Temporal trends in Hematopoietic Stem Cell Transplantation in Argentina: regional differences that mirror the global reality

Introduction: Hematopoietic stem cell transplantation is the only curative treatment for many disorders and international data shows a growing trend. Method: We aimed to evaluate the temporal trends in HSCT transplant rates in Argentina. A time-series analysis was performed for the period 2009 to 2018 using the national database from the National Central Coordinating Institute for Ablations and Implants. Crude and standardized transplant rates were calculated. A permutation joinpoint regression model analysis was used to identify significant changes over time. Results: Altogether, 8,474 transplants were reported to INCUCAI by 28 centers (autologous 67.5%); the main indication was multiple myeloma (30%). The WHO age-sex standardized HSCT rates for the entire country were 153.3 HSCT/10 million inhabitants (95% CI 141.7 −165.8) in 2009 and 260.1 HSCT/10 million inhabitants (95% CI 245.5−275.5) in 2018. There was a large gap in HSCT rates among the states and regions. The transplant rate was higher for autologous transplants throughout the years. Within the allogeneic group, the related donor transplant rate was higher than the unrelated donor transplant rate. The joinpoint regression analysis of HSCT rates for the whole country over time showed an observed annual percentage change of 6.3% (95% CI 5.4-7.3; p < 0.01). No changes were observed for unrelated donors during the study period. Conclusions: Age-sex standardized HSCT rates in Argentina are increasing, mainly due to autologous and family donor allogeneic transplants. A wide variation across the country was found, demonstrating differences in the access to transplantation among Argentine regions

Length-weight relationship and condition factor for Prochilodus lineatus, an important commercial fish, in contrasting water-quality environments of the middle Tietê River basin, Southeast Brazil / Relação peso-comprimento e fator de condição para Prochilodus lineatus, um importante peixe comercial, em ambientes contrastantes em qualidade da água da bacia do médio rio Tietê, sudeste do Brasil

Abstract This work was carried out in order to provide the length-weight relationship (LWR) and the allometric condition factor (Ka), as well as its correlation with limnological variables, for Prochilodus lineatus from the middle Tietê River basin. Fish were collected using gill nets in two rivers with contrasting environmental conditions, totaling 46 specimens in the highly polluted Tietê River, and 37 in the Peixe River, a relatively well-conserved tributary. Environmental measures were obtained concomitantly to the fish capture. The results showed an isometric growth (b = 3.00) for the fish from Tietê River and a positive allometric growth (b = 3.23) for the fish from Peixe River. The mean value of Ka was unexpectedly higher for the main river (Ka = 2.63) when compared to its tributary (Ka = 2.42), being statistically different from each other. This can be explained by the much higher availability of organic sediments in the main river, resulting from a long-term eutrophication process. Nevertheless, the positive and statistically significant correlations with dissolved oxygen, for both rivers, as well as significant negative correlations with electric conductivity, nitrogen and chlorophyll a for Tietê River, indicate the negative effects of the water quality deterioration on the fish condition factor. The work contributes to the expansion of knowledge about P. lineatus, the most important commercial fish of the middle Tietê River basin, which is severely impacted by unsustainable human actions.

Resumo Este trabalho foi realizado com o objetivo de fornecer a relação peso-comprimento (LWR) e o fator de condição alométrico (Ka), bem como sua correlação com variáveis limnológicas, para Prochilodus lineatus da bacia do médio rio Tietê. Os peixes foram coletados com redes de espera em dois rios com condições ambientais contrastantes, totalizando 46 espécimes no altamente poluído rio Tietê, e 37 no rio do Peixe, um tributário relativamente bem conservado. Medidas ambientais foram obtidas concomitantemente à captura dos peixes. Os resultados mostraram um crescimento isométrico (b = 3,00) para os peixes do rio Tietê e um crescimento alométrico positivo (b = 3,23) para os peixes do rio do Peixe. O valor médio de Ka foi, inesperadamente, maior para o rio principal (Ka = 2,63) quando comparado ao seu afluente (Ka = 2,42), sendo estatisticamente diferentes entre si. Isso pode ser explicado pela disponibilidade muito maior de sedimentos orgânicos no rio principal, resultante de um longo processo de eutrofização. No entanto, as correlações positivas e estatisticamente significativas com o oxigênio dissolvido, para ambos os rios, bem como correlações significativas negativas com a condutividade elétrica, nitrogênio e clorofila a para o rio Tietê, indicam os efeitos negativos da deterioração da qualidade da água sobre o fator condição dos peixes. O trabalho contribui para a expansão do conhecimento sobre P. lineatus, o peixe de maior importância comercial da bacia do médio rio Tietê, severamente impactada por ações humanas não-sustentáveis.

