. The presumptive identification of MTC in LJ was mostly obtained after day 20.

CONCLUSION

The key finding of this analysis was the possibility of combining the traditionally accepted method proposed by Tsukamura and Tsukamura in 1964 with the modern, safe and rapid BACTEC MGIT960 methodology.

A population-based study of drug resistance and transmission of tuberculosis in an urban community

SETTING

A low-income neighborhood of Sao Paulo, Brazil.

OBJECTIVE

To determine the incidence, risk factors and transmission patterns of multidrug-resistant tuberculosis (MDR-TB).

DESIGN

Prospective longitudinal study of patients with pulmonary TB (PTB).

METHODS

Sputum culture-confirmed patients with PTB were recruited between March 2000 and May 2002. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with MDR-TB. Mycobacterium tuberculosis isolates were tested for drug susceptibility and typed by IS6110-RFLP analysis.

RESULTS

Of 420 patients, respectively 71% and 27% were new and previously treated; 15.5% of the patients' M. tuberculosis isolates were resistant to at least one drug; of these, 11% and 27% were found among new and previously treated cases, respectively. Respectively 1% and 16.7% of the new and previously treated cases were MDR-TB. RFLP analysis showed that new transmission of MDR strains was uncommon. By multivariate logistic regression analysis, previous TB and hospitalization in the 24 months before TB diagnosis were identified as independent predictors of MDR-TB.

CONCLUSIONS

The results showed an intermediate level of MDR-TB incidence in a neighborhood of Sao Paulo and identified predictors that can be targeted for intervention by national and local TB control programs.

The effect of a selective cyclooxygenase-2 (COX-2) inhibitor on the proliferation rate of retinoblastoma cell lines

PURPOSE

To examine the effect of nepafenac, a selective cyclooxygenase-2 (COX-2) inhibitor, on the proliferation rate of two human retinoblastoma (Rb)cell lines.

METHODS

Two human Rb cell lines (WERI-RB and Y79) were cultured. COX-2 expression in these cell lines was verified by immunocytochemical analysis of cytospin sections and Western blotting. An MTT-based proliferation assay was used to compare Rb cell growth with and without amfenac, the active metabolite of nepafenac. The averaged results per condition were recorded. The Student's t-test was used to compare results from the cells cultured with and without amfenac.

RESULT

The Y79 cell line showed a higher proliferative rate than the WERI-RB cell line. Both cell lines were negative for COX-2 expression by immunocytochemical analysis; however, both cell lines were positive for COX-2 expression by Western blot. When amfenac was added to both of the cell lines, a statistically significant reduction in proliferation was observed in both cell lines. The two Rb cell lines were positive for COX-2 only in the Western blot, indicating that they probably express low levels of COX-2, which was undetectable by immunocytochemical analysis.

CONCLUSION

The selective, anti-COX-2 molecule amfenac inhibited proliferation of both tested Rb cell lines. Further trials should be undertaken to study the effect of selective COX-2 inhibitors on Rb.

Evaluation of a rapid differentiation test for the Mycobacterium tuberculosis complex by selective inhibition with rho-nitrobenzoic acid and thiophene-2-carboxylic acid hydrazide

SETTING

Mycobacterial growth in media to which inhibitory substances are added has been used in species identification. Growth of the Mycobacterium tuberculosis complex (MTC) is inhibited by rho-nitrobenzoic acid (PNB), whereas non-tuberculous mycobacteria (NTM) are resistant. Thiophene-2-carboxylic acid hydrazide (TCH) is useful in the differentiation of MTC when performed together with other tests.

OBJECTIVE

To develop a test using PNB or TCH added to culture medium, and to evaluate its usefulness in the screening of mycobacteria isolates.

DESIGN

In 2001, PNB testing was performed in 109 M. tuberculosis strains identified by Instituto Adolfo Lutz (IAL) and 52 NTM strains from the institute's culture collection. The drugs were added to Löwenstein-Jensen (LJ) medium and to BBL-MGIT.

RESULTS

Species differentiation of MTC with the MGIT/TCH method was similar to that observed using the conventional LJ/TCH method. The accuracy of the MGIT/PNB method to differentiate NTM and MTC strains was 99.4%. The BBL-MGIT system allowed presumptive identification in 3-11 days, compared to > or =12 days with LJ medium.

CONCLUSION

A simple, low-cost test using growth inhibitors may be incorporated into a modern, safe and quick methodology enabling differentiation of MTC and NTM.

Mycobacteraemia among HIV-1-infected patients in São Paulo, Brazil: 1995 to 1998

From July 1995 to August 1998, mycobacterial blood cultures were obtained from 1032 HIV-infected patients seen at the Centro de Referência e Treinamento de AIDS (CRTA), Hospital São Paulo (HSP), and Centro de Referência de AIDS de Santos (CRAS). Overall, 179 episodes of mycobacteraemia were detected: 111 (62.0%) at CRTA, 50 (27.9%) at HSP, and 18 (10.1%) at CRAS. The frequency of positive cultures declined sharply from 22.6% in 1995 to 6.9% in 1998, consistent with the decrease in opportunistic infections following the publicly funded distribution of highly active antiretroviral therapy. In 1995, mycobacteraemia was more frequently due to Mycobacterium avium complex (59.2%) than Mycobacterium tuberculosis (28.6%), whereas in 1998 the relative frequencies were reversed (28.6 vs. 64.3% respectively), probably justified by the increased virulence of M. tuberculosis and the greater risk of invasive infection in less-immunocompromised patients, including patients unaware they are infected with HIV.

