RESUMO A soroprevalência e os possíveis fatores de risco para a infecção por Brucella spp. foram estimados em 2.109 vacas do Município de Monte Negro, Rondônia. De cada animal selecionado foi coletado soro sangüíneo e para as propriedades envolvidas foi preenchido um questionário. As amostras coletadas foram analisadas pelas provas de Antígeno Acidificado Tamponado corado com Rosa Bengala, Soroalgutinação Lenta em Tubos e 2-Mercaptoetanol. A prevalência total da infecção por Brucella spp. em vacas no Município de Monte Negro foi de 15%, sendo 54 (63%) fazendas com animais reagentes. A regressão logística sugeriu que rebanhos com mais de 25 vacas (OD = 2,8; P = 0,02) e a presença de suínos (OD = 2,5; P = 0,04) foram fatores associados a soropositividade dos bovinos. Outras variáveis associadas à infecção pelo teste do Qui-Quadrado foram repetição de cio e nascimento de bezerros enfermos (P < 0,05).

ABSTRACT The seroprevalence of Brucella spp. and the possible associated risk factors were estimated for 2,109 adult cows in Monte Negro county, State of Rondônia, Brazil. A questionnaire was completed for each farm where cattle were sampled. Laboratory tests were Rose-Bengal Agglutination, Standard Tube agglutination, and Mercaptoethanol. The adjusted overall prevalence of Brucella spp. seropositive cows for Monte Negro county was 15% and at least 54 herds (63%) were positive. A logistic regression analysis suggested that the herd size of more than 25 cows and the presence of pigs were significant factors associated with the seropositivity (herd size: OD = 2.8; P=0.02; presence of pigs: OD = 2.5; P =0.04). Other significant variables associated to the infection, analysed by Chi-Square were the presence of seropositivity cows with the herd that were repeat breeders and birth of weak calves (P < 0.05).

Foram testados, pela técnica de soroaglutinação microscópica aplicada à leptospirose, 329 cães provenientes do município de Monte Negro, RO, dos quais 156 eram da área urbana e 173 da área rural. Simultaneamente foi aplicado questionário para verificar a existência de possíveis fatores de risco pela regressão logística. Abordaram-se questões referentes a idade, sexo, dieta, tipo de criação, ambiente, contato com outras espécies e hábito de caça. Foram detectadas reações com títulos >100 em 27,3%, com 90 cães positivos ao agente, das quais 23,7% eram da área (37/156) urbana e 30,6% (53/173), da área rural (P>0,05). Os sorovares predominantes, reatores com títulos mais elevados, foram Autumnalis (22%), Pyrogenes (12%), Canicola (10%) e Shermani (7,5%). Cães com idade acima de 12 meses apresentaram maior ocorrência de anticorpos quando comparados aos cães mais jovens (P<0,05). Dentre os fatores de risco analisados, foram significativos a alimentação (dieta à base de ração comercial - odds ratio: 3,3; intervalo de confiança: 95%: 1,2 - 9,2; P=0,02) e o sexo (macho - odds ratio: 2,3; intervalo de confiança: 95%: 1,3 - 3,9; P=0,003). Ressalta-se a ocorrência de reações para sorovares mantidos na natureza por animais silvestres.

The microscopic agglutination test was applied to 329 samples taken from 156 dogs from urban area and 173 from rural areas of Monte Negro County, Rondônia State, Brazil, to determine anti-Leptospira spp. antibodies. A survey was concomitantly done to detect eventual risk factors thru the use of logistic regression. Studied variables were age, sex, diet, management, environment, contact with other species and hunting habit. Titers >100 were detected in 27.3% (90/329) of the dogs, being 23.7% (37/156) urban and 30.6% (53/173) rural dogs. The most frequent serovars were Autumnalis (22.0%), Pyrogenes (12.0%), Canicola (10.0%) and Shermani (7.5%). Dogs older than 12 months showed higher positive frequencies than younger animals (P<0.05). Risk factor were associated with commercial food as compared to homemade food (odds ratio: 3.3; 95% confidence interval : 1.3 - 3.9; P=0.02) and associated with sex, with higher occurrence in males than in females (odds ratio: 2.3; 95% confidence interval: 1.3 - 3.9; P=0.003). It was emphasized the serological occurrence of serovars kept and spread in nature by wild animals.

