RESUMO
The inclusion of corn-dried distillers' grains (DDG) could be an alternative supplement to increase animal performance, nitrogen efficiency usage (NEU), and decrease enteric methane (CH4) emissions. Our goal was to determine whether DDG could replace a traditional supplement (cottonseed meal) without affecting animal performance, N balance, and CH4 emissions. The experiment was conducted during the forage growing season (December to April), with 15 d adaptation, and a 112 d experimental period. The experimental design was completely randomized with four treatments: a mineral supplement (MS), cottonseed meal supplement (CS), 50% replacement of CS by DDG (50DDG), and 100% replacement of CS by DDG (100DDG). Cottonseed meal and DDG were used as protein supplement. A total of 12 paddocks, 3 per treatment, were used to measure forage mass: morphological and chemical composition of forage, forage allowance, and animal performance. Six animals per treatment were used to evaluate DM intake, digestibility, CH4 emissions, microbial protein production (MCP), and NEU of each treatment. Eighty-one Young Nellore bulls (48 testers, 12 per treatments and 33 adjusters) with initial BW of 255⯱â¯5â¯kg (10-12â¯months old) were supplemented with each supplement type at a level of 0.3% of BW. Pasture management was continuous stocking with a variable stocking rate (put-and-take). Enteric CH4 was measured using the gas tracer technique. The MCP was quantified using purine derivatives and the NEU mass balance. No differences were found in nutrient intake (Pâ¯>â¯0.228). Individual animal performance and gain per area were higher in the treatments with concentrates compared with that of MS; however, there was no difference among treatments CS, 50DDG, and 100DDG. The ADG was 0.83 for MS and 1.08â¯kg/animal/d when supplemented (Pâ¯<â¯0.05). Gain per hectare was 709â¯kg/ha for MS and 915â¯kg/ha when supplemented with concentrates (Pâ¯<â¯0.05). There was no difference in CH4 production among treatments that average 180â¯g/animal/d; however, CH4 per kg of gain was reduced with CS. The CH4 conversion factor averaged 5.91%. There was no difference in the synthesis of MCP and NEU. Corn DDG can replace 100% of cottonseed meal as a protein source for supplementation of young Nellore bulls grazing in tropical pastures without affecting animal performance, NEU, MCP, and CH4 emissions.
Assuntos
Ração Animal , Zea mays , Ração Animal/análise , Animais , Bovinos , Dieta/veterinária , Suplementos Nutricionais , Digestão , Masculino , NitrogênioRESUMO
Objetivou-se avaliar resposta inflamatória e concentrações de proteínas em líquido peritonealde asininas submetidas à ovariectomia por laparotomia e laparoscopia. Foram utilizadas 18 fêmeas adultas, pesando em média 100kg, as quais foram divididas em dois grupos, de nove animais cada: o grupo I, em que foram ovariectomizadas por laparotomia, e o grupo II por laparoscopia. Após as cirurgias, em ambos os grupos foram avaliadas as seguintes variáveis no líquido peritoneal: pH, densidade, número de hemácias, leucócitos e proteínas de fase aguda (fibrinogênio, haptoglobina, albumina, antitripsina, alfa-1 glicoproteína ácida, ceruloplasmina, transferrina, imunoglobulinas A e G). Todas as variáveis foram analisadas antes das cirurgias, 12, 24, 48, 72 horas, oito e 16 dias após os procedimentos cirúrgicos. O número de hemácias e leucócitos aumentou 24 horas depois das cirurgias nos dois grupos. Haptoglobina, alfa-1 glicoproteína ácida,albumina, transferrina, gamaglobulinas A, G e proteínas totais aumentaram nos dois grupos. As concentrações de ceruloplasmina não variaram enquanto a antitripsina não foi detectada no líquido peritoneal de asininos.Foi identificada uma proteína com23.000kD, que não tem denominação nem descrição no líquido peritoneal de asininos.(AU)
The aim of this study was to evaluate the inflammatory response and protein concentrations in the peritoneal fluid of donkeys submitted to laparotomy and laparoscopic ovariectomy. Eighteen adult females, weighing on average 100kg, were divided into two groups, of 09 animals each, where in group I, they were ovariectomized by laparotomy and group II by laparoscopy. Following the surgeries, the following variables were evaluated in the peritoneal fluid: pH, density, number of red cells, leukocytes and acute phase proteins (fibrinogen, haptoglobin, albumin, antitrypsin, alpha-1 acid glycoprotein, ceruloplasmin, transferrin, Immunoglobulins A and G). All variables were analyzed before the surgeries, 12, 24, 48, 72 hours, 8 and 16 days after the surgical procedures. The number of red cells and leukocytes increased 24 hours after the surgeries in both groups. Haptoglobin, alpha-1 acid glycoprotein, albumin, transferrin, gammaglobulins A and G, and total proteins increased in both groups. Concentrations of ceruloplasmin did not change while antitrypsin was not detected in the asinine peritoneal fluid. A protein of 23,000kD, which has no name or description in the peritoneal liquid of donkeys, has been identified.(AU)
