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Abstract Background Migraine affects 1 billion people worldwide and > 30 million Brazilians; besides, it is an underdiagnosed and undertreated disorder. Objective The need to disseminate knowledge about the prophylactic treatment of migraine is known, so the Brazilian Headache Society (SBCe, in the Portuguese acronym) appointed a committee of authors with the objective of establishing a consensus with recommendations on the prophylactic treatment of episodic migraine based on articles from the world literature as well as from personal experience. Methods Meetings were held entirely online, with the participation of 12 groups that reviewed and wrote about the pharmacological categories of drugs and, at the end, met to read and finish the document. The drug classes studied in part II of this Consensus were: antihypertensives, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, calcium channel blockers, other drugs, and rational polytherapy. Results From this list of drugs, only candesartan has been established as effective in controlling episodic migraine. Flunarizine, venlafaxine, duloxetine, and pizotifen were defined as likely to be effective, while lisinopril, enalapril, escitalopram, fluvoxamine, quetiapine, atorvastatin, simvastatin, cyproheptadine, and melatonin were possibly effective in prophylaxis of the disease. Conclusions Despite an effort by the scientific community to find really effective drugs in the treatment of migraine, given the large number of drugs tested for this purpose, we still have few therapeutic options.

Resumo Antecedentes Migrânea afeta um bilhão de pessoas em todo o mundo e mais de 30 milhões de brasileiros; além disso, é um distúrbio subdiagnosticado e subtratado. Objetivo Sabe-se sobre a necessidade de difundir o conhecimento sobre o tratamento profilático da migrânea; por isso, a Sociedade Brasileira de Cefaleias (SBCe) nomeou um comitê de autores com o objetivo de estabelecer um consenso com recomendações sobre o tratamento profilático da migrânea episódica com base em artigos da literatura mundial, assim como da experiência pessoal. Métodos As reuniões foram realizadas inteiramente online, com a participação de 12 grupos que revisaram e escreveram sobre as categorias farmacológicas dos medicamentos e, ao final, reuniram-se para a leitura e conclusão do documento. As classes de medicamentos estudadas na parte II deste Consenso foram: anti-hipertensivos, inibidores seletivos de recaptação de serotonina, inibidores de recaptação de serotonina e noradrenalina, bloqueadores dos canais de cálcio, outros medicamentos e politerapia racional. Resultados Desta lista de medicamentos, apenas o candesartan foi estabelecido como eficaz no controle da migrânea episódica. Flunarizina, venlafaxina, duloxetina e pizotifeno foram definidos como provavelmente eficazes, enquanto lisinopril, enalapril, escitalopram, fluvoxamina, quetiapina, atorvastatina, sinvastatina, ciproheptadina e melatonina foram possivelmente eficazes na profilaxia da doença. Conclusões Apesar do esforço da comunidade científica em encontrarmedicamentos realmente eficazes no tratamento da migrânea, dado o grande número de medicamentos testados para este fim, ainda dispomos de poucas opções terapêuticas.

https://doi.org/10.1055/s-0042-1755320

Consensus of the Brazilian Headache Society (SBCe) for the Prophylactic Treatment of Episodic Migraine: part I
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Melhado, Eliana Meire

; Santos, Paulo Sergio Faro

; Kaup, Alexandre Ottoni

; Costa, Aline Turbino Neves Martins da

; Roesler, Célia Aparecida de Paula

; Piovesan, Élcio Juliato

; Sarmento, Elder Machado

; Theotonio, Giselle Oliveira Martins

; Campos, Henrique Carneiro de

; Fortini, Ida

; Souza, Jano Alves de

; Maciel Júnior, Jayme Antunes

; Segundo, João Batista Alves

; Carvalho, João José Freitas de

; Speziali, José Geraldo

; Calia, Leandro Cortoni

; Barea, Liselotte Menke

; Queiroz, Luiz Paulo

; Souza, Marcio Nattan Portes

; Figueiredo, Marcos Ravi Cerqueira Ferreira

; Costa, Maria Eduarda Nobre de Magalhães

; Peres, Mário Fernando Prieto

; Jurno, Mauro Eduardo

; Peixoto, Patrícia Machado

; Kowacs, Pedro André

; Rocha-Filho, Pedro Augusto Sampaio

; Moreira Filho, Pedro Ferreira

; Silva-Neto, Raimundo Pereira

; Fragoso, Yara Dadalti

Arquivos de Neuro-Psiquiatria

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aug 2022, Volume 80 N. 8 Pages 845 - 861

