Metabolic syndrome: a comprehensive review

Metabolic syndrome (syndrome X) includes several components like diabetes, hypertension, hyperlipidemia etc. Every patient should undergo detailed assessment for the silent presence of the components of metabolic syndrome. Genetic predisposition, increased nutrient- dense food, decreased physical activity and chronic stress are common in metabolic syndrome. Insulin resistance, obesity and hyperglycaemia are commonly seen which can later lead to serious consequences like cardiovascular complications, thrombotic events etc. Clinical features depend on the components of the metabolic syndrome in a patient. Some may present with complications and advanced disease. For non-diabetic individuals, oral glucose tolerance test is indicated. It is better to study serum uric acid level and to screen for silent kidney stones. Specific drugs are prescribed as indicated. Drugs for stress and insomnia are also prescribed. Thrombotic status of the patient should be considered, and antiplatelet drugs are prescribed if risk factors are present. Non-pharmacological measures like diet modification and increased physical activity should be given on a priority basis. Patient compliance of these two measures should be monitored regularly. Future deployment of “artificial intelligence – powered” predictive diagnostic tests will help in detecting and controlling metabolic syndrome. “At risk” individuals and patients showing some components of metabolic syndrome should undergo full investigations to detect other components of metabolic syndrome. Full range of therapeutic drugs, diet modification and increased physical activity should be prescribed.

Granulomatous tracheitis and dermatitis due to Curvularia sp. in a horse: case report / [Traqueíte e dermatite granulomatosas associadas a Curvularia sp. em um equino: relato de caso]

Tracheal fungal infections in horses are rare. This case report describes surgical and clinical management of a filly with a Curvularia sp. infection within the trachea and skin that caused severe intraluminal granulomas and cutaneous nodules, respectively. The patient was successfully treated with itraconazole and surgical excision.(AU)

Infecções fúngicas traqueais em equinos são raras. Este relato de caso descreve condutas clínicas e cirúrgicas em uma égua com infecção por Curvularia sp. na traqueia e na pele, causando granulomas intraluminais severos e nódulos cutâneos, respectivamente. O animal foi tratado com sucesso com itraconazol e exérese cirúrgica.(AU)

Microfilaremia by Cercopithifilaria bainae in a dog from the central western region of Brazil: case report / Microfilaremia por Cercopithifilaria bainae em um cão da região Centro-Oeste do Brasil: relato de caso

Cercopithifilaria bainae is a nematode belonging to the family Onchocercidae that parasitizes the subcutaneous tissue of dogs. Its transmission occurs through the tick Rhipicephalus sanguineus and its geographical distribution overlaps that of this vector. The present study reports the detection of microfilaremia by C. bainae in an eight-year-old male dog that presented anorexia, hyperthermia, motor incoordination, mydriasis, a nodule in the left testicle and concomitant infection by Ehrlichia sp. Blood samples were analyzed using microscopy, PCR and DNA sequencing. Microfilariae measuring 150±5.5µm in length and 7±1.8µm in width were retrieved. The DNA sequence exhibited 98% identity with C. bainae sequences available in Genbank. This is the first report of microfilaremia by C. bainae in a dog in the central western region of Brazil.(AU)

Cercopithifilaria bainae é um nematoide pertencente à família Onchocercidae, que parasita o tecido subcutâneo de cães. Sua transmissão ocorre pelo carrapato Rhipicephalus sanguineus, e sua distribuição geográfica se sobrepõe ao espalhamento desse vetor. O presente estudo relata a detecção de microfilaremia por C. bainae em um cão macho de oito anos que apresentava anorexia, hipertermia, incoordenação motora, midríase e nódulo no testículo esquerdo e infecção concomitante por Ehrlichia sp. A coleta de sangue foi realizada, e o material analisado por meio dos exames de microscopia, PCR e sequenciamento de DNA. Microfilárias medindo 150±5,5µm de comprimento e 7±1,8µm de largura foram recuperadas. A sequência de DNA obtida mostrou 98% de identidade com sequências de C. bainae disponíveis no Genbank. Este é o primeiro relato de microfilaremia de C. bainae em um cão na região Centro-Oeste do Brasil.(AU)

Efficacy and limitations of different approaches to anticipate the diagnosis of pregnancy in cattle / Eficácia e limitações de diferentes abordagens para antecipar o diagnóstico de gestação em bovinos

