Lesión quirúrgica de la vía biliar en residentes. Experiencia de un Centro Formador Universitario / Surgical injury of the biliary tract in residents. Experience of a University Training Center

La lesión quirúrgica de la vía biliar es una complicación peligrosa de la colecistectomía, con importantes secuelas postoperatorias para el paciente en términos de morbilidad, mortalidad y calidad de vida. Tienen una incidencia laparoscópica estimada del 0,4% al 1,5% y del 0,2% al 0,3% en la colecistectomía convencional. El objetivo de este estudio fue evaluar la incidencia de LQVB durante la formación del cirujano y la importancia de realizar colangiografía intraoperatoria (COI) durante esta etapa

Bile duct surgical injury is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality and quality of life. These have an estimated laparoscopic incidence of 0.4% to 1.5% and 0.2% to 0.3% in conventional cholecystectomy. The aim of this study was to evaluate the incidence of LQVB during surgeon training and the importance of performing intraoperative cholangiography (IOC) during this stage

Variables Referentes al Capital y la Responsabilidad Social Relacionadas con Conductas de Precaución Contra el COVID-19 en Tres Muestras Mexicanas / Variables Referring to Social Capital and Responsibility Associated to Precautionary Behaviors against COVID-19 in Three Mexican Samples

Resumen Cumplir con las medidas de prevención de la salud es fundamental para controlar brotes de enfermedades infecciosas como aquellos causados por la COVID-19. Se han realizados numerosas investigaciones para comprender algunas variables psicosociales (desde personalidad hasta diferencias culturales) asociadas con las conductas de precaución en contextos de pandemia. Sin embargo, se sabe poco sobre el papel que el capital y la responsabilidad social pueden jugar en estos comportamientos de precaución en el contexto de la pandemia del COVID-19. El presente trabajo aborda variables psicológicas asociadas con el capital social y conductas socialmente responsables (e.g. amabilidad, empatía, apoyo social, justicia, impulsividad, conducta cívica), que ayudan a un grupo a desarrollar actividades socialmente valiosas propiciando el cumplimiento de las medidas de prevención. El presente estudio evaluó el efecto del capital social y variables asociadas (e.g., personalidad, apoyo social) en comportamientos precautorios relacionados con el COVID-19. Se utilizaron regresiones jerárquicas y modelos mediacionales en 3 diferentes muestras mexicanas (muestra 1: n=709, muestra 2: n=718, muestra 3: n= 309). Los resultados muestran que las variables asociadas con la responsabilidad social evaluadas aquí, con excepción de la legitimidad y la justicia distributiva, se relacionan con un mayor reporte de conductas de precaución. Estos resultados sugieren un enfoque encaminado a aumentar el capital y la responsabilidad social para reducir el efecto de enfermedades infecciosas como el COVID-19.

Abstract Compliance with health protection measures is essential to control outbreaks of infectious diseases such as COVID-19. Extensive research has been done in the pursuit of understanding psychosocial variables (e.g., personality to cultural differences) associated with precautionary behaviors. However, little is known about the role social capital and responsibility may play on these behaviors in the context of COVID-19. The present work assessed psychological variables associated with social capital and responsibility (e.g. agreeableness, empathy, social support, justice, impulsivity, civic behaviors), which help the development of socially valuable activities leading individuals to comply with preventative measures. The present study, using 3 different Mexican samples (sample 1, n=709; sample 2, n=718; sample 3, n= 309) explored the effect of social capital, civic culture, and associated variables (e.g., personality, social support) on COVID-19 related precautionary behaviors using hierarchical linear regressions and mediational models. In the first sample, we explored the relationship between empathy, impulsivity, and precautionary behaviors. In the second sample, we explored whether trust in authorities, social support, and social pressure predicted these behaviors. In the third sample, we used a longitudinal design to assess the mediating role of prosocial and socially responsible behaviors between personality and precautionary behaviors. Results from the first sample showed that empathy predicted precautionary behaviors. In the second sample, we observed that although legitimacy and distributive justice did not predict precautionary behaviors, social pressure had a negative and social support had a positive effect on these behaviors. Finally, our longitudinal data suggested that those who report higher conscientiousness and agreeableness also report more socially responsible and prosocial behaviors and in turn report higher precautionary behaviors. In general, results from all samples, showed that the variables associated with social capital and responsibility are significantly related with increased report of precautionary behaviors. These results suggest that efforts should be focused on increasing social capital and responsibility while seeking to reduce the spread and deleterious effects of infectious diseases like COVID-19.

