Combinación de antidepresivos vs. aumentación con antipsicóticos atípicos tras no lograr la remisión en la depresión unipolar / Combination of antidepressants vs. augmentation with atypical antipsychotics upon failure to achieve remission in unipolar depression

RESUMEN: Introducción: Lograr la recuperación funcional lo más rápido posible en el tratamiento de la depresión unipolar es un reto que la práctica clínica debe tratar de afrontar en la actualidad, ya que cualquier retraso en lograr la remisión de los síntomas es predictivo de un mayor número de recurrencias y mayores tasas de morbimortalidad. En esta revisión comprensiva, nuestro objetivo es guiar a los clínicos en su elección de aumentar con antipsicóticos atípicos o combinar el fármaco de referencia con un segundo antidepresivo, después de que se haya optimizado la dosis del antidepresivo seleccionado inicialmente y/o se haya cambiado el antidepresivo, sin lograr remisión, o bien cuando solo han obtenido una respuesta parcial después de un tiempo suficiente a una dosis apropiada. Estas decisiones surgen con frecuencia en la práctica clínica diaria. Metodología: Se realizó una búsqueda sistemática en PubMed bajo varias combinaciones clave de palabras, resultando en 230 informes. Después de aplicar los criterios de inclusión y según el título y el resumen, el número final de informes seleccionados para la revisión completa fue de 113. Se respondieron dos preguntas principales con base en estos estudios: 1) ¿Existe evidencia para recomendar claramente la combinación de antidepresivos versus potenciación con antipsicóticos (y el momento correcto para hacerlo) en la depresión unipolar no respondedora, una vez que las estrategias de optimización o de cambio han fallado en obtener la remisión? y 2) ¿Es posible identificar algunas características clínicas para guiar la decisión de combinación de antidepresivos versus potenciación con agentes antipsicóticos? Resultados: Según nuestro análisis, no hay datos disponibles para seleccionar una estrategia de otra de manera clara. Sin embargo, sugerimos favorecer una combinación o estrategia de aumento, basada en un enfoque de "tratamiento contra objetivos dianas" para perfilar al paciente, considerando una o dos características clínicas predominantes que permanecen activas como parte de una depresión mayor con respuesta parcial. Un adecuado análisis de los dominios sintomáticos presentes, una visión crítica de las guías clínicas actuales y de las opciones preferidas, considerar la bipolaridad oculta como uno de los principales diagnósticos diferenciales y adoptar una actitud enérgica pero lúcida en esta etapa del tratamiento son, a nuestro juicio, fundamentales para lograr recuperación ad integrum del paciente.

ABSTRACT Introduction: achieving functional recovery as quickly as possible in the treatment of unipolar depression is a challenge that clinical practice must try to meet nowadays, since any delay in accomplishing remission of the symptoms is predictive of a larger number of recurrences and higher morbidity and mortality rates. In this topical review we aim to guide clinicians in their choice to augment with atypical antipsychotics or to combine the baseline drug with a second antidepressant, after the dose of the antidepressant initially selected has been optimized and/or the antidepressant has been changed, not achieving remission, or resulting only in a partial response after sufficient time at an appropriate dose. These decisions arise frequently in everyday clinical practice. Methodology: a systematic search in PubMed was performed under several key combinations of words, resulting in 230 reports. After applying inclusion criteria and based in title and abstract, the final number of reports selected for full revision were 113. Two main questions were answered based on these studies: 1) Is there evidence to clearly recommend combination of antidepressants vs. augmentation with antipsychotics (and the correct moment to do it) in non-responsive unipolar depression, once optimization or switching strategies have failed to obtain remission? and 2) Is it possible to identify some clinical features to guide the decision of combination of antidepressants vs. augmentation with antipsychotic agents? Results: According to our analysis, there is no data available to select one strategy from another in a clear-cut manner. Nevertheless, we suggest favoring a combination or augmentation strategy, based in a "treating to target" approach to profile the patient, considering one or two predominant clinical features that remain active as part of a major depression with partial response. Proper analysis of the symptomatic domains present, a critical view of current clinical guidelines and preferred options, considering hidden bipolarity as one of the main differential diagnoses and adopting an energetic but lucid attitude at this stage of treatment are, in our view, fundamental for achieving ad integrum patient recovery.

Fluorescence spectroscopy for clinical transplantation liver grafts monitoring: possibilities offered by 408 nm excitation

Purpose: Fluorescence spectroscopy techniques have been investigated aiming to reduce the invasiveness of methods for investigation of tissue. In transplantation procedures, it may offer the possibility of a complementary technique for the monitoring of liver grafts' conditions prior to and during the transplantation procedure stages involving cold perfusion. The objective of this study was to evaluate fluorescence spectroscopy under violet light excitation (408 nm) for the monitoring of clinical hypothermic liver transplantation procedures. Methods: Organ grafts were monitored from before the removal of the donor's body to 1 h after the implant into the receptor's body. Fluorescence spectroscopy was assessed over five stages within these transplant stages. Results: The study provided evidence of a correlation between fluorescence information collected during liver grafts transplantation and the survival of patients. Conclusions: Fluorescence spectroscopy can become a tool to monitor transplantation grafts, providing objective information for the final decision of surgeons to use organs.

