Frecuencia de agentes patógenos en meningitis neonatal en Lima, Perú, entre los años 2001 y 2021 / Frequency of pathogens in neonatal meningitis in Lima, Perú, between 2001 and 2021

RESUMEN Objetivo : Describir los agentes patógenos más frecuentes de la meningitis neonatal en el Perú. Material y métodos : Estudio descriptivo, comparativo y de corte transversal. Se realizó una búsqueda bibliográfica en las bases de datos de PubMed y SciELO con las palabras clave «meningitis¼, «neonatal¼ y «Perú¼, y en los repositorios virtuales de las facultades de Medicina del Perú con las palabras clave «meningitis¼ y «neonatal¼, entre los años 2001 y 2021. Asimismo, dos revisores independientes evaluaron los títulos y abstracts de los artículos para su inclusión. Resultados : Se encontraron 477 artículos, de los cuales cinco fueron incluidos. De estos últimos, dos fueron excluidos por falta de datos descriptivos de los gérmenes, quedando tres elegidos. Conclusiones : Los microorganismos más frecuentes fueron Listeria monocytogenes, Staphylococcus coagulasa-negativo y Escherichia coli, con predominio de bacterias grampositivas. La etiología viral fue poco frecuente y de presentación tardía. Solo se registró un caso por Candida albicans. No se encontraron registros de vigilancia epidemiológica de meningitis neonatal.

ABSTRACT Objective : To describe the most frequent pathogenic agents identified in neonatal meningitis in Peru. Material and methods : Descriptive, comparative, cross-sectional study based on data bases from PubMed and SciELO, using the key words "Neonatal", "Meningitis" and "Perú", and from virtual repositories of medical schools in Peru, with the key words "Neonatal" and "Meningitis", between 2001 and 2021. Two independent reviewers assessed the articles' titles and abstracts to be included. Results : 477 articles were found from which only 5 were included; 2 studies were excluded due to lack of descriptive identification of the microorganisms, so that only 3 studies were finally selected. Conclusions : The most frequently found microorganisms were Listeria monocytogenes, coagulada-negative Staphylococcus and Escherichia coli, predominantly grampositive bacterias. The viral etiology was uncommon, and all cases had a late onset. There was only 1 case due to Candida albicans. An epidemiologic monitoring of neonatal meningitis is not established in Peru.

Validity Evidence of the Work-Family Conflict Scale for Public Security Professionals / Evidências de Validade da Escala Conflito Trabalho-Família para Profissionais da Segurança Pública

Abstract The aim of this article is to present evidence of validity for the 'work-family conflict scale' with a sample of 10,383 professionals working in Brazilian public security. Cross-validation procedures were applied through the definition of two subsamples, exploratory and confirmatory factor analyses were performed. All ethical procedures were followed. The results found in both the exploratory factor analysis ('Work Interference with Family' Factor, with factor loadings between .91 and .81 and alpha of .93, and 'Family Interference with Work' Factor, with factor loadings between .96 and .71 and alpha of .90) and the confirmatory analysis (χ2/df <5; CFI >.98; TLI >.98; RMSEA <.10) demonstrate robust evidence of validity, indicating the use of the scale in other organizational contexts.

Resumo O artigo tem como objetivo geral apresentar evidências de validade da escala 'conflito trabalho-família' junto a uma amostra de 10.383 profissionais que atuam na segurança pública brasileira. Optou-se pela condução dos procedimentos de validação cruzada, por meio da definição de duas subamostras, foram realizadas análises fatoriais exploratórias e confirmatórias. Todos os procedimentos éticos foram adotados. Os resultados encontrados tanto na análise fatorial exploratória (Fator 'Interferência do Trabalho na Família', com cargas fatoriais entre 0,91 e 0,81 e alpha de 0,93 e Fator 'Interferência da Família no Trabalho, com cargas entre 0,96 a 0,71 e alpha de 0,90) quanto confirmatória (χ2/gl < 5; CFI > 0,98; TLI > 0,98; RMSEA < 0,1) demonstram robustas evidências de validade, indicando o uso da escala em outros contextos organizacionais.

Inmunoterapia con anticuerpos F(ab')2 neutralizantes anti- SARS-CoV-2 de suero equino en el tratamiento de pacientes ambulatorios con neumonía bilateral por COVID-19 / Immunotherapy with anti-SARS-COV-2 neutralyzing F(ab´)2 antibodies from equine serum in the treatment of out-patients with bilateral COVID-19 pneumonia

