The absence of eosinophils is associated with early metastatic lesions in Leishmania amazonensis-infected mice

BACKGROUND Eosinophils are granulocytes that rapidly increase frequency in the bloodstream during helminthic infections and allergic responses. They are found in tissue infected by Leishmania during early disease, but their role during infection is not entirely understood. OBJECTIVES We aim to compare the disease due to Leishmania amazonensis in BALB/c and Δdbl-GATA1 mice, which lack eosinophils. METHODS BALB/c and Δdbl-GATA1 mice infected with L. amazonensis were observed for several weeks. The parasite load and dissemination pattern were assessed. FINDINGS The Δdbl-GATA1 mice developed an anticipated dissemination of L. amazonensis and a worsening disease. No differences were found in the lesion development or the parasite load in the footpad among Δdbl-GATA1 mice and BALB/c eight weeks after infection. However, nine weeks after infection, massive growth of metastatic lesions appeared in several parts of the skin in Δdbl-GATA1 mice, weeks earlier than BALB/c. We observed increased parasites in the bloodstream, probably an essential dissemination route. Thirteen weeks after infection, metastatic lesions were found in all Δdbl-GATA1 mice. MAIN CONCLUSION These results suggest a protective role of eosinophils in delaying the disease caused by L. amazonensis, although several limitations of this mice strain must be considered.

First report of putative Leishmania RNA virus 2 (LRV2) in Leishmania infantum strains from canine and human visceral leishmaniasis cases in the southeast of Brazil

BACKGROUND Leishmania RNA virus 1 (LRV1) is commonly found in South American Leishmania parasites belonging to the subgenus Viannia, whereas Leishmania RNA virus 2 (LRV2) was previously thought to be restricted to the Old-World pathogens of the subgenus Leishmania. OBJECTIVES In this study, we investigated the presence of LRV2 in strains of Leishmania (L.) infantum, the causative agent of visceral leishmaniasis (VL), originating from different hosts, clinical forms, and geographical regions. METHODS A total of seventy-one isolates were screened for LRV2 using semi-nested reverse transcription-polymerase chain reaction (RT-PCR) targeting the RNA-dependent RNA polymerase (RdRp) gene. FINDINGS We detected LRV2 in two L. infantum isolates (CUR268 and HP-EMO) from canine and human cases, respectively. MAIN CONCLUSIONS To the best of our knowledge, this is the first detection of LRV2 in the New World.

Mechanical Properties of Mini-Implants Used in Extra-Radicular Anchorage

ABSTRACT Objective: To evaluate the mechanical properties of mini-implants (MIs) manufactured from stainless steel and compare them with conventional titanium-aluminum-vanadium alloy MIs. Material and Methods: The following groups were formed: G1 (n=24), 8×1.5 mm steel MIs; G2 (n=24), 12×2.0 mm steel MIs; and G3 (n=24), 10×1.5 mm titanium MIs. The 72 MIs were inserted in the infra zygomatic crest region of the maxilla and retromolar trigone in the jaw of 10 pigs. Pull-out, insertion torque, fracture and percussion tests were performed in order to measure the tensile strength, primary stability and fracture strength of MIs. A digital torque gauge was used to measure insertion and fracture torque, a universal mechanical testing machine was used for pull-out testing and a periotest device was used to measure the micromovement of MIs. For morphological and MI component evaluation, scanning electron microscopy (SEM) was performed. D'Agostino & Pearson, Kruskal-Wallis, and Dunn post-hoc and normality tests were used. Results: G2 insertion and fracture torques were significantly higher than G1 and G3 insertion and fracture torques (p<0.05). The pull-out and percussion tests presented similar values among the groups. SEM revealed that the fracture point was predominantly on the fourth thread for steel MIs (G1 and G2) and on the seventh thread for titanium-aluminum-vanadium MIs (G3). Conclusion: The mechanical properties of stainless steel MIs are superior to those of titanium-aluminum-vanadium alloy MIs.

Craniofacial morphology of patients with unilateral cleft lip and palate at two stages of skeletal maturation

Abstract The aim of this retrospective cross-sectional investigation was to perform a 3D analysis of craniofacial morphology of patients with unilateral cleft lip and palate (UCLP) at two stages of skeletal maturation. Cone-beam computed tomography (CBCT) scans of 52 UCLP patients (34 prepubertal; 18 pubertal) were collected from an outpatient referral center for the treatment of craniofacial deformities. In total 15 multiplanar craniofacial landmarks were identified, 3D virtual surface models were created, and 13 variables were measured to assess the 3D Euclidean distances between landmarks and spatial position of the landmarks in the projected X, Y and Z components. Maxillary and mandibular pitch (clockwise, counterclockwise) rotation relative to the cranial base was also evaluated. The significance level was set at 5%. Maxillary retrusion value relative to the cranial base was higher and statistically significant greater (p = 0.028) in pubertal (SNA, 77.4° ± 6.2; N-ANS Y, 3.3 mm ± 3.1) than in prepubertal patients (SNA 81.0° ± 5.2; N-ANS Y, 5.8 mm ± 2.7). The posterior cranial base length (S-Ba Y) was significantly longer (p = 0.013) in pubertal (20.7 mm ± 3.4) than in prepubertal patients (18.4 mm ± 2.7). The upper facial height (N-ANS Z) was significantly greater (p = 0.01) in pubertal (46.9 mm ± 4.5) than in prepubertal patients (43.4 mm ± 3.0). Prepubertal and pubertal UCLP patients presented distinct patterns of craniofacial morphology, mainly in the sagittal component of the maxilla and in the posterior cranial base length. Pubertal patients had greater maxillary retrusion and posterior cranial base length.

