Abstract Background Obtaining an adequate image of the needle by ultrasound reduces complications resulting from punctures, increasing patient safety and reducing hospitalization costs. Objectives To verify human perception in relation to number of pixels, while also identifying the best puncture angle and which needle should be used, and to evaluate whether there is a difference if needle visualization software is used. Methods 20 images were analyzed by 103 students who classified them as being sufficient or insufficient and were compared with the quality observed using photoshop. We evaluated whether there were differences between puncture angles of less than 45º and more than 45º, between IV catheter and introducer needles, and between images obtained with and without visualization software. Results There was a higher percentage of sufficient ratings for images those that had more than 60 pixels and when the puncture angle was less than 45º, with significant associations between students’ evaluations and each of these groups (p < 0.001). The percentages of images classified as sufficient were higher for images in which a IV catheter was used and also higher for those using the needle visualization software, with significant associations between the results for students’ classifications and each of these groups (p < 0.001). Conclusions The human eye classifies an image as sufficient according to higher numbers of pixels. Images of punctures at angles smaller than 45º in relation to the surface, of punctures performed with a IV catheter, and when using specific visualization software are also better detected by the human eye.

Resumo Contexto A obtenção de uma imagem adequada da agulha pelo ultrassom diminui complicações decorrentes de punções, trazendo segurança para os pacientes e diminuindo custos com hospitalização. Objetivos Verificar a percepção do olho humano em relação aos pixels, identificar qual o melhor ângulo da punção e qual agulha deve ser utilizada e avaliar se há diferença com o uso de software de visualização de agulha. Métodos Vinte imagens foram analisadas por 103 alunos, que as classificaram como sendo suficientes ou insuficientes, e comparadas com a qualidade observada pelo photoshop. Avaliou-se se havia diferença entre punções com menos de 45º e mais de 45º, entre cateter EV e agulha introdutora e entre imagens obtidas com e sem software de visualização. Resultados Houve um percentual mais elevado de imagens suficientes entre aquelas que tinham mais de 60 pixels e quando o ângulo era menor que 45º, com associação significativa entre a classificação das avaliações pelos alunos e cada um desses grupos (p < 0,001). O percentual de imagens suficientes foi maior nas imagens realizadas com cateter EV e naquelas que utilizaram o software de visualização da agulha, ocorrendo associação significativa entre os resultados da classificação pelos alunos e cada um desses grupos (p < 0,001). Conclusões O olho humano classifica a imagem como sendo suficiente de acordo com a maior quantidade de pixels. Imagens puncionadas com ângulos menores que 45º em relação à superfície, realizadas com cateter EV e utilizando software específico de visualização também são mais bem detectadas pelo olho humano.

Abstract Foodborne diseases are common illnesses caused by the consumption of food contaminated with microorganisms, such as viruses, fungi, bacteria, and protozoa. Every year, 600 million people become ill and 420,000 people die as a result of consuming contaminated food. Therefore, food safety is an important issue. In this study, samples of homemade spiced mayonnaise and self-serve acai sold in the city of Araguaína, Tocantins, Brazil were analyzed for microbiological contaminants. Acai was collected from 10 stores, one sample from each store, and tested for mold, yeast, and coliforms, as well as coliform identification and total and thermotolerant coliform counts. Mayonnaise was collected from 20 snack bars, one sample from each. These samples were inoculated on MacConkey and Salmonella Shigella agar plates, and the plates were analyzed for growth. Salmonella spp. were detected in some Mayonnaise samples, and coliforms were detected in all acai samples; 60% of samples had thermotolerant coliforms, and only 40% were within the limits established by ANVISA. The collected samples of mayonnaise and acai were contaminated with molds and yeasts above the established limit of 103 CFU/g. Thus, the analyzed mayonnaise and acai samples were contaminated and unfit for consumption, demonstrating the importance of hygienic-sanitary measures in food handling.

