Salmonellosis in a young Amazonian manatee (Trichechus inunguis) / Salmonelose em um filhote de peixe-boi-da-amazônia (Trichechus inunguis)

ABSTRACT: The objective of this study was to describe a case of salmonellosis in an Amazonian manatee (Trichechus inunguis). The animal was rescued from a tributary of the Capim River, in the municipality of Goianésia do Pará, Pará, Brazil, kept in a pool, and died approximately five months after being rescued. The main changes observed at necropsy were that the cecum and colon had serosal hyperemia, wall edema, thickened mucosa with ulcerated areas and covered by a thin layer of fibrin, and a yellowish liquid content. Histologically, there was moderate multifocal fibrinonecrotic typhlocolitis associated with intense bacterial colonization. Salmonella enterica subsp. enterica (rough) was isolated in cecum and colon fragments. This is the first report of salmonellosis in an Amazonian manatee.

RESUMO: O objetivo deste trabalho é descrever um caso de salmonelose em um peixe-boi-da-amazônia (Trichechus inunguis). O animal foi resgatado em um afluente do rio Capim, no município de Goianésia do Pará, Pará, Brasil, sendo mantido em uma piscina e morrendo aproximadamente cinco meses após o resgate. As principais alterações observadas na necropsia foram ceco e colón com hiperemia da serosa; edema da parede; mucosa espessada, com áreas ulceradas e revestida por uma fina camada de fibrina; e conteúdo líquido amarelado. Histologicamente havia tiflocolite fibrinonecrótica, multifocal, moderada, associada a intensa colonização bacteriana. Em fragmentos de ceco e cólon foi isolada Salmonella enterica subsp. enterica (rugosa). Este é o primeiro relato de salmonelose em peixe-boi-da-amazônia.

Students perceptions about the pedagogic strategies for teaching-learning anatomy at university Eduardo Mondlane in Mozambique

Background: From the need to develop a new curriculum for the medical course, changing the traditional model used for teaching Gross Anatomy it was sought to incorporate active teaching methodologies which can allow students to be more involved in the process of knowledge construction. The way in which Gross Anatomy is delivered in most Faculties of Medicine has been seen as a big challenge to the teachers and the students too as a consequence of permanent changes that are required in order to be in line with the technological development. This study aimed to explore the student's perceptions about the effectiveness of the strategies and resources, used in teaching-learning Gross Anatomy in the medical course at EMU.Methods: Data were collected using a questionnaire administrated to those medical students who attended (1st and 2nd year) Gross Anatomy subjects, in November 2018. Descriptive statistics and data content analysis were performed. The sample comprised 171 students.Results: A convergence of strategies preferred by the students involved in the study was seen. It was recognized that Gross Anatomy curriculum was designed based on the limitations of the use of cadaver dissection, with the emphasis on applied anatomy and learning in small groups using other resources, including computer assisted learning based on the 3-D Slicer software.Conclusions: It appears that the students' desire is that the teaching-learning strategies used in Anatomy classrooms at UEM might contribute to their better training for the professional challenges when graduated. They perceived that with the strategies used for teaching Anatomy, they are being very well prepared to get in an entrepreneurial, transformative profile and are able to learn more complex contents in order to provide a qualified health care to people in the performance of their future functions as doctors.

Trends in mortality of adult patients diagnosed with myeloid leukemia from 1994 to 2011 in southeastern Brazil

Objective: To evaluate trends in mortality among adults with myeloid leukemia in the Vale do Paraíba, State of São Paulo. Methods: Data from the Brazilian National Health Service database DATASUS provided the number of deaths caused by myeloid leukemia and the number of inhabitants per year in the Regional Health Division XVII from 1994 to 2011. Registries were categorized according to gender into four age ranges (over 20 years, 20-49, 50-69 and over 70 years) for an estimation of the annual percent change for age-adjusted mortality rates. The percent changes were calculated using the Joinpoint regression analysis model. Results: Overall, a significant decline per year was demonstrated for the entire sample (over 20 years) across the 18-year period studied (annual percent change: −5.59%; 95% CI: −8.5 to −2.5% for males; p-value < 0.05 and −7.02%; 95% CI −11.2 to −2.8% for females; p-value < 0.05) with no significant difference between genders. In an analysis using two Joinpoints, significant drops were observed from 1994 to 2001 (annual percent change: −21.22%; 95% confidence interval: −27.9 to −13.9%; p-value < 0.05) and from 1994 to 2003 (annual percent change: −12.86%; 95% confidence interval −22.2 to −2.5%; p-value < 0.05) for men and women, respectively. The declining trends were greatest for patients aged over 70 years with the age-adjusted mortality rates in younger groups declining non-significantly except for males aged 50-69 years old. Conclusion: Our data suggest a significant decline per year in age-adjusted mortality rates of adult patients diagnosed with myeloid leukemia from 1994 to 2011 in the Vale do Paraíba, State of São Paulo. .