Effects of aging and the body mass index on male sex hormones: a cross-sectional study in 701 Brazilian men / Efeitos do envelhecimento e do índice de massa corporal sobre os hormônios sexuais masculinos: um estudo transversal em 701 homens brasileiros

Background: Some studies indicated that body mass index (BMI) is inversely proportional to serum testosterone concentrations in men. Purposes: This study aimed to analyze the effects of aging and obesity on total testosterone (TT), free testosterone (FT), bioavailable testosterone (BT), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) levels. Methods: A cross-sectional study was performed to assess the clinical and laboratory profiles of 701 patients treated at a private urology clinic in Ponta Grossa, Brazil, from January 2016 to December 2018. Results: Patients' age ranged from 16 to 88 years (mean, 56.9 ± 13.62 years). Age did not significantly influence serum TT concentrations, except compared to patients aged >70 years. However, changes were observed in FT and BT (p < 0.05). The mean SHBG increased with age (p < 0.05). A tendency toward LH elevation was observed in older patients, but it was not statistically significant. An inverse proportional relationship between TT, FT, and BT and the testosterone deficiency rate (TT < 300 ng/dL) was observed within BMI groups (p < 0.05). The testosterone deficiency rate was 21.5% in individuals with normal BMI, 29% in overweight individuals, and 37% in obese individuals. Conclusions: Aging affected the testosterone concentrations in men and became increasingly evident using FT and BT instead of TT. SHBG increased with age. Obesity was associated with a decrease in TT, FT, and BT but also increased the rate of hypogonadism. (AU)

Fundamentos: Alguns estudos indicam que o índice de massa corporal (IMC) é inversamente proporcional à con-centração de testosterona sérica em homens. Objetivos: O objetivo deste estudo é analisar o efeito do envelhe-cimento e da obesidade na testosterona biodisponível total e livre, bem como nos níveis de hormônio luteinizante e globulina ligadora de hormônio sexual. Métodos: Foi realizado um estudo transversal abordando o perfil clínico e laboratorial de 701 pacientes atendidos em uma clínica privada de urologia em Ponta Grossa, Brasil, de janei-ro de 2016 a dezembro de 2018. Resultados: A idade dos pacientes variou de 16 a 88 anos (média de 56,9 ± 13,62 anos). A idade não influenciou significativamente as concentrações séricas de testosterona total, exceto quando comparada a pacientes com mais de 70 anos. No entanto, foi observada diferença na testosterona livre e biodisponível (p <0,05). A média de globulina de ligação aos hormônios sexuais aumentou com a idade (p <0,05). Embora uma tendência à elevação da luteinização tenha sido observada em pacientes mais idosos, ela não foi significativa. Relação inversa entre testosterona total, livre e biodisponível e taxa de deficiência de testosterona (testosterona total <300 ng / dL) foi observada dentro dos grupos de índice de massa corporal (p <0,05). A taxa de deficiência de testosterona em indivíduos com índice de massa corporal normal foi de 21,5%, indivíduos com sobre-peso foi de 29% e em indivíduos com obesidade foi de 37%. Conclusões: O envelhecimento afetou a concentração de testosterona em homens, mais evidente ao avaliar testosterona livre e biodisponível em vez de testosterona total. A globulina de ligação aos hormônios sexuais aumentou com a idade. A obesidade foi associada à redução da testosterona total, livre e biodisponível e ao aumento da taxa de hipogonadismo. (AU)

Estratégias de marketing para manter e captar clientes durante a pandemia da Covid-19 em academias de Ribeirão Preto-SP, Brasil / Marketing strategies to maintain and attract customers during the Covid-19 pandemic in gyms of Ribeirao Preto-SP, Brazil / Estrategias de marketing para mantener y atraer clientes durante la pandemia del Covid-19 en los gimnasios de Ribeirao Preto-SP, Brasil

Introdução: O Brasil é o terceiro colocado no ranking mundial em faturamento de serviços fitness, com 34.509 academias registradas. Entretanto, a pandemia da Covid-19 trouxe desafios e uma queda nesse faturamento. Com isto, as academias foram forçadas a adotar novas estratégias de gestão e marketing para se manterem no mercado diante deste novo contexto. Objetivo: Identificar as estratégias de marketing esportivo utilizadas por gestores de academias de Ribeirão Preto/SP para manter e captar novos clientes durante a pandemia da Covid-19. Métodos: Realizou-se um estudo qualitativo por meio de entrevista semiestruturada, realizada por meio da ferramenta Google Meet, gravadas para serem transcritas e analisadas posteriormente. Resultados: Dentre as estratégias utilizadas pelos seis gestores entrevistados, destacaram-se: segurança e limpeza da academia como marketing; priorização do relacionamento com o cliente como principal forma de retenção; uso recorrente do marketing de bonificações; pacotes e mensalidades mais atrativos para manter e ao mesmo tempo captar novos clientes; e, a utilização das redes sociais como principal forma de captação. Os problemas encontrados pelos gestores foram similares, com ao menos 1/3 apontando a falta de verba específica para o marketing, campanhas centralizadas em outras sedes ou franquias, lives ineficientes e marketing tradicional com custo muito alto. Considerações finais: Os gestores precisaram superar os obstáculos da pandemia para planejar e promover estratégias de marketing para academias com objetivos, público e porte diferentes. Ainda existem poucos estudos relacionando marketing e o mercado fitness no Brasil, destacando a importância de mais estudos que abordem esta temática.