Ocular toxoplasmosis: more than just what meets the eye

Toxoplasma gondii is an intracellular parasite whose life cycle may include the man as an intermediate host. Close to a billion people are infected with this parasite worldwide. Ocular lesions may occur in up to 25% of those individuals infected. The infection may occur intra-uterus, through the placenta when the mother is infected during pregnancy. The parasite may also infect adults after the ingestion of contaminated food products, most notably meats or water. We have shown that although congenital and post-natal (acquired) infection results in similar ocular lesions, the immunological mechanisms behind the development of disease are different. On the other hand, contrary to published data obtained in mice, we were unable to find evidence that the T. gondii express superantigen activity for human lymphocytes. Our findings are important because they suggest that superantigen activity is not important as a pathological mechanism in human disease. Our data also suggest that, whereas the ocular lesion caused by infection after birth is the result of an excessive or dysfunctional immune response, the lesions caused by congenital infection may be due to a lack of an appropriate response to the parasite.

Lack of evidence for superantigen activity of Toxoplasma gondii towards human T cells

Toxoplasma gondii is an obligatory intracellular parasite whose life cycle may include man as an intermediate host. More than 500 million people are infected with this parasite worldwide. It has been previously reported that T. gondii contains a superantigen activity. The purpose of the present study was to determine if the putative superantigen activity of T. gondii would manifest towards human T cells. Peripheral blood mononuclear cells (PBMC) from individuals with no previous contact with the parasite were evaluated for proliferation as well as specific Vbeta expansion after exposure to Toxoplasma antigens. Likewise, PBMC from individuals with the congenital infection were evaluated for putative Vbeta family deletions in their T cell repertoire. We also evaluated, over a period of one year, the PBMC proliferation pattern in response to Toxoplasma antigens in patients with recently acquired infection. Some degree of proliferation in response to T. gondii was observed in the PBMC from individuals never exposed to the parasite, accompanied by specific Vbeta expansion, suggesting a superantigen effect. However, we found no specific deletion of Vbeta (or Valpha) families in the blood of congenitally infected individuals. Furthermore, PBMC from recently infected individuals followed up over a period of one year did not present a reduction of the Vbeta families that were originally expanded in response to the parasite antigens. Taken together, our data suggest that T. gondii does not have a strong superantigen activity on human T cells.

Development of Zn(II) sensors based on the assisted transfer of metal ions by hydrophobic ligands through gel-supported microinterfaces

Square-wave voltammetry (SWV) has been used to study the transfer of zinc(II) ion under static conditions, assisted by 5,6-diphenyl-3-(2-pyridyl)-1,2,4-triazine (DPT), through gel-supported microinterfaces. Microhole arrays created by laser photoablation of thin polyester films were used to support an organic gel phase prepared by addition of 1,3:2,4-dibenzylidenesorbitol (DBS) to a solution of o-nitrophenyloctyl ether (o-NPOE) with the appropriate supporting electrolyte. The results show that SWV can be used with the gel-supported microinterfaces if a gelified aqueous reference is used for the organic phase. Under such conditions a preliminary estimate of the detection limit for the determination of Zn2+ is 5 x 10(-8) mol L(-1).

Autoimmune keratolysis in a patient with leukocytoclastic vasculitis: unusual erythema elevatum diutinum with granulomatous pattern

PURPOSE

Leukocytoclastic vasculitis (LCCV) is an immune complex-mediated, small vessel disease that is clinically characterized by the presence of palpable purpuric lesions, most often in association with rheumatic diseases. Ocular manifestations of LCCV are rare.

METHODS

We describe a patient with an unusual granulomatous pattern of erythema elevatum diutinum (EED) associated with autoimmune keratolysis.

RESULTS

We studied a 64-year-old man with decreased visual acuity and nodular lesions in both hands. Ocular examination revealed bilateral superior corneal melting with perforation in the left eye and conjunctival thickening in both eyes, in association with a severe inflammatory reaction. Histopathologic examination of the conjunctiva revealed granulomatous vasculitis with neutrophilic infiltrate, giant cells, and fibroblastic proliferation. A punch biopsy taken from his skin showed similar characteristics that suggested EED; however, there were no giant cells.

CONCLUSION

To our knowledge, autoimmune keratolysis secondary to cutaneous LCCV (EED) has not been described previously, and there has been no description of granulomatous reaction (in the conjunctiva) in EED.

A follow-up study of Toxoplasma gondii infection in southern Brazil

PURPOSE

To understand better the natural history of ocular toxoplasmosis by reexamining a well-characterized population in Southern Brazil.

