Parâmetros e protocolos da laserterapia utilizados no tratamento de feridas diabéticas / Parameters and protocols of lasertherapy used in the treatment of diabetic wounds / Parámetros y protocolos de laserterapia utilizados en el tratamiento de las heridas diabéticas

Este estudo tem como objetivo descrever os parâmetros e protocolos utilizados do laser de baixa intensidade em feridas de indivíduos diabéticos.Trata-se de revisão integrativadaliteratura acerca dos parâmetros e protocolos da laserterapia utilizados no tratamento de feridas diabéticas. A busca foi realizada no Google Scholar,Scientific Electronic Library Online(SCIELO), Medical Literature Analysis and Retrieval System Online/US National Library of Medic (MEDLINE/PUBMED). Foi utilizado como estratégia de busca os seguintes descritores específicos e seus acrônimos, para cada base de dados, de acordo com o Medical Subject Headings (MeSH) e Descritores em Ciência da Saúde (DeCs): Terapia com Luz de Baixa Intensidade (Low-Level Light Therapy); Cicatrização; Wound Healing; Ferimentos e Lesões; Complicações do Diabetes (Diabetes Complications). Foram identificados 80 estudos sobre o assunto e,após aplicação dos critérios e inclusão e exclusão, foram inseridos seisestudos, onde trêsdestessão ensaiosclínicos, umasérie de caso, umestudo experimental e umarevisão da literatura. Os estudos apontaram para efeitos significativosna aceleração da cicatrizaçãodeferidas diabéticasapós o uso do laser de comprimento de onda abaixo de 700nm, de luz visível vermelha, com densidade de potência de 30mW, e uma frequência entre 2 e3 vezes por semana, com no mínimo dez intervenções. A utilização do laser se mostrou benéfica em lesões diabéticas, apresentando resultadossuperiores ao uso doDiodo Emissor de luz (LED) e asterapêuticas convencionais de forma isolada.

This study aims to describe the parameters and protocols used for the low power point in laser instruments. This is an integrative review of the literature on laser therapy of the parameters used and treatment protocols for diabetic wounds. The search was performed on Google Scholar, Scientific Electronic Library Online (SCIELO), Medical Literature Analysis and Retrieval System Online/US National Library of Medic (MEDLINE/PUBMED). The following descriptors and their acronyms were used as a search strategy for eachdatabase, according to the Medical Subject Headings (MeSH) and Health Science Descriptors (DeCs): Low-Level Light Therapy (Low-Level) Light Therapy); Healing; Wound healing; Wounds and Injuries; Complications of Diabetes. The case 80 on the subject were evaluated and, after applying the three studies and inclusion and exclusion, a series of experimental studies, a study and a literature review were inserted in these clinical trials. The studies pointed to significant effects in accelerating the healing of diabetic wounds after the use of laser with a wavelength below 700nm, of visible red light, with a power density of 30mW, and a frequency between 2 and 3 times a week, with at least ten interventions. The use of laser differs results (LED) in tasks superior to the diabetic ones, presenting Emitting Diode of light use and as transformers in an isolated way.

Este estudio tiene como objetivo describir los parámetros y protocolos utilizados para el punto de baja potencia en instrumentos láser. Esta es una revisión integradora de la literatura sobre la terapia con láser de los parámetros utilizados y los protocolos de tratamiento de las heridas diabéticas. La búsqueda se realizó en Google Scholar, Scientific Electronic Library Online (SCIELO), Medical Literature Analysis and Retrieval System Online/US National Library of Medic (MEDLINE/PUBMED). Los siguientes descriptores y sus siglas se utilizaron como estrategia de búsqueda para cada base de datos, de acuerdo con los Medical Subject Headings (MeSH) y Health Science Descriptors (DeCs): Low-Level Light Therapy (Low-Level) Light Therapy); Curación; Cicatrización de la herida; Heridas y lesiones; Complicaciones dela Diabetes. Se evaluó el caso 80 sobre el tema y, luego de aplicar los tres estudios e inclusión y exclusión, se insertó una serie de estudios experimentales, un estudio y una revisión de la literatura en estos ensayos clínicos. The studies pointed to significant effects in accelerating the healing of diabetic wounds after the use of laser with a wavelength below 700nm, of visible red light, with a power density of 30mW, and a frequency between 2 and 3 times a week, with at least ten interventions. El usode láser difiere resultados (LED) en tareas superiores a las diabéticas, presentándose diodos emisores de luz y como transformadores de forma aislada.

Comparison of Automated Breast Ultrasound and Hand-Held Breast Ultrasound in the Screening of Dense Breasts.

