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Introdução – Os esporos fúngicos são uma das maiores componentes biológicas atmosféricas; no entanto, são ainda pouco estudados e não lhes é reconhecida a influência devida na doença alérgica respiratória. Neste trabalho pretende-se determinar a importância dos níveis de esporos atmosféricos de Alternaria e Cladosporium na doença alérgica respiratória na cidade de Beja. Método – Analisaram-se os níveis atmosféricos de esporos de Alternaria e Cladosporium na cidade de Beja. A metodologia utilizada é recomendada pela Rede Portuguesa de Aerobiologia: utilizou-se um coletor volumétrico do tipo Hirst, um Burkard seven-day Volumetric Spore-trape®; os esporos foram coletados numa bobine que continha uma fita de Melinex impregnada com silicone e corados com solução de glicerogelatina com fucsina básica. Para a leitura das amostras utilizou-se o método de leitura das quatro linhas longitudinais ao microscópio ótico com uma ampliação de 400x. Os resultados obtidos foram convertidos e expressos em número de esporos por metro cúbico de ar. Selecionaram-se doentes alérgicos a fungos com provas de sensibilização positivas para o alergénio mx1 e realizou-se uma análise de diagnóstico molecular de sensibilização ao alergénio Alt a1 através do equipamento Phadia 250® pelo método de imunoensaio fluoroenzimático. Resultados – No período deste estudo registaram-se 320.862 esporos do tipo Cladosporium e 20.741 esporos do tipo Alternaria. Os testes de diagnóstico molecular confirmaram que 81% dos doentes sensibilizados a fungos são alérgicos a Alternaria. Conclusão – Os níveis atmosféricos de Alternaria são elevados e provocam sensibilização alérgica nos doentes da região de Beja. O alergénio Alt a1 permite identificar a maioria dos doentes alérgicos a fungos nesta região.

Background: The propofolemia becomes directly linked to the clinical effects of this anesthetic and is the focus for studies comparing propofol clinical use, in different administration methods routinely used in endoscopy units where sedation is widely administered to patients., Aim: To evaluate the effects of three different regimens of intravenous propofol infusion in colonoscopies., Methods: A total of 50 patients that underwent colonoscopies were consecutively assigned to three groups: 1) intermittent bolus infusion; 2) continuous manually controlled infusion; 3) continuous automatic infusion. Patients were monitored with Bispectral IndexTM (BIS) and propofol serum levels were collected at three different timepoints. The development of an original dilution of propofol and an inventive capnography catheter were necessary., Results: Regarding clinical outcomes, statistical differences in agitation (higher in group 1, p=0.001) and initial blood pressure (p=0.008) were found. As for propofol serum levels, findings were similar in consumption per minute (p=0.748) and over time (p=0.830). In terms of cost analysis, group 1 cost was R$7.00 (approximately US$2,25); group2, R$17.50 (approximately US$5,64); and group 3, R$112.70 (approximately US$36,35, p<0.001). Capnography was able to predict 100% of the oxygen saturation drop (below 90%)., Conclusion: The use of propofol bolus administration for colonoscopies, through continuous manually controlled infusion or automatic infusion are similar regarding propofolemia and the clinical outcomes evaluated. The use of an innovative capnography catheter is liable and low-cost solution for the early detection of airway obstruction., Competing Interests: none

Background: Physical stress echocardiography is an established methodology for diagnosis and risk stratification of coronary artery disease in patients with physical capacity. In obese (body mass index ≥ 30 kg/m2) the usefulness of pharmacological stress echocardiography has been demonstrated; however, has not been reported the use of physical stress echocardiography in this growing population group., Objective: To assess the frequency of myocardial ischemia in obese and non-obese patients undergoing physical stress echocardiography and compare their clinical and echocardiographic differences., Methods: 4,050 patients who underwent treadmill physical stress echocardiography were studied according to the Bruce protocol, divided into two groups: obese (n = 945; 23.3%) and non-obese (n = 3,105; 76.6%)., Results: There was no difference regarding gender. Obese patients were younger (55.4 ± 10.9 vs. 57.56 ± 11.67) and had a higher frequency of hypertension (75.2% vs. 57, 2%; p < 0.0001), diabetis mellitus (15.2% vs. 10.9%; p < 0.0001), dyslipidemia (59.5% vs 51.9%; p < 0.0001), family history of coronary artery disease (59.3% vs. 55.1%; p = 0.023) and physical inactivity (71.4% vs. 52.9%, p < 0.0001). The obese had greater aortic dimensions (3.27 vs. 3.14 cm; p < 0.0001), left atrium (3.97 vs. 3.72 cm; p < 0.0001) and the relative thickness of the ventricule (33.7 vs. 32.8 cm; p < 0.0001). Regarding the presence of myocardial ischemia, there was no difference between groups (19% vs. 17.9%; p = 0.41). In adjusted logistic regression, the presence of myocardial ischemia remained independently associated with age, female gender, diabetes and hypertension., Conclusion: Obesity did not behave as a predictor of the presence of ischemia and the physical stress echocardiography. The application of this assessment tool in large scale sample demonstrates the feasibility of the methodology, also in obese.

The aim of work was to study the epidemiology of American tegumentary leishmaniasis in a military training unit situated in Zona da Mata region of Pernambuco State. Between 2002 and 2003 twenty-three cases were notified by clinical exam, detection and/or isolation of parasite and Montenegro skin test. Seven stocks of Leishmania (Viannia) braziliensis were obtained from patients, identified by a panel of specific monoclonal antibodies and isoenzymatic electrophoresis profiles. An epidemiologic survey on prevalence of infection was carried out by Montenegro skin test in the population that underwent training activities during the same period, out of which 25.3% were identified as positive. These results in association with previous data from this area, shows the maintenance of a primary transmission cycle and the occurrence of periodical outbreaks after training activities in local areas of remnant Atlantic rain forest.