The study evaluated sonographic and serologic exams performed for early (20 to 30d) diagnosis of pregnancy. One hundred-twenty (n= 120) bovine recipients were synchronized (estrous=D0) and timed embryo transferred (TET, D7) with fresh in vitro produced embryos. In the first trial (n= 46), diagnosis of pregnancy was performed on day 20 (D20) by detecting CL blood flow (BF) and by Pregnancy-Associated Glycoproteins (PAGs) serology. In the second trial (n= 30), pregnancy diagnosis was performed on D25 by ultrasound visualization of uterine contents and by PAGs serology. In the last trial, PAG's serology was performed on D30. Ultrasonographic detection of the uterine contents and embryo viability performed on D30 (DG30) was considered the gold standard. The PROC FREQ procedure was used to test the agreement between diagnostic methods. On D20, the Doppler ultrasonography of the CL had showed high sensitivity (100%), but only moderate specificity (53.3%). On the same day, serologic diagnostic had no agreement (k= -0.08, P< 0.46) with the gold standard, with very low sensitivity (6.3%). However, the sensitivity of the serologic exam increased dramatically (from 6.3 to 100%) from D20 to D25, and it contributed to detect false negatives from the ultrasound diagnosis, improving the overall accuracy from 90% to 96.7%.(AU)

O estudo foi planejado para correlacionar exames ultrassonográficos e sorológicos realizados para o diagnóstico precoce (20 a 30d) de gestação. Cento e vinte (n= 120) receptoras bovinas foram sincronizadas (estro=D0), e embriões frescos produzidos in vitro foram transferidos em tempo fixo (TETF, D7). No experimento 1 (n= 46), o diagnóstico de gestação foi realizado no D20, pela detecção do fluxo sanguíneo do CL e pela sorologia de glicoproteínas associadas à gestação (PAGs). No experimento 2 (n= 30), a detecção da gestação foi realizada por meio da visualização do conteúdo do útero e também pela sorologia para PAGs. No experimento 3, a sorologia para PAGs foi realizada no D30. Em todos os experimentos, a visualização ultrassonográfica da vesícula e da viabilidade embrionária, realizada no D30, foi considerada padrão-ouro. O procedimento PROC FREQ testou o nível de concordância dos métodos diagnósticos. No D20, o diagnóstico baseado na vascularização do CL mostrou alta sensibilidade (100%) e apenas moderada especificidade (53,3%). Nesse mesmo dia, o diagnóstico sorológico não apresentou concordância (k=-0,08, P<0,46) com o padrão-ouro, além de baixa sensibilidade (6,3%). No entanto, a sensibilidade do exame sorológico aumentou drasticamente (6,3 para 100%) do D20 para o D25, contribuindo para detectar falsos negativos diagnosticados pela ultrassonografia, melhorando a acurácia (90 para 96,7%).(AU)

Chromobacteriosis (Chromobacterium violaceum) in a calf from Brazil - case report / Cromobacteriose (Chromobacterium violaceum) em um bezerro do Brasil - relato de caso

Chromobacterium violaceum is a rare opportunistic pathogen that causes highly fatal infections in domestic animals and humans. This report describes a fatal case suggestive of septicemia in a four-day-old female calf with chromobacteriosis. The calf had suppurative omphalophlebitis, suppurative fibrinous polyarthritis, anterior uveitis with bilateral fibrin deposition, fibrinous peritonitis, lymph node abscess and multifocal lymphocytic and neutrophilic encephalitis with multifocal hemorrhages. C. violaceum was isolated from the spleen and peri-renal lymph node and its identity was confirmed by PCR and sequencing. The pathogen was sensitive to azithromycin, gentamicin, enrofloxacin, norfloxacin, marbofloxacin, ciprofloxacin, erythromycin, sulphazotrim, fluorfenicol, tetracycline and doxycycline as well as resistant to penicillin, ampicillin, vancomycin, amoxicillin, amoxicillin + clavulanic acid, cephalothin, cephalexin, oxacillin, B polymyxin, neomycin and bacitracin. This is the first report of chromobacteriosis in a calf from Brazil.(AU)