Assuntos
Animais , Equidae/anormalidades , Laparoscopia/veterinária , Laparotomia/veterinária , OvariectomiaRESUMO
Objetivou-se avaliar resposta inflamatória e concentrações de proteínas em líquido peritonealde asininas submetidas à ovariectomia por laparotomia e laparoscopia. Foram utilizadas 18 fêmeas adultas, pesando em média 100kg, as quais foram divididas em dois grupos, de nove animais cada: o grupo I, em que foram ovariectomizadas por laparotomia, e o grupo II por laparoscopia. Após as cirurgias, em ambos os grupos foram avaliadas as seguintes variáveis no líquido peritoneal: pH, densidade, número de hemácias, leucócitos e proteínas de fase aguda (fibrinogênio, haptoglobina, albumina, antitripsina, alfa-1 glicoproteína ácida, ceruloplasmina, transferrina, imunoglobulinas A e G). Todas as variáveis foram analisadas antes das cirurgias, 12, 24, 48, 72 horas, oito e 16 dias após os procedimentos cirúrgicos. O número de hemácias e leucócitos aumentou 24 horas depois das cirurgias nos dois grupos. Haptoglobina, alfa-1 glicoproteína ácida,albumina, transferrina, gamaglobulinas A, G e proteínas totais aumentaram nos dois grupos. As concentrações de ceruloplasmina não variaram enquanto a antitripsina não foi detectada no líquido peritoneal de asininos.Foi identificada uma proteína com23.000kD, que não tem denominação nem descrição no líquido peritoneal de asininos.(AU)
The aim of this study was to evaluate the inflammatory response and protein concentrations in the peritoneal fluid of donkeys submitted to laparotomy and laparoscopic ovariectomy. Eighteen adult females, weighing on average 100kg, were divided into two groups, of 09 animals each, where in group I, they were ovariectomized by laparotomy and group II by laparoscopy. Following the surgeries, the following variables were evaluated in the peritoneal fluid: pH, density, number of red cells, leukocytes and acute phase proteins (fibrinogen, haptoglobin, albumin, antitrypsin, alpha-1 acid glycoprotein, ceruloplasmin, transferrin, Immunoglobulins A and G). All variables were analyzed before the surgeries, 12, 24, 48, 72 hours, 8 and 16 days after the surgical procedures. The number of red cells and leukocytes increased 24 hours after the surgeries in both groups. Haptoglobin, alpha-1 acid glycoprotein, albumin, transferrin, gammaglobulins A and G, and total proteins increased in both groups. Concentrations of ceruloplasmin did not change while antitrypsin was not detected in the asinine peritoneal fluid. A protein of 23,000kD, which has no name or description in the peritoneal liquid of donkeys, has been identified.(AU)
Assuntos
Animais , Equidae/anormalidades , Laparoscopia/veterinária , Laparotomia/veterinária , Ovariectomia/estatística & dados numéricosRESUMO
The aim of this study was to evaluate genetic divergence in the 'Carioca' (beige with brown stripes) common bean cultivar used by different institutions and in 16 other common bean cultivars used in the Rede Cooperativa de Pesquisa de Feijão (Cooperative Network of Common Bean Research), by using simple sequence repeats associated with agronomic traits that are highly distributed in the common bean genome. We evaluated 22 polymorphic loci using bulks containing DNA from 30 plants. There was genetic divergence among the Carioca cultivar provided by the institutions. Nevertheless, there was lower divergence among them than among the other cultivars. The cultivar used by Instituto Agronômico do Paraná was the most divergent in relation to the Carioca samples. The least divergence was observed among the samples used by Universidade Federal de Lavras and by Embrapa Arroz e Feijão. Of all the cultivars, 'CNFP 10104' and 'BRSMG Realce' showed the greatest dissimilarity. The cultivars were separated in two groups of greatest similarity using the Structure software. Genetic variation among cultivars was greater than the variation within or between the groups formed. This fact, together with the high estimate of heterozygosity observed and the genetic divergence of the samples of the Carioca cultivar in relation to the original provided by Instituto Agronômico de Campinas, indicates a mixture of cultivars. The high divergence among cultivars provides potential for the utilization of this genetic variability in plant breeding.