Prevalence of anemia in a sample of elderly southeastern Brazilians

Objective: To demonstrate the proportion of anemia and its association with demographic and clinical characteristics in a representative sample of elderly people from São José dos Campos, São Paulo. Methods: Demographic data and blood samples were collected from 398 over 65-year-old male and female individuals. Anemia was defined as hemoglobin concentration <12 g/dL in women and <13 g/dL in men. Anemic and non-anemic groups were compared using the chi-squared test and a multiple logistic regression model. Results: The prevalence of anemia was 18.6% (20.8% in men and 17.6% in women). The per- centages of anemia rose significantly across the age groups >75-80, >85-90 and >90-95 years (p-value = 0.0251). There were no significant differences in gender, ethnic background, place of residence, years of schooling, income, comorbidities and use of medications. Accord- ing to gender, the mean hemoglobin concentration and mean corpuscular volume were 11.5 g/dL (range: 8.4-11.9 g/dL) and 90.7 fL (range: 63.0-111.7 fL) for women and 11.9 g/dL (range: 8.6-12.8 g/dL) and 92.1 fL (range: 59.8-100.1 fL) for men. The great majority of ane- mia cases were mild with less than 6% having hemoglobin concentrations below 10.9 g/dL. Mean corpuscular volume was lower than 80 fL in six cases (8%), between 80 and 100 fL in 65 cases (88%) and higher than 100 fL in three cases (4%). Conclusion: A total of 18.6% of elderly people from São José dos Campos had mild anemia with the majority being normocytic. The percentages of anemia rose as the age increased demonstrating an association between age and anemia. .

Transplante autólogo de células-tronco hematopoéticas no Vale do Paraíba-SP: aspectos demográficos, clínicos e curvas de sobrevida / Autologous stem cell transplant in Vale do Paraiba, State of São Paulo: demographics and clinical aspects and survival curves

Demonstrar as características demográficas clínicas e taxas de sobrevida geral (SG) de pacientes tratados com transplante de células-tronco hematopoéticas (TCTH) autólogo no Vale do Paraíba-SP. Métodos - Análise retrospectiva de 129 pacientes atendidos no Hospital Pio XII de São José dos Campos entre 2005 e 2011. Coletaram-se registros de prontuário clínico, viabilidade das células CD34+ descongeladas,número de células CD34+ reinfundidas, reações adversas ao dimetilsulfóxido (DMSO), tempo de recuperação de contagem de neutrófilos (>0.5x109/L) e plaquetas (>20x109/L) e antimicrobianos prescritos. A SG 5 anos após o TCTH autólogo foi estimada para pacientes com mieloma múltiplo (MM), linfoma Hodgkin (LH) e linfoma não Hodgkin (LNH). Resultados - Foram selecionados 129 pacientes (67 homense 62 mulheres). A mediana das idades foi de 51 anos (18-70), 63 pacientes apresentavam MM, 25 LH, 24 LNH, 9 tumor germinativo, 7 leucemia mielóide aguda e 1 leucemia linfoblástica aguda. A mediana do número de células CD34+ reinfundidas foi de 6,02x106/kg (2,23-15,7) com viabilidade celular após descongelamento de 79% (62-93). O tempo para recuperação foi de 12 dias (9-18) para neutrófilose 13 dias (10-21) para plaquetas. Três pacientes apresentaram reações adversas ao DMSO. Trinta e três pacientes (25,6%) receberam antifúngico em associação aos antibióticos de amplo espectro de ação. As taxas de SG foram 57,7% (IC 33,8-71,5), 76,8% (IC 52,5-89,7) e 69,2% (IC 46,9-83,6) para MM, LH e LNH respectivamente. Conclusões - As características apresentadas demonstram que o TCTH autólogo é factível nesta região e as taxas de SG observadas em pacientes com MM, LH e LNH comparam-se favoravelmente com a literatura disponível...

