Acute endometritis induced by Escherichia coli in mares evaluated through color doppler ultrasonography / [Endometrite aguda induzida por Escherichia coli em éguas avaliadas por ultrassonografia com Doppler colorido]

The objectives of this study were to characterize the endometritis induced in mares using color Doppler ultrasonography and traditional exams. Experiment 1. Mares (n=20) were submitted to intrauterine inoculation with Escherichia coli. Uterine evaluation was performed at M0 and M1. Experiment 2. Animals were divided into two groups: control group (n=10), and treated group (n=10) using phytotherapeutic solution. In both groups, the uterine evaluation was performed at time T1, T2, and T3. Experiment 3: Uterine evaluation was compared after antibiotic therapy, phytotherapy, and M0. For statistical analysis, the Tukey test, t Student, and Anova test were applied. Experiment 1. The mean values of vascularization at M1 were significantly higher than those obtained at M0 (P<0.05). Bacterial growth was observed in all samples collected. Experiment 2. The mean value of vascularization at time T1 in both groups was significantly higher (P<0.05) compared to M2 and M3. Experiment 3. After antibiotic therapy, the vascularization of the body and uterine horns was not equivalent to the vascularization presented at M0. We can conclude that it was not possible to correlate results obtained by color Doppler ultrasonography with the traditional findings for the diagnosis of endometritis.(AU)

Os objetivos deste estudo foram caracterizar a endometrite induzida em éguas utilizando-se a ultrassonografia com Doppler colorido e exames tradicionais. Experimento 1: as éguas (n=20) foram submetidas à inoculação intrauterina com Escherichia coli. A avaliação uterina foi realizada em M0 e M1. Experimento 2: os animais foram divididos em dois grupos: grupo controle (n=10) e grupo tratado (n=10), sendo usada solução fitoterápica. Nos dois grupos, a avaliação uterina ocorreu nos momentos T1, T2 e T3. Experimento 3: a avaliação uterina foi comparada após antibioticoterapia, fitoterapia e M0. Para análise estatística, foram aplicados os testes de Tukey, t de Student e ANOVA. Experimento 1: os valores médios de vascularização em M1 foram significativamente maiores que os obtidos no M0 (P<0,05). Houve crescimento bacteriano em todas as amostras coletadas. Experimento 2: o valor médio da vascularização no tempo T1 nos dois grupos foi significativamente maior (P<0,05) do que o obtido em M2 e M3. Experimento 3: após antibioticoterapia, a vascularização do corpo e dos cornos uterinos não era equivalente à vascularização apresentada em M0. Pode-se concluir que não foi possível correlacionar os resultados obtidos pela ultrassonografia com Doppler colorido com os achados tradicionais para o diagnóstico de endometrite.(AU)

Diagnóstico microbiológico de artritis séptica en niños usando botellas de hemocultivos como un método alternativo / Microbiological diagnosis of septic arthritis in children using blood culture bottles as an alternative method

Introducción: La artritis séptica (AS) se define como la infección del espacio articular que afecta cualquier articulación, es más frecuente en niños menores de 5 años y su principal causa es la diseminación hematógena. El diagnóstico etiológico es difícil en niños, logrando aislamiento en menos de la mitad de los casos. Se evaluó el rendimiento diagnóstico de la botella de hemocultivo (BHC) como medio alternativo para la siembra del líquido sinovial comparado con los medios convencionales (MC). Metodología: Estudio de cohorte prospectivo realizado en centro de tercer nivel de 2011-2016, niños de 0 a 12 años con diagnóstico clínico de artritis séptica y disponibilidad de las dos muestras tomadas en cirugía. Resultados: Ingresaron 60 pacientes, masculinos 56%, mediana de edad 48 meses y tiempo de síntomas 58 horas (48-192); 33,3% con antecedente de trauma; 30% recibieron antibióticos previos. Articulaciones afectadas: cadera 44%, rodilla 28% y tobillo 18%. En 39 pacientes (65%) se tomaron hemocultivos; de estos 19 (49%) fueron positivos, todos para S. aureus. Se obtuvo confirmación en líquido sinovial por cualquier método en 27 pacientes (45%), positivos en ambos 21,6%, en MC 13,3% y en BHC 10%, los microorganismos más frecuentes SAMS 21,6%, SAMR 8,3%, S. pyogenes 3,3%, SEMR 3,3%, S. pneumoniae 1,6%, N. meningitidis 1,6%, no se aisló K. kingae. El tratamiento antibiótico más utilizado fueron los betalactamicos, mediana de estancia 18(12-25,5) días, mortalidad del 3,3%. Conclusión: Las BHC son un complemento al medio sólido convencional y aumentaron la confirmación etiológica de artritis séptica del 35% al 45%.