Resumo As doenças transmitidas por alimentos são doenças comuns causadas pelo consumo de alimentos contaminados com microrganismos, como vírus, fungos, bactérias e protozoários. Todos os anos, 600 milhões de pessoas ficam doentes e 420.000 pessoas morrem como resultado do consumo de alimentos contaminados. Portanto, a segurança alimentar é uma questão importante. Neste estudo, amostras de maionese temperada caseira e açaí self-service vendidas na cidade de Araguaína, Tocantins, Brasil foram analisadas quanto a contaminantes microbiológicos. O açaí foi coletado em 10 lojas, uma amostra de cada loja, e testado para mofo, levedura e coliformes, bem como identificação de coliformes e contagem de coliformes totais e termotolerantes. A maionese foi coletada de 20 lanchonetes, sendo uma amostra de cada. Essas amostras foram inoculadas em placas de ágar MacConkey e Salmonella Shigella, e as placas foram analisadas quanto ao crescimento. Salmonela spp. foram detectados em algumas amostras de maionese e coliformes foram detectados em todas as amostras de açaí; 60% das amostras apresentaram coliformes termotolerantes, e apenas 40% estavam dentro dos limites estabelecidos pela ANVISA. As amostras coletadas de maionese e açaí estavam contaminadas com bolores e leveduras acima do limite estabelecido de 103 UFC/g. Assim, as amostras de maionese e açaí analisadas estavam contaminadas e impróprias para o consumo, demonstrando a importância das medidas higiênico-sanitárias na manipulação de alimentos.

ABSTRACT Although silicon nitride ceramics have been shown very propitious to be used for bone replacements, some characteristics can be controlled to improve their osseointegrations process. One of them is the intergranular phase whose composition can be specified to stimulate mineralization and osteoblastic production. In this paper, the intergranular glassy phase was projected in order to contain silicon, strontium and aluminum oxides. Silicon nitride samples containing different contents of SiO2, SrO and Al2O3 were sintered at 1815oC for 1 hour and characterized by scanning electron microscopy and X-ray diffraction. Hardness and fracture toughness were determined by Vickers hardness test and compressive strength was evaluated using an universal material testing machine. The biological behavior was studied in regard to cytotoxicity and cell proliferation by means of in vitro experiments. The samples reached high densities (higher than 95 %TD), total α→β-Si3N4 transformation, fracture toughness higher than 6.5 MPa.m1/2, compressive strength up to 2500 MPa and Vickers hardness less than 9.8 GPa. All samples were non-cytotoxic and able to promote cell proliferation with great potential to be used as components for bone replacements. However, that sample with high content of strontium had the best results of cell proliferation, proving the importance of a careful choice of intergranular phase composition in silicon nitride ceramics.

Silicon nitride based ceramics have been widely used as structural ceramics, due mainly to their thermo-mechanical properties such as high density, high thermal shock resistance, corrosion resistance and chemical stability. The aim of this study was to determine the influence of rare earth and aluminum oxide additions as sintering aids on densification, microstructure and mechanical properties of silicon nitride. Silicon nitride mixtures with 91 wt. (%) Si3N4 and 9% wt. (%) additives were prepared and sintered. The density, microstructure and mechanical properties of the sintered specimens of these mixtures were determined. In most specimens, scanning electron microscopic examination and X ray diffraction analysis revealed elongated grains of β-Si3N4 with aspect ratio of about 2.0 and dispersed in a glassy phase. The density of the sintered specimens was higher than 94% of the theoretical density (td) and specimens with La2O3 and Al2O3 additions exhibited the highest value. The results of this investigation indicate that the rare earth ion size influences densification of silicon nitride, but this correlation was not observed in specimens containing two different rare earth oxides. The hardness values varied in direct proportion to the density of the specimens and the fracture toughness values were influenced by the composition of the intergranular glassy phase.