Efeitos do uso de lodo de estações de tratamento de esgoto sobre a disponibilidade de água em um substrato minerado no Cerrado / Effects of the use of wastewater sludge on water availability of a mine substrate in the Brazilian Savanna

RESUMO A mineração expõe à superfície material genericamente denominado de substrato, que possui atributos físicos, químicos e biológicos diferentes do solo natural. O lodo de estações de tratamento de esgoto (ETE) é a principal fonte de matéria orgânica utilizada na recuperação de áreas mineradas no Distrito Federal. Apesar de as tecnologias de recuperação afetarem positivamente o substrato minerado, seus efeitos sobre a disponibilidade de água para a vegetação foram pouco estudados. Diante disso, este estudo objetivou verificar se a disponibilidade de água em um substrato de mineração de cascalho foi alterada pela aplicação de lodo de ETE. Três materiais foram investigados: substrato minerado sem aplicação de lodo, substrato minerado com aplicação de lodo e solo sob Cerrado original. Esses materiais foram caracterizados por meio da granulometria, densidade aparente, porosidade total, microporosidade, macroporosidade, condutividade hidráulica saturada, teor volumétrico de água à capacidade de campo e ponto de murcha permanente. Posteriormente, monitorou-se, nesses materiais, o teor volumétrico de água e de ar durante 22 semanas. Os resultados indicaram que o substrato minerado armazenou água acima da capacidade de campo durante 86% do período investigado e o teor de ar permaneceu em níveis críticos durante 55% do mesmo período. A incorporação de lodo de ETE e a colonização de plantas aumentaram os valores de condutividade hidráulica na saturação (Ksat) e reduziu o período em que a água se manteve armazenada à capacidade de campo. Todavia, o regime de umidade do substrato tratado com lodo de ETE se manteve dissimilar ao do solo original usado como referência.

ABSTRACT Mining exposes to surface a material generically called substrate, which has different physical, chemical and biological attributes compared to natural soils. The wastewater sludge (WWS) is the main source of organic matter used in reclamation works of mines in the Federal District of Brazil. Reclamation works positively affect mine substrate but their effects on water availability (AW) have been little studied. This work aimed to evaluate the effects of WWS into a mine substrate on its hydraulic conductivity (Ksat) and AW. Samples of a mine substrate exposed to surface, the same material treated with wastewater sludge and soil under natural Savanna vegetation were collected and analyzed for bulk density, granulometry, total porosity, microporosity, macroporosity, saturated Ksat, volumetric water content at field capacity (FC) and at permanent wilt point (PWP). Subsequently, volumetric water and air content were monitored on the field for 22 weeks. Results showed that the substrate exposed by mining presented water content above FC during 86% of the investigation period and air content at critic levels during 55% of the same period. The incorporation of WWS and subsequent plant colonization increased Ksat values and shortened the period in which water was store at FC. However, the moisture regime in the substrate treaded with WWS remained dissimilar to that of the original soil used as reference.

Proximal interphalangeal arthrodesis in seven horses: A retrospective study in Brazil (2011-2019) / Artrodese interfalangeana proximal em sete equinos: um estudo retrospectivo no Brasil (2011-2019)

ABSTRACT: This study discussed several cases of proximal interphalangeal arthrodesis in horses at a veterinary hospital in Brazil. The medical records of seven horses that underwent proximal interphalangeal arthrodesis between 2011 and 2019 were analyzed for indication, technique, and complications. Short- and long-term outcomes were obtained from both the medical records and telephone interviews with the owners. A dynamic compression plate (DCP) was used in one of the seven horses that underwent surgical arthrodesis, and locking compression plates (LCP) were used in the others. Hospital discharge was recorded in 71.4% (5/7) of the horses, with an average hospital stay of 79 ± 45 days. Casting was maintained for 59 ± 26 days. Contact with owners was possible in four cases, two of which regained their prior level of function. The proximal interphalangeal arthrodesis may improve a horse's well-being, especially when it is considered an early intervention, minimizing the chances of immediate postoperative complications. Additional cases of surgical arthrodesis should be evaluated in long term to better characterize the outcomes of this procedure in Brazil.

RESUMO: Este estudo teve como objetivo apresentar e discutir casos de artrodese interfalangeana proximal em equinos atendidos em um Hospital Veterinário no Brasil. Os prontuários de sete equinos submetidos à artrodese interfalangeana proximal foram analisados quanto à indicação, técnica e complicações, entre 2011 e 2019. As informações sobre os desfechos de curto e longo prazo foram obtidas pela avaliação dos prontuário e entrevista telefônica com os proprietários. Em um dos sete cavalos submetidos à artrodese cirúrgica foi utilizado implantes DCP, e nos demais, LCP. A alta hospitalar foi registrada em 71,4% (5/7), com média de permanência hospitalar de 79±45 dias. A imobilização externa durou 59±26 dias. O contato com os proprietários foi possível em quatro casos, dos quais, em dois, os animais voltaram às suas funções. A artrodese interfalangeana proximal pode melhorar a qualidade de vida dos equinos, principalmente quando se considera a intervenção precoce, minimizando as chances de complicações pós-operatórias imediatas. Casos adicionais devem ser avaliados ao longo prazo para melhor caracterizar os resultados desse procedimento no Brasil.

What have we learned from the dead? A compilation of three years of cooperation between entomologists and crime scene investigators in Southern Brazil

ABSTRACT With homicide rates higher than the world average, Brazil stands out as one of the most violent countries worldwide. Time of death estimation based solely on body changes can be biased or inaccurate; forensic entomology can play a determinant role in such cases. Accurate knowledge of necrophilous fauna is essential to validate experimental data and allows for the application of entomological evidence in forensic investigations, which benefits scientists, investigators, and society in general. Entomological evidence from Curitiba and 22 nearby cities were collected by crime scene investigators from the Scientific Police of Paraná. The corpses were found in diverse environments and specimens from each species were collected from all life stages. We present data from 25 cases from 2011 to 2014, including associated species, new records, and comparisons between existing experimental data and data from species collected in the cases presented. We identified 23 total species, of which eight species of Coleoptera and two species of Diptera have not previously been recorded on corpses. In all cases, Calliphoridae (76%) and Silphidae (48%) were the most numerous families collected. Working together with the scientific police gave us insight into which species lacked detailed records and enabled us to collaboratively focus on resolving deficits in our knowledge of necrophagous insects.

