Anafilaxia à lapa: um caso clínico raro / Limpet anaphylaxis: a rare case

A lapa (Patella vulgata) é um molusco frequentemente encontrado em regiões costeiras com clima quente. A alergia alimentar à lapa é muito rara, com poucos casos descritos na literatura. Os autores descrevem um caso de anafilaxia à lapa, com evidência de reação de hipersensibilidade do tipo I, através de IgE específica positiva à lapa, tanto com métodos in vivo, como in vitro.

Limpet (Patella vulgata) is a mollusk mainly found in warm coastal regions. Limpet allergy is considered rare, and few cases can be found in the literature. We describe a clinical case of limpet anaphylaxis, including in vitro and in vivo evidence of IgE mechanism involvement.

Anesthetic and surgical considerations for staged bilateral nephrectomies in a pediatric patient: A case report / Consideraciones anestésicas y quirúrgicas en nefrectomía bilateral en dos tiempos en un paciente pediátrico: Reporte de caso

Abstract We present a 9-year-old patient with end-stage renal disease, on peritoneal dialysis, who underwent a staged prone retroperitoneoscopic bilateral nephrectomy. Bilateral nephrectomy was indicated in preparation for renal transplant in the context of genetic predisposition malignancy when immunosuppressed. The two mirror-image surgeries enable the comparison of the anesthetic management and outcomes in a single patient. Features of interest to anesthesiologists include approach to a child with chronic kidney disease, different requirements for intraoperative antihypertensives; pain management strategies, including a comparison of erector spinae plane block with and without adjunct dexmedetomidine; anesthetic management of retroperitoneoscopic pediatric surgery and the first description of using a Foley bag attached to a peritoneal dialysis catheter to aid in diagnosis and repair of posterior peritoneal cavity entry.

Resumen Se presenta un paciente de 9 años de edad con enfermedad renal terminal, en diálisis peritoneal, quien se sometió a nefrectomía bilateral retroperitoneoscópica estadificada en posición prona. Se indicó la nefrectomía bilateral en preparación para trasplante renal en el contexto de predisposición genética hacia desarrollar una patología maligna al estar inmunosuprimido. Las dos cirugías en espejo permiten hacer una comparación del manejo anestésico y de los desenlaces en un mismo paciente. Las características de interés para los anestesiólogos incluyen el abordaje de un niño con enfermedad renal crónica, con requisitos diferentes de antihipertensivos intraoperatorios; estrategias para el manejo del dolor, incluyendo una comparación de bloqueo del plano del erector espinal con y sin dexmedetomidina adyuvante; manejo anestésico de cirugía pediátrica retroperitoneoscópica y la primera descripción del uso de una bolsa Foley conectada a un catéter de diálisis peritoneal para ayudar en el diagnóstico y la reparación de la entrada de la cavidad peritoneal posterior.

Manejo laparoscópico de hernia diafragmática traumática: reporte de un caso / Laparoscopic management of traumatic diaphragmatic hernia: a case report

La hernia diafragmática traumática representa un reto al momento del diagnóstico. Una detección oportuna permite establecer un correcto tratamiento quirúrgico. Se presenta el caso de un paciente masculino de 37 años de edad con antecedente de trauma torácico por arma blanca 4 años antes; quien acude por cuadro de dolor abdominal intenso localizado en epigastrio que se irradia a hipocondrio izquierdo de aparición súbita 72 horas antes de su ingreso. Al examen físico murmullo vesicular disminuido en campo pulmonar izquierdo, y abdomen doloroso a la palpación a nivel de epigastrio e hipocondrio izquierdo. En exámenes de laboratorio no se evidencian alteraciones, mientras que la tomografía reporta hernia diafragmática izquierda; la misma que fue resuelta quirúrgicamente mediante técnica laparoscópica.