Silicon nitride based ceramics are promising candidates for biomedical applications due to their chemical and dimensional stability associated to suitable mechanical strength and relatively high fracture toughness. However, the bioinert characteristics of these ceramics limit their application to situations where the formation of chemical bonds between the material and the tissue are not essential. A way to broaden the application field of these ceramics in medicine is promoting their bioactivity by means of a hydroxyapatite coating. Therefore, in this paper, samples of silicon nitride were coated with apatite using the biomimetic method. The treated silicon nitride surface was characterized by diffuse reflectance infrared Fourier transformed, X ray diffraction and scanning electron microscopy. The results showed that a layer of hydroxyapatite could be deposited by this method on silicon nitride samples surface.

Fecal samples were collected from 50 female Holstein calves (1-90 days old) from a commercial dairy cattle farm located in Lavras, Minas Gerais, Brazil and examined for presence of Giardia cysts using the zinc sulfate flotation method. A total of 120 samples were collected from March 1999 to April 2000, and fecal consistency (normal or diarrheic) was noted prior to the examination for Giardia cysts. Giardia spp. cysts were found in 11 (9%) of the 120 faecal samples of calves co-infected with Eimeria spp., in calves from 19 to 58 days of age (38±19). In 82% (9/11) calves assessed for mixed infections with Cryptosporidium spp. and Giardia, oocysts of Cryptosporidium were found in three out of four diarrheic calves (75%) positive for Giardia. Giardia cysts (n= 30) sized 13-16 x 10-12µm (mean of 15 x 11µm). They appeared to belong to the morphological group of G. intestinallis according to the size and morphological characteristic of the cysts. This is the first detection of Giardia spp. in calves in Brazil. Considering that Giardia has the potential to cause clinical disease in calves and that organisms infecting humans and domestic ruminants are morphologically and antigenically similar, and calves can shed Giardia cysts potentially infective for humans, the parasite in calves may be of major epidemiological significance, and suggests that naturally infected calves may be reservoirs of Giardia infections for man.

Os efeitos do alcoolismo crônico no músculo gastrocnêmio de camundongos bem nutridos foram estudados morfologicamente com a finalidade de se avaliar a hipótese de que o etanol exerce um papel tóxico direto sobre o músculo esquelético. Foram usados 30 camundongos C57BL10 machos, adultos jovens, divididos em dois grupos: Grupo A (controle) consistindo de 10 camundongos que beberam água e Grupo B (alcoólico) de 20 camundongos que beberam etanol a 25%. Todos os animais receberam" uma ração balanceada de laboratório e foram mantidos nesse regime ad libitum nas mesmas condições ambientais durante 48 semanas e pesados uma vez por semana. O consumo diário de dieta e a ingestão calórica foram calculados tendo os animais apresentado substancial ganho de peso, não mostrando qualquer sinal de desnutrição. Ao final do experimento os animais foram sacrificados para estudos morfológicos. Pela microscopia óptica não foram encontradas alterações. Importantes anormalidades foram observadas pela microscopia eletrônica em todos os espécimens.O retículo sarcoplasmático mostrou-se freqüentemente dilatado, resultando na formação de grandes vesículas e envolvendo as cisternas terminais com deslocamento das tríades. Áreas de estreitamento, ruptura e perda de miofibrilas ocorreram assim como zonas de completa desorganização de miofibrilas com perda do padrão estriado normal. As mitocondrias estavam em linhas gerais dentro dos limites da normalidade. Agregados tubulares peculiares vistos comumente na paralisia periódica e outras condições patológicas humanas, foram encontrados tanto no músculo dos camundongos controles como no dos alcoólicos. Os nervos intramusculares assim como as junções neuromusculares mostravam-se normais. Importantes anormalidades nos capilares musculares foram observadas, consistindo de tumefação das células endoteliais e de espessamento da lâmina basal. Difusa infiltração lipídica microvesicular foi vista no citoplasma dos hepatócitos parecendo constituir uma evidência a mais da ação tóxica do etanol sobre o organismo. Concluímos que a ingestão prolongada de etanol, representando 14,4% de calorias totais, produz no músculo gastrocnêmio de camundongos C57BL10 bem nutridos um elenco de alterações ultraestruturais que refletem um efeito tóxico direto sobre o músculo esquelético. As alterações constatadas são semelhantes àquelas descritas na miopatia alcoólica crônica humana

