Severe oral mucositis relating to pain and worse oral condition among patients with solid tumors undergoing treatment with FOLFIRI and 5-FU: a retrospective study

ABSTRACT BACKGROUND: There is a need for studies that correlate the severity of oral mucositis (OM) with chemotherapy protocols, transient myelosuppression and oral health. OBJECTIVE: To analyze the severity of OM among individuals with solid tumors during hospitalization and its correlation with the type of chemotherapy, myelosuppression and oral health condition. DESIGN AND SETTING: Retrospective study at a public hospital in Bauru, state of São Paulo, Brazil, that is a regional referral center. METHODS: Individuals diagnosed with solid malignant tumors who received chemotherapy during hospitalization for completion of the antineoplastic treatment cycle or who presented complications resulting from this were assessed. RESULTS: Twenty-eight individuals (24.3%) manifested some degree of OM. The most prevalent degrees of OM according to the World Health Organization (WHO) and modified WHO classification were grades 2 (11.3%) and 5 (4.3%), respectively. It was observed that the higher the OM-WHO (P < 0.001; r = 0.306) and modified OM-WHO (P < 0.001; r = 0.295) classifications were, the greater the oral pain reported by the individuals was. Presence of mucositis in the upper lip and buccal mucosa contributed to increased severity of OM and worsening of swallowing during hospitalization. Thus, severe OM was associated with use of the FOLFIRI protocol (folinic acid, fluorouracil and irinotecan). CONCLUSION: Individuals with tumors who presented severe OM had greater severity of oral pain and worse oral health. Use of the FOLFIRI protocol was associated with higher prevalence of severe OM, while use of 5-fluorouracil (5-FU) was correlated with worse oral condition.

Bacterial pneumonia in captive wild boars in southern Brazil: etiological and pathological causes

Respiratory diseases are one of the major health issues described in intensive pig production, causing important economic losses. However, there is little information on the prevalence, etiology and clinical-pathological presentation of these diseases in wild boars. For this reason, this work investigated the presence in captive wild boars of pneumonic lesions and bacterial pathogens commonly detected and associated with respiratory diseases in domestic pigs. A total of 226 captive wild boar lungs from two farms were examined in a slaughterhouse in Southern Brazil. The pneumonic lesions were classified as cranioventral, dorsocaudal, and disseminated, and the quantification of lesions was calculated. From the total of 226 lungs, 121 were collected for laboratory examination. Lungs with macroscopic lesions suggestive of pneumonia were collected for histological, bacteriological and molecular analysis. The molecular analysis was performed to detect the presence of Actinobacillus (A.) pleuropneumoniae, Glaesserella (G.) parasuis, Mycoplasma (M.) hyopneumoniae, Mycoplasma (M.) hyorhinis and Streptococcus (S.) suis serotype 2. The percentages of histological lesions and bacterial agents and their association were calculated. Cranioventral consolidation (75.2%) was the most prevalent macroscopic lung lesion, followed by disseminated (21.5%) and dorsocaudal (3.3%) distribution. Microscopically, chronic lesions were the most prevalent, representing 70.2% of the lungs. Moreover, BALT hyperplasia was present in 86.5% of the lungs, suppurative bronchopneumonia in 65.7%, and alveoli infiltrate in 46.8%. Six bacterial pathogens commonly described as agents of pig pneumonia were identified by bacterial or molecular methods: Pasteurella (P.) multocida, S. suis, M. hyopneumoniae, A. pleuropneumoniae, G. parasuis and M. hyorhinis. Twenty-eight different combinations of pathogens were identified in 84 samples (69.4%). The most common combinations were: M. hyopneumoniae and A. pleuropneumoniae (13.1%), M. hyopneumoniae, G. parasuis and M. hyorhinis (10.7%), and M. hyopneumoniae, A. pleuropneumoniae and G. parasuis (8.3%). Additionally, M. hyopneumoniae was the most frequent pathogen detected in this study, representing 58.7% of the samples. The detection of M. hyopneumoniae and M. hyorhinis by PCR was associated with the presence of BALT hyperplasia (P < 0.05) and there was also an association between the detection of M. hyopneumoniae by PCR and suppurative bronchopneumonia (P < 0.05). In addition, a significant association (P < 0.05) between the detection of M. hyopneumoniae and A. pleuropneumoniae by PCR and the histological classification (acute, subacute or chronic lesions) was observed. The results of this study were similar to those observed in slaughtered domestic pigs, although, the detection of opportunist pathogens was less frequent than that usually described in pig pneumonia. The high prevalence of pneumonia in captive wild boars at slaughter and the similar characteristics of pneumonia in captive wild boars and domestic pigs suggest that the close phylogenetic relationship between pigs and wild boars could influence the susceptibility of both species to the colonization of the same pathogens, indicating that captive wild boars raised in confined conditions could be predisposed to respiratory diseases, similar to domestic pigs.(AU)

Caracterização clínico-epidemiológica de crianças e adolescentes portadores de cardiopatia congênita / Clinical-epidemiological characterization of children and adolescents with congenital heart disease / Caracterización clínico-epidemiológica de niños y adolescentes con cardiopatía congénita

