ABSTRACT Introduction: Bacterial tonsillitis is an upper respiratory tract infection that occurs primarily in children and adolescents. Staphylococcus aureus is one of the most frequent pathogens in the etiology of tonsillitis and its relevance is due to its antimicrobial resistance and persistence in the internal tissues of the tonsils. Tonsillectomy is indicated in cases of recurrent tonsillitis after several failures of antibiotic therapy. Material and methods: In this study we evaluated 123 surgically removed tonsils from patients who had history of recurrent tonsillitis. The tonsils were submitted to microbiological analysis for detection of S. aureus. The isolates were identified by PCR for femA gene. Antimicrobial susceptibility of the isolates was determined by disk diffusion tests. All isolates were submitted to PCR to detect mecA and Panton-Valentine leucocidin (PVL) genes. The genetic similarity among all isolates was determined by pulsed field gel electrophoresis. Results: Sixty-one S. aureus isolates were obtained from 50 patients (40.7%) with mean age of 11.7 years. The isolates showed high level resistance to penicillin (83.6%), 9.8% had inducible MLSb phenotype, and 18.0% were considered multidrug resistant (MDR). mecA gene was detected in two isolates and the gene coding for PVL was identified in one isolate. The genetic similarity analysis showed high diversity among the isolates. More than one genetically different isolate was identified from the same patient, and identical isolates were obtained from different patients. Conclusions: MDR isolates colonizing tonsils even without infection, demonstrate persistence of the bacterium and possibility of antimicrobial resistance dissemination and recurrence of infection. A specific clone in patients colonized by S. aureus was not demonstrated.

In this paper, chemical functionalization of poly(lactic acid) (PLA) was carried out by using of salicyl aldehyde (SAl) and salicylic acid (SAc) as co-initiators of ring opening polymerization (ROP). Two factorial designs (22) were performed to evaluate the effects of the lactide/catalyst and co-initiator/catalyst molar ratios on the content of aldehyde or carboxylic acid end groups, thermal properties and molecular weight (Mw) of PLA. Tin(II) 2-ethylhexanoate was used as a catalyst. The co-initiator/catalyst molar ratio has a statistically significant influence on the polymer functionalization. The highest co-initiator/catalyst molar ratio of 12/1 allows the best aldehyde or carboxylic acid functionalization, independent on the lactide/catalyst molar ratio. On the other hand, the used lactide/catalyst and co-initiator/catalyst molar ratios did not show a statistically significant influence on the polymer thermal properties. Besides, co-initiator/catalyst molar ratio has a statistically significant influence on the polymer molecular weight. So, the highest co-initiator/catalyst molar ratio used (12/1) in combination with the highest lactide/catalyst ratio (125/1) produced functionalized PLA with higher molecular weights.

Resumo Embora a ruptura do miocárdio ocorra em apenas 2 a 4% dos casos de infarto agudo do miocárdio (IAM), está associada a alta mortalidade, principalmente em decorrência do estado de choque cardiogênico agudo. São apresentados os achados anatomopatológicos de três casos de ruptura do miocárdio de pacientes autopsiados nos últimos 30 anos, com diagnóstico de ruptura cardíaca em decorrência de IAM. Nesse período, a porcentagem de IAM com ruptura do miocárdio foi de 0,2%. Os fatores de risco para ruptura do miocárdio pós-IAM incluem idade avançada, arteriosclerose, diabetes mellitus e hipertensão arterial sistêmica.

Summary Although myocardial rupture occurs in only 2% to 4% of cases of acute myocardial infarction (AMI), there is a high mortality rate due to acute cardiogenic shock. We present the anatomopathological findings of three cases of myocardial rupture in autopsied hearts in the last 30 years, with a diagnosis of cardiac rupture in acute myocardial infarction. In these 30 years the percentage of AMI with myocardial rupture was 0.2%. Risk factors for post-AMI myocardial rupture include older age, atherosclerosis, diabetes mellitus and systemic arterial hypertension.