OBJECTIVE: To compare hand-held breast ultrasound (HHBUS) and automated breast ultrasound (ABUS) as screening tool for cancer. METHODS: A cross-sectional study in patients with mammographically dense breasts was conducted, and both HHBUS and ABUS were performed. Hand-held breast ultrasound was acquired by radiologists and ABUS by mammography technicians and analyzed by breast radiologists. We evaluated the Breast Imaging Reporting and Data System (BI-RADS) classification of the exam and of the lesion, as well as the amount of time required to perform and read each exam. The statistical analysis employed was measures of central tendency and dispersion, frequencies, Student t test, and a univariate logistic regression, through the odds ratio and its respective 95% confidence interval, and with p < 0.05 considered of statistical significance. RESULTS: A total of 440 patients were evaluated. Regarding lesions, HHBUS detected 15 (7.7%) BI-RADS 2, 175 (89.3%) BI-RADS 3, and 6 (3%) BI-RADS 4, with 3 being confirmed by biopsy as invasive ductal carcinomas (IDCs), and 3 false-positives. Automated breast ultrasound identified 12 (12.9%) BI-RADS 2, 75 (80.7%) BI-RADS 3, and 6 (6.4%) BI-RADS 4, including 3 lesions detected by HHBUS and confirmed as IDCs, in addition to 1 invasive lobular carcinoma and 2 high-risk lesions not detected by HHBUS. The amount of time required for the radiologist to read the ABUS was statistically inferior compared with the time required to read the HHBUS (p < 0.001). The overall concordance was 80.9%. A total of 219 lesions were detected, from those 70 lesions by both methods, 126 only by HHBUS (84.9% not suspicious by ABUS) and 23 only by ABUS. CONCLUSION: Compared with HHBUS, ABUS allowed adequate sonographic study in supplemental screening for breast cancer in heterogeneously dense and extremely dense breasts.

OBJETIVO: Comparar a ultrassonografia convencional das mamas (US) com a ultrassonografia automatizada das mamas (ABUS) no rastreio do câncer. MéTODOS: Realizamos um estudo transversal com pacientes com mamas mamograficamente densas, sendo avaliadas pela US e pela ABUS. A US foi realizada por radiologistas e a ABUS por técnicos de mamografia e analisada por radiologistas especializados em mama. A classificação Breast Imaging Reporting and Data System (BIRADS) do exame e das lesões o tempo de leitura e de aquisição foram avaliados. A análise estatística foi realizada através de medidas de tendência central, dispersão e frequências, teste t de Student e regressão logística univariada, através do odds ratio, com intervalo de confiança de 95%, e com p < 0,05 sendo considerado estatisticamente significante. RESULTADOS: Foram avaliadas 440 pacientes. Em relação às lesões, a US detectou 15 (7,7%) BI-RADS 2, 175 (89,3%) BI-RADS 3 e 6 (3%) BI-RADS 4, das quais 3 foram confirmadas, por biópsia, como carcinomas ductais invasivos e 3 falso-positivos. A ABUS identificou 12 (12,9%) BI-RADS 2, 75 (80,7%) BI-RADS 3 e 6 (6,4%) BI-RADS 4, incluindo 3 lesões detectadas pela US e confirmadas como carcinomas ductais invasivos, além de 1 carcinoma lobular invasivo e 2 lesões de alto risco não detectadas pela US. O tempo de leitura dos exames da ABUS foi estatisticamente inferior ao tempo do radiologista para realizar a US (p < 0,001). A concordância foi de 80,9%. Um total de 219 lesões foram detectadas, das quais 70 por ambos os métodos, 126 observadas apenas pela US (84,9% não eram lesões suspeitas no ABUS) e 23 apenas pela ABUS. CONCLUSãO: Comparado à US, a ABUS permitiu adequado estudo complementar no rastreio do câncer de mamas heterogeneamente densas e extremamente densas.

Serosurvey of anti-Neospora caninum antibodies in wild boars (Sus scrofa), hunting dogs and hunters of Brazil.

The protozoan Neospora caninum is an important cause of abortion in cattle worldwide, with domestic dogs serving as the definitive hosts. Although hunting activities have been indicated as a potential risk factor for N. caninum infection in dogs, no serological evidence has so far been reported in hunting dogs, wild boars (Sus scrofa), and hunters. A total of 98 wild boars, 168 hunting dogs, and 15 hunters from three Brazilian regions were sampled and tested for anti-N. caninum antibodies by indirect immunofluorescence antibody test, resulting in 15/168 (9%) seropositive hunting dogs, and 0/98 wild boars, and 0/15 hunters seropositive. The absence of N. caninum antibodies in wild boars may suggest low exposure to oocysts shed by hunting dogs and wild canids in three different Brazilian regions. Finally, the absence of hunter seropositivity supports the current lack of evidence that N. caninum is a zoonotic parasite.

