Síncope / Syncope

El síncope es una pérdida transitoria de conciencia y tono postural debido a hipoflujo sanguíneo cerebral que se recupera espontáneamente sin maniobras de RCP. En esta actualización se plantea el síncope vasovagal con sus diagnósticos diferenciales y posibles etiologías, fisiopatología y métodos de estudios. También se presenta la experiencia sobre este tema en nuestro hospital su estudio, tratamiento y diagnostico (tilt test) (AU)

Syncope is a transient loss of consciousness and postural tone due to cerebral blood hypoflow that recovers spontaneously without CPR maneuvers. This update discusses vasovagal syncope with its differential diagnoses and possible etiologies, pathophysiology, and diagnostic methods. Additionally, the experience on this topic of our hospital regarding investigations, treatment, and diagnosis is presented. (AU)

Disseminação do vírus da doença de Aujeszky, envolvendo o comércio de reprodutores suínos de reposição / Spread of virus of Aujeszky's disease by the trade of replacement swine breeders

Relata-se a disseminação da infeção pelo vírus da doença de Aujeszky (VDA) a partir da comercialização de reprodutores suínos oriundos de duas granjas de reprodutores suídeos certificada (GRSC) que tiveram surto da DA. Após a confirmação do diagnóstico de DA, os suínos comercializados 37 a 45 dias anteriores aos surtos foram recolhidos, submetidos ao exame sorológico para o VDA e enviados ao abate. Nos rebanhos-destino foram realizados exames sorológicos para o VDA 17 a 37 dias após o recolhimento, naqueles que estavam lojados nas baias vizinhas àquelas onde haviam sido alojados os suínos comprados; seis meses mais tarde, foi realizada outra sorologia por amostragem dos reprodutores. No total, 52 rebanhos compraram suínos das duas granjas, e, destes, 37 (69,8 por cento) receberam, pelo menos, um animal com sorologia positiva para o VDA. Somente sete (18,9 por cento) deles apresentaram sorologia positiva para o VDA, e em 30 (81,1 por cento), não houve indícios de disseminação da infecção. A contaminação pelo VDA de granjas GRSC representa enorme potencial para a disseminação da infecção, por meio do comércio de suínos de reposição. A rastreabilidade dos animais comercializados em um período anterior ao diagnóstico, com imediata remoção dos lotes de suínos dos rebanhos-destino, evitou a disseminação da infecção

It was reported the spreading of the infection caused by the virus of Aujesky's disease (VAD) by the commercialization of breeders originated from two pigs farms GRSC (Farms of Certified Swine Breeders - FCSB) which had an outbreak of Aujeszky's disease. After the positive diagnosis of Aujesky's disease, the pigs traded from 37 to 45 day before the outbreaks were removed from the herd, bled for serological exams for the VAD and sent to slaughterhouses. The herds which received these pigs were serologically tested for the VAD, 17 to 37 days after the removal of the animals. Serological tests were also performed in pigs lodged at neighboring cages to those which had been lodged with the pigs bought and a sampling test was done six months later. Thus, 52 flocks bought pigs from the farms 1 and 2. From those, 37 (69.8 percent) received at least one serum-positive pig for the VAD. Only seven (18.9 percent) of them were infected and 30 (81.1 percent) pigs showed no indications of infection by the VAD. The occurrence of VAD in FCSB farms represents huge potential for spreading of the VAD, by the trade of replacement pigs. The traceability investigation and removal of the animals traded before the diagnosis, with immediate removal of the positive lots of pigs at the destiny herd, avoided the spread of the infection

Envenomation by the madagascan colubrid snake, Ithycyphus miniatus

We report two cases of envenomation by a Madagascan opisthoglyphous snake, Ithycyphus miniatus. In both cases, the snake bit the finger of a human who was preparing an experiment by tying a string around the snake body. Symptoms of the first case included temporal severe local pain and extensive bleeding. In the second case, severe pain accompanying obvious local swelling was caused and lasted for several hours. The present observations indicate that bite by I. miniatus potentially causes serious physiological effects in humans although the snake is basically calm and reluctant to bite.

Flavivirus infections in Chiang Mai area, Thailand, in 1982.

Infection by JE virus still constitutes major cause of encephalitis in Chiang Mai Area, although some cases of possible dengue encephalopathy were observed. In spite of many apparent encephalitis cases, infection of vector mosquitoes by JE virus was not demonstrated. Virus isolation from hospitalized patients showed that the principal type of dengue virus circulating in Chiang Mai in 1982 was type 1 virus. Seroepidemiological survey on healthy humans indicated that the northern part of Chiang Mai Province in the region of the Maekong Valley has not yet been invaded so much by dengue viruses, compared with the Chiang Mai Valley, where dengue infection apparently became more prevalent than 12 years ago. The survey also indicated that the spread of JE virus in the study area was not uniform. Survey on vertebrates showed that anti-JE antibodies were highly prevalent among swine, horses, mules, sheep, and dogs. On the other hand, antibody prevalence was low in monkeys, ducks, and sparrows, and was negative among chickens and lizards. IgM-ELISA appeared to help differential diagnosis on JE from dengue even when the HI test did not give positive results.