Guideline for the use of immunobiologicals in chronic rhinosinusitis with nasal polyps (CRSwNP) in Brazil / Diretriz para o uso dos imunobiológicos em rinossinusite crônica com pólipo nasal (RSCcPN) no Brasil

Abstract Introduction Severe uncontrolled chronic rhinosinusitis with nasal polyps has a negative impact on an individual's quality of life. Therefore, new biologics have emerged for use in specific phenotypes of chronic rhinosinusitis, changing the paradigms of its treatment. Objective To review the current status of biologic treatment indications in chronic rhinosinusitis. Methods The Brazilian Academy of Rhinology brought together different specialists to suggest a course of action, considering its particularities and aspects related to the national reality. Results Of particular interest for decision making will be the identification of subgroups of patients refractory to pre-existing treatment options and the construction of a strategy that improves their quality of life, with the best cost-benefit ratio. Conclusion The use of biologics is a valid option for treatment in more severe cases. This strategy must be better understood and improved in the future, with more studies and greater clinical experience.

Resumo Introdução A rinossinusite crônica com pólipos nasais grave não controlada impacta negativamente na qualidade de vida do indivíduo. Para esses casos, novos imunobiológicos têm surgido, para uso em fenótipos específicos da rinossinusite crônica, e mudaram os paradigmas de seu tratamento. Objetivo Revisar o estado atual das indicações de imunobiológicos em rinossinusite crônica. Método A Academia Brasileira de Rinologia reuniu diferentes especialistas para sugerir uma conduta que considerasse suas particularidades e seus aspectos relacionados à realidade nacional. Resultados De particular interesse para a tomada de decisão serão a identificação dos subgrupos de pacientes refratários às opções de tratamento pré-existentes e a construção de uma estratégia que realmente melhore a qualidade de vida deles, dentro da melhor relação custo-benefício. Conclusão O uso de imunobiológicos é uma opção válida para tratamento em casos mais graves. Essa estratégia deve ser mais bem compreendida e aprimorada no futuro, com mais estudos e maior experiência clínica.

Brazilian guidelines on the frequency of ophthalmic assessment and recommended examinations in healthy children younger than 5 years / Diretrizes brasileiras sobre avaliação oftalmológica de crianças saudáveis menores de 5 anos: exames recomendados e frequência

ABSTRACT Purpose: To provide guidance on the frequency and components of eye examinations for healthy children aged 0 to 5 years. Methods: These guidelines were developed based on the medical literature and clinical experience of an expert committee. PubMed/Medline searches were performed, with selected publications not restricted to systematic reviews, randomized controlled trials, or observational studies. The Grading of Recommendations Assessment, Development, and Evaluation profile was applied when suitable, and for issues without scientific evidence, recommendations were based on expert consensus. Recommendations by the American Academy of Pediatrics, American Association of Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology, Royal College of Ophthalmologists, and Canadian Ophthalmological Society were also reviewed. The final guideline document was approved by the Brazilian Pediatric Ophthalmology Society and by the Brazilian Pediatric Society. Results: Newborns must undergo the red reflex test and inspection of the eyes and adnexa by a pediatrician within 72 hours of life. The red reflex test should be repeated by the pediatrician during childcare consultations at least three times per year during the first 3 years of life. If feasible, a comprehensive ophthalmologic examination may be performed between 6 and 12 months of age. Until 36 months of age, the pediatrician should assess the infant's visual development milestones, age-appropriate assessment of visual function, ocular fixation, and eye alignment. At least one comprehensive ophthalmologic examination should be performed at 3 to 5 years of age. The examination should minimally include inspection of the eyes and adnexa, age-appropriate visual function assessment, evaluations of ocular motility and alignment (cover tests), cycloplegic refraction, and dilated fundus. Conclusions: Guidelines concerning the frequency of ophthalmic assessment are important tools for directing physicians regarding best practices that avoid treatable vision problems that affect children's development, school, and social performance and cause unnecessary permanent vision loss.