The effects of chronic alcoholism on gastrocnemius muscle of well-nourished mice were morphologically studied to test the direct toxic role of ethanol on skeletal muscle. Thirty male young adult C57BL10 mice were divided in two groups: Group A (control) consisting of ten mice that drank water and Group B (alcoholic) consisting of twenty mice that drank 25% ethanol. All mice were allowed a balanced laboratory chow. The animals were kept on this ad libitum regimen under the same conditions of environment for 48 weeks and were weighed once a week. The daily dietary consumption and caloric intake were estimated, the animals having had a substantial weight gain, showing no signs of malnutrition. At the end of the experiment the animals were killed for morphological studies. No abnormalities were observed by conventional microscopy.Striking deviations from normal were verified by electron microscopy in all specimens. Dilatation of sarcoplasmic reticulum was a common feature, sometimes resulting in the formation of large vesicles and involving the terminal cisternae with the displacement of the triads. Areas of narrowing, splitting and loss of myofibrils were seen. Zones of complete disorganization of miofibrils could be occasionally observed. Mitochondria were generally normal. Peculiar tubular aggregates seen commonly in periodic paralysis and other human pathological conditions, were encountered in both control and alcoholic mice. Intramuscular nerves and neuromuscular junctions were normal. Important abnormalities in muscle capillaries were observed, consisting of swelling of endothelial cells and thickening of the basal lamina. A diffuse microvesicular lipid infiltration was seen in the cytoplasm of the hepatocytes which seems to be a further evidence of the toxic role played by ethanol. We concluded that prolonged ingestion of ethanol, representing 14.4% of total calories, produces in the gastrocnemius muscle of well-nourished C57BL10 mice a distinct spectrum of ultrastructural changes which reflects a direct toxic effect on the skeletal muscle. These alterations are similar to those described in human chronic alcoholic myopathy.

A leptospirose humana, uma das principais endemias/epidemias dos centros urbanos no Brasil, vem crescendo de forma dramática nas três últimas décadas, com prevalência após enchentes causadas pelas chuvas de verão. São descritas as recentes modificações de seus padrões clínicos em nossa região, constituídas pelo surgimento de hemoptise/s maciça/s e da síndrome de angústia respiratória do adulto, ou de ambas associadamente. Essas evidentes mudanças situadas nas estruturas respiratórias despontaram como séria ameaça à vida e como mecanismos de morte, passando a representar entre nós, por sua grande freqüência, a principal causa de óbito na leptospirose. A nova face da doença impõe revisão dos conceitos sobre sua gravidade e especulação sobre a patogenia dessas alterações. A evolução fatal dos seis pacientes descritos, dois deles sem icterícia e sem insuficiência renal, mostra a grandeza do desafio.

Human leptospirosis, one of the main urban endemics/epidemics in Brazil, has dramatically grown in the last three decades, especially after floods caused by summer rains. This presentation describes recent changes in the clinical patterns of this pathology in our region, expressed by the emergence of massive haemoptysis and acute respiratory distress syndrome, or both conditions associated. The evident changes in the respiratory structures emerged as a serious life threat and death mechanisms, becoming the main cause of death in leptospirosis among us because of their high incidence. This new face of the disease demands a revision of current concepts about its seriousness and raises speculations about the pathogenesis of such alterations.

