Unusually Pronounced and Expansive Mandibular Foramen. A Incidental Radiological Finding / Foramen Mandibular Inusualmente Pronunciado y Expansivo: Un Hallazgo Radiológico Incidental

SUMMARY: The mandibular foramen and its canal are one of the most important structures in the skull, as they solely supply the mandible through their associated nerves and vessels. Many anatomical variations have been reported in the literature until now, and this case report represents a clear-cut appearance of its shape in a panoramic radiograph, which is not mostly seen in normal panoramic radiographs. These factors are of utmost importance when it comes to performing various surgeries and preventing complications due to their varied anatomy, which will allow dentists to create a better treatment plan and provide better treatments without any complications.

El foramen mandibular y su canal son algunas de las estructuras más importantes del cráneo y cara, ya que a través de ellos la mandíbula es inervada por nervios e irrigada por vasos. Hasta ahora, en la literatura consultada, se han informado de numerosas variaciones anatómicas. En este trabajo reportamos la forma y trayecto del foramen y canal mandibular, obtenidos en una radiografía panorámica, que no es observada normalmente en este tipo de radiografía. Los factores anatómicos son de importancia a la hora de realizar las cirugías para prevenir complicaciones debido a su variada anatomía, permitiendo a los odontólogos crear un mejor plan de tratamiento sin ningún tipo de complicaciones.

Changes of antioxidant enzymes in the kidney after cardiac arrest in the rat model

Globally, cardiac arrest (CA) is a leading cause of death and disability. Asphyxial CA (ACA)-induced kidney damage is a crucial factor in reducing the survival rate. The purpose of this study was to investigate the role of antioxidant enzymes in histopathological renal damage in an ACA rat model at different time points. A total of 88 rats were divided into five groups and exposed to ACA except for the sham group. To evaluate glomerular function and oxidative stress, serum levels of blood urea nitrogen (BUN) and creatinine (Crtn) and malondialdehyde (MDA) levels in renal tissues were measured. To determine histopathological damage, hematoxylin and eosin staining, periodic acid-Schiff staining, and Masson's trichrome staining were performed. Expression levels of antioxidant enzymes including superoxide dismutase-1 (SOD-1), superoxide dismutase-2 (SOD-2), catalase (CAT), and glutathione peroxidase (GPx) were measured by immunohistochemistry (IHC). Survival rate of the experimental rats was reduced to 80% at 6 h, 55% at 12 h, 42.9% at 1 day, and 33% at 2 days after return of spontaneous circulation. Levels of BUN, Crtn, and MDA started to increase significantly in the early period of CA induction. Renal histopathological damage increased markedly from 6 h until two days post-CA. Additionally, expression levels of antioxidant enzymes were significantly decreased at 6 h, 12 h, 1 day, and 2 days after CA. CA-induced oxidative stress and decreased levels of antioxidant enzymes (SOD-1, SOD-2, CAT, GPx) from 6 h to two days could be possible mediators of severe renal tissue damage and increased mortality rate.

Early discharge predictors among inpatient crack cocaine users

Abstract Introduction High rates of early hospital discharge are often observed in crack cocaine users and are related to adverse outcomes and increased public spending. This study evaluated clinical and sociodemographic factors associated with early treatment discharge among crack users. Methods The sample comprised 308 men diagnosed with crack cocaine use disorder (crack only), aged 18 to 65 years, admitted between 2013 and 2017 to a male-only hospital unit to treat substance use disorders. Sociodemographic and clinical data were obtained using the Addiction Severity Index, 6th version, and a Sociodemographic Questionnaire. Results Early discharge (within 7 days) was significantly associated with lack of own income, insufficient family support, being single, and recent homelessness. Regarding drug use, lower treatment retention was related to younger age of crack use onset, recent alcohol use, and nicotine use. Factors such as age, skin color, and educational level showed no relation to the outcome. Conclusion Our findings suggest that presence of characteristics verifiable at the time of admission may be related to crack users' treatment retention. Identification of these factors can contribute to target interventions in order to improve treatment adherence in crack cocaine users.

