Cuidado de Enfermagem à Pessoa com Paraplegia à Luz de Betty Neuman / Nursing Care for the Person with Paraplegia in the Light of Betty Neuman / Cuidados de enfermería a la persona con paraplejia a la luz de Betty Neuman

Objetivo: Relatar e compreender o cuidado de enfermagem à pessoa com paraplegia secundária a acidente automobilístico. Método:Estudo qualitativo descritivo, tipo relato de caso, realizado em hospital público de Feira de Santana/BA. Procedeu-se à entrevista, com uma participante em situação de paraplegia. Utilizou-se a elaboração da SAE e suas etapas considerando os aspectos da Teoria de Betty Neuman. Resultados:O relato da paciente e informações obtidas em prontuário demonstraram desinformações e condutas soltas que dificultam o cuidado, alimentavam sentimento de angústia e tristeza à paciente. Conclusão:proporcionou o entendimento acerca do indivíduo vítima de politrauma e suas necessidades, entendendo o adoecer com transcurso multifatorial onde segundo a teoria de Betty Neuman o ambiente e o indivíduo dialogam entre si surtindo efeito positivo e negativo sob o equilíbrio do corpo humano

Objective: To report and understand nursing care for individuals with paraplegia secondary to car accidents. Method:Descriptive qualitative study, in the form of a case report, conducted at a public hospital in Feira de Santana/BA. An interview was conducted with a participant in a paraplegic situation. The Nursing Process (NP) was developed, and its stages were considered, taking into account aspects of Betty Neuman's Theory. Results:The patient's account and information obtained from medical records revealed misinformation and disjointed behaviors that hindered care, fostering feelings of anguish and sadness in the patient. Conclusion:This study provided an understanding of individuals suffering from polytrauma and their needs, understanding illness as a multifactorial process where, according to Betty Neuman's theory, the environment and the individual interact, having both positive and negative effects on the balance of the human body.

Objetivo: Informar y comprender el cuidado de enfermería para personas con paraplejia secundaria a accidentes automovilísticos. Método:Estudio cualitativo descriptivo, tipo informe de caso, llevado a cabo en un hospital público en Feira de Santana/BA. Se realizó una entrevista con una participante en situación de paraplejia. Se utilizó el desarrollo del Proceso de Enfermería (PE) y sus etapas considerando los aspectos de la Teoría de Betty Neuman. Resultados:El relato de la paciente y la información obtenida de los registros médicos revelaron desinformación y conductas desarticuladas que dificultaron el cuidado, fomentando sentimientos de angustia y tristeza en la paciente. Conclusión:Este estudio proporcionó una comprensión de las necesidades de individuos que sufren politraumatismos, entendiendo la enfermedad como un proceso multifactorial donde, según la teoría de Betty Neuman, el entorno y el individuo interactúan, teniendo efectos tanto positivos como negativos en el equilibrio del cuerpo humano.

A 39-Year-Old Woman with Endometriosis Who Developed a Subcapsular Liver Hematoma Following Laparotomic Surgical Left Adnexectomy, Rectosigmoid Anastomosis, and Bilateral Ureteral Reimplantation.

BACKGROUND Endometriosis is a chronic inflammatory disease caused by endometrial tissue that grows outside the uterus. Deep endometriosis surgery is associated with considerable rates of complications, although such rates are lower in surgical procedures carried out by expert surgical teams. This report details a case of a rare but life-threatening complication in the postoperative period following 72 h of endometriosis surgery: a giant subcapsular hepatic hematoma, which was successfully managed conservatively. CASE REPORT Here we describe the case of a 39-year-old woman with deep endometriosis with ureteral, ovarian, and intestinal involvement requiring multidisciplinary surgery. She presented with severe anemia, respiratory distress, and oliguria 72 h postoperatively. A 3-phase computed tomography (CT) scan revealed a giant intrahepatic subcapsular hematoma (180×165×50 mm) lateral to the right hepatic lobe, which was managed conservatively. The patient evolved favorably and the hematoma was reduced (77×16 mm) in a follow-up CT scan performed 5 months later. CONCLUSIONS Giant liver hematoma is a rare, life-threatening complication. The current experience relating to its management remains largely limited owing to the rarity of the condition and paucity of published cases. Actually, we found no articles on hepatic hematoma in the context of endometriosis surgery. Early diagnosis and treatment are essential to reduce the patient's risk of death. Imaging diagnosis plays an essential role.

INCIDENCE OF SMALL FOR GESTATIONAL AGE NEONATES, ACCORDING TO THE FENTON AND INTERGROWTH-21ST CURVES IN A LEVEL II MATERNITY.

