Emotional, hyperactivity and inattention problems in adolescents with immunocompromising chronic diseases during the COVID-19 pandemic

Abstract Objective: To assess factors associated with emotional changes and Hyperactivity/Inattention (HI) motivated by COVID-19 quarantine in adolescents with immunocompromising diseases. Methods: A cross-sectional study included 343 adolescents with immunocompromising diseases and 108 healthy adolescents. Online questionnaires were answered including socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and validated surveys: Strengths and Difficulties Questionnaire (SDQ), Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0). Results: The frequencies of abnormal emotional SDQ scores from adolescents with chronic diseases were similar to those of healthy subjects (110/343 [32%] vs. 38/108 [35%], p = 0.548), as well as abnormal hyperactivity/inattention SDQ scores (79/343 [23%] vs. 29/108 [27%], p = 0.417). Logistic regression analysis of independent variables associated with abnormal emotional scores from adolescents with chronic diseases showed: female sex (Odds Ratio [OR = 3.76]; 95% Confidence Interval (95% CI) 2.00-7.05; p < 0.001), poor sleep quality (OR = 2.05; 95% CI 1.08-3.88; p = 0.028) and intrafamilial violence during pandemic (OR = 2.17; 95% CI 1.12-4.19; p = 0.021) as independently associated with abnormal emotional scores, whereas total PedsQL score was inversely associated with abnormal emotional scores (OR = 0.95; 95% CI 0.93-0.96; p < 0.0001). Logistic regression analysis associated with abnormal HI scores from patients evidenced that total PedsQL score (OR = 0.97; 95% CI 0.95-0.99; p = 0.010], changes in medical appointments during the pandemic (OR = 0.39; 95% CI 0.19-0.79; p = 0.021), and reliable COVID-19 information (OR = 0.35; 95% CI 0.16-0.77; p = 0.026) remained inversely associated with abnormal HI scores. Conclusion: The present study showed emotional and HI disturbances in adolescents with chronic immunosuppressive diseases during the COVID-19 pandemic. It reinforces the need to promptly implement a longitudinal program to protect the mental health of adolescents with and without chronic illnesses during future pandemics.

Anoftalmia congénita bilateral: reporte de caso y revisión de la literatura / Bilateral congenital anophthalmia: clinical case report and literature review

Objetivo: Presentar un caso clínico de anoftalmia bilateral congénita y documentar lo encontrado en la literatura sobre esta condición. Diseño del estudio: Reporte de caso clínico. Método: Descripción de un caso clínico de un neonato con anoftalmia bilateral congénita nacido en el Hospital Universitario San Ignacio y que fue atendido por el servicio de oftalmología de la misma institución. Resultados: Se presenta el caso de un paciente masculino con diagnóstico de anoftalmia congénita bilateral y atresia tricuspídea con vasos en D-transposición con coartación aórtica, sin otras malformaciones asociadas ni factores ambientales desencadenantes. Esta es una patología poco frecuente, cuya etiología y procesos fisiopatológicos no se conocen aún en su totalidad. Es relevante continuar el seguimiento y los procesos diagnósticos para esclarecer su proceso de desarrollo y la totalidad de malformaciones complejas con las que puede encontrarse en asociación

Objective: To present a clinical case of congenital bilateral anophthalmia and document what is found in the literature on this entity. Study design: Clinical case report. Method: Description of a clinical case of a neonate with congenital bilateral anophthalmia that was born at the Hospital Universitario San Ignacio and who was treated by the Ophthalmology service in the same institution. Results: We present the case of a male patient with a diagnosis of bilateral congenital anophthalmia and tricuspid atresia with vessels in D-transposition with aortic coarctation, without other associated malformations or environmental risk factors. This is a rare pathology, of which etiology and pathophysiological processes are not yet fully understood. It is relevant to continue follow up and diagnostic processes to clarify its development processes and the entirety of complex malformations with which it can be in association with

Diagnostic performance of brain Natriuretic Peptide, Bioelectrical Impedance Analysis, and Left Ventricular End-Diastolic Diameter in the Determination of Fluid Overload and Mortality In Pediatric Sepsis

Objective@#This pilot study investigated whether serum B-type Natriuretic Peptide (BNP), bioelectrical impedance analysis (BIA), and left ventricular end-diastolic diameter (LVEDD) can be used to predict fluid overload and clinical outcomes in pediatric sepsis. @*Methods@#Pediatric sepsis patients were enrolled. BNP, BIA, and LVEDD were obtained on admission and on Day 3. Diagnostic performances of BNP, BIA, LVEDD and correlation with fluid status were obtained.@*Results@#Twenty-two patients were enrolled. Day 3 BNP was higher in non-survivors (9241 vs. 682.2 pg/mL, p=0.04) and day 3 LVEDD Z-score was lower in non-survivors (-3.51 vs. -0.01, p=0.023). There was no difference in the fluid balance between survivors and non-survivors. Admission BNP >670.34pg/mL predicted vasopressor use with a sensitivity of 85.71% and specificity of 86.67% while ΔBNP>5388.13pg/mL predicted mortality with 100% sensitivity. Day 3 LVEDD <22mm predicted mortality with a sensitivity of 94.74%. Cumulative fluid balance was strongly correlated with BIA and LVEDD (r=0.65, p=0.001; r=0.74, p<0.001 respectively). The median length of stay in hospital days for non-survivors was not significantly different from survivors (4 [1-12] vs. 8 [6-12] days,p=0.21). @*Conclusion@#Rise in BNP levels appear to be independent of fluid status and is a good predictor of mortality, vasopressor, and mechanical ventilator use but not of length of hospital stay. LVEDD and BIA are good estimates of cumulative fluid balance but not as predictors of mortality, vasopressor, mechanical ventilator use, and length of hospital stay. Significance of the outcomes of the study was limited due to the small sample size.

