Posterior Interosseous Nerve Syndrome due to Schwannoma - A Case Report.

Posterior interosseous nerve syndrome is the most frequent syndrome of radial nerve compression, with the arcade of Frohse being the main site of compression. Its symptoms include difficulties in finger and wrist extension with possible radial deviation. Herein, we present a case of posterior interosseous syndrome caused by a schwannoma, a type of neurological tumor.

Nrf2 activation by hydroxytyrosol and dimethyl fumarate ameliorates skin tissue repair in high-fat diet-fed mice by promoting M2 macrophage polarization and normalizing inflammatory response and oxidative damage.

Hydroxytyrosol (HT) or dimethyl fumarate (DMF), activators of nuclear factor erythroid 2-related factor 2 (Nrf2), may reduce obesity in high-fat diet (HFD)-fed animals; nevertheless, the role of these activators on skin tissue repair of HFD-fed animals was not reported. This study investigated whether HT or DMF could improve skin wound healing of HFD-fed obese animals. Mice were fed with an HFD, treated with HT or DMF, and full-thickness skin wounds were created. Macrophages isolated from control and obese animals were treated in vitro with HT. DMF, but not HT, reduced the body weight of HFD-fed mice. Collagen deposition and wound closure were improved by HT or DMF in HFD-fed animals. HT or DMF increased anti-inflammatory macrophage phenotype and protein Nrf2 levels in wounds of HFD-fed mice. Lipid peroxidation and protein tumor necrosis factor-α levels were reduced by HT or DMF in wounds of HFD-fed animals. In in vitro, HT stimulated Nrf2 activation in mouse macrophages isolated from obese animals. In conclusion, HT or DMF improves skin wound healing of HFD-fed mice by reducing oxidative damage and inflammatory response. HT or DMF may be used as a therapeutic strategy to improve the skin healing process in individuals with obesity.

New insights on the phylogeography of Hepatozoon canis in Brazil.

This study aimed to molecularly characterize the Hepatozoon spp. infecting domestic and wild dogs in Brazil. A total of 22 whole blood samples tested positive for Hepatozoon spp., and five samples were sequenced for the 18S rDNA gene from H. canis after PCR amplification with four primer sets. Phylogenetic analysis using Bayesian inference showed that the three H. canis isolates from domestic dogs were not monophyletic; however, they were more closely related to each other than to other H. canis sequences. The isolate from the hoary fox (Lycalopex vetulus) was phylogenetically more distant. Two haplotype networks were constructed, identifying 10 haplotypes of H. canis in Brazil, with H10 constituting the largest group. It contains nine isolates, including three from domestic dogs. The H5 haplotype grouped the sequence of L. vetulus with two additional sequences from hosts Tapirus terrestris and L. vetulus, representing the sole haplotype with wild hosts. Bayesian analysis suggested the possible existence of two genetic groups of H. canis in Brazil, indicating gene flow of this agent within the country. These findings contribute valuable insights for a more comprehensive understanding of the molecular diversity of Hepatozoon spp. in Brazil and may help in the development of effective control measures.

Transradial versus transfemoral approach in cerebral angiography: A meta-analysis.

BACKGROUND: Cerebral angiography has two common access sites: Transradial approach and transfemoral approach. However, there's no definitive answer to which one is superior. OBJECTIVE: Compare transradial approach and transfemoral approach for a cerebral angiography procedure. METHODS: A systematic review of the literature of studies reporting both transradial approach and transfemoral approach results was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. PubMed, Cochrane Library, and Embase were queried. RESULTS: The meta-analysis examined 18 studies comprising 9388 patients undergoing cerebral angiography. Among the patients, 4598 underwent transradial approach (48.9%) and 4790 underwent transfemoral approach (51.1%). Our results revealed no statistical differences between the approaches regarding procedure success, crossover to transfemoral approach, procedure and fluoroscopy time between both approaches in cerebral angiography. Total, major, and minor complications comparisons were more favorable to transradial approach for this procedure. CONCLUSION: These findings suggest, despite the ultimate decision regarding the choice of access method might be influenced by the physician's experience and personal preference, the data distinctly lean toward transradial approach as the preferable option for cerebral angiography. The advantages of transradial approach, highlighted by its lower complication rates, especially major complications, suggest that its adoption could contribute to enhanced patient safety and procedural outcomes.

Prognostic value of neutrophil and lymphocyte counts and neutrophil/lymphocyte ratio for predicting death in patients hospitalized for COVID-19.

