Nivel de conocimiento del profesional de enfermería al administrar el activador plasminógeno tisular en pacientes con ICTUS / Level of knowledge of the nursing professional when applying tissue plasminogen activator in patients with STROKE

Introducción: el tratamiento con activador recombinante del plasminógeno tisular (siglas en inglés rt-PA), aplicado vía intravenosa (IV) es el procedimiento de primera línea en casos de evento vascular cerebral (EVC) en una ventana de 4,5 horas a partir del inicio de los síntomas y con bajo riesgo de transformación hemorrágica del infarto cerebral. El personal de enfermería es un elemento clave para el tratamiento de las personas que han padecido un EVC y se encuentra en su etapa aguda. La fibrinólisis con alteplasa (rt-PA) se ha establecido como tratamiento de primera línea para los casos de ictus isquémico, la administración de este fármaco, control y seguimiento de estos pacientes idealmente debe realizarse por el personal de enfermería en las unidades de ictus. Objetivo: investigar el nivel de conocimiento del personal de enfermería en la administración del activador recombinante del plasminógeno tisular (rt-PA) en el servicio de urgencias en una institución de tercer nivel. Material y métodos: se realizó un estudio descriptivo y transversal en el Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez de la Ciudad de México, con un muestreo por conveniencia, participaron 33 profesionales de enfermería que laboran en el servicio de urgencias, se observaron las 24 horas del día. Se tomó en cuenta a enfermeras de todas las categorías, excluyendo a personal médico, camilleros y enfermeras suplentes. Se aplicó un instrumento para evaluar el conocimiento sobre enfermedad vascular isquémica e intervenciones de enfermería en el cuidado inmediato y mediato en la administración del fármaco activador tisular de plasminógeno (rt-PA). Resultados: llama la atención que sólo 58 % del personal de enfermería conozca el tiempo vital para recuperar al cerebro, otro dato que alarma es que el 30 % no tiene claro el concepto de ictus y al ser una institución de especialidad neurológica de debe establecer un programa de capacitación para establecer intervenciones oportunas con (rt-PA) para reducir secuelas o daño neurológico. Discusión: el papel del personal de enfermería en unidades especializadas en afecciones neurológicas a los pacientes con ictus es proporcionar un cuidado de calidad, eficaz y eficiente, además de participar en la valoración integral del paciente y en la administración del actilyse cuando se trata de una terapia fibrinolítica. En consecuencia, la enfermera debe estar formada sobre los cuidados que requiere este tipo de pacientes, las complicaciones propias de la patología, tratamiento y efectos secundarios del mismo. Proponer un plan de cuidados integral, porque ya el personal tiene conocimientos al respecto de la enfermedad y la aplicación del activador tisular, pero sería interesante implementar para los profesionales en formación, sin olvidar la elaboración de una propuesta como guía de actuación. Conclusión: los cuidados que el personal de enfermería lleva a cabo deben ser especializados en constante actualización y capacitación para ser capaces de detectar y prevenir las complicaciones del proceso patológico y tratamiento.