High prevalence of HIV-associated neurocognitive disorders (HAND) in São Paulo City, Brazil / Alta prevalência de desordem neurocognitiva associada ao HIV (HAND) na Cidade de São Paulo, Brazil

INTRODUCTION: HIV-associated neurocognitive disorders (HAND) are the subject of many studies, some of them reporting a prevalence of up to 50 percent. OBJECTIVES: To determine the prevalence and factors associated with HIV neurocognitive disorders (HAND) in a cohort of HIV-1-infected patients in São Paulo city, Brazil. METHODOLOGY: Descriptive cross-sectional study including 106 HIV-1-infected patients, employing direct interview and neuropsychological tests, applied by trained neuro-psychologists with expertise in the tests. Other, similar assessment tools we used were Brief Neurocognitive Questionnaire, International HIV Dementia Scale, Lawton Instrumental Activities of Daily Living, Hospital Anxiety and Depression Scale, Social Support Scale for People with HIV/Aids, Assessment of Adherence to Antiretroviral Therapy Questionnaire, and a complex neuropsychological assessment. RESULTS: We included 106 patients from May 2015 to April 2018. We found a high prevalence of HAND in our patients (45%), with 27.5% presenting asymptomatic neurological impairment (ANI) and 17.5% mild neurological dysfunction (MND); only one patient presented HIV-associated dementia (HAD) (0.9%). Women were more likely to have MND (52.9%) and the only case of HAD was also female. The high prevalence of neurocognitive disorders was independent of the immunological status, use of efavirenz, or virological control. CONCLUSIONS: This study may mirror the national and international scenarios, showing a high prevalence of HAND (45%) and the prevalence of some risk factors, in special among women

INTRODUÇÃO: As doenças neurocognitivas associadas ao HIV (HAND), são o assunto de muitos estudos, alguns deles relatando uma prevalência de até 50 por cento. OBJETIVOS: Determinar a prevalência e os fatores associados aos distúrbios neurocognitivos do HIV (HAND) em uma coorte de pacientes infectados pelo HIV-1 na cidade de São Paulo, Brasil. METODOLOGIA: Estudo transversal descritivo incluindo 106 pacientes infectados pelo HIV-1, utilizando entrevista direta e testes neuropsicológicos, aplicados por neuropsicólogos treinados com experiência nos testes. Foram utilizados também: Questionário Neurocognitivo Breve, Escala Internacional de Demência do HIV, Atividades Instrumentais de Vida Diária de Lawton, Escala Hospitalar de Ansiedade e Depressão, Escala de Apoio Social para Pessoas com HIV / Aids, Avaliação da Adesão à Terapia Antiretroviral Questionário e uma bateria de avaliação neuropsicológica complexa. RESULTADOS: Foram avalaidos 106 pacientes de maio de 2015 a abril de 2018. Foi observado uma alta prevalência de HAND em nossos pacientes (45%), com 27,5% apresentando comprometimento neurológico assintomático (ANI) e 17,5% comprometimento cognitive leve (MND); apenas um paciente apresentou demência associada ao HIV (DAH) (0,9%). As mulheres eram mais propensas a ter MND (52,9%) e o único caso de HAD também era do sexo feminino. A alta prevalência de distúrbios neurocognitivos foi independente do estado imunológico, uso de efavirenz ou controle virológico. CONCLUSÕES: Este estudo pode espelhar o cenário nacional e internacional, mostrando uma alta prevalência de HAND (45%) e a prevalência de alguns fatores de risco, em especial entre as mulheres

Shapes of pathology

ABSTRACT: The shape is one of the key features of a lesion and a pathologist must be able to identify and interpret these forms in the context of any gross and microscopic changes. One of the principles of adult learning is to engage the learner with previously understood information. If, when presenting material that is new, a connection with something the student already has familiarity with, the learning process is accelerated. As the learners are already familiar with shapes they have encountered throughout their pre-pathology learning, these can be used to hasten the incorporation and understanding of lesions. This paper describes various shapes that are used in describing lesions in veterinary pathology.

RESUMO: A forma é uma das principais características de uma lesão. Um patologista deve ser capaz de identificar e interpretar essas formas no contexto de quaisquer alterações macroscópicas ou microscópicas. Um dos princípios da aprendizagem de adultos é envolver o aluno com informações previamente compreendidas. Se, ao apresentar um material novo, se estabelece uma conexão com algo que o aluno já conhece, o processo de aprendizagem torna-se mais rápido e eficiente. Como os alunos já estão familiarizados com as formas que encontraram ao longo de sua aprendizagem pré-patologia, elas podem ser usadas para acelerar a incorporação e a compreensão das lesões. Este artigo descreve várias formas que são usadas na descrição de lesões em patologia veterinária.

