Optimization of the first extraction protocol for metabolomic studies of Brucella abortus.

Brucellosis is a zoonosis prevalent worldwide and very recurrent in less developed or developing regions. This zoonosis affects livestock, generating high financial losses to producers, in addition to transmitting diseases to humans through meat consumption or handling contaminated products and animals. In this study, five extraction methods for Brucella abortus intracellular metabolites, using different solvent compositions and cell membrane disruption procedures, were evaluated. Derivatized extracts were analyzed by GC-HRMS. Raw data were processed in XCMS Online and the results were evaluated through multivariate statistical analysis using the MetaboAnalyst platform. The identification of the extracted metabolites was performed by the Unknowns software using the NIST 17.L library. The extraction performance of each method was evaluated for thirteen representative metabolites, comprising four different chemical classes. Most of these compounds are reported in the cell membrane composition of Gram-negative bacteria. The method based on extraction with methanol/chloroform/water presented the best performance in the evaluation of the extracted compounds and in the statistical results. Therefore, this method was selected for extracting intracellular metabolites from cultures of Brucella abortus for untargeted metabolomics analysis.

COVID-19 in the Perioperative Period of Cardiovascular Surgery: the Brazilian Experience.

INTRODUCTION: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. METHODS: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. RESULTS: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. CONCLUSION: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.

COVID-19 in the perioperative period of cardiovascular surgery: the brazilian experience

Abstract Introduction: We investigated the clinical course and outcomes of patients submitted to cardiovascular surgery in Brazil and who had developed symptoms/signs of coronavirus disease 2019 (COVID-19) in the perioperative period. Methods: A retrospective multicenter study including 104 patients who were allocated in three groups according to time of positive real time reverse transcriptase-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): group 1, patients who underwent cardiac surgery > 10 days after positive RT-PCR; group 2, patients with a positive RT-PCR within 10 days before or after surgery; group 3, patients who presented positive RT-PCR > 10 days after surgery. The primary outcome was mortality and secondary outcomes were postoperative complications, intensive care unit (ICU) length of stay, and postoperative days of hospitalization. Results: The three groups were similar with respect to age, the European System of Cardiac Operative Risk Evaluation score, and comorbidities, except hypertension. Postoperative complications and death were significantly higher in groups 2 and 3 than in group 1, and no significant difference between groups 2 and 3 was seen. Group 2 showed a high prevalence of surgery performed as an urgent procedure. Although no significant differences were observed in ICU length of stay, total postoperative hospitalization time was significantly higher in group 3 than in groups 1 and 2. Conclusion: COVID-19 affecting the postoperative period of patients who underwent cardiovascular surgery is associated with a higher rate of morbidity and mortality. Delaying procedures in RT-PCR-positive patients may help reduce risks of perioperative complications and death.

S-methyl cysteine sulfoxide mitigates histopathological damage, alleviate oxidative stress and promotes immunomodulation in diabetic rats.

OBJECTIVES: S-methyl cysteine sulfoxide (SMCS) is a hydrophilic cysteine-containing natural compound found in plants and is known to possess antidiabetic and antioxidant properties. We investigated the antioxidant and immunomodulatory properties of SMCS, as well as histopathological changes in the liver and pancreas in streptozotocin (STZ)-induced diabetic rats. METHODS: The rats were divided into the following groups: control (CG), comprising non-diabetic rats; STZ-DB, comprising STZ-induced diabetic rats; and STZ-SMCS, comprising STZ-induced diabetic rats treated with SMCS. SMCS (200 mg/kg) was administered by gavage daily for 30 days. Biochemical and cytokine analyses, catalase (CAT) and superoxide dismutase (SOD) activities assays and histopathological analysis of liver and pancreas tissues were performed. RESULTS: SMCS treatment reduced glycemia (p<0.05), decreased triglyceride (p<0.01) and very-low-density lipoprotein (VLDL) levels (p<0.01), and increased SOD and CAT activity in the liver (both p<0.01) compared with STZ-DB group. Higher activity values of IL-10 were observed in the STZ-SMCS group than in the other groups (p<0.001). Liver glycogen was significantly improved in the STZ-SMCS group compared with the STZ-DB group. SMCS also ameliorated damage to pancreatic islets, which resulted in restoration of their morphology. CONCLUSIONS: Oral treatment of SMCS showed improvement of the morphological alterations in liver and pancreatic islet in diabetic rats. These beneficial morphological effects of SMCS can be partially explained by IL-10 modulation associated with antioxidant action.