Chromobacterium violaceum é um patógeno oportunista raro, que causa infecção fatal em animais domésticos e em humanos. Este relato descreve um caso fatal suspeito de septicemia em um bezerro de quatro dias, fêmea, infectado por C. violaceum. O bezerro apresentava onfaloflebite supurativa, poliartrite supurativa fibrinosa, uveíte anterior com deposição bilateral de fibrina, peritonite fibrinosa, abscesso de linfonodos e encefalite multifocal linfocítica e neutrofílica com áreas hemorrágicas multifocais. C. violaceum foi isolado no baço e no linfonodo, e sua identidade foi confirmada por PCR e sequenciamento. O patógeno foi sensível aos antibióticos azitromicina, gentamicina, enrofloxacina, norfloxacina, marbofloxacina, ciprofloxacina, eritromicina, sulfazotrim, florfenicol, tetraciclina, doxiciclina e foi resistente à penicilina, ampicilina, vancomicina, amoxicilina, amoxicilina + ácido clavulânico, cefalotina, cefalexina, oxacilina, polimixina B, neomicina e bacitracina. Este é o primeiro relato de cromobacteriose em bezerro no Brasil.(AU)

Infecção sistêmica por Salmonella Typhimurium em papagaio-verdadeiro (Amazona aestiva) / Systemic Infection by Salmonella Typhimurium in Blue-fronted Amazon Parrot (Amazona aestiva)

The maintenance of wild animals in captivity can be a source for transmission of infectious and zoonotic diseases. In February 2016, blue-fronted amazon parrots that were kept at the Centro de Reabilitação de Animais Silvestres (CRAS) of Campo Grande - MS died suddenly. The specimens were sent to the Universidade Federal de Mato Grosso do Sul (UFMS), Faculdade de Medicina Veterinária e Zootecnia (FAMEZ) to be necropsied. Anatomopathological exams were performed and organ fragments from all systems were collected for histopathological exams. Liver and spleen fragments were also collected for bacteriological exams. Histopathological exam revealed bacterial aggregates distributed through the organs. Bacteriological exam isolated Salmonella spp. from the fragments of liver and spleen. The confirmation of the genus was made by serum agglutination on slide and by the polymerase chain reaction (PCR). The genetic sequencing identified the sample as Salmonella Typhimurium.(AU)

Classical and recent advances in the treatment of inflammatory bowel diseases

Crohn's disease (CD) and ulcerative colitis (UC) are intestinal disorders that comprise the inflammatory bowel diseases (IBD). These disorders have a significant effect on the quality of life of affected patients and the increasing number of IBD cases worldwide is a growing concern. Because of the overall burden of IBD and its multifactorial etiology, efforts have been made to improve the medical management of these inflammatory conditions. The classical therapeutic strategies aim to control the exacerbated host immune response with aminosalicylates, antibiotics, corticosteroids, thiopurines, methotrexate and anti-tumor necrosis factor (TNF) biological agents. Although successful in the treatment of several CD or UC conditions, these drugs have limited effectiveness, and variable responses may culminate in unpredictable outcomes. The ideal therapy should reduce inflammation without inducing immunosuppression, and remains a challenge to health care personnel. Recently, a number of additional approaches to IBD therapy, such as new target molecules for biological agents and cellular therapy, have shown promising results. A deeper understanding of IBD pathogenesis and the availability of novel therapies are needed to improve therapeutic success. This review describes the overall key features of therapies currently employed in clinical practice as well as novel and future alternative IBD treatment methods.

Association among genetic predisposition, gut microbiota, and host immune response in the etiopathogenesis of inflammatory bowel disease

Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), is a chronic disorder that affects thousands of people around the world. These diseases are characterized by exacerbated uncontrolled intestinal inflammation that leads to poor quality of life in affected patients. Although the exact cause of IBD still remains unknown, compelling evidence suggests that the interplay among immune deregulation, environmental factors, and genetic polymorphisms contributes to the multifactorial nature of the disease. Therefore, in this review we present classical and novel findings regarding IBD etiopathogenesis. Considering the genetic causes of the diseases, alterations in about 100 genes or allelic variants, most of them in components of the immune system, have been related to IBD susceptibility. Dysbiosis of the intestinal microbiota also plays a role in the initiation or perpetuation of gut inflammation, which develops under altered or impaired immune responses. In this context, unbalanced innate and especially adaptive immunity has been considered one of the major contributing factors to IBD development, with the involvement of the Th1, Th2, and Th17 effector population in addition to impaired regulatory responses in CD or UC. Finally, an understanding of the interplay among pathogenic triggers of IBD will improve knowledge about the immunological mechanisms of gut inflammation, thus providing novel tools for IBD control.