Objetivo: Analisar características clínico-epidemiológicas de crianças portadoras de cardiopatia congênita residentes do município de Rio das Ostras referenciadas para unidades especializadas no estado do Rio de Janeiro. Método: Pesquisa descritiva, transversal realizada em duas unidades hospitalares no município do Rio de Janeiro, através da técnica documental retrospectiva por meio de dados nos prontuários. A coleta ocorreu entre setembro de 2018 a fevereiro de 2019. Resultados: Foram analisados 48 prontuários, com maior proporção entre os escolares (33,3%); do sexo masculino (58,3%); Em relação as cardiopatias, verificou-se com maior proporção as acianóticas (62,5%); destacando a comunicação interatrial com (14,6%); seguida da comunicação interventricular (12,5%) e coarctação da aorta (12,5%). Conclusão: A identificação dessas crianças no município de Rio das Ostras e a distribuição destas pelo território nacional são informações imprescindíveis para o planejamento e implementação de programas e políticas públicas que atendam as reais demandas deste segmento populacional

Objetivo: Analizar las características clínicas y epidemiológicas de los niños con cardiopatía congénita que viven en la ciudad de Rio das Ostras remitidos a unidades especializadas en el estado de Río de Janeiro. Método: Investigación descriptiva, transversal realizada en dos hospitales de la ciudad de Río de Janeiro, a través de una técnica documental retrospectiva a través de datos en registros médicos. La recolección se realizó entre septiembre de 2018 y febrero de 2019. Resultados: Se analizaron 48 registros médicos, con una mayor proporción entre los estudiantes (33.3%); hombre (58,3%); Con respecto a la enfermedad cardíaca, hubo una mayor proporción de acianóticos (62.5%); destacando la comunicación interauricular con (14,6%); seguido de comunicación interventricular (12.5%) y coartación aórtica (12.5%). Conclusión: La identificación de estos niños en la ciudad de Rio das Ostras y su distribución en todo el territorio nacional son información esencial para la planificación e implementación de programas y políticas públicas que satisfagan las demandas reales de este segmento de la población

Objective: To analyze the clinical and epidemiological characteristics of children with congenital heart disease living in the city of Rio das Ostras referred to specialized units in the state of Rio de Janeiro. Method: Descriptive, cross-sectional research conducted in two hospitals in the city of Rio de Janeiro, through retrospective documentary technique through data in medical records. The collection took place between September 2018 and February 2019. Results: 48 medical records were analyzed, with a higher proportion among students (33.3%); male (58.3%); Regarding heart disease, there was a greater proportion of acyanotic (62.5%); highlighting interatrial communication with (14.6%); followed by interventricular communication (12.5%) and aortic coarctation (12.5%). Conclusion: The identification of these children in the city of Rio das Ostras and their distribution throughout the national territory are essential information for the planning and implementation of programs and public policies that meet the real demands of this population segment

Evaluation of data input in a rabies testing request form for herbivores / Avaliação da entrada de dados em um formulário de requisição de exame de raiva para herbívoros

Bovines and equines are the domestic animals with the highest incidence of rabies in Brazil. This study evaluated the data input in testing request forms for rabies in herbivores accompanying samples sent to a certified laboratory of rabies diagnosis in the state of Rio Grande do Sul, Brazil. Information was obtained systematically from all forms sent to the laboratory in 2013 and 2014 using a collection instrument that listed variables about the kind of form used, municipality of origin, description of the suspected animal, clinical signs, sample collection, and conservation procedure. The 11 most relevant variables (municipality of origin, geographic coordinates, species, gender, breed, age, herd size, clinical signs, persistence of clinical signs, biological material, and sample conservation) were assessed for the quality of the data entered, and percentage data input was calculated per form. In total, 603 forms were sent to the laboratory. The most used form was the FORM SN, (82.0%, 497/603). "Excellent" and "good" data inputs were observed only for one variable describing the location of suspected rabies cases or outbreaks and animals (species, gender, biological material). Quality of data input of variables describing geographic coordinates, age, breed, herd size, clinical signs, persistence of signs, and sample conservation method varied between "average" and "poor". The data input in testing request forms for herbivores are not dully supplied in suspected cases neurological syndromes, pointing to the need to increase awareness and improve training of field staff.(AU)

Bovinos e equinos são os animais domésticos com maior incidência de raiva no Brasil. Este estudo avaliou formulários de solicitação de testes para raiva em herbívoros acompanhando amostras enviadas a um laboratório certificado de diagnóstico de raiva no estado do Rio Grande do Sul, Brasil. As informações foram obtidas sistematicamente de todos os formulários enviados ao laboratório em 2013 e 2014 utilizando um instrumento de coleta que selecionou variáveis sobre o tipo de formulário utilizado, município de origem, descrição do animal suspeito, sinais clínicos, coleta de amostra e procedimento de conservação. As 11 variáveis mais relevantes (município de origem, coordenadas geográficas, espécie, gênero, raça, idade, tamanho do rebanho, sinais clínicos, persistência de sinais clínicos, material biológico e conservação da amostra) foram avaliadas quanto à qualidade dos dados inseridos, e os dados percentuais foram calculados por formulário. No total, 603 formulários foram enviados para o laboratório. O formulário mais utilizado foi o FORM SN, (82,0%, 497/603). Dados classificados como "excelentes" e "bons" foram observados apenas para uma variável que descreve a localização de casos suspeitos de raiva ou surtos e animais (espécie, gênero, material biológico). A qualidade da entrada dos dados das variáveis que descrevem coordenadas geográficas, idade, raça, tamanho do rebanho, sinais clínicos, persistência de sinais e método de conservação da amostra variou entre "regular" e "ruim". A qualidade dos dados dos formulários de solicitação de testes para herbívoros não foi devidamente fornecida em casos suspeitos de síndromes neurológicas, apontando para a necessidade de aumentar a conscientização e melhorar o treinamento do pessoal de campo.(AU)