RESUMO Objetivo: Fornecer orientações sobre a frequência e os componentes dos exames oftalmológicos para crianças saudáveis de 0 a 5 anos. Métodos: Essas diretrizes foram desenvolvidas com base em revisão bibliográfica e experiência clínica de um comitê de especialistas. Foram realizadas buscas PubMed/Medline; documentos selecionados não se restringiram a revisões sistemáticas, ensaios clínicos randomizados e estudos observacionais. Quando adequado, o perfil GRADE foi aplicado para graduá-los e o consenso de especialistas foi usado nos tópicos sem evidência científica. Também foram revisadas as recomendações pela Academia Americana de Pediatria, Associação Americana de Oftalmologia Pediátrica e Estrabismo, Academia Americana de Oftalmologia, Royal College of Ophthalmologist e Sociedade Canadense de Oftalmologia. O documento final foi aprovado pela Sociedade Brasileira de Oftalmologia Pediátrica e Sociedade Brasileira de Pediatria. Resultados: Os recém-nascidos devem ser submetidos ao teste do reflexo vermelho e inspeção dos olhos e anexos pelo pediatra dentro de 72 horas de vida ou antes da alta da maternidade. O teste do reflexo vermelho deve ser repetido pelo pediatra durante as consultas de puericultura pelo menos três vezes ao ano durante os primeiros 3 anos de vida. Se factível, um exame oftalmológico completo pode ser feito entre 6 a 12 meses de vida. Até os 36 meses de idade, os marcos visuais, função visual apropriada para a idade, fixação e alinhamento ocular também devem ser avaliados pelo pediatra ou médico da família. Pelo menos um exame oftalmológico completo deve ser realizados entre 3 e 5 anos de idade. O exame deve conter pelo menos inspeção dos olhos e anexos, avaliação da função visual apropriada para a idade, avaliação da motilidade e alinhamento ocular (testes de cobertura), refração sob cicloplegia e avaliação do fundo de olho dilatado. Conclusões: As diretrizes sobre a frequência da avaliação oftalmológica são ferramentas importantes para orientar os médicos sobre a melhor prática a fim de evitar problemas visuais tratáveis na infância, que poderiam comprometer seu desenvolvimento social, escolar e global, além de causar perda permanente da visão.

Combined dorsal and ventral inlay buccal mucosal graft urethroplasty for female urethral strictures (Joshi urethroplasty technique): A first in the Philippines

@#Urethral strictures in females are very uncommon. In selected populations of women who underwent urodynamic studies for obstructive symptoms, female urethral strictures represent 4-13% of the causes of bladder outlet obstruction. Literature is limited regarding surgical treatment for near-obliterative urethral strictures in female patients. In this paper, the authors aimed to report a novel technique of double-faced inlay buccal mucosal graft (BMG) urethroplasty, first described by Joshi in 2020. This is a case of a 35-year-old female with progressively worsening lower urinary tract symptoms, several months after undergoing cesarean section despite multiple internal urethrotomies. Grafts were placed both the anterior and posterior urethral walls with noted good urine flow with mild lower urinary tract symptoms on follow-up after 6 months. The combined dorsal and ventral inlay BMG urethroplasty is a feasible technique with good results for female patients with urethral strictures. To the authors’ knowledge, this is the first-ever reported case, for this novel technique, in the Philippines.

Length-weight relationship and diet of the catfish Cambeva guareiensis (Siluriformes; Trichomycteridae) / Relação peso-comprimento e dieta do bagre Cambeva guareiensis (Siluriformes; Trichomycteridae)

Abstract: The length-weight relationship (LWR) and diet of a small trichomycterid catfish, Cambeva guareiensis, was studied based on 58 specimens captured in Corrente stream, Guareí River basin, São Paulo, Brazil. LWR analyses showed values of a ranged from 0.0097 to 0.0149 and b from 2.858 to 3.250. The analysis of the diet showed that high amounts of aquatic insects (93.75% of total items) were consumed by the species. In addition, we found no statistically significant differences when comparing the diet between the dry and rainy periods. Our study contributes to the knowledge on populational biology and feeding ecology of trichomycterid fishes in Brazilian streams.

