Use of ammonium chloride to prevent urolithiasis in sheep / [Utilização do cloreto de amônio na prevenção de urolitíase em ovinos]

Urolithiasis has a high incidence among confined sheep. It is multifactorial and may cause economic damage. Our aim was to determine the capacity of urinary acidification using ammonium chloride in sheep. Twenty-five 3-month-old male sheep were confined and randomly divided into three groups; the G200 and G500 groups received 200mg/kg/GW and 500mg/kg/GW of ammonium chloride daily for 56 consecutive days, respectively, whereas the CG group did not receive ammonium chloride. Sampling times and clinical evaluation were performed weekly, starting from the 14th day of confinement (M1 or immediately before administering ammonium chloride) until the 17th day (M9) of the feedlot. Hemogasometry, biochemical examination of serum urea and creatinine concentration and ultrasound evaluation of the urinary tract were performed. The urinalysis indicated a higher incidence of ammonium magnesium phosphate crystals at the beginning of the study, showing a migration to urate crystal formation, mainly in the G500 group because of urinary acidification. No hemogasometric, serum biochemistry, ruminal fluid, or ultrasonographic changes were observed. Urinary acidification was achieved and maintained after M7 during the administration of ammonium chloride in the G500 group, but not in the other study groups.(AU)

A urolitíase apresenta alta incidência em ovinos confinados, etiologia multifatorial, e pode causar prejuízo econômico. O objetivo do presente estudo foi determinar a capacidade da acidificação urinária mediante o uso de cloreto de amônio em ovinos. Foram utilizados 25 ovinos de três meses de idade, confinados e divididos aleatoriamente em três grupos: grupo CG (controle) não recebeu cloreto de amônio; grupo G200 (200mg/kg/PV) recebeu cloreto de amônio por 56 dias consecutivos; grupo G500 (500mg/kg/PV) recebeu cloreto de amônio por 56 dias consecutivos, administrados diariamente por via oral. Os momentos (M) de colheita de amostras e de avaliação clínica foram realizados com intervalo de sete dias, sendo M1 (imediatamente antes do cloreto de amônio), M2 (sete dias após) até M9, totalizando 70 dias de confinamento. Foram realizadas hemogasometria, concentração sérica de ureia e creatinina e avaliação ultrassonográfica do trato urinário. Na urinálise, houve uma maior incidência de cristais de fosfato amônio magnesiano no início do estudo, com migração para formação de cristais de urato, principalmente no G500, devido à acidificação urinária. Não houve alterações hemogasométricas, na bioquímica sérica, no líquido ruminal, ou alterações ultrassonográficas. A acidificação urinária foi obtida e mantida a partir do M7 durante a administração do cloreto de amônio no grupo G500, não ocorrendo nos outros grupos de estudo.(AU)

Avaliação da maturidade pulmonar de cabritos nascidos a termo e prematuros / [Evaluation of lung maturity of term and premature kid]

Avaliou-se a maturidade pulmonar de cabritos no líquido amniótico de suas mães pela coloração de Shor, pelo azul de Nilo e pela contagem de corpos lamelares, bem como a vitalidade e os níveis de glicose e lactato séricos em cabritos nascidos a termo e prematuros. Para tanto, foram utilizados 32 cabritos, divididos em três grupos, a saber: grupo I: cabritos nascidos de cesarianas com 149 dias de gestação; grupo II: cabritos nascidos de cesarianas com 143 dias de gestação; e grupo III: cabritos nascidos de cesarianas com 143 dias de gestação, oriundos de mães que receberam, por via intramuscular, 20mg/cabra de dexametasona, 36 horas antes da cirurgia eletiva. A coloração de Shorr e a contagem de corpos lamelares demonstraram ser métodos diagnósticos promissores para a avaliação da maturidade pulmonar em neonatos caprinos. Contudo, a administração de dexametasona nas cabras no período antenatal não influenciou a maturidade fetal. Constatou-se, entretanto, que a avaliação física do paciente, logo após o nascimento, também se mostra fundamental no que tange à percepção da vitalidade e da viabilidade de cabritos recém-nascidos.(AU)

Pulmonary maturity of goats in their amniotic fluid was evaluated by Shor, Nile blue staining, and lamellar body count, as well as vitality and serum glucose and lactate levels in term and premature goats. Twenty-four kids were divided into three groups: group I: comprised of eight animals born by cesarean section with 149 days of gestation; group II: comprised of eight animals born by cesarean section with 143 days of gestation; and group III: comprised of eight animals born by cesarean section with 143 days of gestation, in which the does received intramuscular dexamethasone (20mg/goat) 36 hours prior to elective cesarean section. Shorr staining and lamellar body count have shown to be promising diagnostic methods for the assessment of lung maturity in goat neonates. However, the administration of dexamethasone to goats during antenatal period did not influence fetal maturity. It was verified that the physical evaluation of the patient, shortly after birth, is fundamental for the perception of vitality and viability of newborn goats.(AU)

Ocorrência de espécies do gênero Eimeria Schneider, 1875, em cordeiros confinados / Occurrence of Eimeria Schneider, 1875 species in feedlot lambs