Scarabs in the dark: occurrence of Scarabaeoidea beetles (Insecta: Coleoptera) in Brazilian caves

ABSTRACT Scarabeoidea (Insecta: Coleoptera) present more than 2000 species recorded from all over Brazil. They have been scarcely recorded from caves, and truly troglobitic species are yet to be found in the country. In this study, we carried out a review of all existing scarab beetles deposited until 2017 in the Coleção de Invertebrados Subterrâneos de Lavras (ISLA), at the Universidade Federal de Lavras (UFLA) (Minas Gerais, Brazil), one of the most important collections of subterranean invertebrates in South America. Ninety-two individuals belonging to 52 species were recorded, distributed in six families (Cetoniidae, Hybosoridae, Melolonthidae, Passalidae, Scarabaeidae and Trogidae). Scarabaeidae was the most diverse of them, representing more than 50% of the total of species recorded. We found Scarabeoidea beetles in 51 of the ~ 1600 caves examined, distributed in nine Brazilian states: Alagoas, Bahia, Distrito Federal, Espírito Santo, Goiás, Minas Gerais, Pará, Piauí, and Tocantins. Our results provide evidence that Scarabaeoidea beetles are not frequent in Brazilian caves, and their records in this kind of environment are mostly accidental. Exceptions include Trogidae and Aphodiinae species, which may be associated with bat guano. Our study presents the first list of Scarabaeoidea species sampled in Brazilian caves.

Does coping mediate the relationship between competitive anxiety and eating disorders in athletes? / O Coping medeia a relação entre ansiedade competitiva e transtornos alimentares em atletas? / Coping media la relación entre la ansiedad competitiva y los trastornos de la alimentación en los atletas?

The competitive anxiety shows positive and linear relationship with risk behaviors for eating disorders (RBED). The competitive anxiety shows negative and linear relationship with coping strategies. Perhaps the coping strategies can mediate the relationship between competitive anxiety and RBED in athletes. The aim of this study was to analyze the coping mediation between competitive anxiety and RBED in Brazilian male athletes. 739 athletes from various sports participated. To assess the RBED frequency, the Disordered Eating in Sports Scale was adopted. The Brazilian version of the Competitive State Anxiety Inventory was used to evaluate competitive anxiety. Athletic Coping Strategies Inventory was used to evaluate coping strategies. The findings revealed a direct relationship between competitive anxiety and RBED (p = .01). The results indicated that coping strategies potentiated the relationship between competitive anxiety and RBED (p = .01). It was concluded that coping can be considered a psychological determinant in the relationship between competitive anxiety and RBED.

A ansiedade competitiva possui relação positiva e linear com a frequência de comportamentos de risco para os transtornos alimentares (CRTA). A ansiedade competitiva apresenta relação negativa e linear com as estratégias de coping. Talvez o coping possa mediar a relação entre a ansiedade competitiva e a frequência de CRTA em atletas. O objetivo do estudo foi analisar a mediação do coping entre a ansiedade competitiva e os CRTA em atletas brasileiros do sexo masculino. Participaram 739 atletas. Para avaliação da frequência de CRTA, foi adotada a Disordered Eating in Sports Scale. Utilizou-se a versão brasileira do Competitive State Anxiety Inventory (CSAI-2R) para avaliar a ansiedade competitiva. Foi utilizado o Athletic Coping Strategies Inventory para avaliar as estratégias de coping. Os achados revelaram relação direta entre a ansiedade competitiva e os CRTA (p = .01). Os resultados indicaram que as estratégias de coping potencializaram a relação entre a ansiedade competitiva e os CRTA (p = .01). Concluiu-se que o coping pode ser considerado uma variável psicológica determinante na relação entre a ansiedade competitiva e os CRTA.