Acute necrotic hepatotoxicity caused by Lantana camara L. ingestion in dairy cattle

ABSTRACT: This study describes an outbreak of acute necrotic hepatopathy associated with spontaneous poisoning by Lantana camara L. in dairy cattle. A herd of 15 cows and heifers was introduced into a native pasture with limited food supply, and, sixteen days later, eight animals had spontaneous nasal hemorrhage, fever, lethargy, jaundice, and dry, dark stools with mucus and blood. The clinical course varied from two to five days. In the pasture where the cattle were kept, abundant adult specimens of L. camara L. with evident signs of consumption were observed. In total, seven cattle died and necropsy was performed in three of them. All animals had moderate jaundice, hemorrhage in the subcutaneous tissue and on the surface of different organs. The liver was slightly enlarged, with orange discoloration and enhanced lobular pattern. Histologically, multifocal areas of coagulative necrosis of hepatocytes in the centrilobular area, occasionally extending to the midzonal area, were observed, as well as marked hepatocellular degeneration and prominent cholestasis. The current study suggests that L. camara L. poisoning should be considered a differential diagnosis of acute and necrotic hepatotoxicity in cattle, despite the absence of photosensitization.

RESUMO: Esse estudo descreve um surto de hepatopatia necrótica aguda associada a intoxicação espontânea por Lantana camara L. em bovinos leiteiros. Um lote de 15 vacas e novilhas foram introduzidas em um piquete com campo nativo, com escassa oferta de alimento. Após dezesseis dias, oito animais manifestaram epistaxe, febre, apatia, icterícia, fezes ressecadas e escuras com muco e sangue. A evolução do quadro clínico variou de dois a cinco dias. No piquete em que os bovinos estavam alojados havia grande quantidade de L. camara L. com sinais evidentes de consumo. No total, sete bovinos morreram, e destes, o exame post mortem foi realizado em três. Os bovinos exibiam moderada icterícia, hemorragias no tecido subcutâneo e na superfície de diferentes órgãos. O fígado estava discretamente aumentado, com coloração alaranjada e padrão lobular evidente. As lesões histológicas consistiam em acentuada necrose de coagulação de hepatócitos em região centrolobular, por vezes se estendendo a região mediozonal, além de acentuada degeneração dos hepatócitos e evidente Colestase. O presente trabalho alerta para que intoxicação por L. camara L. seja levada em consideração nos diagnósticos diferenciais de hepatotoxicidade necrótica aguda em bovinos, mesmo sem indícios de fotossensibilização.

Gestational echobiometry in brachycephalic bitches using high-definition ultrasonography

ABSTRACT: The objective of the present study was to obtain echobiometric values for the most important canine maternal-fetal tissues using high-definition ultrasonography (HDUS) trying to update the formulas for predicting gestational age. Twelve healthy bitches of brachycephalic breeds weighing 7-13kg and aged one to four years were included. The fetuses were analyzed every day using conventional and high-definition ultrasonography from the eighth day after artificial insemination until the day of delivery, using the ACUSON S2000/SIEMENS ultrasound equipment and specific software. Embryonic and fetal structures; diameter of the embryonic vesicle; length of the embryo; biparietal diameter, abdominal length and kidney height; length of the femur, humerus, scapula, radius, and tibia; thickening of the stomach wall; adrenal length; and cardiac size were measured. These variables were correlated with gestational and adjusted tested according to regression models. The results obtained (P 0.001) for: lateral diameter of the gestational sac (R2=81.8%); length of the embryo (R2=85.7%); biparietal (R2=99.1%) and abdominal diameter (R2=97.2%); thickness of the gastric wall (R2=86.9%); length of the femur (R2=96.6%), radius (R2=97.5%), humerus (R2=96.5%), scapula (R2=95.8%) and tibia (R2=97.3%); kidney length (R2=95.8%) and height (R2=96.0%); adrenal length (R2=89.6%); heart length (R2=93.0%) and height (R2=91.5%) of the canine fetuses showed significant correlation with gestational days. This allowed monitoring fetal growth and estimation of age with high accuracy in different gestational periods.

RESUMO: O objetivo do presente estudo foi obter valores ecobiométricos para os tecidos materno-fetais caninos, usando a ultrassonografia de alta definição (HDUS), desenvolvendo fórmulas para prever a idade gestacional das cadelas. Doze cadelas saudáveis de raças braquicefálicas pesando 7-13kg e com idades entre um e quatro anos foram incluídas. Os fetos foram analisados diariamente com ultrassonografia convencional e de alta definição, do oitavo dia após a inseminação artificial até o dia do parto, utilizando o equipamento de ultrassom ACUSON S2000/SIEMENS e software específico. Estruturas embrionárias e fetais; diâmetro da vesícula embrionária; comprimento do embrião; diâmetro biparietal, comprimento abdominal e altura renal; comprimento do fêmur, úmero, escápula, rádio e tíbia; espessamento da parede do estômago; comprimento adrenal; e tamanho cardíaco foram medidos. Essas variáveis foram correlacionadas com o teste gestacional e ajustado de acordo com os modelos de regressão. Os resultados obtidos (P 0,001) para: diâmetro lateral do saco gestacional (R2=81,8%); comprimento do embrião (R2=85,7%); diâmetro biparietal (R2=99,1%) e abdominal (R2=97,2%); espessura da parede gástrica (R2=86,9%); comprimento do fêmur (R2=96,6%), rádio (R2=97,5%), úmero (R2=96,5%), escápula (R2=95,8%) e tíbia (R2=97,3%); comprimento do rim (R2=95,8%) e altura (R2=96,0%); comprimento adrenal (R2=89,6%); o comprimento do coração (R2=93,0%) e a altura (R2=91,5%) dos fetos caninos apresentaram correlação significativa com os dias gestacionais. Isso permitiu monitorar o crescimento fetal e estimar a idade com alta precisão em diferentes períodos gestacionais.

