Therapeutic ultrasound ameliorates hyperalgesia and edema on CFA-induced persistent inflammatory response in mice

Abstract Background: The present study investigated the effects of pulsed and continuous ultrasound (USP and USC) in edema and hyperalgesia after chronic inflammatory process induced by Complete Freund's Adjuvant-CFA and analyzing the relationship of the application frequency of ultrasound, in pro- and anti-inflammatory cytokine production. Methods: Forty-five animals were divided into 9 groups; all animals from groups 2 to 9 were subjected to a persistent inflammation model induced by CFA in mice. We report the effects and the underlying action mechanisms of USP and USC in the animals which were irradiated two, three or five times a week on the left hind paw. The analyses performed in this study were: evaluation of hind paw edema through the plethysmometer, evaluation of thermal hyperalgesia through withdrawal test using a water container at 44.5°C (± 0.5°C), and the plantar region of the left paw which was removed for analysis of cytokines. Results: Our results showed that USP and USC consistently reduced paw edema, and pulsed ultrasound showed a higher significant effect than the continuous mode. Moreover, groups with irradiation frequency of five times a week presented an inhibition of the edema, and groups with frequency of three or two times a week reduced mainly hyperalgesia, in comparison with the control group. The beneficial effects of the US then seem to be associated with upregulation of anti- and pro-inflammatory mediators, such as IL-10 and IL-6, respectively. Conclusion: This study provided evidence that ultrasound constitutes an important non-pharmacological intervention for the management of inflammatory and pain states.

Efeitos de Diferentes Tipos de Treinamento Físico na Função Endotelial em Pré-Hipertensos e Hipertensos: Uma Revisão Sistemática / Effects of Different Types of Exercise Training on Endothelial Function in Prehypertensive and Hypertensive Individuals: A Systematic Review

Resumo Fundamento: A hipertensão sustentada pode levar ao remodelamento vascular e lesão das células endoteliais, o que pode explicar a disfunção endotelial encontrada em hipertensos. O treinamento físico pode melhorar a saúde vascular em indivíduos com risco cardiovascular, mas pouco se sabe sobre seus efeitos em pré-hipertensos e hipertensos. Objetivo: Revisar a literatura mostrando evidências de alterações da função endotelial em resposta a diferentes modalidades de treinamento físico em pré-hipertensos e hipertensos. Métodos: Realizamos uma revisão sistemática de estudos nas bases de dados MEDLINE, Cochrane, LILACS, EMBASE e SciELO seguindo tanto as diretrizes PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes) quanto a estratégia PICO (paciente/população, intervenção, comparação e resultados). Os ensaios clínicos randomizados (ECRs) publicados até abril de 2019 foram selecionados e avaliados por quatro revisores independentes. A qualidade metodológica foi avaliada por meio da escala PEDro (Physiotherapy Evidence Database). Resultados: Nossa busca rendeu 598 resumos, e 10 estudos foram elegíveis para revisão. Todos eles apresentaram qualidade metodológica aceitável pela escala PEDro. Dos 10 estudos, 7 envolveram treinamento aeróbico, 1 treinamento resistido isométrico e 2 treinamento aeróbico e treinamento resistido dinâmico separadamente. Sete estudos usaram dilatação fluxo-mediada (DFM) para avaliar a saúde vascular, e três usaram pletismografia. A maioria dos protocolos de treinamento envolveu indivíduos hipertensos e consistiu em exercícios de baixa e moderada intensidade. Conclusão: Nossa revisão sistemática mostrou que o treinamento aeróbico contínuo moderado é eficaz para melhorar a saúde vascular em indivíduos hipertensos. Em pré-hipertensos, o treinamento aeróbico intervalado vigoroso parece ser uma alternativa para benefícios à saúde vascular. O treinamento físico resistido isométrico ou dinâmico pode ser usado como alternativa secundária, mas ainda requer mais investigação.