Assessment of cognitive functioning using the Mini Mental State Examination in men with alcohol and crack cocaine use disorder

Abstract Introduction Consumption of substances has been associated with cognitive impairment. The Mini Mental State Examination (MMSE) is an easy-to-apply screening tool used to assess cognitive functions. Objectives To evaluate the cognitive performance of individuals with alcohol (AUD) and/or crack cocaine use disorder (CUD) and polysubstance use using the MMSE and to investigate the impact of substance use profile and the moderation effect of educational level on MMSE performance. Methods Cross-sectional study with 508 adult male inpatients diagnosed with substance use disorders (245 with AUD, 85 with CUD, and 178 with polysubstance use). Cognitive performance was assessed using the MMSE scale (total and composite scores). Results Individuals with AUD had worse total MMSE scores and scored worse for all three MMSE components compared to individuals with polysubstance use (p < 0.001, oral/written language comprehension, p < 0.001, attention/memory, and p = 0.007, motor functions). MMSE scores were positively correlated with educational level (p < 0.017), but were not associated with age, recent drug use, or years of drug use. Educational level moderated the impact of substance use on MMSE performance, especially total score and composite language comprehension score. Individuals with a low educational level (≤ 8 years) had worse performance than those with a high educational level (≥ 9 years), mainly in individuals with AUD (p < 0.001). Discussion Individuals with a low educational level and alcohol use are more prone to present cognitive impairment than crack cocaine users, especially involving language aspects. Better-preserved cognitive function could impact treatment adherence and might guide the decision of therapeutic strategies.

Fatores associados à exposição ao HIV em usuários de álcool / Factors associated with HIV exposure in alcohol users

Introdução: A prevalência de HIV é maior em Porto Alegre comparada ao restante do país. O abuso de álcool afeta o juízo crítico, sendo associado a comportamentos de risco que podem levar à contaminação pelo HIV. Objetiva-se analisar fatores associados à exposição ao HIV em alcoolistas com práticas sexuais de risco comparando com aqueles que se previnem.Métodos: Estudo transversal com 126 homens alcoolistas (HIV negativo), divididos em 2 grupos: Exposto Sexual (n = 42) e Pouco Exposto Sexual (n = 84), considerando uso de preservativo e número de parceiros sexuais.Resultados: A maioria dos sujeitos do grupo Exposto Sexual era solteiro, sem ocupação laboral, com histórico de moradia de rua e de relação com profissional do sexo, apresentavam maior preocupação com infecção por HIV (p < 0,05).Conclusão: Sugere-se o desenvolvimento e monitoramento de intervenções preventivas específicas, considerando as características do abuso de álcool e seu papel na transmissão do HIV.

Introduction: The HIV prevalence is higher in Porto Alegre compared to other capitals in Brazil. Alcohol abuse affects critical judgment, being associated with risky behaviors that can lead to HIV infection. Aim:To analyze factors associated with exposure to HIV in alcohol users, comparing those with risky sexual practices and those who use prevention methods.Methods: Cross-sectional study with 126 male alcohol users (HIV negative), divided into 2 groups: Sexually Exposed (n = 42) and Less Sexually Exposed (n = 84), considering condom use and number of sexual partners.Results: Most subjects in the Sexually Exposed group were single, without a job, with a history of homelessness and a relationship with a sexual worker, and were more concerned about HIV infection (p < 0.05).Conclusion: The development and monitoring of specific preventive interventions is suggested, considering the characteristics of alcohol abuse and its role in HIV transmission.

An undiagnosed case of cervical ectopic pregnancy: A case report

Cervical ectopic pregnancy very rarely presents in the second trimester. A 35-year-old female was diagnosed with a rare case of cervical pregnancy intraoperatively at 18 weeks as it was undetected prior. Emergency laparotomy was done as she started bleeding torrentially, and a hysterectomy was done as postpartum hemorrhage was noted. The patient recovered in 1 day and was discharged on day 10 without any postoperative surgical complications.