Assuntos
Phaseolus/genética , Frequência do Gene , Genes de Plantas , Loci Gênicos , Marcadores Genéticos , Especiação Genética , Heterozigoto , Repetições de Microssatélites , Filogenia , Polimorfismo GenéticoRESUMO
The objective was to evaluate the efficiency of phosphate-buffered saline (PBS) and Minimum Essential Medium (MEM) during the transport of equine preantral and antral follicles at various temperatures and incubation interval. Equine ovaries (n = 10) from an abattoir were cut into 19 fragments; one was immediately fixed in Bouin's solution (control) and the other fragments were placed in PBS or MEM solution at 4, 20, or 39 °C for 4, 12, or 24 h. After the respective incubation periods, all fragments were fixed in Bouin's solution for 24 h and then submitted to standard histologic analysis. In total, 2567 ovarian follicles were analyzed, including 1752 primordial, 764 primary, 34 secondary and seven antral follicles. Relative to the control group, the transport of equine ovarian fragments in both solutions significantly reduced the percentage of morphologically normal follicles with increasing time and temperature. At 4 °C for 4 h, considering primordial and developing follicles, PBS had a higher (P < 0.05) rate (98.9%) of morphologically normal follicles than MEM, 48.7%. At 39 °C for 12 h, all follicles in both solutions were degenerated. Regarding the stage of follicular development, primordial follicles were less (P < 0.05) affected by preservation than primary and secondary follicles in all media, times and temperatures tested, except at 4 °C for 12 h in PBS, in which the primary and secondary follicles were less (P < 0.05) affected. Overall, 43% of antral follicles were morphologically normal when maintained in MEM at 4 °C for 4 h. In conclusion, equine follicles were successfully preserved in ovarian fragments at 4 °C in phosphate-buffered saline for up to 4 h.
Assuntos
Permeabilidade da Membrana Celular/efeitos dos fármacos , Cavalos , Soluções para Preservação de Órgãos/farmacologia , Folículo Ovariano , Temperatura , Preservação de Tecido/métodos , Algoritmos , Animais , Cruzamento/métodos , Permeabilidade da Membrana Celular/fisiologia , Meios de Cultura/farmacologia , Feminino , Cavalos/fisiologia , Folículo Ovariano/efeitos dos fármacos , Folículo Ovariano/ultraestrutura , Estações do Ano , Fatores de Tempo , Preservação de Tecido/veterináriaRESUMO
Autoimmune rheumatic diseases (AIRD) are not uncommon in the general population and up to one third of hospitalized patients with AIRD may need admission to intensive care unit (ICU). This paper describes the causes of admission, the clinical features and outcome of 24 AIRD patients admitted to a medical ICU from a third level hospital. Thirteen patients had systemic lupus erythematosus (54.2%), three rheumatoid arthritis (12.5%), three pulmonary renal syndrome (12.5%), two dermatopolymyositis (8.3%), two scleroderma (8.3%) and one antiphospholipid syndrome (4.2%). The main causes for ICU admission were rheumatic disease flare-up (37.5%), infection (37.5%) and complications derived from rheumatic disease (29.1%). Mortality during ICU stay was 16.7% (four patients). Excluding shock requiring vasopressor support, no statistical difference was found between survivors and nonsurvivors; although there was a trend to higher test severity scores (APACHE II, ODIN) in nonsurvivors. Our results reveal a lower mortality rate in AIRD patients admitted to the ICU than reported previously. Severity scores such as APACHE II are predictors of mortality in patients with AIRD in the ICU.