OBJECTIVE: To compare the incidence of small for gestational age infants among late preterm and term newborns, using the Fenton and Intergrowth-21st curves. METHODS: Observational and retrospective study with newborns in a level II maternity. The study was approved by the Institution's Ethics Committee. Live births from July 2007 to February 2009 with a gestational age from 34 to 41 weeks and seven days were included. Neonates with incomplete data were excluded. Appropriate weight for gestational age was assessed by the Fenton and Intergrowth-21st intrauterine growth curves, considering birth weight <10th percentile as small for gestational age. The degree of agreement between the two curves was assessed by the Kappa coefficient. Numerical variables were compared using the Student t-test or the Mann-Whitney. Categorical variables were compared using the chi-square test. Statistical analyzes were performed using SPSS17® software, considering significant, p<0.05. RESULTS: We included 2849 newborns with a birthweight of 3210±483 g, gestational age of 38.8±1.4 weeks; 51.1% male. The incidence of small for gestational age in the full sample was 13.0 vs. 8.7% (p<0.001, Kappa=0.667) by the Fenton and Intergrowth-21st curves, respectively. Among late preterm, the incidence of small neonates was 11.3 vs. 10.9% (p<0.001; Kappa=0.793) and among full-term infants it was 13.1% vs. 8.5% (p<0.001; Kappa=0.656), respectively for the Fenton and Intergrowth-21st curves. CONCLUSIONS: The incidence of small for gestational age newborns was significantly higher using the Fenton curve, with greater agreement between the Fenton and Intergrowth-21st curves among late preterm, compared to full term neonates.

Incidence of small for gestational age neonates, according to the fenton and intergrowth-21st curves in a level ii maternity / Incidência de recém-nascidos pequenos para a idade gestacional segundo curva de fenton e intergrowth-21st em uma maternidade de nível secundário

ABSTRACT Objective: To compare the incidence of small for gestational age infants among late preterm and term newborns, using the Fenton and Intergrowth-21st curves. Methods: Observational and retrospective study with newborns in a level II maternity. The study was approved by the Institution's Ethics Committee. Live births from July 2007 to February 2009 with a gestational age from 34 to 41 weeks and seven days were included. Neonates with incomplete data were excluded. Appropriate weight for gestational age was assessed by the Fenton and Intergrowth-21st intrauterine growth curves, considering birth weight <10th percentile as small for gestational age. The degree of agreement between the two curves was assessed by the Kappa coefficient. Numerical variables were compared using the Student t-test or the Mann-Whitney. Categorical variables were compared using the chi-square test. Statistical analyzes were performed using SPSS17® software, considering significant, p<0.05. Results: We included 2849 newborns with a birthweight of 3210±483 g, gestational age of 38.8±1.4 weeks; 51.1% male. The incidence of small for gestational age in the full sample was 13.0 vs. 8.7% (p<0.001, Kappa=0.667) by the Fenton and Intergrowth-21st curves, respectively. Among late preterm, the incidence of small neonates was 11.3 vs. 10.9% (p<0.001; Kappa=0.793) and among full-term infants it was 13.1% vs. 8.5% (p<0.001; Kappa=0.656), respectively for the Fenton and Intergrowth-21st curves. Conclusions: The incidence of small for gestational age newborns was significantly higher using the Fenton curve, with greater agreement between the Fenton and Intergrowth-21st curves among late preterm, compared to full term neonates.

RESUMO Objetivo: Comparar a incidência de neonatos pequenos para idade gestacional entre nascidos vivos pré-termo tardios e a termo utilizando as curvas de Fenton e Intergrowth-21st. Métodos: Estudo observacional retrospectivo com recém-nascidos de uma maternidade pública de nível secundário. Foram incluídos nascidos vivos de julho/2007 a fevereiro/2009 com idade gestacional de 34 a 41 semanas e seis dias. O estudo foi aprovado pelo Comitê de Ética da instituição. Foram excluídos recém-nascidos com dados incompletos. Para adequação do peso/da idade gestacional, utilizaram-se as curvas de crescimento intrauterino de Fenton e Intergrowth-21st, considerando-se pequeno aquele com peso ao nascer <10º percentil. O grau de concordância entre as duas curvas foi avaliado pelo coeficiente Kappa. As variáveis numéricas foram comparadas pelo teste t de Student ou de Mann-Whitney, conforme distribuição, e as categóricas pelo teste χ2. As análises estatísticas foram realizadas no programa Statistical Package for the Social Sciences (SPSS) 17®, considerando-se significante p<0,05. Resultados: Foram incluídos 2.849 recém-nascidos com peso ao nascer de 3210±483 g, idade gestacional de 38,8±1,4 semanas, sendo 51,1% masculinos. A incidência de recém-nascidos pequenos para a idade gestacional pela curva de Fenton e Intergrowth-21st na amostra total foi, respectivamente, de 13 e 8,7% (p<0,001; Kappa=0,667). Entre os pré-termo tardios, a incidência foi de 11,3 e 10,9% (p<0,001; Kappa=0,793) e entre os nascidos a termo foi de 13,1 e 8,5%, (p<0,001; Kappa=0,656), respectivamente, para as curvas de Fenton e Intergrowth-21st. Conclusões: A incidência de recém-nascidos pequenos para idade gestacional foi significantemente maior pela curva de Fenton, com maior concordância entre as curvas de Fenton e Intergrowth-21st em recém-nascidos pré-termo tardios do que nos nascidos a termo.