Introduction: Brazil is ranked third in the world in fitness service billing, with 34,509 registered gyms. However, the COVID-19 pandemic brought challenges and a drop in this revenue. Consequently, the gyms were forced to adopt new management and marketing strategies to stay in the market facing the contemporary context. Objective: To identify the sports marketing strategies used by gym managers in Ribeirão Preto, SP, Brazil, to keep and attract new customers during the COVID-19 pandemic. Methods: A qualitative study was performed through semi-structured interviews, conducted through the Google Meet tool, recorded to be transcribed and analyzed. Results: Among the strategies used by the six managers interviewed stand out: gym safety and cleanliness as marketing; the prioritization of the relationship with customers as the main form of retention; the overuse of bonus marketing; packages and more attractive monthly fees to keep and at the same time attract new customers; and, also the use of social networks as the main form of attraction. The problems were similar among the managers, with at least 1/3 indicating the lack of a specific budget for marketing, centralized campaigns in other locations or franchises, inefficient live broadcasts, and traditional marketing with a very high cost. Final words: The managers needed to overcome the pandemic obstacles to plan and promote marketing strategies for gyms with different objectives, public, and size. There are still few studies on the relationship between marketing and Brazil's fitness market, highlighting the importance of more studies that address this theme.

Introducción: Brasil es el tercer país del mundo en facturación de servicios fitness, con 34.509 gimnasios registrados. Sin embargo, la pandemia de Covid-19 llevó a desafíos y un descenso de estos ingresos. Con esto, los gimnasios se vieron obligados a adoptar nuevas estrategias de gestión y comercialización para mantenerse en el mercado ante el nuevo contexto. Objetivo: Identificar las estrategias de marketing deportivo utilizadas por los gestores de gimnasios de Ribeirão Preto, SP, Brasil, para mantener y atraer nuevos clientes durante la pandemia de Covid-19. Métodos: Se realizó un estudio cualitativo a través de entrevista con preguntas preestablecidas, realizadas por la herramienta Google Meet, grabadas para poder transcribirlas y analizarlas. Resultados: Entre las estrategias utilizadas por los seis gestores entrevistados, se destacaron: seguridad y limpieza del gimnasio como marketing; priorización de las relaciones con los clientes como principal forma de retención; el abuso del marketing de bonos; paquetes y cuotas mensuales más atractivas para mantener y al mismo tiempo captar nuevos clientes; y, también el uso de las redes sociales como principal forma de captación. Los problemas encontrados por los gestores fueron similares, con al menos 1/3 apuntando falta de presupuesto específico para el marketing, campañas centralizadas en otras sedes o franquicias, lives ineficientes y el marketing tradicional como una estrategia de muy alto coste. Consideraciones finales: Los gestores necesitaron superar los obstáculos de la pandemia para planificar y promover estrategias de marketing para gimnasios con objetivos, público y tamaño distintos. Todavía hay pocos estudios que relacionen el marketing y el mercado fitness en Brasil, destacando la importancia de más estudios que aborden este tema.

Information and Communications Technology in Dentistry: an informative and educational approach for patients with fixed orthodontic appliances

ABSTRACT Objective: To develop and make available, at no cost to the user, Information and Communications Technology (ICT) tools for Dentistry, providing dental information and advice geared toward patients undergoing orthodontic treatment with fixed appliances. Material and Methods: A Dentistry-based content that contemplated information and advice concerning orthodontic treatment with fixed appliances was elaborated. The materials, which included instructions on oral hygiene and treatment strategies when faced with possible complications, were evaluated and validated by specialists, whose assessments reached a 85% approval. From the validated content, products using four distinct ICT tools were formulated. Results: The following technological products were developed: a program for community radios, three blog posts, four educational and informative videos, and a smartphone application - using texts, as well as images and videos. These ICT tools, geared toward patients wearing fixed orthodontic appliances, were made available by internet at no cost to the user, and the number of accesses is already expressive. Conclusion: These technological-scientific tools, developed and provided freely to the population, can aid patients during their treatment with fixed orthodontic appliances, contributing to the dissemination of reliable information, and clarifying doubts that may arise during orthodontic therapy. These free ICT tools serve to facilitate access to scientific knowledge, thereby favoring social inclusion, bearing in mind that this educational and informative material was offered in a simple and accessible manner to the general population.

RESUMO Objetivos: Desenvolver e disponibilizar, gratuitamente, ferramentas de tecnologia da informação e comunicação (TIC) para a Odontologia, abordando informações e orientações direcionadas a pacientes em tratamento ortodôntico com aparelho fixo. Material e Métodos: Foi elaborado um conteúdo que contemplou informações e orientações concernentes ao tratamento ortodôntico com aparelho fixo. O material, que abrangeu instruções sobre higiene bucal e sobre abordagens diante de possíveis intercorrências, foi avaliado e validado por especialistas. A partir do conteúdo validado, foram elaborados produtos utilizando quatro ferramentas distintas de TIC. Resultados: Foram desenvolvidos os seguintes produtos tecnológicos: um programa para rádios comunitárias, três postagens para blog, quatro vídeos educacionais e informativos, e um aplicativo para smartphones, utilizando não apenas textos, mas também imagens e vídeos. Essas ferramentas de TIC direcionadas a pacientes fazendo uso de aparelho ortodôntico fixo foram disponibilizadas gratuitamente via internet, e já contam com expressivo número de acessos. Conclusões: As ferramentas técnico-científicas, desenvolvidas e fornecidas livremente à população, podem auxiliar pacientes durante o tratamento com aparelho ortodôntico fixo, contribuir para disseminar informações confiáveis e esclarecer dúvidas que surgem durante a terapia ortodôntica. Essas ferramentas gratuitas de TIC facilitam o acesso ao conhecimento científico e, consequentemente, favorecem a inserção social, tendo em vista que esse material educacional e informativo foi ofertado de maneira simples e acessível à população.