To demonstrate the demographic and clinical aspects as well as the overall survival (OS) rates of patients treated with autologous stem cell transplantation (ASCT) in Vale do Paraíba-SP. Methods - Retrospective analysis of 129 patients from Pio XII Hospital of São José dos Campos that received treatment between 2005 and 2011. Data from the pronctuaries of the patients, number of CD34+ cells reinfused, viability of defrosted CD34+ cells, reactions induced by dimethylsulfoxide (DMSO), time to recover neutrophils and platelets count and antimicrobial agents prescribed were collected. Five-year OS was measured in patients with multiple myeloma (MM), Hodgkin´s lymphoma(HL) and non-Hodgkin´s lymphoma (NHL). Results - The median age was 51 years (18-70) among the 129 patients selected (67 male and 62 female). 63 had MM, 25 HL, 24 NHL, 9 germ cell tumors, 7 acute myeloid leukemia and 1 acute lymphoblastic leukemia. The median of number of CD34+ cells reinfused was 6.02 x 106/kg (2.23-15.7) with 79% (62-93%) of viable cells after defrost. Times to neutrophils and platelets count recovery were 12 (9-18) and 13 (10-21) days, respectively. Three patients showed DMSO-induced reactions. Thirty three patients(25.6%) were treated with antifungal in association with extended spectrum antibiotic. Five-year OS were 57.7% (CI 33.8-71.5) for MM patients, 76.8% (CI 52.5-89.7) for HL and 69.2% (CI 46.9-83.6) for NHL. Conclusions - The collected data provided evidence that the ASCT in Vale do Paraiba has favorable OS rates for patients with MM, HL and NHL in comparison to previously reported data from similar treatment in other regions...

Avaliação das condições microbiológicas de um frigorífico bovino / Evaluation of the microbiological condition of a bovine fridge

As Doenças Transmitidas por Alimentos são consideradas um problema para a saúde pública. A higiene correta dos alimentos é necessária para garantir a segurança e a salubridade dos mesmos em todos os estágios de sua elaboração. Dentro deste contexto, objetivou-se avaliar as condições microbiológicas de diversos pontos de superfícies inanimadas e das mãos dos manipuladores em um frigorífico bovino do Noroeste Paulista. Foram coletadas 230 amostras, sendo que 140 pertenciam ao monitoramento de higiene pré-operacional e 90 ao monitoramento de higiene operacional. Para tais coletas, foram utilizados swabs estéreis, acondicionados em tubos com Solução Salina Peptonada com Tween 80. Do total de amostras coletadas, 19,57% se encontram fora dos padrões ideais de higiene, sendo que 12,17% são referentes às amostras coletadas no monitoramento de higiene pré-operacional e 7,40% ao monitoramento de higiene operacional. É de grande importância a avaliação das condições microbiológicas de superfícies inanimadas e mãos de manipuladores para evitar a contaminação dos alimentos, mesmo quando submetidos ao processamento térmico.

Fatal hepatitis B reactivation treated with entecavir in an isolated anti-HBs positive lymphoma patient: a case report and literature review

Hepatitis B virus [HBV] reactivation is a well-recognized complication that occurs in lymphoma patients who undergo chemotherapy. Only very few cases of HBV reactivation in patients with isolated antibody against hepatitis B surface antigen [anti-HBs] have been reported. We present a case of a 78-year-old woman diagnosed with diffuse large B cell non-Hodgkin's lymphoma who only displayed a positive anti-HBs, as the single possible marker of occult HBV infection, before starting therapy. She was treated with several chemotherapeutic regimens [including rituximab] for disease relapses during 3 years. Forty days after the last cycle of chemotherapy, she presented with jaundice, markedly elevated serum aminotransferase levels, and coagulopathy. HBV serology showed positivity for HBsAg, anti-HBc and anti-HBs. HBV DNA was positive. Antiviral treatment with entecavir was promptly initiated, but the patient died from liver failure. A review of the literature of HBV reactivation in patients with detectable anti-HBs levels is discussed