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Giant anteater (Myrmecophaga tridactyla) is an endangered species that resides in much of Latin America, but it has been losing its habitat, especially in the Cerrado biome, where it constantly suffers traumas resulting from fires and roadkill. The anatomical knowledge of structures of the respiratory system is important for a better morphophysiological understanding of the species. Thus, this study aimed to perform the macroscopic and histomorphological description of the pharynx and larynx of the giant anteater. Twelve adult giant anteaters were used, three of them fixed in buffered formalin for further dissection and pharynx and larynx macroscopic analysis of structures. From the other animals, samples of the pharynx and larynx were collected and prepared for histological evaluation under optical microscope. Macroscopically, their pharynx and soft palate are extensive, and the anatomical location of these structures and the larynx differs greatly from that described in other species. The larynx, although more caudal, was similar to that of other animals. Histologically, the epithelium of these regions varied between the pseudostratified ciliated columnar and the non-keratinized stratified squamous epithelium. Laryngeal cartilages were composed of elastic (epiglotti) and hyaline cartilages (arytenoid, cricoid and thyroid cartilage), with an ossification process and glandular clusters around the hyaline cartilage. The distinct anatomical location of the pharynx and larynx of Myrmecophaga tridactyla is the main macroscopic finding of this study, besides the length of the pharynx and soft palate of these animals.

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As the bone marrow is one of the most organs affected by canine visceral leishmaniasis (CVL), samples from this are frequently taken for parasitological tests, with occurrence of myelodysplastic changes, with consequent anemia, leukopenia, and thrombocytopenia. Thus, this study aimed to investigate the histological and immunohistochemical changes in the bone marrow of the femur and sternal manubrium of dogs reactive for leishmaniasis by DPP® and ELISA tests. For this, thirteen canines from the epidemiological routine for CVL carried out by the Directorate of Zoonosis Surveillance of Goiânia (DVZ), GO, Brazil, were subjected to anatomopathological examination. 46.2% of bone marrow samples from the femur showed a higher proportion of the red series, and 53.9% of bone marrow of the sternal manubrium evidenced a higher proportion of the red series. Also, there were varied macrophage hyperplasia, hemosiderosis, and megakaryocytic emperipolesis. Amastigote forms of Leishmania spp. in the bone marrow of the femur and sternal manubrium to histopathological and immunohistochemical evaluations were observed, with good agreement them, but without difference in the parasite intensity between the bone marrow of these anatomical sites. It was concluded that bone marrow of the femur and sternal manubrium of dogs reactive for leishmaniasis by DPP® and ELISA tests has histological changes resulting from the disease, regardless of the parasite presence or intensity, with macrophage hyperplasia, hemosiderosis, and emperipolesis being the main medullary changes in these animals. Also, the bone marrow of the femur and sternal manubrium are useful anatomical sites for the diagnosis of CVL by direct methods.

Como a medula óssea é um dos órgãos mais acometidos pela leishmaniose visceral canina (LVC), amostras desta são frequentemente colhidas para exames parasitológicos, sendo possível a ocorrência de alterações mielodisplásicas, com consequente anemia, leucopenia e trombocitopenia. Assim, este estudo teve como objetivo investigar alterações histológicas e imunoistoquímicas na medula óssea do fêmur e manúbrio esternal de cães reativos para leishmaniose aos testes DPP® e ELISA. Para isso, 13 caninos da rotina epidemiológica para LVC realizada pela Diretoria de Vigilância de Zoonoses de Goiânia (DVZ), GO, Brasil, foram submetidos ao exame anatomopatológico. 46,2% e 53,9% das amostras de medula óssea do fêmur e do manúbrio esternal apresentaram maior proporção da série vermelha, respectivamente. Além disso, havia variados graus de hiperplasia macrofágica, hemossiderose e emperipolese megacariocítica. Formas amastigotas de Leishmania spp. na medula óssea do fêmur e do manúbrio esternal às avaliações histopatológicas e imunoistoquímicas foram observadas, com boa concordância entre essas, mas sem diferença na intensidade parasitária entre a medula óssea desses sítios anatômicos. Conclui-se que a medula óssea do fêmur e do manúbrio esternal de cães reativos para leishmaniose aos testes DPP® e ELISA apresenta alterações histológicas decorrentes da doença, independente da presença ou intensidade do parasito, sendo hiperplasia de macrófagos, hemossiderose e emperipolese as principais alterações medulares nesses animais. Além disso, a medula óssea do fêmur e do manúbrio esternal compreendem sítios anatômicos úteis ao diagnóstico de LVC por métodos diretos.