Leishmania enriettii visceralises in the trachea, lungs, and spleen of Cavia porcellus

BACKGROUND Leishmania (Mundinia) enriettii is a species commonly found in the guinea pig, Cavia porcellus. Although it is a dermotropic species, there is still an uncertainty regarding its ability to visceralise during Leishmania life cycle. OBJECTIVE Here, we investigated the ability of L. enriettii (strain L88) to visceralise in lungs, trachea, spleen, and liver of C. porcellus, its natural vertebrate host. METHODS Animals were infected sub-cutaneously in the nose and followed for 12 weeks using histological (hematoxilin-eosin) and molecular tools (polymerase chain reaction-restriction fragment length polymorphism - PCR-RFLP). To isolate parasite from C. porcellus, animals were experimentally infected for viscera removal and PCR typing targeting hsp70 gene. FINDINGS Histological analysis revealed intense and diffuse inflammation with the presence of amastigotes in the trachea, lung, and spleen up to 12 weeks post-infection (PI). Molecular analysis of paraffin-embedded tissues detected parasite DNA in the trachea and spleen between the 4th and 8th weeks PI. At the 12th PI, no parasite DNA was detected in any of the organs. To confirm that the spleen could serve as a temporary site for L. enriettii, we performed additional in vivo experiments. During 6th week PI, the parasite was isolated from the spleen confirming previous histopathological and PCR observations. MAIN CONCLUSION Leishmania enriettii (strain L88) was able to visceralise in the trachea, lung, and spleen of C. porcellus.

Leishmania infantum in the reproductive organs of dogs / Leishmania infantum em órgãos reprodutivos de cães

ABSTRACT: Leishmania infantum causes canine leishmaniasis. Using parasitological and molecular analyses, we identified L. infantum in the reproductive organs of male and female dogs. Using histochemistry, immunohistochemistry, and PCR, we examined tissue samples from the reproductive organs of 8 male dogs and 16 female dogs diagnosed with leishmaniasis. Despite the absence of macroscopic or microscopic lesions in these organs, we observed L. infantum amastigotes in tissue samples from the testis and the uterus. PCR and sequencing of these tissues revealed sequences that matched 100% with L. infantum DNA available at GenBank. The presence of L. infantum amastigotes and DNA in testicular and uterine tissue samples suggested that these organs can harbor the parasite without associated macroscopic or microscopic lesions, and this can be especially important in the vertical and venereal transmission of leishmaniasis in dogs.

RESUMO: Leishmania infantum é agente etiológico da leishmaniose canina. Por meio de análises parasitológicas e moleculares, a presença do parasita foi investigada em órgãos reprodutivos de cães machos e fêmeas. Amostras de tecidos dos órgãos reprodutivos de 8 cães machos e 16 fêmeas diagnosticados com leishmaniose foram avaliadas por histoquímica, imunohistoquímica e PCR. Apesar de não terem sido observadas lesões macroscópicas ou microscópicas nos órgãos reprodutivos desses cães, formas amastigotas de L. infantum foram observadas em amostras teciduais do testículo e útero. A PCR e o sequenciamento do DNA extraído desses tecidos revelaram sequências 100% idênticas a L. infantum depositadas no GenBank. Nossos resultados sugerem que os testículos e o útero podem abrigar o parasita, sem associação com lesões macroscópicas ou microscópicas, o que pode ter uma grande importância na transmissão venérea e vertical da leishmaniose entre cães.

Molecular cytogenetics insights in two pelagic big-game fishes in the Atlantic, the tarpon, Megalops atlanticus (Elopiformes: Megalopidae), and the sailfish, Istiophorus platypterus (Istiophoriformes: Istiophoridae)

Some pelagic and usually large sized fishes are preferential targets for sport and commercial fishing. Despite their economic importance, cytogenetic data on their evolutionary processes and management are very deficient, especially due to logistical difficulties. Here, information for two of such charismatic species, the tarpon, Megalops atlanticus (Elopiformes: Megalopidae), and the sailfish, Istiophorus platypterus (Istiophoriformes: Istiophoridae), both with a wide Atlantic distribution, were provided. Cytogenetic data were obtained using conventional methods (Giemsa staining, Ag-NORs technique, and C-banding), base-specific fluorochrome staining and fluorescence in situ hybridization (FISH) with rDNA probes. Megalops atlanticus has 2n = 50 chromosomes, all acrocentric ones (NF = 50), while Istiophorus platypterus has 2n = 48 chromosomes, 2m + 2st + 44a (NF = 52). Megalops atlanticus populations from the South Atlantic and Caribbean share identical karyotypic patterns, likely associated with gene flow between them. In turn, I. platypterus presents karyotype similarities with phylogenetically close groups, such as Carangidae. The chromosomal characteristics of these species highlight their independent evolutionary paths. Additionally, the current data contribute to knowledge of new aspects of pelagic fish fauna and will support further comparative studies with congeneric species, clarifying evolutionary karyotype trends of these fish groups.(AU)