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract The Brazilian Headache Society (Sociedade Brasileira de Cefaleia, SBCe, in Portuguese) nominated a Committee of Authors with the aim of establishing a consensus with recommendations regarding prophylactic treatment for episodic migraine based on articles published in the worldwide literature, as well as personal experience. Migraine affects 1 billion people around the world and more than 30 million Brazilians. In addition, it is an underdiagnosed and undertreated disorder. It is well known within the medical community of neurologists, and especially among headache specialists, that there is a need to disseminate knowledge about prophylactic treatment for migraine. For this purpose, together with the need for drug updates and to expand knowledge of the disease itself (frequency, intensity, duration, impact and perhaps the progression of migraine), this Consensus was developed, following a full online methodology, by 12 groups who reviewed and wrote about the pharmacological categories of the drugs used and, at the end of the process, met to read and establish conclusions for this document. The drug classes studied were: anticonvulsants, tricyclic antidepressants, monoclonal anti-calcitonin gene-related peptide (anti-CGRP) antibodies, beta-blockers, antihypertensives, calcium channel inhibitors, other antidepressants (selective serotonin reuptake inhibitors, SSRIs, and dual-action antidepressants), other drugs, and polytherapy. Hormonal treatment and anti-inflammatories and triptans in minimum prophylaxis schemes (miniprophylaxis) will be covered in a specific chapter. The drug classes studied for part I of the Consensus were: anticonvulsants, tricyclic antidepressants, monoclonal anti-CGRP antibodies, and beta-blockers.

Resumo A Sociedade Brasileira de Cefaleia (SBCe) nomeou um Comitê de Autores com o objetivo de estabelecer um consenso com recomendações sobre o tratamento profilático da enxaqueca episódica com base em artigos da literatura mundial e da experiência pessoal. A enxaqueca é um distúrbio subdiagnosticado e subtratado que acomete um bilhão de pessoas no mundo e mais de 30 milhões de brasileiros. É conhecido na comunidade médica de neurologistas e, sobretudo, dos especialistas em cefaleia, a necessidade de se divulgar o conhecimento sobre o tratamento profilático da enxaqueca. Com esta finalidade, aliada às necessidades de atualizações de drogas e de se aumentar o conhecimento sobre a doença em si (frequência, intensidade, duração, impacto e talvez a progressão da enxaqueca), foi elaborado este Consenso, com metodologia totalmente on-line, por 12 grupos que revisaram e escreveram sobre as categorias farmacológicas das drogas e, ao final, reuniram-se para a leitura e conclusão do documento. As classes de drogas estudadas para este Consenso foram: anticonvulsivantes, antidepressivos tricíclicos, anticorpos monoclonais do antipeptídeo relacionado ao gene da calcitonina (peptídeo relacionado ao gene da calcitonina — anti-CGRP), betabloqueadores, anti-hipertensivos, inibidores dos canais de cálcio, outros antidepressivos (inibidores seletivos de recaptação de serotonina, ISRSs, e antidepressivos de ação dual), outras drogas, e politerapia. O tratamento hormonal, bem como anti-inflamatórios e triptanas em esquema de profilaxia mínima (miniprofilaxia), será abordado em um capítulo próprio. As classes de drogas estudadas na parte I do Consenso foram: anticonvulsivantes, antidepressivos tricíclicos, anticorpos monoclonais anti-CGRP, e betabloqueadores.

https://doi.org/10.1055/s-0042-1756441

Tratamento endovascular de hemorragia secundária a lesão da artéria esplênica na pancreatite aguda: relato de caso
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Machado, Alexandre de Tarso

; Procópio, Ricardo Jayme

; Neves, Franco Antônio Cordeiro

; Santos, Giovanni Menezes

; Girundi, Marcelo Gomes

; Afonso, Cristina Toledo

; Navarro, Tulio Pinho

Jornal Vascular Brasileiro

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2010, Volume 9 N. 1 Pages 61 - 65

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A lesão arterial esplênica é uma rara complicação relacionada a situações como trauma, lesão iatrogênica e pancreatite. Hemostasia pode ser feita por identificação do foco do sangramento através de cateterismo seletivo seguido por embolização do ramo sangrante. Relata-se caso clínico de um paciente portador de pancreatite biliar que apresentou, durante procedimento de necrosectomia, hemorragia decorrente da ruptura da artéria esplênica, sendo, então, tratado com sucesso por embolização supersseletiva.