COVID-19 primarily affects the respiratory system and can cause changes in other systems. Early identification of patients with a higher potential for complications is critical to provide the best possible treatment to reduce the disease's lethality. This study aimed to analyze the behavior of hematologic biomarkers in predicting mortality in patients hospitalized with COVID-19. This retrospective cohort study used data from the medical records of patients hospitalized with COVID-19 between March and August 2020 in two referral hospitals for treatment of the disease in the city of Cuiabá (in the state of Mato Grosso, Brazil). Clinical and laboratory characteristics related to cardiovascular involvement and death during hospitalization were evaluated. Neutrophils, lymphocytes, and monocytes, as well as the neutrophil-to-lymphocyte ratio (NLR) and the monocyte-to-lymphocyte ratio (MRL), were used as potential biomarkers of death. A total of 199 patients were included (male: 113; mean age: 51.4 years). Leukocyte, neutrophil, and lymphocyte counts showed a statistically significant association with death, as did NLR and MRL. Satisfactory accuracy in predicting death was observed for leukocyte, neutrophil, lymphocyte, NLR, and MLR counts. The hematologic biomarkers studied may be useful for prognosticating hospitalized patients for the possibility of death from COVID-19.

Canine piroplasmids: Molecular detection and laboratory characterization in dogs from Brasilia, Brazil, with the first molecular evidence of dog exposure to a novel opossum-associated Babesia sp.

Canine piroplasmid infections can be caused by Babesia spp., Theileria spp. and Rangelia vitalii. In Brazil, canine babesiosis caused by Babesia vogeli is endemic and reported throughout the country. On the other hand, Rangeliosis caused by R. vitalii has only been described so far in the South and Southeast regions. Despite that, studies analyzing the laboratory and molecular characterization of these hemoprotozoa are still scarce. To investigate the occurrence, the laboratory features, the molecular characterization, and the diversity of piroplasmids from Midwestern Brazil, a survey was performed using blood samples obtained from 276 domestic dogs from Brasília, Federal District, Midwestern Brazil. A broad-range quantitative PCR (qPCR) targeting the mitochondrial large subunit ribosomal DNA (LSU4) was used to detect piroplasmid DNA. The overall molecular occurrence of piroplasmids was 11.2% (31/276), with 9.7% (27/276) of the sequences identified as Babesia vogeli (98-100% identity to B. vogeli isolate from the USA). Based on a partial 18S rRNA sequence pairwise alignment (-250 bp), 1.4% (4/276) of the sequences showed only 76.8% identity with B. vogeli but 100% identity with opossum-associated Babesia sp. (MW290046-53). These findings suggest the exposure of dogs from Brazil to a recently described Babesia sp. isolated from white-eared opossum. None of the analyzed dogs was positive for Theileria spp. or R. vitalii. Subsequently, all positive sequences were submitted to three additional PCR assays based on the 18S rRNA, cox-1, and cytb genes, aiming at performing a haplotype network analysis. Haplotype network using cox-1 sequences showed the presence of six different haplotypes of B. vogeli; one of them was shared with isolates from Brazil, the USA, and India. When including animals co-infected with other vector-borne diseases, piroplasmid-positive dogs had 2.3 times higher chance of having thrombocytopenia than the negative ones. The molecular results demonstrated that the compared Babesia vogeli sequences showed a low variability as well as evidence of exposure to a putative novel opossum-associated Babesia sp. in dogs from Midwestern Brazil.

Piroplasmid infection is not associated with clinicopathological and laboratory abnormalities in cats from Midwestern Brazil.

Feline piroplasmids include the genera Babesia spp., Cytauxzoon spp., and Theileria spp. In Brazil, there are few reports regarding these hemoprotozoans; however, clinicopathological and molecular data are scarce. This study aimed to characterize the clinical relevance of these parasites through hematological, biochemical, and molecular approaches. For this purpose, 166 cats from Brasilia, Federal District, Midwestern Brazil, were screened using a quantitative polymerase chain reaction (qPCR) for piroplasmids based on the LSU4 mitochondrial gene, which resulted in an overall prevalence of 36/166 (21.7%). Twelve of 166 samples (7.2%) were positive for C. felis, while 19/166 (11.4%) were positive for Babesia vogeli. No samples tested positive for Theileria spp. Babesia vogeli and Cytauxzoon spp. LSU4 sequences showed identities of 97-100% and 99.3%, respectively, to US isolates. The hematological and biochemical findings did not differ significantly between the cats that tested positive and negative for piroplasmids. Although the lack of abnormalities in clinical and laboratory parameters does not eliminate the possibility that these cats were sick and recovered, it may suggest that the Brazilian strain of Cytauxzoon spp. is not as pathogenic as that from the USA, despite the high molecular identity with North American isolates.

Identification of potential new mosquito-associated viruses of adult Aedes aegypti mosquitoes from Tocantins state, Brazil.

Medically important arboviruses such as dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV) are primarily transmitted by the globally distributed mosquito Aedes aegypti. Increasing evidence suggests that the transmission of some viruses can be influenced by mosquito-specific and mosquito-borne viruses. Advancements in high-throughput sequencing (HTS) and bioinformatics have expanded our knowledge on the richness of viruses harbored by mosquitoes. HTS was used to characterize the presence of virus sequences in wild-caught adult Ae. aegypti from Tocantins (TO) state, Brazil. Samples of mosquitoes were collected in four cities of Tocantins state and submitted to RNA isolation, followed by sequencing at an Illumina HiSeq platform. Our results showed initially by Krona the presence of 3% of the sequenced reads belonging to the viral database. After further analysis, the virus sequences were found to have homology to two viral families found in insects Phenuiviridae and Metaviridae. Three possible viral strains including putative new viruses were detected and named Phasi Charoen-like phasivirus isolate To-1 (PCLV To-1), Aedes aegypti To virus 1 (AAToV1), and Aedes aegypti To virus 2 (AAToV2). The results presented in this work contribute to the growing knowledge about the diversity of viruses in mosquitoes and might be useful for future studies on the interaction between insect-specific viruses and arboviruses.

Molecular detection of piroplasmids in synanthropic rodents, marsupials, and associated ticks from Brazil, with phylogenetic inference of a putative novel Babesia sp. from white-eared opossum (Didelphis albiventris).

The order Piroplasmida encompasses tick-borne pathogens of veterinary and medical importance positioned in two main families: Babesiidae and Theileriidae. Even though previous studies carried out in Brazil recorded the occurrence of piroplasmid species circulating in small mammals, 18S RNA gene sequences were only partially sequenced, preventing the assessment of their phylogenetic positioning. The current study aimed to detect and characterize, using morphological, molecular, and bioinformatic approaches, piroplasmids from wild mammals and associated ticks sampled in Central-Western Brazil. Out of 67 Didelphis albiventris sampled, 22 (16.4%) were positive for piroplasmids by PCR. In contrast, none of the 48 small rodents and 14 capybaras (Hydrochoerus hydrochaeris) was PCR-positive. Four Amblyomma dubitatum ticks-one from Rattus rattus, one from H. hydrochaeris, and two from D. albiventris-out of 114 Amblyomma spp. DNA samples were positive for piroplasmids by PCR. The phylogenetic inference performed using the near-complete 18S rRNA gene positioned the putative novel piroplasmid species detected in D. albiventris and associated A. dubitatum ticks near to Babesia sensu lato clade (Western group-cluster III) and distant from the Australian marsupial-associated piroplasms. Phylogenetic inferences based on two additional molecular markers, namely hsp-70 and cox-1, supported the near-complete 18S rRNA gene phylogenetic inference. Finally, the partial 18S rRNA gene sequences detected in ticks from rodents (R. rattus and H. hydrochaeris) showed 97.2-99.4% identity with the Piroplasmida previously detected in a capybara from Brazil, raising evidence that a still uncharacterized piroplasmid species has been identified in the capybara, the largest rodent species from South America.

Relación entre los casos de sífilis y la estrategia de salud de familia en el noreste del Brasil / Relação entre os casos de sífilis e a estratégia saúde da família no nordeste brasileiro / Relationship between syphilis cases and family health strategy in northeastern Brazil

OBJETIVOS: Este estudio tiene como objetivo comprender las relaciones entre el progreso de la cobertura de la Estrategia de Salud de Familia en los nueve estados del noreste y las tasas de detección de sífilis en mujeres embarazadas y congénitas entre 2008 y 2017. MÉTODOS: Se trata de un estudio observacional, descriptivo y transversal en el que se correlacionaron las tasas de detección de sífilis de gestación y sífilis congénita en los estados nororientales y en esta región en su conjunto con la respectiva cobertura media anual de la Estrategia de Salud de Familia. Para ello, se realizó la prueba del coeficiente de correlación de Pearson para estas dos variables utilizando el software del Statistical Package for the Social Sciences 25. RESULTADOS: El análisis estadístico de los datos de los estados permitió identificar que, al igual que en los datos agrupados de la región, a medida que aumentó la cobertura de la Estrategia de Salud de Familia, la tasa de detección de casos de sífilis en mujeres embarazadas y congénitas también aumentó significativamente en la mayoría de los estados, y en la región nordeste en su conjunto. CONCLUSIONES: El Sistema Único de Salud a través de la Estrategia de Salud de Familia ha dado lugar a importantes avances relacionados con el seguimiento del embarazo, el puerperio y el desarrollo infantil, así como en el diagnóstico temprano de infecciones como la sífilis. Sin embargo, además del diagnóstico, se necesitan mejoras significativas en el tratamiento y la prevención de estas enfermedades en la región noreste