The present study evaluated the effect of non-absorbable oral polymyxin on the duodenal microflora and clinical outcome of infants with severe infectious diarrhea. Polymyxin was chosen because classic enteropathogenic Escherichia coli was more sensitive to this antibiotic. Twenty-five infants were randomly assigned to a 7-day treatment with oral polymyxin (2.5 mg/kg in 4 daily doses) or placebo. Duodenal and stool cultures were performed before and after the treatment. Five patients were excluded during the study because of introduction of parental antibiotic therapy due to clinical sepsis (N = 3) or rapid clinical improvement (N = 2). In the polymyxin group, small bowel bacterial overgrowth occurred in 61.5% of the cases (8/13) before treatment and in 76.9% (10/13) after treatment. In the placebo group these values were 71.4% (5/7) and 57.1% (4/7), respectively. By the 7th day, clinical cure was observed in 84.6% of the cases (11/13) in the polymyxin group and in 71.4% (5/7) in the placebo group (P = 0.587). Considering all 25 patients included in the study, clinical cure occurred on the 7th day in 12/14 cases (85.7%) in the polymyxin group and 6/11 cases (54.5%) in the placebo group (P = 0.102). Clinical sepsis occurred in 3/11 (27.3%) of the patients in the placebo group and in none (0/14) in the polymyxin group (P = 0.071). Oral polymyxin was not effective in reducing bacterial overgrowth or in improving the clinical outcome of infants hospitalized with severe infectious diarrhea. Taking into account the small sample size, the rate of cure on the 7th day and the rate of clinical sepsis, further studies with greater number of patients are necessary to evaluate these questions.

Gastroesophageal reflux (GER) disorder was studied in children and adolescents with chronic and/or recurrent rhinosinusitis not associated with bronchial asthma. Ten children with a clinical and radiological diagnosis of chronic and/or recurrent rhinosinusitis, consecutively attended at the Pediatric Otolaryngology Outpatient Clinic, Federal University of São Paulo, were evaluated. Prolonged esophageal pH monitoring was used to investigate GER disorder. The mean age of the ten patients evaluated (eight males) was 7.4 ± 2.4 years. Two patients presented vomiting as a clinical manifestation and one patient presented retrosternal pain with a burning sensation. Twenty-four-hour esophageal pH monitoring was performed using the Sandhill apparatus. An antimony probe electrode was placed in the lower third of the esophagus, confirmed by fluoroscopy and later by a chest X-ray. The parameters analyzed by esophageal pH monitoring included: total percent time of the presence of acid esophageal pH, i.e., pH below 4 (<4.2%); total number of acid episodes (<50 episodes); number of reflux episodes longer than 5 min (3 or less), and duration of the longest reflux episode (<9.2 min). One patient (1/10, 10%) presented a 24-h esophageal pH profile compatible with GER disorder. This data suggest that an association between chronic rhinosinusitis not associated with bronchial asthma and GER disorder may exist in children and adolescents, especially in those with compatible GER disorder symptoms. In these cases, 24-h esophageal pH monitoring should be performed before indicating surgery, since the present data suggest that 10% of chronic rhinosinusitis surgeries can be eliminated.