Resumen Introducción: La inmunoterapia pasiva es una alternativa terapéutica para los pacientes con COVID-19. Métodos: Se tomó la decisión de realizar una base de datos prospectiva de los pacientes con diagnóstico de neumonía por SARS-CoV-2, no hipoxémica, tratados de forma ambulatoria en el Hospital de Bolívar, Dr. Miguel Capredoni, provincia de Buenos Aires, Argentina, con el objetivo de evaluar la eficacia del tratamiento con suero equino hiperinmune en la reducción de casos graves e internaciones. Realizamos un análisis retrospectivo del período comprendido entre el 26/05/2021 al 28/08/2021, se incluyeron 151 pacientes. Las opciones fueron meprednisona y colchicina asociadas a dos infusiones de suero equino (n = 92) o me prednisona y colchicina durante 10 días por vía oral (n = 59). Resultados: No se observaron diferencias en las características poblacionales y comorbilidades entre ambos grupos. El 46% (69) de los pacientes había recibido por lo menos una dosis de vacuna contra COVID-19. Durante el seguimiento el 23% (35) requirió internación, sin diferencias entre el grupo suero equino y el grupo control (p = 0.89). Se observó una tendencia no significa tiva al riesgo de internación prolongada del 15.7%. (Grupo suero equino 38.1% vs. grupo control 53.8%, Fisher Exact test p = 0.41). La mortalidad en el grupo suero equino fue del 3.97% (4), sin observarse diferencias entre ambos grupos. Se observaron diferencias entre los pacientes vacunados y no vacunados, en puntos duros como necesidad de ARM (0% vs. 8% p = 0.001) y muerte (0% vs. 8% p = 0.001). Discusión: Si bien las tasas de internación y muerte fueron menores de lo esperado, la utilización de suero equino hiperinmune en el escenario ambulatorio impresiona no aportar beneficio clínico.

Abstract Introduction: Passive immunotherapy is a therapeutic alternative for patients with COVID-19. Methods: The decision was made to create a prospective database of patients diagnosed with SARS-CoV-2 pneumonia, non-hypoxemic, treated on an outpatient basis at the Hospital de Bolívar, Dr. Miguel Capredoni, province of Buenos Aires, Argentina, with the aim of evaluating the efficacy in reducing severe cases and hospitalizations of treatment with hyperimmune equine serum in this subgroup of patients. We performed a retrospective analysis of the period from 05/26/2021 to 08/28/2021, where a total of 151 patients were included. The options were meprednisone plus colchicine associated with two equine serum infusions (n = 92) or oral meprednisone and colchicine for 10 days (59). Results: No differences were observed between the population characteristics and comorbidities between both groups. A 46% (69) of the patients had received at least one dose of vaccine against COVID-19. During follow-up, 23% (35) required hospitalization, with no differences between the equine serum group and the control group (p = 0.89). A non-significant trend of 15.7% was observed for the risk of prolonged hospitalization. (Equine serum group 38.1% vs. control group 53.8%, Fisher Exact test p = 0.41). Mortality between the equine serum group was 3.97% (4), with no differences between the two groups. Differences were observed between vaccinated and unvaccinated patients in hard points such as the need for MRA (0% vs. 8% p = 0.001) and death (0% vs. 8% p = 0.001). Discussion: Although the rate of hospitalization and death were lower than expected, the use of hyperimmune equine serum in the outpatient setting impresses as not providing clinical benefit.

Vasectomy re-reversal: effectiveness and parameters associated with its success

ABSTRACT Introduction: When the vasectomy reversal (VR) fails, and the patient desires natural conception with his sperm, vasectomy re-reversal (VRR) is the only alternative. Purpose: To determine the VRR effectiveness and whether specific parameters can be associated with its success. Materials and Methods: We retrospectively evaluated 18 consecutive vasectomized patients, who had failed their VR through bilateral vasovasostomy, and posteriorly were submitted to VRR. The parameters of the study were: age of the patients, elapsed time between vasectomy and VRR (V-VRRt), elapsed time between VR and VRR (VR-VRRt), presence of spermatozoa in the proximal vas deferens fluid (SptzVDF) in the VRR and results of semen analysis after VRR (SA-VRR). Results: The mean of the age of the patients was 44.11±6.55 years (32.0-57.0), the mean of V-VRRt was 11.76±6.46 years (1.5-25.0) and the mean of VR-VRRt was 2.13±2.27 years (0.5-10.0). SptzVDF in the VRR were found bilaterally in 8 patients, unilaterally in 4 and absent in 6. SA-VRR demonstrated normozoospermia in 9 patients, oligozoospermia in 3 and azoospermia in 6, with patency rate of 66.67%. SA-VRR showed statistically significant dependence only with SptzVDF in the VRR (p <0.01). Conclusions: VRR was effective in restoring the obstruction in more than half of the patients. Furthermore, the presence of spermatozoa in the vas deferens fluid was the parameter associated with the VRR success.

Genomics and epidemiology of the P 1 SARS-CoV-2 lineage in Manaus, Brazil

Cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Manaus, Brazil, resurged in late 2020 despite previously high levels of infection. Genome sequencing of viruses sampled in Manaus between November 2020 and January 2021 revealed the emergence and circulation of a novel SARS-CoV-2 variant of concern. Lineage P.1 acquired 17 mutations, including a trio in the spike protein (K417T, E484K, and N501Y) associated with increased binding to the human ACE2 (angiotensin-converting enzyme 2) receptor. Molecular clock analysis shows that P.1 emergence occurred around mid-November 2020 and was preceded by a period of faster molecular evolution. Using a two-category dynamical model that integrates genomic and mortality data, we estimate that P.1 may be 1.7- to 2.4-fold more transmissible and that previous (non-P.1) infection provides 54 to 79% of the protection against infection with P.1 that it provides against non-P.1 lineages. Enhanced global genomic surveillance of variants of concern, which may exhibit increased transmissibility and/or immune evasion, is critical to accelerate pandemic responsiveness.