Childhood trauma subtypes may influence the pattern of substance use and preferential substance in men with alcohol and/or crack-cocaine addiction

Objective: To compare the prevalence and subtypes of childhood maltreatment (CM) between individuals with and without substance use disorder (SUD) and investigate the influence of different traumas on the preferential use of substances and the severity of dependence. Methods: The sample consisted of 1,040 men with SUD (alcohol users [n=315], crack-cocaine users [n=406], multiple-substance users [n=319]) and 201 controls. The Childhood Trauma Questionnaire (CTQ) and the Addiction Severity Index-6 (ASI-6) were used to assess CM and drug-use patterns. Results: Individuals with SUD had a higher prevalence of CM than controls (63.4 vs. 28.1%, respectively). Exposure to physical trauma was associated with alcohol use disorder and severity of alcohol use. In contrast, emotional trauma was associated with use of multiple substances and severity of drug use in crack-cocaine users. Conclusions: This study corroborates the association of CM with SUD susceptibility. Our results suggest that the type of CM may influence preferential substance use and addiction severity. In this sense, physical traumas are more associated with alcohol use, while emotional and sexual traumas favor use of multiple drugs, especially crack cocaine. These findings may help the development of tailored prevention and intervention strategies.

Prevalence of suicide in cocaine users accessing health services: a systematic review and meta-analysis

Objective: This study reviewed and analyzed the prevalence of suicidal behaviors among cocaine users who sought health services. Methods: This is a systematic review and meta-analysis of studies published until January 2021. PubMed/MEDLINE, Scopus, Embase, PsycINFO, and LILACS were searched. The inclusion criteria were observational (retrospective or prospective), case-control, and/or cross-sectional reports that contained samples of cocaine users aged over 14 years who were assessed in health facilities or were in treatment. The random-effects model was used to calculate the overall prevalence of suicidal behavior with a 95% confidence interval. Subgroup analysis was conducted to investigate sources of heterogeneity. Results: Twenty articles were included, yielding a total of 2,252 cocaine users. The estimated prevalence was 43.59% (95%CI 31.10-57.38) for suicidal ideation and 27.71% (95%CI 21.63-34.73) for suicide attempts. High heterogeneity was found between studies for both outcomes (I2 ≥ 93%), although subgroup analysis considering the quality of the studies showed a significant difference in suicide attempts (p = 0.03). Conclusion: Cocaine use can be considered a risk factor for suicidal behavior, and prevention and early screening measures should be implemented to facilitate adequate treatment.

Human and Environmental Reservoirs of Intestinal Parasites in the City of Yaoundé, Cameroon: An Update in the Context of COVID-19 Pandemic

Aims: Intestinal parasitic infections are persistent in Africa, and we questioned here whether prevention measures imposed by the occurrence of the COVID-19 pandemic in 2020 could alleviate this threat in lowlands of the city of Yaoundé, Cameroon. Study Design: We monitored the trend of intestinal parasites in human and environmental samples from the seven subdivisions of the city of Yaounde, before (November-December 2019) and during (July-August 2020, November-December 2020) the COVID-19 pandemic. Methodology: Parasitological analysis were performed to check for the presence of helminths and protozoans in stools from inhabitants as well as in water, soil and fresh vegetables, using standard Kato Katz and Formol Ether methods.The minimum effective sample size considered for the estimation of parasite richness, parasite infection and contamination indexeswas 30 for human and 30 for environmental samples (i.e. soils, water and vegetables) per location. Results: Of the 19 parasite species identified in human and the environments, twelve were helminths and seven protozoans. The overall parasite species richness reached 16 in 2019 (12 helminths and 4 protozoans) and 19 in 2020 (12 helminths and 7 protozoans), with about 62.5-68.4% of species shared by human and environments. The parasite frequencies in human (21.03%) and water/soils (32.3%) in 2019 did not differ statistically with those of 2020 (14.6-20.3% and 10.8-35.4%, respectively). The contamination rate of vegetables (i.e. carrots, lettuce, basil, celery, etc.) has increased from 2019 (6.1-9.1%) to 2020 (9.1-24.2%), and was frequently due to roundworms, hookworms, Entamoeba and Cryptosporidium cysts. The findings suggest persistent risk associated with intestinal parasite irrespective to measures imposed by COVID-19 in study locations. Conclusion: The current control approaches may therefore integrateecological epidemiology of the intestinal parasite infections as complementary strategy in African cities.