Assuntos
Doenças Autoimunes/terapia , Unidades de Terapia Intensiva , Doenças Reumáticas/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/mortalidade , Artrite Reumatoide/terapia , Doenças Autoimunes/mortalidade , Colômbia/epidemiologia , Feminino , Hospitais Universitários , Humanos , Lúpus Eritematoso Sistêmico/mortalidade , Lúpus Eritematoso Sistêmico/terapia , Masculino , Pessoa de Meia-Idade , Admissão do Paciente , Estudos Retrospectivos , Doenças Reumáticas/mortalidadeAssuntos
Transfusão de Eritrócitos , Eritrócitos/imunologia , Imunização , Isoanticorpos/sangue , Sistema do Grupo Sanguíneo Rh-Hr/análise , Adulto , Idoso , Doadores de Sangue , Tipagem e Reações Cruzadas Sanguíneas , Feminino , Genótipo , Humanos , Masculino , Sistema do Grupo Sanguíneo Rh-Hr/imunologia , Imunoglobulina rho(D)Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Células Matadoras Naturais/imunologia , Sinvastatina/farmacologia , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Método Duplo-Cego , Humanos , Células Matadoras Naturais/efeitos dos fármacos , Placebos , Triglicerídeos/sangueRESUMO
Pneumococcal surface protein A (PspA) elicits protection in mice against fatal bacteremia and sepsis caused by genetically diverse pneumococci and protects against carriage and lung infection. We determined the PspA families of invasive isolates of Streptococcus pneumoniae recovered from Colombian children <5 years of age. That 97.5% of Colombian isolates belong to PspA families 1 and 2 supports the hypothesis that a human PspA vaccine covering a few PspA families could be broadly effective.
Assuntos
Proteínas de Bactérias/classificação , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , Streptococcus pneumoniae/classificação , Animais , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Antígenos de Bactérias/classificação , Antígenos de Bactérias/genética , Antígenos de Bactérias/imunologia , Proteínas de Bactérias/genética , Proteínas de Bactérias/imunologia , Pré-Escolar , Colômbia , DNA Bacteriano/análise , Humanos , Infecções Pneumocócicas/microbiologia , Vacinas Pneumocócicas/imunologia , Reação em Cadeia da Polimerase , Coelhos , Sorotipagem , Streptococcus pneumoniae/imunologia , Streptococcus pneumoniae/isolamento & purificação , Streptococcus pneumoniae/patogenicidadeRESUMO
In Colombia, penicillin resistance of Streptococcus pneumoniae invasive isolates recovered from children less than 5 years old has increased from 10% in 1994 to 49.4% in 1999, suggesting the circulation of international resistant clones in the country. A total of 167 S. pneumoniae invasive isolates with diminished susceptibility to penicillin (DSP) were studied. The techniques used were pulsed-field gel electrophoresis (PFGE) and restriction fragment length polymorphism (RFLP) of penicillin-binding proteins (PBPs) genes (2B, 2X, and 1A). Forty-nine serotype 23F isolates were grouped in two clusters: 15 (31%) multiresistant isolates showed PFGE pattern A and PBP I profile, thus making them indistinguishable from Spain23F-1 clone, and 34 (69%) with PFGE pattern C, PBP II profile, and intermediate level resistance (ILR) to penicillin and TMP-SMX, features unique to a Colombian clone. Fifty-five serotype 14 isolates were assigned to PFGE B pattern, PBP III profile, having high-level resistance to penicillin, and TMP-SMX, similar to the France9V variant 14. This same pattern was present in five capsular type 9V isolates. Four serotype 14 isolates were assigned to PFGE pattern F, and appeared to be similar to Slovakia(14)-10 PFGE pattern, although they had different PBP profiles. Nine capsular type 6B and one 6A isolates belonged to PFGE pattern M, similar to Spain6B-2, although they showed different PBP profiles. The remaining 44 isolates, corresponding to serotypes 14, 6B, 19F, and 34, showed variable PFGE and PBP patterns. These results show that as many as two international clones may be circulating in Colombia as well as a unique, widely distributed 23F clone with ILR to penicillin. Additionally, some Colombian isolates capsular type 14 and 6B might be related to Slovakia(14)-10 Spain6B-2 clones, respectively.