Splenic artery injury is a rare complication related to trauma, iatrogenic injury, and pancreatitis. Hemostasis can be made by identification of the vascular lesion through selective catheterism followed by embolization of the bleeding vessel. We report a case of a patient with biliary pancreatitis, who presented hemorrhage due to rupture of the splenic artery during a necrosectomy procedure and was successfully treated with selective embolization.

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Intradermal vaccination of adults with three low doses (2 µg) of recombinant hepatitis B vaccine. I. Seroconversion rate and adverse effects
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Baldy, José Luís da S

; Elisbão, Maria do Carmo M

; Anzai, Edson T

; Pontello, Rubens

; Reiche, Edna Maria V

; Zaha-Inouye, Marta M

; Matsuo, Tiemi

; Tonani, Pedro CF

; Ferelle, Antônio

; Henriques, João N

; Neves, Jayme

Memórias do Instituto Oswaldo Cruz

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dec 2003, Volume 98 N. 8 Pages 1101 - 1107

Abstract: En | Text: En | PDF: En

A total of 250 dentists (53.6% men and 46.4% women), with a mean age of 35.1 ± 9.8 years, were submitted to serological tests for the diagnosis of hepatitis B (HB) - HBsAg, anti-HBs, anti-HBc, HBeAg, and anti-HBe - using a radioimmunoassay. One or more of these markers were detected in 78 individuals (31.2%) who were excluded from the group to be vaccinated. Of the 172 HB-susceptible individuals, 135 (78.5%) responded to the call and were intradermally injected with three 2 µg doses of the Belgian HB recombinant vaccine, applied at an interval of one month between the 1st and 2nd dose and of five months between the 2nd and 3rd dose. A new determination of HB markers carried out 50 days after the 3rd dose showed that 110 (81.5%) individuals had become anti-HBs positive (65.5% good responders and 34.5% poor responders). Mean serum anti-HBs titer of these 110 dentists was 42.4 U S/N, similar in both sexes. The adverse effects analyzed in 106 dentists were: (a) local: pain (12.3%), burning sensation (14.1%), pruritus (25.5%), erythema (28.3%), local heat (18.9%), and a hypochromic spot (32.1%); (b) systemic (4.7%): discomfort in two patients, and fever, anorexia, and asthenia in one patient each. Intradermal administration of a fourth 2 µg vaccine dose to 39 dentists (poor or non-responders) increased the total number of anti-HBs-positive individuals from 110 (81.5%) to 114 (84.4%), with the number of good responders increasing from 72 (65.5%) to 85 (74.6%). We conclude that the Belgian recombinant vaccine applied in the scheme used here induces a high rate of seroconversion and causes only mild and transitory adverse effects.

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Intradermal vaccination of adults with three low doses (2 µg) of recombinant hepatitis B vaccine. II. Persistence of immunity and induction of immunologic memory
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Elisbão, Maria do Carmo M

; Baldy, José Luís da S

; Bonametti, Ana Maria

; Reiche, Edna Maria V

; Morimoto, Helena K

; Pontello, Rubens

; Matsuo, Tiemi

; Ferelle, Antônio

; Neves, Jayme

Memórias do Instituto Oswaldo Cruz

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dec 2003, Volume 98 N. 8 Pages 1109 - 1113

Abstract: En | Text: En | PDF: En

Of the 110 dentists who had presented seroconversion 50 days after the intradermal application of three 2 µg doses of the Belgian recombinant vaccine against hepatitis B (HB), administered eight years before at an interval of one month between the 1st and 2nd doses and of five months between the 2nd and 3rd doses, 51 were included for the assessment of the persistence of immunity. None of the dentists had hepatitis or had received HB vaccine during this period. All subjects were submitted to serological tests for the detection of the following markers of hepatitis B virus (HBV) infection: HBsAg, anti-HBc, HBeAg, anti-HBe, and anti-HBs, with no HBsAg, anti-HBc, HBeAg or anti-HBe being detected. A microparticle enzyme immunoassay (MEIA) revealed the presence of anti-HBs at protective titers (> 10 mIU/ml) in 42 dentists (82.4%), with the anti-HBs titer being higher than 100 mIU/ml in 36 of them (70.6%) (good responders), between 10 and 100 mIU/ml in 6 (11.8%) (poor responders), and lower than 10 mIU/ml in 9 (17.6%) (non-responders). According to clinical data and serological tests, none of the dentists had presented disease or latent HBV infection during the eight years following the first vaccination. A 2 µg booster dose was administered intradermally to eight dentists with anti-HBs titers lower than 10 mIU/ml (non-responders) and to six dentists with titers ranging from 10 to 100 mIU/ml (poor responders); the determination of anti-HBs one month later demonstrated the occurrence of seroconversion in the eight non-responders and an increase in anti-HBs titer in the six poor responders. In summary, the present results demonstrated the prolonged persistence of protection against HBV infection and the development of immunologic memory provided by vaccination against HB - with intra-dermal application of three 2 µg doses of the Belgian recombinant vaccine at 0, 1, and 6 months - carried out eight years before in 51 dentists.