Resumo: A relação peso-comprimento (RPC) e dieta de um pequeno bagre trichomycterídeo, Cambeva guareiensis, foi estudada com base em 58 espécimes capturados no riacho Corrente, bacia do rio Guareí, São Paulo, Brasil. As análises de RPC mostraram valores de a variando entre 0,0097-0,0149 e de b entre 2,858-3,250. A análise da dieta mostrou que altas quantidades de insetos aquáticos (93,75% do total de itens) foram consumidas pela espécie. Além disso, não encontramos diferenças estatisticamente significativas quando comparamos a dieta entre os períodos seco e chuvoso. Nosso estudo contribui para o conhecimento da biologia populacional e ecologia alimentar de peixes trichomicterídeos em riachos brasileiros.

Láser de baja potencia y aceleración de movimientos dentarios en ortodoncia: revisión sistemática / Low-level laser accelerating dental movements in orthodontics: systematic review

Según la literatura científica, ¿El láser de baja potencia propicia la aceleración de los movimientos dentarios durante el tratamiento ortodóntico? El objetivo de este trabajo buscasistematizar sobre la capacidad del láser de baja potencia en la aceleración de los movimientos dentarios durante el tratamiento ortodóncico. Para ello, se realizó una revisión sistemática, una búsqueda empleando buscadores booleanos en la plataforma de PubMed. Las palabras clave empleadas para fueron: orthodontic movement, orthodontic tooth movement, orthodontic, orthodontic treatment, low level laser therapy, low level laser,laser therapy y la combinación entre ellos. Las investigaciones incluidas trataron el tema de la aceleración del movimiento dentario durante el tratamiento de ortodoncia empleando láser de baja potencia. Se incluyeron en este estudio publicaciones de revistas indexadas en PubMed, ensayos clínicos, en idioma inglés y que correspondieran a artículos publicados desde el año 2000 a la fecha. A si también,se realizó evaluación del riesgo de sesgo. Las variables analizadas fueron: autor principal, título, año, tipo de artículo, revista, país de investigación y si los artículos demuestran que el láser de baja potencia aumenta el movimiento dentario durante el tratamiento ortodóncico. Los resultados arrojaron que el 60% de los estudios incluidos concluyen que el láser de baja potencia acelera el movimiento dentario durante el tratamiento de ortodoncia; el 30% de estos no encontraron cambios significativos con relación a los grupos estudiados con los de control y un 10% resultó en conclusiones dudosas. Por lo tanto, a pesar de que los resultados son alentadores por la tendencia en que el láser de baja potencia si acelera los movimientos ortodónticos, sería necesaria la presencia de un número superior de estudios clínicos aleatorizados para un esclarecimiento específico de las bondades que aporta esta terapia al sector.

According to scientific literature, does low-power laser promote acceleration of tooth movements during orthodontic treatment? The objective for this work seeksto systematize the ability of the low-power laser to accelerate tooth movements during orthodontic treatment.For this,a systematic review was carried out, a search using Boolean search engines on the PubMed platform. The keywords used for were: orthodontic movement, orthodontic tooth movement, orthodontic, orthodontic treatment, low level laser therapy, low level laser, laser therapy and the combination between them. The included investigations dealt with the issue of acceleration of tooth movement during orthodontic treatment using low-power laser, were from journals indexed in PubMed, clinical trials, in English, and corresponded to articles published since 2000 to date. Assessment of risk of bias was performed. The variables analyzed were: main author, title, year, type of article, journal, country of research, and whether the articles show that low-power laser increases tooth movement during orthodontic treatment.The results showed that 60% of the included studies conclude that the low-power laser accelerates tooth movement during orthodontic treatment, 30% of these did not find significant changes in relation to the groups studied with those of control and 10% resulted in dubious conclusions. Thus, although the results are encouraging due to the trend in which the low-power laser does accelerate orthodontic movements, the presence of a higher number of randomized clinical studies would be necessary for a specific clarification of the benefits that this therapy brings to the patient. sector.