The present study was designed to assess the intestinal absorption of D-xylose and jejunal morphometry in rats with iron-deficiency anemia. Male Wistar rats were randomly divided into a control group (diet containing 50 mg Fe/kg, N = 12) and an anemic group (diet containing <5 mg Fe/kg, N = 12). The animals were housed in individual metabolic cages and deionized water and diet were provided ad libitum for 6 weeks. Hemoglobin and hematocrit were determined at 0, 2, 4, and 6 weeks. At the end of the study the rats were submitted to a D-xylose absorption test (50 mg/100 g body weight) and sacrificed and a jejunal specimen was obtained for morphometric study. At the end of the study the hemoglobin and hematocrit of the anemic rats (8.7 ± 0.9 g/dl and 34.1 ± 2.9%, respectively) were significantly (P < 0.05) lower than those of the controls (13.9 ± 1.4 g/dl and 47.1 ± 1.5%, respectively). There was no statistical difference in D-xylose absorption between the anemic (46.5 ± 7.4%) and control (43.4 ± 9.0%) groups. The anemic animals presented statistically greater villus height (445.3 ± 36.8 µm), mucosal thickness (614.3 ± 56.3 µm) and epithelial surface (5063.0 ± 658.6 µm) than control (371.8 ± 34.3, 526.7 ± 62.3 and 4401.2 ± 704.4 µm, respectively; P < 0.05). The increase in jejunum villus height, mucosal thickness and epithelial surface in rats with iron-deficiency anemia suggests a compensatory intestinal mechanism to increase intestinal iron absorption.

The present prospective study was carried out to determine dietary fiber and energy intake and nutritional status of children during the treatment of chronic constipation. Twenty-five patients aged 2 to 12 years with chronic constipation were submitted to clinical evaluation, assessment of dietary patterns, and anthropometry before and after 45 and 90 days of treatment. The treatment of chronic constipation included rectal disimpaction, ingestion of mineral oil and diet therapy. The standardized diet prescribed consisted of regular food without a fiber supplement and met the nutrient requirements according to the recommended daily allowance. The fiber content was 9.0 to 11.9 g for patients aged less than 6 years and 12.0 to 18.0 g for patients older than 6 years. Sixteen patients completed the 90-day follow-up and all presented clinical improvement. The anthropometric variables did not change, except midarm circumference and triceps skinfold thickness which were significantly increased. Statistically significant increases were also found in percent calorie intake adequacy in terms of recommended daily allowance (55.5 to 76.5% on day 45 and to 68.5% on day 90; P = 0.047). Percent adequacy of minimum recommended daily intake of dietary fiber (age + 5 g) increased during treatment (from 46.8 to 52.8% on day 45 and to 56.3% on day 90; P = 0.009). Food and dietary fiber intake and triceps skinfold thickness increased during follow-up. We conclude that the therapeutic program provided a good clinical outcome.

The objective of the present study was to determine the effect of cellulose on intestinal iron absorption in rats during recovery from iron deficiency anemia. Twenty-one-day-old male Wistar-EPM rats were fed an iron-free ration for two weeks to induce anemia. At 5 weeks of age, the rats were divided into two groups (both groups receiving 35 mg of elemental iron per kg diet): cellulose group (N = 12), receiving a diet containing 100 g of cellulose/kg and control (N = 12), receiving a diet containing no cellulose. The fresh weight of the feces collected over a 3-day period between the 15th and 18th day of dietary treatment was 10.7 ± 3.5 g in the group receiving cellulose and 1.9 ± 1.2 g in the control group (P<0.001). Total food intake was higher in the cellulose group (343.4 ± 22.0 g) than in the control (322.1 ± 13.1 g, P = 0.009) during the 3 weeks of dietary treatment. No significant difference was observed in weight gain (cellulose group = 132.8 ± 19.2, control = 128.0 ± 16.3 g), hemoglobin increment (cellulose group = 8.0 ± 0.8, control = 8.0 ± 1.0 g/dl), hemoglobin level (cellulose group = 12.3 ± 1.2, control = 12.1 ± 1.3 g/dl) or in hepatic iron levels (cellulose group = 333.6 ± 112.4, control = 398.4 ± 168.0 µg/g dry tissue). We conclude that cellulose does not adversely affect the regeneration of hemoglobin, hepatic iron level or the growth of rats during recovery from iron deficiency anemia.