1764 downloads

Tratamento cirúrgico das distrofias da parede abdominal no adulto
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Athias, Fortunato Jayme

; Franco, Glaucilene Aragão

; Silva, Alexandre Augusto Mekdec da

; Neves, Mauro Santos

; Souza, Sádia Martins de Paula

; Pereira, Sérgio Alexandre da Costa

Revista do Colégio Brasileiro de Cirurgiões

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apr 1998, Volume 25 N. 2 Pages 123 - 128

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Os autores apresentam um estudo retrospectivo de 79 pacientes portadores de distrofias abdominais acompanhadas ou não de hérnias, operados no período compreendido entre 01/06/94 a 31/12/96. A idade média foi de 46 anos. A hérnia incisional isoladamente e o abdome distrófico (em avental) foram o principal objetivo do estudo. Enfatizam a importância da dermolipectomia abdominal para a completa recuperação do paciente bem como demonstram facilitar o manuseio técnico das hérnias. A técnica da transposição peritônio-aponeurótica longitudinal bilateral (técnica de Lázaro da Silva) foi utilizada para as grandes hérnias incisionais. É uma técnica já consagrada, que consta de três planos de suturas sem superposição dos mesmos. Sua recidiva em cinco anos de seguimento tem sido em tomo de 5% segundo estudos do próprio autor. A grande vantagem técnica é que, usando o saco herniário (quanto maior e mais espesso, melhor) como fechamento e reforço do anel, evita-se o uso de prótese com todos os inconvenientes da mesma (fístulas, rejeições etc.) Uma variante desta técnica, para as hérnias com anel herniário de até 10cm, é proposta pelos autores, e consiste no fechamento do anel e reforço da sutura com o saco herniário, em jaquetão. A vantagem seria a facilidade de execução e diminuição do tempo operatório, além de evitar dissecções extensas das camadas aponeuróticas. Quando o anel herniário alcançar 10cm e existir ligeira tensão, deve-se realizar incisão relaxadora na aponeurose anterior dos retos e recobrir a superfície cruenta com o próprio saco herniário que deverá estar íntegro. Esta técnica ainda requer maior observação clínica. É feita a revisão dos resultados dos procedimentos realizados isoladamente e acompanhados com dermolipectomia abdominal: 63 pacientes (81,66%) evoluíram sem complicações, cinco recidivas (6,3%); um caso de hematoma extenso (1,26%); dois casos de abscesso de parede em operações sem dermolipectomia (2,5%); uma necrose de linha média+embolia pulmonar (1,26%); e um óbito por embolia pulmonar (1,26%).

The authors present a retrospective study of 79 patients with abdominal dystrophies, both with and without hernias, operated on from June 1st, 1994 to December,31,1996. Their average age was 47 years. The incisional hernia it self and the dystrophic abdomen were principal objects of the study. The authors show the importance of abdominal dermolipectomy for the complete recovery of the patient as well as demonstrate how it facilitates the technical manipulation of hernias. The technique of bilateral, longitudinal peritonio-aponeurotic transposition (the technique of Alcino Lázaro da Silva) was used for large incisional hernias. This technique has been approved by its good results (5% of relapses in five years of follow up according the author). In this technique we use three levels of suture without superposing each other. The great advantage of the technique is that we use the herniary sac itself to close the ring and to strengthen. It avoids the use of meshes and the its complications (rejections, fistulas, etc.). A variation of this technique, for hernias with a hernial ring up to 10cm, is proposed by the authors, which consists in the closure of the ring and the reinforcement of the suture with the hernial sac overlapping its edge. The advantage is the facility of performing, reductions in the operative time and to avoid large dissections of the aponeurotic layer. When the herniary ring is 10cm or bigger it is possible to slack the tension by making a relaxing incision over on the anterior rectum abdominal aponeurosis and covering the wide area with the hernial sac. A review is made of the results of these procedures done associated with abdominal dermolipectomy isolated. The results are: 63 patients recovered without complications (81.66%), three relapsed (3.8%), one of extensive hematoma (1.26%), one necrosis of the midline with respiratory failure (1%), one little stitch gap (1.26%), two umbilical stenosis (3.33%), two wound abscess (2.5%), one cutaneous fistula (1.26%) and one death from pulmonary embolism (1.66%).