Avaliação da força muscular respiratória em crianças e adolescentes com sobrepeso/obesos / Evaluation of respiratory muscle strength in overweight/obese children and adolescents

OBJETIVO: Avaliar a força muscular respiratória de crianças e adolescentes com sobrepeso ou obesidade. MÉTODOS: Estudo transversal com crianças e adolescentes entre quatro e 15 anos de idade de duas instituições de ensino fundamental e uma clínica de nutrição. As crianças foram avaliadas e classificadas em dois grupos, de acordo com a curva proposta pelo National Center for Health Statistics: sobrepeso/obesos (GSO, índice de massa corpórea (IMC) em relação à idade e ao sexo acima do percentil 85) e eutróficos (GE, IMC entre percentil 5 e 85). Para avaliar as pressões inspiratória máxima (PImax) e expiratória máxima (PEmax) foram realizadas três medidas com um manovacuômetro, considerando-se a maior medida a partir da capacidade máxima inspiratória e expiratória. Aplicou-se o teste t para as variáveis quantitativas e o qui-quadrado para as qualitativas. Para ajuste das covariáveis, foi feita a análise de covariância, sendo significante p<0,05. RESULTADOS: Foram avaliadas 69 crianças: 37 (54 por cento) do GSO e 32 (46 por cento) eutróficos. O GSO apresentou menor idade (9,8±2,3 versus 10,9±1,9 anos; p=0,03). A PImax foi 71,4±24,9cmH2O no GSO e 89,6±19,6cmH2O nos eutróficos (p=0,002). A PEmax foi 71,9±24,8cmH2O no GSO e 95,6±19,6cmH2O nos eutróficos (p<0,001). Não houve diferenças quanto ao sexo e à prática de atividade física. Ajustando-se os valores em relação à idade, somente a PEmax manteve-se diferente entre os grupos (p=0,003). CONCLUSÕES: A força muscular expiratória mostrou-se diminuída nesta amostra de crianças e adolescentes com sobrepeso/obesidade, indicando que a obesidade pode comprometer a mecânica pulmonar dessa população.

OBJECTIVE: Evaluate respiratory muscle strength in overweight/obese children and adolescents. METHODS: This cross-sectional study enrolled patients between four and 15 years old, classified according to the National Center for Health Statistics curve for body mass index (BMI): Overweight/Obese Group (OG, BMI> 85th percentile) and Normal Weight Group (NG, BMI between 5th and 85th percentile). Manuvacuometer was used to measure maximal inspiratory pressure (MaxInspP) and maximal expiratory pressure (MaxExpP). Three measurements were obtained using the maximum pulmonary effort and the higher value was considered. Variables were compared by t test chi-square test. Adjustment of possible covariants was made by analysis of covariance, being significant p<0.05. RESULTS: 69 children were included: 37 (54 percent) in the OG and 32 (46 percent) in the NG. Obese patients were younger: 9.8±2.3 versus 10.9±1.9 years (p=0.031). MaxInspP was 71.4±24.9cmH2O in the OG and 89.6±19.6cmH2O (p=0.002). MaxExpP was 71.9±24.8cmH2O in the OG and 95.6±19.6cmH2O in the NG (p<0.001). There was no difference between groups regarding gender and physical activity. After adjustment for age, only the MaxExpP was significantly different between groups (p=0.003). CONCLUSIONS: Maximal expiratory pressure was lower in overweight/obese patients, indicating that obesity may alter pulmonary mechanics.

Mercury toxicity in the Amazon: contrast sensitivity and color discrimination of subjects exposed to mercury

We measured visual performance in achromatic and chromatic spatial tasks of mercury-exposed subjects and compared the results with norms obtained from healthy individuals of similar age. Data were obtained for a group of 28 mercury-exposed subjects, comprising 20 Amazonian gold miners, 2 inhabitants of Amazonian riverside communities, and 6 laboratory technicians, who asked for medical care. Statistical norms were generated by testing healthy control subjects divided into three age groups. The performance of a substantial proportion of the mercury-exposed subjects was below the norms in all of these tasks. Eleven of 20 subjects (55 percent) performed below the norms in the achromatic contrast sensitivity task. The mercury-exposed subjects also had lower red-green contrast sensitivity deficits at all tested spatial frequencies (9/11 subjects; 81 percent). Three gold miners and 1 riverine (4/19 subjects, 21 percent) performed worse than normal subjects making more mistakes in the color arrangement test. Five of 10 subjects tested (50 percent), comprising 2 gold miners, 2 technicians, and 1 riverine, performed worse than normal in the color discrimination test, having areas of one or more MacAdam ellipse larger than normal subjects and high color discrimination thresholds at least in one color locus. These data indicate that psychophysical assessment can be used to quantify the degree of visual impairment of mercury-exposed subjects. They also suggest that some spatial tests such as the measurement of red-green chromatic contrast are sufficiently sensitive to detect visual dysfunction caused by mercury toxicity.