METHODS

Ophthalmological examination and serologic tests for Toxoplasma gondii infection were performed in 1997 on 383 individuals who had undergone the same evaluation in 1990.

RESULTS

Of 109 seronegative subjects in 1990, 21 (19.3%) became seropositive by 1997, and 2 (1.5% of previously seronegative patients; 9.5% of those known to have seroconverted) developed ocular toxoplasmosis. Seroconversion occurred more frequently in individuals under 17 years of age (16 of 46 patients, 34.8%) than in those greater than 17 years of age (5 of 63 patients, 7.9%; p = 0.002). Of 131 seropositive individuals who did not have ocular lesions in 1990, 11 (8.3%) had typical toxoplasmic lesions in 1997. Of the 13 individuals with non-specific hyperpigmented small retinal lesions in 1990, 3 (23%) presented with typical lesions in 1997.

CONCLUSIONS

Acquired T. gondii infection can result in late development of ocular lesions. Small, non-specific hyperpigmented retinal lesions may represent sites of T. gondii infection in seropositive individuals.

Apolipoprotein E serum concentration and polymorphism in six European countries: the ApoEurope Project

As part of the ApoEurope Project, the apolipoprotein E (apo E) serum concentration and polymorphism were determined in 6934 healthy subjects aged 25-64 years recruited in six European countries: Finland; France; Greece; Northern Ireland; Portugal and Spain. Age and sex influenced apo E concentration with concentrations being significantly higher in men than in women for those aged between 25 and 44 years. The age effect differed between the sexes after the age of 44 years, displaying a linear increase in women and a plateau in men. As expected, the serum apo E concentration was highest in varepsilon2 carriers and lowest in varepsilon4 carriers in each country with a significantly higher frequency of the varepsilon4 allele in the northern regions. The main finding of this study was a clear increasing North-South gradient in serum apo E concentration independent of age, sex and apo E genotype. In subjects aged <45 years and with the varepsilon3/varepsilon3 genotype, apo E concentration was higher in the South-East (Greece) as compared to the North by 20% for men and 32% for women. In addition to the genetic polymorphism, the geographical area is an important factor to take into account when studying serum apo E concentration in multicentre studies and defining reference values.

Propranolol stimulates histone phosphorylation by a putative PK-C in partially purified homogenate of rat testicular interstitial cells. A possible mechanism for increased testosterone secretion by propranolol

The beta-adrenoceptor blocker propranolol stimulated testosterone secretion by rat testicular interstitial cells (Leydig cell-enriched preparation) in vitro at concentrations ranging from 10(-5) M to 10(-4) M. Treatment of these cells with H7 (20 microM), an inhibitor of protein kinase C, reduced the stimulatory effect of L-propranolol on testosterone secretion by about 5-fold. At concentrations ranging from 31.25 microM to 1000 microM, L-propranolol reduced [3H]phorbol 12,13-dibutyrate binding (IC50 = 75 microM) to rat testicular interstitial cells. At similar concentrations, L-propranolol displaced the binding of [3H]phorbol 12,13-dibutyrate to the homogenate of these cells by only 5%. These findings suggest that the effect of L-propranolol on [3H]phorbol 12,13-dibutyrate binding could be indirect, possibly by increasing the concentration of a chemical mediator interacting with the regulatory domain of protein kinase C. At even lower concentrations (10(-9) M to 10(-7) M), propranolol added directly to the reaction mixture with protein kinase C partially purified from rat testicular interstitial cells increases the phosphorylation of histone. This phosphorylation was comparable to that obtained with (25 microg/ml) phosphatidylserine. The D- and L-stereoisomers of propranolol were equally active. A complete reversal of this propranolol effect on histone phosphorylation was achieved with (20 microM) H-7. In the absence of Ca2+, propranolol was not able to phosphorylate the histone. Taken together, these results suggest that protein kinase C could be the putative kinase involved in this reaction and that its activation by propranolol may be due to interaction of the drug with the regulatory domain of the enzyme at a site differing from the site of interaction with phorbol 12,13-dibutyrate. The ability of propranolol to activate the putative protein kinase C could be related to its stimulatory effect on testosterone secretion by Leydig cells.

[Tolerance to administration of massive doses of vitamin A associated to mass immunization of children in Northeast Brazil]

A follow-up study was carried out in two localities in the semi-arid region of the State of Bahia, Northeast Brazil, with the aim of identifying the occurrence and nature of possible acute side effects subsequent to vitamin A megadose supplement given together with mass immunization in children 6-59 months old. The sample consisted of 852 children, 416 from the county of Teofilandia who received vitamin A together with vaccines and 436 from Santa Barbara, who received only vaccine. In the 24 hours before immunization, children from both groups had similar incidences of diarrhea, fever, and vomiting. Anorexia was more prevalent in Teofilandia and remained so throughout the study period. The results suggest that acute side effects like diarrhea, vomiting, fever, or anorexia were not associated with the vitamin A dosage given with mass OPV, DPT, and measles immunization.

Transmission of tuberculosis in an endemic urban setting in Brazil

SETTING

Two out-patient facilities in São Paulo, Brazil.