Elefantiasis verrugosa nostra asociada a linfedema crónico y acroangiodermatitis de mali (pseudo sarcoma de Kaposi). Reporte de caso / Elephantiasis nostra verrucosa associated with chronic lymphedema and acroangiodermatitis of mali (pseudo sarcoma of Kaposi). Case report

La elefantiasis verrugosa nostra es una patología poco frecuente secundaria a linfedema crónico no filariásico, con la consecuente deformación y aumento de volumen del miembro afecto acompañado de un engrosamiento excesivo de la piel. Presentamos el caso de un paciente de sexo masculino con hiperplasia verrugosa en miembros inferiores secundaria a linfedema crónico por trastornos de la circulación venolinfática.

The elephantiasis nostra verrucosa is a rare pathology secondary to chronic non-filarial lymphedema, with the consequent deformation and volume increase of the affected limb accompanied by excessive thickening of the skin. We present the case of a male patient with verrucous hyperplasia in the lower limbs secondary to chronic lymphedema due to disorders of the venolymphatic circulation.

Muscle mass to visceral fat ratio is an important predictor of the metabolic syndrome in college students.

This study aimed to evaluate the associations between the muscle mass to visceral fat (MVF) ratio and cardiometabolic risk factors in a large population of college students in Colombia and to propose cut-off points of this index for the metabolic syndrome (MetS). A total of 1464 young adults recruited from the FUPRECOL (Asociación de la Fuerza Prensil con Manifestaciones Tempranas de Riesgo Cardiovascular en Jóvenes y Adultos Colombianos) study were categorised into four groups based on their MVF ratio. Muscle mass and visceral fat level of the participants were measured using a bioelectrical impedance analysis. Cardiometabolic risk factors including lifestyle characteristics, anthropometry, blood pressure and biochemical parameters were assessed. The prevalence of moderate to severe obesity, hypertension and the MetS was higher in subjects in quartile (Q)1 (lower MVF ratio) (P <0·001). ANCOVA revealed that the subjects in Q1 had higher cardiometabolic disturbances, including altered anthropometry, blood pressure, muscle strength and biochemical parameters after adjusting for age and sex compared with young adults in higher MVF ratio quartiles (P <0·001). Muscular mass and physical activity levels were significantly lower in subjects with a lower MVF ratio (P <0·001). The receiver operating characteristic curve analyses indicated that in men the best MVF ratio cut-off point for detecting the MetS was 18·0 (AUC 0·83, sensitivity 78 % and specificity 77 %) and for women, the MVF ratio cut-off point was 13·7 (AUC 0·85, sensitivity 76 % and specificity 87 %). A lower MVF ratio is associated with a higher risk cardiometabolic profile in early adulthood, supporting that the MVF ratio could be used as a complementary screening tool that may help clinicians identify young adults at high cardiometabolic risk.

High rate of virologic suppression with darunavir/ritonavir plus optimized background therapy among highly antiretroviral-experienced HIV-infected patients: results of a prospective cohort study in São Paulo, Brazil

OBJECTIVES: To assess the virologic and immunological response of darunavir/ritonavir plus optimized background therapy in highly antiretroviral-experienced HIV-infected patients in Brazil. METHODS: Prospective cohort study carried out in a tertiary center in Sao Paulo, Brazil. Three-class antiretroviral-experienced patients with confirmed virologic failure began darunavir/ritonavir plus optimized background therapy (nucleoside/tide reverse transcriptase inhibitors ± raltegravir ± enfuvirtide ± maraviroc) after performing a genotypic resistance assay. Clinical evaluation and laboratory tests were collected at baseline and at weeks 12, 24, and 48. Multivariate analysis was performed to identify predictors of virologic response at 48 weeks. RESULTS: Ninety-two patients were included. The median of darunavir resistant mutation was 1 (range 0-6). The median genotypic sensitivity score in the optimized background therapy was 2 (interquartile range 1-2). At week 48, 83% (95% CI: 75-90%) had an HIV RNA level <50 copies/mL and the median CD4 cell count was 301 (interquartile range 224-445) cells/mm³. Baseline HIV RNA >100 000 copies/mL was inversely associated with virologic success at week 48 (HR: 0.22, 95% CI: 0.06-0.85, p = 0.028). CONCLUSIONS: Darunavir/ritonavir plus optimized background therapy was a highly effective salvage regimen under clinical routine conditions in a referral center in Brazil, which is similar to the reported in high-income countries.

High rate of virologic suppression with darunavir/ritonavir plus optimized background therapy among highly antiretroviral-experienced HIV-infected patients: results of a prospective cohort study in São Paulo, Brazil.