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A pericardite tuberculosa é uma forma rara de apresentação de tuberculose extrapulmonar, sendo mais frequente em regiões endêmicas e em pacientes imunocomprometidos. O quadro clínico é na maioria das vezes insidioso, por vezes com sintomas inespecíficos ou com quadro de tamponamento cardíaco. O diagnóstico é feito pela análise do líquido pericárdico ou biópsia pericárdica e o tratamento é realizado com rifampicina, isoniazida, pirazinamida e etambutol. O presente caso relata uma paciente de 51 anos, imunocompetente, com quadro de febre e dispneia há 7 dias. Em tomografia de tórax foi identificado importante derrame pericárdico, sem repercussão hemodinâmica em ecocardiografia transtorácica. A paciente foi submetida à drenagem do derrame pericárdico, com diagnóstico de tuberculose pericárdica pela análise do líquido. Iniciado o tratamento com RHZE, com boa evolução clínica e seguimento ambulatorial.

Tuberculous pericarditis is a rare form of extrapulmonary tuberculosis, being more frequent in endemic regions and in immunocompromised patients. The clinical picture is most often insidious, sometimes with nonspecific symptoms or with cardiac tamponade. Diagnosis is made by analysis of pericardial fluid or pericardial biopsy, and treatment is performed with rifampicin, isoniazid, pyrazinamide, and ethambutol. The present case reports a 51-year-old patient, immunocompetent, with fever and dyspnea for 7 days. A chest tomography showed significant pericardial effusion, without hemodynamic repercussions on transthoracic echocardiography. The patient underwent drainage of the pericardial effusion, with a diagnosis of pericardial tuberculosis by fluid analysis. Treatment with RHZE was started, with good clinical evolution and outpatient follow-up.

RESUMO

A leishmaniose canina (CanL) é uma zoonose causada pelo protozoário da espécie Leishmania infantum. O baço e os linfonodos sofrem alterações morfológicas durante o CanL. Esta pesquisa teve como objetivo realizar um estudo anatomopatológico e imuno-histoquímico desses órgãos em cães reativos para leishmaniose aos testes de Imunoensaio Cromatográfico “Dual Path Platform” (DPP®) e Ensaio de Imunoabsorção Enzimática (ELISA). Vinte e sete cães foram avaliados ao exame anatomopatológico, com 92,6% exibindo alterações à avaliação macroscópica, especialmente esplenomegalia e linfadenomegalia. Todos os cães apresentaram alterações no baço não relacionadas à carga parasitária, sendo a esplenite granulomatosa a alteração mais grave. Hiperplasia cortical e paracortical difusa e hiperplasia e hipertrofia dos cordões medulares foram observadas nos linfonodos. Formas amastigotas de Leishmania spp. foram encontradas no baço e linfonodo às avaliações histopatológica e imuno-histoquímica, com boa concordância entre os métodos (k = 0,55, p = 0,00124), mas não foi observada diferença na intensidade parasitária entre esses órgãos à imuno-histoquímica (p = 0,23). Conclui-se que baço e linfonodo de cães reativos para leishmaniose aos testes DPP® e ELISA apresentam alterações histomorfológicas decorrentes da doença, independente da carga parasitária, assim como esses órgãos apresentam carga parasitária semelhante ao método imuno-histoquímico.