Características clínicas, histopatológicas e imuno-histoquímicas do mastocitoma cutâneo equino: relato de caso / Clinical, histopathological and immunohistochemical chacteristics ofequine cutaneous mastocytoma: case report

Uma égua puro sangue árabe, com 3 anos de idade, pertencente ao rebanho experimental da FMVZ-USP apresentou lesões tumorais cutâneas nos membros pélvicos direito e esquerdo com aproximadamente um ano de evolução. Notou-se nova formação cutânea com crescimento rápido na região do pescoço, e desde então, as lesões dos membros ganharam características inflamatórias. Foi realizada punção aspirativa da lesão do pescoço para análise citológica, em que se identificou infiltrado eosinofílico. Optou-se pelo início de tratamento conservativo com três infiltrações intralesionais consecutivas com corticoesteroide. A partir da falta de sucesso das infiltrações foram realizadas as excisões cirúrgicas totais dos nódulos do pescoço, membro pélvico direito e esquerdo. Todos os materiais obtidos dos procedimentos cirúrgicos foram enviados para avaliação histopatológica e imuno-histoquímica, nas quais se confirmou o diagnóstico de mastocitoma cutâneo. O animal recebeu alta após a cicatrização das feridas cirúrgicas e remissão dos sinais, e não demonstrou recidivas ou outras complicações advindas das lesões tumorais. Algumas neoplasias cutâneas são bem descritas e de comum ocorrência na espécie equina, como o sarcoide, melanoma, papiloma e tumor de células escamosas. Já o mastocitoma cutâneo consiste em neoplasia cutânea rara nessa espécie. Segundo a literatura, não parece existir uma predileção racial para o aparecimento deste tumor, entretanto, alguns autores citam o acometimento maior nos animais Puro Sangue Árabe. Para o estabelecimento do diagnóstico definitivo é importante a associação dos exames físico, histopatológico e imuno-histoquímico e, apesar desta neoplasia ser de raro aparecimento nos equinos, deve ser sempre considerada como diagnóstico diferencial.

A 3 year-old mare, Arab, that belongs to the experimental herd of FMVZ-USP presented cutaneous tumor lesions on right and left posterior limb with approximately one year of evolution. A new formation with rapid growth was observed on the neck region, and since then, the limbs lesion gained inflammatory characteristics. Aspirative punction was performed on the neck formation in order to submit the sample to cytological analyses, in which eosinophilic infiltrate was identified. At this point, a conservative approach was chosen with three consecutive corticoid infiltrations. With lack of success of infiltrative therapy, neck, right and left posterior limbs lesions were surgically removed. The materials obtained from surgical procedures were sent to histophatological and immunohistrochemical evaluation that confirmed cutaneous mastocytoma diagnosis. The mare was discharged after all surgical wound were healed and after full remission of clinical signs, and did not show relapses or any other complication from tumor lesions. Some cutaneous tumors are well described and commonly occur in horses, such as sarcoids, melanoma, papilloma and squamous cell carcinoma. Cutaneous mastocytoma is considered a rare cutaneous tumor in this species. According to literature, equine mastocytoma do not have breed predilection, however, some authors mention a greater involvement in Purebreed Arabian horses. In order to establish a definitive diagnosis, it is important to associate physical exams to histophatological an immunohistochemical evaluation and, even though rare in horses, this neoplasm must be considered as a differential diagnosis.

Clinical, histopathological and immunohistochemical chacteristics of equine cutaneous mastocytoma: case report / Características clínicas, histopatológicas e imuno-histoquímicas do mastocitoma cutâneo equino: relato de caso

A 3 year-old mare, Arab, that belongs to the experimental herd of FMVZ-USP presented cutaneous tumor lesions on right and left posterior limb with approximately one year of evolution. A new formation with rapid growth was observed on the neck region, and since then, the limbs lesion gained inflammatory characteristics. Aspirative punction was performed on the neck formation in order to submit the sample to cytological analyses, in which eosinophilic infiltrate was identified. At this point, a conservative approach was chosen with three consecutive corticoid infiltrations. With lack of success of infiltrative therapy, neck, right and left posterior limbs lesions were surgically removed. The material obtained from surgical procedures were sent to histophatological and immunohistrochemical evaluation, that confirmed cutaneous mastocytoma diagnosis. The mare was discharged after all surgical wound were healed and after full remission of clinical signs, and did not show relapses or any other complication from tumor lesions. Some cutaneous tumors are well described and commonly occur in horses, such as sarcoids, melanoma, papilloma and squamous cell carcinoma. Cutaneous mastocytoma is considered a rare cutaneous tumor in this species. According to literature, equine mastocytoma do not have breed predilection, however, some authors mention a greater involvement in Purebreed Arabian horses. In order to establish a definitive diagnosis, it is important to associate physical exams to histophatological an immunohistochemical evaluation and, even though rare in horses, this neoplasm must be considered as a differential diagnosis.