Alguns peixes pelágicos de grande porte são alvos preferenciais para a pesca esportiva e comercial. Apesar de sua importância econômica, os dados citogenéticos sobre seus processos evolutivos e de manejo são muito deficientes, principalmente devido às dificuldades logísticas. Aqui são apresentadas informações cromossômicas de duas espécies carismáticas, o tarpão, Megalops atlanticus (Elopiformes: Megalopidae), e o agulhão-vela, Istiophorus platypterus (Istiophoriformes: Istiophoridae), ambos com ampla distribuição no oceano Atlântico. Os dados citogenéticos foram obtidos usando métodos convencionais (coloração em Giemsa, técnica de Ag-NORs e bandamento C), coloração com fluorocromos específicos e hibridização fluorescente in situ (FISH) com sondas DNAr. Megalops atlanticus possui 2n = 50 cromossomos, todos acrocêntricos (NF = 50), enquanto Istiophorus platypterus possui 2n = 48 cromossomos, 2m + 2st + 44a (NF = 52). Populações de M. atlanticus do Atlântico Sul e Caribe compartilham padrões cariotípicos idênticos, provavelmente associados ao fluxo gênico entre regiões. Por sua vez, I. platypterus apresenta semelhanças cariotípicas micro e macroestruturais com grupos filogeneticamente próximos, como Carangidae. As características cromossômicas destas espécies destacam seus caminhos evolutivos independentes. Adicionalmente, os dados apresentados contribuem com novos aspectos da fauna pelágica e apoiarão futuros estudos comparativos com espécies congenéricas, esclarecendo as tendências evolutivas do cariótipo destes grupos de peixes.(AU)

Investigation of canine visceral leishmaniasis in a non-endemic area in Brazil and the comparison of serological and molecular diagnostic tests

Abstract INTRODUCTION: Visceral leishmaniasis (VL) is an important zoonosis in Brazil. Previous identification of parasitized dogs can also help prevent the disease in humans, even in non-endemic areas of the country. The Brazilian Ministry of Health recommends diagnosis in dogs using a DPP® (rapid test) as a screening test and an immunoenzymatic assay (ELISA) as a confirmatory test (DPP®+ELISA), and culling infected dogs as a legal control measure. However, the accuracy of these serological tests has been questioned. METHODS: VL in dogs was investigated in a non-endemic area of the São Paulo state for three consecutive years, and the performances of different diagnostic tests were compared. RESULTS: A total of 331 dog samples were collected in 2015, 373 in 2016, and 347 in 2017. The seroprevalence by DPP®+ELISA was 3.3, 3.2, and 0.3%, respectively, and by indirect immunofluorescence assay (IFA), it was 3.0, 5.6, and 5.5%, respectively. ELISA confirmed 18.4% of DPP® positive samples. The concordance between the IFA and DPP® was 83.9%. The concordance between IFA and DPP®+ELISA was 92.9%. A molecular diagnostic test (PCR) was performed in 63.2% of the seropositive samples, all of which were negative. CONCLUSIONS: In non-endemic areas, diagnostic tests in dogs should be carefully evaluated to avoid false results.

Controle pressórico e inércia terapêutica no ambulatório escola da Universidade Iguaçu / Pressure control and therapeutic inertia in the outpatient school of the Iguaçu University

Introdução: Conhecer as taxas de controle da pressão do Ambulatório Escola da Universidade Iguaçu, as estratégias terapêuticas e a taxa de inércia terapêutica frente aos pacientes não controlados, são fundamentais para estabelecer estratégias de alcance de metas pressóricas. Objetivo: Determinar a taxa de pacientes na meta e fora da meta de pressão arterial, a estratégia terapêutica em uso e a taxa de inércia terapêutica frente aos pacientes não controlados. Metodologia: Estudo observacional, prospectivo e analítico através de análise dos prontuários e entrevista com pacientes consecutivos atendidos no ambulatório escola da Universidade Iguaçu, com >18 anos, no período de agosto a dezembro de 2019. Análise de dados demográficos, condições clínicas associadas e presença de outros fatores de risco. Resultados: 202 pacientes estudados na pesquisa, faixa etária de 18 a 85 anos, com 91,08% dos pacientes com hipertensão arterial (40 e 79 anos). Analisando as taxas de controle, 61,38 % encontram-se na meta de pressão arterial de acordo com o risco cardiovascular, segundo a Sociedade Brasileira de Cardiologia, e 38,6%, dos pacientes não se encontram na meta. A adesão terapêutica elevada foi observada em 29,83% dos pacientes na meta vrs 26,92% dos pacientes fora da meta. A taxa de inercia terapêutica foi de 41,03% pacientes com conduta mantida. Conclusão: Dos pacientes atendidos, 38,61% estão fora da meta de pressão arterial, e a inercia terapêutica é um importante problema. Como a maioria dos pacientes hipertensos sem comorbidades são acompanhados nas unidades básicas de saúde por generalistas, a capacitação desses profissionais é de grande importância para um melhor controle da pressão arterial.

Introduction:Knowing the pressure control rates of the outpatient school at the Iguaçu University, therapeutic strategies and the rate of therapeutic inertia in the face of uncontrolled patients are essential to establish strategies to achieve pressure goals. Objective: Determine the rate of patients on and off the blood pressure target, the therapeutic strategy in use and the rate of therapeutic inertia compared to uncontrolled patients. Methodology:Observational, prospective and analytical study through analysis of medical records and interviews with consecutive patients over 18 years old seen at the outpatient school at Universidade Iguaçu, from August to December 2019. Analysis of demographic data, associated clinical conditions and the presence of others risk factors. Results:202 patients studied in the research, age range from 18 to 85 years, with 91.08% of patients with arterial hypertension (40 and 79 years). Analyzing the control rates, 61.38% are on the blood pressure target according to cardiovascular risk, according to the Brazilian Society of Cardiology, and 38.6%, of the patients are not on the target. High therapeutic adherence was observed in 29.83% of patients on target vs. 26.92% of patients off target. The therapeutic inertia rate was 41.3% of patients in the target. Conclusion: Of the patients seen, 38.61% are outside the blood pressure target, and therapeutic inertia is an important problem. As the majority of hypertensive patients without comorbidities are monitored in basic health units by general practitioners, the training of these professionals is of great importance for a better control of blood pressure