Anger and substance abuse: a systematic review and meta-analysis

Objective: Conduct a systematic review and meta-analysis to evaluate levels of anger among substance users compared to non-user controls and to analyze the possible association between anger and psychoactive substance use (PSU). Methods: The procedures of this review followed the Meta-Analyzes of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases (MEDLINE, EMBASE, BIREME, PsycINFO) were searched. Results: Twelve studies were included in the meta-analysis; 10 used the State-Trait Anger Expression Inventory (STAXI) anger trait subscale and two used the Buss-Perry-Aggression Questionnaire (BPAQ) anger subscale. The sample included 2,294 users of psychoactive substances and 2,143 non-users, all male. The mean difference in anger scale scores between users and non-users was 2.151 (95%CI 1.166-3.134, p ≤ 0.00, inconsistency index [I2] = 98.83) standard deviations. Age and abstinence duration did not moderate the difference in anger between substance users and non-users. Conclusion: Users of psychoactive substances had elevated anger scores compared to non-users, which represents a high risk of relapse. It is suggested that PSU treatment programs include intensive anger management modules, focusing on factors such as dealing with daily stressors, family conflicts, frustrations, and problems.

In vivo evaluation of clinical performance of Cention N and glass ionomer cement in proximal restorations of primary molars

Introduction: Restoring a proximal lesion in primary tooth has met with many challenges which has led to evolution of many materials. An alternative to Glass Ionomer Cements which has fluoride releasing capacity, offers good bond strength and is esthetic have been long looked for. Aim: This study aimed to compare the clinical performance of GIC and Cention N in proximal restorations of primary molars. Materials and Methodology: A prospective study was conducted on 154 primary molars in patients aged between 5 and 8 years using a split-mouth design. Patients were divided into two groups. Control group restored with GIC and study group received Cention N. Both groups were assessed at baseline 3, 6 and 9 months according to Ryge criteria and data was statistically analysed using Fisher's Exact. Results: Statistically significant difference was found between GIC and Cention N restorations for color match at baseline and color stability at 3 months (P < 0.001), while the other parameters did not show any significant difference among the two restorative materials. Conclusion: Cention N can be used as a suitable alternative to GIC for restoring Class II restorations in primary molars.

Poor prognosis indicators of type-2 diabetic COVID-19 patients

Diabetes is associated with a worse prognosis and a high risk of morbidity and mortality in COVID-19 patients. We aimed to evaluate the main factors involved in the poor prognosis in diabetic patients. A total of 984 patients diagnosed with COVID-19 admitted to the hospital were included in this study. Patients were first divided into type-2 diabetic (DM+) and non-diabetic (DM-) groups. The participants were analyzed based on the National Early Warning Score (NEWS) and on the Quick-Sequential Organ Failure Assessment (qSOFA) to find the best prognostic risk score for our study. The DM+ and DM- groups were divided into non-severe and severe groups. Comparative and correlative analyses were used to identify the physiological parameters that could be employed for creating a potential risk indicator for DM+ COVID-19 patients. We found a poorer prognosis for the DM+ COVID-19 patients with a higher ICU admission rate, mechanical ventilation rate, vasopressor use, dialysis, and longer treatment times compared with the DM- group. DM+ COVID-19 patients had increased plasma glucose, lactate, age, urea, NEWS, and D-dimer levels, herein referred to as the GLAUND set, and worse prognosis and outcomes when compared with infected DM- patients. The NEWS score was a better indicator for assessing COVID-19 severity in diabetic patients than the q-SOFA score. In conclusion, diabetic COVID-19 patients should be assessed with the NEWS score and GLAUND set for determining their prognosis COVID-19 prognosis.