Traumatic diaphragmatic hernia represents a challenge at diagnosis. A timely detection allows to establish a correct surgical treatment. It is presented the case of a 37-year-old male patient with a history of stabbing chest trauma 4 years earlier; who comes for symptoms of intense abdominal pain located in the epigastrium that radiates to the left hypochondrium of sudden onset 72 hours before admission. On physical xamination, vesicular murmur decreased in the left lung field, and a painful abdomen on palpation at the level of the epigastrium and left hypochondrium were showed. Laboratory tests did not show any alterations, but tomography reports a left diaphragmatic hernia; this one was solved surgically by laparoscopic technique.

Chagas disease in Virgem da Lapa, Minas Gerais, Brazil: left ventricle aneurysm and the risk of death in the 24-year interval

BACKGROUND Left ventricular aneurysm (LVA) is indicator of high morbidity in Chagas' disease. A cross-sectional study performed identified LVA in 18.8% of the chronic chagasic patients (CCP). OBJECTIVE Determine the risk of death of patients with chronic chagasic cardiopathy (CCC) and LVA in 24-year interval. MATERIAL AND METHODS In 1995 a cohort of 298 CCP was evaluated by anamnesis, physical examination, EKG and ECHO and classified in groups: G0 = 86 without cardiopathy; G1 = 156 with cardiopathy without LVA and G2 = 56 with cardiopathy and LVA. 38 patients of G0 and G1 used benznidazole. Information about the deaths was obtained in the notary, death certificates, hospital records and family members. FINDINGS Were registered 113 deaths (37.9%): 107 (35.9%) attributed to cardiopathy and 6 (2.0%) to other causes (p < 0.05). Amongst these 107 deaths, 10 (11.6%) occurred in G0; 49 (31.4%) occurred in G1 and 48 (85.7%) occurred in G2 (p < 0.05). The risk of death was 2.7 and 7.4 times significantly higher in G2, than in G1 and G0, respectively. CONCLUSION Chronic chagasic patients with LVA and ejection fraction < 45% have a higher risk of death than those without.

New records of two endemic troglobitic and threatened arachnids (Amblypygi and Opiliones) from limestone caves of Minas Gerais state, southeast Brazil.

BACKGROUND: The endemic and threatened troglobites (organisms restricted to caves) Charinus eleonorae (Amblypygi) and Iandumoema uai (Opiliones), both from Olhos d'Água cave, located at Peruaçu Caves National Park (southeast Brazil), have their distribution expanded for a new locality inside of the National Park (Lapa do Cipó cave), extending their distribution at least in 9.5km(2). NEW INFORMATION: This new data suggest that these arachnids can be in a differentiation process and/or there are several possibilities of dispersion in the karst of Peruaçu. Indeed, a revision of their categorical status at IUCN Red List is necessary. We herein report a new distribution range (Lapa do Cipó cave) of the troglobitic species I. uai and C. eleonorae, which are, to date, known to occur in the Olhos d'Água cave, located at the Peruaçu Caves National Park (PCNP).

Beach almond (Terminalia catappa, Combretaceae) seed production and predation by scarlet macaws (Ara macao) and variegated squirrels (Sciurus variegatoides) / Producción de semillas y depredación del almendro de playa (Terminalia catappa, Combretaceae) por lapas rojas (Ara macao) y ardillas chizas (Sciurus variegatoides)

Knowledge of ecological impacts of exotic beach almond (Terminalia catappa) in the central Pacific of Costa Rica are little known, but studies have found this species to be a potentially important food source for endangered scarlet macaws (Ara macao). In this study, reproductive phenology and seed predation by variegated squirrels (Sciurus variegatoides) and scarlet macaws were measured during March and April 2011 on beaches of central Pacific coastal Costa Rica. Seed productivity and predation levels were quantified on a weekly basis for 111 beach almond trees to assess the importance of beach almond as a food source for scarlet macaws and the extent of resource partitioning between seed predators. Seed production of the trees was great (about 194 272 seeds) and approximately 67% of seeds were predated by seed predators. Macaws consumed an estimated 49% of seeds while squirrels consumed 18%. Additionally, evidence of resource partitioning between squirrels and macaws was found. Scarlet macaws preferred to feed on the northern side and edge of the canopy while squirrels preferred to feed on the southern and inside parts of the canopy. Both species ate most seeds on the ocean side of the tree. Despite the status of this tree as an exotic species, the beach almond appears to be an important resource for scarlet macaw population recovery. The resource produced by this tree should be taken into account as reforestation efforts continue in Costa Rica. Rev. Biol. Trop. 62 (3): 929-938. Epub 2014 September 01.