Uma égua puro sangue árabe, com 3 anos de idade, pertencente ao rebanho experimental da FMVZ-USP apresentou lesões tumorais cutâneas nos membros pélvicos direito e esquerdo com aproximadamente um ano de evolução. Notou-se nova formação cutânea com crescimento rápido na região do pescoço, e desde então, as lesões dos membros ganharam características inflamatórias. Foi realizada punção aspirativa da lesão do pescoço para análise citológica, em que se identificou infiltrado eosinofílico. Optou-se pelo início de tratamento conservativo com três infiltrações intralesionais consecutivas com corticoesteroide. A partir da falta de sucesso das infiltrações foram realizadas as excisões cirúrgicas totais dos nódulos do pescoço, membro pélvico direito e esquerdo. Todos os materiais obtidos dos procedimentos cirúrgicos foram enviados para avaliação histopatológica e imuno-histoquímica, nas quais se confirmou o diagnóstico de mastocitoma cutâneo. O animal recebeu alta após a cicatrização das feridas cirúrgicas e remissão dos sinais, e não demonstrou recidivas ou outras complicações advindas das lesões tumorais. Algumas neoplasias cutâneas são bem descritas e de comum ocorrência na espécie equina, como o sarcoide, melanoma, papiloma e tumor de células escamosas. Já o mastocitoma cutâneo consiste em neoplasia cutânea rara nessa espécie. Segundo a literatura, não parece existir uma predileção racial para o aparecimento deste tumor, entretanto, alguns autores citam o acometimento maior nos animais Puro Sangue Árabe. Para o estabelecimento do diagnóstico definitivo é importante a associação dos exames físico, histopatológico e imuno-histoquímico e, apesar desta neoplasia ser de raro aparecimento nos equinos, deve ser sempre considerada como diagnóstico diferencial.

Can Sarcophagidae (Diptera) be the most important entomological evidence at a death scene? Microcerella halli as a forensic indicator

Abstract Although a corpse can harbor several species of flies, only a few have been sufficiently studied to be used as forensic indicators. Sarcophagidae are an example of how the forensic use of insects can be impaired by taxonomic and biological data limitation. This manuscript provides the first record of the Neotropical flesh fly Microcerella halli (Engel, 1931) on a human body and its use in forensics. M. halli and Sarconesia chlorogaster (Widemann, 1830) were sampled from a body located indoors at 20 °C. Only M. halli was used to estimate the mPMI (minimum post mortem interval) because it was the oldest larval stage on the corpse. Based on the development time of M. halli we estimate an mPMI of at least 10 days. In addition, we provide for the first time a case in which a flesh fly was the main source of entomological evidence in Southern Brazil. We also provide evidence that Sarcophagidae arrived before Calliphoridae in this case, an unusual successional pattern.

Power Doppler sonography in the assessment of neovascularization following surgical fracture repair in sheep: case report / Utilização da ultrassonografia Power Doppler no acompanhamento de neovascularização no pós-operatório de ovino submetido a osteossíntese: relato de caso

Sonography is a safe and non-invasive imaging modality, with the added benefit of providing dynamic images. Power Doppler sonography allows blood vessel identification regardless of flow intensity or direction. A one-year-old Ile de France ewe was admitted to the FMVZ-USP Veterinary Hospital with a complete tibial fracture. The animal was submitted to general inhalation anesthesia and fracture repair using a 3.5 mm locking compression plate. Power Doppler sonography was used to assess neovascularization over the course of the bone healing process. Formation of new vessels was noted between postoperative days 14 and 21; new vessels regressed progressively on subsequent assessments (postoperative days 28 and 35). Power Doppler sonography enabled early detection of newly formed blood vessels at the fracture site. The non-invasive nature of this imaging modality prevented patient stress and provided useful information on the progression of bone healing. Early neovascularization was thought to reflect successful postoperative healing of the tibial fracture described.(AU)

A ultrassonografia é técnica de imagem segura e não invasiva que fornece imagens dinâmicas. O Power Doppler é modalidade ultrassonográfica que permite a visualização de vasos sanguíneos sem depender de intensidade e direção de fluxo. Admitiu-se no Hospital Veterinário da FMVZ-USP um ovino fêmea, de raça Ile de France, com um ano de idade e apresentando fratura completa de tíbia em bisel. O animal foi submetido à anestesia inalatória para a realização de osteossíntese com placa bloqueada de 3,5 mm. Durante o período pós-operatório foram realizadas imagens de ultrassonografia Power Doppler para a avaliação da neovascularização ao longo do processo de regeneração óssea. Entre o 14º e o 21º dia do período pós-operatório, identificou-se a presença de vasos sanguíneos neoformados, que apresentaram sinais de regressão nas avaliações subsequentes (realizadas no 28º e no 35º dia pós-operatório). A ultrassonografia Power Doppler mostrou-se eficiente na detecção precoce de vasos sanguíneos neoformados na região da fratura no período pós-operatório, sendo um exame não invasivo, que não gerou estresse para o animal e que pode estar relacionado ao sucesso no reparo ósseo da tíbia do animal submetido à osteossíntese.(AU)

Coleoptera species of forensic importance from Brazil: an updated list

ABSTRACT A list of the Coleoptera of importance from Brazil, based on published records was compiled. The checklist contains 345 species of 16 families allocated to 16 states of the country. In addition, three species of two families are registered for the first time. The fauna of Coleoptera of forensic importance is still not entirely known and future collection efforts and taxonomic reviews could increase the number of known species considerably in the near future.

Floristic woody composition of revegetated mining sites in the Brazilian Federal District / Composição florística lenhosa de jazidas revegetadas no Distrito Federal

The extension degraded by mining in the Brazilian Federal District - BFD is proportionately five times larger than country's average. The restoration of plant communities at these sites is ecologically necessary and legally compulsory. Native woody species are commonly used for ecosystem restoration and this study aimed to identify the floristic composition of woody species introduced in BDF mining sites and discuss its outcomes. The floristic survey was conducted by sampling groups of one hundred individuals until sampling sufficiency was achieved. In total 4,500 plants were sampled in ten sites, which housed 92 autochthonous and 21 allochthonous woody species. Plant communities in the sites assembled between 13 and 62 species, planted at low density - 467 ± 222 plants ha-1. The preferential use of autochthonous species in the revegetation projects resembles the standards recommended by successional restoration models, but the floristic diversity and plant density in initial communities fall below the values deemed as ideal. The 92 autochthonous species include representatives of various habitats, ecological groups and dispersal syndromes. These 92 species currently in use may be regrouped in initial plant communities denser and more diverse than those found in the revegetated sites. The surveyed plant communities were massively composed of arboreal species and such pattern may drive succession towards the formation of forest ecosystems where previously inhabited savanna formations.

