Histopathological Findings Associated With Gastroesophageal Reflux Disease and Aspiration After Lung Transplantation: Initial Brazilian Single-Center Experience.

BACKGROUND: Gastro-esophageal reflux disease (GERD) and broncho-aspiration (BA) are known to increase the risk for chronic lung allograft dysfunction (CLAD). However, specific lung injury mechanisms are not clearly known. The objective of the study was to describe histopathological findings in surveillance lung transbronchial biopsies that can be correlated with episodes of BA in the lung allograft. METHODS: This retrospective analysis of surveillance transbronchial biopsies was performed in lung transplant recipients, with available data of broncho-alveolar fluid (cultures and cytology), lung function parameters, and esophageal functional tests. RESULTS: Were analyzed 11 patients, divided into 3 groups: (1) GERD group: 4 patients with GERD and CLAD diagnosis; (2) control group: 2 patients without GERD or CLAD; and (3) BA group: 5 patients with foreign material in lung biopsies. A histopathological pattern of neutrophilic bronchitis (NB) was present in 4 of 4 cases in the GERD group and in 1 of 5 cases in the BA group in 2 or more biopsy samples; culture samples were all negative; the 5 NB-positive patients developed CLAD and died (3/5) or needed re-transplantation (2/5). The other 3 patients in the BA group had GERD without NB or CLAD. Both patients in the control group had transient NB in biopsies with positive cultures but remained free of CLAD. CONCLUSIONS: Surveillance transbronchial biopsies may provide useful information other than the evaluation of acute cellular rejection and can help to identify high-risk patients for allograft dysfunction related to gastro-esophageal reflux.

Periodontal disease detection in primary and mixed dentitions.

AIM: This was to compare the periodontal status of children with primary and mixed dentition at the time of their first consultation. METHODS: Children (200), aged 0-12 years (156 with mixed and 44 with primary dentition), were examined by assessing their simplified plaque index (PI) and simplified periodontal record (PSR). Statistical analysis (Chi-square test) was performed with appropriate software to find any significant associations between sex, type of dentition and PI with the PSR codes (0, 1, 2, 3 and 4). RESULTS: There was no statistically significant difference with regard to gender (p = 0.82). Generalised PI was associated more significantly with mixed dentition (p = 0.025 and higher PSR scores (p < 0.001). There was no significant relationship between sex and PSR codes (p = 0.82). CONCLUSION: Children presenting with a mixed dentition had worse PI values and PSR scores. It is important to perform periodontal examination in children to diagnose and prevent future periodontal disease and maintain their dentition as well as to identify any associated systemic conditions.

Posterior reversible encephalopathy syndrome in lung transplantation: 5 case reports.

Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiologic entity characterized by typical neurologic symptoms with characteristic cerebral image alterations. It has been reported in solid organ transplantations, especially related to the use of calcineurin inhibitors. The incidence of PRES in lung transplantation is unknown and probably under-reported in the literature. Here we describe 5 cases of PRES after bilateral lung transplantation. One of the reported cases was the first in the literature in which the neurologic onset precluded the introduction of calcineurin inhibitor. Therefore, although calcineurin inhibitors are known to play an important role in the development of PRES in the setting of lung transplantation, other causes seems to be involved in the physiopathology of this syndrome.

Substituição parcial do milho por sorgo granífero na alimentação de matrizes suínas primíparas durante a lactação / Partial substitution of corn by sorghum in the feeding of primiparous female pigs during lactation

Avaliou-se o efeito da substituição parcial do milho por sorgo granífero na dieta de matrizes suínas híbridas durante as fases de lactação e pós-desmame. Foram utilizadas 25 fêmeas, distribuídas em três tratamentos, com porcentagens crescentes de sorgo granífero - 0 por cento, 25 por cento e 50 por cento - em substituição ao milho. Os animais foram avaliados durante as fases de lactação e pós-desmame, tendo sido mensurados o peso vivo (PV) e a espessura de toucinho (ET) ao parto, ao oitavo, 16º e 25º dias de lactação - desmame. Nesses momentos, foram realizadas colheitas de amostras de leite para análise bioquímica. As leitegadas foram pesadas no mesmo intervalo de tempo. No estro pós-desmame (RE), determinou-se o intervalo estro-cobertura (dias), PV e ET. Quanto às fêmeas, não ocorreram efeitos sobre o PV e a ET. Quanto ao número e ao peso dos leitões, as fêmeas do grupo controle apresentaram maior número de leitões nascidos vivos. O GPD dos leitões foi maior nas leitegadas dos tratamentos com 50 por cento de sorgo. Não houve diferença para as análises do leite. No RE, não ocorreram efeitos. Dessa forma, conclui-se que o sorgo granífero pode substituir o milho em até 50 por cento na dieta de fêmeas suínas durante lactação, sem comprometer os parâmetros produtivos e reprodutivos.(AU)