Metabolic Profile and Body Composition in Twins Concordant and Discordant for Physical Exercise.

The aim of this study was to evaluate the differences in the metabolic profile and body composition of monozygotic (MZ) twins concordant and discordant for the practice of physical exercise. The sample consisted of 92 MZ twins (72.5% female and 27.5% male, mean age 25.4 ± 5.69 years), registered with the Brazilian Registry of Twins, residing in Natal, Brazil. Data collection was carried out between the years 2016 and 2018. On day 1, subjects underwent a whole-body fitness evaluation, including measures of weight, height, body composition by Dual-Energy X-ray Absorptiometry and the Cardiorespiratory Exercise Test. On day 2, 10 ml blood samples were collected (overnight fasting) to determine the lipid profile and fasting glucose. The sample was separated into three groups: Active Concordant twins (Concordant A, n = 44 subjects), Inactive Concordant twins (Concordant I, n = 22 subjects) and Discordant pairs for Physical Exercise (Discordant PE, n = 26 subjects). The results demonstrated a difference between the discordant twins for exercise and also between the active versus sedentary groups, indicating a causal effect of exercise on the fat percentage, maximum oxygen consumption (VO2max) and second ventilatory threshold variables. Between groups, a difference was also observed between the groups in ventilatory threshold, very low-density lipoprotein and triglycerides. We concluded that, regardless of genetics, the practice of physical exercise was sufficient to generate alterations in body composition and VO2max in MZ twins, but not in the lipid profile or fasting glucose.

Influence of curcumin on glycemic profile, inflammatory markers, and oxidative stress in HIV-infected individuals: A randomized controlled trial.

To evaluate the influence of curcumin supplementation on the glycemic profile, inflammatory markers, and oxidative stress in HIV-infected individuals under antiretroviral therapy. This double-blind, crossover, randomized clinical trial was composed of 20 subjects arranged initially into experimental group (n = 10) and placebo group (n = 10) groups, receiving 1,000 mg curcumin/day or microcrystalline cellulose/day, respectively, during a 30-day period and 12-day washout. Subsequently, the groups were switched to follow the crossover design. Fasting glucose and insulin, IL-10, tumor necrosis factor alpha, malonialdehyde, and reduced glutathione were measured. Food consumption was evaluated as a control variable. Descriptive statistics are presented as mean and standard deviation, and inferential analyses were performed from two-way analysis of variance and the magnitude of the effect. No significant improvements were observed in the glycemic, inflammatory, or oxidative stress profiles. Although the mean serum fasting glucose levels and the homeostatic model assessment index presented qualitative improvement in the CG, this result should be interpreted with caution since the observed variation may represent acceptable fluctuation, in addition to the small difference between the means, added to the large variation observed in the standard deviation. Supplementation with curcumin in HIV-infected individuals undergoing antiretroviral therapy and training did not improve the glycemic, inflammatory, or oxidative stress profiles.