Estimation of salivary proteins in early childhood caries before and after treatment using gel electrophoresis

Background: Saliva being an important biological fluid of our body contains both specific and nonspecific protective factors which form an integral part of our immune system. Salivary proteins play a substantial role in protecting humans against infection. Their level in oral cavity is subject to constant variations which is dependent on various factors. Purpose: The purpose of the study was to compare the levels of salivary proline-rich proteins (PRPs), glycoproteins, amylase bands, and salivary pH in children with early childhood caries before and after treatment using gel electrophoresis. Materials and Methods: The whole salivary pH, mean protein concentrations, and electrophoretic profiles of the salivary proteins were measured using sodium dodecylsulfate–polyacrylamide gel electrophoresis in both pre- and posttreatment groups. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 15.0 software. Chi-square test and independent t-test were used to further compare the results. Results: The results were statistically significant in all the groups. There was variation in pre- and posttreatment values seen. Conclusion: Salivary proteins (glycoproteins, PRPs, and amylase) establish an imperative defense mechanism as antimicrobial agents.

Cutaneous mast cell tumor in a captive Bush dog (Speothos venaticus): pathological and immunophenotypical aspects - case report / Mastocitoma cutâneo em um cachorro-do-mato vinagre (Speothos venaticus) de cativeiro: aspectos patológicos e imunofenotípicos - relato de caso

A senile male captive bush dog (Speothos venaticus) presented a small perianal cutaneous nodule. Histologically, there was an ulcerated round cell tumor composed of well differentiated mast cells with abundant intracytoplasmic purple Giemsa-positive granules, with a diffuse eosinophilic infiltrate. Immunohistochemistry revealed that 30% of the neoplastic cells were positive for Kit in the cytoplasm and cell membrane, and all neoplastic cells were negative for MAC and CD3. Less than 10% of the neoplastic cells were positive for Ki67. At necropsy other primary tumors were identified in this animal, including an intestinal adenoma, an adrenal cortex adenoma and a testicular interstitial cell tumor.(AU)

Um cachorro-vinagre (Speothos venaticus) apresentou um nódulo cutâneo pequeno na região perianal. Histologicamente havia neoplasia cutânea de células redondas e ulcerada, constituída por mastócitos bem diferenciados, com abundantes grânulos citoplasmáticos metacromáticos na coloração de Giemsa e infiltrado eosinofílico difuso. A imuno-histoquímica demonstrou que 30% das células neoplásicas eram positivas para a proteína Kit no citoplasma e na membrana celular. As células foram negativas para MAC e CD3. Menos de 10% das células neoplásicas foram positivas para Ki67. Durante a necropsia, foram identificados outros tumores primários, como adenoma intestinal, adenoma cortical da adrenal e tumor de células intersticiais do testículo.(AU)

Development of tetra-primer ARMS-PCR protocol to genotype the prolactin receptor SNP 39136666 and assessment of this SNP in Brazilian locally adapted cattle breeds / [Desenvolvimento de protocolo de tetra-primer ARMS- PCR para genotipagem do SNP 39136666 do receptor da prolactina e avaliação desse SNP em raças bovinas brasileiras localmente adaptadas]