No se sabe si el afrontamiento media la relación entre la ansiedad y los comportamientos de riesgo para los trastornos de la alimentación (CRTA) en atletas. El objetivo del estudio fue analizar la mediación de afrontamiento entre la ansiedad competitiva y CRTA en los atletas masculinos brasileños. Participaron 739 atletas. Para evaluar la frecuencia de los CRTA se adoptó Disordered Eating in Sports Scale. Se utilizó la versión brasileña del Competitive State Anxiety Inventory para evaluar la ansiedad competitiva. Se utilizó el Athletic Coping Strategies Inventory para evaluar las estrategias de afrontamiento. Los resultados revelaron una relación directa entre la ansiedad competitiva y CRTA (p = .01). Los resultados indicaron que las estrategias de afrontamiento potenciaron la relación entre la ansiedad competitiva y CRTA (p = .01). Se concluyó que el afrontamiento se puede considerar una variable psicológica decisiva en la relación entre la ansiedad competitiva y CRTA.

Cross-cultural adaptation of the Internet Gaming Disorder Scale - Short Form (IGDS9-SF) to the Brazilian context

Abstract Introduction The Internet Gaming Disorder Scale - Short Form (IGDS9-SF) assesses the severity, harmful effects and/or consequences of excessive online and offline gaming. Its conciseness and theoretical foundations on current diagnostic criteria of gaming disorders make it a useful resource for clinical and screening settings. Objective To describe the process of cross-cultural adaptation of the IGDS9-SF to the Brazilian context. Methods The cross-cultural adaptation involved the steps of independent translation of the instrument, synthesis version, back-translation, pre-test and elaboration of the final version. Content validity assessment was conducted by a multidisciplinary committee of experts and consisted of both a quantitative analysis (calculation of content validity coefficients - CVC) and a qualitative analysis (assessment of the experts' comments and suggestions). The pre-test sample consisted of 30 gamers with variable sociodemographic characteristics. Results The cross-cultural adaptation of the scale followed the proposed protocol, and the CVC was satisfactory (≥ 0.83) for all the structures and equivalences assessed. Most of the suggestions made by the experts were accepted (mainly adjustments and language standardization). The gamers who participated in the pre-test judged the scale easy to understand and did not suggest changes. Discussion The Brazilian version of the IGDS9-SF showed adequate content validity and is available for researchers and clinicians, as well as for the investigation of additional psychometric characteristics.

Impacto nutricional da cirurgia bariátrica: estudo comparativo do Bypass gástrico em Y de Roux e do Sleeve entre pacientes dos sistemas público e privado de saúde / Nutritional impact of bariatric surgery: a comparative study of Roux-en-Y Gastric Bypass and Sleeve gastrectomy between patients from the public and private health systems

RESUMO Objetivos: Comparar a evolução do perfil nutricional de pacientes submetidos ao bypass gástrico em Y de Roux (BGYR) e ao Sleeve, em hospitais dos setores público e privado da Saúde de Pernambuco. Método: O estudo incluiu pacientes submetidos à cirurgia bariátrica nos setores público e privado de saúde de Pernambuco no período de 2008 a 2016. Foram avaliados dados antropométricos e bioquímicos (Hemoglobina, Vitamina B12, Ferro e Ferritina) no período pré-operatório e com 3, 6 e 12 meses de pós-operatório. Resultados: Não foram registradas diferenças significativas entre os pacientes internados nos dois setores da Saúde no tocante às variáveis: níveis hemoglobina, anemia por deficiência de ferro e vitamina B12 em nenhuma das avaliações e conforme o tipo de cirurgia. Entre os pacientes submetidos ao BGYR, os níveis de ferro sérico foram significativamente menores nos pacientes do setor privado da Saúde apenas na primeira avaliação. Baixos níveis de ferritina sérica foram observados na segunda avaliação, sendo os pacientes do setor privado os que apresentaram menores valores. O sucesso cirúrgico foi significativamente maior no grupo que realizou o BGYR na rede privada. Conclusões: Com um seguimento de 12 meses pós-cirurgia bariátrica, não foi observada diferença estatisticamente significante no que diz respeito às deficiências de micronutrientes entre pacientes usuários dos setores público e privado de Saúde.