Biometría testicular y características seminales en felinos neotropicales (Carnivora: Felidae) sometidos a cateterismo uretral

Introducción: La administración de un fármaco agonista de un alfa- 2-adrenérgicos asociado con la técnica del cateterismo uretral, es un método de desarrollo reciente en la recolección seminal en felinos, ofreciendo las ventajas sobre la recolecta por electroeyaculación y la recolecta epididimaria. La técnica se ha probado en Panthera onca y felinos de pequeño porte. Objetivos: Realizar la recolección seminal en felinos neotropicales utilizando la técnica de cateterización uretral. Determinar los parámetros testiculares y seminales de muestras recolectadas por la técnica de cateterización uretral. Metodología: En este estudio se utilizó un individuo por especie de Panthera onca, Puma yagouaroundi yLeopardus wedii localizados en el parque Zoobotánico Getúlio Vargas, Salvador, Bahia, Brasil. El semen fue recolectado por medio del cateterismo uretral y se utilizaron los farmácos: clorhidrato de medetomidina (0.1 mg /kg) y ketamina (5.0 mg /kg). Durante el desarrollo del procedimiento, se realizó la recolecta de los datos biométricos corporales y testiculares, así como la ultrasonografía de los testículos. Mediante microscopia óptica, en las muestras seminales se determinó: el vigor espermático, motilidad total, motilidad progresiva, la integridad estructural y funcional de la membrana plasmática y la morfología espermática. Las muestras se sometieron al proceso de congelación - descongelación utilizando tres diferentes crioprotectores. Las muestras descongeladas fueron evaluadas por microscopía convencional, análisis seminal computarizado y citometría de flujo. Resultados: En este estudio fue realizado con éxito la técnica de recolección seminal en las tres especies, siendo el primer estudio que informa de los parámetros seminales deP. yagouaroundiy el primero que reporta la recolección seminal uretral en L. wiedii. Los datos presentados describen de forma pionera la morfocinética espermática de las especies incluidas. No hubo diferencias (P > 0.05) en la calidad seminal evaluando por grupo de crioprotector, ni diferencias en la integridad de las membranas pré e post-congelamento. Fue posible solamente la comparación con otras técnicas de recolección seminal o con resultados de calidad seminal obtenidos de muestras de gato doméstico. Conclusión: La cateterización uretral asociada al fármaco alfa- 2-adrenérgicos es una técnica eficiente para la recolección seminal en felinos neotropicales. El establecimiento de una potencial asociación de las características físicas del animal y la calidad seminal, es información de suma importancia en la aplicabilidad para la elección de reproductores en los programas de reproducción asistida.

Introduction: The urethral catheterization associated with the application of alfa- 2 adrenergic agonist drug is a recent development and application technique for the collection of feline semen, with advantages over electro-ejaculation harvesting and epididymal harvesting. Objetives: Seminal collection in neotropical felines using the urethral catheterization technique. Determine the testicular and seminal parameters of samples collected by the urethral cataterization technique. Methods: The technique has been tested on Panthera onca and others small cats. In this study, individuals of Panthera onca, Puma yagouaroundi and Leopardus wiedii were used in captivity at Getulio Vargas Zoobotanical Park, Salvador, Bahia, Brazil. Medetomidine hydrochloride (0.1 mg/kg) and ketamine (5.0 mg/kg) were used as sedatives, the semen was collected by urethral catheterization. In the process were checked the testicular biometry was performed with percutaner and ultrasonography technique. The fresh samples were evaluated for conventional microscopy in the parameters of volume, sperm vigor, total motility, progressive motility, structural and functional integrity of the plasmatic membrane and sperm morphology. The samples were subjected to a freeze - thaw process using three different extenders. The thawed samples were tested using conventional microscopy, automated system analysis and flow cytometry. Results: In this study, the urethral harvest technique was successfully used in the three species. In the literature used don't have report about seminal parameters in P. yagouaroundi and urethral seminal collection in L. wiedii. The data presented describe the spermatic morphocinetics of the included species in a pioneer study. There were no differences (P > 0.05) in the seminal quality evaluating the extender, nor differences in the integrity of pre and post-freeze membranes of the samples. Conclusion: The urethral catheterization associated with the application of alfa- 2 adrenergic agonist drug it's an efficient technique for semen collection in neotropical cats. The establishment of a potential association of physical characteristics with seminal quality is extremely important information on the applicability of reproductive traits in assisted reproduction programs.