Introduction: Septic arthritis (SA) is defined as the infection of any joint space; it is more common in children under 5 years and its main cause is hematogenous dissemination. The etiological diagnosis is difficult in children, achieving isolation in less than half of the cases. The diagnostic performance of the blood culture bottle (BCB) was evaluated as an alternative medium for seeding synovial fluid compared to conventional media (CM). Methods: A prospective cohort survey was conducted in a third-level center from 2011-2016, in children aged 0 to 12 years with a clinical diagnosis of septic arthritis and availability of the two samples taken in surgery. Results: 60 patients were admitted, being 56% male, with a median age of 48 months and symptom time of 58 hours (48-192); 33.3% had a history of trauma; 30% received previous antibiotics. Affected joints: hip (44%), knee (28%), and ankle (18%). Blood cultures were taken in 39 patients (65%); of these, 19 (49%) were positive, all for S. aureus. Confirmation in synovial fluid was obtained by any method in 27 subjects (45%), positive in both: 21.6%, 13.3% in CM, and 10% in BCB. The most frequent microorganisms were: MSSA (21.6%), MRSA (8.3%), S. pyogenes (3.3%), MRSE (3.3%), S. pneumoniae (1.6%), N. meningitidis (1.6%). K. kingae was not isolated. The most commonly used antibiotic treatment was beta-lactams. The median of stay was 18 days (12-25.5), with a mortality of 3.3%. Conclusion: BCB are a complement to the conventional solid medium and increased the etiological confirmation of septic arthritis from 35 to 45%.

Diagnóstico de la Tricomonas vaginalis en la mujer / Diagnosis of Trichomonas vaginalis in women

OBJETIVO: revisar los diferentes métodos de diagnóstico de la tricomoniasis vaginal disponibles hasta el presente. MATERIALES Y MÉTODOS: se revisó la bibliografía latinoamericano e internacional a través de los sitios electrónicos de Pub-Med y Scielo. RESULTADOS: la Tricomonas vaginalis es considera como la enfermedad de transmisión sexual no viral, curable más frecuente y prevalente en el mundo. Se revisan los diferentes de métodos para diagnosticar la presencia de la tricomonas vaginalis en pacientes femeninos con síntomas y signos de la infección producida por el protozoario flagelado. CONCLUSIONES: se revisaron los diferentes métodos de diagnostico de la infección producida por la Tricomonas vaginalis en pacientes femeninas, desde los clásicos hasta los más actuales que emplean alta tecnología.

OBJECTIVE: to review the different diagnostic methods of Trichomonas vaginal available at the present time. MATERIAL AND METHOD: it was reviewed the Latin-American and international bibliography using the Pub-Med and Scielo web sites. RESULTS: Trichomonas vaginalis is considered the most common and prevalent sexual transmitted disease curable and non-viral worldwide. It was reviewed the different methods to diagnose the presence of Trichomonas vaginalis in female patients with symptoms and signs of infection produces by the flagellate protozoa. CONCLUSION: Different methods of diagnosis of the infection produced by Trichomonas vaginalis, since the classics to the most current methods that use high technology, were reviewed.