ABSTRACT Purpose: To compare the nutritional status follow up of patients who underwent Roux-en-Y gastric bypass (BGYR) and Sleeve gastrectomy (SG) in hospitals of the private and public health systems, in Pernambuco. Methods: This study included patients who underwent bariatric surgery in the public and private health systems, in Pernambuco, from 2008 to 2016. Anthropometric and biochemical (hemoglobin, B12, iron and ferritin) data were evaluated in the preoperative period and at 3, 6 and 12 months after the operation. Results: There were no significant difference between patients seen at the two health systems regarding the levels of hemoglobin, iron, anemia and vitamin B12. Patients who underwent the RYGB, presented with iron deficiency which was significantly lower for those in the private system, but only at the 3 month evaluation. Low levels of ferritin were observed at the 6 month evaluation, and patients in the private health system presented with the highest ferritin deficiency. The rate of surgical success was significantly higher in those patients undergoing the RYGB at the private system. Conclusions: After a 12-month bariatric surgery follow-up, there was no statistically significant difference regarding micronutrient deficiency between patients followed up at the private and public health systems.

Análisis de las lesiones encefálicas en resonancia magnética en pacientes con señales transitorias de alta intensidad detectadas por Doppler transcraneal / Analysis of Encephalic Lesions in Magnetic Resonance Imaging in patients with High Intensity Transient Signals detected on Transcranial Doppler

Resumen Objetivo: Describir los hallazgos en resonancia magnética (RM) de encéfalo en pacientes menores de 65 años que fueron estudiados por Doppler transcraneal (DTC) con contraste de microburbujas, con antecedentes de accidente cerebrovascular (ACV) criptogénico y sospecha de foramen oval permeable (FOP). Materiales y métodos: Este estudio transversal retrospectivo incluyó pacientes de ambos sexos, menores de 65 años. Resultados: Nuestra muestra (n = 47, 47% masculino y 53% femenino, edad media de 42 años) presentó señales transitorias de alta intensidad (HITS, por su sigla en inglés) positivo en el 61,7% y HITS-negativo en el 38,3%. En pacientes HITS-positivo, predominaron las lesiones a nivel de las fibras en U subcorticales, únicas o múltiples con distribución bilateralmente simétrica. En pacientes con HITS moderados, predominaron las lesiones en el territorio vascular de la circulación posterior. Conclusión: En pacientes menores de 65 años con ACV criptogénico y lesiones en fibras en U subcorticales, únicas o múltiples con distribución bilateral y simétrica, debe tenerse en cuenta un FOP como posible causa de dichas lesiones.

Abstract Objectives: To analyze the findings on brain magnetic resonance imaging (MRI) in patients less than 65 years of age with history of cryptogenic stroke and suspected patent foramen ovale (PFO) who were studied with Contrast-Transcranial Doppler. Materials and Methods: This transversal retrospective study included both, men and women less than 65 years of age. Results: Our sample (n = 47, 47% male and 53% female, average age 42 years old) had High Intensity Transient Signals (HITS)-positive in 61.7% and HITS-negative in 38.3%. In HITS-positive patients, lesions were predominantly located on the subcortical U fibers, lone or multiple bilateral symmetric distributions. In patients with moderate-severity HITS, the posterior circulation was the most affected. Conclusion: In patients less than 65 years of age with cryptogenic stroke with lesions affecting the subcortical U fibers, with unique or multiple bilateral symmetric distributions, a PFO should be considered as an underlying cause.