Introduction: recombinant tissue plasminogen activator (rt-PA) therapy, given intravenously (IV), is the first-line procedure in cases of cerebral vascular event (CVE) within 4.5 hours of symptom onset and with low risk of haemorrhagic transformation of cerebral infarction. Nurses are a key element in the management of people who have suffered a stroke and are in the acute stage. Fibrinolysis with alteplase (rt-PA) has been established as the first-line treatment for ischaemic stroke, and the administration of this drug, control and follow-up of these patients should ideally be carried out by nurses in stroke units. Objective: to investigate the level of nursing staff knowledge in the administration of recombinant tissue plasminogen activator (rt-PA) in the emergency department of a tertiary care institution. Material and methods: a descriptive, cross-sectional study was carried out at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery in Mexico City, with convenience sampling. 33 nursing professionals working in the emergency department participated, and 24 hours a day were observed. All categories of nurses were considered, excluding medical staff, orderlies and substitute nurses. An instrument was used to assess knowledge of ischaemic vascular disease and nursing interventions in immediate and intermediate care in the administration of tissue plasminogen activator (rt-PA). Results: It is striking that only 58 % of nursing staff are aware of the vital time to recover the brain, another alarming fact is that 30 % are not clear about the concept of stroke and, being a neurological speciality institution, a training programme should be established to establish timely interventions with (rt-PA) to reduce sequelae or neurological damage. Discussion: the role of nurses in units specialising in neurological disorders in stroke patients is to provide quality, effective and efficient care, in addition to participating in the comprehensive assessment of the patient and in the administration of actilyse in the case of fibrinolytic therapy. Consequently, the nurse must be trained in the care required by this type of patient, the complications of the pathology, treatment and its side effects. Propose a comprehensive care plan, because the staff already has knowledge of the disease and the application of the tissue activator, but it would be interesting to implement it for professionals in training, without forgetting the development of a proposal as a guide for action. Conclusion: the care carried out by nursing staff must be specialised and constantly updated and trained in order to be able to detect and prevent complications of the pathological process and treatment.

Molecular characterization of Babesia vogeli in dogs from Belém, northern Brazil.

Babesiosis is an infectious hemolytic disease that occurs worldwide, and is caused by a protozoan of the Babesia genus (Apicomplexa). Little is known about this genus; therefore, this study conducted a molecular characterization of Babesia spp in naturally infected dogs in northern Brazil. Blood samples were collected from 172 dogs from metropolitan Belém, and screened for Babesia spp using semi-nested polymerase chain reactions. Subsequently, 18S rDNA gene fragments were amplified and sequenced. Alignments of the 27 nucleotide sequences returned fragments measuring 1023 bp in size, which did not include any polymorphic sites (100% identity). This genotype was very similar to the 18S rDNA gene in B. vogeli. This study provides an important molecular characterization of the parasite responsible for canine babesiosis in naturally infected dogs in metropolitan Belém. In addition, the 18S rDNA gene in B. vogeli may represent the most common genotype occurring in South America.

Adição de óleo de palma na dieta sobre a lipidemia e a qualidade do sêmen de bubalinos (Bubalus bubalis) / Addition of palm oil to diet on serum lipid profile and seminal quality of buffaloes (Bubalus bubalis)

O estudo visou investigar o efeito da suplementação dietética com óleo de palma sobre o perfil sérico lipídico e as características seminais de touros bubalinos (Bubalus bubalis), bem como suas correlações. Doze touros foram alocados no Grupo CONT (n=5) ou Grupo ÓLEO (n=7) e receberam alimentação isoproteica composta por silagem de milho e concentrado (milho triturado, farelo de trigo e ureia), com proporção volumoso/concentrado de 50%, durante 130 dias (Períodos 1 e 2). Diferencialmente, óleo de palma foi adicionado ao concentrado (2% MS) do Grupo ÓLEO. Sêmen e sangue foram colhidos quinzenalmente. Houve aumento nas concentrações séricas de colesterol, HDL e lipídios totais nos animais do Grupo ÓLEO, enquanto o período influenciou nas taxas de colesterol, LDL, lipídios totais e VLDL (P<0,05). Houve decréscimo no turbilhonamento e discreta redução na integridade de membranas nos animais do Grupo ÓLEO (P<0,05). Correlações significativas foram encontradas entre triglicerídeos e defeitos menores (r=-0,412; P=0,006), LDL e defeitos totais (r=-0,333; P=0,030), lipídios totais e defeitos menores (r=-0.366; P= 0,017), lipídios totais e defeitos totais (r=-0.309; P= 0,046), e VLDL e viabilidade espermática (r=0,381; P=0,012), apontando efeitos positivos da maior lipidemia na morfologia e na viabilidade espermática. O uso de óleo de palma alterou o perfil lipídico sérico, mas não favoreceu per se os parâmetros seminais relacionados com o potencial de fertilidade dos touros.

