Acute visceral leishmaniasis is associated with an antigen-specific immunosuppression of mononuclear cells as evidenced by defective in vitro production of interferon gamma. We evaluated treatment with recombinant human interferon gamma in combination with conventional pentavalent antimony therapy in patients with visceral leishmaniasis. Six of eight patients with visceral leishmaniasis (mean duration, 17 months) that had been unresponsive to multiple courses of pentavalent antimony responded to treatment with recombinant human interferon gamma (100 to 400 micrograms per square meter of body-surface area per day) in addition to pentavalent antimony (20 mg per kilogram of body weight per day) for 10 to 40 days. The other two patients improved initially but then relapsed and required treatment with amphotericin B. Eight of nine additional patients with previously untreated severe visceral leishmaniasis were also successfully treated with the combination of interferon gamma and pentavalent antimony. The 14 patients who responded to this regimen had marked improvement in symptoms and in measures of anemia and leukopenia, as well as weight gain, a decrease in spleen size, and an absence or reduction of leishmanias in splenic aspirates. These patients had no recurrence of illness after a mean (+/- SE) follow-up of 8 +/- 1 months. Fever was the only major side effect of interferon gamma. We conclude that the combination of interferon gamma and pentavalent antimony is effective in treating seriously ill patients with refractory or previously untreated visceral leishmaniasis.

These results allow us to consider the use of LAAOs as anticancer agents, as tools in biochemical studies to investigate cellular processes, and to obtain a better understanding of the envenomation mechanism.

In a 4-year follow-up study, patients with acute sporadic non-A, non-B (NANB) hepatitis were evaluated to determine the etiology and natural history of the disease. Acute hepatitis C virus (HCV) was detected in 13 of 43 (30%) of patients, anti-hepatitis E virus (HEV) IgG in 5 (12%), and 25 (58%) were considered non-A-E. The HCV RNA was detected in all HCV patients but none of the non-A-E cases. The initial clinical and biochemical presentation of the HCV and non-A-E cases was quite similar, although 2 of the non-A-E patients had severe disease. The 5 patients who were found to be anti-HEV IgG-reactive recovered within 6 months of follow-up. Of the 13 HCV cases, alanine transaminase (ALT) levels returned to normal in 7 (53.8%), while 6 (46.2%) continued to show abnormal ALT after 6 months of follow-up. However, 9 (69.2%) of them remained HCV-RNApositive, denoting virological/biochemical dissociation. Longterm follow-up showed a reappearance of HCV RNA in 2 of the 4 patients who were in virological remission performing 84% of chronicity rate. Acute non-A-E hepatitis patients were less likely to evolve toward chronicity, as compared with acute HCV cases (16% vs. 84%; P ‫؍‬ .0001). Only 4 (16%) of the non-A-E patients were hepatitis G virus (HGV)-RNA-positive. Concerning risk factors for acquiring parenterally transmitted viruses, tattooing was the only one that could be associated with HCV transmission (P ‫؍‬ .002). No risk factors could be identified for putative non-A-E virus transmission. Liver biopsies performed for chronic HCV patients showed a variable degree of inflammation, while the non-A-E patients presented less severe histological disease. (HEPATOLOGY 1999;30:289-293.)

Objectives: To understand the beliefs and practices of grandmothers regarding breastfeeding; describe the influence of grandmothers in the management of breastfeeding their daughters and / or wives. Method: A descriptive study with a qualitative approach. The scenario was the Rooming Maternity Hospital Gaffrée and Guinle in Rio de Janeiro. The subjects were 20 grandparents who visited his grandsons or granddaughters during hospitalization. Data collection between the months of March and May 2011. The instrument was a questionnaire filled out by the researchers. Results: The grandparents recognize the importance of breastfeeding and passes these values to their daughters and wives. Conclusion: The grandparents are fundamental in supporting women during the breastfeeding period. Descriptors: Breastfeeding, lactation, culture, nursing. RESUMO Objetivos: Conhecer as crenças e as práticas das avós com relação ao aleitamento materno; descrever a influência das avós no manejo do aleitamento das suas filhas e/ou noras. Método: Estudo descritivo com abordagem qualitativa. O cenário foi o Alojamento Conjunto da Maternidade do Hospital Universitário Gaffrée e Guinle no Rio de Janeiro. Os sujeitos foram 20 avós que visitaram seus netos ou netas no período de internação. Coleta de dados entre os meses de março e maio de 2011. O instrumento foi um questionário preenchido pelas pesquisadoras. Resultados: As avós reconhecem a importância do aleitamento e passa esses valores para suas filhas e noras. Conclusão: As avós são peças fundamentais no apoio a mulher, durante o período de amamentação. Descritores: Aleitamento materno, lactação, cultura, enfermagem. RESUMEN Objetivos: Conocer las creencias y prácticas de las abuelas con respecto a la lactancia materna; describir la influencia de las abuelas en el manejo de la lactancia materna a sus hijas y / o esposas. Método: Se realizó un estudio descriptivo con un enfoque cualitativo. El escenario fue el Gaffrée Maternidad alojamiento conjunto y Guinle en Río de Janeiro. Los sujetos fueron 20 los abuelos que visitaron a sus nietos o nietas durante la hospitalización. La recolección de datos entre los meses de marzo y mayo de 2011. El instrumento fue un cuestionario rellenado por los investigadores. Resultados: Los abuelos reconocen la importancia de la lactancia materna y pasa estos valores a sus hijas y esposas. Conclusión: Los abuelos son fundamentales en el apoyo a las mujeres durante el periodo de lactancia. Descriptores: