Creatina fosfocinasa MB como marcador diagnóstico de disfunción miocárdica en pacientes pediátricos con quemadura eléctrica / Creatine phosphokinase MB levels as a diagnostic marker of myocardial dysfunction in pediatric patients with electrical burns

Resumen Introducción: La disminución de la fracción de eyección ventricular izquierda (FEVI) como consecuencia de una disfunción ventricular se reporta dentro de las alteraciones cardiacas secundarias a una lesión eléctrica. Como complemento de la exploración física, la ecografía cardiaca enfocada (FoCUS) permite una evaluación rápida, no invasiva, que da información para contribuir a tomar mejores decisiones terapéuticas, sobre todo en pacientes en estado crítico. El objetivo de este estudio fue explorar la utilidad de la creatina fosfocinasa MB (CPK-MB) como marcador diagnóstico de disfunción miocárdica en pacientes de 6 a 18 años con quemadura eléctrica. Métodos: Durante el periodo de noviembre de 2018 a agosto de 2019 se llevó a cabo un estudio transversal analítico de 10 pacientes, de 6 a 18 años de edad, con quemadura eléctrica, en quienes se obtuvo el porcentaje de FEVI a través del protocolo FoCUS. Posteriormente, el porcentaje de FEVI se correlacionó con los valores de CPK-MB y el porcentaje de superficie corporal quemada (SCQ) en las primeras 24 horas después de la lesión. Resultados: Se encontraron 10 casos de quemadura eléctrica, ocho de sexo masculino y dos de sexo femenino, con una media de edad de 13 años. El 80% de estos casos presentó disminución leve de la FEVI (45-59%). Al realizar el protocolo FoCUS se reportó hipocinesia miocárdica en siete pacientes. Se encontró una correlación moderada entre la FEVI y los valores de CPK-MB (r = −0.671), aunque no se observó correlación entre la FEVI y la SCQ. Conclusiones: La ecografía cardiaca influye en la toma de decisiones y mejora el pronóstico de estos pacientes.

Abstract Background: The decrease of the left ventricular ejection fraction (LVEF) as consequence of a ventricular dysfunction is reported in cardiac alterations secondary to electrical injury. The focused cardiac ultrasound (FoCUS) helps to complete the clinical examination because it allows a faster non-invasive evaluation, and provides information that contributes to make better therapeutic decisions, especially those for patients in critical condition. The objective of this study was to explore the utility of creatine phosphokinase MB (CPK-MB) as a diagnostic tool of myocardial dysfunction in patients from 6 to 18 years old with electrical burn. Methods: From November 2018 to August 2019, we conducted a transversal analytic study of 10 children with electric burn (6 to 18 years of age), in whom the percentage of LVEF was obtained through the FoCUS protocol in the first 24 hours after injury. Results: We found 10 cases of electrical burn injury, eight males and two females, with an average of 13 years of age. Eighty percent of these cases showed a slight decrease in LVEF (45-59%). When performing the FoCUS protocol, myocardial hypokinesia was reported in seven patients. We observed a moderate correlation between LVEF and CPK-MB levels (r = −0.671), and no correlation between LVEF and body surface area affected by the electrical burn. Conclusions: The cardiac ultrasound influences decision making to improve the prognosis of these patients.

Serological survey of bluetongue virus in sheep from Minas Gerais / Inquérito sorológico do vírus da língua azul em ovinos de Minas Gerais

Bluetongue is an infectious, non-contagious disease that affects domestic and wild ruminants, caused by a virus from the Orbivirus genus, Reoviridae family, transmitted by arthropod vectors of the Culicoides genus. This paper aims to be the first serological survey of bluetongue in sheep from the Meso-regions of Campo das Vertentes and South and Southeast of Minas Gerais. Samples were collected from sheep from different properties. The serum samples were submitted to Agar Gel Immunodiffusion (AGID) and competitive Enzyme-Linked Immunosorbent Assay (cELISA). 303 serum samples were submitted to AGID and cELISA. In these samples, 164 (54.13%) were positive in the AGID technique, and 171 (56.44%) positive in the cELISA technique, with an almost perfect agreement between the techniques (kappa index = 0.887). In all visited properties, positive animals have been found in the herd. Animals acquired from properties of the studied mesoregions were more likely to be positive in IDGA and cELISA tests than animals acquired from properties in other regions of Brazil (p<0.001). These results suggest that bluetongue virus (BTV) is widespread in the mesoregions of Campo das Vertentes and South and Southeast of Minas Gerais.(AU)

A língua azul (LA) é uma doença infecciosa, não contagiosa, que acomete ruminantes domésticos e silvestres, causada por um vírus do gênero Orbivirus da família Reoviridae, transmitida por vetores artrópodes do gênero Culicoides. O presente estudo representa o primeiro trabalho a realizar um inquérito sorológico da língua azul em rebanhos ovinos nas Mesorregiões de Campo das Vertentes e Sul e Sudoeste de Minas Gerais. Foram coletadas amostras de soro de ovinos de diferentes propriedades. As amostras de soro foram submetidas aos testes de imunodifusão em gel de ágar (IDGA) e ensaio de imunoadsorção enzimática por competição (cELISA). Ao todo 303 amostras de soro foram submetidas ao IDGA e cELISA. Dessas amostras, 164 (54,13%) foram positivas na técnica de IDGA e 171 (56,44%) positivas na técnica de cELISA, havendo concordância quase perfeita entre as técnicas (índice kappa = 0,887). Em todas as propriedades visitadas, foram encontrados animais positivos no rebanho. Animais adquiridos de propriedades das Mesorregiões estudadas, tiveram mais chances de serem positivos nos testes de IDGA e cELISA do que animais adquiridos de propriedades de outras Regiões do Brasil (p<0,001). Esses resultados sugerem que o vírus da língua azul encontra-se disseminado em ovinos nas Mesorregiões de Campo das Vertentes e Sul e Sudoeste de Minas Gerais.(AU)

Left Ventricular Remodeling Patterns in Primary Healthcare / Padrões de Remodelamento Ventricular Esquerdo na Atenção Primária à Saúde

Abstract Background: Left ventricular remodeling (LVR) is related to both non-fatal and fatal outcomes. Objective: To describe the geometric patterns of the LV and their associations. Methods: A total of 636 individuals between the ages of 45 and 99 years in Rio de Janeiro, Brazil, were submitted to clinical evaluation, laboratory tests, electrocardiogram, and tissue Doppler echocardiography (TDE). The difference between categories was tested with Kruskall-Wallis with post hoc tests, once all variables studied are non-normally distributed and Pearson's Qui-square (categorical variables). Gross and adjusted ORs were estimated by logistic regression. The level of significance was 5% for all tests. Subjects had LVR characterized as: normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). Results: The prevalence of altered patterns was 33%. Subjects presented NG (n = 423; 67%); EH (n = 186; 29%); CH (n = 14; 2%); and CR (n = 13; 2%). The variables of gender, age, level of education and albumin/creatinine ratio (A/C), showed a relationship with the chance of EH even after adjustment. Conclusion: Approximately one third of the studied individuals had LVR and were at risk for developing heart failure. Altered A/C in urine was associated with EH, indicating an early relationship between cardiac and renal dysfunction.

Resumo Fundamento: O remodelamento ventricular esquerdo (RVE) está relacionado a desfechos não fatais e fatais. Objetivo: Descrever os padrões geométricos do VE e suas associações. Métodos: Um total de 636 indivíduos entre 45 e 99 anos no Rio de Janeiro, Brasil, foi submetido a avaliação clínica, exames laboratoriais, eletrocardiograma e ecocardiograma com Doppler tecidual (EDT). A diferença entre as categorias foi testada com Kruskall-Wallis com testes post hoc, uma vez que todas as variáveis estudadas não são normalmente distribuídas e o qui-quadrado de Pearson (variáveis categóricas). As ORs brutas e ajustadas foram estimadas por regressão logística. O nível de significância foi de 5% para todos os testes. Os indivíduos tinham RVE caracterizada como: geometria normal (GN), remodelamento concêntrico (RC), hipertrofia concêntrica (HC) e hipertrofia excêntrica (HE). Resultados: A prevalência de padrões alterados foi de 33%. Os sujeitos apresentaram GN (n = 423; 67%); HE (n = 186; 29%); HC (n = 14; 2%); e RC (n = 13; 2%). As variáveis sexo, idade, escolaridade e razão albumina/creatinina (A/C) mostraram relação com a chance de HE, mesmo após o ajuste. Conclusão: Aproximadamente um terço dos indivíduos estudados apresentavam RVE e corriam risco de desenvolver insuficiência cardíaca. A/C alterada na urina foi associada à HE, indicando uma relação precoce entre disfunção cardíaca e renal.

Preparation and resumption of clinic services after enhanced community quarantine: A consensus statement by the standards of medical practice and ethics committee

Readiness of Health Care Staff@#Statement 1. Family physicians and their staff should prepare themselves mentally, physically and emotionally before resuming clinic services. Prior to starting every clinic day, physicians and their staff should take their temperature and note respiratory symptoms. Statement 2. All clinical staff should be properly trained on proper use of PPEs, clinic disinfection, infection control and other safety procedures. Statement 3. Family Physicians should design an office management and operations plan that includes triage, patient flow, treatment and other patient care protocols including strict implementation of infection prevention and control procedures, management of PPE supplies and potential staff shortages. Statement 4. The clinic staff must inform their patients of the changes that may result from the new management and operations plan that will be made in the facility@*Clinic Procedures, Disinfection and Infection Control@#Statement 5. After undergoing proper triage, non-COVID 19 patients entering the clinic should use a hand sanitizer, step on a foot bath or pad soaked in chlorine or any approved disinfectant solution at the entrance. All clinic staff, patients and accompanying persons should be wearing at least a mask inside the clinic. They should be instructed to avoid touching their face or mask and perform hand hygiene immediately before and after if cannot be avoided. Statement 6. Appropriate visual alerts or educational posters regarding infection control, proper handwashing, cough or sneezing etiquette should be visible inside the clinic. Statement 7. The clinic facility must have infection prevention and control measures that adhere to international and local standards. Statement 8. After appropriate triaging, a family physician when attending to a patient shall wear mask, single use gloves and eye protection while apron or gown is optional. It is up to the discretion of the family physician to use higher level of protection based on his risk assessment of the clinic environment and if resources are available.@*Clinical Services@#Statement 9. As much as possible, family physicians should continue all primary care services in the clinics. However, it is advisable to first limit the service to non-COVID-19 (suspect or diagnosed) patients. Patients needing COVID-19 assessment and management should be referred to appropriate facilities and follow the guidelines set forth by the Department of Health. Statement 10. A patient who consulted and whose symptoms were resolved may choose not come back for follow-up. Patients with chronic diseases may be followed-up at longer intervals if their illness is stable. Statement 11. Referrals for further assessment, diagnostic tests, or other procedures not available in the clinic must first be coordinated with the referral center/site