As raças taurinas de origem ibérica Limonero e Carora (Bos primigenius taurus) possuem o fenótipo de pelo curto, liso e com baixa densidade folicular, o que confere a esses animais maior tolerância térmica e melhor produtividade em regiões quentes. Diferentes mutações associadas a esse fenótipo foram descritas no gene do receptor de prolactina PRLR, localizado no cromossomo bovino BTA20. Uma mutação recentemente encontrada é a substituição do nucleotídeo C por T, SNP 39136666 (p. R497*), no exon 11, que gera um códon de parada e, consequentemente, uma menor isoforma desse receptor. Neste trabalho, desenvolveu-se um protocolo rápido e de baixo custo para detecção desse SNP, utilizando-se a técnica de tetra-primer ARMS-PCR. Assim, foi possível detectar essa mutação nas raças brasileiras de origem ibérica localmente adaptadas: Caracu, Crioulo Lageano, Mocho Nacional e Pantaneiro. O alelo T foi mais frequente na raça Caracu (80%), enquanto o alelo C foi mais frequente na raça Crioulo Lageano (84%). Essa simples metodologia pode ser usada para genotipar esse SNP e ajudar na aplicação dessas informações moleculares em programas de melhoramento focados na tolerância térmica em bovinos taurinos e seus mestiços.(AU)

Detection of enteroviruses during a 2018 hand, foot and mouth disease outbreak in Malaysia

@#Hand, foot, and mouth disease (HFMD) is a common childhood disease caused by enteroviruses. In 2018, a HFMD outbreak in Malaysia affected over 76,000 children. In this study, we used RT-qPCR and CODEHOP PCR to detect the causative agents in 89 clinically diagnosed HFMD patients in Kuala Lumpur and Selangor. Most (62.9%) of the children were below 3 years old. PCR with either assay detected enteroviruses in 84.2% (75/89) and CODEHOP PCR successfully typed 66.7% (50/75) of the enteroviruses. Sequencing of CODEHOP amplicons showed co-circulation of multiple enteroviruses with coxsackievirus A6 (CV-A6) and A16 as the predominant serotypes, but not the neurovirulent enterovirus A71. CV-A6 infection was more common in children less than 12 months old (p=0.01) and was more likely to cause vesicles in the gluteal area (p=0.01) compared to other enteroviruses. Establishing a robust identification method during HFMD outbreaks is important for patient management and public health responses.

Psychosocial impact of the COVID-19 pandemic on paediatric healthcare workers

INTRODUCTION@#Frontline healthcare workers (HCWs) exposed to coronavirus disease 2019 (COVID-19) are at risk of psychological distress. This study evaluates the psychological impact of COVID-19 pandemic on HCWs in a national paediatric referral centre.@*METHODS@#This was a survey-based study that collected demographic, work environment and mental health data from paediatric HCWs in the emergency, intensive care and infectious disease units. Psychological impact was measured using the Depression, Anxiety, Stress Scale-21. Multivariate regression analysis was performed to identify risk factors associated with psychological distress.@*RESULTS@#The survey achieved a response rate of 93.9% (430 of 458). Of the 430 respondents, symptoms of depression, anxiety and stress were reported in 168 (39.1%), 205 (47.7%) and 106 (24.7%), respectively. Depression was reported in the mild (47, 10.9%), moderate (76, 17.7%), severe (23, 5.3%) and extremely severe (22, 5.1%) categories. Anxiety (205, 47.7%) and stress (106, 24.7%) were reported in the mild category only. Collectively, regression analysis identified female sex, a perceived lack of choice in work scope/environment, lack of protection from COVID-19, lack of access to physical activities and rest, the need to perform additional tasks, and the experience of stigma from the community as risk factors for poor psychological outcome.@*CONCLUSION@#A high prevalence of depression, anxiety and stress was reported among frontline paediatric HCWs during the COVID-19 pandemic. Personal psychoneuroimmunity and organisational prevention measures can be implemented to lessen psychiatric symptoms. At the national level, involving mental health professionals to plan and coordinate psychological intervention for the country should be considered.

