Hospital sewage in Brazil: a reservoir of multidrug-resistant carbapenemase-producing Enterobacteriaceae.

The One Health concept recognizes that human health is clearly linked to the health of animals and the environment. Infections caused by bacteria resistant to carbapenem antibiotics have become a major challenge in hospitals due to limited therapeutic options and consequent increase in mortality. In this study, we investigated the presence of carbapenem-resistant Enterobacteriaceae in 84 effluent samples (42 from hospital and 42 from non-hospital) from Campo Grande, midwest Brazil. First, sewage samples were inoculated in a selective culture medium. Bacteria with reduced susceptibility to meropenem and ertapenem were then identified and their antimicrobial susceptibility was determined using the Vitek-2 system. The blaKPC genes were detected using PCR and further confirmed by sequencing. Carbapenem-resistant Enterobacteriaceae (CRE) were identified in both hospital (n=32) and non-hospital effluent (n=16), with the most common being Klebsiella pneumoniae and of the Enterobacter cloacae complex species. This is the first study to indicate the presence of the blaKPC-2 gene in carbapenem-resistant Enterobacteriaceae, classified as a critical priority by the WHO, in hospital sewage in this region. The dissemination of carbapenem antibiotic-resistant genes may be associated with clinical pathogens. Under favorable conditions and microbial loads, resistant bacteria and antimicrobial-resistance genes found in hospital sewage can disseminate into the environment, causing health problems. Therefore, sewage treatment regulations should be implemented to minimize the transfer of antimicrobial resistance from hospitals.

Investigation of Salmonella spp. in free-range chickens (Gallus gallus domesticus) in Southern Rio Grande do Sul / Pesquisa de Salmonella spp. em galinhas coloniais (Gallus gallus domesticus) no sul do Rio Grande do Sul

Salmonelose é uma doença causada por bactérias do gênero Salmonella, com importância para saúde pública e animal. Dentre os sorotipos hospedeiro-específicos, destaca-se o Gallinarum, que possui os biovares Gallinarum e Pullorum adaptados às aves e amplamente difundidos pelo mundo. Os dados sobre a ocorrência de Salmonella spp. em criações avícolas alternativas no Brasil são escassos. O objetivo deste estudo foi pesquisar a ocorrência de Salmonella spp. em galinhas coloniais encaminhadas para necropsia ao LRD/FV/UFPel. Foram realizadas análises histopatológicas, microbiológicas e moleculares das colônias bacterianas isoladas de 12 amostras de órgãos de galinhas domésticas dos municípios de Pelotas e Piratini, no Rio Grande do Sul. Na análise microbiológica, foram isoladas bactérias do gênero Salmonella sorotipo Gallinarum das 12 amostras, sendo 10/12 bioquimicamente compatíveis com biovar Gallinarum e 2/12 com biovar Pullorum. Na análise molecular PCR 11/12, 91,7% foram identificadas genotipicamente como Salmonella spp. O presente estudo demonstrou uma elevada frequência de isolamento de Salmonella Gallinarum biovar Gallinarum em aves sintomáticas criadas em regime extensivo. Além disso, os dados epidemiológicos das aves analisadas demonstram que a infecção por Salmonella Gallinarum nesses casos está associada ao contato com aves silvestres e falhas de manejo sanitário.(AU)

Doenças de felinos domésticos diagnosticadas no sul do Rio Grande do Sul: estudo de 40 anos / Domestic feline diseases diagnosed in southern Rio Grande do Sul: a 40-year study

O objetivo deste estudo foi identificar as principais doenças de felinos na região sul do Rio Grande do Sul. Foram revisados os protocolos de necropsia e das amostras biológicas de felinos encaminhados ao Laboratório Regional de Diagnóstico da Faculdade de Veterinária da Universidade Federal de Pelotas (LRD/UFPel), no período de 1978 a 2018. Nesse período foram recebidas 1633 amostras de felinos, sendo 363 (22%) entre os anos de 1978 e 1999 e 1270 (78%) entre os anos de 2000 e 2018. Com relação aos diagnósticos, 457 felinos (28%) apresentaram tumores benignos ou malignos, sendo os tegumentares e os mamários os mais frequentes. As doenças bacterianas, fúngicas, virais, parasitárias, sem agente definido e as intoxicações totalizaram 554 casos (33,9%), destacando-se a esporotricose, com 12,8% dos diagnósticos. Concluiu-se que, na região sul do RS, o encaminhamento de felinos para diagnóstico aumentou significativamente após o ano 2000, comprovando que a espécie passou a ter maior importância como animal de companhia. Concluiu-se, também, que as neoplasias têm papel relevante entre as doenças de felinos e que a esporotricose é uma das mais importantes zoonoses na região.(AU)