Prevalence of Antimicrobial Resistance Among Vibrio spp. Isolated from the Digestive Tract of Cultured Penaeus vannamei

Shrimp digestive tract microflora has been considered important, as it provides several protective and metabolic functions. Misuse of antibiotics could lead to AMR in the gut microbial community, which could be transferred to humans. The present study aimed in determining the prevalence of the digestive tract microbial community and AMR associated with them. A total of 173 isolates were collected and characterised from the digestive tract of 120 shrimps, collected from six different regions of Maharashtra and Gujarat. A total of 144 gram negative isolates comprised predominantly of Vibrio spp were isolated and characterised. Antimicrobial susceptibility pattern of the isolates against 12 different antibiotics was carried out using disk diffusion method. Most of the isolates showed resistant against beta-lactam class of antibiotics and macrolide antibiotics. Among the 144 G negative isolates, 61 (39.5%) isolates were presumptively identified as Vibrio spp, based on their growth on the specific agar plates. Biochemical characterisation of the 61 Vibrio isolates revealed the presence of 31.14% of Vibrio cholerae, 31.14% of V. parahaemolyticus, 19.67% of V. vulnificus, 9.8% of V. harveyi and 8.2% of V. alginolyticus. The antibiogram profile showed that the 40 (74.07%) isolates were resistant to ampicillin, 24 (44.4%) were resistant to cephalothin, 21 (38.8%) were to aztreonam and 17 (31.5%) were resistant against erythromycin. Prevalence of multi-drug resistance was also observed among the bacterial isolates.

Experimental poisoning by Brachiaria decumbens in rabbits / Intoxicação experimental por Brachiaria decumbens em coelhos

Brachiaria spp. are important sources of forage for ruminants in Brazil, due to the easy cultivation, good resistance to drought, good adaptation to different soils and low maintenance cost. However, the ingestion of this grass has been related to photosensitization outbreaks in cattle and sheep with significant economic losses. The hepatotoxic effects related to the ingestion of grass are the formation of crystals and foamy macrophages due to the accumulation of toxic metabolites. The use of cattle and sheep in experiments involving the plant presents several obstacles in the ethical, economic and animal management. The objective of this study was to evaluate the sensitivity of rabbits as an experimental model for B. decumbens poisoning. Two experiments were carried out. In Experiment 1 four rabbits received the fresh plant in daily doses of 10, 20, 40 and 80g/kg body weight for 120 days. In Experiment 2 three rabbits received the fresh plant in amounts of 500g daily with duration of 210 days. The animals of Experiment 1 showed no clinical signs and no macroscopic and microscopic changes characteristic of B. decumbens poisoning. In Experiment 2 the animals also showed no clinical signs or significant macroscopic alterations. Histological analysis showed isolated foamy macrophages or present in random groups of cells in the liver and mesenteric lymph nodes. Samples of liver and mesenteric lymph nodes of the rabbits of Experiment 2 were submitted to the lectin-histochemistry technique. The WGA, sWGA and RCA lectins showed reactivity in foamy macrophages in both organs. This is the first study of our knowledge that demonstrates histopathological lesions caused expetimentally by Brachiaria spp. in rabbits, demonstrating its potential as an animal model.(AU)

Brachiaria ssp. são importantes fontes de forragem para ruminantes no Brasil, devido ao fácil cultivo, boa resistência a seca, boa adaptação a diferentes solos e baixo custo de manutenção. Entretanto, a ingestão desta gramínea está relacionada a surtos de fotossensibilização, em bovinos e ovinos, principalmente, ocasionando prejuízos econômicos significativos. Os efeitos hepatotóxicos relacionados à ingestão da gramínea são a formação de cristais e macrófagos espumosos causados pelo acúmulo de metabólitos tóxicos. A utilização de bovinos e ovinos em experimentos envolvendo a planta apresenta vários empecilhos, tanto no âmbito ético, econômico e no manejo dos animais. O objetivo do presente trabalho foi avaliar a sensibilidade de coelhos como modelo experimental para intoxicação por B. decumbens. No presente estudo foram realizados dois experimentos. O Experimento 1 utilizou quatro coelhos que receberam a planta fresca em doses diárias de 10, 20, 40 e 80 g/Kg de peso vivo durante 120 dias. O Experimento 2 utilizou três coelhos recebendo a planta fresca em quantidades de 500g diárias por animal com duração de 210 dias. No Experimento 1, os animais não apresentaram sinais clínicos e nem alterações macroscópicas e microscópicas características de intoxicação por B. decumbens. No Experimento 2 os animais também não apresentaram sinais clínicos e alterações macroscópicas significativas. Na análise histológica observou-se presença de macrófagos espumosos isolados ou em grupos aleatórios de células no fígado e nos linfonodos mesentéricos. Amostras de fígado e linfonodos mesentéricos dos animais do Experimento 2 foram submetidos à técnica de lectino-histoquímica. As lectinas WGA, sWGA e RCA apresentaram reatividade em macrófagos espumosos nos dois órgãos. Este é o primeiro trabalho de nosso conhecimento que demonstra lesões histopatológicas por Brachiaria spp conduzido de forma experimental em coelhos, demonstrando seu potencial como modelo animal nesse campo de estudo.(AU)

Sarcoptic mange (Sarcoptes scabiei) in wild canids (Cerdocyon thous) / Sarna sarcóptica (Sarcoptes scabiei) em cachorro-do-mato (Cerdocyon thous)

Crab-eating foxes (Cerdocyon thous) are wild canids found in practically all Brazilian states. They usually live and hunt in pairs, but can be found in small groups, which favors the transmission of diseases such as sarcoptic mange. This study aims to describe the epidemiological, parasitological and pathological findings of two fatal cases of sarcoptic mange in C. thous. Two wild canids were necropsied and cytological examination of skin and crust samples and histologic evaluation of various tissue samples were performed. Gross findings included poor body condition and extensive alopecia with thick skin crusts interspersed by intensely reddened alopecic areas. The cytological examination revealed numerous mites with short gnathosoma and rounded idiosoma that were transversally striated and presented triangular spines on the dorsal surface, terminal anus, and short and thick legs, characteristic of Sarcoptes scabiei. Histologic examination of the skin revealed numerous tunnels into and under the stratum corneum of the epidermis containing high amounts of S. scabiei. The mites were associated with marked acanthosis and hyperkeratosis, and mild superficial dermatitis. The findings reveal that sarcoptic mange is an important disease in wild canids.(AU)

Cachorros-do-mato (Cerdocyon thous) são canídeos selvagens encontrados em praticamente todos os estados brasileiros. Geralmente vivem e caçam em pares, mas podem ser encontrados em pequenos grupos, o que favorece a transmissão de doenças, como a sarna sarcóptica. O presente trabalho tem como objetivo descrever os achados epidemiológicos, parasitológicos e patológicos de dois casos fatais de sarna sarcóptica em cachorros-do-mato. Foram realizados necropsia de dois cachorros do mato, exame citológico de amostras de pele e crostas e exame histológico de amostras dos órgãos e tecidos. Na necropsia foram observados mau estado corporal, extensas áreas de alopecia, crostas cutâneas espessas que se desprendiam e eram intercaladas por áreas alopécicas intensamente eritematosas. No exame citológico foi observada grande quantidade de ácaros com gnatossoma curto e largo, idiossoma globoso, transversalmente estriado e com espinhos triangulares na superfície dorsal, ânus terminal e pernas curtas e grossas, característicos de Sarcoptes scabiei. Ao exame histológico da pele havia muitos túneis no estrato córneo da epiderme e abaixo dele, contendo grande quantidade de S. scabiei. Essas estruturas parasitárias estavam associadas a acantose e hiperqueratose acentuadas e dermatite superficial discreta. Os achados revelam a sarna sarcóptica como uma doença importante em cachorros do mato.(AU)

Placental lesions associated with abortion and stillbirth in goats naturally infected by Neospora caninum / Lesões placentárias associadas a abortos e natimortos em cabras naturalmente infectadas pelo Neospora caninum

Neospora caninum has been described as a parasite that sporadically causes reproductive problems in goats. Several aspects of the pathogenesis of neosporosis in naturally infected goats remain to be established. The aims of the present study were to characterize the placental lesions in goats naturally infected by N. caninum and to evaluate several diagnostic techniques for effective detection of this protozoan in the goat placenta. Some placentas in this study originated from abortion and stillbirth in which there were severe lesions. The lesions were characterized mainly by necrosis involving the mesenchyme of the chorionic villi and trophoblast cells often alongside mononuclear inflammation and in some cases with neutrophilic infiltration. N. caninum DNA was detected in these placentas, but parasite structures were not visualized through immunohistochemistry (IHC). However, five of 11 placentas from N. caninum-infected goats that gave birth to healthy kids had histological lesions characterized by mononuclear inflammation. Of these 11 placentas, N. caninum DNA was detected in seven, and N. caninum tachyzoites were detected in only one of these seven placentas using IHC. The present study demonstrates that severe lesions in the placenta are associated with abortion and stillbirth in caprine neosporosis and the placental alterations are likely involved in abortion pathogenesis. Moreover, the results highlight the importance of using more than one diagnostic technique for the detection of the protozoan in placentas because N. caninum cannot be reliably detected by histological and immunohistochemical tests.(AU)

Neospora caninum é descrito como um parasito que causa problemas reprodutivos esporádicos em cabras. Muitos aspectos da patogênese da neosporose em cabras naturalmente infectadas ainda precisam ser estabelecidos. Os objetivos deste trabalho foram caracterizar as lesões placentárias em cabras naturalmente infectadas por N. caninum e avaliar as técnicas diagnósticas para a detecção efetiva do protozoário na placenta. Algumas placentas deste estudo são originárias de abortos e natimortos, nas quais havia lesões graves. As lesões foram classificadas principalmente por necrose envolvendo o mesênquima das vilosidades coriônicas e células trofoblásticas, geralmente associadas a infiltrado inflamatório mononuclear e em alguns casos infiltrado neutrofílico. O DNA do N. caninum foi detectado nestas placentas, porém estruturas parasitárias não foram visualizadas na imuno-histoquímica (IHQ). Entretanto, cinco das onze placentas de cabras infectadas, que deram à luz a conceptos saudáveis, apresentaram lesões histológicas caracterizadas por infiltrado inflamatório mononuclear. Destas 11 placentas, foi detectado DNA de N. caninum em sete e taquizoítos foram encontrados em apenas uma por meio de imuno-histoquímica. O presente estudo demonstra que abortos e natimortos na espécie caprina, causados pelo N. caninum estão associados a lesões acentuadas nas placentas, sendo que as mesmas estão envolvidas na patogênese do aborto. Os resultados também ressaltam a importância do uso de mais de uma técnica diagnóstica para a detecção do protozoário em placentas, pois o N. caninum não pode ser confiavelmente detectado somente pelos exames de histopatologia e imuno-histoquímica.(AU)

Aspectos patológicos da intoxicação por aceturato de diminazeno em camelídeos sul-americanos / Pathological aspects of diminazene aceturate toxicosis in american camelids

Aceturato de diminazeno é um fármaco quimioterápico sintético comumente usado na medicina veterinária para o tratamento de doenças causadas por parasitos hematozoários. Entretanto, seu uso pode levar a efeitos colaterais, como alterações neurológicas graves e morte. A criação de camelídeos é uma atividade recente no Brasil, fazendo-se necessário conhecer mais sobre as doenças que acometem essas espécies. De dez camelídeos (seis lhamas e quatro alpacas) da propriedade, seis tiveram sinais clínicos e, destes, apenas uma lhama com manifestações leves recuperou-se. Os sinais clínicos incluíam apatia, andar cambaleante, fraqueza, sialorreia, cabeça baixa e pendida lateralmente, dificuldade em levantar e dispneia, observados a partir de 18 horas após o uso do medicamento. À necropsia e ao exame histopatológico foram observadas alterações de encefalopatia hemorrágica bilateral e simétrica, mais graves em tronco encefálico e tálamo. Este trabalho descreve as principais lesões observadas em um surto de intoxicação por diminazeno em alpacas (Lama pacos) e lhamas (Lama glama) e alerta criadores e veterinários sobre o risco de intoxicação por aceturato de diminazeno em camelídeos sul americanos.(AU)

Diminazene aceturate is a synthetic chemotherapeutic drug commonly used in veterinary medicine for the treatment of diseases caused by hematozoan parasites. However, side effects as severe neurological disorders and death can occur. The raising of american camelids is a recent activity in Brazil, requiring knowledge about diseases that affect these species, in order to avoid misguided conducts. In a herd of ten camelids (six llamas and four alpacas) six showed clinical signs and five died; only a llama with mild signs recovered. The clinical signs included apathy, difficulty to stand up, staggering gait, weakness, down head and drooping the head laterally, dyspnea and drooling of saliva, observed from 18 hours after use of the drug. At necropsy and histopathological examination was found bilateral and symmetrical hemorrhagic encephalopathy, more severe in brainstem and thalamus. This paper describes the main lesions observed in an outbreak of diminazene aceturate poisoning in alpacas (Lama pacos) and llamas (Lama glama) and alert breeders and veterinarians about the risk of poisoning by this drug in american camelids.(AU)

Aspectos anatomopatológicos em cães naturalmente infectados por Hepatozoon canis / Anatomopathological findings in dogs naturally infected by Hepatozoon canis

A hepatozoonose canina é causada principalmente pelos protozoários Hepatozoon canis e H. americanum, transmitida por ingestão de carrapatos parasitados. Os sinais clínicos podem ser inespecíficos ou de difícil reconhecimento, pois geralmente ocorre associada a outras doenças. No Brasil, o parasito, e a doença, já foram identificados em vários Estados, no entanto pouco se sabe sobre as alterações clínicas e anátomo-patológicas decorrentes da infecção. O presente trabalho relata cinco casos de infecções naturais por Hepatozoon canis em cães do Estado de Minas Gerais e descreve pela primeira vez no Brasil os achados de necropsias e histopatológicos relacionados à infecção. Merontes de Hepatozoon sp., submetidos a avaliação morfométrica, foram observados em cortes histológicos de fígado, baço, medula óssea e rim.(AU)

Canine hepatozoonosis is mainly caused by protozoa Hepatozoon canis and H. americanum that are transmitted by ingestion of infected ticks. Clinical signs may be unspecific or difficult to identify, because usually hepatozoonosis occurs associated with other disease. In Brazil, the parasite and the disease, have been identified in several states, however little is known about the clinical and anatomopathological lesions resulting from the infection. This paper reports five cases of natural infection by Hepatozoon canis in dogs from Minas Gerais State and describes for the first time in Brazil the necropsy and histopathological findings related to infection. Meronts of Hepatozoon sp., submitted to morphometric evaluation, were observed in histological sections of liver, spleen, bone marrow and kidney.(AU)

Association of three putative periodontal pathogens with chronic periodontitis in Brazilian subjects

ABSTRACT Objective The aim of this study was to evaluate the association of Porphyromonas endodontalis, Filifactor alocis and Dialister pneumosintes with the occurrence of periodontitis. Material and Methods Thirty subjects with chronic periodontitis (ChP) and 10 with periodontal health (PH) were included in the study. Nine subgingival biofilm samples were collected as follows: i) PH group - from the mesial/buccal aspect of each tooth in two randomly chosen contralateral quadrants; ii) ChP group - from three sites in each of the following probing depth (PD) categories: shallow (≤3 mm), moderate (4-6 mm) and deep (≥7 mm). Checkerboard DNA-DNA hybridization was used to analyze the samples. Results We found the three species evaluated in a higher percentage of sites and at higher levels in the group with ChP than in the PH group (p<0.05, Mann-Whitney test). We also observed these differences when the samples from sites with PD≤4 mm or ≥5 mm of subjects with ChP were compared with those from subjects with PH (p<0.05, Mann-Whitney test). In addition, the prevalence and levels of D. pneumosintes, and especially of F. alocis were very low in healthy subjects (0.12x105 and 0.01x105, respectively). Conclusion F. alocis and D. pneumosintes might be associated with the etiology of ChP, and their role in the onset and progression of this infection should be further investigated. The role of P. endodontalis was less evident, since this species was found in relatively high levels and prevalence in the PH group.