Gestational echobiometry in brachycephalic bitches using high-definition ultrasonography / Ecobiometria gestacional em cadelas braquicefálicas utilizando ultrassonografia de alta-definição

The objective of the present study was to obtain echobiometric values for the most important canine maternal-fetal tissues using high-definition ultrasonography (HDUS) trying to update the formulas for predicting gestational age. Twelve healthy bitches of brachycephalic breeds weighing 7-13kg and aged one to four years were included. The fetuses were analyzed every day using conventional and high-definition ultrasonography from the eighth day after artificial insemination until the day of delivery, using the ACUSON S2000/SIEMENS ultrasound equipment and specific software. Embryonic and fetal structures; diameter of the embryonic vesicle; length of the embryo; biparietal diameter, abdominal length and kidney height; length of the femur, humerus, scapula, radius, and tibia; thickening of the stomach wall; adrenal length; and cardiac size were measured. These variables were correlated with gestational and adjusted tested according to regression models. The results obtained (P<0.001) for: lateral diameter of the gestational sac (R2=81.8%); length of the embryo (R2=85.7%); biparietal (R2=99.1%) and abdominal diameter (R2=97.2%); thickness of the gastric wall (R2=86.9%); length of the femur (R2=96.6%), radius (R2=97.5%), humerus (R2=96.5%), scapula (R2=95.8%) and tibia (R2=97.3%); kidney length (R2=95.8%) and height (R2=96.0%); adrenal length (R2=89.6%); heart length (R2=93.0%) and height (R2=91.5%) of the canine fetuses showed significant correlation with gestational days. This allowed monitoring fetal growth and estimation of age with high accuracy in different gestational periods.(AU)

O objetivo do presente estudo foi obter valores ecobiométricos para os tecidos materno-fetais caninos, usando a ultrassonografia de alta definição (HDUS), desenvolvendo fórmulas para prever a idade gestacional das cadelas. Doze cadelas saudáveis de raças braquicefálicas pesando 7-13kg e com idades entre um e quatro anos foram incluídas. Os fetos foram analisados diariamente com ultrassonografia convencional e de alta definição, do oitavo dia após a inseminação artificial até o dia do parto, utilizando o equipamento de ultrassom ACUSON S2000/SIEMENS e software específico. Estruturas embrionárias e fetais; diâmetro da vesícula embrionária; comprimento do embrião; diâmetro biparietal, comprimento abdominal e altura renal; comprimento do fêmur, úmero, escápula, rádio e tíbia; espessamento da parede do estômago; comprimento adrenal; e tamanho cardíaco foram medidos. Essas variáveis foram correlacionadas com o teste gestacional e ajustado de acordo com os modelos de regressão. Os resultados obtidos (P<0,001) para: diâmetro lateral do saco gestacional (R2=81,8%); comprimento do embrião (R2=85,7%); diâmetro biparietal (R2=99,1%) e abdominal (R2=97,2%); espessura da parede gástrica (R2=86,9%); comprimento do fêmur (R2=96,6%), rádio (R2=97,5%), úmero (R2=96,5%), escápula (R2=95,8%) e tíbia (R2=97,3%); comprimento do rim (R2=95,8%) e altura (R2=96,0%); comprimento adrenal (R2=89,6%); o comprimento do coração (R2=93,0%) e a altura (R2=91,5%) dos fetos caninos apresentaram correlação significativa com os dias gestacionais. Isso permitiu monitorar o crescimento fetal e estimar a idade com alta precisão em diferentes períodos gestacionais.(AU)

Shapes of pathology / As formas da patologia

The shape is one of the key features of a lesion and a pathologist must be able to identify and interpret these forms in the context of any gross and microscopic changes. One of the principles of adult learning is to engage the learner with previously understood information. If, when presenting material that is new, a connection with something the student already has familiarity with, the learning process is accelerated. As the learners are already familiar with shapes they have encountered throughout their pre-pathology learning, these can be used to hasten the incorporation and understanding of lesions. This paper describes various shapes that are used in describing lesions in veterinary pathology.(AU)

A forma é uma das principais características de uma lesão. Um patologista deve ser capaz de identificar e interpretar essas formas no contexto de quaisquer alterações macroscópicas ou microscópicas. Um dos princípios da aprendizagem de adultos é envolver o aluno com informações previamente compreendidas. Se, ao apresentar um material novo, se estabelece uma conexão com algo que o aluno já conhece, o processo de aprendizagem torna-se mais rápido e eficiente. Como os alunos já estão familiarizados com as formas que encontraram ao longo de sua aprendizagem pré-patologia, elas podem ser usadas para acelerar a incorporação e a compreensão das lesões. Este artigo descreve várias formas que são usadas na descrição de lesões em patologia veterinária.(AU)