The aim of this research was to evaluate the effect of partial substitution of corn with sorghum on the diets of hybrid female pigs during lactation and post-weaning. Twenty-five females were distributed in three treatments with increasing levels of grain sorghum - 0 percent, 25 percent and 50 percent - as partial substitute of the corn. The females were evaluated during the lactation and post-weaning phases, measuring live weight (LW) and age at puberty and LW and backfat thickness (BT). The females were weighed on the 8th, 16th and 25th days of lactation (weaning), simultaneously with the measurement of BT and milk samples for biochemical analysis. Also, the litters were weighed at the same interval. The estrus detection after weaning was determined by the range-topping estrus (days), LW and BT. As for females, there was no effect on LW and BT. As to the piglets number and weight, the females in the control group had a high number of piglets born alive. The daily gain of piglets was higher in litters with treatment with 50 percent sorghum. There was no difference in the milk analysis. In the post-weaning there were no effects. Thus, it was concluded that grain sorghum can replace corn by 50 percent on the diet of female pigs during lactation without compromising the productivity and reproductive parameters.(AU)

Substituição parcial do milho por sorgo granífero na alimentação de matrizes suínas primíparas durante a lactação / Partial substitution of corn by sorghum in the feeding of primiparous female pigs during lactation

Avaliou-se o efeito da substituição parcial do milho por sorgo granífero na dieta de matrizes suínas híbridas durante as fases de lactação e pós-desmame. Foram utilizadas 25 fêmeas, distribuídas em três tratamentos, com porcentagens crescentes de sorgo granífero - 0 por cento, 25 por cento e 50 por cento - em substituição ao milho. Os animais foram avaliados durante as fases de lactação e pós-desmame, tendo sido mensurados o peso vivo (PV) e a espessura de toucinho (ET) ao parto, ao oitavo, 16º e 25º dias de lactação - desmame. Nesses momentos, foram realizadas colheitas de amostras de leite para análise bioquímica. As leitegadas foram pesadas no mesmo intervalo de tempo. No estro pós-desmame (RE), determinou-se o intervalo estro-cobertura (dias), PV e ET. Quanto às fêmeas, não ocorreram efeitos sobre o PV e a ET. Quanto ao número e ao peso dos leitões, as fêmeas do grupo controle apresentaram maior número de leitões nascidos vivos. O GPD dos leitões foi maior nas leitegadas dos tratamentos com 50 por cento de sorgo. Não houve diferença para as análises do leite. No RE, não ocorreram efeitos. Dessa forma, conclui-se que o sorgo granífero pode substituir o milho em até 50 por cento na dieta de fêmeas suínas durante lactação, sem comprometer os parâmetros produtivos e reprodutivos...

The aim of this research was to evaluate the effect of partial substitution of corn with sorghum on the diets of hybrid female pigs during lactation and post-weaning. Twenty-five females were distributed in three treatments with increasing levels of grain sorghum - 0 percent, 25 percent and 50 percent - as partial substitute of the corn. The females were evaluated during the lactation and post-weaning phases, measuring live weight (LW) and age at puberty and LW and backfat thickness (BT). The females were weighed on the 8th, 16th and 25th days of lactation (weaning), simultaneously with the measurement of BT and milk samples for biochemical analysis. Also, the litters were weighed at the same interval. The estrus detection after weaning was determined by the range-topping estrus (days), LW and BT. As for females, there was no effect on LW and BT. As to the piglets number and weight, the females in the control group had a high number of piglets born alive. The daily gain of piglets was higher in litters with treatment with 50 percent sorghum. There was no difference in the milk analysis. In the post-weaning there were no effects. Thus, it was concluded that grain sorghum can replace corn by 50 percent on the diet of female pigs during lactation without compromising the productivity and reproductive parameters...