OBJECTIVE

To study the transmission pattern of tuberculosis (TB) among human immunodeficiency virus (HIV) infected and uninfected persons in a setting endemic for TB.

DESIGN

A prospective study comparing HIV-seropositive and -seronegative TB patients identified consecutively between 1 March 1995 and 1 April 1997. The patients were stratified according to their Mycobacterium tuberculosis isolate IS6110 RFLP patterns. Risk factors were sought for infection with an RFLP cluster pattern strain, inferred to represent recent transmission.

RESULTS

Fifty-eight (38%) of 151 HIV-seropositive patients and 36 (25%) of 142 HIV-seronegative patients were infected with M. tuberculosis isolates that belonged to cluster patterns (OR 1.84, 95% CI 1.08-3.13). Multidrug-resistant (MDR) strains were isolated from 19 patients, all of whom were HIV seropositive; 12 (63%) of these, and 46 (35%) of 132 drug-susceptible isolates had cluster patterns (OR 3.20, 95% CI 1.08-9.77).

CONCLUSION

In a TB-endemic urban setting in Brazil, the proportion of cases resulting from recent transmission appears to be greater among HIV-seropositive than among HIV-seronegative patients. A large proportion of MDR-TB (63%) cases was caused by strains that had cluster RFLP patterns, suggesting recent transmission of already resistant organisms. This type of knowledge regarding TB transmission may help to improve locally appropriate TB control programs.

Lithogenic risk factors in normal black volunteers, and black and white recurrent stone formers

OBJECTIVE

To compare lithogenic risk factors in normal black volunteer men (BN), male black stone formers (BSF) and male white recurrent stone formers (WSF); in addition, the differential diagnoses in the stone formers were compared to determine if the causes of renal stones differed in the two groups.

SUBJECTS AND METHODS

The study included 22 BN, 22 consecutive BSF and 122 consecutive WSF seen over a 10-year period. Each subject was assessed by a thorough medical history, dietary analysis and a full serum and urinary biochemical evaluation.

RESULTS

Although the WSF were significantly more overweight (P<0.001) and obese (P<0.001) than the BSF, neither group had values significantly different from those of their respective normal populations. There was no significant difference in serum levels of Ca, phosphorus, ionised Ca, calcitriol and alkaline phosphatase in BSF and WSF, but levels of parathyroid hormone tended to be (P<0.1) and calcitriol was significantly higher in BSF than WSF (P<0.03). The BSF urinary excretion levels tended to be more like that of the WSF, with the following pattern present; BN<BSF<WSF, except for citrate, where BSF< BN<WSF. No dietary or metabolic abnormality was found in 9% of BSF and 5% of WSF. Pure dietary lithogenic risk factors were present in 9% of BSF and 21% of WSF. The prevalence of metabolic risk factors was similar in the two groups but the distribution differed. Renal hypercalciuria, absorptive hypercalciuria and mild metabolic hyperoxaluria were 2.5-3 times more prevalent in the WSF.

CONCLUSION

Although the urine of BSF tends to be more like that of WSF, the lithogenic risk factors present differed and were less severe. The increase in urinary calcium excretion, coupled with a lower citrate excretion, may be the most important reason for stone formation in the black population. An increased protein intake may also play a role. In this small group of BSF there was no family history of urolithiasis, supporting the view that there may be a more prominent genetic influence in WSF.

Immunohistochemical expression of S-100 beta in choroidal melanomas

OBJECTIVE

To investigate the expressivity of S-100 beta antibodies in choroidal melanomas and to compare it with that of S-100 protein and HMB-45.

DESIGN

Twenty-seven choroidal melanoma specimens obtained from the McGill University Ophthalmic Pathology Registry were classified as spindle cell, epithelioid cell or mixed-cell type. Immunohistochemistry was performed using the standard peroxidase-antiperoxidase technique with monoclonal HMB-45, polyclonal S-100, polyclonal S-100 beta and monoclonal S-100 alpha beta antibodies in formalin-fixed, paraffin-embedded sections.

OUTCOME MEASURE

Intensity of immunoreaction. The result was considered positive when at least five focal areas of stained cells were observed within the tumour.

RESULTS

All 27 tumours were positive for HMB-45, 19 (70%) for S-100, 23 (85%) for S-100 beta, and 21 (78%) for S-100 alpha beta. No correlation was found between the intensity of the immunoreaction and cell classification.

CONCLUSIONS

HMB-45 is the most reliable marker for choroidal melanomas. S-100 beta is a more sensitive marker than S-100 for choroidal melanomas regardless of cell type. Contrary to previous reports, S-100 beta should not be considered a useful immunomarker to differentiate between primary choroidal melanoma and cutaneous melanoma metastatic to the choroid.