Association between dietary pattern and metabolic disorders in children and adolescents with urolithiasis / Associação entre o padrão alimentar e distúrbios metabólicos em crianças e adolescentes com urolitíase

Abstract Objective: To describe the dietary patterns and occurrence of metabolic disorders in children and adolescents with urolithiasis treatment at a referral hospital in southern Brazil in order to learn the features of urolithiasis in this population to better develop preventive actions. Methods: Descriptive study conducted between 2016 and 2017 in a tertiary care referral hospital. Fourty patients aged 2-19 years old with urolithiasis proven by imaging were included. Clinical and dietary data were obtained through interviews and medical records. For statistical analyses, the chi-squared test was performed. Results: 40 individuals were analyzed. Mean age at diagnosis was 7.2 ± 4 years. 25% were overweight or obese. 95% had metabolic disorders, hypocitraturia being the predominant type. Protein intake was adequate in all participants and carbohydrate intake, in 70% of them; 37.5% had lipid intake above recommended and 65% had low fiber intake. The mean daily sodium intake was 2.64 g (±1.74), with 55% of participants ingesting more than the recommended amount. A total of 52.5% had low potassium intake, with a mean of 4.79 g/day (±2.49). Calcium intake was adequate in 27.5%. No significant differences were identified in relation to mean daily consumption among participants with or without the various metabolic disorders. Conclusion: Pediatric urolithiasis is often accompanied by metabolic disorders; therefore, metabolic evaluation should be part of the diagnostic process and subsequent analysis of these patients' dietary patterns, helping to optimize treatment and prevent recurrences and complications.

Resumo Objetivo: Descrever o padrão alimentar e a ocorrência de distúrbios metabólicos em crianças e adolescentes portadoras de urolitíase acompanhadas em hospital de referências no sul do Brasil a fim de conhecer as particularidades da urolitíase nessa população para melhor desenvolver ações de prevenção. Métodos: Estudo observacional descritivo realizado entre 2016 e 2017 em centro de referência em atenção terciária. Foram selecionados 40 pacientes de dois a 19 anos com urolitíase comprovada por exame de imagem. Dados clínicos e alimentares foram obtidos através de prontuário e entrevista. Para análise estatística, utilizou-se o teste qui-quadrado. Resultados: Foram analisados 40 indivíduos, 55% masculinos. Idade média ao diagnóstico 7,2 ± 4 anos; 25% tinham sobrepeso ou obesidade; 95% tinham distúrbios metabólicos, predominou a hipocitratúria. O consumo proteico e de carboidratos foi adequado em 100% e 70% dos participantes, respectivamente, 37,5% apresentaram ingestão de lipídeos acima do recomendado e 65% apresentaram ingestão de fibras alimentares abaixo do recomendado. O consumo diário médio de sódio foi de 2,64 g (± 1,74), com 55% acima do recomendado; 52,5% apresentaram baixa ingestão de potássio com média de 4,79 g/dia (± 2,49). O consumo de cálcio foi adequado em 27,5%. Não foram identificadas diferenças significativas em relação ao consumo médio diário dos nutrientes entre os participantes com ou sem os diversos distúrbios metabólicos. Conclusões: A urolitíase pediátrica é frequentemente acompanhada de distúrbios metabólicos, o que confirma a necessidade de avaliação metabólica adequada ao diagnóstico e análise do padrão alimentar a fim de identificar erros alimentares, aprimorar o tratamento desses distúrbios e prevenir recorrências e complicações.

Tremorgenic syndrome caused by Ipomoea pes caprae in cattle / Síndrome tremorgênica causada pela ingestão de Ipomoea pes caprae em bovinos

Poisonous plants are a significant cause of death among adult cattle in Brazil. Plants that affect the central nervous system are widely spread throughout the Brazilian territory and comprise over 30 toxic species, including the genus Ipomoea, commonly associated with a lysosomal storage disease and a tremorgenic syndrome in livestock. We describe natural and experimental Ipomoea pes caprae poisoning in cattle from a herd in the Northside of Rio de Janeiro, Brazil. Affected cattle presented episodes of severe ataxia, abnormal posture followed by falling, muscular tremor, contraction, and spasticity, more prominent in the limbs, intensified by movement and forthcoming, and recumbence. Grossly, a substantial amount of leaves and petioles were found in the rumen. Histopathological examination showed degenerative neuronal changes, mostly in cerebellar Purkinje cells, which were confirmed with Bielschowsky silver. The characteristic clinical changes and mild histological lesion strongly suggested a tremorgenic syndrome. Lectin- immunohistochemistry evaluation reinforced this hypothesis; all lectins tested failed to react with affect neurons and Purkinje cells, which ruled out an underlying lysosomal storage disease. One calf given I. pes caprae leaves experimentally developed clinical signs similar to natural cases. On the 28th day of the experiment, the plant administration was suspended, and the calf recovered within four days. I. pes caprae's spontaneous tremorgenic syndrome in cattle is conditioned to exclusive feeding for several months. We were able to experimentally reproduce toxic clinical signs 12 days following the ingestion.(AU)