Comparison of automated breast ultrasound and hand-held breast ultrasound in the screening of dense breasts / Comparação entre a ultrassonografia automatizada e a ultrassonografia convencional no rastreio de mamas densas

Abstract Objective To compare hand-held breast ultrasound (HHBUS) and automated breast ultrasound (ABUS) as screening tool for cancer. Methods A cross-sectional study in patients with mammographically dense breasts was conducted, and both HHBUS and ABUS were performed. Hand-held breast ultrasound was acquired by radiologists and ABUS by mammography technicians and analyzed by breast radiologists. We evaluated the Breast Imaging Reporting and Data System (BI-RADS) classification of the exam and of the lesion, as well as the amount of time required to perform and read each exam. The statistical analysis employed was measures of central tendency and dispersion, frequencies, Student t test, and a univariate logistic regression, through the odds ratio and its respective 95% confidence interval, and with p<0.05 considered of statistical significance. Results Atotal of 440 patientswere evaluated. Regarding lesions,HHBUS detected 15 (7.7%) BI-RADS 2, 175 (89.3%) BI-RADS 3, and 6 (3%) BI-RADS 4, with 3 being confirmed by biopsy as invasive ductal carcinomas (IDCs), and 3 false-positives. Automated breast ultrasound identified 12 (12.9%) BI-RADS 2, 75 (80.7%) BI-RADS 3, and 6 (6.4%) BI-RADS 4, including 3 lesions detected by HHBUS and confirmed as IDCs, in addition to 1 invasive lobular carcinoma and 2 high-risk lesions not detected by HHBUS. The amount of time required for the radiologist to read the ABUS was statistically inferior compared with the time required to read the HHBUS (p<0.001). The overall concordance was 80.9%. A total of 219 lesions were detected, from those 70 lesions by both methods, 126 only by HHBUS (84.9% not suspicious by ABUS) and 23 only by ABUS. Conclusion Compared with HHBUS, ABUS allowed adequate sonographic study in supplemental screening for breast cancer in heterogeneously dense and extremely dense breasts.

Resumo Objetivo Comparar a ultrassonografia convencional das mamas (US) com a ultrassonografia automatizada das mamas (ABUS) no rastreio do câncer. Métodos Realizamos um estudo transversal com pacientes com mamas mamograficamente densas, sendo avaliadas pela US e pela ABUS. A US foi realizada por radiologistas e a ABUS por técnicos de mamografia e analisada por radiologistas especializados em mama. A classificação Breast Imaging Reporting and Data System (BIRADS) do exame e das lesões o tempo de leitura e de aquisição foram avaliados. A análise estatística foi realizada através de medidas de tendência central, dispersão e frequências, teste t de Student e regressão logística univariada, através do odds ratio, com intervalo de confiança de 95%, e com p<0,05 sendo considerado estatisticamente significante. Resultados Foram avaliadas 440 pacientes. Em relação às lesões, a US detectou 15 (7,7%) BI-RADS 2, 175 (89,3%) BI-RADS 3 e 6 (3%) BI-RADS 4, das quais 3 foram confirmadas, por biópsia, como carcinomas ductais invasivos e 3 falso-positivos. A ABUS identificou 12 (12,9%) BI-RADS 2, 75 (80,7%) BI-RADS 3 e 6 (6,4%) BI-RADS 4, incluindo 3 lesões detectadas pela US e confirmadas como carcinomas ductais invasivos, além de 1 carcinoma lobular invasivo e 2 lesões de alto risco não detectadas pela US. O tempo de leitura dos exames da ABUS foi estatisticamente inferior ao tempo do radiologista para realizar a US (p<0,001). A concordância foi de 80,9%. Um total de 219 lesões foram detectadas, das quais 70 por ambos os métodos, 126 observadas apenas pela US (84,9% não eram lesões suspeitas no ABUS) e 23 apenas pela ABUS. Conclusão Comparado à US, a ABUS permitiu adequado estudo complementar no rastreio do câncer de mamas heterogeneamente densas e extremamente densas.

Biochemical markers of muscle damage and high serum concentration of creatine kinase in patients on statin therapy.

Aim: Some patients experience statin-associated muscle symptoms (SAMS) and elevated serum concentrations of CK. The relationship between SAMS and biomarkers of muscle damage was examined. Methods: We analyzed 359 consecutive patients taking statins with high CK values. Muscle-related symptoms and biochemical variables, including CK, MB isoenzyme of creatine kinase (CK-MB), troponin and carbonic anhydrase type III were evaluated. Results: SAMS was reported by 181 (50.4%) patients and they had greater BMI (p = 0.021) and a trend toward higher CK-MB values (p = 0.064). The use of simvastatin (OR: 2.24; 95% CI: 1.47-3.42), CK-MB (OR: 1.59; 95% CI: 1.02-2.49) and BMI (OR: 1.06; 95% CI: 1.01-1.10) were independent variables for SAMS. Conclusion: Simvastatin use, BMI and CK-MB were independent markers of SAMS.