The study aimed to investigate the effect of dietary supplementation with palm oil on serum lipid profile, the seminal characteristics of buffaloes (Bubalus bubalis) and the correlations between them. Twelve bulls were divided into Group CONT (n = 5) or Group OIL (n = 7). Animals in both groups were fed with isoproteic diets composed of corn silage and concentrated (ground corn, wheat bran and urea), with 50% forage/concentrate ratio, during 130 days (Periods 1 and 2). Palm oil (2%DM) was added to diet offered to Group OIL. Semen and blood samples were collected every two weeks. Increased serum levels of cholesterol, HDL and total lipids were observed for Group OIL, while the period influenced on cholesterol, LDL, total lipids and VLDL (P<0,05). Treatment decreased gross motility (P<0.05) and slightly reduced sperm membrane integrity (P<0.05) in animals of Group OIL. There were significant correlations between triglycerides and minor defects (r=-0.412, P=0.006), LDL and total defects (r=-0.333, P=0.030), total lipids and minor defects (r=-0.366, P=0.017), VLDL and spermatic viability (r=0.381, P=0.012), and total lipids and totals defects (r=-0.309, P=0.046), highlighting positive effects of higher lipid serum levels on sperm morphology and viability. The incorporation of palm oil in the diet altered the serum lipid profile, but it showed no positive effect on seminal parameters related to the potential of bull fertility.

Genetic diversity of Ehrlichia canis in Brazil.

Canine monocytic ehrlichiosis is a highly prevalent disease in Brazil, where the genetic diversity of Ehrlichia canis remains undefined. In this study, we used the TRP36 gene to examine the genetic diversity of E. canis strains from naturally infected dogs residing in five distinct geographic regions in Brazil. E. canis DNA was detected in 82/126 (65%) dogs by dsb-specific PCR and E. canis was isolated in cell culture from 13 dogs. Sequences obtained from dsb genes amplified from the isolates were identical to the US E. canis strain. An extended molecular characterization based on the TRP36 gene identified two major genogroups based on differences among eight isolates. Isolates with tandem repeat amino acid sequence (TEDSVSAPA) identical to the previously reported TRP36 sequence were found in the midwest, northeast and southeast regions of Brazil, and classified into the US genogroup. A novel Brazilian genotype with a different tandem repeat sequence (ASVVPEAE) was also identified in midwest, northern and southern regions. Similarity in the N-terminal sequence of a US genogroup member with the Brazilian genogroup suggested that genomic recombination between the two genogroups may have occurred. Other subtypes within the Brazilian genogroup were also identified using C-terminal amino acid divergence. We identified two distinct major Brazilian genogroups and several subtypes based on analysis of TRP36, and such information will be useful for further genotyping and possible associations with disease severity, understanding of the genetic and antigenic variability of E. canis, and for developing strain-specific vaccines and diagnostic methods based on TRP36.

Risk factors associated with dizziness during treatment of mucosal leishmaniasis with meglumine antimoniate: 16-year retrospective study of cases from Rio de Janeiro, Brazil.

OBJECTIVE: To evaluate dizziness in patients receiving meglumine antimoniate for the treatment of mucosal leishmaniasis. MATERIALS AND METHODS: We retrospectively studied 127 patients treated at the Laboratory of Leishmaniasis Surveillance, Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil, between 1 January 1989 and 31 December 2004. RESULTS: A low dose of meglumine antimoniate (5 mg/kg/day) was used in 86.6 per cent of patients; a dose of 10 mg/kg/day or higher was used in 13.4 per cent of patients. Dizziness was reported by 4.7 per cent of patients. The adjusted odds ratios were 7.37 for dizziness in female patients, 4.9 for dizziness in patients aged 60 years or older, and 7.77 for dizziness in the presence of elevated serum lipase. CONCLUSION: We suggest that dizziness may be a side effect of meglumine antimoniate, particularly in elderly individuals, in females and in patients with elevated serum lipase.