OBJECTIVES: To assess the virologic and immunological response of darunavir/ritonavir plus optimized background therapy in highly antiretroviral-experienced HIV-infected patients in Brazil. METHODS: Prospective cohort study carried out in a tertiary center in Sao Paulo, Brazil. Three-class antiretroviral-experienced patients with confirmed virologic failure began darunavir/ritonavir plus optimized background therapy (nucleoside/tide reverse transcriptase inhibitors ± raltegravir ± enfuvirtide ± maraviroc) after performing a genotypic resistance assay. Clinical evaluation and laboratory tests were collected at baseline and at weeks 12, 24, and 48. Multivariate analysis was performed to identify predictors of virologic response at 48 weeks. RESULTS: Ninety-two patients were included. The median of darunavir resistant mutation was 1 (range 0-6). The median genotypic sensitivity score in the optimized background therapy was 2 (interquartile range 1-2). At week 48, 83% (95% CI: 75-90%) had an HIV RNA level <50 copies/mL and the median CD4 cell count was 301 (interquartile range 224-445) cells/mm(3). Baseline HIV RNA >100000 copies/mL was inversely associated with virologic success at week 48 (HR: 0.22, 95% CI: 0.06-0.85, p=0.028). CONCLUSIONS: Darunavir/ritonavir plus optimized background therapy was a highly effective salvage regimen under clinical routine conditions in a referral center in Brazil, which is similar to the reported in high-income countries.

Evaluation of rapid tests for human immunodeficiency virus as a tool to detect recent seroconversion

The identification of recent HIV infection is important for epidemiological studies and to monitor the epidemic. The objective of this study was to evaluate two rapid tests that are easily available to the Brazilian scientific community for using as markers of recent HIV infection. The Rapid Test - HIV-1/2 Bio-Manguinhos (Bio-Manguinhos/Fiocruz, Brazil) and the Rapid Check HIV 1&2 (NDI-UFES, Center for Infectious Diseases, Universidade Federal do Espírito Santo) were tested, using 489 samples with HIV positive serology, from blood donors, previously classified as recent or long-term infection by serological testing algorithm for recent HIV seroconversion (STARHS) or LS-HIV Vitros assay methods. The samples were diluted prior to testing (1:50 and 1:100 for the Rapid Test - HIV-1/2 Bio-Manguinhos, and 1:500 and 1:600 for the Rapid Check HIV 1&2). Negative samples were considered recent infection, whereas those showing any color intensity were associated with long-term infection. The best dilutions were 1:100 for HIV-1/2 Bio-Manguinhos test (Kappa = 0.840; overall agreement = 0.93), and 1:500 for the Rapid Check HIV 1&2 (Kappa = 0.867; overall agreement = 0.94). The results suggest that both rapid tests can be used to detect recent seroconversion.

Evaluation of rapid tests for human immunodeficiency virus as a tool to detect recent seroconversion.

The identification of recent HIV infection is important for epidemiological studies and to monitor the epidemic. The objective of this study was to evaluate two rapid tests that are easily available to the Brazilian scientific community for using as markers of recent HIV infection. The Rapid Test - HIV-1/2 Bio-Manguinhos (Bio-Manguinhos/Fiocruz, Brazil) and the Rapid Check HIV 1&2 (NDI-UFES, Center for Infectious Diseases, Universidade Federal do Espírito Santo) were tested, using 489 samples with HIV positive serology, from blood donors, previously classified as recent or long-term infection by serological testing algorithm for recent HIV seroconversion (STARHS) or LS-HIV Vitros assay methods. The samples were diluted prior to testing (1:50 and 1:100 for the Rapid Test - HIV-1/2 Bio-Manguinhos, and 1:500 and 1:600 for the Rapid Check HIV 1&2). Negative samples were considered recent infection, whereas those showing any color intensity were associated with long-term infection. The best dilutions were 1:100 for HIV-1/2 Bio-Manguinhos test (Kappa = 0.840; overall agreement = 0.93), and 1:500 for the Rapid Check HIV 1&2 (Kappa = 0.867; overall agreement = 0.94). The results suggest that both rapid tests can be used to detect recent seroconversion.

Immunomodulatory effects of aqueous and organic fractions from Petiveria alliacea on human dendritic cells.