Este trabalho descreve as espécies do gênero Eimeria Schneider, 1875, que ocorreram em um confinamento de cordeiros, bem como as dinâmicas da eliminação de oocistos no ambiente, a correlação com o ganho de peso médio diário (GMD) e as variáveis climáticas, durante nove semanas. Cento e quatro cordeiros de diversas raças e cruzas, com aproximadamente 60 dias de vida, foram confinados e submetidos a pesagens e avaliações clínicas e coprológicas periódicas. Amostras de fezes com mais de 500 oocistos de Eimeria por grama de fezes (OoPG) foram separadas para esporulação e identificação das espécies. Entre os oocistos avaliados, foram identificadas as espécies: E. parva, E. crandallis, E. ovinoidalis, E. weybridgensis, E. bakuensis, E. marsica, E. ahsata, E. granulosa, E. pallida e E. faurei. Eimeria crandallis foi a mais frequente, presente em 44 das 58 amostras avaliadas, enquanto E. parva foi a mais abundante nas contagens individuais. Nenhum dos animais apresentou quadro de eimeriose, e coeficientes negativos foram encontrados nas correlações OoPG vs. GMD (-0,075) e OoPG vs. pluviosidade (-0,1164), enquanto para OoPG vs. temperatura foi encontrado coeficiente positivo (0,2914). Animais positivos para a eliminação de oocistos apresentaram infecção mista nas avaliações semanais, com até sete espécies parasitando um mesmo cordeiro.(AU)

This study describes the Eimeria Schneider, 1875 species that occurred in a lamb feedlot, as well as the dynamics of oocyst output in the environment and its correlation with daily weight gain (DWG) and climatic variables during nine weeks. One hundred and four lambs of various breeds and crossbreeds, at approximately 60 days old, were placed in a feedlot and submitted to periodic weighing and clinical and coprological evaluations. Fecal samples presenting more than 500 Eimeria spp. oocysts per gram (OPG) were separated for sporulation, and oocysts were identified at species level. Among evaluated oocysts, the following species were identified: E. parva, E. crandallis, E. ovinoidalis, E. weybridgensis, E. bakuensis, E. marsica, E. ahsata, E. granulosa, E. pallida and E. faurei. Eimeria crandallis was the most frequent one, being identified in 44 of the 58 evaluated samples, while E. parva was the more abundant in individual counts in most weeks. None of the animals presented clinical signs of eimeriosis and negative correlation coefficients were found for OPG vs DWG (-0.075) and OPG vs rainfall, as for OPG vs temperature this coefficient was positive. Animals shedding oocysts presented mixed infection, with up to seven species parasitizing the same lamb.(AU)

Transferrina como marcador de maturação pulmonar em cordeiros nascidos a termo ou prematuros / Transferrin as a marker of pulmonary maturation in lambs born at term or premature

O objetivo do estudo foi procurar proteínas de fase aguda que possam indicar sinais de maturação no neonato prematuro, por meio da quantificação sérica delas. Identificou-se a imunoglobulina A, a ceruloplasmina, a haptoglobina, a glicoproteína ácida, a transferrina, a albumina e as imunoglobulinas G de cadeias leve e pesada, pela comparação do perfil dos proteinogramas de cordeiros nascidos a termo com os prematuros submetidos a diferentes protocolos terapêuticos, a fim de estimular a atividade respiratória. Constituíram-se seis grupos: PN (n= 9): nascidos de parto normal; CN (n= 7): nascidos de cesariana em tempo normal de gestação; CP (n= 6): nascidos de cesariana prematura sem nenhum tipo de tratamento; DEX (n= 9): prematuros cujas mães receberam dexametasona pré-parto; SURF (n= 6): prematuros tratados com surfactante; e DEXSURF (n= 6): prematuros tratados com surfactante cujas mães receberam dexametasona pré-parto. As avaliações foram realizadas nos momentos imediatamente após o nascimento (M0), após 24 (M24) e após 48 horas (M48). As amostras foram processadas por meio de eletroforese em gel de poliacrilamida contendo dodecil sulfato de sódio (SDS-PAGE). A albumina, as imunoglobulinas e a proteína total dos cordeiros tiveram elevação após a ingestão de colostro. Maiores valores séricos de transferrina são referentes a maior período gestacional, podendo essa proteína ser utilizada como marcador de maturação neonatal.(AU)

The aim of this study was to search for acute phase proteins that could indicate signs of maturation in the premature neonate by quantifying them in serum. Immunoglobulin A, ceruloplasmin, haptoglobin, acid glycoprotein, tranferrin, albumin, light and heavy chain immunoglobulin G were quantified, comparing the profile of proteinograms from term to preterm lambs submitted to different protocols that stimulate respiratory activity. Six groups were used: PN (n= 9): born from normal birth; CN (n= 7): born from caesarean section at normal time of gestation; CP (n= 6): born from premature cesarean without any type of treatment; DEX (n= 9) preterm whose mothers received prepartum dexamethasone; SURF (n= 6) preterm treated with surfactant; DEXSURF (n= 6): preterm treated with surfactant whose mothers received prepartum dexamethasone. The evaluations were performed immediately after birth (M 0), after 24 and 48 hours (M 24 and M 48). Samples were processed with sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Albumin, immunoglobulins, and serum total protein of the lambs were elevated, after colostrum ingestion. Higher serum transferrin values refer to a longer gestational period, and this protein may be used as a marker of neonatal maturation.(AU)

An oral manifestation of IBD: Pyostomatitis vegetant, about two cases.