Molecular characteristics of methicillin-resistant Staphylococcus aureus isolates from hospital and community environments in northeastern Brazil

ABSTRACT This study characterized 30 MRSA isolates from intensive care unit (ICU) environment and equipment surfaces and healthy children. The SCCmec types I, IVa and V were detected in HA-MRSA isolates while CA-MRSA showed the SCCmec type IVa and V. Most isolates were classified as agr group II. All isolates presented the sei gene, and only HA-MRSA were positive for etb e tst genes. Three genotypes were related to Pediatric (ST5/SCCmecIV) and Berlin (ST45/SCCmecIV) clones. The present study showed molecular similarity between CA- and HA-MRSA isolates in hospital and community settings in a Brazilian region.

Eficácia e segurança da toxina botulínica no tratamento da paraparesia espástica: revisão sistemática / Efficacy and safety of botulinum toxin in the treatment of spastic paraparesis: systematic review

A paraparesia espástica é caracterizada pela perda de função total ou parcial dos membros inferiores associado ao aumento do tônus muscular velocidade-dependente. A toxina botulínica é utilizada no tratamento de diversos padrões de espasticidade, sejam em flexão, extensão ou adução. Objetivo: determinar a eficácia e segurança do bloqueio químico com toxina botulínica em pacientes com paraparesia espástica. Método: foi realizada uma revisão sistemática com busca nas bases de dados do PUBMED, MEDLINE, LILACS e SCIELO. Os critérios de inclusão foram: ensaios clínicos que utilizaram a toxina botulínica para o tratamento de pacientes com paraparesia espástica e publicados em inglês a partir da década de 1980. Os desfechos considerados foram: a pontuação na Escala de Ashworth Modificada, a amplitude de movimento passiva e ativa e os efeitos adversos da toxina botulínica. Resultados: foram incluídos cinco artigos. Todos mostraram melhora da espasticidade nos pacientes estudados. Quatro artigos mostraram aumento da amplitude de movimento passivo e três relataram aumento da amplitude de movimento ativo. Três artigos trouxeram relatos de efeitos adversos após o uso da toxina botulínica, mas a maioria deles não eram graves e cessaram espontaneamente. Conclusão: os estudos analisados mostraram que a toxina botulínica é eficaz e segura em pacientes com paraparesia espástica.(AU)

Spastic paraparesis is the loss of total or partial lower limb function associated with increased speed-dependent muscle tone. Botulinum toxin is used in the treatment of several spasticity presentations that include flexion, extension and adduction. Objective: To determine both safety and efficacy of botulinum toxin as a blocking agent in the treatment of spastic paraparesis. Method:A systematic review was carried out with a search on PUBMED, MEDLINE, LILACS and SCIELO databases. The inclusion criteria were: clinical trials that used botulinum toxin for the treatment of patients with spastic paraparesis and published in English from the 1980s. The following outcomes were assessed by the studies: the Ashworth Modified scale score, the range of passive and active motion and botulinum toxin adverse effects. Results:Five articles were included. All of them showed spasticity improvements in the patients. Four studies showed increases in passive range of motion and three articles showed increase in active range of motion. Three papers reported adverse effects after botulinum toxin use but they were mostly mild and ceased spontaneously. Conclusion: Most analyzed studies indicated that botulinum toxin is safe and efficient inthe treatment of spastic paraparesis. (AU)

Osteologia do membro torácico de Lycalopex gymnocercus Fischer, 1814 (Carnivora, Mammalia): abordagens comparada, radiográfica e osteométrica / Osteology of the thoracic limb in the Lycalopex gymnocercus Fischer, 1814 (Carnivora, Mammalia): comparative, radiograpahic and osteometric approaches