El conocimiento de los impactos ecológicos del almendro de playa exótico (Terminalia catappa) en el Pacífico Central de Costa Rica son poco conocidos, pero los estudios han encontrado que esta especie es una fuente de alimento potencialmente importante para la lapa roja (Ara macao), en peligro de extinción. En este estudio, se midieron la fenología reproductiva y la depredación de semillas por las ardillas (Sciurus variegatoides) y lapas rojas durante marzo y abril 2011 en las playas de la costa Pacífica Central de Costa Rica. Los niveles de productividad y depredación de semillas se cuantificaron semanalmente para 111 almendros de playa, para evaluar la importancia del almendro de playa como fuente de alimento para la lapa roja y el grado de repartición de recursos entre los depredadores de semillas. La producción de semillas de los árboles fue alta (cerca de 194 272 semillas) y aproximadamente el 67% de las semillas fueron comidas por los depredadores, las lapas rojas consumen un estimado de 49% de las semillas, mientras que las ardillas consumen el 18%. Adicionalmente, se encontró evidencia de la repartición de recursos entre las ardillas y las lapas. Las lapas rojas prefieren alimentarse en el lado norte y el borde de la copa, mientras que las ardillas prefieren las regiones del sur y el interior de la copa. Ambas especies se comieron la mayoría de las semillas en la parte del árbol con lado al mar. A pesar de la situación de este árbol como una especie exótica, la playa de almendras parece ser un recurso importante para la recuperación de la población de lapas rojas. El recurso que produce este árbol debe tomarse en cuenta para continuar con los esfuerzos de reforestación en Costa Rica.

New species of Cyclodontina from Bahia, Brazil (Gastropoda, Pulmonata, Odontostomidae) / Nova espécie de Cyclodontina da Bahia, Brazil (Gastropoda, Pulmonata, Odontostomidae)

A new species of pulmonate snail was recently collected in a small forest fragment in the city of Bom Jesus da Lapa, Bahia state, Brazil. Bahia is known for a high diversity of land snails and Bom Jesus da Lapa is an interesting locality, since it is close to the interface between two major Brazilian biomes: Cerrado and Caatinga. The new species is described as Cyclodontina tapuia sp. nov. and can be easily identified by its brown shell, conical spire, convex whorls, a sculpture comprised of strong ribs, and an aperture with four barriers: a median parietal tooth, a median palatal tooth, a median basal tooth and a strong columellar lamella. This discovery is also a reminder of how little the Brazilian continental molluscan fauna is known and of the urgency in studying and preserving the rich (though usually overlooked) fauna of the Caatinga.(AU)

Uma nova espécie de gastrópode pulmonado foi coletada recentemente em um pequeno fragmento de mata em Bom Jesus da Lapa, Bahia, Brasil. O estado da Bahia é conhecido por sua alta diversidade de moluscos terrestres e Bom Jesus da Lapa é uma localidade particularmente interessante, pois localiza-se na interface entre os biomas Cerrado e Caatinga. A nova espécie é descrita como Cyclodontina tapuia sp. nov. e pode ser facilmente identificada por sua concha de cor marrom, espira cônica, voltas convexas, escultura composta por fortes costelas e uma abertura com quatro barreiras: um dente parietal, um dente palatal, um dente basal e uma forte lamela columelar. A presente descoberta atua como um lembrete de quão pouco é conhecida a malacofauna continental brasileira e também da urgência em estudar e preservar a rica (mas comumente negligenciada) fauna da Caatinga.(AU)