5792 downloads

Dystrophies of the abdominal wall in adults: Surgical treatment
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Athias, Jayme Fortunato

; Horta, António Carlos Bentes

; Franco, Glaucilene Aragão

; Silva, Alexandre Augusto Mekdec da

; Neves, Mauro Santos

; Souza, Sadia Martins de Paula

; Pereira, Sérgio Alexandre da Costa

Acta Cirúrgica Brasileira

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mar 1997, Volume 12 N. 1 Pages 74 - 78

Abstract: En | Text: En | PDF: En

The authors present a retrospective study of 60 patients with abdominal dystrophies, both with and without hernias, operated on in the period between 01 June 1994 and 30 January 1996. Their average age was 47 years. The incision at hernia itself and the dystrophic abdomen were the principal objects of the study. The authors show the importance of abdominal dermolipectomy for the complete recovery of the patient as well as demonstrate how it facilitates the technical manipulation of hernias. The technique of bilateral, longitudinal peritonio-aponeurotic transposition {the technique of Alcíno Lázaro da Silva) was used for large incisional hernias. A variation of this technique, for hernias with a hernial ring of up to 10 cm, is proposed by the authors, which consists in the closing of the ring and the reinforcement of the suture with the hernial sac. A revision is made of the results of these procedures realized in isolation and accompanied with abdominal dermolipectomy. Forty-nine recovered without complications (81.66%), three relapsed (5%), one necrosis of the midline with respiratory failure (1.67%), one little stitch gap (1,67%), two umbilical stenosis (3,33%), two wound abscess (3.33%), one cutaneous fistula (1,67%) and one death from pulmonary embolism (1.66%).

5388 downloads

Pulmonary manifestations in the initial phase of schistosomiasis mansoni
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Rocha, Manoel Otávio C.

; Rocha, Regina Lunardi

; Pedroso, Ênio Roberto P.

; Greco, Dirceu B.

; Ferreira, Cid Sérgio

; Lambertucci, José Roberto

; Katz, Naftale

; Rocha, Roberto S

; Rezende, Dilermando F.

; Neves, Jayme

Revista do Instituto de Medicina Tropical de São Paulo

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aug 1995, Volume 37 N. 4 Pages 311 - 318

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Foram estudadas as alterações clínicas e radiológicas pulmonares da fase inicial da esquistossomose mansoni em 30 indivíduos previamente sadios, que se infectaram simultaneamente. Os achados foram comparados aos de um grupo - controle e relacionados a possíveis fatores patogenéticos como carga parasitária, eosinofilia sangüínea e área de reação intradérmica imediata, esta como estimativa de IgE ligada a mastócito. As manifestações pulmonares foram de intensidade leve ou moderada, sendo a tosse seca o sintoma mais comum. As alterações radiológicas significativas constaram de espessamento de paredes brônquicas, micronodulação em rosário e micronodulação esparsa, localizadas predominantemente nas porções inferiores dos campos pulmonares. Verificou-se associação significativa de sibilos e área da reação intradérmica imediata, bem como entre o número de eosinófilos sangüíneos e a ocorrência de alterações radiológicas tomadas em conjunto. Houve correlação entre a carga parasitária, expressa pelo número de ovos eliminados nas fezes, e a presença de sibilos, dor torácica e micronodulação em rosário.

The clinical and radiological pulmonary manifestations in the initial phase of schistosomiasis mansoni were studied in thirty previously healthy individuals who were simultaneously infected. The findings were compared with those concerning a control group and related to possible pathogenetic factors. The respiratory manifestations were of light or of moderate intensity, the dry cough being the most common symptom. The significant radiological alterations were: thickening of bronchial walls and beaded micronodulation, predominantly localized in the lower pulmonary fields. It was observed significant association between wheezing and IgE levels, estimated by the area of immediate intradermal reaction, as well as between the number of blood eosinophils and the occurrence of radiological changes. Moreover, there was correlation between the worm burden and the presence of wheezing, thoracic pain and beaded micronodulation. Thus, the clinical and radiological pulmonary manifestations described are significant part of the initial phase of schistosomiasis mansoni and present the worm burden, eosinophilia and levels of IgE as probable pathogenetic factors.