A extensão minerada no Distrito Federal - DF é proporcionalmente cinco vezes superior à média nacional. A restauração das comunidades vegetais nesses locais é necessária e obrigatória, e o plantio de espécies lenhosas é prática comum de restauração. Dessa forma, este trabalho visou identificar e avaliar a composição florística lenhosa introduzida em jazidas mineradas no DF como meio de restaurar o ecossistema natural. O levantamento florístico nas áreas selecionadas foi realizado por meio da amostragem de grupos de cem indivíduos, até se obter suficiência amostral. Foram amostradas 4.500 plantas em dez jazidas, que abrigavam 92 espécies lenhosas autóctones e 21 alóctones. As comunidades vegetais levantadas eram formadas por 13 a 62 espécies, plantadas a uma baixa densidade - 467 ± 222 plantas ha-1. O uso preferencial de espécies autóctones nos projetos de revegetação os assemelham aos padrões recomendados pelos modelos sucessionais de restauração, mas a diversidade florística e densidade de plantas nas comunidades iniciais estão abaixo dos valores considerados ideais. Entre as 92 espécies identificadas há representantes de variados habitats, grupos ecológicos e síndromes de dispersão. Portanto, essas 92 espécies podem ser reagrupadas em comunidades iniciais mais densas e diversas do que as verificadas nos projetos executados. As comunidades vegetais nos locais investigados eram predominantemente compostas por espécies arbóreas e tal padrão pode levar à formação de ecossistemas florestais onde antes havia formações savanânicas.

Grupos funcionales alimentarios de macroinvertebrados acuáticos en el río Gaira, Colombia

Functional feeding groups of macroinvertebrates in Gaira river, Colombia. Tropical rivers are frequently described on their biodiversity but few studies have considered the ecological value of this richness in their food webs. We determined the trophic structure of aquatic macroinvertebrate communities (expressed in the richness and abundance of taxa and biomass proportions of different functional feeding groups) at the level of the river, stretch and microhabitats (functional units - UFs). We evaluated the spatial and temporal variation of these descriptors during wet and dry events, and selected three sites associated with different altitudinal belts. We reported 109 taxa, with 11 167 individuals who contributed 107.11g of biomass. Density of macroinvertebrates was favored with increasing height, and biomass showed the opposite pattern (K-W=10.1, d.f.=1, p<0.05), due to the addition of large crustaceans (Macrobrachium), and the taxa diversity was higher in the middle stretch of the river (H’=3.16). The Gaira stream runs through a mid-sized river basin, for this reason we found mainly bedrock (epilithon=50.5%), gravel and sand (43.7%). The functional unit with more habitat and food resources that contains a higher abundance of leaf litter macroinvertebrates was foliage followed by epilithon, fine sediment and gravel-sand (K-W=25.3, d.f.=3, p<0.05). The biomass values of these organisms were higher in leaves followed by gravel-sands, epilithon and sediment (K-W=15.3, d.f.=3, p<0.05). Autochthonous biomass input by different functional feeding groups can be considered very low, but they define the functionality of the stream, being represented almost exclusively by shredders (Macrobrachium, 73%), present only in the lower reaches, followed by shredder Leptonema with 15%, located mostly in the upper reaches and predatory stoneflies of the genus Anacroneuria to 6.56%, which dominated in the middle stretch of stream. Excluding Macrobrachium from the analysis, there was dominance of Anacroneuria in the lower reaches. Between rainfall and drought events, biomass of functional feeding groups was higher in rain (W=10.1, d.f.=1, p<0.05), favoring the growth of decapods, but the abundance was much higher during drought events. Rev. Biol. Trop. 59 (4): 1537-1552. Epub 2011 December 01.

Para Colombia, la información sobre grupos funcionales alimentarios de macroinvertebrados acuáticos es muy escasa. Por lo tanto, en este estudio se determinó la riqueza, abundancia y biomasa de los GFAs de estos organismos a escala de río, tramo y unidades funcionales, con el objeto de evaluar su variación espacio-temporal. Se seleccionaron tres tramos de 200m. En total se reportan 109 táxones, con una abundancia de 11 167 individuos que aportaron una biomasa de 107.11g. La densidad de los macroinvertebrados se vio favorecida con el incremento en la altura, la biomasa presentó un patrón inverso pues fue mayor hacia el tramo bajo y la diversidad de táxones fue mayor en el tramo medio del río (H’=3.16). Los valores de biomasa de estos organismos fueron mayores en hojarasca seguida de gravas-arenas, epiliton y sedimento. El tramo bajo fue dominado por Macrobrachium con el 73%, seguido de Leptonema con el 15 % en el tramo alto y Anacroneuria con el 6.56 %, en el tramo medio del río. Entre eventos de lluvia y sequía, la biomasa aportada por los grupos funcionales alimentarios fue mayor en lluvia, pero la abundancia fue muy superior durante eventos de sequía.