Diseases of the central nervous system in swine in Southern Brazil / Doenças do sistema nervoso central de suínos no Sul do Brasil

Brazil is the fourth largest exporter of pork worldwide, with its production concentrated in the Southern region of the country. To reduce the economic impacts and increase herd health, an efficient diagnosis of diseases is necessary. The frequency, seasonal, and annual distribution of diseases that affecting the swine nervous system in Southern Brazil were determined through a retrospective study conducted from 2008 to 2018. A total of 231 pigs were evaluated, and distributed in the following phases: suckling piglets, nursery, growing, finishing, and adults. Piglets in the nursery phase were the most affected with 58.01%. Infectious diseases accounted for 87.01% (201/231) of lesions in the nervous system. Bacterial meningitis was observed in 58.87% of cases, presenting an endemic distribution, and a propensity to occur in the months of autumn/winter. The highest number of cases of porcine circovirus-2 were observed in 2008 and 2009, with a subsequent decline. Porcine circovirus, salt poisoning, and brain abscesses exhibited no association between the seasonal occurrence and annual distribution. Salt poisoning was observed more frequently in the last years of this study. Both, non-suppurative encephalomyelitis and selenium toxicosis exhibited an association between their occurrence and seasonal distribution in, the months of winter, and summer, respectively.(AU)

Brasil é o quarto maior exportador de carne suína do mundo, com sua produção concentrada na região Sul do país. Para reduzir os impactos econômicos e aumentar a saúde do rebanho, é necessário o diagnóstico eficiente das doenças. A frequência, distribuição sazonal e anual das doenças que afetam o sistema nervoso de suínos no Sul do Brasil foram determinadas através de um estudo retrospectivo no período de 2008 a 2018. Foram avaliados 231 suínos, distribuídos nas seguintes fases: maternidade, creche, crescimento, terminação e adultos. Leitões da fase de creche foram os mais afetados com 58,01%. As doenças de origem infecciosa foram responsáveis por 87,01% (201/231) das causas de lesões no sistema nervoso. Meningite bacteriana foi observada em 58,87% dos casos, apresentando distribuição endêmica, e uma tendência a ocorrer nos meses de outono/inverno. O maior número de casos de circovírus suíno foram observados em 2008 e 2009, com declínio posterior. Circovírus suíno, intoxicação por sal e os abscessos encefálicos não apresentaram associação entre a ocorrência sazonal e distribuição anual. A intoxicação por sal foi observada com maior frequência nos últimos anos deste estudo. A encefalomielite não supurativa e a intoxicação por selênio exibiram associação entre a sua ocorrência e distribuição sazonal, nos meses de inverno e verão, respectivamente.(AU)

Acute necrotic hepatotoxicity caused by Lantana camara L. ingestion in dairy cattle / Hepatotoxicidade necrótica aguda por ingestão de Lantana camara L. em bovinos leiteiros

This study describes an outbreak of acute necrotic hepatopathy associated with spontaneous poisoning by Lantana camara L. in dairy cattle. A herd of 15 cows and heifers was introduced into a native pasture with limited food supply, and, sixteen days later, eight animals had spontaneous nasal hemorrhage, fever, lethargy, jaundice, and dry, dark stools with mucus and blood. The clinical course varied from two to five days. In the pasture where the cattle were kept, abundant adult specimens of L. camara L. with evident signs of consumption were observed. In total, seven cattle died and necropsy was performed in three of them. All animals had moderate jaundice, hemorrhage in the subcutaneous tissue and on the surface of different organs. The liver was slightly enlarged, with orange discoloration and enhanced lobular pattern. Histologically, multifocal areas of coagulative necrosis of hepatocytes in the centrilobular area, occasionally extending to the midzonal area, were observed, as well as marked hepatocellular degeneration and prominent cholestasis. The current study suggests that L. camara L. poisoning should be considered a differential diagnosis of acute and necrotic hepatotoxicity in cattle, despite the absence of photosensitization.(AU)

Esse estudo descreve um surto de hepatopatia necrótica aguda associada a intoxicação espontânea por Lantana camara L. em bovinos leiteiros. Um lote de 15 vacas e novilhas foram introduzidas em um piquete com campo nativo, com escassa oferta de alimento. Após dezesseis dias, oito animais manifestaram epistaxe, febre, apatia, icterícia, fezes ressecadas e escuras com muco e sangue. A evolução do quadro clínico variou de dois a cinco dias. No piquete em que os bovinos estavam alojados havia grande quantidade de L. camara L. com sinais evidentes de consumo. No total, sete bovinos morreram, e destes, o exame post mortem foi realizado em três. Os bovinos exibiam moderada icterícia, hemorragias no tecido subcutâneo e na superfície de diferentes órgãos. O fígado estava discretamente aumentado, com coloração alaranjada e padrão lobular evidente. As lesões histológicas consistiam em acentuada necrose de coagulação de hepatócitos em região centrolobular, por vezes se estendendo a região mediozonal, além de acentuada degeneração dos hepatócitos e evidente Colestase. O presente trabalho alerta para que intoxicação por L. camara L. seja levada em consideração nos diagnósticos diferenciais de hepatotoxicidade necrótica aguda em bovinos, mesmo sem indícios de fotossensibilização.(AU)