The goal of this paper was to identify the main disease affecting felines in the southern region of Rio Grande do Sul. The necropsy protocols and feline biological materials submitted to the Regional Diagnostic Laboratory of the Veterinary College of the Federal University of Pelotas (LRD / UFPel) were reviewed, from 1978 to 2018. During this period 1633 feline samples were received, 363 (22%) between 1978 and 1999 and 1270 (78%) between 2000 and 2018. 59% of felines did not present a defined breed. As for diagnoses, 457 felines (28%) presented benign or malignant tumors, the most common being the integumentary and mammary tumors. Bacterial, fungal, viral, parasitic or undefined agent infections and intoxications were observed in 554 cases (33.9%), especially sporotrichosis with 12.8 % of the diagnoses. It was concluded that in southern RS the referral of cats for diagnosis increased significantly after the year 2000, proving that they became more significant as companion animals. It was also concluded that neoplasia play a relevant role among feline diseases, and that sporotrichosis is one of the most important zoonoses in the region.(AU)

Outbreak of avian aspergillosis in colonial-bred chicks (Isa Brown) in southern Rio Grande do Sul - case report / [Surto de aspergilose aviária em pintainhas (Isa Brown) de criação colonial na região sul do Rio Grande do Sul - relato de caso]

In this study we describe the epidemiology, clinical signs, and pathology of an outbreak of avian aspergillosis in alternative breeding in the southern region of Rio Grande do Sul, Brazil. Between the fifth and tenth day of life, 360 chicks from a flock of 4000 developed unspecific clinical signs and died. The birds were housed in a reused aviary litter, without previous treatment. In 11 six-day-old female ISA Brown chicks (Gallus gallus domesticus), necropsy revealed firm, yellowish-white, multinodular lesions extending from the pleura to the lung parenchyma. Histologically, a granulomatous, multifocal to coalescent pneumonia was observed. Granulomas were characterized by central necrosis, with heterophil and epithelioid macrophage infiltration and presence of countless Y-shaped intralesional septate hyphae morphologically compatible with Aspergillus spp. The diagnosis through isolation confirmed Aspergillus fumigatus. We highlight the importance of aspergillosis as a primary cause of diseases in the respiratory tract of young birds in alternative breeding. Measures to prevent aspergillosis mainly regarding the reuse of aviary litter are essential in poultry husbandry to prevent economic losses, reduce environmental contamination and mitigate the potential risk to public health.(AU)

Descrevem-se os aspectos epidemiológicos e patológicos de um surto de aspergilose aviária em criação alternativa na região sul do Rio Grande do Sul, Brasil. De um lote de 4000 pintainhas, entre o quinto e o 10º dia de vida, 360 aves apresentaram sinais clínicos inespecíficos e morreram. As aves foram alojadas em cama reutilizada do aviário, sem tratamento prévio. Na necropsia de 11 pintainhas (Gallus gallus domesticus), fêmeas, seis dias de idade da linhagem Isa Brown, foram observadas no pulmão lesões multinodulares, branco-amareladas e firmes, que se estendiam da pleura ao parênquima. Histologicamente foi observada pneumonia granulomatosa, multifocal a coalescente. Os granulomas eram caracterizados por necrose central, com infiltrado inflamatório de heterófilos, macrófagos, células epitelioides com presença de inúmeras hifas septadas intralesionais, semelhantes à letra "Y", morfologicamente compatíveis com Aspergillus spp. O diagnóstico foi confirmado pelo isolamento de Aspergillus fumigatus. Alerta-se para a importância da aspergilose como causa primária de afecções no trato respiratório de aves jovens em criações alternativas. Medidas preventivas relacionadas ao manejo dessas aves são indispensáveis principalmente quanto à reutilização da cama dos aviários, a fim de evitar perdas econômicas, reduzir a contaminação ambiental e o potencial risco à saúde pública.(AU)