Abstract Oxaliplatin was inserted into polymeric matrices aiming to study the interaction of this drug with these polymers and its capability to diffuse to the environment. Tested polymers were: (1) polyethylene glycol (PEG), (2) poly(lactic-co-glycolic acid) (PLGA), and (3) a copolymer of them (PLGA-PEG). The latter two were synthesized by us using polycondensation in bulk. Oxaliplatin was included in the matrices by the melt mixing process followed by casting. Fourier tran sform infrared spectroscopy (FTIR), proton nuclear magnetic resonance (1H-NMR) and X-ray diffraction (DRX) studies of the polymers were performed proving the obtaining of the desired materials. In addition, the interaction between drug and matrices and the release profile of the oxaliplatin from these matrices were analyzed. Among them, PEG did not control the oxaliplatin release. In turn, PLGA and PLGA-PEG present drug release profiles quite similar. Oxaliplatin was completely released from PLGA and PLGA-PEG in 5 hours, by a relaxation mechanism. There was no evidence of oxaliplatin interaction with the different polymers. In addition, as the PEG improves the biocompatibility and biomasking, obtained results prove the obtaining of a drug release system, which allowed the total use of the drug improving the cancer treatment and even the welfare of the patients.

Introduction  In recent years, there has been a reduction in mortality rates in neonatal intensive care units (NICUs) due to the impact of modern technological advances in the perinatal field. As a consequence, prolonged orotracheal intubation is used more frequently, and there has been an increase in acquired subglottic stenosis (SGS) in children. Subglottic stenosis is a narrowing of the endolarynx and one of the most common causes of stridor and respiratory distress in children. The laryngoplasty balloon has proven effective in dealing with stenosis both as primary and secondary treatments, after open surgery, with the added advantage of being less invasive and not requiring external access. Materials and Methods  This study involved children from pediatric intensive care units or NICUs suffering from respiratory distress and who presented an endoscopic diagnosis of Myer and Cotton grade I to III SGS. These patients underwent balloon laryngoplasty with different numbers of interventions depending on the response in each individual case. Results  All the patients responded satisfactorily to the balloon laryngoplasty. None required tracheostomy after treatment and all remained asymptomatic even after 6-month follow-up. One patient required just 1 dilation, 4 required 2, 3 underwent the procedure 3 times, and another had 5 dilations. Conclusion  The experience presented here is that of balloon laryngoplasty post–orotracheal intubation SGS with very satisfactory results at a tertiary care pediatric hospital. Although the number of patients is limited, our incidence corroborates other studies that demonstrate the efficacy and safety of balloon dilatation in the treatment of SGS.

Polycrystalline ITO films with good optoelectronics characteristics and homogeneous surface has been obtained upon annealing at 550 °C in N² atmosphere using a low-cost chemical vapor deposition (CVD) system. The films were evaluated as pH sensors in separative extended gate field-effect transistor (SEGFET) apparatus, exhibiting a sensitivity of 53 mV/pH, close to the expected Nernstian theoretical value for ion sensitive materials. The use of CVD process to synthesize ITO, as described here, may represent an alternative for fabrication of SEGFET pH sensors at low cost to be used in disposable biosensors since H+ ions are the product of several oxireductase enzymes.

Este trabalho aborda aspectos da natalidade num território de fronteira. A região oeste da Província de São Paulo, em sua área delimitada pelos rios Tietê e Paranapanema, foi a fronteira do povoamento durante boa parte do século XIX. A análise dos registros paroquiais e cartoriais de Lençóes permitiu traçar aspectos da família nessa região. Por meio desse estudo, vemos que a ilegitimidade era baixa, menor do que em outras áreas que serviram de parâmetro, contrariando o que poderia se esperar para uma área de fronteira. Os batismos ocorriam em maior quantidade nos meses finais do ano (novembro e dezembro), seguidos pelo mês inicial, janeiro. Não havia acentuadas variações sazonais com relação aos batismos, embora os meses de outubro, fevereiro e março fossem aqueles de menor ocorrência. Enquanto o domingo era o dia preferido pelos pais para esta cerimônia, concentrando aproximadamente um terço delas, sexta-feira era um dia a ser evitado.

This work approaches the aspects of birth rate in a frontier territory. The west region of São Paulo Province, in its area delimitated by the Tietê and the Paranapanema rivers, was the frontier of the settlement during great part of the nineteenth century. The analysis from the parish and registry office in "Lençóes" (a city in Brazil) allowed us to mark out a family description in the frontier. Through this, we can see that the illegitimacy was low, smaller rather than in other areas that were used as a parameter, going against what people could expect from a frontier area. The baptisms used to take place in a large quantity at the end of the year (November and December), followed by the initial month, January. There weren't marked seasonal variations related to the baptisms, although October, February and March were the months with less occurrence. While Sunday was the preferred day by the parents for such a ceremony, concentrating approximately a third of them, Friday was a day to be avoided.