Abstract Background: Sustained high blood pressure can lead to vascular remodeling and endothelial cell injury, which may explain the endothelial dysfunction found in hypertensive individuals. Exercise training can improve vascular health in individuals with cardiovascular risk, but little is known about its effects in prehypertensive and hypertensive individuals. Objective: To review the literature showing evidence of changes in endothelial function in response to different modalities of exercise training in prehypertensive and hypertensive individuals. Methods: We conducted a systematic review of studies in the MEDLINE, Cochrane, LILACS, EMBASE, and SciELO databases following both the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and the PICO framework (patient/population, intervention, comparison and outcomes). Randomized clinical trials (RCTs) published up to April 2019 were selected and assessed by four independent reviewers. The methodological quality was assessed using the PEDro (Physiotherapy Evidence Database) scale. Results: Our search yielded 598 abstracts, and 10 studies were eligible for review. All of them had acceptable methodological quality by PEDro scale. Of the 10 studies, 7 involved aerobic training, 1 isometric resistance training, and 2 aerobic training and dynamic resistance training separately. Seven studies used flow-mediated dilation (FMD) to assess the vascular health, and three used plethysmography. Most training protocols involved hypertensive individuals and consisted of low and moderate-intensity exercise. Conclusion: Our systematic review showed that moderate continuous aerobic training is effective to improve vascular health in hypertensive individuals. In prehypertensive individuals, vigorous interval aerobic training seems to be an alternative to determine vascular health benefits. Resistance exercise training, either isometric or dynamic, can be used as a secondary alternative, but still requires further investigation.

Continuous Aerobic Training and High Intensity Interval Training Increase Exercise Tolerance in Heart Failure Patients: A Retrospective Study

Abstract Background: Conventional aerobic training is the first choice in cardiac rehabilitation for patients with chronic heart failure (CHF). However, high-intensity interval training (HIIT) may be an alternative, although it has little evidence. Objectives: To evaluate the effect of continuous aerobic training (CAT) or HIIT on exercise tolerance in CHF patients. Methods: Retrospective study with 30 patients, of both genders, members of a 10-week CAT or HIIT program. The control group (CON) consisted of patients who did not participate voluntarily in the program. Peak oxygen uptake (VO2peak), thresholds (LV1 and LV2), and ventilatory efficiency in the production of dioxide (VE/VCO2 slope), oxygen uptake efficiency (OUES), and VO2 recovery kinetics were analyzed. A two-way or repeated measures ANOVA was used, followed by Fisher's post-hoc test (p<0.05). Results: After 10 weeks of training, the CAT group increased the treadmill speed at LV1 (p=0.040), while the HIIT increased both the speed (p=0.030) and incline of the treadmill (p<0.001) for VO2peak and LV2, as well as the total time of the cardiopulmonary test. The VE/VCO2 slope was lower than that predicted for CAT (p=0.003) and HIIT (p=0.008). There was no change in VO2peak, recovery of heart rate (HR), and VO2, VE/VCO2, and OUES in both groups. Conclusions: After 10 weeks, both CAT and HIIT increased the tolerance to physical exercise. However, HIIT showed improvement in more parameters, differently from CAT.

Influence of resin cement and thermocycling on milled lithium disilicate ceramic microshear bond strength / Influência do cimento resinoso e da termociclagem na resistência de união à cerâmica de dissilicato de lítio fresada

ABSTRACT The aim of this study was to compare the microshear bond strength of different resin cements to CAD/CAM-created lithium disilicate ceramics after 24 hours and after 1 year (10,000 thermocycles). Forty (40) ceramic bars were subjected to pretreatment comprising airborne abrasion with aluminum oxide particles, etching with 10% hydrofluoric acid and Monobond N application. Bars were divided into 4 groups (n = 10), based on cement type: light-cured Variolink Esthetic LC (VLC) and dual-cured Variolink N (VN) at two different times: after 24 hours and after 1 year. Silicone molds were used to prepare cement cylinders on a ceramic surface. The set was stored in distilled water at 37ºC, for 24 hours or subjected to 10,000 thermocycles. The molds were removed and microshear bond strength was tested. Data were submitted to two-way analysis of variance and Tukey's test (α = 0.05). Based on the comparison between cement values at different aging times (p = 0.035), VN after 24 hours (27.10 ± 0.92) and after 1 year (20.62 ± 1.25) presented significantly higher values than VLC after 24 hours (14.79 ± 0.76) and after 1 year (6.61 ± 0.81). Bond strength recorded for both cements after 24 hours (VN: 27.10 ± 0.92 and VLC: 14.79 ± 0.76) was significantly higher than the one recorded after 1 year (VN: 20.62 ± 1.25 and VLC: 6.61 ± 0.81). The thermocycling reduced the values observed for both investigated cements; bond strength was greater for dual-cure resin cement than for light-cured resin cement.