Meningioma microcístico com metástase pulmonar em canino: relato de caso / Microcystic meningioma with pulmonary metastasis in canine: case report

Meningiomas são os principais tumores primários do sistema nervoso central (SNC) que afetam cães e gatos. Na maioria dos casos, são neoplasias benignas, geralmente expansivas, causando compressão do SNC, e raramente fazem metástase para outros órgãos. O presente trabalho tem como objetivo relatar a ocorrência de um meningioma microcístico com metástase pulmonar em um canino de 11 anos de idade, com sinais clínicos de andar cambaleante, compressão da cabeça contra objetos, agitação, salivação e agressividade. Na necropsia, foram observadas, no encéfalo, massas bem delimitadas pardo-avermelhadas, firmes, de aspecto granular, localizadas no córtex parietal e nos núcleos da base. Inúmeras micronodulações de aspecto semelhante foram observadas no pulmão. Histologicamente observaram-se nódulos formados por células neoplásicas fusiformes, com núcleos grandes e alongados e nucléolos evidentes, dispostas de forma frouxa, formando vacúolos e microcistos. À imuno-histoquímica, o meningioma apresentou marcação fortemente positiva para citoqueratina e negativa para vimentina. Por meio da histopatologia e da imuno-histoquímica, foi possível estabelecer a classificação histológica de meningioma microcístico, bem como diferenciá-lo de outras doenças que cursam com sinais nervosos.(AU)

Meningiomas are the main tumors of the central nervous system (CNS) affecting dogs and cats. In most of the cases they are benign neoplasms, usually expansive, causing compression of the CNS and rarely metastasize to other organs. We describe the occurrence of a microcystic meningioma with pulmonary metastasis in an 11 - year - old canine with clinical signs of staggering gait, head compression against objects, agitation, salivation and aggressiveness. At necropsy, well-defined, firm, granular-looking masses located in the parietal cortex and nuclei of the base were observed in the encephalon. Numerous micronodulations of similar appearance were observed in the lung. Histologically, nodules formed by spindle neoplastic cells with large, elongated nuclei and evident nuclei were loosely arranged, forming vacuoles and microcysts. Immunohistochemistry were strongly positive for cytokeratin and negative for vimentin. Through the histopathology and immunohistochemistry, it was possible to establish the histological classification of microcystic meningioma, as well as to differentiate from other diseases that present with nervous signals.(AU)

Cell-free DNA as an obesity biomarker.

Obesity is a disease that affects about 13 % of the world population (2016) (Who 2018). This condition generates a process of systemic inflammation that may contribute to the release of cell-free DNA (cfDNA) into the bloodstream. cfDNA has been considered a potential biomarker to monitor several physiological and pathological conditions, such as tumors, exercise intensity and obesity. Therefore, the objective of this study was to evaluate the association of cfDNA levels with the amount of weight and fat mass lost six months after bariatric surgery. Thirty-eight subjects classified as obese (BMI, 43.5+/-6.2; BFP, 46.6+/-4.8) were evaluated anthropometrically and underwent bariatric surgery. Weight, BMI, body fat percentage (BFP), waist circumference, C-Reactive Protein (CRP) and cfDNA levels were evaluated before and six months after surgery; furthermore, a correlation was performed between cfDNA levels and BFP and CRP. Decrease in total body weight and CRP were observed after bariatric surgery; however, the cfDNA levels remained unchanged. There was a weak correlation between cfDNA levels and BFP before the bariatric surgery, and a moderate correlation between cfDNA and CRP. Obese subjects who underwent bariatric surgery, the decrease in body fat percentage did not result in changes in cfDNA levels six months after surgery.

Mandibular kinematic changes after unilateral cross-bite with lateral shift correction.