INTRODUCTION: Pyostomatitis vegetan (PV) is often associated with chronic inflammatory bowel disease (IBD). OBSERVATION: Two cases of PV are reported. Case number 1 is a 66-year-old patient treated with infliximab for ulcerative colitis (UC). He presented himself with rapidly progressing crusty, whitish, ulcerated lesions on his lips. Diagnosis of PV was made after biopsy. Regression of oral lesions was favourable with local application of dermocorticoids while continuing infliximab treatment. Case number 2 is a 20-year-old patient treated with infliximab for Crohn's disease (CD). She had cheilitis and angular cheilitis. Diagnosis of PV was made after biopsy. The evolution was favourable after treating with topical dermocorticoids. DISCUSSION: PV is associated in 75% of the cases with IBD. The digestive check-up is systematic. Diagnostic delay is often noted. Topical dermocorticoids are the first line of therapy.

Influence of dexamethasone and surfactant in the vitality and lung function of preterm lambs born by cesarean section / Influência da dexametasona e do surfactante na vitalidade e na função pulmonar de cordeiros prematuros nascidos por cesariana eletiva

The aim of this study was to assess the vitality and lung function of preterm lambs. Twenty seven preterm lambs were divided in four groups. Group I (n=6) preterm lambs/ control; group II (n=9) lambs born to mothers that were treated with dexamethasone antepartum; group III (n=6) lambs treated with surfactant; and group IV (n=6) lambs treated with surfactant and born to mothers that were treated with dexamethasone antepartum. The APGAR score was performed after birth (T0) and 15 minutes later (T1/4) to assess vitality. The vital signs, blood gas analysis, spirometry and capnometry were assessed immediately after birth and continued until 48 hours. Chest radiographs were performed at T0, T24 and T48. Significant rectal temperature interactions occurred at T1 and T6 depending on the type of treatment used. All animals showed low pH values, which were associated with high pCO2 values and HCO3 -values that increased over time from immediately after birth to two days of age. Higher tidal volume values were observed at T1/4, T1 and T24 when the animals were not treated with surfactant. Capnometry showed significant interactions between treatments at T0. Premature animals showed low vitality and impaired pulmonary function.(AU)

O objetivo do presente trabalho foi avaliar a vitalidade e a função pulmonar de cordeiros prematuros. Vinte e sete cordeiros foram divididos em quatro grupos: grupo I (n= 6), cordeiros prematuros/controle; grupo II (n= 9), cordeiros prematuros nascidos de mães tratadas com dexametasona antes do parto; grupo III (n= 6), cordeiros prematuros tratados com surfactante; e grupo IV (n= 6), cordeiros prematuros tratados com surfactante e nascidos de mães tratadas com dexametasona antes do parto. O escore APGAR foi realizado após o nascimento (T0) e 15 minutos depois (T1/4). Os parâmetros vitais, hemogasometria, espirometria e capnometria foram avaliados após o nascimento até 48 horas. As radiografias torácicas foram realizadas em T0, T24 e T48. Interações significativas de temperatura retal ocorreram em T1 e T6, dependendo do tipo de tratamento utilizado. Todos os animais apresentaram valores de pH baixos, que foram associados com altos valores de pCO2 e valores de HCO3 que aumentaram ao longo do tempo. Os maiores valores de volume corrente foram observados em T1/4, T1 e T24, quando os animais não foram tratados com surfactante. A capnometria mostrou interações significativas entre tratamentos em T0. Os animais prematuros apresentaram pouca vitalidade e deficiência da função pulmonar.(AU)

Elastogram quality assessment score in vibration-controlled transient elastography: Diagnostic performance compared to digital morphometric analysis of liver biopsy in chronic hepatitis C.

Vibration-controlled transient elastography (VCTE) is widely used for noninvasive fibrosis staging in chronic hepatitis C. However, internal validation is based solely on variability and success rate and lacks reproducible quality indicators. We analysed the graphic representation of shear wave propagation in comparison with morphometric results of liver biopsy, eliminating observer variability bias. Individual elastograms were classified according to two morphologic criteria: extension of wave propagation (length of the graphic representation) and shear wave dispersal (level of parallelism displayed in the elastogram). Then, a score based on these criteria stratified the elastogram in classes I through III (highest to lowest technical quality). Liver stiffness results of each measurement were compared with collagen contents in liver biopsy by morphometric analysis. A total of 3243 elastograms were studied (316 patients). Digital morphometry in liver biopsy showed significant fibrosis in 66% of samples and advanced fibrosis in 31%. Elastogram quality analysis resulted in 1438 class I measurements (44%), 1070 class II (34%) and 735 class III. Area under the receiver operating curve (AUROC) for severe fibrosis according to class (I, II and III) was 0.941, 0.887 and 0.766, respectively. For advanced fibrosis, AUROCs were 0.977, 0.883 and 0.781, respectively. Spearman's correlation testing for all classes and levels of fibrosis demonstrated significant independent association (r2  = -.95, P < .01). Our study is the first to propose measurable quality criteria for VTCE and to validate them against objective assessment of liver biopsy through digital morphometric imaging analysis. We concluded that VCTE performance is significantly influenced by quality assessment of individual measurements. Considering these criteria in clinical practice may improve accuracy.