Abordagem das técnicas diagnósticas da DTM como uma doença biopsicossocial: uma revisão de literatura / Approach of diagnostic techniques of the DTM as a biopsychosocial disease: a literature review

Introdução: A disfunção temporomandibular (DTM) consiste em um conjunto de condições musculoesqueléticas e neuromusculares que envolve o complexo articular temporomandibular, a musculatura e os componentes ósseos adjacentes. Sua etiologia inclui múltiplos fatores desencadeantes biológicos, ambientais, emocionais, sociais e cognitivos. Objetivo: O trabalho objetivou realizar uma revisão de literatura a respeito dos métodos de diagnóstico englobando uma visão biopsicossocial da DTM. Materiais e Métodos: Constituise em uma busca bibliográfica realizada em uma respeitada base de pesquisa online para a produção do conhecimento em saúde: PubMed ­ U.S. National Library of Medicin, limitando-se a busca ao período de 2005 a 2019. Resultados: Devido a diversidade etiológica e características clínicas variadas, a análise biopsicossocial individualizada associada à exames imaginológicos surge como uma relevante ferramenta para o diagnóstico desse distúrbio. Conclusão: Uma abordagem de diagnóstico com base em um modelo de doença biopsicossocial é fundamental para que seja possível avaliar o paciente em toda a sua integralidade física, psicológica e social com o propósito de efetivar o planejamento de intervenções preventivas e terapêuticas sob medida para cada caso clínico.

Introduction: Temporomandibular dysfunction (TMD) consists of a set of musculoskeletal and neuromuscular conditions that involve the temporomandibular joint complex, the musculature and the adjacent bone components. Its etiology includes multiple biological, environmental, emotional, social and cognitive triggers. Objective: This study aimed to perform a literature review on diagnostic methods encompassing a biopsychosocial view of TMD. Materials and Methods: This study is a bibliographic search conducted in a respected online research base to produce health knowledge: PubMed - US National Library of Medicine, limiting the search to the period from 2005 to 2019. Results: Due to etiological diversity and varied clinical characteristics, individualized biopsychosocial analysis associated with imaging exams is a relevant tool for the diagnosis of this disorder. Conclusion: A diagnostic approach based on a biopsychosocial disease model is essential to assess the patient in all their physical, psychological and social completeness with the purpose of planning preventive and therapeutic interventions tailored to each case. clinical.

Algunas especificidades sobre la mortalidad asociada a la hemorragia por enfermedad ulcerosa péptica gastroduodenal / Some specificities on mortality associated with hemorrhage due to gastroduodenal peptic ulcerous disease

En la actualidad constituye un verdadero problema científico la diversidad de criterios sobre las características epidemiológicas, clínicas y quirúrgicas de la hemorragia digestiva alta no varicosa, debido a sus altas tasas de letalidad y mortalidad, por cuanto resulta de gran importancia identificar los factores pronósticos de complicaciones y decesos, inherentes a esta entidad clínica, a fin de elaborar un protocolo de actuación y buenas prácticas, una vez reconocidas las condiciones modificables que disminuyan el número de fallecimientos por esta causa, sobre todo en la población envejecida como grupo vulnerable, de donde se derivaría la trascendencia de su impacto médico social. Todo ello justifica la necesidad de profundizar en los principales aspectos cognoscitivos relacionados con este tema, puesto que solo contando con equipos de trabajo altamente especializados, podrá elevarse la calidad asistencial y, con esa premisa, el índice de supervivencia de quienes presenten ese tipo de sangrado por enfermedad ácido péptica.

At present the diversity of criteria on the epidemiological, clinical and surgical characteristics of the high digestive hemorrhage non varicose constitutes a true scientific problem, due to their high lethality and mortality rates, so that it is of great importance to identify the complications prognosis factors and death, inherent to this clinical entity, in order to elaborate a performance protocol and good practices, once the modifiable conditions which decrease the number of deaths due to this cause are recognized, mainly in the aged population as vulnerable group, from where the transcendency of its social medical impact would be derived . All this justifies the necessity to deepen in the main cognitive aspects related to this topic, since just having highly specialized working teams, it will be able to rise the assistance quality and, with that premise, the survival index of those who suffer from that type of bleedding caused by acid peptic disease.

Métodos de diagnóstico para detecção de prostatopatias caninas / Canine prostatic disease: diagnosis methods

As doenças prostáticas são comuns em cães, desenvolvendo-se após a maturidade sexual. Entre as afecções que acometem a próstata desses animais, a mais frequente é a hiperplasia prostática benigna (HPB). As neoplasias prostáticas, apesar de menos frequentes, são altamente malignas e um diagnóstico tardio está associado a um prognóstico ruim. Os principais métodos de diagnóstico das enfermidades prostáticas em cães incluem um exame clínico detalhado, ultrassonografia, punção aspirativa e biópsia. A utilização de biomarcadores séricos vem sendo estudada como uma maneira de se detectar a doença precocemente, evitando possíveis complicações no quadro clínico dos pacientes. Assim, estudos visando ao diagnóstico precoce de prostatopatias caninas, especialmente o câncer prostático, são cruciais para um tratamento eficaz e melhora da qualidade de vida do animal acometido.