Primary skin diseases and cutaneous manifestations of systemic diseases in swine / Doenças primárias da pele e manifestações cutâneas de doenças sistêmicas em suínos

Skin diseases in pigs can negatively impact the production. They cause losses related to the death of the affected pigs, to the cost with the treatment, growth retardation and condemnations in the slaughterhouses. This study was developed to determine the frequency and describe the histopathological findings of skin diseases in pigs in different age groups through a retrospective study from 2006 to 2018. A total of 154 conclusive cases were analyzed, including skin restricted diseases (allergic dermatitis, exudative epidermitis, vesicular dermatitis, pityriasis rosea, swinepox, follicular cyst, papilloma and scrotal hemangioma) or skin lesions secondary to systemic diseases (erysipelas, porcine dermatitis and nephropathy syndrome (PDNS), bacterial septicemia and multiple hemorrhages without definite cause). The skin lesions were classified as bacterial (46.1%), viral (26.6%), allergic (12.3%), neoplastic (1.3%) and others (13.6%). Swine erysipelas was the most frequent diagnosis (47/154), followed by PDNS (23/154), allergic dermatitis (19/154) and exudative epidermitis (15/154). Vesicular dermatitis (9/154), pityriasis rosea (9/154), septicemia with cutaneous manifestations (9/154), swinepox (9/154) and multiple hemorrhages without definite cause (7/154) were also observed. Follicular cyst (3/154), hyperkeratosis without definite cause (2/154), papilloma (1/154), and scrotal hemangioma (1/154) were less frequently described. Of the conclusive diagnosis, age was reported in 138 cases, with the highest frequency of skin lesions observed at the inspection process during slaughter (56/138).(AU)

As doenças de pele em suínos podem impactar negativamente a produção. Estas causam perdas relacionadas à morte dos acometidos, a custo com tratamentos, atraso no crescimento e condenações nos frigoríficos. Este trabalho foi desenvolvido para determinar a frequência e descrever os achados histopatológicos das doenças de pele em suínos nas diferentes faixas etárias, através de um estudo retrospectivo no período de 2006 a 2018. Foram analisados 154 casos conclusivos incluindo as doenças restritas a pele (dermatites alérgicas, epidermite exsudativa, dermatite vesicular, pitiríase rósea, varíola suína, cisto folicular, papiloma e hemangioma escrotal) e as secundárias a doenças sistêmicas (erisipela, síndrome dermatite nefropatia suína (SDNS), septicemia bacteriana e hemorragias múltiplas de causa não determinada). Estas foram classificadas em bacterianas (46,1%), virais (26,6%), alérgicas (12,3%), neoplásicas (1,3%) e outras (13,6%). A erisipela suína foi a enfermidade mais diagnosticada (47/154), seguida por SDNS (23/154), dermatite alérgica (19/154) e epidermite exsudativa (15/154). Observamos ainda dermatite vesicular (9/154), pitiríase rósea (9/154), septicemia bacteriana com manifestações cutâneas (9/154), varíola suína (9/154) e hemorragias múltiplas de causa não determinada (7/154). Em menor número, cisto folicular (3/154), hiperqueratose sem causa definida (2/154), papiloma (1/154) e hemangioma escrotal (1/154). Dos casos conclusivos, a idade foi informada em 138 casos, sendo a maior frequência das lesões de pele observadas na linha de inspeção, durante o abate (56/138).(AU)

Epidemiological and pathological aspects of noninfectious diseases of the gastrointestinal tract in 114 horses in Southern Brazil / Aspectos epidemiológicos e patológicos de doenças não infecciosas do trato gastrointestinal de 114 equinos no sul do Brasil

Equine colic is one of the most common cause of death in horses, but few studies have investigated specifically the conditions at the necropsy. This study aimed to describe the epidemiological and pathological features of noninfectious diseases of the gastrointestinal tract in horses. A retrospective study was conducted in search of cases of these diseases affecting horses from 2005 to 2017. During this period, 114 horses died of noninfectious diseases of the gastrointestinal tract, and the main causes were: primary gastric dilation (27/114), volvulus (27/114), enterolithiasis (20/114), rectal (colonic) perforation (15/114), gastric or cecocolonic impaction (10/114), incarcerations (6/114), intussusception (4/114), and others (5/114). Mixed breeds horses (56/114) and males (69/114) were mostly affected. The horses had a median and mean age of 10 and 10.9-years old, respectively. Primary gastric dilation was characterized by distension of the stomach by moderate to large amounts of content, which in 21 cases caused tearing of the stomach wall at the greater curvature (peritonitis), and the main predisposing factor was alimentary overload (17/27). Intestinal volvulus occurred within the small intestine (14 cases) and within the large intestines (13 cases). Grossly, there was intestinal ischemia with reddened to deep-black serosa and diffusely red mucosae. Enterolithiasis caused partial or complete obstruction of the right dorsal colon (9/20), transverse colon (4/20), small colon and right dorsal colon (3/20), rectum and right dorsal colon (2/20), and small colon (2/20). Viscera perforation and peritonitis occurred in 11 cases. Rectal (colonic) perforation involved the rectum (10/15), rectum/small colon (4/15), and the small colon (1/15). It was characterized by a focally extensive transmural tearing, associated with reddened borders, and retroperitoneal to diffuse peritonitis. Palpation related iatrogenic injuries (11/15) were the main cause. Impactions affected the large colon (7/10), the cecum (2/10), and the stomach (1/10). Incarcerations consisted of inguinoscrotal hernias (2/6), small intestine entrapment by a mesenteric failure (2/6), diaphragmatic hernia, and umbilical eventration. Grossly, the organs were constricted by a hernial ring, with intestinal ischemia and reddened to dark-red serosa. Predisposing factors included previous surgeries (2/6) and patent inguinal ring (1/6). Intussusception involved the small intestine (3/4) and ileocecum (1/4). Foals with lack of colostrum intake and concomitant pneumonia was a characteristic presentation (3/4). Grossly, the intussusceptum slipped into intussuscipiens, with diffuse deep black-red discoloration. Other causes included large colon displacement (2/5), extrinsic and intrinsic obstruction of the small intestine (2/5), and an intestinal adenocarcinoma. Noninfectious gastrointestinal diseases are major causes of death in horses. Epidemiological and gross features of the conditions should be accounted to obtain a final diagnosis of the cause of the colic.(AU)