A intoxicação por plantas tóxicas está entre as três causas de morte mais importantes em bovinos adultos no Brasil. O grupo das plantas que causam alterações neurológicas, muito bem representada no país, encerra mais de trinta espécies tóxicas, entre as quais do gênero Ipomoea, amplamente distribuídas no território brasileiro. As plantas tóxicas desse gênero podem causar doenças do armazenamento ou síndrome tremorgênica. Descrevem-se a intoxicação natural e reprodução experimental por Ipomoea pes caprae em bovinos, verificada no norte do Estado do Rio de Janeiro. Foram observados episódios de intensa ataxia locomotora, postura anormal seguida de queda, incapacidade de levantar-se, tremores, contrações, espasticidades musculares nos membros, intensificados após estimulação ou a simples aproximação e decúbito. Nos bovinos afetados há mais de 6 meses, os sinais clínicos tornavam-se permanentes. À necropsia havia apenas significativa quantidade de folhas e pecíolos da planta no rúmen. O estudo histopatológico evidenciou lesões neuronais degenerativas principalmente nos neurônios de Purkinje. A impregnação argêntica pela técnica de Bielschowsky ratificou esses achados microscópicos. As lesões histológicas sutis associadas ao quadro clínico indicam que trata-se de intoxicação tremorgênica. O fato de não haver nenhum armazenamento intracitoplasmático, confirmado pelo resultado do estudo lectino-histoquímico (não houve afinidade das lectinas Con-A, WGA e sWGA e de outras lectinas empregadas aos neurônios de Purkinje e outros neurônios afetados), é suficiente para descartar a possibilidade de tratar-se de doença do armazenamento. No bezerro intoxicado experimentalmente verificaram-se sinais clínicos semelhantes, entretanto, com a interrupção do fornecimento da planta no 28º dia, os sinais clínicos desapareceram após quatro dias. I. pes caprae causa síndrome tremorgênica espontânea em bovinos, quando ingerida como alimentação exclusiva durante períodos prolongados (muitos meses). Experimentalmente, os primeiros sinais clínicos da intoxicação foram reproduzidos após 12 dias de ingestão da planta.(AU)

Brain Abscess and Esophageal Dilatation: Where is the Link? ­ Case Report

Introduction Caustic substance ingestion is a common cause of esophageal stricture in children. The primary treatment is esophageal dilatation. Although it is known that endoscopic esophageal dilatation is a procedure associated with a high rate of bacteremia, current guidelines do not recommend routine throat swab cultures or antibiotic prophylaxis for the general children population. Case Report We describe a case of a 7-year-old boy presenting with refractory headaches who was diagnosed with cranial abscess after multiple esophageal dilatations due to stenosis caused by caustic soda ingestion. The patient was subjected to neurosurgical intervention and intravenous antibiotic treatment for 6 weeks. Streptococcus viridans culture was positive in purulent abscess content. Conclusion We highlight this condition that, although rare, needs immediate diagnosis and proper treatment. We also recommend routine testing of throat swabs and antibiotics prophylaxis to children undergoing esophageal dilatation.

Yellow fever surveillance challenge: Investigation of a marmoset non-autochthonous case

Yellow fever (YF) surveillance in Brazil is focused mainly on the detection of epizootic events regarding New World non-human primates (NWNHP). We present a challenging case of a Callitrichidae (Callithrix spp) kept as a domiciliated pet that lived in the urban area of São Paulo municipality and was positive to YF virus by RT-qPCR and immunohistochemistry. After investigation, it was the first occurrence of non-autochthonous YF case of NWNHP described, with probable place of infection in the North shore of São Paulo state. This case illustrates the importance of coordinated laboratorial and field actions, and risks posed by transit of wildlife.