Em 23 pacientes com leptospirose apresentando comprometimento pulmonar, internados no Hospital Universitário Antônio Pedro da XJFF, Niterói, hemoptise e hemoptóicos foram observados em 21,7% e 30,4%, respectivajnente. Gasometria arterial revelou hipoxemia e hipocapnia na maioria dos casos. Radiografia de tórax em 15 pacientes mostrou comprometimento alveolar em 60%, comprometimento intersticial-reticular em 6%, padrão misto (alveolar e intersticial) em20%e ausência de alterações radiológicas em 14%. A necrópsiade 13 pacientes mostrou edema, congestão e hemorragia nos pulmões em 100% dos casos. A hemorragia foi focal em 46% e difusa em 54% dos casos. Houve formação de membrana hialina em 30% e trombos de fibrina em 46% dos pulmões estudados, o que estabelece o diagnóstico da coagulação intravascular disseminada e a ocorrência da síndrome de angústia respiratória na leptospirose.

Tostudy thepulmonary complications in leptospirosis case records of 23 such patients admitted at the Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brasil, were reviewed. Hemoptysis were seen in 21.7% and sputal blood in 30.4% of patients. Arterial gasometry detected hypoxemia and hypocapnia in most cases. Thoracic radiology showed an alveolar pattern in 60% of the patients, alveolo-interstitial in 20%, interstitial in 6%, and in 14% the lungs were considered to be normal Necropsy of 13 cases showed edema, congestion and hemorrhage in the lungs in all cases. Hyaline membrane was found in 30% and fibrin thrombi in 46% of these cases, resulting in a diagnosis of adult respiratory distress syndrome and acute disseminated intravascular coagulation (consumption coagulopathy) in leptospirosis.

Os efeitos da desnutrição sobre o músculo «gastrccnemius plantaris» de ratos albinos, limitando-se à genitora a dieta em 6,7% de proteínas e aos seus produtos, em 3,2% após o desmame, foram observados em microscopia óptica e eletrônica e comparados com os controles. Os animais, em número de 40, foram distribuídos em grupo hipoproteico e normal, sendo a metade de cada grupo sacrificada aos 15 dias e a restante, após o desmame, aoa 30 dias. Observamos acentuada redução ponderai dos ratos com alimentação bipoproteica, chegando a cerca de 50% em relação aos normais. As fibras do músculo estudado, nos ratos desnutridos, apresentaram importante redução de seus diâmetros. As reações histoquímicas revelaram que tanto as fibras do tipo I como as do tipo II estavam comprometidas, ocorrendo maior redução nas últimas. Fibras do tipo II, de pequena espessura, com aspecto de fibra P (fetal) foram encontradas nos animais subnutridos de 15 dias, denotando retardo na maturação destas fibras. As avaliações em ultramicroscopia não mostraram alterações específicas dia ultra-estrutura muscular, revelando apenas intensa redução do calibre das fibras, quando comparadas às dos ratos normais. Concluímos pela hipoplasia e não atrofia do tecido muscular dos animais submetidos a desnutrição pré e pós-natal. O presente estudo, somado a outros nos quais foram analisados a ponta anterior da medula e o nervo periférico de ratos desnutridos, permite-nos considerar que na privação proteica ocorrem retardo no desenvolvimento e hipoplasia da unidade mootra. Conjecturamos a possibilidade de, na amiotrofía espinhal progressiva da infância (doença de Werdnig-Hoffmann), acontecer também hipoplasia das fibras do tipo II e não atrofia, aventando a hipótese de, nesta doença, haver alterações no metabolismo proteico.

The effects of undernutrition on the «gastrocnemius plantaris» muscle of young albino nats were observed with light and electronmicroscopy and were compared with controls. Pregnant rats received a diet containing 6.7% protein and the neonates had a 3.2% protein diet after weaning. A total number of 40 animals were distributed in two groups: one nypoproteic and one control. Half of the animals of each group were killed 15 days after birth and the remaining ones at 30 days. We could observe important reduction in the weight of the undernourished rats reaching about 50% when compared with the control animals. An important reduction in the diameter of muscle fibers was noted in undernourished rats. Histochemical reactions showed that not only the type I but also the type II fibers were involved, the latter being more severely reduced in size. Type II fibers os small diameter, resembling F (fetal) fiber were found in animals at 15 days indicating a delay in maturation. TJltrastructural evaluation of the muscle did not show specific changes except for a severe reduction in the caliber of fibers when compared with control animals. We concluded that there was hypoplasia and not atrophy of the muscular tissue in animals submitted to pre- and post-natal undernutrition. The present study, associated with others in which the spinal motor cells and peripheral nerves of undernourished rats were analysed, allow us to consider that with protein deprivation there is a delay in the development, a hypoplasia of the motor unit. We think that in infantile progressive spinal amyotrophy (Werdnig-Hoffmann disease) there is possibly hypoplasia and not atrophy of the type II fibers and we postulate that a metabolic proteic problem is involved in this disease.