Antidiarrheal effect of extract from the bark of Combretum leprosum in mice.

This study investigated the effects of the ethanolic extract from the bark of Combretum leprosum (ECL) on intestinal transit and castor-oil induced diarrhea in mice. The oral administration of ECL (750 and 1000 mg/kg) slowed intestinal transit (ID50 of 455 mg/kg). The ECL (250-1000 mg/kg) reduced castor-oil induced diarrhea, in a time- and dose-dependent manner (p < 0.05). To determine if antidiarrheal effect of ECL involves α2-adrenergic or opioid receptor activation, the mice were pretreated with antagonists of these receptors, yohimbine or naloxone respectively. None of these drugs inhibited the antidiarrheal effect of ECL. To test if antidiarrheal effect of ECL is due to an antisecretory action, we realized the enteropooling assay on rats. The ECL increased bowel content and did not inhibit intestinal fluid secretion increase induced by misoprostol (100 µg/kg, s.c.). To determine if antimotility effect of ECL is due to a reduction on gastric motility, we realized the organ bath assay in the rat fundus stomach. Isotonic recordings show that the carbachol /KCl - induced contraction was not reversed by the addition of ECL. In conclusion, our results suggest that ECL contains antidiarrheal compounds and these compounds could induce a reduction of intestinal tract motility.

Direct sequencing of the white spot syndrome virus from Brazil: Genome assembly and new insights on phylogeny.

White spot syndrome virus (WSSV) has been the cause of great economic losses in world shrimp farming. In this work the genome of a Brazilian WSSV isolate was determined from direct sequencing of total DNA extracted from an infected whiteleg shrimp, and assembled based on a chimera template approach. Comparisons between WSSV-BR and other isolates revealed that the Brazilian virus has a relatively small genome, and is very similar to isolates from Thailand and Mexico. A phylogenetic relationship using different approaches has demonstrated that these isolates share a common evolutionary history. An analysis of conflicting phylogenetic signals also considering genomes of other isolates revealed that the evolutionary history of WSSV may be related to recombination events. We observed that these events can also be traced at some level by analyzing the homologous regions in the WSSV genome. The existence of recombination events introduces a new point of view that must be considered in the evolutionary history of WSSV.

Skeletal age and explosive strength in young volleyball players / Idade óssea e força explosiva de jovens praticantes de voleibol

Abstract Identifying different anthropometric, physiological and motor aspects is essential to obtain success in sports practice. However, these components may be developed in same age subjects differently, in part due biological development. The aim of the study was compare and correlate the explosive strength to biological maturation by sex, obtained by estimation of skeletal age based on anthropometric variables. The sample consisted of 239 subjects of both sexes, aged 10 to 13 years. Maturation was assessed by skeletal age predictive equation and upper and lower limbs explosive strength using medicine ball throw test and vertical jump, respectively. Skeletal age was assessed by skeletal age using a predictive anthropometrical based equation. Upper and lower limbs explosive strength were evaluated by medicine ball throwing test and vertical jump test, respectively. Post hoc analysis showed delayed biological development subjects had worst medicine ball throwing test performance than accelerated boys (p=0.001; d=0.96) and girls (p< 0.01; d= 2.01); regarding to vertical jump test, worst performance was also detected to maturational delayed boys when compared to accelerated ones (p=0.24; d=1.1) and girls (p=0.007; d=0.75). Regression analysis showed skeletal age explained variance of 36% and 19.2% for boys and 45.2% and 16.1% for girls upper and lower limbs explosive strength. Skeletal age is positively related to upper and lower limbs explosive strength and show higher performance for accelerated biological development young players when compared to delayed ones, independently from sex.