Comparing the efficacy of periprostatic nerve block alone versus periprostatic nerve block plus oral tramadol plus paracetamol tablet for pain control of patients during and after transrectal biopsy of the prostate gland: A randomized controlled trial

OBJECTIVE@#To compare the efficacy of periprostatic nerve block (PPNB) alone versus periprostatic nerve block plus oral Tramadol+Paracetamol Tablet for pain control during and after transrectal ultrasound-guided (TRUS) biopsy of the prostate gland.@*METHODS@#This was a double-blind, placebo-controlled randomized clinical trial. The authors randomized 40 male patients each to either PPNB or PPNB plus oral tramadol and paracetamol (37.5mg/325mg) an hour prior to prostate biopsy. A ten-point visual analog scale was used to measure pain intensity and was recorded upon insertion of the ultrasound probe, during the biopsy, and one hour after the procedure.@*RESULTS@#The two groups were similar in terms of baseline characteristics. Reductions in pain scores were statistically significantly different (p<.001) for each group when comparing pain from at point of insertion of the probe versus during biopsy and versus one-hour post-operatively. However, when comparing the two groups, the pain scores were not statistically significantly different upon insertion of the probe (p=.68), during the biopsy (p=.26) and one-hour post-operatively (p=.54).@*CONCLUSION@#Tramadol and paracetamol combination in addition to periprostatic nerve block produces pain relief similar to standard periprostatic nerve block alone.

Salvage treatment for refractory or relapsed acute myeloid leukemia: a 10-year single-center experience

OBJECTIVES: The outcomes of refractory and relapsed acute myeloid leukemia (AML) patients in developing countries are underreported, even though the similar classic regimens are widely used. METHODS: We conducted a retrospective comparison of "MEC" (mitoxantrone, etoposide, and cytarabine) and "FLAG-IDA" (fludarabine, cytarabine, idarubicin, and filgrastim) in adults with first relapse or refractory AML. RESULTS: In total, 60 patients were included, of which 28 patients received MEC and 32 received FLAG-IDA. A complete response (CR) rate of 48.3% was observed. Of the included patients, 16 (27%) died before undergoing bone marrow assessment. No statiscally significant difference in CR rate was found between the two protocols (p=0.447). The median survival in the total cohort was 4 months, with a 3-year overall survival (OS) rate of 9.7%. In a multivariable model including age, fms-like tyrosine kinase 3 (FLT3) status, and stem-cell transplantation (SCT), only the last two indicators remained significant: FLT3-ITD mutation (hazard ratio [HR]=4.6, p<0.001) and SCT (HR=0.43, p=0.01). CONCLUSION: In our analysis, there were no significant differences between the chosen regimens. High rates of early toxicity were found, emphasizing the role of supportive care and judicious selection of patients who are eligible for intensive salvage therapy in this setting. The FLT3-ITD mutation and SCT remained significant factors for survival in our study, in line with the results of previous studies.

Neuromuscular and physiological responses to different training loads in Randori of elite judo athletes

Abstract Aim: To compare two different randori structure (high volume and short pauses - TRAD training vs low volume with long pauses - COMP training) in the neuromuscular and metabolic responses of elite judo athletes. Methods: The first situation (TRAD) consisted of 12 randoris of 5 minutes with 45 seconds rest, and the other situation (COMP), consisted of 6 randoris of 5 minutes with 10 minutes between them. Physiological (Blood Lactate and Creatine Kinase), neuromuscular (Countermovement Jump and Medicine Ball Throws) and perceptive variables (Rating Perceived Exertion) were measured before and at the end of the sessions. Results: The subjective perception of effort at the end of the training was significantly higher in the TRAD training type (TRADpost: 8.1 ± 0.9 AU; COMPpost: 6.6 ± 1.5 AU, p <0.001). Blood lactate concentration (TRADpost: 6.4 ± 2.2 mmol/L; COMPpost: 8.1 ± 2.9 mmol/L; p <0.001), CMJ height (TRADpost: 36.2 ± 4.6 cm; COMPpost: 35.9 ± 4.3 cm, p = 0.012) and upper limb power performance (TRADpost: 6.4 ± 0.9 m; COMPpost: 6.3 ± 0.9 m p = 0.03) were significantly higher at the end of the two training sessions compared to their start, but there are no group effect. There is group effect in CK (TRADpost: 490.7 ± 273.5 U/L; COMPpost: 357.4 ± 203.8 U/L; p <0.001). Conclusions: This study demonstrated that TRAD and COMP Judo training induced similar physical demands, and both seem to not be enough to reach higher intensities, which made them distant methods of competitive reality.