The aim of this randomised prospective study was to evaluate the effects of slow maxillary expansion with expansion plates and Hyrax expanders on the kinematics of the mandible after cross-bite correction. Thirty children (15 boys and 15 girls), aged 7·1-11·8, with unilateral cross-bite and functional shift were divided into two groups: expansion plate (n = 15) and Hyrax expander (n = 15). Thirty children with normal occlusion (14 boys and 16 girls, aged 7·3-11·6) served as control group. The maximum vertical opening, lateral mandibular shift (from maximum vertical opening to maximum intercuspation, from rest position to maximum intercuspation and from maximum vertical opening to rest position) and lateral excursions were recorded before and 4 months after treatment. After treatment, the expansion plate group showed a greater lateral shift from rest position to maximum intercuspation than did the control group. The expansion plate patients also presented greater left/contralateral excursion than did the control group. Comparisons of changes after treatment in the cross-bite groups showed significant decreases in the lateral shift from the maximum vertical opening to maximum intercuspation and from the maximum vertical opening to rest position, a significant increase in the homolateral excursion and a significant decrease in the contralateral excursion in the Hyrax expander group, whereas no significant differences were found in the expansion plate group. In conclusion, the Hyrax expander showed better results than did the expansion plate. The Hyrax expander with acrylic occlusal covering significantly improved the mandibular lateral shift and normalised the range of lateral excursion.

Detection of hepatitis C virus RNA in formalin-fixed paraffin-embedded sections with digoxigenin-labeled cRNA probes.

Although recent studies have analyzed Hepatitis C (HCV) infections in liver tissue by in situ hybridization (ISH), many of these studies have been of limited diagnostic utility because of the low copy numbers of HCV in formalin-fixed paraffin-embedded (FFPE) tissue and failure to correlate the ISH analysis with other methods of detecting HCV. Thirty six cases of liver biopsies from patients with known HCV antibody status including 20 cases of serum HCV positive and 16 cases of serum HCV negative were analyzed. All cases showed histologic features suggestion of HCV infection. Analyses of all 36 cases were done by RT-PCR combined with Southern hybridization (RT-PCR-SH) and in situ hybridization (ISH). A prolactin riboprobe was used as a negative control. Immunohistochemistry (IHC) with an antibody against HCV (Rb 246) was also used to analyze HCV viral protein in the tissues. Of the 20 serum antibody-positive cases, RT-PCR-SH detected 18 positive cases, while ISH and IHC detected 19 and 16 positive cases, respectively. Of the 16 serum antibody-negative cases, RT-PCR-SH detected 8 positive cases while ISH and IHC detected 8 and 11 positive cases, respectively. A positive ISH signal for HCV was also detected in some lymphocytes and bile ducts in the liver. These results show that ISH with a highly specific riboprobe is comparable to RT-PCR-SH for detection of HCV infection in liver tissue.

COX-2, MMP-9, and Noguchi classification provide additional prognostic information about adenocarcinoma of the lung. A study of 117 patients from Brazil.

We report immunohistochemical staining results for cyclooxygenase (COX)-2 and matrix metalloproteinase (MMP)-9 in primary tumors of 117 patients with resected adenocarcinoma of the lung (median follow-up, 20 months). For COX-2, we graded the degree of tumor staining according to the sum of staining intensity and the proportion of cells staining. For MMP-9, we used morphometry to quantify cytoplasmic staining. We used the Cox proportional hazards model to analyze overall survival. With only 29 patients censored at last follow-up, after controlling for the effect of pathologic stage, staining for COX-2 and MMP-9 and subtype of tumor were related significantly to survival (P < 6 x 10(-5)). The effects of COX-2 and MMP-9 were opposite. Whereas any staining for COX-2 decreased the hazard and increased survival time, increased staining for MMP-9 increased the hazard and decreased survival time. The results also suggested that staining for COX-2 decreases with dedifferentiation. Our results suggest that staining for the combination of COX-2 and MMP-9 and categorizing tumors into papillary and nonpapillary types may provide important prognostic information for patients with resected adenocarcinoma of the lung; it is possible that these 3 variables could aid decisions about postoperative adjuvant treatment.

Antimicrobial activity of essential oils isolated from Portuguese endemic species of Thymus.