Prostatic diseases are common in older dogs, developing after sexual maturity. The most common affecting canine prostate is benign prostatic hyperplasia (BPH). Although less frequent, prostatic neoplasias are highly malignant, and a late diagnosis is closely associated with a poor prognosis. The main methods of diagnosis of the canine prostatic disease include a detailed clinical exam, ultrasound, prostatic fine-needle aspirate and biopsy. Studies towards early diagnosis of this condition are crucial for effective treatment and improvement of quality of life of affected animals. The use of biomarkers has been studied for early detection of the disease, avoiding possible complications in clinical patients.

Cephalometric norms according to the Harvold´s analysis / Normas cefalométricas de acuerdo al análisis de Harvold

The purpose of this study was to establish cephalometric norms by age and gender of Harvold´s analysis for people living in the central region of Mexico and compare them with other populations to found morphologic craniofacial differences. One hundred sixteen males and 125 females were studied. The participants were divided into age groups. The parents and grandparents of the participants were born in Mexico. All participants had class I occlusion with normal growth, facial symmetry, no crowding and no previous orthodontic, orthopedic or maxillofacial surgery treatment. Lateral skull x-rays were obtained; each radiograph was analyzed on with a Harvold-like analysis. For statistical evaluation, the Student t´ test was used to compare the age groups between males and females. Significant gender differences were found in the following measurements: maxillary position, mandible position, and the anterior lower facial height in all age groups. Differences were found in the cranial and dental positions with other races respect to facial growth. Because every gender and race have their own characteristics, it is appropriate to use correct cephalometric norms in daily orthodontic practice. It is suggested to use the analysis of Harvold in a complementary way when in diagnosing a patient there is doubt on the alterations in the maxillae.

El propósito de este estudio fue establecer normas cefalométricas por edad y sexo de acuerdo al análisis de Harvold, para población de la región central de México y comparar estos patrones con otras poblaciones para encontrar diferencias en las características morfológicas craneofaciales. 116 hombres y 125 mujeres conformaron el estudio, divididos por grupos de edad. Los padres y abuelos de los participantes eran originarios de México. Todos los sujetos tenían clase I molar con un desarrollo normal, simetría facial, sin apiñamiento y sin previo tratamiento ortodóntico, ortopédico o cirugía maxilofacial. Se obtuvieron las radiografías laterales de cráneo; cada una se examinó de acuerdo al análisis cefalométrico de Harvold. Para el análisis estadístico, se aplicó la prueba t’ de Student para hacer la comparación entre grupos de edad y sexo. Se encontraron diferencias significativas entre hombres y mujeres en los siguientes parámetros: posición maxilar, posición mandibular y altura facial anteroinferior en todos los grupos de edad. Se demostraron diferencias en la posición dental y craneal con otras razas, respecto al crecimiento facial. Cada género y raza presenta sus características propias, por lo que es apropiado utilizar normas cefalométricas adecuadas en la práctica ortodóntica diaria. Se sugiere utilizar el análisis de Harvold como auxiliar o complemento cuando existe duda en el diagnóstico del paciente debido a alteraciones de los maxilares.

Diagnóstico do estado nutricional de escolares: comparação entre critério nacional e internacional / Diagnosing the nutritional status of schoolchildren: a comparison between Brazilian and international criteria