Resumo Para se alcançar o sucesso no esporte, a identificação de diferentes aspectos antropométricos, motores e fisiológicos são imprescindíveis. Porém, esses componentes podem se desenvolver diferentemente em indivíduos na mesma faixa etária, em parte pelo desenvolvimento biológico. O objetivo do estudo foi comparar e relacionar a força explosiva com a maturação biológica de acordo com o sexo. A amostra foi composta por 239 sujeitos, com idades entre 10 a 13 anos. A idade óssea foi estimada por uma equação preditora baseada em variáveis antropométricas. A força explosiva de membros superiores e inferiores foram avaliadas através do teste de arremesso de medicine ball e de salto vertical, respectivamente. A análise de post hoc mostrou que os sujeitos com desenvolvimento biológico atrasado obtiveram o pior desempenho no teste de arremesso de medicine ball quando comparados com o grupo acelerado dos meninos (p=0.001; d=0.96) e meninas (p< 0.01; d= 2.01); em relação ao teste de salto vertical, desempenho inferior também foi observado para o estágio atrasado quando comparado com o grupo acelerado dos meninos (p=0.24; d=1.1) e meninas (p= 0.007; d=0.75). Análise de regressão demonstrou que 36% e 19,2% da variância no desempenho da força explosiva de membros superiores e inferiores foi compartilhada pela idade óssea dos meninos, e 45,2% e 16,1%, respectivamente, nas meninas. Conclui-se que a força explosiva de membros superiores e inferiores se relaciona de forma positiva com a idade óssea, sendo o desempenho destes componentes superiores em jovens com desenvolvimento biológico acelerado, quando comparados com o desenvolvimento atrasado, independente do sexo.

Analysis of new isolates reveals new genome organization and a hypervariable region in infectious myonecrosis virus (IMNV).

Infectious myonecrosis virus (IMNV) has been the cause of many losses in shrimp farming since 2002, when the first myonecrosis outbreak was reported at Brazilian's northeast coast. Two additional genomes of Brazilian IMNV isolates collected in 2009 and 2013 were sequenced and analyzed in the present study. The sequencing revealed extra 643 bp and 22 bp, at 5' and 3' ends of IMNV genome respectively, confirming that its actual size is at least 8226 bp long. Considering these additional sequences in genome extremities, ORF1 can starts at nt 470, encoding a 1708 aa polyprotein. Computational predictions reveal two stem loops and two pseudoknots in the 5' end and a putative stem loop and a slippery motif located at 3' end, indicating that these regions can be involved in the start and termination of translation. Through a careful phylogenetic analysis, a higher genetic variability among Brazilian isolates could be observed, comparing with Indonesian IMNV isolates. It was also observed that the most variable region of IMNV genome is located in the first half of ORF1, coinciding with a region which probably encodes the capsid protrusions. The results presented here are a starting point to elucidate the viral's translational regulation and the mechanisms involved in virulence.

Infectious hypodermal and hematopoietic necrosis virus from Brazil: Sequencing, comparative analysis and PCR detection.

A 3739 nucleotide fragment of Infectious hypodermal and hematopoietic necrosis virus (IHHNV) from Brazil was amplified and sequenced. This fragment contains the entire coding sequences of viral proteins, the full 3' untranslated region (3'UTR) and a partial sequence of 5' untranslated region (5'UTR). The genome organization of IHHNV revealed the three typical major coding domains: a left ORF1 of 2001 bp that codes NS1, a left ORF2 (NS2) of 1091 bp that codes NS2 and a right ORF3 of 990 bp that codes VP. Nucleotide and amino acid sequences of the three viral proteins were compared with putative amino acid sequences of viruses reported from different regions. Comparisons among genomes from different geographic locations reveal 31 nucleotide regions that are 100% similar, distributed throughout the genome. An analysis of secondary structure of UTR regions, revealed regions with high probability to form hairpins, that may be involved in mechanisms of viral replication. Additionally, a maximum likelihood analysis indicates that Brazilian IHHNV belongs to lineage III, in the infectious IHHNV group, and is clustered with IHHNV isolates from Hawaii, China, Taiwan, Vietnam and South Korea. A new nested PCR targeting conserved nucleotide regions is proposed to detect IHHNV.