Propranolol stimulates testicular interstitial fluid formation and testosterone secretion in rats

We investigated the effect of intratesticularly injected propranolol on testicular interstitial fluid (TIF) formation and on testosterone levels in the TIF of intact adult male Wistar rats (4-9 rats per group). dl-propranolol at doses of 0.6, 1.2, or 6.0 mg/kg was injected into the left (L) testis whereas the right (R) testis (control testis) received vehicle. dl-propranolol (6.0 mg/kg) caused a significant increase in both TIF volume (329%) and TIF levels of testosterone (257%) in the L testis but not in the R (control) testis 3 h post-injection. In rats treated simultaneously with human chorionic gonadotropin (hCG, 5 IU/rat, sc) the same dose or propranolol (6.0 mg/kg) significantly increased the stimulatory effect of hCG on testosterone secretion by 1.8-fold, but hCG did not modify the stimulatory effect of propranolol on TIF volume. These results demonstrate a direct stimulatory effect of propranolol on TIF volume and testosterone secretion, both under basal and hCG-stimulated conditions.

Mechanisms of interferon-induced inhibition of Toxoplasma gondii replication in human retinal pigment epithelial cells

Inflammation associated with retinochoroiditis is a major complication of ocular toxoplasmosis in infants and immunocompetent individuals. Moreover, Toxoplasma gondii-induced retinal disease causes serious complications in patients with AIDS and transplant patients. The retinal pigment epithelial (RPE) cell is an important regulatory cell within the retina and is one of the cells infected with T. gondii in in vivo. We have developed a human RPE (HRPE) cell in vitro model system to evaluate T. gondii replication and the regulation of this replication by cytokines. T. gondii replication was quantitated by counting the foci of infection (plaque formation) and the numbers of tachyzoites released into the supernatant fluids. Pretreatment of cultures with recombinant human tumor necrosis factor alpha, alpha interferon (IFN-alpha), IFN-beta, or IFN-gamma for 24 h prior to inoculation inhibited T. gondii replication in a dose-dependent manner. Of these cytokines, IFN-gamma was the most potent, and T. gondii replication was completely inhibited at a concentration of 100 U/ml. The anti-toxoplasmotic activity of IFN-gamma was significantly blocked by monoclonal antibody to IFN-gamma. Treatment of the cultures with IFN-gamma from day 1 or 2 postinoculation with T. gondii also offered protection against the parasite. The anti-toxoplasmotic activity of tumor necrosis factor alpha or IFN-alpha, -beta, or -gamma in these cultures was found to be independent of the nitric oxide (NO) pathway, since NO production was not found in HRPE cells treated with these cytokines. However, addition of tryptophan to IFN-gamma-treated cells significantly reversed the inhibitory effects of IFN-gamma, suggesting that IFN-gamma acts by depleting cellular tryptophan. This effect was further confirmed by reverse transcription-PCR and Northern (RNA) blot analysis, which indicated induction of indoleamine 2,3-dioxygenase (IDO), an enzyme that converts tryptophan to kynurenine. These results indicated that interferons inhibited T. gondii replication in HRPE by NO-independent but IDO-dependent mechanisms. This in vitro model of T. gondii replication in HRPE may be useful in evaluating the effects of cytokines and drugs on T. gondii replication within the retina.

Indapamide (Natrilix): the agent of choice in the treatment of recurrent renal calculi associated with idiopathic hypercalciuria

OBJECTIVE

To compare the hypocalciuric and potential side-effects of hydrochlorothiazide (HCT) to indapamide (IND; a thiazide-like drug) in patients with idiopathic hypercalciuria.

PATIENTS, SUBJECTS AND METHODS

Twelve patients with recurrent renal calculi and renal hypercalciuria were studied using a randomized double-blind cross-over protocol. In addition, because the side-effects of HCT are attenuated using small doses, the hypocalciuric effect of 12.5, 25 and 50 mg daily was assessed in six normal subjects.

RESULTS

There was a significant reduction in urinary calcium excretion using both agents, with a mean (SD) of 6.06 (2.68) and 3.37 (2.00) mmol/24 h using IND, and 5.58 (1.98) and 3.93 (2.35) mmol/24 h using HCT, before and after treatment (P < 0.05). The treatment was not sufficiently prolonged to assess adequately all the side-effects of either agent but both produced a similar decrease in serum potassium, whilst HCT significantly increased the mean (SD) serum urate levels, from 0.34 (0.09) to 0.43 (0.08) mmol/L (P < 0.01). There was also a significant decrease in mean (SD) urinary citrate excretion in those receiving HCT, from 1.41 (1.05) to 1.00 (0.71) mmol/24 h (P < 0.001), but not in those receiving IND, from 1.19 (0.71) to 1.18 (0.79) mmol/24 h. Although there was a hypocalciuric effect with doses of 12.5 and 25 mg HCT, it was sub-therapeutic when compared with the dose of 50 mg.

CONCLUSION

At a daily dose of 2.5 mg, IND is at least as effective as 50 mg HCT in controlling hypercalciuria. Because of its safety profile and lack of effects on urinary citrate excretion, this agent should be the preferred therapy for patients with idiopathic hypercalciuria and recurrent renal calculi.