Parâmetros hematológicos e perfil bioquímico renal de cordeiros nascidos a termo e prematuros / Hematologic parameters and renal biochemical profile in full-term and premature lambs

O objetivo do presente estudo foi avaliar as variáveis hematológicas e o perfil bioquímico renal sérico de cordeiros nascidos a termo e prematuros do nascimento às 48 horas de vida, bem como verificar a influência da dexametasona sobre tais variáveis. Foram constituídos quatros grupos experimentais: PN (cordeiros nascidos de parto normal, n=15, média de 146 dias); PNDEX (cordeiros nascidos de parto normal cujas mães receberam 16mg de dexametasona aos 141 de gestação, n=8, média de 143 dias); PRE (cordeiros prematuros nascidos de cesarianas aos 138 dias de gestação, n=10) e PREDEX (cordeiros prematuros nascidos de cesarianas aos 138 dias de gestação cujas mães receberam 16mg de dexametasona dois dias antes, n=9). Os valores médios do volume globular e de hemoglobina diminuíram ao longo das 48 horas de observação, nos quatro grupos experimentais, porém dentro dos limites fisiológicos para a espécie. Houve variação da concentração plasmática de proteínas totais em todos os momentos, sendo os menores valores no grupo PRE. A contagem leucocitária foi mais alta no grupo PN apenas no M24h. Ao longo do período, apenas o grupo PN mostrou diferença entre o M24h e os demais momentos, e o grupo PRE apresentou os menores valores de neutrófilos no M0h, M15min e M60min. As concentrações séricas de creatinina foram mais altas no grupo PRE no M60min, M24h e M48h. Em todos os grupos, houve diminuição no M24h e M48h. Os parâmetros avaliados foram afetados pela prematuridade na espécie ovina e a dexametasona teve influência positiva sobre a taxa de sobrevivência dos animais prematuros.(AU)

The aim of the study was to evaluate hematologic parameters and renal biochemical profile of full-term and premature lambs from birth to 48 hours of life, and assess the effect of dexamethasone on such variables. Four experimental groups were formed: NDG (normal delivery group - lambs vaginally delivered, n=15, average of 146-day gestation); NDEXG (normal delivery with dexamethasone group - lambs vaginally delivered whose mothers received 16 mg of dexamethasone at 141 days of gestation, n=8, average of 143-day gestation); PRE (premature lambs born by cesarean section at 138 days of gestation, n=10) and PREDEX (premature lambs born by cesarean section at 138 days gestation, whose mothers received 16 mg of dexamethasone two days before, n=9). Mean values of cell volume and hemoglobin content decreased during the observation period of 48 hours in all groups, but within the physiologic limits for ovine species. There was significant variation in plasma concentration of total protein in all periods evaluated, with the lowest mean values in PRE group. The leukocyte count was significantly higher in PN group only in M24h. Throughout the observation period, only PN group showed differences between M24h and the other moments and PRE group showed the lowest values of neutrophils in M0h, M15min and M60min. Serum creatinine concentration was significantly higher in group PRE in M60min, M24h and M48h. In all groups, there was a decrease in M24 and M48. The evaluated parameters were affected by prematurity in sheep and dexamethasone had a positive effect on the survival rate of premature animals.(AU)

Nanocomposites of Recycled Polycarbonate/Nano-Zinc Oxide (rPC/nZno): Effect of Nanofiller and Gamma-Radiation on the Properties and as Barrier Against Ultraviolet Light.

In order to promote barrier against ultraviolet radiation and increase of mechanical characteristics performance, nanocomposites of recycled polycarbonate/nano-zinc oxide (rPC/nZnO) with different nZnO content were prepared and submitted to doses of gamma-radiation (10­50 kGy). The nanocomposites were also exposed to Xenon light source in a weather chamber viewing to evaluate the action of nZnO against ultraviolet light. The rPC/nZnO nanocomposites were characterized by thermogravimetry (TGA), differential scanning calorimetry (DSC), wide angle X-ray diffraction (WAXD) and infrared spectrometry (FT-IR). There was a progressive reduction of the glass transition temperature (T g) and degradation temperatures, T onset and T max, as function of gamma-radiation dose and nano-zinc oxide content. The lowering of the thermal properties was attributed to the alcoholysis reaction between hydroxyl groups onto the nZnO surface and carbonate linkages of the rPC during the molten state. WAXD revealed a possible chains arrangement (induction of crystallinity) and/or segregation of chains size (scission of rPC chains generating oligomers) associated to the alcoholysis reaction. The action of gamma-radiation as crosslinking agent was not effective. The degree of swelling is zero on account of the stabilization of rPC radicals by oxygen during gamma-radiation exposure. Before exposure to UV light the carbonyl index (CI) show trend to decrease­corroborating the scission of the rPC carbonate bonds. After 100 hours of exposure a recovering of the CI was noticed. The result was associated to the free radicals recombination and esterification reactions. In some extent the combined action of nZnO and gamma-radiation as barrier to UV light was successful.