O membro torácico é a parte do esqueleto pós-craniano que mais informações oferece sobre a locomoção e hábitos de vida de uma espécie. Objetivou-se realizar uma descrição macroscópica, comparativa, radiográfica e osteométrica do esqueleto do membro torácico de Lycalopex gymnocercus. Para tal foram analisados ossos de 24 espécimes adultos coletados mortos em rodovias. Foram realizadas descrições macroscópicas e comparadas com as de outros canídeos, imagens radiográficas para reconhecimento dos padrões de trabeculação e topografia óssea, mensurações lineares e tridimensionais e avaliações histológicas das clavículas. O esqueleto do membro torácico de L. gymnocercus apresentou adaptações morfofuncionais em todos os segmentos para a locomoção cursorial especializada e alguma capacidade de pronação e supinação para captura de presas de porte menor. Houve uma tendência de os ossos serem maiores nos machos, especialmente na região distal do úmero, presumivelmente para a fixação de músculos antebraquiais mais fortes. A clavícula vestigial foi encontrada em todos os espécimes, teve natureza predominantemente cartilagínea e foi significativamente maior nos machos. A conformação básica do esqueleto do membro torácico foi semelhante à dos canídeos domésticos e silvestres descritos na literatura, ainda que particularidades de L. gymnocercus sejam encontradas.(AU)

The forelimb is the part of the post-cranial skeleton that provides more information about locomotion and life habits of a species. The objective of this study was to perform a detailed macroscopic, comparative, radiographic and osteometric investigation of the thoracic limb of Lycalopex gymnocercus. Twenty-four adult specimens collected dead from roadkill were studied. Analysis included macroscopic and comparative descriptions to other canids, radiographic images for recognition of trabeculation patterns and topographical arrangement of bones, linear and three-dimensional measurements, and histological evaluation of the clavicles. The forelimb skeleton of L. gymnocercus presented morphological and functional adaptations in every segment for a specialized cursorial locomotion and some ability to pronation and supination for capture of small vertebrates. There was a tendency for the bones to be longer in males, especially in the distal end of humerus, presumably to fixation of stronger antebrachial muscles. The vestigial clavicle bone was found in all the specimens, had a predominantly cartilaginous nature and was significantly larger in males. The basic conformation of the forelimb skeleton was similar to that of domestic and wild canids described in the literature, although peculiar characteristics of L. gymnocercus have been found.(AU)

Bacterial pathogens of the lower respiratory tract of calves from Brazilian rural settlement herds and their association with clinical signs of bovine respiratory disease / Patógenos bacterianos do trato respiratório inferior de bezerros criados em rebanhos de assentamentos brasileiros e sua associação com os sinais clínicos da doença respiratória dos bovinos

Bovine respiratory disease (BRD) is considered the major cause of economic losses in dairy and beef cattle production. The study aimed to detect the most important bacteria related to respiratory disease in tracheobronchial fluid samples of healthy and dairy calves with clinical signs of BRD in Brazilian rural settlements. Hundred and forty-one mongrel dairy calves were randomly selected from 42 family farm dairy herds from Brazilian settlements. Physical examination was performed and calves were classified as healthy (n=100) and BRD (n=41). Tracheobronchial fluid samples were collected. Isolation and molecular detection of Mycoplasma dispar, M. bovis and M. mycoides subsp. mycoides SC besides isolation of other aerobic bacteria were performed. Abnormal lung sounds (crackle/snoring/whistle), mucopurulent/purulent nasal discharge, body temperature >39.5°C and respiratory rate >40 breaths/min were higher in BRD calves compared to healthy calves (P<0.05). Bacillus sp., Staphylococcus intermedius and non-fermentative Gram-negative were the most prevalent bacteria isolated. Non-identified species from Enterobacteriaceae family was higher in BRD calves compared to healthy calves (P<0.05). Mollicutes were isolated in 7.4% of samples and only M. dispar was detected. Mollicutes was associated with purulent/mucopurulent nasal discharge (P=0.017). Pantoea agglomerans was associated to tachypnea (P=0.020), and Streptococcus spp. was associated with hyperthermia. Statistical tendencies were observed to M. dispar and tachypnea (P=0.066), and P. agglomerans and tachycardia (P=0.066). The obtained results describe the microorganisms found in tracheobronchial fluid of calves with BRD in some herds of Brazilian family farming and their relation to clinical signs of BRD.(AU)