Escherichia coli enteropatogênica clássica (EPEC) tem sido o agente enteropatogênico mais freqüentemente isolado nas fezes de lactentes, de baixo nível socioeconômico, hospitalizados com diarréia aguda grave, na cidade de São Paulo. OBJETIVOS. 1) Analisar as características clínicas de lactentes do sexo masculino, hospitalizados com diarréia aguda grave associada à EPEC; 2) quantificar suas perdas fluidas fecais, ingestão de fórmulas alimentares e variações de peso corporal durante a evolução intra-hospitalar. CASUÍSTICA E MÉTODOS. Estudaram-se 38 lactentes do sexo masculino. Foram avaliadas as características clínicas e epidemiológicas dos pacientes e a freqüência dos diferentes sorogrupos de EPEC identificados. As crianças foram mantidas em cama metabólica, e balanços metabólicos diários foram obtidos durante toda a duração do quadro diarréico. Os lactentes permaneceram, em média, 5,8 dias em estudo metabólico. Duzentos e vinte balanços diários foram acumulados e analisados. RESULTADOS. O grupo estudado apresentou como principais características clínicas: idade inferior a 12 meses, peso insuficiente ao nascer; desmame precoce e formas graves de desnutrição protéico-calórica. O sorogrupo O111 foi o mais freqüentemente identificado (68,4%), sendo a idade dos pacientes com tal agente significativamente maior que a dos portadores do sorogrupo O55. A média dos volumes fecais diários foi de 66mL/kg/dia, havendo diferenças segundo dias de estudo. A média de ingestão diária de fórmulas alimentares foi de 85,2mL/kg/dia. Leite de vaca foi a dieta mais precocemente utilizada e as crianças que dela fizeram uso apresentaram volumes fecais maiores que os que receberam caseinato ou nutrição parenteral e incremento de peso corporal menor que os que utilizaram hidrolisado protéico ou NPT. CONCLUSÕES. Os sorogrupos de EPEC acarretaram perdas fluidas fecais de moderada e grave intensidade nos lactentes estudados. A duração da diarréia mostrou curso agudo (menor ou igual a 14 dias) na maioria das crianças estudadas, reafirmando a evolução potencialmente autolimitada da diarréia aguda. Sete (18,4%) pacientes, entretanto, desenvolveram quadro de diarréia persistente, indicando que tal evolução é esperada em uma parcela razoável de lactentes jovens hospitalizados com tal enfermidade. Os volumes médios de ingestão das fórmulas alimentares encontrados mostram o impacto da diarréia aguda na diminuição da ingestão alimentar. As médias observadas nas três diferentes fórmulas alimentares ficaram abaixo da ingestão calórica sugerida como padrão pela FAO/WHO (100cal/kg/dia). Não houve diferenças entre os volumes de aceitação segundo os tipos de fórmulas alimentares utilizadas.

Enteropathogenic Escherichia coli (EPEC) strains are the most prevalent enteropathogenic agents isolated in the stools of hospitalized infants with severe acute diarrhea in São Paulo. These microorganisms induce a severe intestinal secretion of fluids and electrolytes that can cause dehydration leading to hospital admission in the majority of the cases. OBJECTIVES. This investigation aims at the following objectives: 1) to study the clinical features of acute diarrhea in male infants who were hospitalized owing to EPEC infection; 2) to determine the fecal fluid losses, formula intake and variation of the body weight during the evolution of the disease. PATIENTS AND METHODS. Thirty eight male infants with acute diarrhea due to EPEC strains were studied. The clinical and epidemiological features of the patients were recorded and the different EPEC serogroups were identified. The infants were kept in a metabolic bed in order to allow the collection of stools and urine separately during the whole period of the disease, and daily metabolic balances were also obtained. The mean duration of the metabolic study was 5.8 days, and during this period of time 220 daily metabolic balances were accumulated and analyzed. RESULTS. The main clinical features of the studied group were as follows: age below 12 months; low birth weight; precocious weaning; severe protein-calorie malnutrition. EPEC O111 was the most frequent serogroup identified, present in 68.4% of the infants. The average daily fecal fluid losses were 66 ml/kg and the mean daily formula intake was 85.2 ml/kg. Cow's milk was the most precocious food utilized and the infants who received cow's milk feeding presented the largest stool losses in comparison with lactose free formulas and total parenteral nutrition. CONCLUSION. EPEC strains are able to induce moderate to severe fecal fluid losses in infants and the duration of diarrhea is usually below 15 days, although in several circumstances diarrhea can show a protracted evolution owing to food intolerance associated or not with intestinal secretion.