OBJETIVO: Comparar critério nacional e internacional para avaliação do estado nutricional de escolares. MÉTODOS: Estudo transversal incluindo 160 crianças, 91 meninos e 69 meninas, de 7 a 9 anos completos, alunos de escola pública da cidade do Rio de Janeiro. Utilizou-se o índice de massa corporal (IMC) por gênero e idade para diagnosticar baixo peso, peso adequado e excesso de peso, empregando-se critérios propostos por Cole et al., Conde & Monteiro e pela Organização Mundial da Saúde (OMS). Foram aplicados teste t de Student, qui-quadrado, concordância de Kendall, qui-quadrado de tendência e gráficos demonstrando a evolução do IMC, segundo diagnóstico nutricional obtido com cada critério. RESULTADOS: As médias de IMC não diferiram entre sexos (t = 0,2845 e p = 0,7789). Segundo critérios propostos por autores, não houve baixo peso, enquanto que para os critérios da OMS, ocorreu um caso de baixo peso entre meninos. O teste de Kendall não demonstrou diferença significativa entre os três critérios (coeficiente de concordância: meninos = W < 0,0004, meninas = W < 0,0008 e p = 1,00). As discordâncias na avaliação predominaram entre meninos, atingindo 15,13 por cento, sendo 13,04 por cento para meninas. Observou-se significativa tendência crescente de diferenciação dos critérios com a idade dos meninos (qui-quadrado de tendência = 6,552 e p = 0,0105), evidenciada no gráfico e independente do estado nutricional. CONCLUSÕES: Os critérios utilizados convergem para o mesmo resultado, não havendo discrepâncias ou vantagens entre eles. Entretanto, para meninos, houve significativa tendência de diferenciação nos diagnósticos e evolução do IMC por idade, alertando para cuidado na opção dos diferentes critérios.

OBJECTIVE: To compare Brazilian and international criteria for assessing the nutritional status of schoolchildren. METHODS: This was a cross-sectional study that enrolled 160 schoolchildren from a public school in the city of Rio de Janeiro, 91 boys and 69 girls, aged 7 to 9 full years. Body mass index (BMI) for sex and age was used to diagnose underweight, healthy weight and overweight, according to Cole et al., Conde & Monteiro, and the World Health Organization (WHO) criteria. Student's t test, the chi-square test, the Kendall concordance test and the chi-square test for tendencies were used to analyze the data; graphs were plotted demonstrating BMI by age, according to the nutritional diagnosis at each set of criteria. RESULTS: Mean BMI did not differ by sex (t = 0.2845, p = 0.7789). According to the first two sets of criteria, none of the children were underweight, whereas, according to the WHO criteria, one of the boys was underweight. The Kendall test did not demonstrate any significant difference between the three sets of criteria (coefficient of concordance for boys was W < 0.0004 and for girls it was W < 0.0008, with p = 1.00). There was a greater proportion of assessments that did not agree among the boys, at 15.13 percent, while for the girls this figure was 13.04 percent. A significant tendency was observed for the difference between the criteria to increase with age among the boys (chi-square for tendencies = 6.552, p = 0.0105), which was evident on the graph and was independent of nutritional status. CONCLUSIONS: The criteria used here converged on the same result, without discrepancies between them or advantages for either. Nevertheless, among the boys there was a significant tendency for the diagnoses to differentiate and BMI to increase with age, which is a warning to take care when choosing among criteria.

El diagnóstico convencional de Mycoplasma pneumoniae como agente causal de Neumonías Adquiridas en la Comunidad (NAC) / Conventional diagnosis of Mycoplasma pneumonia as causative agent of Community Acquired Pneumonia (CAP)

Resumen Las enfermedades infecciosas constituyen un importante problema de salud y específicamente la neumonía se encuentra entre las diez primeras causas de muerte a nivel mundial y en novena posición entre las principales causas de muerte en Venezuela. La Neumonía Adquirida en la Comunidad (NAC), se define como aquella que se presenta en pacientes no hospitalizados en los siete días previos al diagnóstico, o durante las primeras 48 horas de ingreso en pacientes hospitalizados. Entre los principales agentes etiológicos de la NAC, ocupando un segundo lugar en orden de frecuencia, se encuentra Mycoplasma pneumoniae. Los patógenos implicados en la neumonía extra-hospitalaria, difieren de aquellos causales de neumonías originadas en el hospital, y existe una notable diferencia en cuanto a su frecuencia de aparición y patrones de sensibilidad a drogas, por lo que es importante la identificación del agente causal. En este trabajo revisaremos los principales métodos convencionales (cultivo y serología) para el diagnóstico de este microorganismo, y analizaremos sus limitaciones, las cuales a menudo resultan en la aplicación de tratamiento de forma empírica.