Síndrome de déficit atencional del adulto: correlación de hallazgos clínico-imagenológicos a partir de la técnica de SPECT cerebral / NeuroSPECT evaluation in adult attention deficit hyperactivity disorder

Contexto del problema. El Síndrome de Déficit Atencional (SDA) del adulto es un trastorno de difícil diagnóstico y cuyo oportuno reconocimiento y tratamiento puede impactar significativamente la calidad de vida de quienes lo padecen. La ausencia de pruebas diagnósticas concluyentes justifica la utilización de técnicas de neuro-imagen cerebral funcional en la investigación dirigida a reconocer patrones neuro-funcionales de valor diagnóstico. Objetivo. Realizar una descripción de los hallazgos neuro-funcionales encontrados en una cohorte de 23 pacientes adultos con SDA en estado de reposo a partir de la técnica de neuro-SPECT. A partir de estos hallazgos se proponen patrones neuro-funcionales con significado diagnóstico. Método. Se estudió una muestra aleatoria de 23 adultos (hombres: 17; mujeres: 6) con diagnóstico clínico de SDA tratados en la práctica privada. La muestra fue estudiada a través de la técnica de SPECT cerebral, analizándose 58 áreas de Brodmann, regiones de interés (ROI), incluyendo corteza cerebral y estructuras sub-corticales. Resultados. En el análisis de perfusión máxima cortical destaca la hiper-perfusión bilateral de las áreas 9, 10, 17, 18, 22, 23, 24 y 31 de Brodmann. En el análisis de mínimos se aprecia hipo-perfusión en áreas 4,11, 12, 18, 19 y 36 bilateral y 20 a izquierda. Al evaluar los valores promedios se observa hipo-perfusión en el área 24 izquierda y 25 bilateral. A nivel de estructuras sub-corticales destaca una hiper-perfusión talámica bilateral. Conclusiones. Los resultados reportados por nuestro grupo apoyan el rol de estructuras que se encuentran fuera del córtex frontal en la patogenia del SDA; especialmente el área que comprende la intersección de los lóbulos temporo-occipital, así como regiones parietales. Se discute el valor clínico de la hiper-perfusión frontal media como parte de un “default mode” y las implicancias que esto tendría como modelo...

Clinical Problem Context. The Attention Deficit Syndrome (ADS) in the adult is a clinical entity of difficult diagnosis and with a rewarding improvement of quality of life when this entity is diagnosed and treated successfully. There is an absence of diagnostic tests and therefore there is full justification for research applications for Functional NeuroIMaging techniques in ADS. Objectives. We report functional imaging findings by means of HMPAO NeuroSPECT in a group of 23 adult SDA patients. These findings submit diagnostic Neuroimaging functional patterns that are characteristic of adult SDA. Method. We report results in a group of 23 adult patients (17 males and 6 females) with clinical diagnosis of SDA. Patients were subjected to NeuroSPECT imaging and 58 Brodmann areas ROIS were analyzed including cortex and subcortical structures. Results. Analisis of MAXIMAL perfusion within the Brodmann Area (2.5 percent higher pixel counts, expressed as percent of higher pixel in cortex or cerebellum, whichever was smaller) demonstrates bilateral focal hyperperfusión in areas 9,10, 17,18,22,23,24 and 31 of Brodmann. In the analysis of MINIMAL values (2.5 percent minimal values within the Brodmann area) there is bilateral focal hypoperfusion in areas 4,11,12,18,19, and 36 and area 20 left. MEAN uptake in these Broadmann areas was diminished in area 24 left and bilateral areas 25. In the subcortical structures there is bilateral thalamic hyperperfusión. Conclusions. Our results support the concept of the role of structures outside of the cerebral frontal cortex in the pathogenie of SDA. We refer to areas in the intersection of temporo-occipital lobes and also the parietal lobes. We analyzed the clinical weight of medial frontal hyperperfusión as part of the default mode, and the explanation that this model might have in the variance of neuropsychological performances observed in these patients...

Neuro – functional and endocrine findings in patients with post-traumatic stress disorder

The authors studied the neuro-functional findings demonstrated by SPECT in a group of 7 patients diagnosed with post traumatic stress disorder (PTSD) and their correlation with endocrinologic and clinical variables. Brain perfusion was assessed using SPECT Tc99m – ECD. The Davidson Trauma Scale (DTS) for post traumatic stress disorder and the abbreviated version of the Beck Depression Inventory (BDI) were used to corroborate clinical impressions. Endocrine measures included: T3, total T4, TSH and cortisol levels. Neuro-functional findings included abnormal radiopharmaceutical uptake in regions involved in the recovery of verbal memories and executive functions (frontal and pre-frontal cortex), and limbic system. No endocrine alterations affecting thyroid or cortisol levels were found. The broad distribution of neuro-functional abnormalities causes us to hypothesize a diffuse etiologic mechanism, possibly involving a dysfunction in the permeability of the blood-brain barrier due to an underlying inflammatory process.

Alteraciones neuro-funcionales y neuro-endocrinas en una cohorte de pacientes que cursan con trastorno por estrés post traumático / Neuroendocrine and neurofunctional alterations in patient with post traumatic stress disorder