Brinzolamide/timolol versus dorzolamide/timolol fixed combinations: A hospital‑based, prospective, randomized study.

Purpose: To compare the efficacy and tolerability of brinzolamide/timolol (BT) and dorzolamide/ timolol (DT) fixed combinations on intraocular pressure (IOP) reduction. Methods: Patients with primary open angle glaucoma or normal tension glaucoma were randomized to receive either BT or DT. IOPs were measured at baseline, 2 weeks, and 1, 2, and 3 months. The primary outcome measures were the mean change in IOP from baseline at each visit. Secondary outcome measures included the tolerability of each fixed combination. Results: Seventy‑three patients (73 eyes) were included; 37 eyes in BT group and 36 eyes in DT group. Baseline mean IOP were 24.14 ± 4.5 and 29.53 ± 6 mmHg for BT and DT, respectively (P < 0.001). Both BT and DT provided statistically significant mean IOP reductions from baseline values within each group at all study visits (P < 0.001). DT provided greater mean IOP reductions from baseline than BT at each visit which was statistically significant at 2 weeks (P = 0.037). Mean percentage of IOP reduction was 24.35% and 46.33% at 2 weeks (P < 0.001), and 24.65% and 47% at 3 months (P < 0.001) for BT and DT, respectively. Patients’ tolerability appeared to be better for DT than for BT with complete ocular comfort without any ocular adverse effects in 31 patients (81.1%) in DT group and 11 patients (29.7%) in BT group (P < 0.001). Conclusion: Both drops provide effective IOP reduction which was greater, and patients were more likely to achieve lower target pressures with DT than with BT.

Matrix-assisted laser desorption ionization-time of flight mass spectrometry based identification of Edwardsiella ictaluri isolated from Vietnamese striped catfish (Pangasius hypothalamus)

Edwardsiella (E.) ictaluri is a major bacterial pathogen that affects commercially farmed striped catfish (Pangasius hypothalamus) in Vietnam. In a previous study, 19 strains of E. ictaluri collected from striped catfish were biochemically identified with an API-20E system. Here, the same 19 strains were used to assess the ability of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS; applied using a MALDI Biotyper) to conduct rapid, easy and accurate identification of E. ictaluri. MALDI-TOF MS could directly detect the specific peptide patterns of cultured E. ictaluri colonies with high (> 2.0, indicating species-level identification) scores. MALDI Biotyper 3.0 software revealed that all of the strains examined in this study possessed highly similar peptide peak patterns. In addition, electrophoresis (SDS-PAGE) and subsequent immuno-blotting using a specific chicken antibody (IgY) against E. ictaluri revealed that the isolates had highly similar protein profiles and antigenic banding profiles. The results of this study suggest that E. ictaluri isolated from striped catfish in Vietnam have homologous protein compositions. This is important, because it indicates that MALDI-TOF MS analysis could potentially outperform the conventional methods of identifying E. ictaluri.

Physiological and lifestyle factors contributing to risk and severity of peri-orbital dark circles in the Brazilian population

AbstractBACKGROUND:Peri-orbital dark circles are a cosmetic concern worldwide, and have been attributed to hyperpigmentation from allergy or atopic dermatitis, blood stasis, structural shadowing effects, and a thin epidermis/dermis under the eye. It is of interest to better understand lifestyle and demographic risk factors and the relative impact of melanin, blood and epidermal/dermal factors on the severity of Peri-orbital dark circles.OBJECTIVE:To compare by non-invasive imaging the impact of biological factors to a visual grading scale for Peri-orbital dark circles, and test the correlation of various demographic factors with Peri-orbital dark circles.METHODS:Subjects completed a lifestyle and health survey, and Peri-orbital dark circles severity was evaluated using standardized photographs. Hyperspectral image analysis was used to assess the contributions of melanin, blood volume, degree of blood oxygen saturation, and dermal scattering.RESULTS:Family history was the most significant risk factor for Peri-orbital dark circles. The average age of onset was 24 years, and earlier onset correlated with higher severity scores. Asthma was significantly associated with Peri-orbital dark circles scores, but self-reported allergy was not. In this study, sleep was not correlated with Peri-orbital dark circles scores. Hyperspectral imaging indicated that melanin was the dominant correlate for Peri-orbital dark circles severity, while oxygen saturation was secondary. The difference between under-eye and cheek measurements for ΔL*and ΔE* were the most significant instrumental parameters correlated with visual assessment of Peri-orbital dark circles severity.CONCLUSION:Although typically associated with lack of sleep, risk of Peri-orbital dark circles is primarily hereditary. The main factors contributing to the appearance of Peri-orbital dark circles are melanin and (deoxygenated) blood.

