Investigação de marcadores moleculares sanguíneos durante a infecção pelo vírus Chikungunya / Investigation of blood molecular markers during Chikungunya virus infection

A febre Chikungunya (CHIKF) é uma infecção viral causada pelo vírus Chikungunya (CHIKV). Os sintomas agudos incluem febre alta de início súbito, erupção cutânea, poliartrite e poliartralgia. Embora a infecção geralmente seja resolvida em menos de duas semanas, muitos pacientes experenciam recorrente dor e inflamação nas articulações, que podem persistir por anos. Esse estudo buscou marcadores moleculares no sangue de infectados pelo CHIKV que estejam associados a dor articular e cronicidade da CHIKF. O sequenciamento de receptores de células B (BCR) e T (TCR) demonstrou que a infecção por CHIKV diminui a diversidade desses receptores. Essa diversidade é ainda menor, durante a fase aguda da infecção, naqueles pacientes que irão desenvolver cronicidade. A menor diversidade de BCR em infectados está associada a um aumento na expressão de genes envolvidos na diferenciação e ativação de osteoclastos pela sinalização RANK/RANKL. Em adição, a cronicidade pode estar relacionada um aumento na expressão do gene ZBTB7A cuja expressão confere maior resistência a apoptose em precursores de osteoclastos naqueles pacientes que vão se tornar crônicos. Caso o envolvimento dos osteoclastos durante a patogênese de CHIKF seja confirmado, os pacientes poderão se beneficiar de abordagens terapêuticas já existentes como alternativas adicionais ao tratamento de CHIKF

Chikungunya fever (CHIKF) is a viral infection caused by the Chikungunya virus (CHIKV). Acute symptoms include sudden-onset high fever, rash, polyarthritis, and polyarthralgia. Although the infection usually resolves within two weeks, many patients experience recurrent joint pain and inflammation, which can persist for years. This study sought molecular markers in the blood of CHIKV-infected individuals that are associated with joint pain and chronicity of CHIKF. Sequencing of B (BCR) and T (TCR) cell receptors demonstrated that CHIKV infection decreases the diversity of these receptors. The diversity is even lower, during the acute phase of the infection, in those patients who will develop chronicity. The lower diversity of BCR in infected individuals is associated with an increase in the expression of genes involved in the differentiation and activation of osteoclasts by RANK/RANKL signaling. In addition, chronicity may be related to an increase in the expression of the ZBTB7A gene whose expression confers greater resistance to apoptosis in osteoclast precursors in those patients who will become chronic. If osteoclast role during CHIKF pathogenesis is confirmed, patients may benefit from existing therapeutic approaches as additional alternatives to CHIKF treatment

Chemical study of Adenocalymma axillarum crude leaf extract and isolated compounds

Abstract Adenocalymma axillarum (K.Schum.) L.G. Lohmann is a liana belonging to the family Bignoniaceae. In traditional medicine, the genus Adenocalymma is used to treat fever, skin ailments, and body, joint, and facial muscle pains, and it is also applied as cosmetic. Biological assays conducted with the A. axillarum crude leaf ethanol extract have indicated leishmanicidal activity and absence of cytotoxicity. This study aimed to analyze the A. axillarum leaf ethanol crude extract by high-performance liquid chromatography-high-resolution mass spectrometry- diode array detector (HPLC-HRMS-DAD) and to evaluate the leishmanicidal and cytotoxic activities of this crude extract, its fractions, and isolated compounds. HPLC-HRMS-DAD analysis of this extract revealed that it consisted mainly of flavonoids, with nine major compounds. Extract purification yielded 4-hydroxy-N-methylproline, 6-β-hydroxyipolamiide, quercetin-3-O-robinobioside, hyperin, isorhamnetin-3-O-robinobioside, and 3'-O-methylhyperin, which were identified by Nuclear Magnetic Resonance. The isolated compounds were inactive against Leishmania amazonensis promastigotes and human lung fibroblast cells.

Musculoskeletal ultrasonography of the elbow joint in dogs: applicability and evaluation protocol / Ultrassonografia musculoesquelética da articulação do cotovelo em cães: aplicabilidade e protocolo de avaliação

The elbow is a complex joint and has great clinical relevance in small animal medicine. Previous research in this area has been performed using radiographic and tomographic methods; however, there are limited studies on ultrasonography. The aims of this study was suggesting an evaluation protocol for elbow scan and describe the ultrasonographic anatomy of the elbow joint in dogs. Ten cross-breed dogs weighing 5-15kg underwent radiography and were selected for this ultrasonographic study. The protocol was established for the ultrasonographic description dividing the articular areas in the proximal, middle, and distal, lateral, cranial, medial, and caudal faces. The approach was performed in the longitudinal, transverse and oblique planes and the musculoskeletal structures were described according to the architecture, echogenicity and echotexture. Computed tomography and magnetic resonance imaging scans were obtained for one animal for comparison. Ultrasonography was effective in visualizing and analyzing muscles, tendons and ligaments. Bone contours and regions that have clinical significance such as the medial coronoid process and anconeus process were identified, but with limited access. Prior knowledge of the normal sonographic anatomy of the elbow joint, as well as its technical advantages and limitations will allow further studies related to the identification of musculoskeletal disorders.(AU)