A cólica em equinos é considerada como a principal causa de morte de cavalos, porém poucos estudos têm investigado especificamente as condições envolvidas através da necropsia. O objetivo desse estudo foi descrever os aspectos epidemiológicos e patológicos de doenças não infecciosas do trato gastrointestinal de equinos. Foi conduzido um estudo retrospectivo em busca de casos dessas doenças envolvendo cavalos de 2005 a 2017. Durante esse período, 114 equinos morreram devido a doenças não infecciosas do trato gastrointestinal, e as principais causas foram: dilatação gástrica (27/114), vólvulos (27/114), enterolitíase (20/114), ruptura retal (colônica) (15/114), compactação gástrica ou cecocolônica (10/114), encarceramentos (6/114), intussuscepções (4/114), e outros (5/114). Animais sem raça definida (56/114) e machos (69/114) foram mais afetados. Os equinos apresentavam uma média e mediana de idade de 10 e 10,9 anos, respectivamente. A dilatação gástrica primária era caracterizada por distensão do estômago por moderada a grande quantidade de conteúdo, que em 21 casos provocava ruptura da parede gástrica na curvatura maior (peritonite), e o principal fator predisponente foi sobrecarga alimentar (17/27). Vólvulo intestinal ocorreu no intestino delgado e no intestino grosso (14 e 13 casos, respectivamente). Macroscopicamente, havia isquemia intestinal com serosa avermelhada a enegrecida e mucosa difusamente avermelhada. A enterolitíase causou obstrução parcial ou completa do cólon dorsal direito (9/20), cólon transverso (4/20), cólon menor e cólon dorsal direito (3/20), cólon menor (2/20), e reto e cólon maior direito (2/20). Perfuração de vísceras e peritonite foram observadas em 11 casos. A ruptura retal (colônica) envolveu o reto (10/15), reto/cólon menor (4/15) e cólon menor (1/15). Essa era caracterizada por ruptura transmural focalmente extensa, com bordos avermelhados e peritonite retroperitoneal a difusa. Traumas relacionados à palpação (11/15) foram a principal causa. Compactações afetaram o cólon maior (7/10), ceco (2/10) e estômago (1/10). Encarceramentos consistiram em hérnias inguinoescrotais (2/6), encarceramento de alças intestinais por falha no mesentério (2/6), hérnia diafragmática e eventração umbilical. Macroscopicamente, os órgãos estavam constritos por um anel hernial, com isquemia intestinal e serosa avermelhada a vermelho-escura. Fatores predisponentes incluíram cirurgias prévias (2/6) e anel inguinal patente (1/6). Intussuscepções envolveram o intestino delgado (3/4) e íleoceco (1/4). A apresentação característica foi em potros com falta de colostro e concomitante pneumonia. Macroscopicamente, o intussuscepto deslizava em direção ao intussuscepiente, exibindo coloração vermelho-enegrecida difusa. Outras causas incluíram deslocamento de cólon maior (2/5), obstrução extrínseca e intrínseca do intestino delgado (2/5), e um caso de adenocarcinoma intestinal. Doenças não infecciosas são importantes causas de morte em equinos. Os aspectos epidemiológicos e macroscópicos das condições devem ser considerados para o que o diagnóstico final da causa da cólica seja obtido.(AU)

Neuroprotection and immunomodulation by dimethyl fumarate and a heterologous fibrin biopolymer after ventral root avulsion and reimplantation