Treatment of hepatitis C virus genotype 3 infection with direct-acting antiviral agents.

Hepatitis C virus (HCV) genotype 3 is responsible for 30.1% of chronic hepatitis C infection cases worldwide. In the era of direct-acting antivirals, these patients have become one of the most challenging to treat, due to fewer effective drug options, higher risk of developing cirrhosis and hepatocellular carcinoma and lower sustained virological response (SVR) rates. Currently there are 4 recommended drugs for the treatment of HCV genotype 3: pegylated interferon (PegIFN), sofosbuvir (SOF), daclatasvir (DCV) and ribavirin (RBV). Treatment with PegIFN, SOF and RBV for 12 weeks has an overall SVR rate of 83-100%, without significant differences among cirrhotic and non-cirrhotic patients. However, this therapeutic regimen has several contraindications and can cause significant adverse events, which can reduce adherence and impair SVR rates. SOF plus RBV for 24 weeks is another treatment option, with SVR rates of 82-96% among patients without cirrhosis and 62-92% among those with cirrhosis. Finally, SOF plus DCV provides 94-97% SVR rates in non-cirrhotic patients, but 59-69% in those with cirrhosis. The addition of RBV to the regimen of SOF plus DCV increases the SVR rates in cirrhotic patients above 80%, and extending treatment to 24 weeks raises SVR to 90%. The ideal duration of therapy is still under investigation. For cirrhotic patients, the optimal duration, or even the best regimen, is still uncertain. Further studies are necessary to clarify the best regimen to treat HCV genotype 3 infection.

Avaliação endoscópica das vias aéreas, do perfil de gases, dos eletrólitos e do equilíbrio ácido-base em equinos submetidos ao treinamento de três tambores / Endoscopic airway, blood gas, electrolytes, and acid-base in equine submitted to three-barrel training

O objetivo deste estudo foi avaliar as vias aéreas por endoscopia, o perfil de gases, de eletrólitos e o equilíbrio ácido-base de equinos da raça Quarto de Milha (QM) antes e após o exercício de três tambores. Dezesseis cavalos, divididos em dois grupos de oito animais, treino regular (TR - cinco vezes) e treino esporádico (TE - duas vezes por semana), foram utilizados no experimento. A endoscopia foi realizada antes e 90 min após o exercício. Foram realizadas duas coletas de sangue por punção da artéria facial transversa antes do aquecimento (M0) e imediatamente após o exercício (M1), e as leituras foram realizadas com o I-Stat(r). Foram determinadas PCO2, PO2, SO2, pH, BE, HCO3 e TCO2, Na+, K+, iCa, glicose, Hg e Ht. Foi utilizada ANOVA com medidas repetidas no tempo para comparações dos grupos e dos momentos (P<0,05). A HFL acometeu em grau leve (1-2) os animais de ambos os grupos, com 8/8 (100%) no TR e 5/8 (62,5%) no TE. Observou-se presença de secreção serosa na traqueia em 4/8 (50%) para ambos os grupos. A HPIE acometeu em grau leve (1-2) os animais de ambos os grupos, com 4/8 (50%) no grupo TR e 3/8 (37,5%) no grupo TE. Os animais com grau 2 de HPIE apresentaram leve hipoxemia e hipercapnia pós-exercício. SO2, PCO2, pH, HCO3, BE, K e iCa+ não diferiram estatisticamente (P>0,05) entre os grupos. Os cavalos da raça QM submetidos ao exercício de TT apresentam HPIE e acidose metabólica.(AU)

The aim of this study was to evaluate the airways by endoscopy, gas profile, electrolytes and acid-base balance of horses in the Quarter Horse (QM) race before and after training three drums. Sixteen horses divided into two groups of 8 animals, with regular training (RT - 5 times a week) and sporadic training (ET - 2 times a week) were used in the experiment. Endoscopy was performed before and 90 min after training. Two blood samples were taken by puncturing the transverse facial artery before heating (M0) and immediately after training (M1), and the readings were performed with the I-Stat(r). PCO2, PO2, SO2, pH, BE, HCO3 and TCO2, Na +, K +, iCa, Glucose, Hg, and Ht were determined. ANOVA was used with repeated measures over time for comparisons of groups and time (P<0.05). The HFL befell was mild (1-2), the animals from both groups with 8/8 (100%) in the TR and 5/8 (62.5%) for the TE. There was presence of serous trachea 4/8 (50%) for both groups. The EIPH befell was mild (1-2) in the animals from both groups with 4/8 (50%) in the RT group and 3/8 (37.5%) for the TE group. Animals with grade 2 EIPH had mild hypoxemia and hypercapnia after exercise. The SO2, PCO2, pH, HCO3, BE, K, and iCa did not differ P <0.05 between groups. QM race submitted to TT exercise have EIPH and metabolic acidosis.(AU)

Loss to follow-up in anti-HCV-positive patients in a Brazilian regional outpatient clinic.