Use of infrared thermography in Quarter Horse submitted to team roping / Uso da termografia infravermelha em equinos da raça Quarto de Milha submetidos à prova de laço em dupla

This study aimed to verify whether the body and local temperatures change after high-intensity, short-duration exercise (team roping) and whether different pieces of training influence these changes. To this end, twelve animals, males and females, aged 3-6 years, with an average weight of 450 kg, were used. The horses were divided into two groups: regular training (RTG) and sporadic training (STG). The surface temperatures were assessed using a specific thermal camera. Temperatures of the ocular, thoracolumbar, distal tendon (thoracic and pelvic limbs) and croup regions were measured 30 min before, immediately after, and one, two, six and 24 hours after competition simulation. In the RTG, there was an increase in surface eye temperature two hours after exercise, returning to baseline level 24 hours later. In the STG, increase in eye temperature occurred immediately after exercise and returned to baseline level two hours later. Temperature of the pelvic limb tendons and croup (right side) rose immediately after exercise and did not return to baseline level 24 hours later. Team roping exercise increased the surface temperature of the distolateral thoracic and pelvic limb, croup and thoracolumbar regions in both groups and the eye temperature in the STG. Training frequency influenced the surface temperature profile in the distolateral pelvic limb, croup and thoracolumbar regions.(AU)

Os objetivos do presente estudo foram verificar se as temperaturas corpóreas e locais se alteram após exercício de alta intensidade e curta duração (prova de laço em dupla) e se treinamentos distintos podem influenciar nestas alterações. Foram utilizados 12 animais, machos e fêmeas, com idade entre 3 e 6 anos e peso médio de 450kg. Os animais foram divididos em dois grupos: treino regular (GTR) e treino esporádico (GTE). As aferições da temperatura por meio de termografia infravermelha foram feitas por uma câmera termal específica. As medições das temperaturas das regiões ocular, toracolombar, tendíneas distais (membros torácicos e pélvicos) e garupa foram realizadas 30 minutos antes, imediatamente depois, uma, duas, seis e 24 horas após a simulação de competição. No GTR houve aumento de temperatura ocular duas horas após o exercício, retornando ao basal apenas 24 horas depois. No GTE o aumento ocorreu imediatamente após o exercício e retornando ao basal duas horas depois. As temperaturas da região dos tendões dos membros pélvicos e garupa (lado direito) elevaram-se imediatamente após o exercício e não retornaram ao basal após 24 horas. O exercício de laço em dupla aumentou as temperaturas superficiais nas regiões distolateral de membros torácicos e pélvicos, garupa e região toracolombar de ambos os grupos e da temperatura ocular do GTE. A frequência de treinamento influenciou o perfil de temperatura superficial na região distal de membros pélvicos, garupa e toracolombar.(AU)

Características clínicas y epidemiológicas de pacientes con paracoccidioidomicosis diagnosticados en un hospital de Resistencia, Chaco / Clinical and epidemiological characteristics of patients with paracoccidioidomycosis diagnosed in a hospital of Resistencia, Chaco

Con el objetivo de describir las características clínico-epidemiológicas de la paracoccidioidomicosis, se realizó un estudio descriptivo de los casos diagnosticados por el Servicio de Microbiología Clínica del hospital de adultos Dr. Julio C. Perrando, de la ciudad de Resistencia (Chaco, Argentina). Entre 2011 y 2014 se detectaron 46 casos. En 2013 y 2014 se constató un incremento de la tasa de incidencia de alrededor de 4 veces con respecto a los anos anteriores. La forma crónica fue la predominante, con una media de edad de los pacientes de 53 anos. Del total de ellos, a 39 se les realizaron pruebas serológicas. En 15 de 39 casos, las pruebas serológicas fueron la única herramienta diagnóstica, mientras que en 4 de estos casos con diagnóstico microbiológico, la prueba resultó no reactiva. La inclusión de la paracoccidioidomicosis en el diagnóstico diferencial de pacientes de áreas endémicas que presentan un síndrome infeccioso inespecífico y la aplicación de las herramientas diagnósticas disponibles contribuyen al diagnóstico oportuno, así como a disminuir las secuelas de esta afección y su impacto socioeconómico.

In order to describe the clinical and epidemiological characteristics of paracoccidioidomycosis, a descriptive study of all the cases diagnosed by the Clinical Microbiology Service at Dr. Julio C. Perrando hospital in the city of Resistencia (Chaco Province, Argentina) was conducted. Between 2011 and 2014, 46 cases were detected. In the period 2013-2014, an almost 4-fold increase in the incidence rate was detected. The chronic form of the disease was predominant with an average age of 53 years. Serological tests in 39 out of 46 patients were performed. In 15 of 39 patients, serological tests were the only diagnostic tool while in 4 patients with a microbiological diagnosis serological tests were non-reactive. In patients from endemic areas with non-specific infectious syndrome it is important to include paracoccidioidomycosis in the differential diagnosis and to apply all available diagnostic tools to reach a timely diagnosis and to reduce the long-term sequelae and their socio-economic impact.