Apesar do acometimento do miocárdio e do músculo esquelético pelo álcool etílico vir sendo estudado minuciosamente, o comprometimento simultâneo destes dois tecidos pelo etanol não tem merecido destaque na literatura médica. Selecionamos dez enfermos que apresentavam miocardiopatia alcoólica e os submetemos a minucioso exame neurológico, a dosagens plasmáticas de enzimas musculares, a eletroneuromiografia e a biópsia muscular com exame do fragmento Delas microscopias convencional e eletrônica. Dos dez pacientes, somente um apresentava fraqueza e atrofia proximal dos membros inferiores com alterações eletroneuromiográficas e histológicas musculares, caracterizando a forma clínica da miopatia crônica produzida pelo álcool. O exame eletromiográfico revelou-se normal em um paciente, com padrão do tipo miopático, em oito, e neuropático, em um enfermo. O estudo do tecido muscular, à microscopia óptica, mostrou-se normal somente em um paciente. Os outros nove apresentavam alterações caracterizadas por proliferação de núcleos subsarcolemais, atrofia de fibras, imagens de hialinização e vacuolização, perda da estriação de fibra muscular e atrofia em grupo. Na ultramicroscopia, um exame revelou-se normal. Os outros mostraram edema intracelular, dissociação de miofilamentos, alteração da linha Z, modificação de forma e aumento do número de mitocôndrias, espessamento do sarcolema, vacuolização e aumento dos grânulos de glicogênio. Concluímos haver íntima relação entre a miocardiopatia e a miopatia alcoólicas, sendo comum o acomentimento simultâneo destas duas estruturas.

Myocardial and skeletal muscle impairment caused by alcohol has been thoroughly studied. Nevertheless, the simultaneous involvement of those tissues by ethanol has not been broached in medical literature. We have studied ten patients undergoing alcoholic cardiomyopathy. They were subjected to a detailed neurological examination, muscle enzymes serum level determinations, electromyography, and muscle biopsy with analysis of the tissue by usual histological techniques and by electron microscopy. Only one of ten patients exhibited proximal weakness and atrophy of the lower limbs, the electromyographic and histological findings correlating with the clinical feature of the chronic muscle disease due to alcohol consumption. The electromyographic findings included muscle disease in eight patients, neuron disease in one patient and no changes at all in the tenth patient. In one patient only, the skeletal muscle proved normal when examined by conventional histological techniques. In the other nine patients there were several minimal changes, such as the proliferation of nuclei beneath the sarcolemma, atrophy of fibers, hyalinisation, vacuolation, loss of muscle fiber striae, and atrophy of groups of fibers. Electron microscopy demonstrated the following changes in nine patients: intracellular edema, dissociation of myofilaments, alteration of the Z line, changing in the shape and increase in the number of mitochondriae, thickening of sarcolemma, and vacuolation and increase of the glycogen granules. Since all patients exhibited skeletal muscle injury, we concluded that there is a close relation between alcoholic cardiomyopathy and skeletal muscle disease.