Satisfação dos pacientes oncológicos acerca dos cuidados de enfermagem / Satisfaction of cancer patients about nursing care

Objetivo: conhecer a satisfação dos pacientes com câncer acerca dos cuidados de enfermagem. Método: trata-se de um estudo bibliográfico do tipo revisão integrativa com buscas nas bases de dados COCHRANE, MEDLINE, LILACS e Bibliotecas Virtuais­BVS e SCIELO. Selecionaram-se os estudos publicados entre 2007 e 2017, e se apresentam em forma de figuras. Resultados: identificaram-se, inicialmente, 802 artigos, que culminaram na amostra final de 13 estudos analisados na íntegra. Evidenciam-se, na maioria dos estudos, os usuários como satisfeitos com o atendimento recebido pela equipe de Enfermagem. Conclusão: revela-se que avaliar a qualidade dos cuidados de Enfermagem, sob a ótica dos pacientes, permite analisar os problemas de diferentes perspectivas, além de buscar soluções consensuais.(AU)

Objective: to assess the satisfaction of cancer patients about nursing care. Method: this is a bibliographic study of type integrative review with searches on the databases MEDLINE, Cochrane, LILACS and Virtual Libraries-BVS and SCIELO. We selected studies published between 2007 and 2017, and present themselves in the form of figures. Results: we identified, initially, 802 articles, which culminated in the final sample of 13 studies analyzed in full. Demonstrate, in most studies, as users satisfied with the care received by the nursing staff. Conclusion: reveals that evaluate the quality of nursing care, under the perspective of patients, allows to analyze the problems from different perspectives, as well as seek consensual solutions.(AU)

Objetivo: evaluar el grado de satisfacción de los pacientes con cáncer acerca de los cuidados de enfermería. Método: se trata de un estudio bibliográfico del tipo revisión integradora, con búsquedas en las bases de datos MEDLINE, COCHRANE, LILACS y bibliotecas virtuales-BVS y SCIELO. Se seleccionaron los estudios publicados entre 2007 y 2017, y se presentan en forma de cifras. Resultados: se identificaron, inicialmente, 802 artículos, que culminaron en la muestra final de 13 estudios analizados en su totalidad. Demostrar, en la mayoría de los estudios, ya que los usuarios satisfechos con la atención recibida por el personal de enfermería. Conclusión: revela que evalúan la calidad de la atención de enfermería, bajo la perspectiva de los pacientes, permite analizar los problemas desde diferentes perspectivas, así como de buscar soluciones consensuadas.(AU)

Consumption of animal-based and processed food associated with cardiovascular risk factors and subclinical atherosclerosis biomarkers in men.

OBJECTIVE: To evaluate the frequency of food consumption in apparently healthy men and their association with cardiovascular risk factors and biomarkers of subclinical atherosclerosis. METHODS: In this observational study, 88 men had their food standard obtained through the food frequency questionnaire (FFQ). Associations of dietary patterns with cardiovascular risk factors, such as anthropometric data, laboratory and clinical evaluations, carotid-femoral arterial stiffness (IMT) and pulse wave velocity were evaluated. RESULTS: The highest values were observed, for most of the risk factors evaluated, with the highest frequency of weekly consumption of dairy products, meats, sweets, fats, cold meats, sodas, milk and white chocolate; and lower frequency of weekly consumption of fruits, cereals, vegetables, legumes, oilseeds, and soy. There was no significant difference for coffee and dark chocolate. CONCLUSIONS: A diet with high consumption of animal products has a higher correlation with cardiovascular risk factors; the opposite is true for the consumption of plant-based food, associated with the profile of more favorable biomarkers for cardiovascular health and better biochemical and structural parameters.

Consumption of animal-based and processed food associated with cardiovascular risk factors and subclinical atherosclerosis biomarkers in men

SUMMARY OBJECTIVE To evaluate the frequency of food consumption in apparently healthy men and their association with cardiovascular risk factors and biomarkers of subclinical atherosclerosis. METHODS In this observational study, 88 men had their food standard obtained through the food frequency questionnaire (FFQ). Associations of dietary patterns with cardiovascular risk factors, such as anthropometric data, laboratory and clinical evaluations, carotid-femoral arterial stiffness (IMT) and pulse wave velocity were evaluated. RESULTS The highest values were observed, for most of the risk factors evaluated, with the highest frequency of weekly consumption of dairy products, meats, sweets, fats, cold meats, sodas, milk and white chocolate; and lower frequency of weekly consumption of fruits, cereals, vegetables, legumes, oilseeds, and soy. There was no significant difference for coffee and dark chocolate CONCLUSIONS A diet with high consumption of animal products has a higher correlation with cardiovascular risk factors; the opposite is true for the consumption of plant-based food, associated with the profile of more favorable biomarkers for cardiovascular health and better biochemical and structural parameters.

RESUMO OBJETIVO Avaliar a frequência do consumo alimentar de indivíduos homens aparentemente saudáveis e a associação desta com fatores de risco cardiovascular e biomarcadores de aterosclerose subclínica. MÉTODOS Neste estudo observacional, 88 homens tiveram o padrão alimentar obtido por meio do questionário de frequência alimentar (QFA). Foram avaliadas as associações dos padrões alimentares com os fatores de risco cardiovascular, como dados antropométricos, avaliações laboratoriais e clínica, rigidez arterial determinada pela carótida-femoral (IMT) e velocidade da onda de pulso (VOP). RESULTADOS O padrão observado para a maioria dos fatores de risco avaliados foi de valores mais altos, segundo maior frequência de consumo semanal de lácteos, carnes, doces, gorduras/frituras, embutidos, refrigerantes, chocolates ao leite e branco; e de menor frequência de consumo semanal de frutas, cereais, legumes, verduras, leguminosas, oleaginosas e soja. Não houve diferença significativa para café e chocolate amargo. CONCLUSÕES Uma dieta com alto consumo de produtos animais apresenta maior correlação com fatores de risco cardiovascular, sendo o oposto para o consumo de alimentos de origem vegetal, associado ao perfil de biomarcadores de saúde cardiovascular mais favorável e melhores parâmetros bioquímicos e estruturais.

Dysregulation of insulin levels in Chagas heart disease is associated with altered adipocytokine levels.

Metabolic, inflammatory, and autonomic nervous system (ANS) dysfunction are present in patients with heart failure. However, whether these changes are due to left ventricular dysfunction or heart failure etiology is unknown. We evaluated metabolism and inflammatory activity in patients with idiopathic dilated cardiomyopathy (IDC) and Chagas cardiomyopathy (CHG) and their correlation with the ANS. Forty-six patients were divided into 3 groups: IDC, CHG, and control. We evaluated adiponectin, leptin, insulin, interleukin-6, and tumor necrosis factor-alpha. ANS were analyzed by heart rate variability in time and frequency domains on a 24-hour Holter monitor. Levels of glucose, cholesterol, leptin, and adiponectin did not show differences between groups. Insulin levels were lower in CHG group (5.4 ± 3.3 µU/mL) when compared with control (8.0 ± 4.9 µU/mL) and IDC (9.9 ± 5.0 µU/mL) groups (p = 0.007). Insulin was positively associated with LFr/HFr ratio (r = 0.562; p = 0.029) and with the LFr component (r = 0.562; p = 0.029) and negatively associated with adiponectin (r = -0.603; p = 0.017) in CHG group. The addition of an adiponectin unit reduced average insulin by 0.332 µg/mL. Insulin levels were decreased in the CHG group when compared with the IDC group and were associated with ANS indexes and adiponectin levels.

Factors Associated to Apical Root Resorption after Orthodontic Treatment.

OBJECTIVE: The aim of this study was to assess the possible factors associated to root resorption, common to daily clinical orthodontics, especially parafunctional habits. METHODS: A retrospective study of 600 patients (308 females and 292 males) previously treated orthodontically was conducted. The sample was divided into two groups related to the degree of root resorption at the ending of treatment according to Malmgren. Group 1 comprised 507 patients with a mean initial age of 14.21 years and who had absent or mild final external root resorption, characterized by grades 0, 1 and 2 of root resorption; Group 2 comprised 93 patients with initial mean age of 14.57 years and who had moderate or severe root resorption, characterized by grade 3 and 4. The groups were then compared in terms of age at the beginning and ending of the treatment, treatment time, gender, type of treatment (with and without extractions), parafunctional habits (bruxism, onychophagia, the habit of biting objects, tongue thrusting habit and thumb sucking habit), allergies and pretreatment root resorption. RESULTS: The results show that the initial age, gender, type of malocclusion, parafunctional habits and allergies do not represent a statistically significant risk of root resorption. CONCLUSION: Treatment time and type (with and without extractions) and the presence of external root resorption at the beginning of the treatment showed significant differences.

Comparison of Changes in Incisors Position in Cases Treated with Damon Self-Ligating and Conventional Fixed Appliances.

OBJECTIVE: This study aimed to compare the changes in maxillary and mandibular incisors position in cases treated with Damon self-ligating and conventional fixed appliances. METHODS: The sample comprised 51 patients with Class I malocclusion, mild to moderate crowding, treated without extractions, divided into 2 groups: Group 1 consisted of 20 patients treated with Damon self-ligating appliance, with a mean initial age of 15.00 years, treated for a mean period of 2.01 years; and Group 2 comprised 31 patients treated with conventional fixed appliances, with a mean initial age of 14.98 years, treated for a mean period of 1.81 years. The initial and final cephalograms of each patient were measured. The intergroup comparisons were performed with independent t or Mann-Whitney tests. RESULTS: Both groups showed a mild protrusion and a buccal inclination of the maxillary and mandibular incisors, with no statistically significant difference between them. CONCLUSION: The changes in maxillary and mandibular incisors position were similar between the groups treated with Damon self-ligating and conventional fixed appliances.

Role of P-selectin in thromboembolic events in patients with cancer.