Tongue development in stillborns autopsied at different gestational ages / Desenvolvimento da língua em natimortos autopsiados em diferentes idades gestacionais

Abstract Objectives: This study aimed to analyze, through the morphometric method, the perimeter and length of the tongue, the collagen fibers, and the perimeter of blood vessels at different gestational ages and fetal weights. Material and methods: Tongues (n = 55) of stillborns autopsied at 23-40 weeks of gestational age were macroscopically analyzed, and their length and perimeter were measured. Fifty-five tongue fragments were collected through a longitudinal section in the region that accompanies the median lingual sulcus and histologically processed. Slides were stained with picrosirius and immunolabeled with CD31 antibody. Quantification was performed on collagen fibers under polarized light, and on the perimeter of vessels with the CD31. Results: A positive and significant correlation of gestational age with tongue perimeter and length was found. There was a positive and significant correlation between collagen fibers and gestational age, as well as between gestational age and the perimeter of blood vessels. Between collagen fibers and fetal weight, a positive and significant increase was observed. Regarding the correlation between the perimeter of blood vessels and the fetal weight, an increase was observed. Conclusion: As gestational age advances, there is an increase in tongue perimeter and length, in the percentage of collagen fibers, and in vascular perimeter, demonstrating that tongue formation is directly related to tongue growth and development.

Resumo Objetivo: Analisar, por meio do método morfométrico, o perímetro e o comprimento da língua, as fibras de colágeno, o perímetro dos vasos sanguíneos, em idades gestacionais e de acordo com o peso fetal. Materiais e métodos: Línguas (n = 55) de natimortos autopsiados com 23-40 semanas de idade gestacional foram analisadas macroscopicamente, medidas em comprimento e perímetro; 55 fragmentos das línguas foram coletados por meio de uma secção longitudinal na região que acompanha o sulco lingual médio e processados histologicamente. As lâminas foram coloridas com picrosirius e imunomarcadas com o anticorpo CD31. A quantificação foi feita em fibras de colágeno examinadas com microscópio de luz polarizada e o perímetro dos vasos com o CD31. Resultados: Foi encontrada uma correlação positiva e significativa da idade gestacional com o perímetro e o comprimento da língua. Houve uma correlação positiva e significativa entre as fibras de colágeno e a idade gestacional; bem como entre a idade gestacional e o perímetro dos vasos sanguíneos; e houve um aumento positivo e significativo entre as fibras de colágeno e o peso fetal. No que diz respeito à correlação entre o perímetro dos vasos sanguíneos e o peso fetal, houve um aumento. Conclusão: Conforme a idade gestacional avança, há um aumento no perímetro e no comprimento da língua, um aumento no percentual de fibras de colágeno e um aumento no perímetro vascular, demonstra que a formação da língua está diretamente relacionada ao crescimento e ao desenvolvimento da língua.

Hikikomori: revisão sobre um grave fenômeno de isolamento social / Hikikomori: review on a severe phenomenon of social withdrawal

RESUMO Objetivos Expandir os conhecimentos sobre o fenômeno de isolamento social prolongado, voluntário e grave denominado hikikomori e facilitar a identificação e o acompanhamento terapêutico desses indivíduos. Métodos Foi realizada uma revisão da literatura de 2000 a 2017, sendo utilizadas várias bases de dados como instrumentos de busca usando as palavras-chave: "hikikomori", "youth social withdrawal" e "isolamento social prolongado". Resultados O hikikomori foi descrito inicialmente no Japão, sendo considerado uma síndrome ligada à cultura nipônica. Porém, nos últimos anos foi descrito em diversos países, inclusive no ocidente. Afeta principalmente adolescentes e adultos jovens do sexo masculino, os quais vivem espontaneamente reclusos em seus quartos por pelo menos seis meses. São pessoas solitárias, tímidas, com um suporte social deficiente e que, frequentemente, tiveram alguma experiência traumática na infância. A maioria dos indivíduos apresenta algum transtorno psiquiátrico associado. O fenômeno acarreta terríveis prejuízos para o indivíduo, familiares e para a sociedade como um todo. Conclusão O hikikomori é subdiagnosticado e subtratado fora do Japão, pelo desconhecimento dos profissionais da saúde e pela recusa dos portadores em buscar ajuda. O fenômeno ainda não foi incluído numa categoria de diagnóstico psiquiátrico, o que dificulta a padronização e a realização de pesquisas ao redor do mundo.

ABSTRACT Objectives To expand the current knowledge on the phenomenon of severe, voluntary and prolonged social withdrawal called hikikomori, and to facilitate the identification and treatment of these individuals. Methods A comprehensive review of the literature from 2000 to 2017 has been conducted, using several data bases as search instruments using the keywords "hikikomori", "youth social withdrawal" and "prolonged social isolation". Results Hikikomori was firstly described in Japan and was considered a culture-bound syndrome. However, in the last years, it has been described in several other countries, including western countries. It affects mainly male adolescents and young adults, who spontaneously live recluse in their rooms, for at least six months. They are lonely and shy people, with insufficient social support, who frequently had some traumatic experience in childhood. Most of them present some associated psychiatric disorder. The phenomenon leads to terrible losses to the individuals, their families and to society. Conclusion Hikikomori is an underdiagnosed and undertreated condition outside Japan, due to the lack of knowledge of health professionals, and for the sufferers' refusal to seek help. The phenomenon was not yet included as a psychiatric disorder in the classifications, what difficults the standardization and conduction of research around the world.