Loss to follow-up (LF), which refers to patients who started care but voluntary stopped it, is a problem for patients with chronic disease. We aimed to estimate the rate of LF among patients seropositive for hepatitis C virus (HCV) and identify possible demographic and lifestyle risk factors associated with LF. From January 2009 through December 2012, 1010 anti-HCV-positive patients were included in the study. Among participants, 223 (22.1%) met the case definition for LF (more than 1-year elapsed since the last clinical appointment). Among 787 patients who remained in follow-up, 372 (47.2%) were discharged after undetectable HCV RNA, 88 (11.1%) were transferred (and remained on regular follow-up at the destination), and 25 (3.1%) died. According to univariate analysis, male gender, absence of a life partner, black race, psychiatric illness, previous alcohol abuse, previous or current recreational drug use, and previous or current smoking were significantly associated with LF. In multivariate analysis, absence of a life partner (adjusted odds ratio (AOR)=1.44; 95% confidence interval (95%CI)=1.03-2.02), black race (AOR=1.81, 95%CI=1.12-2.89), psychiatric illness (AOR=1.77, 95%CI=1.14-2.73), and the presence of at least one lifestyle risk factor (pertaining to substance abuse) (AOR=1.95, 95%CI=1.29-2.94) were independently associated with LF. Our study provides an estimate of the incidence of LF among anti-HCV-positive patients and identifies risk factors associated with this outcome. In addition, these results can help clinicians recognize patients at risk for LF, who require additional support for the continuity of care.

Transient elastography and APRI score: looking at false positives and false negatives. Diagnostic performance and association to fibrosis staging in chronic hepatitis C.

Although long regarded as the gold standard for liver fibrosis staging in chronic hepatitis C (CHC), liver biopsy (LB) implies both the risk of an invasive procedure and significant variability. The aim of this study was to evaluate the diagnostic performance for transient elastography (TE) and aspartate aminotransferase to platelet index (APRI) used alone and in combination compared to liver biopsy and to analyze false positive/negative results. Patients with CHC, and no previous clinical diagnosis of cirrhosis were enrolled to undergo liver biopsy, TE and APRI. A total of 182 adult patients with a median age of 55 years and median body mass index of 26.71 kg/m2 were analyzed. On LB, 56% of patients had significant levels of fibrosis (METAVIR F≥2) and 28% had advanced fibrosis (F3/F4). The strongest performance for both tests was observed for exclusion of advanced fibrosis with good negative predictive values (89 and 86%, respectively). Low necroinflammatory activity on LB was associated with false negative TE. False positives were associated with NASH and smaller LB fragments. Correlation between APRI and Fibroscan for F≥2 was 100% and 84% for F≥3 and remained high in both false negative and false positive instances, correctly identifying F<2 in 71% of cases and F<3 in 78% (and potentially foregoing up to 84% of LB). We concluded that low individual performance indicators could be attributable to limitations of LB. Poorer differentiation of lower levels of fibrosis is a known issue for LB and remains so for noninvasive tests. Good predictability is possible, however, for advanced fibrosis.

Predictors of early treatment discontinuation and severe anemia in a Brazilian cohort of hepatitis C patients treated with first-generation protease inhibitors.

The aim of this study was to determine risk factors for adverse events (AE)-related treatment discontinuation and severe anemia among patients with chronic hepatitis C virus (HCV) genotype 1 infection, treated with first-generation protease inhibitor (PI)-based therapy. We included all patients who initiated treatment with PI-based therapy at a Brazilian university hospital between November 2013 and December 2014. We prospectively collected data from medical records using standardized questionnaires and used Epi Info 6.0 for analysis. Severe anemia was defined as hemoglobin ≤8.5 mg/dL. We included 203 patients: 132 treated with telaprevir (TVR) and 71 treated with boceprevir (BOC). AE-related treatment discontinuation rate was 19.2% and anemia was the main reason (38.5%). Risk factors for treatment discontinuation were higher comorbidity index (OR=1.85, CI=1.05-3.25) for BOC, and higher bilirubin count (OR=1.02, CI=1.01-1.04) and lower BMI (OR=0.98, CI=0.96-0.99) for TVR. Severe anemia occurred in 35 (17.2%) patients. Risk factors for this outcome were lower estimated glomerular filtration rate (eGFR; OR=0.95, CI=0.91-0.98) for patients treated with TVR, and higher comorbidity index (OR=2.21, CI=1.04-4.67) and ribavirin dosage (OR=0.84, CI=0.72-0.99) for those treated with BOC. Fifty-five (57.3%) patients treated with TVR and 15 (27.3%) patients treated with BOC achieved sustained virological response (SVR). Among patients who received TVR and interrupted treatment due to AE (n=19), only 26.3% (n=5) achieved SVR (P=0.003). Higher number of comorbidities, lower eGFR and advanced liver disease are associated with severe anemia and early treatment cessation, which may compromise SVR achievement.