Freqüencia de anticorpos anti-Anaplasma marginale em rebanhos leiteiros da Bahia / Frequency of antibodies against Anaplasma marginale in dairy herds of Bahia State, Brazil

Determinou-se a freqüência de bovinos soro-reagentes para Anaplasma marginale em rebanhos leiteiros das microrregiöes de Jequié, Itabuna e Vitória da Conquista, Estado da Bahia, pelas técnicas de imunoadsorçäo enzimática (ELISA), imunofluorescência indireta (IFI) e teste de conglutinaçäo rápida (TCR). Das 324 amostras de soro bovino analisadas, 96,9 por cento, 97,2 por cento e 91,0 por cento foram positivas para anticorpos contra A. marginale, respectivamente pelo ELISA, IFI e TCR. Todas as regiöes caracterizaram-se por estabilidade enzoótica para a anaplasmose. O desempenho dos três testes sorológicos foi bastante similar na detecçäo de anticorpos contra A. marginale

Significado clínico dos anticorpos antinucleares na artrite reumatóide juvenil / Clinical significance of antinuclear antibodies in juvenile rheumatoid arthritis

Os anticorpos antinucleares (AAN) têm sido demonstrados em freqüência extremamente variável na artrite reumatóide juvenil (ARJ), dependendo do substrato empregado e da seleçäo dos pacientes. Além disso, a associaçÝo entre estes anticorpos e a atividade ou a gravidade da doença näo está bem estabelecida. Objetivo: Determinar a freqüência dos AAN e possível associaçöes com diferentes parâmetros clínicos da ARJ, como duraçäo, atividade e gravidade da doença. Material e métodos: 86 pacientes com ARJ foram estudados quanto à presença de AAN (pesquisados pelo método de imunofluorescência indireta em células HEp-2); 32 pacientes com lúpus eritematoso sistêmico juvenil e 52 crianças saudáveis constituíram os grupos-controles. A atividade da doença foi definida segundo uma escala de dois pontos, enquanto a gravidade foi avaliada pelo grau de capacidade funcional. Resultados: AAN foram encontrados em 36 (42 por cento) pacientes com ARJ, sendo mais prevalentes no tipo de início oligoarticular do que no sistêmico (p<0,05). Uma associaçäo com a duraçäo, atividade ou a gravidade da doença näo foi evidenciada (p>0,05), embora uma tendência tenha sido observada em pacientes do tipo de início poliarticular, em atividade de doença (P=0,054). O padräo pontilhado fino foi o mais freqëntemente observado (64 por cento), conquanto outros padröes, como o centrossômico e o do corpo intermediário, também tivessem sido notados. Conclusäo: Anticorpos antinucleares foram encontrados em menor freqüência que aquela descrita na maioria dos trabalhos da literatura para a ARJ, nÝo apresentando associaçäo com o sexo, duraçäo, atividade ou gravidade de doença. Embora o padräo de fluorescência mais freqüente tenha sido o pontilhado, a presença de padröes inusitados de fluorescência nuclear sugere que AAN na ARJ possam apresentar especificidades ainda näo definidas, que poderäo futuramente ser melhor caracterizadas

Effect of caffeine adminsitration on latent learning ability of male rats in a simple maze task

Animals can acquire information about the environment in the absence of conventional rewards. This latent or incidental learning depends on their interaction with the environment. The present report examines whether caffeine (120 micron mol/kg) could enhance latent learning of a simple maze task by increasing exploratory activity of rats in the maze. Though caffeine increased the activity of rats in the maze under a nonappetitive condition, methylxanthine did not improve performance in rats tested under an appetitive condition in the maze. The results suggest that caffeine (120 micron mol/kg) does not facilitate latent learning of a simple maze task. An interesting and unexpected finding of the present study was that caffeine caused greater stimulation of exploratory activity in the open-field than in the maze under nonappetitive conditions. This may be due to differences in the complexity of the two paradigms