The outcomes of mini-laparoscopic pyeloplasty in children - brazilian experience

ABSTRACT Objetive Pelvicureteric junction (PUJ) obstruction is the main cause of hydronephrosis in childhood. Open pyeloplasty has been the gold standard treatment of this condition with success rate above 90%. The role of laparoscopic pyeloplasty (LP) in children is less well defined and has slowly emerged as an alternative procedure. We report outcomes of our initial experience with LP in 38 children from 2 months of age. Materials and Methods From June 2015 to December 2017 38 children aged 2-60 months (mean age 1.7 years) underwent LP for correction of PUJ obstruction. The mean pre operative anteroposterior diameter of the renal pelvis (APD) was 43,5mm and all patients had hydronephrosis (APD 21.4-76 mm) and obstructed curve on diuretic renogram. Anderson-Hynes pyeloplasty was the performed technique. Results are reported. Results Mean operative time was 107 minutes (70-180) with no conversion to open procedure. Pain control was needed mainly in the first 12hs. Mean hospitalization was 2 days (1-5). There were complications in 5 children not affecting the final outcome. Two patients had a re-obstruction requiring a second procedure with good result. The mean follow up was 18 months (13-36). The mean reduction on the postoperative APD was 41% - p<0,001 (end APD 5 to 41mm). Overall success rate was 94,7%. All children had good cosmetic results. Conclusions This is a small series limited by short follow up, however its data suggest that LP has good functional and cosmetic results, not compromising the success of the open procedure, regardless patient age.

Lipophosphoglycans from dermotropic Leishmania infantum are more pro-inflammatory than those from viscerotropic strains

Although Leishmania infantum is well-known as the aethiological agent of visceral leishmaniasis (VL), in some Central American countries it may cause atypical non-ulcerated cutaneous leishmaniasis (NUCL). However, the mechanisms favoring its establishment in the skin are still unknown. Lipophosphoglycan (LPG) is the major Leishmania multivirulence factor involved in parasite-host interaction. In the case of viscerotropic L. infantum, it causes an immunosuppression during the interaction with macrophages. Here, we investigated the biochemical and functional roles of LPGs from four dermotropic L. infantum strains from Honduras during in vitro interaction with murine macrophages. LPGs were extracted, purified and their repeat units analysed. They did not have side chains consisting of Gal(β1,4)Man(α1)-PO4 common to all LPGs. Peritoneal macrophages from BALB/c and C57BL/6 were exposed to LPG for nitric oxide (NO) and cytokine (TNF-α and, IL-6) production. LPGs from dermotropic strains from Honduras triggered higher NO and cytokine levels compared to those from viscerotropic strains. In conclusion, LPGs from dermotropic strains are devoid of side-chains and exhibit high pro-inflammatory activity.

Molecular detection of Cercopithifilaria bainae and other tick-borne pathogens in Rhipicephalus sanguineus s.l. isolated from dogs in Midwest Brazil / Detecção molecular de Cercopithifilaria bainae e outros patógenos transmitidos por carrapatos em Rhipicephalus sanguineus s.l. isolados de cães no Centro-Oeste do Brasil

Abstract The aim of the present study was to detect Cercopithifilaria bainae and other tick-borne pathogens and to perform molecular characterization of the tick Rhipicephalus sanguineus s.l. collected from dogs. Ticks (n = 432, including 8 larvae, 59 nymphs, and 365 adults) were sampled from domiciled dogs (n = 73) living in Campo Grande, Mato Grosso do Sul (Midwest Brazil). All ticks were morphologically identified as R. sanguineus. Genomic DNA was extracted in pools (three to five ticks per animal) and was used for definition of R. sanguineus haplotypes (based on 16S rRNA analysis) and pathogen identification (Cercopithifilaria sp., Ehrlichia canis, Anaplasma platys, Hepatozoon canis, Babesia vogeli and Rickettsia spp.). Rhipicephal us sanguineus specimens were identified as haplotypes A and B. DNA of Cercopithifilaria bainae (43.83%; 32/73), Ehrlichia canis (24.65%; 18/73), Anaplasma platys (19.17%; 14/73), and Hepatozoon canis (5.47%; 4/73) was detected. The identity of pathogens was confirmed by DNA sequence analysis. The present study confirms the presence of haplotypes A and B of R. sanguineus in the state of Mato Grosso do Sul and its importance as a vector of several pathogens of veterinary concern. Finally, this is the first report to identify C. bainae in ticks in the Midwestern region of Brazil.