RESUMO O objetivo nesse estudo foi comparar a resistência de união de diferentes cimentos resinosos à cerâmica de dissilicato de lítio processada por CAD/CAM após 24 horas e após 1 ano (10.000 termociclos). Foram utilizadas 40 barras cerâmicas com tratamento prévio por jateamento com óxido de alumínio, condicionamento com ácido fluorídrico 10% e aplicação do Monobond N. As barras foram divididas em 4 grupos (n=10) de acordo com o tipo de cimento: fotopolimerizável Variolink Esthetic LC (VLC) e dual Variolink N (VN) em diferentes tempos: após 24 horas e 1 ano. Matrizes de silicone foram usadas para preparar cilindros de cimento na superfície cerâmica. O conjunto foi armazenado em água destilada a 37ºC por 24 horas ou submetidos protocolo de termociclagem com 10.000 ciclos. As matrizes foram removidas e o teste de microcisalhamento realizado. Os dados foram avaliados por análise de variância a dois fatores e teste de Tukey (α=0,05). Ao comparar os valores dos cimentos em diferentes tempos de envelhecimento (p=0,035), observou-se que VN, após 24 horas (27,10 ± 0,92) e 1 ano (20,62 ± 1,25) apresentou valores significativamente superior a VLC após 24 horas (14,79 ± 0,76) e 1 ano (6,61 ± 0,81). A resistência para ambos os cimentos após 24 horas (VN: 27,10 ± 0,92 e VLC: 14,79 ± 0,76) foi significativamente superior que 1 ano (VN: 20,62 ± 1,25 e VLC: 6,61 ± 0,81). A termociclagem promoveu diminuição nos valores de ambos os cimentos estudados e o cimento resinoso dual mostrou maior resistência de união que o cimento resinoso fotopolimerizável.

Medical therapy using omeprazole in 12 hydrocephalic dogs: clinical, diagnostic, and therapeutic findings / Terapia médica utilizando omeprazol em 12 cães hidrocefálicos: achados clínicos, diagnósticos e terapêuticos

According to experimental studies with healthy dogs, omeprazole might decrease the CSF production by about 26%; therefore, book texts have been suggested the usage of omeprazole in medical protocols for hydrocephalus treatment. However, to the best knowledge of the authors, the usage and medical response of the omeprazole with substantial group of illness dogs, such as hydrocephalic animals, was lacking. This report describes clinical, diagnostic, and therapeutic findings in 12 dogs with hydrocephalus in which omeprazole were used for medical treatment. The diagnosis of hydrocephalus was accomplished by transcranial sonography (TCS) and/or computed tomography. The ventricular measurement was assessed periodically by TCS during medical treatment. Six dogs were diagnosed with non-obstrutive hydrocephalus and in the other 6 cases hydrocephalus occurred with other concomitant anomalous encephalic disease often related with obstructive hysdrocephalus, such as quadrigeminal cist, arachnoid cyst, chiary-like malformation, and syringomyelia. All of them had medical improvement after the use of omeprazole and the most of the cases had ventricular size reduction. In 10 dogs, the omeprazole was used as single drug, and in 2 dogs medical treatment with steroids and/or diuretics was previously being performed, and omeprazole was added because conventional treatment was resulting in mild to unsatisfactory medical control of the neurological status. The results of this paper shown that omeprazole may be used to ameliorate the neurological status in symptomatic hydrocephalic dogs. This work may represent the first description about the use of omeprazole in order to treat a substantial group of affected dogs with suspected increased intracranial pressure by hydrocephalus, probably due to limitation of CSF production.(AU)

O omeprazol diminui a produção do fluido cerebrospinal (FCE) por cerca de 26% de acordo com estudos experimentais em cães saudáveis. Segundo o conhecimento dos autores, embora utilizado na prática clínica e recomendado em livros textos, não há até o momento estudos clínicos em um grupo substancial de animais avaliando a resposta terapêutica ao uso do omeprazol em pacientes enfermos, tais como cães hidrocefálicos sintomáticos. Este trabalho descreve os achados clínicos, diagnósticos e terapêuticos em 12 cães com hidrocefalia que foram submetidos ao tratamento com omeprazol para o manejo médico de hidrocefalia. O diagnóstico de hidrocefalia e doenças neurológicas concomitantes foi realizado por ultrassonografia transcraniana (USTC) e/ou tomografia computadorizada. A mensuração do tamanho ventricular foi realizada pela USTC durante o tratamento médico. Seis cães foram diagnosticados com hidrocefalia não obstrutiva e os outros 6 casos apresentaram hidrofalia concomitante com outras afecções encefálicas anômalas comumente associada à hidrocefalia obstrutiva, tal como cisto quadrigêmio, cisto aracnóide, síndrome de chiari-like e seringomegalia. Em 10 cães o omeprazol foi utilizado como droga única e em 2 cães a terapia inicial foi a convencional utilizando esteroides e diuréticos, e o omeprazol foi adicionado, pois a resposta clínica a terapia convencional foi insatisfatória. Todos os animais obtiveram melhora dos parâmetros neurológicos e a maioria teve uma redução do tamanho ventricular após o uso do omeprazol. Os resultados deste estudo demonstram que o omeprazol pode ser utilizado para melhorar o estado neurológico em cães com hidrocefalia. Este estudo representa a primeira descrição clínica usando o omeprazol para tratar uma série de cães com suspeita de aumento da pressão intracraniana devido à hidrocefalia, provavelmente pela capacidade do fármaco em limitar a produção do FCE.(AU)