1868 downloads

Characterization of the non-apparent clinical form in the initial phase of schistosomiasis mansoni
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Rocha, Manoel Otávio da Costa

; Pedroso, Enio Roberto Pietra

; Neves, Jayme

; Rocha, Roberto Sena

; Greco, Dirceu Bartolomeu

; Lambertucci, José Roberto

; Rocha, Regina Lunardi

; Katz, Naftale

Revista do Instituto de Medicina Tropical de São Paulo

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jun 1993, Volume 35 N. 3 Pages 247 - 251

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Foram estudados 115 recrutas que tiveram contato simultaneamente com águas infectadas pelo Schistosoma mansoni. Trinta e quatro pacientes apresentaram a fase inicial da infecção, diagnosticada através de parâmetros laboratoriais, clínicos e epidemiológicos, sendo que três deles não evidenciaram quadro clínico, sendo considerados como portadores da forma inaparente da doença. Não se verificou, entretanto, diferença estatística entre a intensidade da eosinofilia sanguínea, as áreas da reação intradérmica de leitura imediata e as médias das contagens do número de ovos de 5. mansoni eliminados nas fezes, quando se compararam os resultados obtidos em pacientes com as formas aguda e inaparente. Os casos ora descritos constituem evidenciação objetiva da forma inaparente, antes apenas presumida na literatura.

In this paper the history of 115 recruits that had bathed simultaneously in streams contaminated with Schistosoma mansoni, during military maneuvers, is reported. Thirty four of the infected patients presented the initial phase of the infection diagnosed through epidemiologic, clinical and laboratorial parameters. Three out of the 34 patients did not reveal the clinical picture of the infection, thus being considered representatives of the non-apparent form of the disease. Differences between the intensity of blood eosinophilia, the area of immediate cutaneous reaction and the number of Schistosoma eggs eliminated in the stools proved not to be statistically significant (p>0.05) when the non-apparent and acute cases of schistosomiasis were compared. These cases actually may be considered evidences of the non-apparent form hitherto merely taken for granted in the literature.

1681 downloads

10.

Forma aguda ou toxêmica da esquistossomose mansoni
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Neves, Jayme

Memórias do Instituto Oswaldo Cruz

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1992, Volume 87 Suppl. 4 Pages 321 - 324

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

The acute toxemic form of schistosomiasis mansoni is studied under anatomic and clinical point of view, according to classification made by Neves, Raso and Bagliolo in 1975. The first phase is characterized by the following facts: cutaneous (immediate and late) manifestations; high fever or in progressive elevation; intense diaphoresis abdominal disconfort; intense acquous diarrhea; dehidratation; loss of weight, dry cough; painful hepatosplenomegaly; discreet lymphademegaly, progressive increase of blood leucocytes and eosinophisles; radiological pulmonary alterations; absence of alterations in serum protein and hepatic functional tests; the hepatic function byopsy shows focus of acute hepatitis. The second stage or properly named toxemic period was clinically characterized by the neat aggravation of the previously observed phenomena. At last, the evolutive course of the disease has implication derived not only of the worm's presence, but from the intense dissemination of eggs in the tissue. In the pre-laying phase one studied the forms of cercarian dermatitis, prodromic and innapparent. In the post laying phase, the properly named acute toxemic form, with its types: pseudocholeraic, pseudotyphous, pseudodysenteric-bacillary, pseudonophritic, pseudoenterovirotic, the reactivated, the ischemic enterocolitis and others; whenever possible clinical and anatomic correlation will be made.

1732 downloads

11.

Envolvimento renal na associação salmonella-Schistosoma mansoni
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Lambertucci, José Roberto

; Godoy, Pérsio

; Bambirra, Eduardo Alves

; Neves, Jayme

; Tafuri, Washington L.

; Leite, Virginia Hora Rios

Revista da Sociedade Brasileira de Medicina Tropical

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jun 1987, Volume 20 N. 2 Pages 83 - 90

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Vinte pacientes com a associação Salmonella-S. mansoni (Grupo 1) e 20 com esquistossomose mansoni hepatesplênica (Grupo 2) foram selecionados para o estudo. Submeteram-se os pacientes dos Grupos le 2 a exame clínico minucioso e a uma série de exames complementares, com destaque para as provas de função renal. Em 10 pacientes do Grupo 1 e 20 do Grupo 2, realizou-se, ainda, estudo histológico do rim à microscopia óptica, de fluorescência e eletrônica. As alterações renais foram mais freqüentes nos pacientes do Grupo 1. Após o tratamento dos pacientes do Grupo 1, com antibióticos e/ou esquistossomicidas, observou-se regressão das alterações renais sob o ponto de vista clínico, laboratorial e imunopatológico. Os autores concluem pela existência de duas nefropatias distintas: a nefropatia esquistossomótica e a encontrada em pacientes com a associação Salmonella-S. mansoni.