Resumo O objetivo do presente estudo foi detectar Cercopithifilaria bainae e outros patógenos transmitidos por carrapatos e realizar a caracterização molecular do carrapato Rhipicephalus sanguineus s.l. coletado em cães. Carrapatos (n = 432, incluindo 8 larvas, 59 ninfas e 365 adultos) foram amostrados de cães domiciliados (n = 73) residentes no município de Campo Grande, Mato Grosso do Sul (centro-oeste do Brasil). Todos os carrapatos foram identificados morfologicamente como R. sanguineus. O DNA genômico foi extraído em pools (três a cinco carrapatos por animal), seguido pela definição de haplótipos (com base no gene 16S rRNA) e pela investigação de patógenos (Cercopithifilaria sp., Ehrlichia canis, Anaplasma platys, Hepatozoon canis, Babesia vogeli e Rickettsia spp.). Os espécimes coletados foram identificados como haplótipos A e B de R. sanguineus. Foram detectados DNA de Cercopithifilaria bainae (43,83%; 32/73), Ehrlichia canis (24,65%; 18/73), Anaplasma platys (19,17%; 14/73) e Hepatozoon canis (5,47%; 4/73). A identidade dos patógenos foi confirmada por análise de sequência de DNA. O presente estudo confirma a circulação dos haplótipos A e B de R. sanguineus no estado de Mato Grosso do Sul e sua importância como vetor de vários patógenos de interesse veterinário. Finalmente, este é o primeiro relato de C. bainae em carrapatos na região centro-oeste do Brasil.

Synanthropic rodents as virus reservoirs and transmitters

Abstract This review focuses on reports of hepatitis E virus, hantavirus, rotavirus, coronavirus, and arenavirus in synanthropic rodents (Rattus rattus, Rattus norvegicus, and Mus musculus) within urban environments. Despite their potential impact on human health, relatively few studies have addressed the monitoring of these viruses in rodents. Comprehensive control and preventive activities should include actions such as the elimination or reduction of rat and mouse populations, sanitary education, reduction of shelters for the animals, and restriction of the access of rodents to residences, water, and food supplies.

Molecular detection of Leishmania infantum DNA according to clinical stages of leishmaniasis in dog / Deteção molecular de DNA de Leishmania infantum em diferentes estágios clínicos da leishmaniose em cães

Abstract The aim of this study was to compare molecular tests used to diagnose Leishmania spp. in dogs with different stages of infection. Blood and conjunctival swab (CS) samples from dogs classified in four clinical stages were subjected to different PCR protocols (13A/13B, MC1/MC2, LITSR/L5.8S and LEISH-1/LEISH-2 primers). To the study, 22.3% (48/215) of dogs were classified as without clinical signs, 67.5% (145/215) stage I (mild disease), 7.0% (15/215) stage II (moderate disease) and 3.2% (7/215) stage III (severe disease). The results showed that in blood samples, 13A/13B detected a significant higher number of positive dogs in stage I (25/145) and in total (42/215) (p≤0.05). However, when CS samples were tested, no difference was observed (p>0.05). On the other hand, in blood samples, MC1/MC2 detected significantly fewer positive dogs classified as without clinical signs (0/48), in stage I (0/145) and in total (1/215) (p≤0.05). Likewise, in CS samples, this primers showed also lower detection (1/215) (p≤0.05). So than, we can conclude that PCR on blood samples with 13A/13B primers has greater capacity to detect positive dogs, mainly at the initial of clinical disease than do other primers and MC1/MC2 are not a good choice to detect Leishmania infantum infection in dogs.

Resumo O objetivo deste estudo foi comparar testes moleculares usados para diagnosticar Leishmania spp., em cães apresentando diferentes estágios de infecção. Amostras de sangue e suabe conjuntival (SC) de cães classificados em quatro estágios clínicos foram submetidas a diferentes PCRs (primers 13A/13B, MC1/MC2, LITSR/L5.8S e LEISH-1/LEISH-2). Para o estudo, 22,3% (48/215) dos cães foram classificados como sem sinais clínicos, 67,5% (145/215) estágio I (doença leve), 7,0% (15/215) estágio II (doença moderada) e 3,2% (7/215) estágio III (doença grave). Os resultados mostraram que, em amostras de sangue, 13A/13B detectou número significativamente maior de cães positivos no estágio I (25/145) e no total (42/215) (p≤0,05). No entanto, quando as amostras de SC foram testadas, nenhuma diferença foi observada (p>0,05). Por outro lado, no sangue, MC1/MC2 detectou significativamente menos cães positivos sem sinais clínicos (0/48), em estágio I (0/145) e no total (1/215) (p≤0,05). Da mesma forma, em amostras de SC, MC1/MC2 também apresentou menor detecção (1/215) (p≤0,05). Assim, a PCR em amostras de sangue com 13A/13B tem maior capacidade de detectar cães positivos, principalmente no início da doença do que outros primers, e o par de primers MC1/MC2 não é uma boa escolha para detectar infecção por Leishmania infantum em cães.

Molecular detection of Leishmania spp. in cattle from Brazil by means of PCR using internal transcribed spacer 1 / Detecção molecular de Leishmania spp. em gado no Brasil por PCR com espaçador interno transcrito 1

Abstract Leishmania spp. are important agents of human and animal leishmaniases that have an important impact on public health. In this study, we aimed to detect the circulation of Leishmania spp. in cattle from a visceral leishmaniasis non-endemic area of the state of São Paulo, Brazil. DNA was extracted from blood samples from 100 heifers in the municipality of Pirassununga and was amplified using primers specific for the first internal transcriber spacer (ITS1), to assess the presence of trypanosomatids. The assays revealed that one sample presented bands of between 300 and 350 base pairs. In GenBank, this sample matched 100% with Leishmania infantum (314 base pairs). The results suggest that cattle can be infected by Leishmania infantum in Brazil.

Resumo Leishmania spp. são agentes causadores das leishmanioses em humanos e em animais, gerando grande impacto à saúde pública. Este estudo objetivou detectar a circulação de Leishmania spp. em área não endêmica para leishmaniose visceral de São Paulo, Brasil. Foram extraídas amostras de DNA de 100 novilhas da cidade de Pirassununga. Estas amostras foram amplificadas com os iniciadores específicos para tripanosomatídeos Internal Transcriber Spacer 1 (ITS1). Os ensaios revelaram uma amostra com bandas entre 300 e 350 pares de base (pb). A amostra demonstrou 100% de identidade com Leishmania infantum (314 pb). Os resultados sugerem que o gado pode ser infectado por L. infantum no Brasil.