Abortos por Neosporacaninum em bovinos do sul de Minas Gerais / Neosporacaninum abortions in cattle in southern Minas Gerais, Brazil

Este estudo avaliou a participação de Neospora caninum em casos de abortos em bovinos provenientes de propriedades rurais da região sul de Minas Gerais por meio de análises histopatológicas, imuno-histoquímicas (IHQ) e pela reação em Cadeia de Polimerase (PCR). O material utilizado foi obtido de um estudo retrospectivo de casos de aborto recebidos pelo Setor de Patologia Veterinária da Universidade Federal de Lavras e de fetos necropsiados durante os anos de 2011 a 2013. De 60 fetos estudados, 30 (50%) tinham lesões microscópicas. Destes, 19 (63%) apresentaram lesões compatíveis com aborto por N. caninum, caracterizadas principalmente por encefalite não supurativa multifocal, necrose e gliose multifocal, assim como, miocardite e miosite não supurativa. Em 14 fetos chegou-se ao diagnóstico definitivo. Destes, cinco tiveram sua confirmação somente pela marcação IHQ e cinco foram positivos somente na PCR. Quatro fetos foram positivos tanto na IHQ quanto na PCR. Cinco fetos, provenientes do estudo retrospectivo apresentaram lesões compatíveis com N. caninum, mas a presença do protozoário não foi confirmada pela marcação IHQ. Os achados demonstram que o N. caninum é um importante agente associado ao aborto em bovinos na região sul de Minas Gerais. Para tanto, além das lesões microscópicas a associação entre a IHQ e a técnica de PCR foi essencial para a confirmação do diagnóstico.

The present study evaluates the participation of Neospora caninum in bovine abortions from farms in the southern region of Minas Gerais state, Brazil, through histopathological, immunohistochemical (IHQ) analysis and DNA detection by polymerase chain reaction (PCR). The material used in this study was obtained through retrospective study of bovine abortion cases received by the Setor de Patologia Veterinária da Universidade Federal de Lavras and by necropsies performed in fetuses from 2011 to 2013. From 60 fetuses studied, 30 (50%) had microscopic lesions; 19 (63%) of them had histologic lesions compatible with N. caninum abortion, characterized by multifocal non-suppurative encephalitis, necrosis and gliosis in the central nervous system and multifocal nonsuppurative myocarditis and myositis. From the 19 fetuses with protozoa lesions in 14 the final diagnosis was performed; five were confirmated only by IHQ staining and five were positive only by PCR. Four fetuses were positive in IHC and in PCR. In five fetuses from the retrospective study lesions compatible with N. caninum were seen, but the presence of the protozoan was not confirmed by IHQ labeling. The findings demonstrate that N. caninum is an important agent associated with abortion in cattle from Minas Gerais. Therefore, beyond the microscopic lesions association between IHC and PCR was essential to confirm the diagnosis.

Prevalência e aspectos anatomopatológicos das neoplasias primárias do coração, de tecidos da base do coração e metastáticas, em cães do Sul de Minas Gerais (1994-2009) / Prevalence and anatomopathological findings of primary cardiac neoplasms of the heart base tissues and metastases in dogs from southern Minas Gerais, Brazil (1994-2009)

Este estudo teve como objetivo determinar a prevalência e achados anatomopatológicos de tumores primários e metastáticos do coração ou de tecidos da base do coração, diagnosticados em caninos do Sul de Minas Gerais. O diagnóstico foi realizado mediante análise histopatológica e imuno-histoquímica das neoplasias. Durante os anos de 1994-2009, foram realizadas 2397 necropsias em caninos. Neoplasias no coração foram detectadas em 31 cães (1,29%), onde, sete (22,58%) eram primárias e 24 (77,42%) metastáticas. As neoplasias diagnosticadas como primárias do coração foram o hemangiossarcoma (1/7) e o mixoma (1/7); e como primárias da base do coração o quimiodectoma (3/7) e o carcinoma de tireoide ectópica (2/7). A frequência foi maior em cães machos (5/7), da raça Boxer (3/7) e com idade média de 9,7±1,88 anos. Nas neoplasias metastáticas, a frequência foi maior em fêmeas (15/24), em cães da raça Rottweiler (7/24) e a idade média foi de 7,5±3,23 anos, sendo o linfoma de células T a neoplasia metastática de maior ocorrência (7/27).

The purpose of this study was to determine the prevalence and anatomopathological findings of primary and metastatic heart tumors and from heart base tumors diagnosed in dogs from southern Minas Gerais, Brazil. The diagnosis was based on histological characteristics and immunophenotyping of the tumors cells. From 1994 to 2009, 2397 necropsies of dogs were performed. Cardiac neoplasms were diagnosed in 31 dogs (1.29%), where seven (22.58%) were primary and 24 (77.42%) were metastatic. Neoplasms of the heart diagnosed as primary were hemangiosarcoma (1/7) and myxoma (1/7), and, primary of heart base, the chemodectoma (3/7) and ectopic thyroid carcinoma (2/7). Frequency was higher in male dogs (5/7), of Boxer breed (3/7) with mean age of 9.7±1.88 years. In metastatic neoplasms, the frequency was higher in female dogs (15/24), of Rottweiler breed (7/24) with the mean age of 7.5±3.23 years. The T cell lymphoma (7/27) was the most frequent neoplasm, diagnosed as metastatic.