[Neonatal screening of hemoglobinopathies in a population residing in Portugal]

The primary objective of newborn screening of hemoglobinopathies is the early identification of infants with sickle cell disease, as they are at increased clinical risk. Other goals include the identification of other types of clinically significant hemoglobinopathies and the detection of heterozygous carriers followed by the screening and counselling of family members. We performed a pilot study for the neonatal screening of hemoglobinopathies in 400 samples of cord blood taken from a maternity in Lisbon. We did not find any newborn with sickle cell disease. Six samples were from sickle cell heterozygotes, the respective families were studied and informed. We looked for the presence of alpha-thalassemia at birth in 100 consecutive samples of cord blood, by the presence of Hb Bart's, abnormal red blood cell indices and alpha-globin genotype. The results show an incidence of 10% of alpha-thalassemia (-alpha) carriers and 4% of triple alpha-globin gene carriers. The authors discuss the feasibility of neonatal screening of hemoglobinopathies in a Portuguese-speaking population consisting of a low prevalence of Hb S trait autoclonous group and a high prevalence immigrant minority.

[Asialotransferrin discriminating excessive, subacute and chronic active alcohol consumption. Clinical usefulness in hepatic disease]

The determination of serum levels of carbohydrate deficient transferrin (CDT) and transferrin ratio in the persistent abusive alcohol consumer arises with promising utility in the study of alcohol related disorders. This series shows the excellent specificity (97%), though poor sensitivity (52%), for CDT. However the CDT/Tft ratio affords a higher sensitivity, reaching 74%, maintaining the high specificity. In persistent abusive consumers (> 70 g/day) this index, which is positively correlated with serum transferrin, is capable of defining these amounts of alcohol per capita with a high frequency and provides independent information since it is not significantly correlated with the levels of traditional biological markers (AST, ALT, GGT, AGV). Although with defined methodological limitations, these indexes denote, with the improvement of technical accessibility, a practical applicability in the screening of chronic abusive consumers. In the field of hepatology the behaviour of CDT and the transferrin ratio is capable of showing the involvement of ethanol in the study of the nature of a chronic hepatic disease with a high frequency. However, the degree of liver lesion show by the PGA hepatic index, has no significant influence on the serum levels of CDT and the transferrin ratio. In this series, the circumstances and conditions of alcohol consumption seem to be the independent determinant of the informative character which these indexes reveal.

[Nutritional status of pre-school children of the semi-arid region of Bahia (Brazil): II--Vitamin A deficiency]

A survey of 754 preschool children was undertaken in the urban areas of seven small towns of the semi-arid region of Bahia, Northeastern Brazil, to determine the prevalence of vitamin A deficiency, as well as its association with variables such as a age, family income, mother's schooling and dietary adequacy in vitamin A. Protein energy malnutrition and anemia were also studied and are reported separately. The clinical ophthalmological examination did not reveal any signs or symptoms of xerophthalmia amongst these children. In 563 children serum retinol was determined and the average value found was 20.3 micrograms/dl (SD = 10.8 micrograms/dl); the prevalence of deficient serum retinol (below 10.0 micrograms/dl) was of 15.3%. In all 7 localities studied, the prevalence of deficient retinol levels was above 5.0%, the criterion recommended by WHO for considering it a Public Health Problem. The distribution of serum retinol was similar between the sexes, but there was an age trend: the prevalence of deficient and low levels decreased with age. There was no association between deficient serum retinol and family income per capita or mother's education. Results from the 24 h food consumption survey revealed that only 8% of children had an adequate intake of vitamin A through the diet; 66% received less than 1/2 and 35% less than 1/4 of the recommended daily intake of vitamin A. Vitamin A deficiency should be considered a Public Health Problem in the region due to the high prevalence of deficient levels of serum retinol as well as the large dietary inadequacy.

Mycobacterium avium complex (MAC) isolated from AIDS patients and the criteria required for its implication in disease

Before the AIDS pandemia, the Mycobacterium avium complex (MAC) was responsible in most cases for the pneumopathies that attack patients with basic chronic pulmonary diseases such as emphysema and chronic bronchitis. In 1981, with the advent of the acquired immunodeficiency syndrome (AIDS), MAC started to represent one of the most frequent bacterial diseases among AIDS patients, with the disseminated form of the disease being the major clinical manifestation of the infection. Between January 1989 and February 1991, the Section of Mycobacteria of the Adolfo Lutz Institute, São Paulo, isolated MAC from 103 patients by culturing different sterile and no-sterile processed specimens collected from 2304 patients seen at the AIDS Reference and Training Center and/or Emilio Ribas Infectology Institute. Disseminated disease was diagnosed in 29 of those patients on the basis of MAC isolation from blood and/or bone marrow aspirate. The other 74 patients were divided into categories highly (5), moderately (26) and little suggestive of disease (43) according to the criteria of DAVIDSON (1989). The various criteria for MAC isolation from sterile and non-sterile specimens are discussed.