Aggressive osteoblastoma with degeneration to secondary aneurysmal bone cyst / Osteoblastoma agressivo com degeneração secundária para cisto ósseo aneurismático

ABSTRACT A 4-year-old male patient presented with headaches that started 18 months ago and were associated with progressive loss of balance and difficulty walking. Magnetic resonance imaging (MRI) demonstrated an expansile extra-axial mass lesion in the posterior aspect of the posterior fossa on the left, compressing the adjacent brain, as well as the cerebellar hemispheres; it also distorts the fourth ventricle with severe obstructive hydrocephalus upstream. Histological evaluation diagnosed aggressive osteoblastoma with a secondary aneurysmal bone cyst of the skull. We report a case of aggressive osteoblastoma in which the lesion in the MRI was mimicking brain tumor or intracranial primary tumor rather than primary bone tumor.

RESUMEN Paciente masculino, de 4 años de edad, con cefalea de 18 meses asociada a pérdida progresiva de equilibrio y dificultad de deambulación. La resonancia magnética (RM) mostró una lesión espansiva extraaxial en la porción posterior de la fosa posterior a la izquierda, comprimiendo el tejido cerebral adyacente, así como los hemisferios cerebelares; aún deforma el cuarto ventrículo con hidrocefalia obstructiva severa. La evaluación histológica diagnosticó osteoblastoma agresivo con quiste óseo aneurismático secundario del cráneo. Reportamos un caso de osteoblastoma agresivo en lo cual la lesión visualizada con la RM estaba mimetizando tumor cerebral o tumor primario intracraniano y no un tumor óseo primario.

RESUMO Paciente do sexo masculino, 4 anos de idade, com cefaleia há 18 meses associada à perda progressiva do equilíbrio e à dificuldade de deambulação. A ressonância magnética (RM) demonstrou uma lesão expansiva extra-axial na porção posterior da fossa posterior à esquerda, comprimindo o cérebro adjacente, bem como os hemisférios cerebelares; ainda distorce o quarto ventrículo com hidrocefalia obstrutiva grave a montante. A avaliação histológica diagnosticou osteoblastoma agressivo com cisto ósseo aneurismático secundário do crânio. Relatamos um caso de osteoblastoma agressivo em que a lesão na RM estava mimetizando tumor cerebral ou tumor primário intracraniano em vez de tumor ósseo primário.

Outbreaks of nutritional cardiomyopathy in pigs in Brazil / Surtos de cardiomiopatia nutricional em suínos no Brasil

Dilated cardiomyopathy (DCM) is a condition that affects the myocardium, seldom reported in pigs. The DCM is characterized by ventricular dilation, which results in systolic and secondary diastolic dysfunction and can lead to arrhythmia and fatal congestive heart failure. This study described the clinical, pathological, chemical and toxicological findings of nutritional dilated cardiomyopathy (DCM) in nursery pigs through natural and experimental studies. Naturally occurring cases of DCM in three swine farms were investigated through necropsy (fourteen pigs), microscopic, virological, chemical and toxicological exams for the detection of the etiology. The experimental study was conducted with nine 40 days-old piglets, which were divided into three groups of three piglets each. Group 1 was fed with the suspected diet of the naturally occurring cases, Group 2 with half of the suspected diet and half of a control diet, and Group 3 received only the control diet. Clinical signs were recorded. All pigs were submitted of euthanized, necropsie and collection sample for laboratories exams, after 15 days of experiment onset. At the necropsy, all naturally occurring cases had bilateral cardiac dilatation associated to hepatic enhanced lobular pattern (nutmeg liver) and lungs edema. Microscopically, the heart revealed severe hypertrophy and vacuolization of cardiomyocytes, as well as myofiber disarray. Feed analysis revealed low-quality standard soybean meal. After the suspected feed was replaced, clinically ill pigs recovered, and mortality ceased. At the experimental study, two piglets from Group 1 had cough, dyspnea and diarrhea. At the necropsy, these animals had similar gross and microscopic lesions to the natural cases. The nutritional DCM in pigs may be associated to the diet with low-quality soybean meal, as it was further confirmed through an experimental study.(AU)