Epipericardial fat necrosis: an underdiagnosed condition.

OBJECTIVE: Epipericardial fat necrosis (EFN) is an uncommon benign and self-limited condition that leads patients to the emergency department (ED) owing to the onset of acute pleuritic chest pain. The aim of this study was to describe the cases of this disease in our institution and to illustrate the associated clinical and radiological findings. METHODS: We reviewed 3604 chest scans referred by the ED from November 2011 to July 2013. Patients diagnosed with epipericardial necrosis had their medical records and original tomography reports analysed. RESULTS: Chest pain was the primary complaint in 426 patients; 11 of them had definitive EFN findings characterized by a round soft-tissue attenuation lesion with a varying degree of strands. All patients presented with pleuritic chest pain on the same side as the lesion. Pericardial thickening, pleural effusion and mild atelectasis were the associated tomography findings. Cardiac enzyme and D-dimer tests performed during the episode were normal in all cases. 27% of the cases only were correctly diagnosed with EFN at the time of presentation. CONCLUSION: EFN is a benign inflammatory condition frequently overlooked in the ED by physicians and radiologists but is an important factor in the differential diagnosis of patients with acute chest pain. ADVANCES IN KNOWLEDGE: The article adds clinically and radiologically useful information about the condition and displays the importance of making the correct diagnosis to avoid unnecessary examinations.

Morphometry and histomorphometry of the testis in crossbred pigs fed diets with different protein levels / Morfometria e histomorfometria do testículo em suínos híbridos recebendo dietas com diferentes níveis de proteína

Aiming to evaluate the effect of the diet protein content on testicular parameters in pigs, 21 non-gelded male Dalland pigs were used and randomly divided into three groups. Males belonging to groups G2 and G3 received a diet with crude protein levels of 15% below and above, respectively, in relation to G1 (control). At 210 days of age, animals were castrated, and testis and epididymis were collected for morphometric and histomorphometry analyses. No difference was observed in relation to the total length of seminiferous tubules (G1=3239.9±333,3m; G2=2989.4±171,7m and G3=3059.5±254.9m), population of Sertoli cell (G1=4.7±0.5x10(9); G2=4.3±0.3x10(9) and G3=4.7±0.5x10(9)), population (G1=31.6±5.58x10(9); G2=27.3±4.0x10(9) and G3=26.4±3.9x10(9)) and volume of Leydig cells (G1=1289.3±182.6µm³; G2=1179.1±85.4µm³ and G3=1133.3±37.8µm³) and sperm production (G1=5.9±0.9x10(9); G2=5.6±0.6x10(9) and G3=5.1±0.3x10(9)). Protein levels were sufficient to maintain spermatogenesis in different experimental groups. It can be concluded that the magnitude of variation in levels of protein used in different stages of development was not sufficient to promote significant changes in testicular development and spermatogenesis process in adult animals.(AU)

Avaliou-se o efeito do teor de proteína da dieta sobre características testiculares em suínos, utilizando-se 21 suínos da raça Dalland, distribuídos aleatoriamente em três grupos. Os animais do G2 e G3 receberam dieta com porcentagens de proteína bruta de 15% para mais e para menos, respectivamente, em relação ao G1 (controle). Aos 210 dias de idade, os animais foram orquiectomizados e os testículos e epidídimos foram coletados para análises morfométricas e histomorfométricas. Observou-se efeito significativo da porcentagem de proteína sobre o comprimento e a largura dos testículos, e nenhuma diferença foi identificada em relação ao comprimento total dos túbulos seminíferos (G1=3239,9±333,3m; G2=2989,4±171,7m e G3=3059,5±254,9m), à população de células de Sertoli (G1=4,7±0,5x10(9); G2=4,3±0,3 x10(9) e G3=4,7±0,5x10(9)), à população (G1=31,6±5,58x10(9); G2=27,3±4,0x10(9) e G3=26,4±3,9x10(9)) e ao volume das células de Leydig (G1=1289,3±182,6µm³; G2=1179,1±85,4µm³ e G3=1133,3±37,8µm³) e à produção espermática (G1=5,9±0,9 x10(9); G2=5,6±0,6x10(9) e G3=5,1±0,3x10(9)). Os percentuais de proteína foram suficientes para a manutenção da espermatogênese nos diferentes grupos. Pode-se concluir que a magnitude da variação dos níveis de proteína usada em diferentes fases do desenvolvimento não foi suficiente para promover alterações significativas no desenvolvimento testicular e no processo espermatogênico em animais adultos.(AU)