Acetylcysteine for the prevention of renal outcomes in patients with diabetes mellitus undergoing coronary and peripheral vascular angiography: a substudy of the acetylcysteine for contrast-induced nephropathy trial.

BACKGROUND: Diabetes mellitus represents an independent risk factor for contrast-induced acute kidney injury. We report the results of a prespecified substudy of patients with diabetes mellitus included in the Acetylcysteine for Contrast-Induced Nephropathy Trial (ACT), the largest randomized study evaluating the effects of acetylcysteine for the prevention of contrast-induced acute kidney injury conducted to date. METHODS AND RESULTS: From the 2308 patients included in the ACT, 1395 had diabetes mellitus and were considered for the present analysis. The study drugs (acetylcysteine 1200 mg or matching placebo) were administered orally twice daily for 2 doses before and 2 doses after the procedure. The allocation was concealed (central Web-based randomization). Participants, healthcare staff, data collectors, and outcome assessors were blinded. All analysis followed the intention-to-treat principle. The incidence of contrast-induced acute kidney injury (primary end point) was 13.8% in the acetylcysteine group and 14.7% in the control group (relative risk 0.93; 95% confidence interval, 0.69-1.26; P=0.64). A combined end point of death or need for dialysis at 30 days was also similar in both the groups (2.2% and 2.1%, respectively; hazard ratio, 1.07; 95% confidence interval, 0.52-2.19; P=0.86). CONCLUSIONS: In this subanalysis, acetylcysteine did not reduce the risk of contrast-induced acute kidney injury or other clinically relevant outcomes in patients with diabetes mellitus undergoing coronary and peripheral vascular angiography. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00736866.

[Fatal case during treatment of american tegumentary leishmaniasis with sodium stibogluconate bp 88 (shandong xinhua)]. / Obito durante tratamento da leishmaniose tegumentar americana com stibogluconato de sódio bp 88 (shandong xinhua).

The authors report the occurrence of a fatal case in patient with cutaneous leishmaniasis in the municipality of Caxias, MA. Male patient, 22 years old, road sweeper, presented with an ulcer in left leg, diagnosed as cutaneous leishmaniasis and treated with sodium stibogluconate BP88 (Sb+5) (Shandong Xinhua) at a dose of 10mg/Sb+5/kg/day/20 days. After dose three he presented arthralgia, myalgia, nausea and weakness. During the therapy there was an aggravation of the symptoms with abdominal pain and irradiation into the thorax. After dose seven he presented a picture of associated dyspnea and thoracic pain of mild intensity. At dose nine there was further worsening of the picture, nevertheless the therapy was continued up to dose 11, when the patient's state deteriorated to such an extent that he was hospitalized in the intensive care unit. Exams: erythrocytes, 4.4 million; hemoglobin, 10.6%; hematocrits, 35%; white blood cells 26,400, basophiles and myelocytes (0); segmented leukocytes, 59%; lymphocytes 30%; monocytes 2%; platelets (normal); glucose, 42mg%; urea, 73mg%; creatinine, 2.4mg%; and ECG (blockade of right branch). The patient died from cardiorespiratory insufficiency. The current report underscores the need to clarify health workers regarding the use of Sb+5 and also to remind the Health Ministry to verify the quality and origin when acquiring new products.