The objective of the present study was to evaluate the role of P-selectin in patients with cancer with suspected thromboembolic events (TEEs). Patients with cancer have a four times greater risk of developing TEEs. P-selectin is a glycoprotein that has the function of facilitating the interaction (adhesion) of leukocytes with the endothelium, or with platelets. There is a well-defined relationship between P-selectin and thrombosis; however, it is likely that the cut-off value of P-selectin for patients with cancer should be considered differently from that of the general population. In the present report, a prospective cross-sectional study was performed with patients of the Cancer Hospital of Barretos who were suspected of having TEEs. Among the 178 study participants, 167 (93.82%) were suspected of having deep vein thrombosis, while 59 of them (35.33%) were confirmed as such; and 11 (6.18%) were suspected of having pulmonary thromboembolism, while 3 of them were confirmed as such (27.69%). The mean results obtained were: P-selectin, 25.37 ng/ml; and D-dimer, 2,181.22 ng/ml. The P-selectin levels averaged 33.60 ng/ml with the confirmed TEE group compared with 20.40 ng/ml with the unconfirmed TEE group, with a standard deviation of 23.35 compared with 6.92 (P<0.001); and the level of D-dimer was 4,615.38 ng/ml compared with 977.52 ng/ml, with a standard deviation of 6,460.54 compared with 2,145.50 (P<0.001). Multiple logistic regression adjusted for distant metastases and the Eastern Cooperative Oncology Group (ECOG) score (2,3 and 4) were constructed. The cut-off value of P-selectin for patients with cancer was identified to be different from that reported in the literature for the general population, and the models using D-dimer and P-selectin therefore have been demonstrated to be a potentially useful tool to be used in a panel of tests to predict TEEs, either independently or in a prediction score.

Prevalence of Bluetongue virus serotype 4 in cattle in the State of Sao Paulo, Brazil.

Bluetongue (BT) is considered endemic in several regions of Brazil. The State of Sao Paulo was divided into 7 cattle production regions (circuits) according the different systems of breeding, operational and logistical capacity of the state veterinary service. At least 1 animal from each property (a total of 1,716 farms) was tested by competitive ELISA for the presence of antibodies against BTV. Sero­positive sera were subsequently also tested by virus neutralization tests (VNT) using serial dilutions from 1:10 (cutoff) up to 1:640 (in MEM). BTV­4 neutralizing antibodies were detected in 86% (1,483/1,716) of the animals tested. These results show that BTV­4 is endemic and widespread in the State of San Paulo and indirectly confirm that in the State there are favourable conditions for the multiplication of competent vectors. However, as no clinical signs have ever been reported in cattle in the region, BTV­4 infection is likely to occur silently in the State of Sao Paulo.

Herd-level prevalence and risk factors for bovine viral diarrhea virus infection in cattle in the State of Paraíba, Northeastern Brazil.

Serological surveys based on a planned sampling on bovine viral diarrhea virus (BVDV) infection in Brazilian cattle herds are scarce. A cross-sectional study was carried out to determine herd- and animal-level seroprevalences and to identify risk factors associated with herd-level seroprevalence for BVDV infection in the State of Paraíba, Northeastern Brazil, from September 2012 to January 2013. The state was divided into three sampling strata, and for each stratum, the prevalence of herds infected with BVDV and the prevalence of seropositive animals was estimated by a two-stage sampling survey. In total, 2443 animals were sampled from 478 herds. A virus-neutralization test was used for BVDV antibody detection. A herd was considered positive when at least one seropositive animal was detected. The herd- and animal-level prevalences in the State of Paraíba were 65.5% (95% confidence interval (CI) = 61.1-69.7%) and 39.1% (95% CI = 33.1-45.6%), respectively. The frequency of seropositive animals per herd ranged from 10 to 100% (median of 50%). The risk factors identified were as follows: more than six calves aged ≤12 months (odds ratio (OR) = 3.72; 95% CI = 2.08-6.66), animal purchasing (OR = 1.66; 95% CI = 1.08-2.55), pasture rental (OR = 2.15; 95% CI = 1.35-3.55), and presence of veterinary assistance (OR = 2.04; 95% CI = 1.10-3.79). Our findings suggest that the implementation of control and prevention measures among farmers, with the aim of preventing dissemination of the agent in the herds, is necessary. Special attention should be given to addressing the identified risk factors, such as sanitary control prior to animal purchasing and to discourage the pasture rental, as well as to encourage the vaccination in the herds.

The social context and the need of information from patients with epilepsy: evaluating a tertiary referral service.

OBJECTIVE: Characterize the social profile and the need of information from patients with refractory epilepsy. METHOD: A semi-structured questionnaire was applied to 103 patients to investigate sociodemographic aspects, pharmacotherapy and any doubts about epilepsy. RESULTS: Patients were highly dependent on having a free and accessible supply of antiepileptic drugs. Sixty-eight percent of the population was unemployed, and 26% confirmed receiving social security benefits due to epilepsy. Twenty-nine percent of the population reached high school. Eighty-five percent of the patients had at least one doubt about epilepsy; treatment and epilepsy aspects in general were the main topics. CONCLUSION: As observed in developed countries, patients with refractory epilepsy from a developing country also have high rates of unemployment and low educational levels. The results raise a concern about the need of information about epilepsy by patients and their families, urging the necessity to invest in strategies to solve this deficiency in knowledge.