Avaliação da lactatemia e das enzimas musculares de equinos Quarto de Milha submetidos à prova de laço em dupla com diferentes tipos de treinamento / Evaluation of lactatemia and muscle enzymes in Quarter Horses subjected to team ropping with different types of training

O objetivo do trabalho foi avaliar a influência de diferentes tipos de treinamento sobre o condicionamento físico de equinos por meio da determinação do lactato sanguíneo e da atividade sérica de creatina quinase, aspartato aminotransferase e lactato desidrogenase após exercício físico de alta intensidade e curta duração. Amostras de sangue venoso foram obtidas de 16 equinos da raça Quarto de Milha, divididos em dois grupos: grupo de treinamento regular (GTR) e grupo de treinamento esporádico (GTE), em sete diferentes momentos: 30 minutos antes do exercício (M0), imediatamente após (M1), 30 minutos (M2), uma (M3), duas (M4), seis (M5) e 24 (M6) horas após o exercício. Para a análise estatística, os dados foram testados quanto à normalidade e homogeneidade de variâncias. Para comparar os grupos e os momentos em cada grupo foram utilizados testes paramétricos (ANOVA) para a análise das atividades séricas das enzimas musculares e não paramétricos (Mann-Whitney e Friedmann) para a análise do lactato sanguíneo (P<0,05). Não houve diferença significativa entre os grupos para nenhuma variável. No entanto, dentro dos grupos experimentais foi possível observar diferenças significativas entre os momentos avaliados, em relação ao lactato e à LDH. No GTE, foram observadas diferenças significativas quanto ao lactato, entre o M0 e o M1, com valores respectivos de 0,90 mmol/L (mín. 0,8 - máx. 1,6) e 3,65mmo/L (mín. 1,0 - máx. 5,7) e quanto à LDH, onde os valores descritos no M6 diferiram significativamente de M0, M1, M2, M3 e M4. No GTR, diferenças significativas entre os momentos experimentais foram observadas em relação à LDH, sendo que os valores observados no M6 foram os menores e diferiram significativamente daqueles encontrados no M1, M2, M3 e M4. Em conclusão, não houve diferença entre o condicionamento físico dos animais treinados regularmente e aqueles treinados esporadicamente. A baixa magnitude das elevações das concentrações de CK, AST e LDH após o exercício e o rápido retorno aos valores basais, inclusive do lactato, observados em ambos os grupos, sugere que todos os animais avaliados estavam condicionados e aptos a realizar tal atividade física.(AU)

The aim of this study was to evaluate the influence of different types of training on physical fitness through the determination of blood lactate and serum creatinine kinase, aspartate aminotransferase, and lactate dehydrogenase activity after high intensity and short duration physical exercise. Venous blood samples were obtained from 16 Quarter Horses, divided into two groups: the regular training group (GTR) and sporadic training group (GTE), in seven different moments: 30 minutes before exercise (M0), immediately after the exercise (M1), 30 minutes (M2), one hour (M3), two hours (M4), six hours (M5) and 24 hours (M6) after the exercise. For statistical analysis, data was tested for normality and homogeneity of variances. To compare the groups and times in each group, parametric tests (ANOVA) were used for muscular enzymes activity and not parametric tests (Mann-Whitney and Friedmann) were used to analyze blood lactato (P<0.05). There was no significant difference between groups for any variable. However, within the experimental groups it was possible to observe significant differences between the evaluated moments, in relation to lactate and LDH. In the GTE, significant differences were observed for lactate between M0 and M1, with respective values ​​of 0.90 mmol/L (min. 0.8, max. 1.6) and 3.65 mmol/L (min. 1.0, max. 5,7) and for LDH, where the values ​​described in M6 differed significantly from M0, M1, M2, M3 and M4. In the GTR, significant differences between the experimental moments were observed in relation to LDH, and the values ​​observed in M6 were the lowest and differed significantly from those found in M1, M2, M3 and M4. In conclusion, there was no difference between the fitness of animals regularly trained and those trained sporadically. The low magnitude of elevations of serum CK, AST and LDH activity after exercise and the quick return to baseline values, including the blood lactate observed in both groups, suggest that all of evaluated animals were conditioned and able to perform such physical activity.(AU)

Mycoplasma pneumoniae: manifestaciones neurológicas y controversias diagnósticas. A propósito de un caso / Mycoplasma pneumoniae: neurologic manifestations and diagnostic controversies. A case report

Mycoplasma pneumoniae (Mp) es el agente causal de un 30% de las manifestaciones respiratorias de la población general. La neumonía ocupa el primer lugar dentro de este grupo. Las manifestaciones neurológicas representan las formas más frecuentes de presentación clínica extrapulmonar (40%). Las encefalitis y meningoencefalitis son las formas más habituales de sintomatología neurológica asociada a infección por Mp. La presentación de más de una variante clínica en un mismo paciente asociada a primoinfección por Mp es posible. El diagnóstico serológico plantea, habitualmente, controversias en su interpretación. A partir del caso de una niña de 7 años con inyección conjuntival, adenopatía cervical, rash descamativo y fotofobia con "pseudoedema de papila bilateral", que desarrolla durante su evolución parálisis facial periférica y meningitis aséptica, se analizarán las controversias que se plantean en relación con la interpretación diagnóstica asociada al compromiso neurológico por Mp.