New species of Cyclodontina from Bahia, Brazil (Gastropoda, Pulmonata, Odontostomidae) / Nova espécie de Cyclodontina da Bahia, Brazil (Gastropoda, Pulmonata, Odontostomidae)

A new species of pulmonate snail was recently collected in a small forest fragment in the city of Bom Jesus da Lapa, Bahia state, Brazil. Bahia is known for a high diversity of land snails and Bom Jesus da Lapa is an interesting locality, since it is close to the interface between two major Brazilian biomes: Cerrado and Caatinga. The new species is described as Cyclodontina tapuia sp. nov. and can be easily identified by its brown shell, conical spire, convex whorls, a sculpture comprised of strong ribs, and an aperture with four barriers: a median parietal tooth, a median palatal tooth, a median basal tooth and a strong columellar lamella. This discovery is also a reminder of how little the Brazilian continental molluscan fauna is known and of the urgency in studying and preserving the rich (though usually overlooked) fauna of the Caatinga.

Uma nova espécie de gastrópode pulmonado foi coletada recentemente em um pequeno fragmento de mata em Bom Jesus da Lapa, Bahia, Brasil. O estado da Bahia é conhecido por sua alta diversidade de moluscos terrestres e Bom Jesus da Lapa é uma localidade particularmente interessante, pois localiza-se na interface entre os biomas Cerrado e Caatinga. A nova espécie é descrita como Cyclodontina tapuia sp. nov. e pode ser facilmente identificada por sua concha de cor marrom, espira cônica, voltas convexas, escultura composta por fortes costelas e uma abertura com quatro barreiras: um dente parietal, um dente palatal, um dente basal e uma forte lamela columelar. A presente descoberta atua como um lembrete de quão pouco é conhecida a malacofauna continental brasileira e também da urgência em estudar e preservar a rica (mas comumente negligenciada) fauna da Caatinga.

Biología de la lapa (Cuniculus paca Brisson): una perspectiva para la zoocría / Biology of agouti (Cuniculus paca Brisson): a breeding perspective / Biologia da Paca (Cuniculus paca Brisson): uma perspectiva para sua criação em cativeiro

La lapa (Cuniculus paca) es un roedor de la región neotropical. Es de mediano tamaño, noctámbulo, solitario, territorial y sedentario. Es utilizada como fuente de alimento por la población indígena y rural. Su demanda es creciente, dado el exquisito sabor de su carne, incrementándose su caza para comercio ilegal. Lo anterior ha generado la extracción indiscriminada de su hábitat natural, causando una seria reducción de sus poblaciones. La zoocría es una alternativa para mitigar su depoblación. En Brasil, Ecuador, Panamá, México y Colombia se ha intentado su reproducción en cautiverio, con resultados interesantes. El objetivo del presente artículo de revisión es dar a conocer los comportamientos biológicos de lapa in situ y ex situ, para su manejo adecuado en cautiverio.

The agouti (Cuniculus paca) is a rodent of the Neotropics. It is medium-sized, night owl, solitary, territorial, and sedentary. Indigenous and rural populations use it is a food source. Illegal hunting and trade of agouti is increasing given the exquisite flavor of its meat. This has led to an indiscriminate extraction from their natural habitat, causing a serious reduction in its wild populations. Farm breeding is an alternative to mitigate its depopulation. Researchers in Brazil, Ecuador, Panama, Mexico, and Colombia have attempted to breed agouti in captivity, with interesting results. The aim of this review is to present the in situ and ex situ behavior of agouti for its proper handling in captivity.

A Paca (Cuniculus paca) é um roedor da região neotropical de tamanho médio, hábitos noturnos, solitário, territorial e sedentário. É utilizada como fonte de alimento pela população indígena e rural. Atualmente tem aumentado a demanda de carne de Paca por ser muito gostosa e palatável, o qual incrementou a caça predatória e o comercio ilegal, gerando uma seria diminuição progressiva de suas populações em seus habitats naturais. Uma alternativa para mitigar este problema é a criação zootécnica em cativeiro. Tem se realizado alguns ensaios para lograr sua reprodução com resultados interessantes no Brasil, Equador, Panamá, México e na Colômbia, mas seu objetivo tem sido principalmente a pesquisa ou a conservação. Embora, existem experiências em estes países que tem permitido conhecer parâmetros zootecnicos idôneos para sua criação comercial em cativeiro. O objetivo do presente artigo de revisão é dar a conhecer os comportamentos biológicos da Paca in situ e ex situ para seu manejo adequado e pertinente em cativeiro para fins comerciais.