Spider envenoming of dog - case report

This report refers to a female Pinscher treated at the Veterinary Hospital of the Botucatu School of Veterinary Medicine and Animal Husbandry (FMVZ)-Säo Paulo State University (UNESP), Botucatu, 14 hours after a suspected spider envenoming. The animal showed spastic limbs, dyspnea, salivation, hypothermia, muscular fasciculation, non-responsive mydriasis, and claudication of the right hindlimb. The spider was later identified by the Center for the Study of Venoms and Venomous Animals-CEVAP/UNESP, Botucatu as Phoneutria nigriventer. The treatment with potent analgesic was efficient.

Soroprevalência de brucelose canina na cidade de Alfenas, MG. dados preliminares / Serum prevalence of canine brucellosis in Alfenas city MG, Brazil, Preliminary data

One hundred and two blood serum samples from dogs referred to the Veterinary Teaching Hospital of Alfenas University, were submitted to the agarose immune diffusion and to the fast serum-agglutination tests addressed to find antibodies anti-Brucella canis and B. abortus, respectively. Five samples (4.9 percent) were positives for B.canis and none for B. abortus. This prevalence is considered by some as an alert for an epidemiologic and public healthy problems, considering the serious zoonotic aspect of canine brucellosis

A novel chimeric mitochondrial RNA localized in the nucleus of mouse sperm.

Six identical cDNA clones corresponding to an RNA of 1685 nucleotides that is enriched in mouse sperm compared with testis were isolated from a mouse testis cDNA library. The sequence of these clones corresponds to the 16S mitochondrial RNA plus an inverted repeat of 120 bp covalently joined to the 5' end of the RNA. By RT-PCR, it was demonstrated that this transcript, referred to as chimeric RNA, was present in mouse sperm, testis, liver, kidney, brain, and spleen. The absence of an equivalent sequence in mitochondrial DNA or as a mitochondrial pseudogene in total DNA extracted from sperm, testis, and somatic tissues suggests that the chimeric RNA is a post-transcriptional product, maybe resulting from a trans splicing reaction. The chimeric RNA was found by RT-PCR in total RNA extracted from purified sperm heads. This result was confirmed by in situ hybridization, which showed clear staining of the sperm nucleus with probes corresponding to sequences of the mitochondrial 16S RNA and the inverted repeat.

Effect of hormone replacement therapy on the bone mass and urinary excretion of pyridinium cross-links.

CONTEXT: The menopause accelerates bone loss and is associated with an increased bone turnover. Bone formation may be evaluated by several biochemical markers. However, the establishment of an accurate marker for bone resorption has been more difficult to achieve. OBJECTIVE: To study the effect of hormone replacement therapy (HRT) on bone mass and on the markers of bone resorption: urinary excretion of pyridinoline and deoxypyridinoline. DESIGN: Cohort correlational study. SETTING: Academic referral center. SAMPLE: 53 post-menopausal women, aged 48-58 years. MAIN MEASUREMENTS: Urinary pyr and d-pyr were measured in fasting urine samples by spectrofluorometry after high performance liquid chromatography and corrected for creatinine excretion measured before treatment and after 1, 2, 4 and 12 months. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DEXA) before treatment and after 12 months of HRT. RESULTS: The BMD after HRT was about 4.7% (P < 0.0004); 2% (P < 0.002); and 3% (P < 0. 01) higher than the basal values in lumbar spine, neck and trochanter respectively. There were no significant correlations between pyridinium cross-links and age, weight, menopause duration and BMD. The decrease in pyr and d-pyr was progressive after HRT, reaching 28.9% (P < 0.0002), and 42% (P < 0.0002) respectively after 1 year. CONCLUSIONS: Urinary pyridinoline and deoxypyridinoline excretion decreases early in hormone replacement therapy, reflecting a decrease in the bone resorption rate, and no correlation was observed with the bone mass evaluated by densitometry.