Canine leishmaniasis (CanL) is a zoonosis caused by the protozoan of the species Leishmania infantum. The spleen and lymph nodes undergo morphological changes during CanL. This research aimed to perform an anatomopathological and immunohistochemical study of these organs in dogs reactive to leishmaniasis in the Dual-path Platform chromatographic immunoassay (DPP®) and Enzyme Immunoabsorption Assay (ELISA). Twenty-seven dogs were evaluated for anatomopathological examination with 92.6% showing changes at gross evaluation, specially splenomegaly and lymphadenomegaly. All dogs showed changes in the spleen unrelated to the parasitic load, with granulomatous splenitis being the most severe change. Diffuse cortical and paracortical hyperplasia, and hyperplasia and hypertrophy of the medullary cords were observed in the lymph node. Amastigote forms of Leishmania spp. were found in the spleen and lymph node at histopathological and immunohistochemical evaluations, with good agreement between these evaluations (k = 0.55, p = 0.00124), but no difference was observed in the parasitic intensity of these organs at immunohistochemistry (p = 0.23). It was concluded that spleen and lymph node from dogs reactive to leishmaniasis on the DPP® and ELISA tests show histomorphological changes resulting from the disease, independent to the parasitic load, as well as these organs show similar parasitic load at immunohistochemical test.

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Canine leishmaniasis (CanL) is a zoonosis caused by the protozoan of the species Leishmania infantum. The spleen and lymph nodes undergo morphological changes during CanL. This research aimed to perform an anatomopathological and immunohistochemical study of these organs in dogs reactive to leishmaniasis in the Dual-path Platform chromatographic immunoassay (DPP®) and Enzyme Immunoabsorption Assay (ELISA). Twenty-seven dogs were evaluated for anatomopathological examination with 92.6% showing changes at gross evaluation, specially splenomegaly and lymphadenomegaly. All dogs showed changes in the spleen unrelated to the parasitic load, with granulomatous splenitis being the most severe change. Diffuse cortical and paracortical hyperplasia, and hyperplasia and hypertrophy of the medullary cords were observed in the lymph node. Amastigote forms of Leishmania spp. were found in the spleen and lymph node at histopathological and immunohistochemical evaluations, with good agreement between these evaluations (k = 0.55, p = 0.00124), but no difference was observed in the parasitic intensity of these organs at immunohistochemistry (p = 0.23). It was concluded that spleen and lymph node from dogs reactive to leishmaniasis on the DPP® and ELISA tests show histomorphological changes resulting from the disease, independent to the parasitic load, as well as these organs show similar parasitic load at immunohistochemical test.

A leishmaniose canina (CanL) é uma zoonose causada pelo protozoário da espécie Leishmania infantum. O baço e os linfonodos sofrem alterações morfológicas durante o CanL. Esta pesquisa teve como objetivo realizar um estudo anatomopatológico e imuno-histoquímico desses órgãos em cães reativos para leishmaniose aos testes de Imunoensaio Cromatográfico "Dual Path Platform" (DPP®) e Ensaio de Imunoabsorção Enzimática (ELISA). Vinte e sete cães foram avaliados ao exame anatomopatológico, com 92,6% exibindo alterações à avaliação macroscópica, especialmente esplenomegalia e linfadenomegalia. Todos os cães apresentaram alterações no baço não relacionadas à carga parasitária, sendo a esplenite granulomatosa a alteração mais grave. Hiperplasia cortical e paracortical difusa e hiperplasia e hipertrofia dos cordões medulares foram observadas nos linfonodos. Formas amastigotas de Leishmania spp. foram encontradas no baço e linfonodo às avaliações histopatológica e imuno-histoquímica, com boa concordância entre os métodos (k = 0,55, p = 0,00124), mas não foi observada diferença na intensidade parasitária entre esses órgãos à imuno-histoquímica (p = 0,23). Conclui-se que baço e linfonodo de cães reativos para leishmaniose aos testes DPP® e ELISA apresentam alterações histomorfológicas decorrentes da doença, independente da carga parasitária, assim como esses órgãos apresentam carga parasitária semelhante ao método imuno-histoquímico.