Os autores apresentam os resultados observados no estudo histopatológico de biópsia muscular em 16 pacientes com leptospirose. Os achados mais importantes foram a necrose focal da fibra muscular, a infiltração hemorrágica dos focos necróticos e da interstício a raridade de reação inflamatória. Além dêstes chamam atenção para a vacuolização sarcoplasmátvca acompanhada de tumefação e perda da estriação transversal da fibra muscular como alterações precoces, precedendo à lesão necrótica. Observaram ainda a basofilia sarcoplasmática associada a hiperplasia nuclear subsarcolêmica nas formas leves da doença e naquelas de involução demonstradas nas biópsias posteriores. Quanto às estruturas sarcovlasmáticas multinucleadas sugerem que êstes elementos representem uma tentativa âe regeneração da fibra musculair que em geral não chega a têrmo, como puderam depreender do estudo das biópsias em fase evolutiva tardia da doença; nesta fase tais estruturas sofrem modificações regressivas até a fibrose. Concluindo, consideram as alterações musculares no seu conjunto, se, não específicas, bastante características e de grande valor no diagnóstico da leptospirose.

The authors present the results of a histopathologic study in muscle biosy of 16 cases of leptospirosis. The most important findings were focal necrosis of the muscle fibers, hemorrhagic infiltration in the necrotic focus and interstitial hemorrhages; the inflamatory reaction was very rare or almost inexistent. Besides those findings attention was called to sacoplasmatic vacuolization of muscle fibers preceeding the muscle necrosis. The multinuclear sacoplasmatic strueture seems to be an attempt at muscle regeneration, well succeeded. Finally, the authors consider that muscle alterations, of not generally not specific of leptospirosis, are very characteristic and help to diagnose the disease.

Vinte casos de leptospisoses, (15 por Leptospira ictohemorragiae, 1 por Leptosplra canícola e 4 não determinadas) foram estudados minuciosamente do ponto de vista clínico, laboratorial e anátomo-patológico (5 necrópsias e lObiópsias musculares). Chamou atenção o início súbito, a febre alta, as dores musculares intensas, a congestão e hemorragia conjuntivais, além da icterícia de coloração rubínica, como elementos clínicos importantes para o diagnóstico diferencial com icterícias de outras etiologias. Em contraste, as "provas de função hepática" e as transaminases mostram-se pouco alteradas. As lesões hepáticas mais freqüentes foram a desorganização trabecular e a atrofia de hepatócitos isolados, mais evidentes em lôrno da veia centro-lobular. O rim tem o aspecto da nefrose colêmica; mostra impregnação biliar nas células, cilindros biliares nos túbulos e necrose tubular predominantemente proximal. Nos músculos esqueléticos observam-se intensa infiltração linfocitária intersticial, binucleação e às vêzes infiltração hemorrágica e grave processo degenerativo das fibras musculares. No trato gastro intestinal predominam a congestão e as hemorragias punctiformes e no pulmão hemorragias petequiais de pleura, edema e hemorragias alveolares. No coração foi constante a observação de edema e infiltração intersticial e fragmentação de fibras miocárdicas.

Twenty cases of leptospirosis, (15 by Leptospira icterohaemorragiae, one by Leptospira canicola and four undetermined) were studied from a clinical, laboratorial and anatomo-pathological viewpoint (five necropsies and ten muscular biopsies). Important clinical elements for the differencial diagnosis of jaundice from other etiologies, were the sudden beginning with fever, intense muscular pain, congestion and conjunctival hemorrhage, besides the reddish color of the jaundice. In contrast, the liver function tests and the transaminasis showed little alteration. The most frequent hepatic lesion, were the trabecular disorganization and the atrophy of isolated hepatic cells which were more evident around the central lobular vein. The kidney has the aspect of colemic nephrosis; shows biliary impregnation of the cells, biliar cylinders on the tubules and predominant proximal tubular necrosis. An intense interstitial lymphocytic infiltration, binucleation, occasionally hemorrhagic infiltration and a serious degenerative pra- cess of the muscular fibers were observed. Congestion and punctiform hemorrhages predominated in the gasòro-intestinal tract, petechial hemorrhages of the pleura, edema and alveolar hemarrhages were seen in the lungs. Edema and fragmentation of the miocardiac fibers were constantly observed in the heart.