Mycoplasma pneumoniae (Mp) is responsible for 30% of the respiratory manifestations of the general population. Pneumonia occupies the first place within this group. Among the extra-respiratory forms (40%), the neurological ones are the most frequent. Meningoencephalitis and aseptic meningitis are the most common. The presentation of more than one clinical variant in the same patient associated with primoinfection by Mp is possible. In relation to the serological diagnosis, controversies in interpretation sometimes occur. This is a 7-year-old girl with conjunctival injection, cervical adenopathy, photophobia with bilateral papilla pseudoedema, and scaly rash that develops peripheral facial paralysis and aseptic meningitis. We will discuss diagnostic controversies.

Spermatozoa retrieval for cryopreservation after death

ABSTRACT Objectives To describe the retrieval spermatozoa technique for cryopreservation after death, including the proximal part of vas deferens. Material and Methods A 28-years old man, with previous history of infertility, who had died 12 hours before, was submitted to spermatozoa retrieval for cryopreservation, with surgical bilateral resection in bloc of the proximal part of vas deferens, testicle and epididymis. At the laboratory, by milking the epididymis and vas deferens, the extracted fluid was collected; also, three samples of each testicle parenchyma were also harvested. Results The fluid from the vas deferens showed spermatozoa, mostly with in situ motility. Testicular fragments also presented spermatozoa, mostly with small tail movements or immobile. Conclusion The inclusion of the proximal part of vas deferens during spermatozoa retrieval after death must be performed, since it contains high concentration of spermatozoa, and even in the presence of previous infertility, as was with this patient, it is possible to retrieve spermatozoa.

Biodiversity of species of Aspergillus section Fumigati in semi-desert soils in Argentina / Biodiversidad de especies de Aspergillus de la sección Fumigati en suelos semidesérticos de Argentina

The distribution of Aspergillus species in soil has been widely studied all over the world. The aim of this study was the phenotypic and genotypic characterization of species belonging to section Fumigati present in soils from two Argentinian semi-desert areas having different geological conditions. Altogether, 23 isolates belonging to Aspergillus section Fumigati were recovered and identified using a polyphasic approach including phenotypic and molecular identifications. Aspergillus fumigatus sensu stricto and Aspergillus fumigatiaffinis had the highest frequency, of occurrence while isolates closely related to Aspergillus udagawae and Aspergillus felis were rarely observed. A. fumigatiaffinis and isolates closer to A. udagawae were isolated for the first time from Argentinian soils and this is the first report on the occurrence of species belonging to the A. felis clade in South America. Recent scientific interests in biodiversity, as well as the increasing importance of aspergilli as causative agents of human and animal diseases increase the need to understand the diversity and occurrence of these fungi in nature.

La distribución de especies de Aspergillus en el suelo se ha estudiado ampliamente en todo el mundo. El objetivo de este trabajo fue caracterizar fenotípica y genotípicamente las especies pertenecientes a la sección Fumigati presentes en los suelos de dos zonas semidesérticas de Argentina con diferentes geologías. En total, 23 Aspergillus de la sección Fumigati fueron aislados e identificados utilizando un enfoque polifásico incluyendo identificaciones fenotípicas y moleculares. Aspergillus fumigatus sensu stricto y Aspergillus fumigatiaffinis aparecieron con mayor frecuencia, mientras que los aislamientos relacionados a Aspergillus udagawae y a Aspergillus felis se observaron raramente. Este es el primer informe de A. fumigatiaffinis y de aislamientos estrechamente relacionados a A. udagawae en suelos argentinos; también el primero sobre la ocurrencia de especies pertenecientes al clado A. felis en Sudamérica. El emergente interés científico en la biodiversidad, así como la creciente importancia de Aspergillus como agentes causales de enfermedades humanas y animales, aumentan la necesidad de conocer la diversidad y la ocurrencia de estos hongos en la naturaleza.

Protothecosis in a patient with T cell lymphocytic leukemia / Prototecosis en un paciente con leucemia linfocítica de células T

Human protothecosis is a rare infection caused by algae of the genus Prototheca. Prototheca wickerhamii has been recognized as the main species that causes infection in immunocompromised hosts with deficits in innate or cellular immunity. We report a case of persisting subcutaneous protothecosis in a patient with T-cell large granular lymphocyte leukemia, who also presented a history of disseminated histoplasmosis.

La prototecosis humana es una infección rara causada por algas del género Prototheca. Prototheca wickerhamii ha sido reconocida como la principal especie causante de infección en huéspedes inmunocomprometidos, con déficit de inmunidad innata o celular. Presentamos un caso de prototecosis subcutánea persistente en un paciente con leucemia linfocítica granular de células T, con antecedentes de histoplasmosis diseminada.