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OBJECTIVE: To determine whether there is an association between the profile of cognitive dysfunction and academic outcomes in patients with juvenile systemic lupus erythematosus (JSLE). METHODS: Patients aged ≤18 years at the onset of the disease and education level at or above the fifth grade of elementary school were selected. Cognitive evaluation was performed according to the American College of Rheumatology (ACR) recommendations. Symptoms of anxiety and depression were assessed by Beck scales; disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI); and cumulative damage was assessed by Systemic Lupus International Collaborating Clinics (SLICC). The presence of autoantibodies and medication use were also assessed. A significance level of 5% (p<0.05) was adopted. RESULTS: 41 patients with a mean age of 14.5±2.84 years were included. Cognitive dysfunction was noted in 17 (41.46%) patients. There was a significant worsening in mathematical performance in patients with cognitive dysfunction (p=0.039). Anxiety symptoms were observed in 8 patients (19.51%) and were associated with visual perception (p=0.037) and symptoms of depression were observed in 1 patient (2.43%). CONCLUSION: Patients with JSLE concomitantly with cognitive dysfunction showed worse academic performance in mathematics compared to patients without cognitive impairment.

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Abstract Objective To determine whether there is an association between the profile of cognitive dysfunction and academic outcomes in patients with juvenile systemic lupus erythematosus (JSLE). Methods Patients aged ≤18 years at the onset of the disease and education level at or above the fifth grade of elementary school were selected. Cognitive evaluation was performed according to the American College of Rheumatology (ACR) recommendations. Symptoms of anxiety and depression were assessed by Beck scales; disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI); and cumulative damage was assessed by Systemic Lupus International Collaborating Clinics (SLICC). The presence of autoantibodies and medication use were also assessed. A significance level of 5% (p < 0.05) was adopted. Results 41 patients with a mean age of 14.5 ± 2.84 years were included. Cognitive dysfunction was noted in 17 (41.46%) patients. There was a significant worsening in mathematical performance in patients with cognitive dysfunction (p = 0.039). Anxiety symptoms were observed in 8 patients (19.51%) and were associated with visual perception (p = 0.037) and symptoms of depression were observed in 1 patient (2.43%). Conclusion Patients with JSLE concomitantly with cognitive dysfunction showed worse academic performance in mathematics compared to patients without cognitive impairment.

Resumo Objetivo Determinar se há associação entre o perfil de disfunção cognitiva e os resultados acadêmicos em pacientes com lúpus eritematoso sistêmico juvenil (LESj). Métodos Foram selecionados pacientes com idade de início da doença ≤ 18 anos e com escolaridade mínima do quinto ano do Ensino Fundamental seguidos em um hospital universitário. A avaliação cognitiva foi feita de acordo com as recomendações do Colégio Americano de Reumatologia (ACR). Os sintomas de ansiedade e depressão foram avaliados pelas escalas Beck, a atividade da doença foi avaliada pelo Systemic Lupus Erythematosus Disease Activity Index (Sledai) e o dano cumulativo pelo Systemic Lupus International Collaborating Clinics (Slicc). Também foram avaliados a presença de autoanticorpos e o uso de medicação. Adotou-se nível de significância de 5% (p < 0,05). Resultados Foram incluídos 41 pacientes com média de 14,5 ± 2,84 anos. Disfunção cognitiva foi observada em 17 (41,46%). Observou-se pioria significativa no desempenho de matemática em pacientes com disfunção cognitiva (p = 0,039). Sintomas de ansiedade foram observados em oito pacientes (19,51%) e estavam associados à percepção visual (p = 0,037) e sintomas de depressão foram observados em um paciente (2,43%). Conclusão Pacientes com LESj com disfunção cognitiva apresentam pior desempenho acadêmico em matemática em relação a pacientes sem disfunção cognitiva.

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