The responses of Plasmodium falciparum to antimalarial drugs were evaluated through the in vitro test using blood sample collected from patients of 7 municipalities of the south of Pará State. Sixty nine microtests for chloroquine and mefloquine, 62 for amodiaquine and 61 for quinine were pet formed. The results showed a high resistancefor chloroquine (71%), a relatively low resistance level for amodiaquine (25.8%) and little resistance to quinine (8.2%). For mefloquine 100% of sensitivity wasfound.

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12.

Patologia da forma aguda, toxêmica, da esquistossomose mansoni
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Raso, Pedro

; Pedroso, Enio Roberto Pietra

; Neves, Jayme

Revista da Sociedade Brasileira de Medicina Tropical

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mar 1986, Volume 19 N. 1 Pages 45 - 55

Abstract: Pt | Text: Pt | PDF: Pt

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13.

Viabilidade de ovos de Ascaris lumbricoides após tratamento humano com medicamentos específicos: I— Levamisole e Pamoato de pirantel
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Souza, Maria Suzana de Lemos

; Souza, Dirceu Wagner Carvalho de

; Carvalho, Omar dos Santos

; Neves, Jayme

; Massara, Cristiano Lara

Revista do Instituto de Medicina Tropical de São Paulo

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aug 1985, Volume 27 N. 4 Pages 197 - 200

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Com o objetivo de testar a viabilidade do ciclo biológico, 15 pacientes (masculinos, de quatro a 14 anos) com Ascaris lumbricoides, foram selecionados ao acaso. Após tratamento clássico com sais básicos de levamisole (7 pacientes) e de pamoato de pirantel (8), os ovos retirados das fêmeas expelidas ficaram incubados por 18 dias em de H2SO4 N/10. A seguir foram administrados per os a grupos de 5 camundongos por pacientes. Decorridos 8 dias da infecção, os animais foram sacrificados para pesquisas microscópica de larvas nos fragmentos pulmonares. Dos 75 animais, somente 1, pertencente ao grupo de tratados com levamisole, não apresentou larvas nos fragmentos pulmonares. Concluiu-se que as drogas, nas doses utilizadas, não possuem ação deletéria sobre os ovos de A. lumbricoides, mas promovem a eliminação de material infectivo, com possibilidade de incrementar a poluição onde vivem comunidades sem adequadas condições de saneamento básico.

A total of 15 patients from 4 to 14 years of age were submitted to specific treatment for Ascaris lumbricoides infection. Seven out of these 15 patients received Levamisole (150 mg/ kg of body weight), and eight received Pyrantel Pamoate (10 mg/kg of body weight). Eggs collected directly from the uteri of the female were incubated for 18 days in H2SO4 N/10 solution. These eggs were administered per os to groups of five white mice per patient. Eight days after the infection, the mice were sacrificed to permit microscopic searching of larvae in lung specimens. Only in one out of the 75 examined mice, in the group of patients treated with Levamisole, larvae were not recovered from the lungs. Thus, it is to conclude that the drugs used in the treatment did not demonstrate deleterious effect on the A. lumbricoides eggs. However, the drugs really promote the elimination of infectious eggs. In these circumstances it is possible to believe in the in- creasing of the pollution level in communities without adequate basic sanitation facilities.

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14.

The value of the Widal test in the diagnosis of Prolonged Septicemic Salmonellosis
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Lambertucci, José Roberto

; Marinho, Roberto Pedercini

; Ferreira, Maria das Dores

; Neves, Jayme

Revista do Instituto de Medicina Tropical de São Paulo

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apr 1985, Volume 27 N. 2 Pages 82 - 85