OBJETIVOS: Este estudo tem por objetivo conhecer as relações existentes entre o avanço da cobertura da Estratégia Saúde da Família nos nove estados nordestinos e as taxas de detecção da sífilis em gestantes e congênita entre os anos de 2008 e 2017. MÉTODOS: Trata-se de um estudo observacional, descritivo e transversal, em que as taxas de detecção para sífilis na gestação e congênita dos estados do Nordeste e desta região como um todo foram correlacionadas com as respectivas médias anuais de cobertura da Estratégia Saúde da Família. Para isso, foi realizado o teste de coeficiente de correlação de Pearson, para essas duas variáveis, através do software Statistical Package for the Social Sciences 25. RESULTADOS: A análise estatística dos dados estaduais possibilitou identificar que, assim como nos dados agrupados da região, à medida que aumentava a cobertura da ESF, a taxa de detecção dos casos de sífilis em gestantes e congênita também crescia significativamente na maioria dos estados, e na região Nordeste integralmente. CONCLUSÕES: O Sistema Único de Saúde através da Estratégia Saúde da Família tem protagonizado grandes avanços relacionados ao acompanhamento da gestação, puerpério e desenvolvimento infantil, como no diagnóstico precoce de infecções, como a sífilis. Entretanto, além do diagnóstico, é preciso melhorias significativas no tratamento e prevenção destas doenças na região Nordeste

OBJECTIVES: This study aims to verify the relationships between the advancing of coverage of the Family Health Strategy in the nine northeastern states and the rates of detection of syphilis in pregnant women and congenital between the years 2008 and 2017. METHODS: Observational, descriptive and cross-sectional study, in which the detection rates for gestational syphilis and congenital in the nine states of the Northeast and this region as a whole were correlated with the respective annual averages Family Health Strategy coverage. For that, Pearson's correlation coefficient test was performed for these two variables, using the Statistical Package for the Social Sciences 25 software. RESULTS: The statistical analysis of the state data made it possible to identify that, as well as in the grouped data of the region, as the Family Health Strategy coverage increased, the detection rate of syphilis cases in pregnant women and congenital also increased significantly in most states, and in the Northeast region entirely. CONCLUSIONS: The Unified Health System through the Family Health Strategy has made great advances related to the monitoring of pregnancy, puerperium and child development as in the early diagnosis of infections like syphilis. However, in addition to the diagnosis, significant improvements are needed in the treatment and prevention of these diseases in the Northeast region

Eurytrema coelomaticum natural infection in small ruminants: a neglected condition.

Pancreatic eurytrematosis (PE) is an under diagnosed and neglected parasitosis in goats and sheep in the Americas. Clinical and pathological features of PE are not well defined in small ruminants worldwide. Natural cases of PE in small ruminants were detected in the Federal District, Brazil. A survey of necropsy records, including epidemiological and clinicopathological data, in goats and sheep was conducted. Most cases of PE occurred during the rainy season in adult females, with an incidence of 12.9% in goats and 0.8% in sheep. Clinical signs varied from asymptomatic infections to anorexia, lethargy, weakness, marked weight loss and death in some goats. Overall, most cases of PE in goats and sheep were incidental necropsy findings with minor pancreatic lesions. Three goats, however, showed severe chronic pancreatitis, dilation of major pancreatic ducts with numerous trematodes present and marked abdominal fat necrosis. Morphological and molecular characterization of flukes detected Eurytrema coelomaticum. Our findings shed light on the prevalence of E. coelomaticum infections in small ruminants in the region and highlight the possibility of severe and lethal cases in goats. PE must be further investigated in small ruminant populations in relevant livestock production regions of the Americas.

Faecal Virome Analysis of Wild Animals from Brazil.