A doença respiratória dos bovinos (DRB) é considerada a principal causa de perdas econômicas nas produções de leite e carne. O objetivo deste estudo foi detectar as mais importantes bactérias relacionadas a doença respiratória presentes em amostras de lavado traqueobrônquico de bezerros sadios e com sinais clínicos da DRB de assentamentos brasileiros. Cento e quarenta e um bezerros leiteiros sem raça definida foram randomicamente selecionados de 42 rebanhos leiteiros de assentamentos brasileiros. Exame físico foi realizado e os animais foram classificados em sadios (n=100) e com DRB (n=41). Amostras de lavado traqueobrônquico foram coletadas. Foram realizados o isolamento e a detecção molecular de Mycoplasma dispar, M. bovis e M. mycoides subsp. mycoides SC além de isolamento de outras bactérias aeróbias. Ruídos pulmonares anormais (crepitação/ ronco/sibilo), secreção nasal mucopurulenta/purulenta, temperatura corporal >39.5°C e frequência respiratória >40 movimentos respiratórios/min foram observados com maior frequência em bezerros com DRB comparado aos animais sadios (P<0.05). Bacillus sp, Staphylococcus intermedius e bactérias Gram-negativas não fermentadoras foram as bactérias mais prevalentes. Bactérias da família Enterobacteriaceae cuja espécie não fora identificada foram mais frequentes em bezerros com DRB comparado aos bezerros sadios (P<0.05). Mollicutes foram isolados em 7,4% das amostras e somente M. dispar foi detectado. Mollicutes foi associado à secreção nasal purulenta/mucopurulenta (P=0.017). Pantoea agglomerans foi associada a taquipneia (P=0.020), e Streptococcus spp. Foi associado a hipertermia. Tendência estatística foi observada para M. dispar e taquipneia (P=0.066), e P. agglomerans e taquicardia (P=0.066). Os resultados obtidos descrevem os micro-organismos encontrados no lavado traqueobrônquico de bezerros com DRB em rebanhos de agricultura familiar brasileira e sua relação com as manifestações clínicas da DRB.(AU)

Community-acquired methicillin-resistant Staphylococcus aureus carrying SCCmec type IV and V isolated from healthy children attending public daycares in northeastern Brazil

Abstract Nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) have increasingly been reported in healthy communities. This study aimed to assess the rate of S. aureus in general and MRSA in particular from nasal secretion of children in daycare centers in Vitória da Conquista, Brazil. The isolates were identified based on morphology, biochemical tests and by PCR. Detection of virulence genes, biofilm production, and susceptibility test by disk diffusion agar were performed. MRSA isolates were characterized by spa, SCCmec, and multilocus sequence typing (MLST). S. aureus were recovered from 70 (47.3%) of 148 children. Among the 11 MRSA strains (15.7%), two SCCmec types (IV and V) were detected. MLST identified four STs related to three clonal complexes (CC): 5, 45, and 398. Four spa types were found circulating in this setting. Resistance of S. aureus isolates to ampicillin, erythromycin, ciprofloxacin, clindamycin, and tetracycline was 80%, 32.8%, 7.1%, 7.1% and 4.3%, respectively. One isolate presented intermediate resistance to vancomycin detected by Etest methodology. All strains were biofilm producers. The virulence genes seb, sec, spa, and pvl were detected in some isolates. This study revealed a high rate of children carrying MRSA among healthy attendees in daycare centers in Vitória da Conquista, Brazil.