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Vinte pacientes com SSP (Grupo 1) e 20 com esquistossomose mansoni (Grupo 2) foram selecionados para o estudo. Realizou-se a reação de Widal, com antígenos preparados da amostra Ty 901 (S. typhi), nos pacientes dos Grupos 1 e 2. Em seis pacientes do Grupo 1, a reação de Widal foi feita com antígenos preparados a partir de salmonelas isoladas destes pacientes (autoantígenos). Foram considerados significativos os títulos superiores a 1:200. Dez pacientes do Grupo 1 (50%) tiveram a reação positiva para o antígeno "H" e cinco (25%) para o "O". Em quatro casos em que se isolou a S. typhi, a reação de Widal foi positiva. Em três pacientes com reação negativa para "H" e "O", houve viragem da reação com títulos elevados quando se utilizou autoantígenos; outros dois casos positivos mantiveram os mesmos títulos e em um caso houve elevação de quatro vezes nos títulos quando a reação foi feita com antígenos da Salimonella isolada. A reação de Widal foi positiva na maioria dos casos quando as salmonelas isoladas eram do Grupo D. Para o grupo 2, caso se aceitem os títulos superiores a 1:200 todos os exames foram negativos. Os Autores concluem que a reação de Widal apresenta baixa positividade na SSP. Com o uso de antígenos de S. paratyphi A e B e de uma mistura de antígenos de salmonelas de grupos distintos, a reação provavelmente será de valor no diagnóstico da SSP.

Twenty patients with prolonged septicemic salmonellosis (Group 1) and 20 with schistosomiasis mansoni (Group 2) were selected for this study. In both groups, the Widal test was done using antigens of the sample Ty 901 (S. typhi). The test was also applied in 6 group 1 patients with antigens prepared from salmonellae isolated from these patients (autoantigens). Titres over 1:200 were considered significant. Ten group 1 patients (50%) were positive for antigen "H" and 5 (25%) were positive for antigen "O". Three patients with negative "H" and "O" reactions became positive with high titres when using autoantigens. Two other cases maintained the same positive titres and one case showed a fourfold increase in titres when the test was done 'with antigens of the Salmonella isolated. The Widal test was positive in most patients infected with group D Salmonellae. Considering titres above 1:200, all cases were negative in Group 2. The authors conclude that the Widal test has low positivity in prolonged septicemic salmonellosis. The test may be valuable in the diagnosis of this disease when using S. paratyphi "A" and "B" antigens and a mixture of Salmonella antigens taken from other groups.

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15.

Eficácia terapêutica da oxamniquine oral no tratamento da salmonelose septicêmica prolongada
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Lambertucci, José Roberto

; Marinho, Roberto Pedercini

; Ferreira, Maria das Dores

; Neves, Jayme

; Pedroso, Ênio Roberto Pietra

Revista do Instituto de Medicina Tropical de São Paulo

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feb 1985, Volume 27 N. 1 Pages 33 - 39

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Trinta e cinco pacientes com salmonelose septicêmica prolongada (SSP) foram selecionados para o estudo. Vinte (Grupo 1), foram tratados com a oxamniquine oral (15-20mg/kg de peso, dose única) e 15 (Grupo 2) com o cloranfenicol (50mg/kg de peso/15-20 dias). Realizaram-se exames clínico, laboratorial e radiológico antes e após o tratamento. Oito pacientes do Grupo 1 (40%) exibiram uma ou mais queixas após o tratamento. Exceção feita a um paciente que apresentou crise convulsiva, uma hora após a ingestão do medicamento, os demais efeitos colaterais foram de pouca importância. Não se observou efeito tóxico da oxamniquine à luz dos exames complementares realizados após o tratamento. Os pacientes do Grupo 2, não apresentaram qualquer manifestação que pudesse ser imputada ao cloranfenicol. No Grupo 1, 90% dos pacientes foram considerados curados e no Grupo 2, 93% também o foram. Os Autores concluem pela boa eficácia e baixa toxicidade da oxamniquine no tratamento da SSP.

Thirty-five patients with Prolonged Septicemic Salmonellosis were selected for this trial. Twenty patients (Group 1) were treated with a single oral dose of oxamniquine (15-20mg/kg body weight) and 15 (Group 2) were treated with cloramphenicol (50mg/kg body weight, for 15-20 days). Clinical, laboratory and radiological examinations were performed before and after treatment. Eight Group 1 patients (40%) presented one or more complaints after treatment. With the exception of one patient With seizures, one hour after taking oxamniquine, the others symptoms were unimportant. No toxic effects of oxamniquine were observed on laboratorial tests done after treatment. Group 2 patients did not present complaints related to cloramphenicol. In Group 1, 90% of the patients were cured, and in Group 2, 93% also were considered as cured. The Authors conclude that oral oxamniquine in the prescribed dosage has low toxicity and good therapeutic efficacy in patients with Prolonged Septicemic Salmonellosis.

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