The social context and the need of information from patients with epilepsy: evaluating a tertiary referral service / O contexto social e a necessidade de informações de pacientes com epilepsia: avaliando um serviço terciário de referência

Objective Characterize the social profile and the need of information from patients with refractory epilepsy. Method A semi-structured questionnaire was applied to 103 patients to investigate sociodemographic aspects, pharmacotherapy and any doubts about epilepsy. Results Patients were highly dependent on having a free and accessible supply of antiepileptic drugs. Sixty-eight percent of the population was unemployed, and 26% confirmed receiving social security benefits due to epilepsy. Twenty-nine percent of the population reached high school. Eighty-five percent of the patients had at least one doubt about epilepsy; treatment and epilepsy aspects in general were the main topics. Conclusion : As observed in developed countries, patients with refractory epilepsy from a developing country also have high rates of unemployment and low educational levels. The results raise a concern about the need of information about epilepsy by patients and their families, urging the necessity to invest in strategies to solve this deficiency in knowledge. .

Objetivo : Caracterizar o perfil social e a necessidade de informações por parte de pacientes com epilepsia refratária. Método Um questionário semi-estruturado foi aplicado a 103 pacientes para investigar aspectos sociodemográficos, farmacoterapia e quaisquer dúvidas sobre epilepsia. Resultados Os pacientes mostraram-se altamente dependentes de um fornecimento gratuito e acessível de drogas antiepilépticas. Sessenta e oito por cento da população estava desempregada, e 26% confirmaram receber algum benefício social devido à epilepsia. Vinte e nove por cento da população alcançou ensino médio. Oitenta e cinco por cento dos pacientes tinha ao menos uma dúvida sobre epilepsia; tratamento e aspectos gerais da epilepsia foram os principais temas. Conclusão Tal qual observado em países desenvolvidos, pacientes com epilepsia refratária em países em desenvolvimento também apresentam altas taxas de desemprego e baixos níveis educacionais. Os resultados são preocupantes no que diz respeito à necessidade de informações sobre epilepsia por parte dos pacientes e seus familiares, apontando a necessidade de se investir em estratégias que solucionem esta deficiência de conhecimento. .

Avaliação do extrato etanólico de casca de Punica granatum (romã) na diminuição da replicação viral do BoHV-1 Colorado em embriões murinos experimentalmente infectados / Evaluation of ethanol extract of Punica granatum (Pomegranate) peel decrease in viral replication of BoHV-1 in Colorado murine embryos experimentally infected

O objetivo do trabalho foi avaliar a diminuição da replicação viral (BoHV-1 Colorado) em embriões murinos após tratamento do extrato etanólico da casca de Punica granatum (EEPg). Camundongos fêmeas Swiss com idade entre 6 e 8 semanas foram superovuladas com 0,2 mL a 5 UI de hormônios (eCG e hCG), e acasaladas com machos da mesma idade. Após 18 horas, as fêmeas sofreram eutanásia em câmara de CO2 e, através de abertura no peritônio, os zigotos foram coletados e lavados com solução de pronase 0,5%.Os zigotos foram divididos em quatro grupos: G1 (controle), G2 (expostos aos vírus BoHV-1 Colorado a 108 TCID50/mL), G3 (expostos ao EEPg) e G4 (expostos aos vírus e ao EEPg). Os grupos foram mantidos a 37,5ºC em meio TCM199 (100µL) com 10% de soro fetal bovino em estufa a 5% de CO2 e 95% de umidade. Após 24 h, analisamos a taxa de clivagem (teste exato de Fisher; p<0,05), a morfologia (por microscopia óptica), a nested-PCR e a titulação dos embriões em cocultura com células MDBK após mais 72 h do tratamento (teste de Mann-Whitney; p<0,05) e microscopia eletrônica de transmissão (ME). Os embriões murinos tratados com EEPg apresentaram resultados satisfatórios: sem alterações morfológicas, taxa de clivagem semelhante ao controle e, apesar da detecção da presença do vírus pela nested-PCR e ME, houve diminuição do título viral após tratamentos com esse extrato, o que sugere interferência desse tratamento no ciclo viral do BoHV-1 Colorado sem alterar o desenvolvimento dos embriões.(AU)

The aim of this study was to evaluate the reduction of viral replication (Colorado BoHV-1) in murine embryos after the treatment of ethanol extract of Punica granatum peel (PgEE). Swiss female mice aged 6 to 8 weeks were superovulated with 0.2 mL of the 5 UI hormones (eCG and hCG) and mated with males of the same age. After 18 hours, the females were euthanized in a CO2 chamber, and through the opening in the peritoneum, zygotes were collected and washed with 0.5% pronase solution. The zygotes were divided into four groups: G1 (control), G2 (exposed to the virus Colorado BoHV -1 to 108 TCID50/mL), G3 (exposed to PgEE) and G4 (exposed to the virus and to PgEE). The groups were maintained at 37.5ºC in TCM199 (100 mL) with 10% fetal bovine serum in an incubator at 5% CO2 and 95% humidity. After 24 h, we analyzed the cleavage rate (Fisher's exact test; p<0.05), the morphology (by light microscopy), the nested-PCR and the titration of embryos in co-culture with MDBK cells after over 72 h of treatment (Mann-Whitney test; p<0.05) and transmission electron microscopy (TEM). The murine embryos treated with PgEE showed satisfactory results: no morphological changes, cleavage rate similar to controls, despite the detection of the presence of virus by nested PCR and TEM, there was a decrease of the viral titer after the treatment with this extract, which suggests interference of this treatment in the viral cycle BoHV-1 Colorado without altering the embryo development.(AU)