Cardiomiopatia dilatada (CMD) é uma condição que afeta o miocárdio, raramente relatada em porcos. A DCM é caracterizada por dilatação ventricular, que resulta em disfunção sistólica e disfunção diastólica secundária e pode levar a arritmias e insuficiência cardíaca congestiva fatal. Este estudo descreve os achados clínicos, patológicos, químicos e toxicológicos da CMD em suínos de creche através de estudos naturais e experimentais. Investigaram-se três granjas com surtos de mortalidade por CMD através de exames de necropsia (catorze suínos), microscópicos, virológicos, químicos e toxicológicos para a detecção da etiologia. O estudo experimental foi conduzido com nove leitões de 40 dias de idade, divididos em três grupos de três leitões cada. O grupo 1 foi alimentado com a dieta suspeita dos casos naturais; o 2 com metade da dieta suspeita e metade de dieta controle; e o 3 recebeu apenas a dieta controle. Sinais clínicos foram registrados. Todos os suínos foram submetidos a eutanásia, necropsia para a coleta de amostras para exames laboratoriais após 15 dias do início do experimento. Na necropsia, todos os leitões dos casos naturais apresentavam dilatação cardíaca bilateral associada a padrão lobular hepático aumentado (fígado de noz-moscada) e edema pulmonar. Microscopicamente, o coração revelou hipertrofia severa e vacuolização de cardiomiócitos, bem como desordem de miofibras. A análise da ração demonstrou que o farelo de soja apresentava baixa solubilidade o que indica baixa qualidade. Após a substituição da ração suspeita, os porcos clinicamente doentes recuperaram e a mortalidade cessou. No estudo experimental, dois leitões do grupo 1 apresentaram tosse, dispneia e diarreia. Na necropsia, esses animais apresentavam lesões macroscópicas e macroscópicas similar aos casos naturais. A CMD nutricional em suínos pode estar associado à dieta com farelo de soja de baixa qualidade, como foi confirmado através de um estudo experimental.(AU)

Multidrug-resistant Candida glabrata strains obtained by induction of anidulafungin resistance in planktonic and biofilm cells

Candida glabrata has emerged as a common cause of serious life-threatening fungal infections, largely owing to their low susceptibility to azole antifungals. Recent guidance indicates the use of echinocandins as the first-choice drug for the treatment of systemic infections of C. glabrata; however, C. glabrata resistance to echinocandins is reportedly increasing. Herein, we present the induction of anidulafungin resistance in planktonic and sessile cells of C. glabrata and the development of fluconazole cross-resistance. MICs of 21 clinical C. glabrata strains were determined by a broth microdilution method using anidulafungin and fluconazole. Biofilm formation on a tracheal catheter was determined using 1- × 1-cm2 polyvinyl polychloride catheter fragments. Induction of anidulafungin resistance in planktonic and sessile cells and evaluation of its stability were performed by exposing the strains to successively higher concentrations of the antifungal. The induction resulted in strains strongly resistant to anidulafungin (MICs: 1-2 µg/mL) and fluconazole (≥64 µg/mL). Most of the sessile cells of C. glabrata presented slightly reduced susceptibility compared with the planktonic cells. Clinically, this cross-resistance could lead to therapeutic failure while using fluconazole in patients previously exposed to subinhibitory concentrations of anidulafungin for extended periods.

Genomics and epidemiology for gastric adenocarcinomas (GE4GAC): a Brazilian initiative to study gastric cancer

Gastric cancer (GC) is the fifth most common type of cancer worldwide with high incidences in Asia, Central, and South American countries. This patchy distribution means that GC studies are neglected by large research centers from developed countries. The need for further understanding of this complex disease, including the local importance of epidemiological factors and the rich ancestral admixture found in Brazil, stimulated the implementation of the GE4GAC project. GE4GAC aims to embrace epidemiological, clinical, molecular and microbiological data from Brazilian controls and patients with malignant and pre-malignant gastric disease. In this letter, we summarize the main goals of the project, including subject and sample accrual and current findings

Effect of calcium sources in the diets of adult cats on urinary parameters and acid-base balance / Efeitos das fontes de cálcio na dieta de gatos adultos sobre parâmetros urinários e equilíbrio ácido-básico