O cotovelo é uma articulação complexa e tem grande relevância clínica na medicina veterinária de pequenos animais. Pesquisas prévias nesta área foram realizadas utilizando radiografias e tomografia computadorizada, entretanto há limitados estudos com ultrassonografia. O objetivo desse estudo é sugerir um protocolo de avaliação da articulação do cotovelo e descrever sua anatomia ultrassonográfica. Dez cães sem raça definida, pesando 5-15kg foram submetidos à radiografias e foram selecionados para o estudo ultrassonográfico. O protocolo foi estabelecido para a descrição anatômica ultrassonográfica dividindo as articulações em proximal, média e distal, faces lateral, cranial, medial e caudal. A abordagem foi realizada nos planos longitudinal, transverso e oblíquo e as estruturas foram descritas de acordo com a arquitetura, ecogenicidade e ecotextura. Tomografia computadorizada e ressonância magnética foram realizadas em um animal para comparação. A ultrassonografia foi efetiva na visualização e análise de músculos, tendões e ligamentos. Os contornos ósseos e regiões com significado clínico como o processo coronóide medial e o processo ancôneo foram identificados, mas com acesso limitado. Conhecimento prévio da anatomia ultrassonográfica normal da arquitetura do cotovelo, bem como suas vantagens e limitações, irão permitir estudos adicionais relacionados à identificação de desordens musculoesqueléticas.(AU)

Refractory seizures with global developmental delay: A rare cause.

Aicardi syndrome is a genetic disorder characterized by the triad of infantile spasm in flexion, callosal agenesis and ocular abnormalities (chorioretinal lacunae, coloboma of optic disc). We report a typical case of Aicardi syndrome with all the classical features.

Bartsocas-Papas syndrome.

We report three sibs born to a third degree consanguineous Indian family affected with Bartsocas Papas Syndrome. All the three pregnancies were complicated by severe oligohydramnios, which is not commonly seen with Bartsocas-Papas syndrome.

Treatment of severe juxta-articular deformities using Ilizarov technique

Proper alignment of the mechanical axis and joint orientation lines in juxta-articular deformities requires a combination of angulation and translation of a metaphyseal osteotomy. In severe deformities, the translation required decreases bone contact at the osteotomy site to a great extent. In addition, this translation may cause a bony prominence and a bad cosmetic effect. This study was carried out to evaluate the results of treatment of severe juxta articular deformities using an Ilizarov external fixator with hinges at the center of rotation of angulation of the deformity to produce angulation and translation at a metaphyseal osteotomy to correct the mechanical axis. In addition we aimed at assessment of the effect of bone displacement on the cosmetic appearance of the patients. The material of this work consisted of 14 severe juxta- articular lower limb deformities that were treated using llizarov technique and a metaphyseal angulation displacement osteotomy. Ten cases had unilateral deformities and two cases had bilateral deformities. The study included 9 males and 3 females. Their age ranged from 11 to 35 years [mean: 19.75 +/- 8.37]. The mean preoperative deformity was 30 +/- 7.81. The mean preoperative limb length discrepancy in unilateral cases was 4.3 +/- 2.2 cm. All osteotomies healed. The mean external fixation time was 22 +/- 9 weeks. All deformities were successfully corrected to within the normal range except one patient who had 10 mm of lateral mechanical axis deviation after treatment for a varus deformity with 10 cm of limb length discrepancy. The amount of lengthening ranged from 2 to 8 cm [mean: 3.37 +/- 2]. All patients were satisfied with the cosmetic appearance after correction of their deformities. Severe juxta-articular deformities can be corrected most accurately with metaphyseal angulation displacement osteotomy using Ilizarov external fixator

Comparative evaluation of effectiveness of different motor muscles in modified lasso procedure for correction of finger clawing

A retrospective study was carried out to compare the effectiveness of different muscles as motors in modified lasso procedures for correction of finger clawing in leprosy. It was observed that palmaris longus and extensor carpi radialis longus were more suitable than the flexor digitorum superficialis. In some patients, removal of superficialis is associated with complications which could not be predicted before surgery. Extensor carpi radialis longus has advantages over palmaris longus in selected cases.

Síndrome CCC (cuello corto, campodactilia, cardiopatía) con variabilidad: nuevo síndrome autosómico dominante / Syndrome CCC (short neck, camptodactily, cardiopathy) with variability expression: a new autosomic dominant syndrome

Se presenta el cuadro clínico no descrito anteriormente de una familia en la que se encontraron 16 personas que mostraban, en forma constante, cuello corto y ancho, cardiopatía a expensas del ventrículo izquierdo y camptodactilia con hipoplasia de los pliegues de flexión. Todos tenían talla baja con variabilidad en su expresión. Otros datos no constantes fueron paladar alto, depresión del puente nasal, micrognatia, cúbito varo, posición dental anormal e hiperplasia gingival. Al tomar en cuenta las malformaciones constantes se le ha denominado "sindrome CCC", siglas que corresponden a cuello corto, cardiopatía y camptodactilia.

Artrogriposis múltiple congénita: estudio clínico y genético / Congenital arthrogryposis multiplex

Se estudiaron 46 casos de artrogriposis múltiple congénita (AMC) atendidos en la Consulta Externa de genética del Instituto Nacional de Pediatría. Se encontraron tres casos familiares, dos de los cuales sugerían una forma de herencia autosómica recesiva y el otro probablemente dominante. Casi la mitad de los casos fue de producto de la primera gestación. Las anteraciones en las extremidades permitieron clasificarlos en AMC generalizada (54%), de predominio en extremidades inferiores (30%), de predominio superior (5%) y distal (11%). Las alteraciones concomitantes más frecuentes fueron el hemangiona plano, la facie redonda, la micrognatia y la dificultad para abrir la boca. Se concluye que la AMC causa limitaciones importantes, su gravedad es variable y suele acompañarse de otros defectos que deben buscarse. Aunque en su mayoría son esporádicos, el árbol genealógico puede indicar una herencia mendeliana que amerite asesoramiento genético