Aquisição de imunidade passiva em cabritos alimentados com colostro de cabras com e sem mastite / Immunity of procurement in passive kids fed colostrum from goats with and without mastitis

O objetivo deste trabalho foi avaliar a transferência de imunidade passiva de cabras, que pariram com mastite, para seus respectivos cabritos. Os animais foram distribuídos em dois grupos, a saber: grupo 1 (GI), constituído por cabritos, filhos de cabras sem isolamento microbiológico em ambas as glândulas mamárias, e grupo 2 (GII), composto por cabritos, filhos de cabras com resultado positivo à lactocultura, em pelo menos uma das glândulas mamárias. Foram coletadas amostras de colostro e sangue à parição, bem como às 24 e às 48 horas após o parto/nascimento. O diagnóstico e o monitoramento da mastite nos animais foram realizados por meio do California Mastitis Test (CMT), contagem de células somáticas e isolamento microbiológico. A proteína total foi mensurada pelo método do biureto, e as concentrações de imunoglobulina A (IgA), imunoglobulina G (IgG), transferrina, albumina e haptoglobina por meio da eletrofoerese em gel de poliacrilamida contendo dodecil sulfato de sódio (SDS-PAGE). Os agentes mais isolados na cultura microbiológica foram os Staphylococcus coagulase negativa. Não houve diferença significativa (P<0,05) entre os valores médios de imunoglobulina G (IgG) nos cabritos provenientes de cabras com mastite quando comparados aos recém-nascidos oriundos de cabras livres de infecções intramamárias. Da mesma forma, a atividade de gamaglutamiltransferase (GGT) não mostrou diferença entre os grupos em todos os momentos avaliados. A ingestão de colostro decorrente de cabras com mastite não causou falha na transferência de imunidade passiva nos respectivos conceptos.

The aim of this study was to evaluate the transfer of passive immunity goats kidded with mastitis to their kids. The animals were divided into two groups, namely: Group 1 (GI) containing kids, sons of goats without microbiological isolation in both mammary glands, and Group 2 (GII), composed of kids, sons of goats with positive result to lactoculture in at least one of mammary glands. Colostrum samples and blood were collected after delivery, 24 and 48 hours after delivery / birth. The diagnosis and monitoring of mastitis in animals were performed using the California Mastitis Test (CMT), somatic cell count and microbiological isolation. Total protein was measured by the biuret method, and the concentrations of immunoglobulin A (IgA), immunoglobulin G (IgG), transferrin, albumin and haptoglobin through eletrofoerese polyacrylamide gel containing sodium dodecyl sulfate (SDS-PAGE). The agents most isolated in microbiological culture were coagulase-negative Staphylococcus. There was no significant difference (p <0.05) between the acquisition of immunoglobulin G (IgG) in goats from goats with mastitis compared to infants originating free goat mammary infections. Similarly the gamma glutamyl transferase (GGT) was equal in the comparison between groups in all evaluated moments. The colostrum intake resulting from goats with mastitis caused no failure in the passive transfer of immunity in their fetuses.

Predictors of early treatment discontinuation and severe anemia in a Brazilian cohort of hepatitis C patients treated with first-generation protease inhibitors

The aim of this study was to determine risk factors for adverse events (AE)-related treatment discontinuation and severe anemia among patients with chronic hepatitis C virus (HCV) genotype 1 infection, treated with first-generation protease inhibitor (PI)-based therapy. We included all patients who initiated treatment with PI-based therapy at a Brazilian university hospital between November 2013 and December 2014. We prospectively collected data from medical records using standardized questionnaires and used Epi Info 6.0 for analysis. Severe anemia was defined as hemoglobin ≤8.5 mg/dL. We included 203 patients: 132 treated with telaprevir (TVR) and 71 treated with boceprevir (BOC). AE-related treatment discontinuation rate was 19.2% and anemia was the main reason (38.5%). Risk factors for treatment discontinuation were higher comorbidity index (OR=1.85, CI=1.05-3.25) for BOC, and higher bilirubin count (OR=1.02, CI=1.01-1.04) and lower BMI (OR=0.98, CI=0.96-0.99) for TVR. Severe anemia occurred in 35 (17.2%) patients. Risk factors for this outcome were lower estimated glomerular filtration rate (eGFR; OR=0.95, CI=0.91-0.98) for patients treated with TVR, and higher comorbidity index (OR=2.21, CI=1.04-4.67) and ribavirin dosage (OR=0.84, CI=0.72-0.99) for those treated with BOC. Fifty-five (57.3%) patients treated with TVR and 15 (27.3%) patients treated with BOC achieved sustained virological response (SVR). Among patients who received TVR and interrupted treatment due to AE (n=19), only 26.3% (n=5) achieved SVR (P=0.003). Higher number of comorbidities, lower eGFR and advanced liver disease are associated with severe anemia and early treatment cessation, which may compromise SVR achievement.