Clinical and therapeutic aspects of an outbreak of canine trypanosomiasis / Aspectos clínicos e terapêuticos de um surto de tripanossomíase canina

Abstract Trypanosomiasis caused by Trypanosoma evansi can seriously affect both domestic and wild animals. This article reports on an outbreak of canine trypanosomiasis on a farm in the Pantanal region of Brazil. The farm had 38 dogs, 20 of which died before receiving veterinary care. The remaining 18 dogs were underwent anamnesisn, clinical examination, hematological and biochemical evaluations. Blood smears and PCR analysis were performed for the diagnosis. The treatment protocols used according to the clinical recovery or parasitological cure of the dogs, using diminazene diaceturate, isometamidium chloride or quinapyramine sulfate. Post-treatment parasitological evaluation was performed by the microhematocrit technique. 7/18 dogs were PCR positive for T. evansi (confirmed by sequencing). There was clinical findings, which were consistent with both the acute and chronic stages of the disease in dogs. The infected dogs all exhibited at least one clinical sign of the disease. The hematological findings were compatible with trypanosomiasis, highlighting the hypochromic microcytic anemia as the main outcome. No treatment protocol was fully effective and the prolonged use of diminazene diaceturate caused the death of an animal. The trypanosomiasis can cause high rates of morbidity and mortality in dogs and difficulty in establishment an effective and safe therapeutic protocol.

Resumo A tripanossomíase causada por Trypanosoma evansi pode acometer gravemente os animais domésticos e selvagens. Este artigo relata um surto de tripanossomíase canina em uma fazenda na região do Pantanal, Brasil. Na fazenda havia 38 cães, 20 dos quais morreram antes de receber cuidados veterinários. Os 18 cães restantes foram submetidos a anamnese, exame clínico, avaliação hematológica e bioquímica. Esfregaços de sangue e análise da PCR foram realizados para o diagnóstico. Os protocolos de tratamento foram utilizados de acordo com a recuperação clínica ou cura parasitológica dos cães, utilizando diaceturato de diminazeno, cloreto de isometamídio ou sulfato de quinapiramina. A avaliação parasitológica pós-tratamento foi realizada pela técnica de microhematócrito. 7/18 cães foram PCR positivos para T. evansi (confirmado por sequenciamento). Os achados clínicos encontrados, foram consistentes com os estágios agudo e crônico da doença em cães. Todos os cães infectados exibiram pelo menos um sinal clínico da doença. Os achados hematológicos foram compatíveis com a tripanossomíase, destacando a anemia microcítica hipocrômica como principal consequência. Nenhum protocolo de tratamento foi totalmente eficaz e o uso prolongado de diaceturato de diminazeno causou a morte de um animal. A tripanossomíase pode causar altas taxas de morbidade e mortalidade em cães e dificultar o estabelecimento de um protocolo terapêutico eficaz e seguro.

Panoramic Radiography and Cone Beam Computed Tomography in the Early Diagnosis of Atheroma in the Extracranial and Intracranial Internal Carotid Artery: A Case Report / Radiografía Panorámica y Tomografía Computarizada de Haz Cónico en el Diagnóstico Precoz de Ateroma en la Arteria Carótida Interna, Extracraneal e Intracraneal: Reporte de Caso

ABSTRACT: Carotid stenosis usually results from the accumulation of atherosclerotic plaque in the carotid artery wall and is an important risk factor for ischemic cerebral vascular accident (CVA). This study describes the importance of diagnostic imaging exams used in dentistry for the early identification of atheroma plaques in the extracranial and intracranial internal carotid artery. A male patient was referred to a radiology clinic to perform panoramic radiography (PR) and a cone beam computed tomography (CBCT) to develop treatment plan options. In the PR and CBCT a radiopaque image, suggestive of atheroma in the extracranial internal carotid artery, was observed on the right side. The diagnosis was confirmed by color DOPPLER ultrasonography. In the CBCT, the presence of calcifications in the intracranial internal carotid artery was also observed. Diagnostic imaging exams used in dentistry allow the identification of asymptomatic individuals, facilitating early intervention and consequent reduction in the risk of ischemic CVA.

RESUMEN: La estenosis carotídea generalmente es consecuencia de la acumulación de placa aterosclerótica en la pared de la arteria carótida y es un factor de riesgo importante para el accidente cerebral vascular (ACV) isquémico. Este estudio describe la importancia de los exámenes de diagnóstico por imágenes utilizados en odontología para la identificación precoz de placas de ateroma en la arteria carótida interna, a nivel extracraneal e intracraneal. Un paciente masculino fue remitido a una clínica de radiología para realizar una radiografía panorámica (RP) y tomografía computarizada de haz cónico (TCHC) para analizar opciones de tratamiento. En el RP y TCHC se observó una imagen radiopaca, sugestiva de ateroma en la arteria carótida, extracraneal, en el lado derecho. El diagnóstico fue confirmado por ultrasonido DOPPLER color carotídeo. En el TCHC, también se observó la presencia de calcificaciones en la arteria carótida interna, intracraneal. Los exámenes de imagenología diagnóstica utilizados en odontología permiten la identificación de individuos asintomáticos, lo que facilita la intervención temprana y la consiguiente reducción en el riesgo de ACV isquémico.