Serological evidence and risk factors associated with Caprine herpesvirus 1 in dairy goat flocks in a semiarid region of northeastern Brazil.

A cross-sectional study was carried out to determine the flock-level seroprevalence of Caprine herpesvirus 1 (CpHV-1) and Bovine herpesvirus 1 (BoHV-1) and 2 (BoHV-2) and risk factors associated with CpHV-1 in dairy goat flocks from a semiarid region of northeastern Brazil. A total of 1,034 serum samples from 110 flocks were collected from March 2009 through March 2010. A structured questionnaire focusing on variables related to risk factors for CpHV-1 infection was given to each farmer at the time of blood collection. Antibodies against CpHV-1, BoHV-1, and BoHV-2 were detected by neutralization tests. The flock-level prevalences of CpHV-1, BoHV-1, and BoHV-2 were 89.1% (98/110; 95% confidence interval [CI]: 81.7-94.2), 80% (88/110; 95% CI: 71.3-87), and 4.5% (5/110; 95% CI: 1.5-10.3), respectively. Frequencies of seropositive animals were 36.6% (379/1,034), 25.8% (267/1,034), and 0.6% (6/1,034) for CpHV-1, BoHV-1, and BoHV-2, respectively. The use of natural mating was identified as a risk factor associated with CpHV-1 flock-level prevalence (P = 0.001). It is suggested that adoption of veterinary services and active surveillance of the at-risk flocks in the study region should be initiated to reduce the prevalence of herpesvirus infections.

Estimation of the diagnostic accuracy of the glyco-C and US9 gene-based polymerase chain reaction technique for the detection of bovine Herpesvirus type 5 DNA in decomposed brain suspension from a slaughter house using Bayesian analysis, Brazil.

Brazil represents the greatest beef producer among tropical countries, and the major obstacle for meat international trade is sanitary problems especially closely related to viral encephalitis. The goal of this study was to estimate the accuracy of the glycol and US9 gene-based polymerase chain reactions (PCRs) for the detection of bovine Herpesvirus type 5 (BoHV-5) from decomposed brain samples (n = 95). For this purpose, a latent-class (bayesian) approach was used. Sensitivity (Se) was estimated to be 70% (95% probability interval, 40-80) and specificity (Sp) 100% in the statistical analysis for both PCRs used. Accordingly, a minimum of ≥40% of the calves was estimated to harbor BoHV-5 DNA even after 72 h of decomposition at room temperature. It was concluded that US9 gene-based PCR could also be considered a cost-effective alternative in sanitary programmers. However, given the importance of veterinary diagnoses, PCR-positive samples should be further confirmed through in vitro isolation and/or sequencing.

Changes in cardiac heparan sulfate proteoglycan expression and streptozotocin-induced diastolic dysfunction in rats.

BACKGROUND: Changes in the proteoglycans glypican and syndecan-4 have been reported in several pathological conditions, but little is known about their expression in the heart during diabetes. The aim of this study was to investigate in vivo heart function changes and alterations in mRNA expression and protein levels of glypican-1 and syndecan-4 in cardiac and skeletal muscles during streptozotocin (STZ)-induced diabetes. METHODS: Diabetes was induced in male Wistar rats by STZ administration. The rats were assigned to one of the following groups: control (sham injection), after 24 hours, 10 days, or 30 days of STZ administration. Echocardiography was performed in the control and STZ 10-day groups. Western and Northern blots were used to quantify protein and mRNA levels in all groups. Immunohistochemistry was performed in the control and 30-day groups to correlate the observed mRNA changes to the protein expression. RESULTS: In vivo cardiac functional analysis performed using echocardiography in the 10-day group showed diastolic dysfunction with alterations in the peak velocity of early (E) diastolic filling and isovolumic relaxation time (IVRT) indices. These functional alterations observed in the STZ 10-day group correlated with the concomitant increase in syndecan-4 and glypican-1 protein expression. Cardiac glypican-1 mRNA and skeletal syndecan-4 mRNA and protein levels increased in the STZ 30-day group. On the other hand, the amount of glypican in skeletal muscle was lower than that in the control group. The same results were obtained from immunohistochemistry analysis. CONCLUSION: Our data suggest that membrane proteoglycans participate in the sequence of events triggered by diabetes and inflicted on cardiac and skeletal muscles.