Morphometry and histomorphometry of the testis in crossbred pigs fed diets with different protein levels / Morfometria e histomorfometria do testículo em suínos híbridos recebendo dietas com diferentes níveis de proteína

Aiming to evaluate the effect of the diet protein content on testicular parameters in pigs, 21 non-gelded male Dalland pigs were used and randomly divided into three groups. Males belonging to groups G2 and G3 received a diet with crude protein levels of 15% below and above, respectively, in relation to G1 (control). At 210 days of age, animals were castrated, and testis and epididymis were collected for morphometric and histomorphometry analyses. No difference was observed in relation to the total length of seminiferous tubules (G1=3239.9±333,3m; G2=2989.4±171,7m and G3=3059.5±254.9m), population of Sertoli cell (G1=4.7±0.5x10(9); G2=4.3±0.3x10(9) and G3=4.7±0.5x10(9)), population (G1=31.6±5.58x10(9); G2=27.3±4.0x10(9) and G3=26.4±3.9x10(9)) and volume of Leydig cells (G1=1289.3±182.6µm³; G2=1179.1±85.4µm³ and G3=1133.3±37.8µm³) and sperm production (G1=5.9±0.9x10(9); G2=5.6±0.6x10(9) and G3=5.1±0.3x10(9)). Protein levels were sufficient to maintain spermatogenesis in different experimental groups. It can be concluded that the magnitude of variation in levels of protein used in different stages of development was not sufficient to promote significant changes in testicular development and spermatogenesis process in adult animals.

Avaliou-se o efeito do teor de proteína da dieta sobre características testiculares em suínos, utilizando-se 21 suínos da raça Dalland, distribuídos aleatoriamente em três grupos. Os animais do G2 e G3 receberam dieta com porcentagens de proteína bruta de 15% para mais e para menos, respectivamente, em relação ao G1 (controle). Aos 210 dias de idade, os animais foram orquiectomizados e os testículos e epidídimos foram coletados para análises morfométricas e histomorfométricas. Observou-se efeito significativo da porcentagem de proteína sobre o comprimento e a largura dos testículos, e nenhuma diferença foi identificada em relação ao comprimento total dos túbulos seminíferos (G1=3239,9±333,3m; G2=2989,4±171,7m e G3=3059,5±254,9m), à população de células de Sertoli (G1=4,7±0,5x10(9); G2=4,3±0,3 x10(9) e G3=4,7±0,5x10(9)), à população (G1=31,6±5,58x10(9); G2=27,3±4,0x10(9) e G3=26,4±3,9x10(9)) e ao volume das células de Leydig (G1=1289,3±182,6µm³; G2=1179,1±85,4µm³ e G3=1133,3±37,8µm³) e à produção espermática (G1=5,9±0,9 x10(9); G2=5,6±0,6x10(9) e G3=5,1±0,3x10(9)). Os percentuais de proteína foram suficientes para a manutenção da espermatogênese nos diferentes grupos. Pode-se concluir que a magnitude da variação dos níveis de proteína usada em diferentes fases do desenvolvimento não foi suficiente para promover alterações significativas no desenvolvimento testicular e no processo espermatogênico em animais adultos.

Substituição parcial do milho por sorgo granífero na alimentação de matrizes suínas primíparas nos períodos de puberdade e gestação / Partial substitution of corn by sorghum in the feeding of primiparous female pigs during puberty and pregnancy

Avaliou-se o efeito da substituição parcial do milho por sorgo granífero na dieta de matrizes suínas híbridas durante a puberdade e a gestação. Foram utilizadas 25 leitoas, distribuídas em três tratamentos com porcentagens crescentes de sorgo granífero - 0%, 25% e 50% - em substituição ao milho. As fêmeas foram avaliadas durante as fases de pré-puberdade, puberdade e gestação, tendo sido mensurados o peso vivo (PV) e a idade à puberdade nas jovens e o PV e a espessura de toucinho (ET) nas fêmeas gestantes - à cobrição e aos 30, 60, 90 e 110 dias de prenhez. Na fase de pré-puberdade, o ganho de peso diário diminuiu com o aumento da utilização do sorgo, e durante a puberdade não houve efeito dos tratamentos. Houve efeito linear da substituição sobre o PV aos 90 dias de gestação. Nos demais períodos, não foram encontrados efeitos significativos. Conclui-se que o sorgo granífero pode substituir o milho em até 50% na dieta de fêmeas suínas durante a puberdade e a gestação, sem comprometer as variáveis produtivas e reprodutivas.(AU)