Scarlet Macaw (Ara macao) (Psitaciformes: Psittacidae) Parental Nest Visitation in Costa Rica: Implications for Research and Conservation

We studied temporal parental visitation of Scarlet Macaws (Ara macao) to six active nests in the Central Pacific Conservation Region of Costa Rica. Total parental time in the nest decreased significantly as the nestlings aged. Results provide guidelines to scientists for planning invasive activities to nestlings, such as placement of radio collars, or biological sample collection. These activities should be performed close to the end of the nesting period for minimal disturbance of parents and nestlings. Our results also provide information to aid wildlife guards in protecting active nests from poachers when chicks are close to fledging. Rev. Biol. Trop. 57 (1-2): 395-400. Epub 2009 June 30.

Estudiamos las visitas temporales de padres de la lapa roja (Ara macao) a seis nidos activos en el Área de Conservación del Pacifico Central (Costa Rica). El tiempo total que pasaron los padres en los nidos bajó en forma significativa en relación con el crecimiento de los pichones. Estos resultados pueden ayudar a los científicos a planear sus actividades "invasivas", tales como colocación de radio collares o colección de muestras biológicas. Las actividades deben coincidir con el final de la época de anidación para molestar menos a las aves. Nuestros resultados proveen información que puede ayudar a los guardaparques a proteger nidos activos cuando los pichones estan casi listos para salir.

Scarlet Macaw, Ara macao, (Psittaciformes: Psittacidae) diet in Central Pacific Costa Rica

From 1993 to 1997, we observed Scarlet Macaw (Ara macao) feeding behavior in Central Pacific Costa Rica. Feeding data acquired in this study were not collected systematically, but opportunistically whenever macaws were observed feeding. To supplement feeding observations, we conducted interviews with local residents. Scarlet Macaws fed on seeds, fruits, leaves, flowers and/or bark of 43 plant species. Various plant parts eaten by macaws from several tree species contain secondary compounds toxic to humans, and additional species included in their diet are nonnative, introduced for agricultural purposes. Important macaw feeding tree species are Ceiba pentandra, Schizolobium parahybum, and Hura crepitans; these species are also crucial to this macaw population because of nest cavities they provide. The results of this study contribute to the conservation of Scarlet Macaws in Central Pacific Costa Rica through promoting protection of individual trees, and through local elementary school reforestation programs focusing on tree species that macaws use for feeding and/or nesting. Scarlet Macaw conservation is extremely important, as numerous population pressures have caused significant declines in macaw numbers in Costa Rica.

Entre 1993-97, observamos el comportamiento de alimentación de la lapa roja (Ara macao) en el Pacifico Central de Costa Rica. La lapa roja se alimentó de semillas, frutas, hojas, flores y corteza de 43 especies de plantas. Varias partes de las plantas comidas por las lapas contienen compuestos secundarios tóxicos al ser humano, y especies adicionales incluidas en la dieta son exóticas; introducidas por razones agrícolas, forestales o estéticas. Especies de árboles importantes como alimento de la lapa roja incluyen: Ceiba pentandra, Schizolobium parahybum, y Hura crepitans; también son criticas para la población de la lapa roja debido a proveen cavidades para anidación. Los resultados de este estudio contribuyen a la conservación de la lapa roja en el Pacifico Central de Costa Rica a través de la promoción de la protección de árboles individuales y programas de reforestación a nivel de escuela primaria que se enfocan en especies de árboles que la lapa utiliza para alimentación o anidación. La conservación de la lapa roja es importante, debido al declive de sus números en Costa Rica.