Calcium is a macroelement that is part of the mineral composition of the diet of companion animals, and is considered a cation of strong alkalizing power, increasing urinary pH. Calcium salts have different solubilities and depending on the anion to which calcium is associated with, it can be more or less absorbed, modifying the pH of the urine. The aim of this study was to evaluate the efficiency of calcium sources on alkalinization of urinary pH, as well as excretion of urinary electrolytes and acid-base balance of adult cats. An extruded diet for cats was selected, and had 160mEq/kg of calcium from the sources of either calcium carbonate (CaCO3) or calcium gluconate (C12H22CaO14) added. In the control treatment there was no addition of calcium sources, resulting in three treatments. Nine adult cats were used, mixed breed, in two experimental periods, with six replicates per treatment. Animal average age was 4±1.3 years old and average weight was 3.96±0.71kg. The cats remained in metabolic cages for an adaptation period of seven days, followed by six days of urine total collection, with volume, density, pH and calcium concentration (g/d) measurements. The acid-base balance was studied by blood gas analysis of venous blood. The two sources of calcium alkalinized the urine (P<0.001). However, calcium gluconate had less alkalinization power compared to the calcium carbonate (P<0.05). Urinary calcium was not affected by treatments, and represented less than 0.5% of calcium intake. The experiment showed that calcium, although an alkaline cation and considered strong influencer of the EB of the diet, cannot be evaluated individually, because depending on its associated anion it may have greater or lesser influence on cats urine pH.(AU)

O cálcio (Ca) é um macroelemento que faz parte da composição mineral da dieta de animais de companhia. Este macroelemento é considerado um cátion de forte capacidade alcalinizante e, de acordo com a fonte e quantidade inclusa, pode aumentar o pH urinário. Os sais de cálcio têm diferentes solubilidades e dependendo do ânion ao qual o cálcio está associado, pode ser mais ou menos absorvido e assim, alterar o pH da urina. O objetivo deste estudo foi avaliar os efeitos de duas fontes de cálcio na alcalinização do pH urinário, bem como a excreção de eletrólitos urinários e o equilíbrio ácido-básico de felinos. Foi selecionada uma dieta extrusada para gatos e adicionados 160mEq/kg de cálcio das fontes carbonato de cálcio (CaCO3) ou gluconato de cálcio (C12H22CaO14). No tratamento controle, não houve adição de fontes de cálcio. Foram utilizados nove gatos adultos, de raças mistas, em dois períodos experimentais, com seis repetições por tratamento. Os animais apresentavam idade média de 4,0±1,3 anos e peso corporal médio de 3,96±0,71kg. Estes permaneceram em gaiolas metabólicas em período de adaptação durante sete dias, seguido de coleta total de urina durante seis dias. Nestas amostras foram aferidos o volume, densidade, pH e concentração de cálcio (g/d). O equilíbrio ácido-básico foi avaliado por hemogasometria em amostras de sangue venoso. As duas fontes de cálcio alcalinizaram a urina (P<0,001). No entanto, o gluconato de cálcio apresentou menor potencial de alcalinização em comparação ao carbonato de cálcio (P<0,05). O cálcio urinário não foi afetado pelos tratamentos e representou menos de 0,5% da ingestão de Ca. O experimento demonstrou que o cálcio, apesar de ser um cátion alcalinizante e influenciador do EB da dieta, não pode ser avaliado individualmente, porque dependendo do ânion associado, pode apresentar maior ou menor influência no pH da urina de gatos.(AU)

G26P[19] rotavirus A strain causing acute gastroenteritis in the American continent

In Brazil, the rotavirus A genotype G26 was first identified in suckling piglets, while the P[19] genotype has not been identified in any animal species so far. This report details the genetic characterisation of a G26P[19] RVA strain detected from an eight year-old child, vaccinated with Rotarix®, hospitalised with acute diarrhoeal disease in Rio de Janeiro in 2015. Most likely, the genome constellation (I5-R1-C1-M1-A8-N1-T1-E1-H1) observed in the G26P[19] Brazilian strain was a result of interspecies transmission events between humans and pigs. In addition, a rearrangement in the NSP5 gene was observed downstream of the 3' non-coding region.