The Brazilian Cerrado fauna shows very wide diversity and can be a potential viral reservoir. Therefore, the animal's susceptibility to some virus can serve as early warning signs of potential human virus diseases. Moreover, the wild animal virome of this biome is unknown. Based on this scenario, high-throughput sequencing contributes a robust tool for the identification of known and unknown virus species in this environment. In the present study, faeces samples from cerrado birds (Psittacara leucophthalmus, Amazona aestiva, and Sicalis flaveola) and mammals (Didelphis albiventris, Sapajus libidinosus, and Galictis cuja) were collected at the Veterinary Hospital, University of Brasília. Viral nucleic acid was extracted, submitted to random amplification, and sequenced by Illumina HiSeq platform. The reads were de novo assembled, and the identities of the contigs were evaluated by Blastn and tblastx searches. Most viral contigs analyzed were closely related to bacteriophages. Novel archaeal viruses of the Smacoviridae family were detected. Moreover, sequences of members of Adenoviridae, Anelloviridae, Circoviridae, Caliciviridae, and Parvoviridae families were identified. Complete and nearly complete genomes of known anelloviruses, circoviruses, and parvoviruses were obtained, as well as putative novel species. We demonstrate that the metagenomics approach applied in this work was effective for identification of known and putative new viruses in faeces samples from Brazilian Cerrado fauna.

Efeitos da prática mental associada à fisioterapia motora sobre a marcha e o risco de quedas na doença de Parkinson: estudo piloto / Efectos de la práctica mental asociada a la fisioterapia motora sobre la marcha y el riesgo de caídas en la enfermedad de Parkinson: estudio piloto / Effects of mental practice associated with motor physical therapy on gait and risk of falls in Parkinson's disease: a pilot study

RESUMO O objetivo deste estudo piloto, realizado em um hospital universitário de referência em Pernambuco, foi avaliar os efeitos da prática mental associada à fisioterapia motora sobre a marcha e o risco de queda em pessoas com doença de Parkinson. A amostra da pesquisa foi composta por 18 sujeitos, de ambos os sexos, com doença de Parkinson idiopática, divididos em grupo experimental (8 indivíduos) e controle (10 indivíduos). Ambos os grupos realizaram 15 sessões de 40 minutos de fisioterapia motora, duas vezes por semana. No grupo de intervenção, a fisioterapia foi associada a prática mental (15 minutos). Em relação às variáveis de desfecho primário, o tempo de execução do timed up and go e do teste de caminhada de 10 metros reduziu, mas a diferença não foi significativa. Em relação à velocidade, cadência e escore do dynamic gait index, houve aumento após a intervenção no grupo experimental, com diferença significativa (p=0,02). O número de passos foi mantido em ambos os grupos. Os resultados sugerem que a prática mental associada à fisioterapia motora reduz o risco de quedas em comparação com a fisioterapia motora aplicada isoladamente.

RESUMEN El objetivo de este estudio piloto, realizado en un hospital universitario de referencia en Pernambuco, fue el de evaluar los efectos de la práctica mental asociada a la fisioterapia motora sobre la marcha y el riesgo de caída en personas con enfermedad de Parkinson. La muestra de la investigación fue compuesta por 18 sujetos, de ambos sexos, con enfermedad de Parkinson idiopática, divididos en grupo experimental (8 individuos) y de control (10 individuos). Ambos grupos realizaron 15 sesiones de 40 minutos de fisioterapia motora, dos veces por semana. En el grupo de intervención, la fisioterapia se asoció a la práctica mental (15 minutos). En cuanto a las variables de desenlace primario, el tiempo de ejecución del timed up and go y de la prueba de caminata de 10 metros se redujo, pero la diferencia no fue significativa. En cuanto a la velocidad, cadencia y puntaje del dynamic gait index, hubo aumento después de la intervención en el grupo experimental, con diferencia significativa (p= 0,02). El número de pasos se ha mantenido en ambos grupos. Los resultados sugieren que la práctica mental asociada a la fisioterapia motora reduce el riesgo de caídas en comparación con la fisioterapia motora aplicada aisladamente.

ABSTRACT The objective of this pilot study, carried out in a university hospital of reference in Pernambuco, was to assess the effects of mental practice associated with motor physical therapy on gait and the risk of falls in people with Parkinson's disease. The study sample consisted of 18 subjects, of both sexes, with idiopathic Parkinson's disease, divided into experimental group (8 individuals) and control group (10 individuals). Both groups performed fifteen 40-minute sessions of motor physical therapy twice a week. In the intervention group, physical therapy was associated with mental practice (15 minutes). Regarding the primary outcome variables, the duration of the timed up and go test and of the 10-meter walking test reduced, but the difference was not significant. Speed, cadence and dynamic gait index increased after the intervention in the experimental group, with a significant difference (p=0.02). The number of steps was maintained in both groups. The results suggest that the mental practice associated with motor physical therapy reduces the risk of falls compared with applied motor physical therapy alone.