Petiveria alliacea is a plant traditionally known for its anti-inflammatory and anti-tumor activities; however, the molecular and cellular mechanisms of its immunomodulatory properties are still unknown. Dendritic cells (DC) promote adaptive immune response by activating T lymphocytes, inducing an effector response or tolerance depending on the DC differentiation level. Herein, we evaluated the immunomodulatory activity of aqueous and organic plant fractions from P. alliacea using human monocyte-derived dendritic cells. The phenotype, cytokine secretion and gene expression were estimated after treatment with the plant fractions. We found that P. alliacea aqueous fraction induced morphological changes and co-stimulatory expression of CD86, indicating partial DC maturation. In addition, pro-inflammatory cytokines such as IL-1ß, IL-6, IL-8, IL-10, IL-12p70, and TNF-α were secreted. The fraction also increased NF-κB gene expression while down-regulating TGFß gene expression. These results suggest that the aqueous fraction can induce partial DC activation, a situation that can be relevant in tolerance induction. It is important to state that the organic fraction by itself does not show any immunomodulatory activity. This study provides evidence for possible immunomodulatory activity of P. alliacea extracts which has been used in traditional medicine in Colombia.

Dirofilaria immitis: una zoonosis presente en el mundo / Dirofilaria immitis: a zoonoses present on a global level / Dirofilaria immitis: uma zoonose presente a nível mundial

La dirofilariasis, causada por Dirofilaria immitis, o gusano del corazón del perro, es una enfermedad de distribución mundial transmitida por mosquitos de los géneros Aedes, Anopheles,Culex y Taeniorhynchus; en humanos, esta filaria causa lesiones cutáneas y pulmonares, aunque ya se han reportado casos de dirofilariasis humana con localizaciones diferentes tales como grandes vasos mesentéricos, peritoneales, cordón espermático y aun en lado derecho del corazón. En el humano, a diferencia del perro, no hay una filaremia. Los síntomas más comunes son: dolor retroesternal, tos y hemoptisis. Un nódulo fibrótico (de uno a tres centímetros de diámetro) muchas veces es asintomático y se identifica solo en las radiografías de tórax como una lesión en forma de moneda. En los Estados Unidos existen unos cincuenta casos reportados en humanos, aunque también se han reportado casos en Japón, Asia, Australia, Brasil y Argentina. En la Universidad de La Salle se realizó una investigación para determinar la frecuencia de presentación de la Dirofilaria immitis en perros de Bogotá D. C (2600 msnm) mediante la prueba enzimática de Elisa Petchek®, la cual es específica y no presenta reacción cruzada con otros parásitos, brindando un diagnóstico rápido y certero de la enfermedad. Se encontró una frecuencia del 1%, de perros positivos a Dirofilaria immitis; si se tiene en cuenta que en esta ciudad hay una población aproximada de 800.000 perros, el posible número de animales positivos al parásito estaría en el orden de 8.000 perros, que potencialmente podrían transmitir la enfermedad al humano a través de la picadura de los mosquitos.

The Dirofilaria immitis or heartworm is a worldwide distribution disease spread by mosquitoes of the Aedes, Anopheles, Culex and Taeniorhynchus kind; in humans, this filaria causes skin and lung lesions, though some cases of human dirofilariasis have already been reported with different locations, such as large mesenteric vessels, peritoneal vessels, the spermatic cord and even the right side of the heart. Unlike in dogs, there is no filaremia in humans. The most common symptoms are: retrosternal pain, coughing and hemoptysis. A fibrotic nodule (with a diameter from one to three centimeters) is often asymptomatic and can only be identified in chest X-rays as a coin-shaped lesion. Around fifty cases have been reported in humans in the United States, although cases have also been reported in Japan, Asia, Australia, Brazil and Argentina. A research was carried out at La Salle University in order to determine the frequency with which Dirofilaria immitis occurs in dogs in Bogotá D.C. (2600 meters over sea level) through the Elisa Petchek® enzyme test, which is specific and does not show any crossed reactions with other parasites, thus providing a quick and accurate diagnosis of the disease. A frequency of 1% was found of dogs that came out positive with Dirofilaria immitis. Considering that the dog population in this city is of approximately 800,000, the possible number of animals that would come out positive for the parasite would be of around 8,000 dogs, which could potentially spread the disease to humans through a mosquito bite.

A Dirofilaria immitis, ou verme do coração do cachorro, é uma doença de distribuição mundial transmitida por mosquitos dos gêneros Aedes, Anopheles, Culex e Taeniorhynchus; em humanos, esta filaria causa lesões cutâneas e pulmonares, entretanto já foram relatados casos de dirofilariose humana com localizações diferentes tais como grandes vasos mesentéricos, peritoneais, cordão espermático e também no lado direito do coração. No humano, ao contrário do cachorro, não há uma filaremia. Os sintomas mais comuns são: dor retroesternal, tosse e hemoptise. Um nódulo fibrótico (de um a três centímetros de diâmetro) muitas vezes é assintomático e se identifica somente nas radiografias de tórax como uma lesão em forma de moeda. Nos Estados Unidos existem uns cinquenta casos relatados em humanos, entretanto também foram relatados casos no Japão, na Ásia, na Austrália, no Brasil e na Argentina. Na Universidade de La Salle realizou-se uma pesquisa para determinar a frequência de apresentação da Dirofilaria immitis em cachorros de Bogotá D. C (2600 m de altitude) mediante o teste enzimático de Elisa Petchek®, o qual é específico e não apresenta reação cruzada com outros parasitas, oferecendo um diagnóstico rápido e certeiro da doença. Foi encontrada uma frequência de 1%, de cachorros positivos para Dirofilaria immitis; considerando que nesta cidade há uma população aproximada de 800.000 cachorros, o possível número de animais positivos ao parasita estaria na ordem de 8.000 cachorros, que potencialmente poderiam transmitir a doença ao humano através da picada dos mosquitos.