Cardiac parameters and endothelial function in a strength athlete: a case report

We aimed to discuss a case of strength training athlete who competes in international competitions regarding cardiac (dimension and function), vascular (endothelium and vascular resistance), hemodynamic (blood pressure), given limited evidence supporting these cardiovascular adaptations as well as concerning endothelial function in long-term high-intensity strength training. Methods: We assessed heart structure and function (echocardiography); systolic (SBP) and diastolic blood pressure (DBP); endothelium-dependent vasodilation (flow-mediated dilation, FMD); maximum force tested in the squat, bench press, and deadlift; and maximum oxygen consumption (spirometry). Results: powerlifter's cardiac dimensions (interventricular septum 13 mm; posterior wall thickness 12 mm; LV diastolic diameter 57 mm; left ventricle mass 383 g; LV mass adjusted by body surface area 151.4 g/m2) are above the proposed cutoff values beyond which pathology may be considered. Moreover, cardiovascular function systolic (ejection fraction by Simpson's rule, 71%) is preserved and FMD measure is fairly close and above normal; however, a mild increase in systolic and diastolic blood pressure was observed (130/89 mmHg, respectively). Conclusion: Cardiac remodeling cannot be viewed as either pathological or harmful to the cardiovascular system. Furthermore, we showed an improvement in endothelial function.(AU)

Malignant Triton tumor: a rare cause of sciatic pain and foot drop / Tumor de Triton maligno: uma causa rara de dor ciática e pé pendente

ABSTRACT Malignant peripheral nerve sheath tumors (MPNST) are very rare and are frequently localized in the buttocks, thigh, arm, or paraspinal region; one variant is the malignant Triton tumor, with rhabdomyosarcomatous differentiation. The authors present a challenging differential diagnosis of a sciatic pain and foot drop in a woman with history of lumbar disk herniation, which was found to be caused by a Triton tumor of the sciatic nerve. She underwent surgical excision, followed by radiation and chemotherapy. Malignant Triton tumor cases have rarely been described and reported in the literature. The recommended treatment is radical excision followed by high-dose radiotherapy and chemotherapy. The prognosis, although poor, depends on the location, grade, and completeness of surgical margins.

RESUMO Os tumores malignos da bainha dos nervos periféricos (TMBNP) são muito raros e localizam-se mais frequentemente na região nadegueira, paraespinal, coxa ou braço; uma variante é o tumor de Triton maligno, com uma diferenciação rabdomiosarcomatosa. Apresentamos um diagnóstico diferencial desafiante de dor ciática e pé pendente em uma paciente com antecedentes de hérnia discal lombar, que se descobriu que era causada por um tumor de Triton do nervo ciático. A paciente foi submetida a excisão cirúrgica, seguida de radio e quimioterapia. Poucos casos de tumores de Triton malignos foram descritos e relatados na literatura. O tratamento recomendado é a excisão radical, seguida de radioterapia em alta dose e quimioterapia. O prognóstico, embora mau, depende da localização, do grau e das margens cirúrgicas da exérese.

Cessation of dangerousness status: an analysis of 224 reports from the Instituto de Perícias Heitor Carrilho, Rio de Janeiro, Brazil

Objectives: To evaluate factors related to dangerousness cessation at the end of involuntary commitment based on an analysis of expert reports. In light of the current legal requirement of dangerousness cessation as a pre-requisite for prison or internment release of individuals subjected to the safety measure, we sought elements to reflect on the practice of expert examiners in charge of making this decision. Methods: The authors revised 224 expert psychiatric dangerousness cessation reports released 2011 through 2014 and collected data for a statistical analysis. Results: The following variables were associated with positive risk cessation assessments: no inadequate behavior (according to the assistant professionals), no productive psychotic symptoms, no negative symptoms, presence of insight, presence of a support network, and no psychoactive substance abuse. The following variables were associated with negative dangerousness cessation decisions: early onset of malfunction, lack of insight, negative attitudes, active signs of major mental illness, presence of impulsiveness, poor response to treatment, presence of plans lacking feasibility, exposure to destabilizing factors, lack of personal support, and presence of stress. Conclusions: In this study we were able to identify factors associated with dangerousness in a sample of expert reports. The knowledge of factors linked to a higher risk of recidivism in illegal activities or violent behavior is crucial for decision-making regarding the release of offenders after their legally established period of involuntary commitment.