Obito durante tratamento da leishmaniose tegumentar americana com stibogluconato de sódio bp 88® (shandong xinhua) / Fatal case during treatment of american tegumentary leishmaniasis with sodium stibogluconate bp 88® (shandong xinhua)

Os autores relatam a ocorrência de óbito em paciente portador da forma cutânea da LTA no município de Caxias-MA. Trata-se de paciente do sexo masculino, 22 anos, gari, portador de lesäo ulcerada no membro inferior (perna esquerda), diagnosticado, após encontro do parasita (Leishmania) na lesäo, tratado com stibogluconato de sódio BP88® (Shandong Xinhua) na dose de 10mg/Sb+5/kg/dia/20 dias. Após a 3ª dose apresentou dores articulares, naúseas, mal estar geral. Com a continuaçäo da medicaçäo houve agravamento do quadro com dor epigástrica e no hipocôndrio direito irradiando-se para o hemitórax homolateral. Após a 7ª dose apresentou dispnéia associado à dor torácica de leve intensidade. Na 9ª dose houve piora do quadro, mesmo assim continuou a usar o medicamento até a 11ª dose quando seu estado agravou-se. Foi internado, necessitando de tratamento intensivo. Nos exames realizados apresentou: 4,4 milhöes de eritócitos, 10,6 por cento de hemoglobina, 35 por cento de hematócrito, 26.400 de leucócitos, basófilos e mielócitos (0), 59 por cento de segmentados, 30 por cento de linfócitos, 2 por cento de monócitos, plaquetas (normais), glicose 42mg por cento, uréia 73mg por cento, creatinina (2,4mg por cento), eletrocardiograma (bloqueio de ramo direito). Veio a falecer tendo como causa do óbito, insuficiência cárdio respiratória. O relato atual mostra a necessidade de esclarecimento das equipes de saúde quanto ao uso dos Sb+5 e também lembrar o Ministério da Saúde quando da aquisiçäo de novos produtos, preocupar-se com a qualidade e procedência do mesmo

Uso de cerclagem esofágica para o tratamento de crianças de alto risco com atresia de esôfago e fístula tráqueo-esofágica distal / Use of esophageal cerclage for the treatment of high risk children with esophageal atresia and distal tracheoesophageal fistula

A atresia do esôfago com fístula tráqueo-esofágica distal apresenta várias formas de tratamento de acordo com as condiçöes clínicas do recém-nascido. Nos pacientes de alto risco este tratamento é estadiado, o que favorece o refluxo do conteúdo gástrico para a árvore respiratória através da fístula. Desde 1982 os autores passaram a utilizar, além da sonda de gastrostomia e jejunal (passadas através da mesma abertura), a cerclagem do esôfago abdominal (na verdade "uma alça" ao nível do esôfago abdominal), que é exteriorizada e amarrada cranialmente à incisäo, sem tensäo, com o propósito de tracionar levemente o esôfago abdominal, evitando o refluxo do conteúdo gastrico para a árvore respiratória. Posteriormente este fio é retirado sem qualquer dificuldade, sem a necessidade de reabrir o abdome, täo logo as condiçöes clínicas sejam favoráveis à reconstruçäo esofágica. Os autores relatam 7 casos tratados por este método, no período de 1982 a 1992, todos prematuros, baixo peso (1.020g à 1.829g) e com anomalias associadas ou pneumonite. Foram submetidos a este procedimento no primeiro dia de vida (6 pacientes) e no quinto dia de vida (1 paciente). Três pacientes tiveram suas cirurgias definitivas 8, 10 e 13 dias após o primeiro procedimento de 3, 1 e 2 anos após, respectivamente, sem intercorrências. Houve 4 óbitos relacionados a malformaçöes cardíacas graves associadas, porém a necrópsia evidenciou que o esôfago e cárdia estavam preservados. Os autores reproduziram este procedimento em 20 cadáveres de recém-nascidos, com a finalidade de comprovar a sua eficácia em impedir a passagem do conteúdo gástrico para o trato respiratório. O método obteve sucesso nos 20 cadáveres em que foi realizado o procedimento

Cistoadenoma mucinoso de apendice: relato de um caso / Mucinous cystadenoma of the appendix

Os autores apresentam um caso de cistoadenoma mucinoso de apendice em uma paciente de 38 anos e fazem revisao da literatura, ressaltando a frequencia desta patologia, idade de apresentaçao, incidencia segundo o sexo e possibilidade terapeuticas