Non-marine invasive gastropods on Ilha Grande (Angra dos Reis, Rio de Janeiro, Brazil): distribution and implications for conservation / Moluscos continentais invasores na Ilha Grande (Angra dos Reis, Rio de Janeiro, Brasil): distribuição e implicação para a conservação

Abstract Invasive species are one of the main causes of biodiversity loss and the knowledge of their distribution is essential for conservation efforts. The present study inventoried the land and freshwater invasive molluscs of 25 villages of Ilha Grande (Rio de Janeiro, Brazil), an island with Atlantic Rainforest remnants. Three invasive species are found: Melanoides tuberculata (Müller, 1774), Physa acuta Draparnaud, 1805, both on two localities; and Achatina fulica Bowdich, 1822, on 16 localities. Most records were done on the island continental side, in anthropic areas, probably due to ease of access. One record was inside a conservation area, that calls concern about the spread of those species on the island and possible effects.

Resumo As espécies invasoras são uma das maiores causas de perda de biodiversidade e o conhecimento acerca da sua distribuição é essencial para os esforços de conservação. O presente estudo inventariou os moluscos continentais invasores em 25 vilas da Ilha Grande (Rio de Janeiro, Brasil), uma ilha com remanescentes de Mata Atlântica. Três espécies invasoras foram encontradas: Melanoides tuberculata (Müller, 1774), Physa acuta Draparnaud, 1805, ambas em duas localidades; e Achatina fulica Bowdich, 1822, em 16 localidades. A maior parte dos registros foi no lado continental da ilha, provavelmente devido a facilidade de acesso. Um dos registros foi dentro de uma área de conservação, o que chama a atenção para a dispersão destas espécies na ilha, e seus possíveis efeitos.

Profilaxis pre-exposición para la prevención de infección por VIH (PrEP) en mujeres de áreas vulnerables del conurbano de Buenos Aires / Pre-exposure prophylaxis for the prevention of HIV infection (PrEP) in women from vulnerable areas of the suburbs of Buenos Aires

Se describen una serie de casos desarrollados en la región oeste del conurbano bonaerense, en los cuales se presentaron situaciones de alto riesgo de infección por VIH, de modo de poder analizar y explorar el potencial uso de PrEP en mujeres como parte de la estrategia combinada de prevención. Si bien la eficacia de la PrEP está adecuadamente documentada, su implementación se encuentra demorada en la región. Las mujeres no parecen estar dentro de las poblaciones consideradas clave y por lo tanto son alejadas de esas estrategias. Incorporar el uso de PrEP en mujeres jóvenes con riesgo de infección puede contribuir al logro de los objetivos de control de la epidemia y evitar la transmisión vertical del VIH. La falta de un adecuado conocimiento y la baja percepción del riesgo de infección se describen como barreras para una implementación exito

A series of cases developed in the western region of Buenos Aires, in which there were situations of high risk of HIV infection, are described in order to analyze and explore the potential use of PrEP in women as part of the combined prevention strategy. Although the effectiveness of PrEP is well documented, its implementation is delayed in the region. Women do not seem to be within the considered key populations and therefore far from those strategies. Incorporating the use of PrEP in young women at risk of infection can contribute to the achievement of the objectives of epidemic control and avoid vertical transmission of HIV. The lack of adequate knowledge and the low perception of the risk of infection are described as barriers to a successful implementation. Keywords:

Diaphragm quantitative electromyography in difficult-to-treat asthmatic patients / Eletromiografia quantitativa do diafragma em pacientes com asma de difícil controle

ABSTRACT Quantitative electromyography is an important tool to evaluate myopathies, and some difficult-to-treat asthmatic patients may have a subclinical corticosteroid myopathic process, using only inhaled corticosteroid, according to some studies. In this report, diaphragm quantitative electromyography was used to evaluate asthmatic difficult-to-treat patients, comparing them with a control group. Significant differences were obtained in amplitude, duration and size index of motor unit action potentials, with lower parameters in the asthmatic patients, which may indicate a myopathic process.