Synergistic antifungal activity of the lipophilic fraction of Hypericum carinatum and fluconazole

ABSTRACT Hypericum species, Hypericaceae, are recognized as a source of therapeutical agents. Purified fractions and isolated compounds have been shown antimicrobial activity. As the indiscriminate use of antifungals and the increase of infections caused by emerging species are leading to the search of new alternative treatments, the aim of this study was to continue the study with Hypericum carinatum Griseb. lipophilic fraction, rich in phloroglucinol derivatives, investigating the effect of its association with fluconazole against emerging yeasts (Candida krusei, C. famata, C. parapsilosis and Cryptococcus neoformans). The synergistic activity between H. carinatum lipophilic fraction and fluconazole was assessed by two methodologies for multiple dose–response analysis: checkerboard and isobologram. Regarding synergistic experiments, the effect of the association was higher than the effect of fluconazole alone against Candida krusei and C. famata isolates (MIC fluconazole decreased about eight and four folds, respectively), suggesting that, somehow, H. carinatum lipophilic fraction compounds are facilitating the action of this drug. On the other hand, when tested against Cryptococcus neoformans and C. parapsilosis, fluconazole showed better results than the association. Thus, against Candida krusei and C. famata, the lipophilic fraction of H. carinatum was able to reduce the MIC values of fluconazole and could be considered as a potential alternative to be used against emerging yeast species.

Estudo epidemiológico e avaliação de fatores de risco da infecção por Toxoplasma gondii e achados clinico-patológicos da infecção aguda em cães admitidos em um Hospital Escola Veterinário / Epidemiological study and evaluation of risk factors for infection with Toxoplasma gondii and clinical and pathological findings of acute infection in dogs admitted at a Veterinary School Hospital

Esse trabalho teve como objetivo estudar a prevalência e respectivos fatores de risco para infecção do Toxoplasma gondii em cães provenientes de uma população hospitalar. Além disso, avaliou-se as taxas de ocorrência e as repercussões clínico-patológicas da infecção aguda pelo T. gondii nesses animais. Anticorpos foram detectados em 7% (26/386) da população estudada, composta de 386 cães de ambos os sexos e diferentes raças e idades. Somente as variáveis, ingestão de vísceras, origem rural e contato com bovinos apresentaram valores significativos com p<0.05. Adicionalmente os cães de origem rural apresentaram maiores risco (OD=7.00) de infecção do que aqueles de origem urbana. Em 6,5% (25/386) foram detectados títulos de contato (entre 16 e 256); esses títulos não significam necessariamente infecção aguda e sim apenas exposição prévia. É de fundamental importância o reconhecimento da infecção prévia por T. gondii nesses pacientes hospitalares. Dependendo da causa da admissão, mesmo não sendo a toxoplasmose a responsável, o paciente deve receber o tratamento anti-protozoário profilaticamente ou ser monitorado para posterior tratamento em caso de reagudização da enfermidade por recrudescência dos bradizoítos encistados. Apenas um animal (3.44%, 1/386) foi admitido com titulação elevada, o qual pode ser sugestivo de infecção aguda (titulo de 4096). Embora o animal com infecção aguda tenha sido apresentado com sinais neurológicos, cautela é necessária para não extrapolar uma falsa interpretação que a toxoplasmose é a grande responsável por quadros neurológico, uma vez que inúmeros outros casos incluídos nesse estudo tinham manifestações neurológicas e não tinham títulos de infecção aguda, nem mesmo título de contato prévio. A toxoplasmose aguda não foi uma afecção clínica expressiva nessa ambiência hospitalar, no entanto diagnóstico diferencial deve ser feito nos pacientes enfermos, principalmente os da área rural, e diagnostico definitivo deve ser alcançado para a correta conduta terapêutica.(AU)

We aimed to verify the prevalence and risk factors for Toxoplasma gondii infection in dogs addimitted at the hospital. We also assessed the occurrence rates and the clinical and pathological repercussion of the acute infection by T. gondii in these animals. Antibodies were detected in 7% (26/386) of a population of 386 dogs of both genders and different breeds and ages. Only variables, eating offal, rural origin and contact with cattle have significant values of p<0.05. Dogs from rural areas showed higher risk (OD=7.00) of infection than those of urban origin. In 6.5% (25/386) contact titles were detected (between 16 and 256); these titles do not necessarily mean acute infection, but only prior exposure. The recognition of prior infection by T. gondii is vital in those hospital patients. Depending on the cause of admission, although not being toxoplasmosis the responsible, the patient should receive prophylactic anti-parasite treatment or be monitored for further treatment in case of further acute occurrence of the disease by recrudescence of encysted bradyzoites. Only one dog (3:44%, 1/386) was admitted with high titer, what may be suggestive of acute infection (title of 4096). Although the dog with acute infection has shown neurological signs, caution is required not to extrapolate a false interpretation that toxoplasmosis is the main responsible for neurological signs, since numerous other cases included in this study had neurological signs without title of acute infection, even title of prior contact. Acute toxoplasmosis was not a significant clinic disease in this hospital; however differential diagnosis should be made in ill patients, especially those from rural areas, and definitive diagnosis must be reached for the correct therapeutic approach.(AU)