Abstract Communicable diseases. among them specifically pneumonia, constitute an important public health problem, and they appear among the ten most important causes of death at a world wide level, and in the ninth place of causes of death in Venezuela. Community Acquired Pneumonia (CAP) is defined as that which occurs in non hospitalized patients during the seven days prior to diagnosis, or during the first 48 hours after internment in hospitalized patients. Mycoplasma pneumoniae is one of the main etiological agents of CAP, occupying the second place in order of frequency. Pathogens implicated in extra-hospital pneumonia differ from those that produce hospital originated pneumonia and there is a notable difference regarding their frequency of occurrence and drug sensibility patterns; therefore, it is important to identify the causative agent. In this study we will revise the main conventional diagnostic methods (culture and serology) for this microorganism, and we will analyze their limitations, that often are consequence of empirically applied treatments.

Costo-efectividad de los métodos de diagnóstico de la tuberculosis / Cost-effectiveness of diagnostic methods for tuberculosis

La tuberculosis puede ser una enfermedad insidiosa que, cuando su diagnóstico es tardío, puede evolucionar hacia formas crónicas o a la muerte; a veces, el estudio post mortem es el que da el diagnóstico de la enfermedad. La tuberculosis pulmonar se diagnostica con los métodos ya existentes, a diferencia de la tuberculosis extrapulmonar, en la que es más difícil el diagnóstico y en la que se requiere, en algunas ocasiones, de biopsias o material de aspiración. Para el diagnóstico de tuberculosis los métodos más usados han sido el examen microscópico para detectar bacilos ácido alcohol resistentes por tinción de Ziehl-Neelsen, la técnica de fluorescencia y el cultivo en medio de Löwestein-Jensen. En la actualidad existen nuevos métodos como la reacción en cadena de la polimerasa y la adenosin desaminasa, aplicable a líquidos corporales. El cultivo Mycobacterium Growth Identification Tube por fluorescencia permite identificar a la micobacteria de la manera más rápida e iniciar el tratamiento médico, evitar la progresión de la enfermedad, prevenir complicaciones y secuelas que tienen un costo muy elevado para las instituciones de salud. En el presente estudio se presentan las ventajas y el costo-efectividad de los diversos métodos de diagnóstico, evaluando la sensibilidad y especificidad, el valor predictivo positivo y negativo de cada uno de ellos.

Tuberculosis can be a silent disease that can progress into chronic and irreversible forms leading to incapacitaron and death; not rarely the diagnosis in made at the autopsy table. Lung tuberculosis is diagnosed by readily avaible methods; extrapulmonary tuberculosis diagnosis may require biopsy material. The usual laboratory diagnosis includes Ziehl-Neelsen smears for acid fast bacilli fluorescence techniques and Lowestein-Jensen cultures; for body fluids, new procedures include polymerase chain reaction and adenosine deaminase. The Mycobacterium growth identification tube culture allows a quicker identification of mycobacteria and earlier medical treatment, preventing the progression of TB and potential appearance of complications that represent a heavy monetary burden for the responsible institutions. This study presents the advantages and cost-effectiveness of several diagnostic procedures for TB, pondering the sensitivity, specificity, positive and negative predictive values of each one.

Actualidad en el diagnóstico de tuberculosis por el laboratorio / Current events in the laboratory diagnosis of Tuberculosis

La tuberculosis ha sido declarada por la Organización Mundial de la salud como una emergencia mundial, el número de casos nuevos y de muertes atribuidas a esta infección viene aumentando considerablemente por año. El diagnóstico es una de las estrategias fundamentales para el control, y la rapidez en proporcionar resultados incide en el manejo inicial del paciente y en el control de la cadena de transmisión. Implementar, desarrollar o evaluar nuevas tecnologías es una actividad importante en un laboratorio de referencia de tuberculosis como medio para realizar diagnósticos rápidos y precisos. La actualidad del diagnóstico de tuberculosis por el laboratorio se presenta en forma de revisión de tema, haciendo énfasis en los métodos diagnósticos actualmente utilizados o en los cuales se ha tenido experiencia en el laboratorio de la Unidad de Bacteriología y Micobacterias en la Corporación para Investigaciones Biológicas. El reto en la situación actual consiste en que el laboratorio utilice los mejores métodos disponibles sin que los costos comprometan su viabilidad