El trastorno por estrés post traumático (TEPT) se perfila en la actualidad como una patología emergente debido a las condiciones de vida modernas cada vez más exigentes y al énfasis epidemiológico y en salud mental por pesquisar las consecuencias de traumas cotidianos, como de aquellos derivados de conflictos bélicos o de la acción de fuerzas de seguridad y orden ciudadanos. Se describe que aproximadamente un 8 por ciento de quienes sufren un trauma experimentarán un cuadro clínico compatible con TEPT. Sin embargo, la larga duración y frecuente cronicidad de estos casos demanda un enorme esfuerzo al equipo de salud y costos elevados a los organismos que acogen a estos pacientes. El presente trabajo tiene por objetivo realizar un estudio neuro-funcional, clínico y de laboratorio en una muestra de 7 pacientes que cursan con un cuadro compatible con TEPT. Método: Se evaluó clínicamente a 7 pacientes que cursaban con TEPT, aplicándoseles una escala de evaluación para esta patología (Escala de Davidson) y el inventario de depresión de Beck. Se obtuvieron muestras de sangre con el objeto de evaluar los niveles de cortisol plasmático y hormonas tiroideas T3, T4 y TSH. Finalmente, los sujetos fueron evaluados a partir de la técnica de neuro SPECT delineándose una serie de Regiones e Interés (ROI) involucradas en la neurobiología del TEPT. Resultados: Se reportan para todos los pacientes de la cohorte estudiada valores elevados en escala Davidson para TEPT y en la escala de Beck para depresión (91.85 y 25.28 respectivamente). Se describen valores promedios normales de cortisol plasmático y de hormonas tiroideas T3, T4 y TSH (17.35 ug/dl, 1.34 ng/ml, 6,98 ug/dl y 2,95 uUI/ml respectivamente). Destaca la presencia de hiper-cortisolemia en tres de los pacientes estudiados. Los hallazgos neuro-funcionales se caracterizan por una hiper-perfusión a nivel de córtex fronto-parietal e hipo-perfusión...

Post Traumatic Stress Disorder (PTSD) is one of the most important emergent pathologies in mental health and is usually associated with current post modern´s life styles and with specific traumatic event such as belic conflicts or incident involving criminal behaviors affecting civilians. It is well known that 8% of victims of a traumatic event will develop PTSD. Furthermore, the chronicity and social impairment associated to this clinical entity requires an enormous effort from mental health’s professionals and huge costs to the systems involved in the rehabilitation of these patients. The aim of this study is to evaluate a sample of 7 patients affected from PTSD in order to understand their clinical characteristics, neuro-functional features and possible neuro-endocrine abnormatilies. Method: 7 patient affected with PTSD were clinically evaluated and submitted to a specific-validated post traumatic scale (Davidson scale) and also to a depression inventory (Beck depression inventory). Then, blood samples were taken in order to assess Neuro- endocrine levels of cortisol in plasma and T3, T4 and TSH levels. Finally, the subjects were studied by means of SPECT, delineating specific Region of Interest (ROI) involved in the neurobiological basis of PTSD. Results: we report on, for the entire sample, high scores on both scales used (Davidson scale: 91.85; Beck inventory: 25.28). These results confirm the previously reported high comorbidity between this two clinical entities. We describe average normal values for plasmatic cortisol levels and thyroid hormones levels T3, T4, TSH (17.35 ug/dl, 1.34 ng/ml, 6.98 ug/dl and 2.95 uUI/ml respectively). It is important to remark the presence of hypercortisolemia in 3 of the patients studied. Neuro-functional features were characterized by a cortical fronto-parietal hyper-perfusion and hypo-perfusion on limbic areas. This results were consistently replicated in the entire sample...

Evaluation of the mitochondrial respiration of cardiac myocytes in rats submitted to mechanical bile duct obstruction / Avaliação da respiração mitocondrial de miócitos cardíacos em ratos ictéricos sumetidos à obstrução do ducto biliar

PURPOSE: The objective of the present study was to evaluate the capacity of the myocardium for energy production by the analysis of mitochondrial respiration in rats with jaundice submitted to bile duct ligature. METHODS: Sixteen male Wistar rats were divided into 2 Groups: Group SO submitted to nontherapeutic laparotomy (sham operation) and Group IC (icteric group) submitted to bile duct ligature. After 7 days, laparotomy was again performed in all animals for cardiac muscle extraction and analysis. Mitochondrial oxygen consumption was determined by stage 3 velocity and stage 4 velocity. The respiratory control ratio (RCR) was obtained by the ratio of stage 3 to stage 4 velocity. Statistical analysis was performed by the Mann-Whitney test, with the level of significance set at 5 percent (p<0.05). RESULTS: Statistical analysis revealed a significant drop in oxygen consumption during stage 3 mitochondrial respiration in group IC compared with SO, whereas the values obtained during stage 4 were basically identical for the two groups. Likewise, RCR values exhibited a significant reduction. CONCLUSION: The cellular respiration of the "jaundiced heart" is depressed. This was demonstrated by the reduced capacity of cardiac mitochondria to consume oxygen and synthesize ATP, supporting the idea of a latent cardiac impairment responsible for the hemodynamic decompensation occurring during cholestasis.

OBJETIVO: A proposta deste trabalho é avaliar a capacidade de produção energética do miocárdio mediante análise da respiração mitocondrial em ratos ictéricos submetidos à ligadura do ducto biliar. MÉTODOS: Foram utilizados 16 ratos Wistar machos divididos em 2 Grupos: Grupo SO , os quais foram submetidos à Laparotomia branca e Grupo IC, os quais sofreram ligadura do ducto biliar para o desenvolvimento de icterícia obstrutiva. Todos os animais após 7 dias de cirurgia foram submetidos à nova laparotomia para extração e análise do músculo cardíaco. O consumo de oxigênio pelas mitocôndrias foi determinado pela velocidade do estado 3 e velocidade do estado 4. A razão do controle respiratório (RCR) foi obtida pela relação entre as velocidades dos estados 3 e 4. A análise estatística foi feita pelo teste de Mann-Whitney com nível de significância de 5 por cento (p<0.05). RESULTADOS: Observou-se queda estatisticamente significante nos valores do consumo de oxigênio do estado 3 da respiração mitocondrial no grupo IC em relação ao SO, no entanto os valores para estado 4 permaneceram basicamente inalterados entre os grupos. Os valores de RCR entre os grupos também apresentaram diminuição significativa. CONCLUSÃO: A respiração celular do 'coração ictérico' está deprimida em decorrência da redução da capacidade da mitocôndria cardíaca em consumir oxigênio e sintetizar ATP, o que pode contribuir para a disfunção cardiovascular na vigência da colestase.