Avaliação das relações entre ensino e aprendizado de imunologia: diagnóstico para mudança / Assessment of the relationship between teaching and learning immunology: diagnosis for change

As diretrizes curriculares nacionais (DCN) em suas orientações para o ensino superior indicam as principais habilidades e competências necessárias ao desempenho profissional efetivo. A prática atual de ensino de imunologia é focada apenas no ensino dos conteúdos e não tem contribuído para o aprendizado significativo e mudança conceitual pelos estudantes...O plano didático criado e implementado foi efetivo visto que os estudantes: identificaram a importância da reflexão e do método científico no aprendizado de disciplina científica, manifestando-se positivamente quanto ao alcance de suas expectativas e ao aproveitamento dos recursos didáticos para o aprendizado. E por fim, o desenvolvimento docente é importante para a concretização acertada de um plano didático teoricamente fundamentado.

Determinación de los valores fisiológicos del sodio, el potasio y el ion calcio en plasma, con su variación pre y postejercicio, en caballos de paso fino en la sabana de Bogotá / Determination of the physiological plasmatic values of sodium, potassium and ion calcium and its pre and post exercise variations in paso fino horsesin the bogota savannah

Este estudio presenta el análisis y los resultados del comportamiento de los electrolitos sodio (Na+), potasio (K+) y calcio iónico (iCa2+) en equinos de paso fino colombiano. Se establecieron los valores de referencia en reposo y la respuesta de los electrolitos ante el ejercicio. Se utilizaron 115 equinos en edad de competencia, hembras y machos, entre 43 y 78 meses de edad, de diferentes criaderos de la Sabana de Bogotá. Se tomaron tres muestras en diferentes tiempos: T0 (reposo), T1 (inmediatamente después de 45 minutos de ejercicio) y T2 (1 hora posejercicio). Las muestras se procesaron en un analizador portátil i-STAT®, utilizando el cartucho EG7+, y los resultados fueron analizados usando estadística descriptiva y pruebas de comparación múltiples de promedio a través de la prueba de Tukey. Como resultado, se obtuvieron los valores normales para la raza en los diferentes tiempos y se estableció la curva de comportamiento de los electrolitos según los valores estadísticamente significativos, con un nivel de confianza superior a 95%. Los resultados fueron los valores normales para la raza en los diferentes tiempos y la curva de comportamiento de los electrolitos. Los valores obtenidos en mEq/L fueron: para T0: Na+ (136,71+/-0,23), K+ (4,05+/-0,03), Ca2+ (1,58+/-0,006); para T1: Na+ (136,44+/-0,24), K+ (3,92+/-0,24), Ca2+ (1,42+/-0,0080); y para T2: Na+ (137,32+/-0,23), K+ (3,68+/-0,03), Ca2+ (1,51+/- 0,009). El Na+ en el T2 aumentó significativamente después del reposo pos ejercicio, mientras que los valores de K+ y Ca2+ disminuyeron en T1. El ion calcio aumentó de manera significativa en T2 contrariamente al K+ que disminuyó. Esta investigación busca generar un aporte a la medicina deportiva equina colombiana, ya que no hay literatura reportada sobre datos de referencia para los valores de electrolitos en la raza paso fino colombiano.

This research intends to be a contribution to the Colombian sports equine medicine by providing data on electrolytes standards, a field where there is a substantial lack of literature. This research analyzeand determines the normal values of sodium (Na+), potassium (K+) and ion calcium (iCa2+) electrolytes for Colombian Paso Fino horses. The establishment of the reference intervals was done at rest and after exercise. To achieve this, blood samples were taken from farms located in the Bogotá savannah. The 115 mares and stallions used for this study were actively competing with ages ranging from 43 to 78 months old. The samples were taken at three intervals: T0 (Rest), T1 (inmediately after 45 minutes of exercise), and T2 (1 hour post exercise). The samples were processed using a portable blood analyzer i-STAT® and the data was interpreted using descriptive and comparative statistic according to Tukey tests. The normal values for the breed were established and an electrolytic behaviorcurve was created, using values inside intervals at 95% confidence levels. The values obtained in mEq/L were: for T0: Na+ (136,71+/-0,23), K+ (4,05+/- 0,03), Ca2+ (1,58+/-0,006); for T1: Na+ (136,44+/- 0,24), K+ (3,92+/-0,24), Ca2+ (1,42+/-0,008); and for T2: Na+ (137,32+/-0,23), K+ (3,68+/-0,03), Ca2+ (1,51+/-0,009). Na+ values increased after exercise. On the contrary K+ and Ca2+ values didn’t increase in T1. Calcium increased on T2 and K+ decreased. The findings of this research will serve as a framework for future analysis. Moreover, further studies and developmentsin this field is recommended and will prove to be very useful for equine practitioners.