Beta-thalassaemia unlinked to the beta-globin gene interacts with sickle-cell trait in a Portuguese family

An autosomally transmitted hypochromic microcytic mild anaemia with elevated haemoglobin (Hb) A2 and globin chain imbalance has been observed in a three-generation family of Portuguese origin. Extensive DNA analysis of the beta-globin gene cluster, including the complete sequencing of the beta-globin gene and flanking regions, failed to reveal any genetic alteration. The co-segregation of sickle-cell trait in this family enabled us to postulate a defective erythroid trans-acting factor was playing a role in the down-regulation of both beta A- and beta S-globin genes. Among the transcription factors that could possibly have caused the reported phenotype, NF-E2 is unlikely to be implicated, whereas Nrf1 and Nrf2 cannot be ruled out. Thus, this family carries a novel beta-thalassaemia autosomal determinant unlinked to the beta-globin gene. This observation reinforces the notion of the haemoglobinopathies as single gene disorders under polygenic regulation.

[Lipids in children and young people. A public health problem]

Cardiovascular diseases represent an important Public Health problem among us. It is known that the atherosclerotic process on which they are based is mostly dependent on hyperlipidemia, mainly of those characterized by hypercholesterolemia and starts early in childhood. In this paper some lipid parameters were evaluated in children and youngsters and the prevalence of those at risk was compared with the one found in a population sample of adult people, collected at random, using the same determinations and laboratory methods. The authors conclude that preventive measures should be implemented as early as possible in childhood as there are many children and youngsters with hypercholesterolemia and the latter may become lower; some ideas and recommendations for those measures are pointed out.

[Vitamin A deficiency in children of rural areas of the semi-arid region in Bahia]

The distribution and magnitude of vitamin A deficiency and dietary consumption of 161 children at 6 to 72 months of age in rural zones in Cansancao-Bahia-Brazil were evaluated. The serum retinol levels were measured by the spectrophotometric method (Bassey-Lowry modified by Araujo and Flores). The serum retinol average was found to be distributed homogeneously throughout the different age groups. Inadequate serum retinol levels (<20,0 mu g/dl) were detected in 44.7% of the children, which characterized the deficiency as constituting a public health problem. The serum retinol levels showed no statistically significant association as between the sex and age of the children; however the children of less than 24 months showed a higher prevalence of inadequate serum retinol levels. The main available source of vitamin A for these children was represented by carotenoids, especially beta-carotene. Foods regarded as being rich in vitamin A were consumed by all age groups. The greatest diversification of consumption of foodstuffs with moderate and low vitamin A content was observed in the group of children of from 24 to 72 months of age, through this was no guarantee of adequate serum retinol levels in this group however.

Clearance of a chylomicron-like emulsion from plasma is delayed in patients with coronary artery disease

To determine whether the metabolism of chylomicrons and their remnants is related to atherogenesis, a triglyceride-rich emulsion known to mimic chylomicron behavior in plasma and labeled with 1-14C-cholesteryl oleate was injected intravenously into 11 normolipidemic patients (triglycerides: 133 +/- 60 mg/dl; total cholesterol: 207 +/- 20 mg/dl; LDL: 143 +/- 20 mg/dl; VLDL: 27 +/- 13 mg/dl; and HDL cholesterol: 41 +/- 11 mg/dl; apo AI: 1.27 +/- 0.54 g/l and apo B: 1.42 +/- 0.31 g/l) with atherosclerotic coronary artery disease and into 11 control subjects (triglycerides: 109 +/- 32 mg/dl; total cholesterol: 190 +/- 38 mg/dl; LDL: 125 +/- 29 mg/dl; VLDL: 22 +/- 6 mg/ dl; and HDL cholesterol: 44 +/- 9 mg/dl; apo AI: 1.09 +/- 0.28 g/l and apo B: 1.09 +/- 0.28 g/l) without the disease. The emulsion (69% triolein, 23% lecithin, 6% cholesteryl oleate and 2% cholesterol) was injected intravenously at approximately 9:00 a.m., after a 12-h fast. The clearance of the emulsion label from plasma, expressed as fractional clearance rate (FCR), was lower in coronary artery disease compared to controls (0.019 +/- 0.005/min vs 0.036 +/- 0.018/min, respectively, P < 0.05). These results indicate that the rate of removal of chylomicron remnants is slower in patients with coronary artery disease.

Mycobacterium avium complex (MAC): an unusual potential pathogen in cerebrospinal fluid of AIDS patients

Mycobacterium avium complex (MAC) is frequently isolated from patients with late complications of Acquired Immunodeficiency Syndrome (AIDS), especially in North America and Europe. However, its isolation from the central nervous system (CNS) has been seldom reported in these countries. MAC infections in AIDS patients in African and Latin American countries are believed to be uncommon. We report the isolation of MAC from cerebrospinal fluid (CSF) of 11 AIDS patients out of 1723 (0.63%) seen at "Centro de Referência e Treinamento-AIDS", São Paulo and discuss the significance of its isolation.