Bipolar disorder complicated by selfmutilation: neurofunctional changes demonstrated by Tc99mHMPAO Neuro SPECT

We report neurofunctional changes in patients with selfmutilation and bipolar disorder. We compared a sample of 29 patients with selfmutilation and bipolar disorder with a group of 20 patients with bipolar disorder without selfmutilation. Furthermore we had an additional control of 22 patients with Major Depression without selfmutilation. Among the findings in selfmutilation, increased anterior dorsal-ventral thalamic perfusion stands out, this is associated with decreased perfusion in the perilimbic area (areas 24, 32 and 23 of Brodmann). There are multiple reports relating in animals and humans selfmutilation with hypoalgesia, anesthesia and disestesias; an hypothesis can be formulated relating self mutilation phenomena with a dysfunction of thalamus and perilimbic circuits associated with nosoceptive circuits and somato-psychic conscience.

Alteraciones neuro-funcionales en trastornos del ánimo que cursan con conductas auto-mutilatorias: estudio de perfusión regional cerebral a partir de la técnica de Neuro-SPECT Tc99-HMPAO / Neuro functional alterations in mood disorders with self-injurious behavior: study of regional cerebral perfusion through Tc-99m HMPAO NeuroSPECT

Se reportan los hallazgos encontrados a partir de NeuroSPECT en trastornos del ánimo, incluyendo trastorno bipolar, depresión mayor y auto-mutilación. Se compararon los resultados de una muestra de 29 pacientes con trastorno afectivo en espectro bipolar complicado con conductas auto-mutilatorias, un grupo de 20 pacientes bipolares sin auto-mutilación y 22 pacientes depresivos sin auto-mutilación. Dentro de los hallazgos destaca la asociación entre trastornos del ánimo y auto-mutilación con hiper-perfusión talámica bilateral en el segmento dorso-ventral-anterior, asociado a hipo-perfusión en corteza peri-límbica (áreas 32, 24 y 23 de Brodmann). Los múltiples reportes que relacionan, tanto en animales como en humanos, las conductas auto-mutilatorias con fenómenos de hipo-algesia, anestesia o disestesias, permiten hipotetizar la participación de una disfunción en circuitos tálamo-peri-límbicos asociados a vías nocioceptivas y a conciencia somato-psíquica y su relación con fenómenos auto-mutilatorios.

We report NeuroSPECT findings in mood disorders, including bipolar disorder, major depression and self-mutilation. We compare results in 29 patients with bipolar disorder complicated by self-mutilation, a group of 20 patients with bipolar disorder uncomplicated and 22 patients with mayor depression uncomplicated by self-mutilation. Among the NeuroSPECT findings we report the association of mood disorders and self-mutilation with hyperperfusion of the anterior-dorsal-ventral segment of both thalami concomitant with hypoperfusion in perilimbic cortex, namely areas 32, 24 (anterior cingulate gyrus) and 23 of Brodmann. Multiple reports in the literature relate both, in animals and man, self-mutilation with phenomena of hypoalghesia, anesthesia, or dysestesias and are the basis for our hypothesis linking dysfunction of limbic-thalamic circuits, associated with nocioceptive fibers, somato-psychic consciousness and self-mutilation phenomena.

Estudo anátomo-cirúrgico do cólon transverso do eqüino por acesso paralombar esquerdo / Anatomic and surgical study of the equine transverse colon from left paralombar aprouch

O cólon transverso é um estreitamento do canal alimentar, sujeito a sofrer processos obstrutivos. A ampliação do conhecimento sobre essa estrutura e adjacentes é de grande importância cirúrgica. Neste estudo foram utilizados 10 cadáveres de eqüinos de diferentes raças, idades e sexos, divididos em dois grupos de cinco. No primeiro grupo foi realizada uma incisão no 16º espaço intercostal esquerdo e posterior ressecção da 16ª costela. No segundo grupo a incisão foi feita sobre a 17ª costela com a remoção da mesma. Todas as estruturas identificadas foram registradas em fichas individuais, assim como a extensão exteriorizada do cólon transverso. Em todas os animais o cólon transverso foi totalmente visualizado e parcialmente exteriorizado, sendo que houve melhor manipulação e exteriorização no segundo grupo, além da maior facilidade no emprego da técnica, com a incisão sobre a costela a ser ressecada. Dessa forma, concluímos que o cólon transverso pode ser acessado pela fossa paralombar esquerda, sendo que a remoção da 17ª costela proporciona o melhor acesso para essa estrutura.

The transverse colon is a constriction of the bowel lumen, which canbe submitted to obstructive process. The knowledge enlargement about this structure and the adjacent ones has a great surgical importance. For such study, ten anatomic pieces, from equines corpses of different breed, age and sex, were used and divided in two groups. In the first group an incision was made in the left 16 intercostal space and farther resection of the 16 rib. In the second group an incision was made over the 17 rib, before its ressection. All the identified structures were registered into individual files, such as the extension of the exteriorized portion. In all of the studied pieces, the transverse colon was entirely visualized and partially exteriorized. However, we had better handling and exteriorization in the second group, as well as we noticed its technique was of easier execution. In accordance with the results, through this work is possible to conclude that the transverse colon can be approached by the left flank, and that the removal of the 17 rib provides a better access to the transverse colon.