Near full-length genome analysis of low prevalent human immunodeficiency virus type 1 subclade F1 in São Paulo, Brazil.

BACKGROUND: The genetic diversity of the human immunodeficiency virus type 1 (HIV-1) is critical to lay the groundwork for the design of successful drugs or vaccine. In this study we aimed to characterize and define the molecular prevalence of HIV-1 subclade F1 currently circulating in São Paulo, Brazil. METHODS: A total of 36 samples were selected from 888 adult patients residing in São Paulo who had previously been diagnosed in two independent studies in our laboratory as being infected with subclade F1 based on pol subgenomic fragment sequencing. Proviral DNA was amplified from the purified genomic DNA of all 36 blood samples by 5 fragments overlapping PCR followed by direct sequencing. Sequence data were obtained from the 5 fragments of pure subclade F1 and phylogenetic trees were constructed and compared with previously published sequences. Subclades F1 that exhibited mosaic structure with other subtypes were omitted from any further analysis RESULTS: Our methods of fragment amplification and sequencing confirmed that only 5 sequences inferred from pol region as subclade F1 also holds true for the genome as a whole and, thus, estimated the true prevalence at 0.56%. The results also showed a single phylogenetic cluster of the Brazilian subclade F1 along with non-Brazilian South American isolates in both subgenomic and the full-length genomes analysis with an overall intrasubtype nucleotide divergence of 6.9%. The nucleotide differences within the South American and Central African F1 strains, in the C2-C3 env, were 8.5% and 12.3%, respectively. CONCLUSION: All together, our findings showed a surprisingly low prevalence rate of subclade F1 in Brazil and suggest that these isolates originated in Central Africa and subsequently introduced to South America.

Determinación de frecuencia cardiaca, frecuencia respiratoria, lactato deshidrogenasa, creatinkinasa y ácido láctico en caballos durante competencia de salto en la Sabana de Bogotá / Determination of cardiac and respiratory rate, Lactate dehydrogenase, creatin kinase and lactic acid during a horse jumping competition in Bogotá

El estudio presenta los primeros resultados de investigación en variables fisiológicas y sus cambios por el ejercicio en equinos en competencia de salto en el país. Se utilizarin 24 ejemplares de las razas Silla Argentina, PSI y mestizo de la Escuela de Equitación del Ejercito Nacional de Colombia, que participaron en pruebas de salto (1,10 – 1,20 m) en diferentes centros ecuestres de la Sabana de Bogotá. Se determinó frecuencia cardiaca, frecuencia respiratoria y enzimas musculares (creatinquinasa (CK), lactato deshidrogenasa (LDH) y el ácido láctico). Se tomaron tres muestras: reposo, inmediatamente después del ejercicio y a las 6 horas posejercicio. Para la frecuencia cardiaca se utilizó un monitor POLAR S625; la frecuencia respiratoria se determinó mediante fonendoscopio; y las enzimas y el ácido láctico se analizaron en laboratorio. Se utilizó el método estadístico ANAVA para enzimas musculares y acido láctico y estadística descriptiva para frecuencia cardiaca y respiratoria. En los resultados se encontró un comportamiento estadísticamente significativo (p < 0.05) del ácido láctico y la enzima creatinkinasa, a diferencia del comportamiento de la enzima lactato deshidrogenasa, que fue no significativo. Las frecuencias cardiaca y respiratoria se elevaron de manera significativa posejercicio y regresaron a lo normal alrededor de las 6 horas. El ácido láctico se incrementó posejercicio y disminuyó a las 6 horas, contrario a lo reportado por otros autores. Se concluye que una vez analizadas estas variables, hay diferencias con los valores obtenidos por otros autores, que pueden deberse a la altitud, al tipo y tiempo de ejercicio realizado. Por tanto es indispensable continuar haciendo estudios en este campo...

Distinct resistance mutation and polymorphism acquisition in HIV-1 protease of subtypes B and F1 from children and adult patients under virological failure.