Distal intestinal obstruction syndrome: a diagnostic and therapeutic challenge in cystic fibrosis / Síndrome da obstruc¸ão intestinal distal: um desafio diagnóstico e terapêutico na fibrose cística

Abstract Objective: To evaluate the demographics, genotype, and clinical presentation of pediatric patients presenting with distal intestinal obstruction syndrome (DIOS), and factors associated with DIOS recurrence. Methods: Case series of ten patients (median age 13.2 years), followed-up in a reference center, retrospectively assessed. Data analyzed included age, gender, cystic fibrosis genotype, meconium ileus at birth, hydration status, pulmonary exacerbation, Pseudomonas aeruginosa colonization, pancreatic insufficiency (PI), body mass index (BMI) at the episodes, clinical manifestations of DIOS, imaging studies performed, acute management of DIOS, maintenance therapy, and recurrence on follow-up. Results: All patients had two positive sweat chloride tests, and nine of ten also had genotype study. The most common genotype identified was homozygosis for the delta F508 mutation. In seven cases, a previous history of meconium ileus was reported. All patients had pancreatic insufficiency. Diagnosis of DIOS was based on clinical and imaging findings. Of the total number of episodes, 85% were successfully managed with oral osmotic laxatives and/or rectal therapy (glycerin enema or saline irrigation). Recurrence was observed in five of ten patients. Conclusion In this first report of pediatric DIOS in South America, the presence of two risk factors for DIOS occurrence was universal: pancreatic insufficiency and severe genotype. Medical history of meconium ileus at birth was present in most patients, as well as in the subgroup with DIOS recurrence. The diagnosis relied mainly on the clinical presentation and on abdominal imaging. The practices in the management of episodes varied, likely reflecting changes in the management of this syndrome throughout time.

Resumo Objetivo: Avaliar os dados demográficos, o genótipo e o quadro clínico de pacientes pediátricos que apresentam síndrome da obstrução intestinal distal (DIOS) e os fatores associados à recidiva da DIOS. Métodos: Casuística de 10 pacientes (média de 13,2 anos) monitorados em um centro de referência e avaliados de forma retroativa. Os dados analisados incluíram idade, sexo, genótipo da fibrose cística, íleo meconial no nascimento, estado de hidratação, exacerbação pulmonar, colonização por Pseudomonas aeruginosa, insuficiência pancreática (IP), IMC nos episódios, manifestações clínicas da DIOS, estudos de diagnóstico por imagem realizados, manejo agudo da DIOS, terapia de manutenção e recidiva no acompanhamento. Resultados: Todos os pacientes apresentaram dois exames de cloreto no suor positivos e 09/10 também apresentaram estudo do genótipo. O genótipo mais comum identificado foi a homozigose da mutação delta F508. Em sete casos foi mencionado um histórico de íleo meconial. Todos os pacientes apresentaram insuficiência pancreática. O diagnóstico da DIOS teve como base achados clínicos e de imagem; 85% do número total de episódios foram tratados com sucesso com laxantes osmóticos orais e/ou terapia retal (enema de glicerina ou irrigação salina). A recidiva foi observada em 5 de 10 pacientes. Conclusão: Neste primeiro relatório da DIOS pediátrica na América do Sul, a presença de dois fatores de risco na ocorrência da DIOS foi universal: insuficiência pancreática e genótipo associado a doença grave. O histórico de íleo meconial no nascimento esteve presente na maioria dos pacientes, bem como no subgrupo com recidiva da DIOS. O diagnóstico dependeu principalmente do quadro clínico e do diagnóstico por imagem abdominal. As práticas de manejo de episódios variaram, provavelmente refletiram as mudanças no tratamento dessa síndrome ao longo do tempo.