The effect of partial substitution of corn by sorghum on the diets of hybrid female pigs during puberty and pregnancy was evaluated. Twenty-five females were distributed in three treatments with increasing percentage of grain sorghum - 0%, 25% and 50% - as a partial substitute for corn. The females were evaluated during the growth, puberty and pregnancy phases, measuring live weight (LW) and age at puberty in young females and LW and backfat thickness (BT) during gestation - at mating, 30, 60, 90 and 110 days of pregnancy. During the growth period, daily gain decreased with increased use of sorghum and there was no effect of treatments on puberty. For pregnancy, there was a linear effect on LW at day 90. Thus, it was concluded that grain sorghum can replace corn up to 50% on the diet of female pigs during puberty, pregnancy and lactation without compromising the productivity and reproductive variables.(AU)

Substituição parcial do milho por sorgo granífero na alimentação de matrizes suínas primíparas nos períodos de puberdade e gestação / Partial substitution of corn by sorghum in the feeding of primiparous female pigs during puberty and pregnancy

Avaliou-se o efeito da substituição parcial do milho por sorgo granífero na dieta de matrizes suínas híbridas durante a puberdade e a gestação. Foram utilizadas 25 leitoas, distribuídas em três tratamentos com porcentagens crescentes de sorgo granífero - 0%, 25% e 50% - em substituição ao milho. As fêmeas foram avaliadas durante as fases de pré-puberdade, puberdade e gestação, tendo sido mensurados o peso vivo (PV) e a idade à puberdade nas jovens e o PV e a espessura de toucinho (ET) nas fêmeas gestantes - à cobrição e aos 30, 60, 90 e 110 dias de prenhez. Na fase de pré-puberdade, o ganho de peso diário diminuiu com o aumento da utilização do sorgo, e durante a puberdade não houve efeito dos tratamentos. Houve efeito linear da substituição sobre o PV aos 90 dias de gestação. Nos demais períodos, não foram encontrados efeitos significativos. Conclui-se que o sorgo granífero pode substituir o milho em até 50% na dieta de fêmeas suínas durante a puberdade e a gestação, sem comprometer as variáveis produtivas e reprodutivas.

The effect of partial substitution of corn by sorghum on the diets of hybrid female pigs during puberty and pregnancy was evaluated. Twenty-five females were distributed in three treatments with increasing percentage of grain sorghum - 0%, 25% and 50% - as a partial substitute for corn. The females were evaluated during the growth, puberty and pregnancy phases, measuring live weight (LW) and age at puberty in young females and LW and backfat thickness (BT) during gestation - at mating, 30, 60, 90 and 110 days of pregnancy. During the growth period, daily gain decreased with increased use of sorghum and there was no effect of treatments on puberty. For pregnancy, there was a linear effect on LW at day 90. Thus, it was concluded that grain sorghum can replace corn up to 50% on the diet of female pigs during puberty, pregnancy and lactation without compromising the productivity and reproductive variables.

Obsessive-compulsive symptoms in adults with history of rheumatic fever, Sydenham's chorea and type I diabetes mellitus: preliminary results.

OBJECTIVE: Rheumatic fever (RF) associated with Sydenham's chorea (a neurological variant of RF), but not RF without chorea, has been acutely related to obsessive-compulsive symptomatology/disorder (OCS/OCD). This study investigated the presence of OCS in adults who had RF with or without chorea in childhood. METHOD: The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to evaluate OCS in 38 adults with history of RF (13 with chorea; 25 without chorea) or diabetes (controls; n = 19). RESULTS: The OCS was similar in both groups, although the intensity of symptoms was not clinically relevant. Moreover, subjects with RF with or without chorea did not score differently in the Y-BOCS. CONCLUSION: The similar occurrence of OCS in patients with history of RF and diabetes suggests that the development of this symptomatology, triggered by group A beta-haemolytic streptococcus infections, is restricted to the RF acute phase, occurred during infancy, and did not seem to predispose the appearance of OCS in adulthood.