Molecular basis of alpha-thalassemia in Portugal

We have estimated the incidence and molecular basis of alpha-thalassemia in a Portuguese population, mostly from the Greater Lisbon area. In a group of 100 consecutive cord blood samples, the gene frequency of the rightward deletion (-alpha 3.7) was 0.035, and the leftward deletion (-alpha 4.2) was 0.015. In this group, we have also found four heterozygotes for the triple alpha-globin gene rearrangement (alpha alpha alpha anti 3.7. gene frequency 0.020). We have characterized the subtypes of -alpha 3.7 and alpha alpha alpha anti 3.7 rearrangements. On the whole, these results give an incidence of 10% for deletional alpha-thalassemia carriers in the studied Portuguese population. In a group of 342 subjects presenting beta-thalassemia, or Hb S trait, beta-thalassemia major sickle cell disease or low red blood cell indices, the -alpha 3.7, -alpha 4.2, -SEA, -MED, (alpha alpha)MM, and alpha alpha alpha anti 3.7 haplotypes were found in different combinations. Only one nondeletional alpha-thalassemia determinant (a 5 nucleotide deletion in the alpha 2-globin gene in the second intervening sequence donor site) was detected, which might suggest a low incidence of these defects in the Portuguese population.

High frequency of strains multiply resistant to ampicillin, trimethoprim-sulfamethoxazole, streptomycin, chloramphenicol, and tetracycline isolated from patients with shigellosis in northeastern Brazil during the period 1988 to 1993

The occurrence and antimicrobial resistance pattern of Shigella isolates obtained from persons in community and hospital-based studies of diarrhea and matched controls in northeastern Brazil were studied. The isolation rate of Shigella spp. from patients with diarrhea during 1988 to 1993 varied from 4.5% (26 of 575) for the urban community of Gonçalves Dias to 6.7% (12 of 179) and 5.9% (7 of 119) for Hospital Infantil and Hospital Universitário, respectively. Of the 55 Shigella isolates (45 from patients with diarrhea, 8 from controls, and 2 undetermined) 73% (40 of 55) were Shigella flexneri, 16% (9 of 55) were S. sonnei, 7% (4 of 55) were S. boydii, and 4% (2 of 55) were S. dysenteriae. Of 39 S. flexneri strains, over half were resistant to ampicillin, trimethoprim-sulfamethoxazole, or both. Over 64% were resistant to streptomycin, chloramphenicol, and tetracycline. Overall, 82% of all S. flexneri isolates were resistant to four or more antimicrobial agents tested. As elsewhere, in the northeast of Brazil, ampicillin and trimethoprim-sulfamethoxazole are no longer reliable for treatment of S. flexneri infection. Most Shigella strains were resistant to four or more antimicrobial agents. Nalidixic acid was still useful for treatment of infections due to S. flexneri.

Bacterial agents isolated from cerebrospinal fluid of patients with acquired immunodeficiency syndrome (AIDS) and neurological complications

Cerebrospinal fluid (CSF) samples from 2083 patients with acquired immunodeficiency syndrome (AIDS) and neurological complications were bacteriologically examined during a period of 7 years (1984-1990). The percentage of patients who had at least one bacterial agent cultured from the CSF was 6.2%. Mycobacterium tuberculosis was the most frequently isolated agent (4.3%), followed by Mycobacterium avium complex or MAC (0.7%), Pseudomonas spp (0.5%), Enterobacter spp (0.4%), and Staphylococcus aureus (0.3%). Among 130 culture positive patients, 89 (68.5%) had M. tuberculosis and 15 (11.6%) had MAC. The frequency of bacterial isolations increased from 1988 (5.2%) to 1990 (7.2%), partly due to the increase in MAC isolations. Bacterial agents were more frequently isolated from patients in the age group 21-30 years and from women (p < 0.05).

[The Program of External Quality Evaluation in Clinical Chemistry. An overview and evaluation after 11 years of functioning]

After an eleven-year period, the goals and way of functioning are remembered the External Quality Assessment Scheme in Clinical Chemistry, under the responsibility of the National Institute of Health. The authors try to evaluate the quality of results obtained at the time by the 160 participant laboratories, belonging to the public and private sectors as well as to the Portuguese reference laboratories which have to assign the expected values on the control sera to be analysed. As regards the 22 biochemical blood parameters, we came to the conclusion that there is a high performance level in what concerns the reference laboratories and a quality level of participant laboratories in accordance with their considered peer foreign laboratories.

Frequency of Candida sp infection in tuberculous patients with acquired immunodeficiency syndrome: morphological and immunocytochemical study in sputum

Sputum samples from AIDS patients with and without pulmonary tuberculosis were analyzed morphologically and immunocytochemically to determine the frequency of occurrence of Candida sp. Mycobacterial infection was detected by bacterioscopy and/or culture and cytological evaluation was performed using Papanicolaou and Toluidine Blue staining. Immunoreaction for Candida sp was performed using polyclonal antibody in selected cases with fungal structures in smears stained by the Papanicolaou or Toluidine Blue method. An increased frequency of Candida sp (2.5 times) was observed in the tuberculous group compared to the group of AIDS patients without tuberculosis. The Toluidine Blue stain showed good results for the detection of Candida sp in sputum. Due to the increased risk of this opportunistic infection among more severely immunocompromised patients. Toluidine Blue staining of sputum samples submitted to analysis seems to be a reliable screening method.