Surto de compactação primária de abomaso em bovinos leiteiros associado ao consumo de silagem de girassol / Outbreak of primary abomasal impaction in dairy cattle associated with consumption of sunflower silage

Um surto de compactação primária de abomaso associada ao consumo de silagem de girassol ocorreu num rebanho bovino leiteiro do estado de Minas Gerais, do qual seis de 21 vacas secas em fase final de gestação e que recebiam silagem de girassol morreram. Os bovinos que adoeceram apresentaram distensão abdominal, fezes ressecadas e escassas e, nos bovinos que morreram, eram pastosas, escuras e fétidas; nesses havia também desidratação acentuada e palidez de mucosas. Três bovinos foram necropsiados e os achados patológicos eram constituídos principalmente por distensão acentuada do abomaso associada a grande quantidade de conteúdo alimentar ressecado coberto por coágulos de sangue. No abomaso havia úlceras, com perfuração da parede em um dos bovinos. A alimentação de bovinos de maior exigência nutricional com silagem de girassol de características indesejáveis como única fonte de volumoso foi o principal fator para a compactação de abomaso nos casos apresentados.

An outbreak of primary abomasal impaction associated with consumption of sunflower silage occurred in a dairy cattle herd from the state of Minas Gerais. Six of 21 dry cows in late pregnancy fed with sunflower silage died. Cattle that became ill presented abdominal distension and scant and dried feces. In the animals that died, severe dehydration, pale mucous membranes, dark, sticky and stinking feces were seen. Three cows were necropsied and the main pathological findings consisted of severe abomasal distension associated with a large quantity of dried alimentary content covered by bloody clots. Ulcers were found in abomasum, with perforation in one cow. Feeding cattle with high nutritional needs, with sunflower silage of undesirable characteristics as unique source of roughage was the main cause for the abomasal impaction.

Congenital Neosporosis in Goats from the State of Minas Gerais, Brazil

Congenital Neospora caninum infection was diagnosed in two Saanen goat kids from two distinct herds with a history of abortion and weak newborn goat kids in the Southern region of the State of Minas Gerais, Brazil. The first kid was weak at birth, had difficulty to rise and was unable to nurse. Gross lesions of porencephaly and hydrocephalus ex vacuo were seen. Multifocal necrosis, gliosis and non-supurative encephalitis were observed in the brain. Several parasitic cysts with a thick wall that reacted strongly only with polyclonal antiserum to Neospora caninum were seen in the cerebral cortex, brain stem and cerebellum. The second kid was born from a Neospora caninum seropositive mother that aborted in the last pregnancy. It was born without clinical signs. The diagnosis of neosporosis was based on antibody titer of 1:800 to N. caninum by indirect fluorescence antibody test obtained from blood collected before the goat kid ingested the colostrum and Neospora caninum DNA was detected by polymerase chain reaction and sequenced from placenta. This is the first report of neosporosis in goats in the southeast region of Brazil.

Registro brasileiro de biológicos: processo de implementação e resultados preliminares do BiobadaBrasil / Brazilian biologic registry: BiobadaBrasil implementation process and preliminary results

OBJETIVOS: O presente estudo teve por objetivo descrever o processo de implementação de um registro nacional em um país em desenvolvimento (Brasil) e relatar os principais resultados preliminares do registro BiobadaBrasil. MATERAL E MÉTODOS: Através de um acordo com a PANLAR, o protocolo Biobadaser foi utilizado como modelo para a implementação de um novo registro no nosso país. Durante os dois primeiros anos desse esforço, o protocolo original foi adaptado, traduzido e apresentado a todos os reumatologistas brasileiros. Durante dez meses, dados de 1.037 pacientes (750 tratados com biológicos e 287 controles) de 15 centros foram coletados. RESULTADOS: A maioria dos pacientes tinha artrite reumatoide (AR) (n = 723). Infliximabe foi o agente anti-TNF mais usado, e a exposição total a biológicos foi 2.101 pacientes-ano. A razão mais comum para suspensão da droga foi ineficiência ou perda de efetividade (50 por cento), e 30 por cento dos pacientes interromperam o tratamento devido a eventos adversos. Três casos de tuberculose foram observados no grupo biológico, representando maior incidência do que aquela da população brasileira geral. Infecções foram observadas em 23 por cento dos pacientes do grupo biológico, sendo o trato respiratório superior o local mais comumente afetado. Apenas um caso de hanseníase tuberculoide foi observado. Nenhuma morte nem malignidade atribuível ao efeito dos medicamentos foi observada até fevereiro de 2010. CONCLUSÕES: A implementação do registro foi bem sucedida. Embora recente, o registro BiobadaBrasil já forneceu importantes dados.

OBJECTIVES: The present study aimed at describing the implementation process of a national registry in a developing country (Brazil) and at reporting the main preliminary results of the BiobadaBrasil registry. MATERIAL AND METHODS: Through a PANLAR agreement, the Biobadaser protocol was used as a model for implementing the new registry in our country. During the first two years of this effort, the original protocol was adapted, translated, and presented to all Brazilian rheumatologists. For ten months, data of 1,037 patients (750 subjects treated with biological drugs and 287 control subjects) from 15 centers were collected. RESULTS: Most patients had rheumatoid arthritis (RA) (n = 723). Infliximab was the most frequently used anti-TNF agent, and the total exposure to biologic drugs was 2,101 patient-years. The most common reason for interrupting drug use was lack or loss of efficacy (50 percent), while 30 percent withdrew from the treatment arm due to adverse events. Three cases of tuberculosis were observed in the biologic group, with an incidence higher than that of the general Brazilian population. Infections were observed in 23 percent of the biologic group, and the upper respiratory tract was the most commonly affected site. Only one case of tuberculoid leprosy was observed. No deaths or malignancies attributed to drug effects were observed as of February 2010. CONCLUSIONS: The implementation of the BiobadaBrasil registry was successful, and, although recent, the registry has provided important data.