AIMS: Thymus species are wild species mostly found in the arid lands of Portugal. Possible antimicrobial properties of Thymus essential oils have been investigated. The chemical composition of the essential oils and the antimicrobial activity of Thymus mastichina (L) L. subsp. mastichina, T. camphoratus and T. lotocephalus from different regions of Portugal were analysed. METHODS AND RESULTS: Hydrodistillation was used to isolate the essential oils and the chemical analyses were performed by gas chromatography (GC) and GC coupled to mass spectrometry. The antimicrobial activity was tested by the disc agar diffusion technique against Candida albicans, Escherichia coli, Listeria monocytogenes, Proteus mirabilis, Salmonella spp. and Staphylococcus aureus. Pure linalool, 1,8-cineole and a mixture (1 : 1) of these compounds were included. Linalool, 1,8-cineole or linalool/1,8-cineole and linalool/1,8-cineole/linalyl acetate were the major components of the essential oils, depending on the species or sampling place. The essential oils isolated from the Thymus species studied demonstrated antimicrobial activity but the micro-organisms tested had significantly different sensitivities. CONCLUSIONS: The antimicrobial activity of essential oils may be related to more than one component. SIGNIFICANCE AND IMPACT OF THE STUDY: Portuguese endemic species of Thymus can be used for essential oil production for food spoilage control, cosmetics and pharmaceutical use. Further studies will be required to elucidate the cell targets of the essential oil components.

Development of vegetable extracts by microencapsulation.

The microencapsulation of essential oils offers protection against oxidation and evaporation, and allows the concurrent utilization of several vegetable extracts. Complex coacervation methods have been described for essential oils. Even though microencapsulation involves wrapping the essential oils in shells, some difficulties arise in the process of stabilizing the essential oils: oil may be lost by evaporation and partial dissolution in the water-gelatin phase and this will vary with the type of essential oil being encapsulated. In order to investigate the efficacy of the gelatin-polyphosphate methods we analysed their essential oil microcapsules peppermint and rosemary, in particular their granulometric size distribution, oil content (%) and encapsulation yield (%). In addition the essential oils were analysed by GC before and after microencapsulation so as to investigate the loss of their components during the process.

Síndrome de Cushing por secreçäo ectópica de corticotrofina (ACTH) / Cushing's syndrome due to ectopic ACTH secretion

Avaliamos oito pacientes (4F e 4M) com quadro clínico de síndrome de Cushing por secreçäo ectópica de ACTH. A idade cronológica variou de 15 a 45 anos e o tempo de duraçäo da doença de 3 a 48 meses. Todos os pacientes apresentavam aspecto cushingóide e hipertensäo arterial e quatro revelavam hiperpigmentaçäo. Cinco pacientes portavam glicemia de jejum elevada e todos, exceto um caso, apresentavam hipopotassemia; K sérico = 2,2 a 3,9 m Eq/l. O ritmo circadiano do cortisol estava ausente em todos os pacientes e os níveis basais de cortisol estavam elevados em todos os pacientes, exceto em um caso; os níveis de ACTH, em sete pacientes avaliados elevados em seis (29 a 1.050pg/ml MRC). Em seis casos avaliados, näo houve depressäo dos níveis de cortisol sérico e de 17-OH urinário após dois dias de 2 mg de dexametasona; após dois dias de 8 mg de dexametasona, um paciente apresentou depressäo normal e um paciente, depressäo parcial dos níveis de 17-OH urinários. O teste da metopirona (750 mg VO 4/4 horas x 6 doses), realizado em realizado em sete pacientes, mostrou resposta normal de composto S e 17-OH urinário no caso que apresentava depressäo normal após 8 mg de dexametasona. Quatro pacientes eram portadores de carcinóides (três de timo e um de brônquio), dois de tumor de ilhotas do pâncreas, um de feocromocitoma bilateral e carcinoma medual e um carcinoma oat cell do pulmäo e carcinoma medular da tiróide. Seis pacientes faleceram num período de três anos após o diagnóstico. RX simples de tórax identificou lesäo primária em quatro casos, confirmada pela tomografia computadorizada (CT). A CT de abdome identificou feocromocitoma bilateral e revelou aumento difuso das adrenais em todos os casos. Sugerimos que RX de tórax e tomografia computadorizado de crânio, tórax e abdome sejam realizados rotineiramente em todos os casos de síndrome de Cushing, já que os achados clínicos e hormonais podem ser semelhantes na secreçäo ectópica de ACTH e doença de Cushing