Molecular characterization of ureaplasmas isolated from reproductive tract of goats and sheep from Brazil

Abstract Ovine/caprine ureaplasmas have not yet been assigned a species designation, but they have been classified into nine serotypes. Herein ureaplasmas were searched for in 120 samples of vulvo vaginal mucous from sheep and 98 samples from goats at 17 farms. In addition, semen samples were collected from 11 sheep and 23 goats. The recovered ureaplasma were from sheep and goats from animals without any reproductive disorder symptoms, but not all animals presented positive cultures. In sheep, 17 (68%) cultures of vulvovaginal mucous were positive for ureaplasma and 11 (27%) samples of semen presented positive cultures in animals with clinical signs of orchitis, balanoposthitis or low sperm motility. In goats four ureaplasma isolates were obtained from vulvovaginal mucus, but the semen samples were all negative. The isolates were submitted to Pulsed-field gel electrophoresis methodology and their 16S rRNA genes were sequenced. Fifty percent of ureaplasma recovered from sheep allowed for PFGE typing. Eleven isolates showed eight profiles genetically close to the bovine ureaplasmas. The 16S rRNA gene sequencing showed differences or similarities of isolates from sheep and goats, and the reference strains of bovine and human ureaplasma. Four clinical isolates from sheep were grouped separately. The studied ureaplasma isolates showed to be a diverse group of mollicutes.

A simple technique can reduce cardiopulmonary bypass use during lung transplantation

Cardiopulmonary bypass causes an inflammatory response and consumption of coagulation factors, increasing the risk of bleeding and neurological and renal complications. Its use during lung transplantation may be due to pulmonary hypertension or associated cardiac defects or just for better exposure of the pulmonary hilum. We describe a simple technique, or open pericardium retraction, to improve hilar exposure by lifting the heart by upward retraction of the pericardial sac. This technique permits lung transplantation without cardiopulmonary bypass when bypass use is recommended only for better exposure.

Carotid artery stenting in the context of endovascular treatment of acute ischemic stroke / Angioplastia com stent de carótida no contexto do tratamento endovascular do acidente vascular cerebral isquêmico agudo

ABSTRACT Mechanical thrombectomy as an adjunctive to intravenous thrombolysis is now the standard treatment for acute ischemic stroke (AIS) due to large vessel occlusions. However, the best management of acute carotid tandem occlusions (CTO) remains controversial. Method Twenty patients underwent endovascular treatment of acute CTO. The primary endpoint was the composite rate of complete or partial recanalization without a symptomatic intracranial hemorrhage (sICH). Secondary endpoints were recanalization times, procedure times, and clinical outcomes at three months. Results The primary endpoint was reached in 17 (85%) patients. Recanalization rate was reached in 90% of patients (19/20) and sICH rate was 5% (1/20). At the 3-month follow-up we obtained a mRS ≤ 2 rate of 35% (7/20) and a mortality rate of 20% (4/20). Conclusion Carotid angioplasty stenting and endovascular treatment of AIS due to CTO appears effective with an acceptable rate of sICH.

RESUMO Trombectomia mecânica com stentrievers associada a trombólise endovenosa com rTPA é o tratamento padrão-ouro do acidente vascular cerebral isquêmico agudo (AVCi) devido à oclusões de grandes vasos. No entanto, a melhor estratégia terapêutica para oclusões carotídeas combinadas ainda permanece controversa. Método Vinte paciente receberam tratamento endovascular. O desfecho primário foi a taxa de recanalização completa sem sangramento intracraniano sintomático. Os desfechos secundários foram os tempos de recanalização, duração dos procedimentos e desfechos clínicos em 3 meses. Resultados O desfecho primário foi alcançado em 17 (85%) pacientes. A taxa de recanalização foi de 90% (19/20) e a taxa de HIS foi de 5% (1/20). Em três meses, foi obtido bom desfecho neurológico em 35% (7/20) dos pacientes e a mortalidade foi de 20% (4/20). Conclusão A angioplastia com stent de carotída associada ao tratamento endovascular para oclusões combinadas agudas de carótida parece ser efetiva sem um aumento de HIS.