Perfil metabólico de filhotes de peixe-boi da Amazônia (Trichechus inunguis) em cativeiro, alimentados com diferentes sucedâneos do leite materno / [Metabolic profile of captive Amazonian manatee calves (Trichechus inunguis), fed different substitutes for maternal milk]

Dez filhotes de peixe-boi da Amazônia criados em cativeiro foram amamentados com diferentes dietas lácteas em duas etapas. Na primeira, com sucedâneo 1 (S1), utilizado rotineiramente no Inpa e, na segunda, com sucedâneo 2 (S2), elaborado com base na composição centesimal do leite materno da espécie. Cada etapa durou 62 dias, realizando-se coleta de sangue ao final de cada uma para avaliação dos valores de proteínas totais (PT), albumina (ALB), globulinas (GLO), glicose (GLI), lipídeos totais (LT), colesterol (COL), triglicerídeos (TRI), cálcio (Ca), fósforo (P), magnésio (Mg), sódio (Na), potássio (K), hematócrito (Ht) e hemoglobina (Hb). Houve redução dos níveis séricos de PT, ALB, GLO, Ca, P, K, GLI, LT, COL e TRI, após a alimentação dos animais com S2 quando comparados aos valores obtidos com S1. Os níveis de Na foram maiores quando administrado o S2 (143,47±0,99mmol/L). Valores de Ht e Mg não diferiram entre os tratamentos. O perfil metabólico, em geral, esteve dentro dos níveis normais para a espécie.(AU)

Ten Amazonian manatee calves who live in captivity were fed with different substitutes for maternal milk in two phases. During the first phase, the calves were fed substitute 1 (S1), which is what was routinely used by INPA, and during the second phase they were fed substitute 2 (S2), which was formulated based on the nutritional composition of T. inunguis maternal milk. Each phase lasted 62 days, when blood samples were collected for analysis of values of total protein (PT), albumin (ALB), globulin (GLO), glucose (GLI), total lipids (LT), cholesterol (COL), triglycerides (TRI), calcium (Ca), phosphorus (P), magnesium (Mg), sodium (Na), potassium (K), hematocrit (Ht) and hemoglobin (Hb). There was a decrease in PT, ALB, GLO, Ca, P and K after feeding the animals with S2 when compared to values obtained with S1. Sodium levels were higher when S2 was administered (148.16±1.15mmol/L) than when S1 was given (143.47±0.99 mmol/l). Values of Ht and Mg did not differ between treatments. The metabolic profile was within normal levels for this species.(AU)

Comparison of modified biophysical profile and Doppler ultrasound in prediction of perinatal outcome in high-risk pregnancies

Background: The objective of this present study was to compare MBPP and umbilical artery Doppler flow in high-risk pregnant women in prediction of perinatal outcome.Methods: A cohort study was done on 150 high-risk pregnant women over 16 months. Antenatal women with singleton pregnancy who delivered within 48 hours of performing MBPP and Doppler USG, with presence of ≥1 high-risk factor like pre-eclampsia/gestational HTN, BOH, post-dated pregnancy, FGR, GDM, maternal heart disease, anaemia, hypothyroidism and IHCP were included in the study. MBPP (NST and AFI) and umbilical artery Doppler was performed. Perinatal outcome was measured in terms of stillbirth/IUD, LBW, Apgar <7 at 5 minutes, admission to NICU, neonatal death within 48 hours of delivery, MSL and neonatal seizures within 24-48 hours. Quantitative variables were compared using independent t-test/Mann Whitney test. Qualitative variables were correlated using Chi square test/Fisher exact test. Sensitivity, specificity, NPV, PPV were calculated and p-value <0.05 was considered statistically significant. Data analysis was done using social sciences (SPSS) licensed version 21.0.Results: Majority belonged to the age group 21-25 years and were between 37-40 weeks of gestation. It was found that highest perinatal complications occurred in those with both abnormal MBPP and Doppler followed by those with only abnormal MBPP (p-value<0.0001).Conclusions: MBPP is a better predictor of perinatal outcome compared to umbilical artery Doppler USG in high-risk pregnant women. MBPP should be done in all high-risk pregnancies even if Doppler is normal. Both the tests must be performed in all high-risk pregnancies to improve perinatal outcome.