INTRODUÇÃO: A glomerulonefrite aguda (GNA) após infecção de vias aéreas superiores ou pele é uma doença renal causada geralmente por cepas estreptocócicas nefritogênicas, podendo cursar com quadro súbito de hematúria macroscópica, hipertensão arterial, edema e, ocasionalmente, insuficiência renal aguda, sendo comum na infância e pouco incidente em adultos e indivíduos mais jovens. OBJETIVO: Analisar, de forma descritiva, os dados da apresentação inicial da GNA após infecção de vias aéreas superiores ou pele em pacientes com mais de 14 anos de idade, com ênfase em seus aspectos epidemiológicos e clínicos. PACIENTES E MÉTODOS: Foram analisados os dados clínicos de 82 pacientes, atendidos em nosso Serviço no período de 1972 a 2001, distribuídos em três grupos etários: grupo 1, com indivíduos entre 14 e 20 anos (n = 52); grupo 2, entre 21 e 30 anos (n = 19); e grupo 3, com idade > 31 anos (n = 11). RESULTADOS: Houve um predomínio do quadro entre pacientes mais jovens (grupo 1), do sexo masculino e da cor branca, precedido, principalmente, por infecção de pele, manifestando-se mais comumente por edema de membros inferiores e/ou face. Em alguns casos, até com síndrome nefrótica, e hipertensão arterial, sobretudo nos adultos com mais de 30 anos (grupo 3), sendo menos frequente o achado de hematúria macroscópica e, raramente, de insuficiência renal aguda. CONCLUSÃO: Nossos achados ressaltam a importância de se estudar a GNA após infecção de vias aéreas superiores ou pele em indivíduos mais jovens e adultos, procurando melhor caracterizar seus aspectos clínicos, sobretudo por se tratar de um grupo de pacientes no qual a doença é menos incidente.

INTRODUCTION: Acute glomerulonephritis (AGN) after infection of the upper airways or skin is a kidney disease usually caused by streptococcal nephritogenic strains and may present with sudden onset of gross hematuria, hypertension, edema and, occasionally, acute renal failure, is common in childhood and little incident in adults and younger individuals. OBJECTIVE: To analyze, in a descriptive way, data from the initial presentation of GNA after infection of the upper airways or skin in patients over 14 years of age, with emphasis on its epidemiological and clinical aspects. PATIENTS AND METHODS: We reviewed the clinical data of 82 patients treated at our department during the period 1972-2001, divided into three groups: group 1, with individuals between 14 and 20 years (n = 52), group 2, between 21 and 30 years (n = 19) and group 3, aged >; 31 years (n = 11). RESULTS: There was a predominance of the table among younger patients (group 1), male and white, mostly preceded by infection of the skin, appearing most commonly on lower extremity edema and/or face. In some cases, even with nephrotic syndrome, and hypertension, especially in adults over 30 years (group 3), being the least frequent finding of gross hematuria, and rarely, acute renal failure. CONCLUSION: Our findings underscore the importance of studying the AGN after infection of the upper airways or skin in younger individuals and adults, seeking to better characterize its clinical, mainly because it is a group of patients where the disease is less incident.

Descrevem-se as alterações anatomopatológicas observadas na necropsia de chagásico crônico, provavelmente, portador da forma indeterminada da doença. O coração mostrou lesões dos três folhetos e do sistema excito-condutor, traduzidas especialmente por pequenos focos inflamatórios. Havia discreta fibrose do miocárdio contrâtil, nódulo átrio-ventricular e origem do ramo esquerdo do feixe de His. Tais alterações, embora de leve intensidade, assemelham-se, qualitativamente, às relatadas nas demais formas crônicas da doença de Chagas e representam lesões ativas, com potencial evolutivo. No esôfago, observou-se entre outros fatos, despopulação neuronal acentuada.

The authors describe the morphological changes in the "postmortem " study of a man probably with the indeterminate form of the Chagas' disease. The heart exhibited lesions of the epicardium, myocardium and endocardium, as well as of the conduction system, primarily small inflammatory foci. There was mild fibrosis of the myocardium, atrioventricular node, and left bundle branch (at its origin). These alterations, although mild, were similar, in quality, to those described in the other chronic forms of Chagas' disease, and suggest active lesions, with a potential for further development. In the esophagus, among other features, a striking reduction of the number of neurons was observed.