Síndrome de ativação macrofágica secundária à infecção aguda pelo vírus Epstein-Barr

A síndrome de ativação macrofágica (SAM) ou síndrome hemofagocítica secundária (reativa) consiste de uma rara, grave e potencialmente fatal complicação das doenças reumáticas crônicas, particularmente da artrite idiopática juvenil de início sistêmico, doença de Still do adulto e lúpus eritematoso sistêmico. É caracterizada pela excessiva ativação dos macrófagos, resultando febre, hepatoesplenomegalia, linfadenomegalia, envolvimento neurológico, graus variáveis de citopenias, hiperferritinemia, distúrbio hepático, coagulação intravascular e freqüente falência de múltiplos órgãos. Também ocorre em associação com neoplasias, imunodeficiências e variedade de agentes infecciosos virais (sobretudo do grupo do herpes), bacterianos e fúngicos. Relatamos um caso de SAM decorrente de infecção viral aguda pelo vírus Epstein-Barr tratado com corticóide ora

The lateritic ore deposits of Brazil. Les gisements miniers d'origine latéritique du Brésil

In Brazil, the same processes responsiblefor the formation of the thick lateritic mantle, which covers nearly 65 % of its territory , arc also responsible for metal accumulation which forms, under special condition, the lateritic ore deposits. In the origin of those accumulation, the parent rock composition and/or the convergence of the biological and morphoclimatic factors play a fundamental role. Considering this point of view, different lateritic ore deposits are discussed in this paper. Thus, the weathering of the Banded Iron Formations (from Archean to Upper Proterozoic) gave origin to some of the biggest iron deposits in the world at Carajas (Para), Quadrilatero Ferrifero (Minas Gérais) and Urucum (Mato Grosso). The products of the weathering of various rocks constituted very important bauxite deposits : Cretaceous alkaline massifs in the Southeast Brazil (Minas Gérais, Sao Paulo, Rio de Janeiro, Santa Catarina) ; Precambrian metamorphic or volcanic rocks in the Central-East Brazil (Quadrilatero Ferrifero, Atlantic coastal ridge) ; and Tertiary continental sediments in the Amazonian Basin (Trombetas, Paragominas, ...). The lateritic alteration concentrated the manganese from rocks that have been previously enriched in this element by volcanic-sedimentary processes (Amazônia, Minas Gérais). Finally, nicke-liferous latentes were accumulated by the weathering of ultramafic massifs scattered all over the country, concentrated mainly in Central Brazil (Barro Alto and Niquelandia, Goias), but also occurring in the more humid regions (Atlantic Coast and Amazônia). All this lateritic evolution of very specific bed rocks occurred essentially in the Tertiary during periods of tectonic stability which are related with extense erosional surfaces. The influence of lithologie, climatic and morphotectonic factors on the mechanism of formation of lateritic deposits is discussed.Au Brésil, les mécanismes d'altération supergène ont conduit à la formation d'un épais recouvrement latéritique sur environ 65 % de la surface totale ; dans des conditions particulières, l'accumulation de certains métaux dans ce manteau peut atteindre le stade économique : il s'agit des gisements latéritiques. Pour l'élaboration de ce type de gisements, la composition de la roche-mère, les facteurs morphoclimatiques et biologiques jouent un rôle fondamental. Les différents gisements miniers d'origine latéritique du Brésil sont discutés ici. Ainsi les gisements de fer, qui sont parmi les plus importants du monde (Carajas -Para, Quadrilatère ferrifère -Minas Gérais, Urucum -Mato Grosso), résultent-ils de l'altération d'itabirites (d'âge Archéen à Protérozoïque supérieur). De même, d'importants gisements de bauxites ont été élaborés par altération de divers types de roches : massifs de roches alcalines d'âge Crétacé dans le Sud-Est (Minas Gérais, Sao Paulo, Rio de Janeiro, Santa Catarina) ; Précambrien métamorphique ou volcanique dans le Centre-Est (Quadrilatère ferrifère, chaîne littorale Atlantique) ; et sédiments continentaux tertiaires du bassin amazonien (Trombeta, Paragominas, ...). L'altération latéritique a concentré le manganèse à partir de roches préalablement enrichies en cet élément par des mécanismes volcano-sédimentaires (Amazonie, Minas Gérais). Enfin, des latérites nickélifères ont été accumulées par l'altération de massifs ultrabasiques dispersés à travers tout le pays, depuis le Brésil central où ils sont les plus importants (Barro Alto et Niquelandia, Goias). jusqu'aux régions plus humides du littoral Atlantique et du Nord amazonien. La latéritisation de ces diverses roches mères, tout à fait spécifiques de chaque type de gisement, est intervenue pour l'essentiel au Tertiaire, pendant des épisodes de stabilité tectonique auxquels correspondent des surfaces d'aplanissement généralisées. Le rôle des facteurs lithologiques, climatiques et morpho-tectoniques dans le mécanisme de genèse des gisements latéritiques est discuté.Melfio Adolpho José, Trescases Jean-Jacques, Carvalho A., Barros De Oliveira Sonia Maria, Ribeiro Filho Evaristo, Laquintine Formosow Milton Luis. The lateritic ore deposits of Brazil. Les gisements miniers d'origine latéritique du Brésil. In: Sciences Géologiques. Bulletin, tome 41, n°1, 1988. Latérites périatlantiques. pp. 5-36

Hemispheric strokes: clinical or surgical management? Intracranial pressure monitoring of a case and review of the literature Acidentes cerebrovasculares hemisféricos: conduta clínica ou cirúrgica? Monitorização da pressão intracraniana em um caso e revisão da literatura

The authors report a case of a right hemispheric ischemic infarction on a 77-year-old patient that was monitored with an extradural intracranial pressure monitor (Ladd device).We show the huge intracranial hypertension that the brain was submitted despite of the medical treatment. The treatment of hemispheric strokes can be very challenging. The usual antiedema drugs very often prove to be of no help against the mass effect and the high intracranial pressure that some patients present. More recently reports on the literature are showing good results following a decompressive surgery on such ischemic infarcts.<br>Os autores apresentam um caso clínico de infarto hemisférico em paciente de 77 anos, no qual a pressão intracraniana foi monitorizada. Apesar do tratamento clínico realizado, a pressão intracraniana se manteve elevada. O tratamento clínico nessa entidade infelizmente mostra, na maioria dos casos, resultados insatisfatórios. Recentemente, novos estudos publicados na literatura mostram resultados promissores obtidos através da craniotomia descompressiva

A promoção e a produção das redes de águas e esgotos na cidade de São Paulo, 1875-1892

This article seeks to analyse the creation of the water and sewerage systems in the\ud city of São Paulo in the last decade of the 19th Century. The provincial government contracted\ud a private company, the Companhia Cantareira & Esgotos, for the construction of the new\ud water supply system, its execution and administration. Unable to fulfil its part in the contract,\ud the company loses the rights to the services, and is taken over by the State, becoming the\ud Water and Sewerage Technical Department [Repartição Técnica de Águas e Esgotos].\ud Therefore, the State moves from the promotion to the production of this infrastructure in São\ud Paulo