Ventral root avulsion (VRA) is an experimental approach in which there is an abrupt separation of the motor roots from the surface of the spinal cord. As a result, most of the axotomized motoneurons degenerate by the second week after injury, and the significant loss of synapses and increased glial reaction triggers a chronic inflammatory state. Pharmacological treatment associated with root reimplantation is thought to overcome the degenerative effects of VRA. Therefore, treatment with dimethyl fumarate (DMF), a drug with neuroprotective and immunomodulatory effects, in combination with a heterologous fibrin sealant/biopolymer (FS), a biological glue, may improve the regenerative response. Methods: Adult female Lewis rats were subjected to VRA of L4-L6 roots followed by reimplantation and daily treatment with DMF for four weeks. Survival times were evaluated 1, 4 or 12 weeks after surgery. Neuronal survival assessed by Nissl staining, glial reactivity (anti-GFAP for astrocytes and anti-Iba-1 for microglia) and synapse preservation (anti-VGLUT1 for glutamatergic inputs and anti-GAD65 for GABAergic inputs) evaluated by immunofluorescence, gene expression (pro- and anti-inflammatory molecules) and motor function recovery were measured. Results: Treatment with DMF at a dose of 15 mg/kg was found to be neuroprotective and immunomodulatory because it preserved motoneurons and synapses and decreased astrogliosis and microglial reactions, as well as downregulated the expression of pro-inflammatory gene transcripts. Conclusion: The pharmacological benefit was further enhanced when associated with root reimplantation with FS, in which animals recovered at least 50% of motor function, showing the efficacy of employing multiple regenerative approaches following spinal cord root injury.(AU)

The APOB rs693 polymorphism impacts the lipid profile of Brazilian older adults

The apolipoprotein B (APOB) gene contains several polymorphic sites described as risk modifiers for cardiovascular events. The objective of this study was to verify the association of the classic APOB Xba I polymorphism (rs693) with atherosclerotic risk factors in a segment of the Brazilian elderly population considering their usual dietary intake. Clinical and biochemical characteristics as well as total caloric and fat intake data were determined from 644 elderly individuals. Polymorphism analysis was performed by conventional polymerase chain reaction followed by enzyme restriction. Statistical analyses compared measures and proportions according to different APOB genotypic combinations. Statistically significant association was found between Xba I polymorphism and serum LDL, total cholesterol, and total lipid levels, with important elevations among T homozygotes compared to the other genotypes. There was homogeneity in all other parameters analyzed (including intake pattern), with a tendency for reduced levels of circulating apolipoprotein B among TT individuals. Our results pointed out that genetic variation in APOB affected the lipemic profile of elderly individuals in a context not biased by diet, generating a pattern suggestive of secretory disorder of lipoprotein particles, with possible implication in atherosclerotic risk.

Alterações do córtex cingulado anterior como um preditor de resposta à terapia cognitivo-comportamental / Alterations of anterior cingulate cortex as predictors of response to cognitive-behavioral therapy

RESUMO Objetivo A terapia cognitivo-comportamental (TCC) tem eficácia bem-documentada na literatura científica para transtornos relacionados aos sintomas da ansiedade. No entanto, há uma parcela de pacientes que não responde ao tratamento psicoterápico. Por isso, os estudos sobre as alterações no córtex cingulado anterior (CCA) como preditoras neurais do tratamento têm contribuído para encontrar respostas sobre as diferenças nas respostas ao tratamento. O objetivo do presente estudo é descrever, por meio de revisão sistemática, os estudos encontrados até o ano de 2018 sobre o papel do CCA na predição de resposta à terapia. Métodos Foram realizadas buscas nas bases PsycInfo, Web of Science e PubMed com termos referentes ao tema "córtex cingulado anterior", "terapia cognitivo-comportamental" e "predição de respostas", incluindo estudos com neuroimagem estrutural e funcional. Resultados As buscas apresentaram 14 artigos sobre "transtorno de estresse pós-traumático (TEPT)", "transtorno obsessivo-compulsivo (TOC)" e "transtorno de ansiedade social (TAS)". Os estudos com neuroimagem estrutural apresentaram resultados promissores. A maior espessura do CCA foi preditora de melhor resposta ao tratamento para TEPT e TOC. Os resultados de neuroimagem funcional foram promissores para maior ativação como preditora de melhor resposta para TAS. Por outro lado, os resultados para TEPT apontaram que a menor ativação pode ser preditora de melhores respostas. Conclusão As alterações nos estudos de neuroimagem sugerem que o CCA tenha um papel de predição de resposta ao tratamento com TCC. Estudos posteriores com amostras maiores podem contribuir para a ampliação da eficácia nos tratamentos de tais transtornos.

ABSTRACT Objective The efficacy of cognitive-behavioral therapy (CBT) on the treatment of anxiety-related disorders has been well documented. However, a number of patients do not respond to psychotherapeutic treatment. Therefore, changes in the anterior cingulate cortex (ACC) as a neural predictor of treatment response have contributed to understanding the differences in treatment outcome. The aim of this study is to describe, through a systematic review, studies published until 2018 that investigate the role of the anterior cingulate cortex on the prediction of response to therapy. Methods Searches have been conducted in the PsycInfo, Web of Science and PubMed databases for articles related to the terms "anterior cingulate cortex", "cognitive-behavioral therapy" and "prediction of response", including studies with structural and functional neuroimaging. Results We selected 14 articles on "post-traumatic stress disorder (PTSD)", "obsessive-compulsive disorder (OCD)" and "social anxiety disorder (SAD)". Overall, Structural neuroimaging studies functional neuroimaging results were promising. A greater thickness on the ACC was associated with a better response to treatment for PTSD and OCD. Greater activation of the ACC was positively associated with a greater response to treatment for patients with SAD. On the other hand, for those with PTSD, lower activation may be a better predictor of improvement. Conclusion The structural and functional alterations observed in neuroimage studies suggest that the ACC has a role in predicting treatment response to CBT. Future studies with larger samples may contribute to the improvement of treatment efficacy in such disorders.