RESUMO Eletromiografia quantitativa é uma ferramenta importante para a avaliação de miopatias, e alguns pacientes asmáticos de difícil controle podem ter um processo miopático subclínico, mesmo usando apenas corticosteroides inalatórios, de acordo com alguns artigos. Nesse artigo a eletromiografia quantitativa do diafragma foi usada para avaliar os pacientes asmáticos de difícil controle, comparando com um grupo controle. Diferenças significativas nas amplitudes, durações e índices de tamanho dos potenciais de unidades motoras foram encontradas, com parâmetros mais baixos nos pacientes asmáticos, o que pode indicar um processo miopático.

Tuberculosis of the central nervous system in cattle in Paraíba, Brazil / Tuberculose no sistema nervoso central de bovinos na Paraíba

This paper describes six cases of tuberculosis in the central nervous system (CNS) of cattle in the state of Paraíba in northeastern Brazil. We reviewed the autopsy reports of 851 bovine necropsies performed from 2003 to 2016. Seventy-three (8.6%) cattle were diagnosed with tuberculosis and six showed lesions in the CNS. Three cases affected cattle up to two-year-old and other three affected adults. Three cattle presented exclusively nervous signs, two had respiratory signs and weight loss and one did not present any clinical signs. At necropsy, five cattle had thickening of the leptomeninges of the cerebellum, pons, obex, spinal cord and cortex, mainly, in the region near the brain basilar Willis´ circle. Another animal, presented a single focal lesion in the cerebellum. Microscopically we observed moderate to severe granulomatous meningitis and encephalitis. Five cattle presented lesions in the lungs and mediastinal lymph nodes and three of them had disseminated lesions in other organs. In all cattle acid-fast bacilli were observed in the lesions and marked positive for immunohistochemistry with polyclonal antibody anti-Mycobacterium tuberculosis. It is concluded that bovine tuberculosis of central nervous system occurs sporadically in Paraíba, in cattle of different ages, most of them with disseminate lesions in other organs. The location of the lesions suggests that the agent invaded the brain by hematogenous route through the circle of Willis.(AU)

Descrevem-se seis casos de tuberculose no sistema nervoso central (SNC) em bovinos, no semiárido da Paraíba. Foram revisados os laudos de um total de 851 necropsias de bovinos realizadas no período de 2003 a 2016. Destes, 73 (8,6%) foram diagnosticados com tuberculose e seis apresentavam lesões no SNC. Três casos ocorreram em bovinos de até dois anos de idade e três em bovinos adultos. Três bovinos apresentaram exclusivamente sinais nervosos, dois tinham sinais respiratórios e perda de peso e um não apresentava nenhum sinal clínico. Macroscopicamente, em cinco bovinos, havia espessamento das leptomeninges do cerebelo, medula espinhal, ponte, obex, colículos e córtex, principalmente, na região basilar encefálica próxima ao polígono de Willis. Em apenas um bovino houve a presença de tubérculo único no cerebelo. Microscopicamente observou-se moderada a acentuada meningite e encefalite granulomatosa. Cinco bovinos apresentaram lesões pulmonares e nos gânglios mediastínicos e três deles tinham lesões disseminadas em outros órgãos. Em todos os bovinos foram encontrados bacilos ácido-álcool resistentes intralesionais e todos tiveram marcação positiva na técnica de imuno-histoquímica com anticorpo policlonal anti-Mycobacterium tuberculosis. Conclui-se que a tuberculose do sistema nervoso central de bovinos ocorre de forma esporádica na Paraíba, principalmente em bovinos com lesões disseminadas em outros órgãos. Sugere-se que a disseminação do agente ocorre pela via hematógena, possivelmente através do polígono de Willis.(AU)