The goal of this work was to compare the differences between human immunodeficiency virus type 1 (HIV-1) of B and F1 subtypes in the acquisition of major and minor protease inhibitor (PI)-associated resistance mutations and of other polymorphisms at the protease (PR) gene, through a cross sectional study. PR sequences from subtypes B and F1 isolates matched according to PI exposure time from Brazilian patients were included in this study. Sequences were separated in four groups: 24 and 90 from children and 141 and 99 from adults infected with isolates of subtypes F1 and B, respectively. For comparison, 211 subtype B and 79 subtype F1 PR sequences from drug-naïve individuals were included. Demographic and clinical data were similar among B- and F1-infected patients. In untreated patients, mutations L10V, K20R, and M36I were more frequent in subtype F1, while L63P, A71T, and V77I were more prevalent in subtype B. In treated patients, K20M, D30N, G73S, I84V, and L90M, were more prevalent in subtype B, and K20T and N88S were more prevalent in subtype F1. A higher proportion of subtype F1 than of subtype B strains containing other polymorphisms was observed. V82L mutation was present with increased frequency in isolates from children compared to isolates from adults infected with both subtypes. We could observe a faster resistance emergence in children than in adults, during treatment with protease inhibitors. This data provided evidence that, although rates of overall drug resistance do not differ between subtypes B and F1, the former accumulates resistance at higher proportion in specific amino acid positions of protease when compared to the latter.

Comportamiento de los electrolitos: Sodio, Cloro y Potasio pre y post ejercicio en equinos atletas de alto rendimiento en salto en Bogotá / Electolitic of sodium,clorum and patassium, pre and post excersive in high performance athletic jumping hor ses at Bogotá

Se determinó y analizó el comportamiento de los electrolitos sodio (Na+), cloro (CL-) y potasio (K+) en equinos atletas de alto rendimiento en salto en Bogotá, con el fin de establecer los valores normales en reposo y la respuesta de los electrolitos al ejercicio. Las muestras fueron tomadas en la Escuela de equitación del Ejército Nacional, Club los Arrayanes y la Escuela de Carabineros de la Policía Nacional (CESPO) en la ciudad de Bogotá. Se utilizaron 40 equinos deportistas de salto alto, hembras y machos, entre los 6 y los 12 años de edad. Se tomaron muestras en cuatro tiempos: T0(Reposo), T1 (inmediatamente despues de los saltos), T2 (entre media y una hora después de los saltos) y T3 (entre la 1 hora y hora y media después de los saltos). Como resultado se obtuvo los valores normales en los diferentes tiempos y se estableció la curva de comportamiento de los electrolitos. Los valores obtenidos en mmol/L fueron: para el T0: sodio:140.70+/-2.61, Potasio:3.67+/-0.98, cloro: 101.76+/-1.48; para el T1: sodio: 130.56+/-34.59, potasio: 4.34+/-0.29, cloro: 103.81+/-2.07; para el T2 Sodio: 129.92+/-33.48 potasio: 3.79+/-0.29, cloro: 10.1.21+/-2.22; y, por último, el T3: sodio: 139.07+/-3.96, potasio: 3.90+/-0.37, cloro: 101.07+/-2.28. este trabajo es un gran aporte a la medicina deportiva del país ya que esta información no existía en el país y se puede trabajar ahora la medicina deportiva con fundamentos científicos...

Drug resistance among chronic HIV-1-infected patients naïve for use of anti-retroviral therapy in Sao Paulo city.

Primary infection with drug-resistant HIV appears to be increasing in the regions where HAART is widely available, which may reduce efficacy of first-line antiretroviral therapy. To determine prevalence of antiretroviral drug-resistant mutations in newly diagnosed subjects in a clinical setting where HAART has been widely used since 1997. One hundred and thirty-six HIV-1-infected adult patients were diagnosed with HIV infection between January 2000 and December 2006 in the HIV out-clinic at the HC/FMUSP, Sao Paulo city. These antiretroviral naïve patients were mainly referred from the blood bank, situated in the same building or elsewhere in the city. The samples were genotyped to provide HIV protease and reverse transcriptase sequence data. Major antiretroviral drug resistance mutations were classified according to Shafer et al. [Shafer, R.W., Rhee, S.Y., Pillay, D., et al., 2007. HIV-1 protease and reverse transcriptase mutations for drug resistance surveillance. AIDS 21, 215-223]. Thirteen cases had no DNA amplification, and 123 patients were successfully analyzed, with a mean age of 37 years and 89 (72%) were males. Antiretroviral drug resistance mutations were detected in 8/123 patients (6.5%), all eight were heterosexuals and HIV asymptomatic, the mean of the CD4 cells count was 323 cells/mm(3), and the RNA plasma viral load was 4.7 log(10)/mL. We found NRTI (n=2, 1.6%), NNRTI-resistant (n=2, 1.6%) mutations, and one cases with PI mutation (0.8%). Three cases (2.4%) showed mutations for NRTI, NNRTI or PI, simultaneously. Eighty-two percent were HIV-1 B subtype, and HIV-1 F (6.5%), HIV-1 C (5.7%) and recombinant viruses (5.8%) were observed. In an unselected cohort, primary drug resistance was seen in 6.5% of the naïve for drug ART use. These results indicate that HIV drug resistance testing should be a practical approach in monitoring first-line ART. In addition, HIV-1 C seems to be emerging in Sao Paulo city.