Transient elastography and APRI score: looking at false positives and false negatives. Diagnostic performance and association to fibrosis staging in chronic hepatitis C

Although long regarded as the gold standard for liver fibrosis staging in chronic hepatitis C (CHC), liver biopsy (LB) implies both the risk of an invasive procedure and significant variability. The aim of this study was to evaluate the diagnostic performance for transient elastography (TE) and aspartate aminotransferase to platelet index (APRI) used alone and in combination compared to liver biopsy and to analyze false positive/negative results. Patients with CHC, and no previous clinical diagnosis of cirrhosis were enrolled to undergo liver biopsy, TE and APRI. A total of 182 adult patients with a median age of 55 years and median body mass index of 26.71 kg/m2 were analyzed. On LB, 56% of patients had significant levels of fibrosis (METAVIR F≥2) and 28% had advanced fibrosis (F3/F4). The strongest performance for both tests was observed for exclusion of advanced fibrosis with good negative predictive values (89 and 86%, respectively). Low necroinflammatory activity on LB was associated with false negative TE. False positives were associated with NASH and smaller LB fragments. Correlation between APRI and Fibroscan for F≥2 was 100% and 84% for F≥3 and remained high in both false negative and false positive instances, correctly identifying F<2 in 71% of cases and F<3 in 78% (and potentially foregoing up to 84% of LB). We concluded that low individual performance indicators could be attributable to limitations of LB. Poorer differentiation of lower levels of fibrosis is a known issue for LB and remains so for noninvasive tests. Good predictability is possible, however, for advanced fibrosis.

Acute effect of alcohol intake on sine-wave Cartesian and polar contrast sensitivity functions

The aim of this study was to assess contrast sensitivity for angular frequency stimuli as well as for sine-wave gratings in adults under the effect of acute ingestion of alcohol. We measured the contrast sensitivity function (CSF) for gratings of 0.25, 1.25, 2.5, 4, 10, and 20 cycles per degree of visual angle (cpd) as well as for angular frequency stimuli of 1, 2, 4, 24, 48, and 96 cycles/360°. Twenty adults free of ocular diseases, with normal or corrected-to-normal visual acuity, and no history of alcoholism were enrolled in two experimental groups: 1) no alcohol intake (control group) and 2) alcohol ingestion (experimental group). The average concentration of alcohol in the experimental group was set to about 0.08%. We used a paradigm involving a forced-choice method. Maximum sensitivity to contrast for sine-wave gratings in the two groups occurred at 4 cpd sine-wave gratings and at 24 and 48 cycles/360° for angular frequency stimuli. Significant changes in contrast sensitivity were observed after alcohol intake compared with the control condition at spatial frequency of 4 cpd and 1, 24, and 48 cycles/360° for angular frequency stimuli. Alcohol intake seems to affect the processing of sine-wave gratings at maximum sensitivity and at the low and high frequency ends for angular frequency stimuli, both under photopic luminance conditions.

Acute effect of alcohol intake on sine-wave Cartesian and polar contrast sensitivity functions.

The aim of this study was to assess contrast sensitivity for angular frequency stimuli as well as for sine-wave gratings in adults under the effect of acute ingestion of alcohol. We measured the contrast sensitivity function (CSF) for gratings of 0.25, 1.25, 2.5, 4, 10, and 20 cycles per degree of visual angle (cpd) as well as for angular frequency stimuli of 1, 2, 4, 24, 48, and 96 cycles/360°. Twenty adults free of ocular diseases, with normal or corrected-to-normal visual acuity, and no history of alcoholism were enrolled in two experimental groups: 1) no alcohol intake (control group) and 2) alcohol ingestion (experimental group). The average concentration of alcohol in the experimental group was set to about 0.08%. We used a paradigm involving a forced-choice method. Maximum sensitivity to contrast for sine-wave gratings in the two groups occurred at 4 cpd sine-wave gratings and at 24 and 48 cycles/360° for angular frequency stimuli. Significant changes in contrast sensitivity were observed after alcohol intake compared with the control condition at spatial frequency of 4 cpd and 1, 24, and 48 cycles/360° for angular frequency stimuli. Alcohol intake seems to affect the processing of sine-wave gratings at maximum sensitivity and at the low and high frequency ends for angular frequency stimuli, both under photopic luminance conditions.

Soroprevalência de Maedi-Visna em ovinos na região de Araçatuba, SP / Occurrence of Maedi-visna in sheep from Araçatuba region - SP - Brazil

The seroprevalence of Maedi-Visna in sheep from Araçatuba region - SP, was determined and correlated to age, gender, breed, or sheep production systems. Blood samples were collected from 444 sheep, aging from two to 12 year-old. Both sexes and different breeds were sampled in 20 farms of this region. Physical examination was performed in all animals. Agar gel immunodiffusion test kit was used to diagnose in serum samples. Twelve animals, from five different farms, were AGID positive, yielding a seroprevalence of 2.7%, with no correlation among breed, gender, or sheep production systems and the detection of the disease. No animal considered positive for Maedi-Visna showed clinical signs compatible with Maedi-Visna.