Assuntos
Proteínas de Bactérias , Hexosiltransferases , Peptidil Transferases , Infecções Pneumocócicas/microbiologia , Streptococcus pneumoniae/efeitos dos fármacos , Proteínas de Transporte/genética , Proteínas de Transporte/metabolismo , Colômbia , Impressões Digitais de DNA , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , Resistência Microbiana a Medicamentos , Eletroforese em Gel de Campo Pulsado , Humanos , Muramilpentapeptídeo Carboxipeptidase/genética , Muramilpentapeptídeo Carboxipeptidase/metabolismo , Resistência às Penicilinas , Proteínas de Ligação às Penicilinas , Fenótipo , Sorotipagem , Streptococcus pneumoniae/genéticaAssuntos
Hiperlipidemias/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Transplante de Rim , Sinvastatina/uso terapêutico , Adulto , Análise de Variância , Colesterol/sangue , Método Duplo-Cego , Feminino , Humanos , Hiperlipidemias/sangue , Hipolipemiantes/efeitos adversos , Imunossupressores/uso terapêutico , Masculino , Sinvastatina/efeitos adversosRESUMO
OBJECTIVES: To measure the quality of life (QOL) of patients on RRT with regard to depression, anxiety, and adjustment to illness. MATERIAL: The study was conducted between 1996 and 1998 at a teaching hospital in Porto Alegre, Brazil. The study population included 125 patients (transplant n = 64, hemodialysis n = 42 and continuous ambulatory peritoneal dialysis [CAPD] n = 19). METHODS: The Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and the Psychosocial Adjustment to Illness Scale (PAIS) were used for patient assessment. Results were analyzed using the Kruskall-Wallis, Mann-Whitney and ANOVA tests. RESULTS: Depression scores were higher for hemodialysis patients compared with transplant patients (H = 15.22; p < 0.005). CAPD patients had intermediate scores (no statistical difference). As far as anxiety was concerned, no statistical difference was observed when the groups were compared. In terms of adjustment to illness, hemodialysis patients were significantly less well adjusted than transplant patients (H = 23.34; p < 0.001). Patients on CAPD had intermediate scores, with no significant difference compared with the other two groups. CONCLUSION: The overall quality of life of transplant patients is higher than that of hemodialysis patients.
Assuntos
Ansiedade/psicologia , Depressão/psicologia , Terapia de Substituição Renal/psicologia , Ajustamento Social , Adolescente , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Diálise Peritoneal Ambulatorial Contínua , Qualidade de Vida/psicologiaRESUMO
Third stage larvae (L3) from Angiostrongylus costaricensis were incubated in water at room temperature and at 5 degrees C and their mobility was assessed daily for 17 days. Viability was associated with the mobility and position of the L3, and it was confirmed by inoculation per os in albino mice. The number of actively moving L3 sharply decreased within 3 to 4 days, but there were some infective L3 at end of observation. A mathematical model estimated 80 days as the time required to reduce the probability of infective larvae to zero. This data does not support the proposition of refrigerating vegetables and raw food as an isolated procedure for prophylaxis of human abdominal angiostrongylosis infection.
Assuntos
Angiostrongylus/fisiologia , Infecções por Strongylida/prevenção & controle , Temperatura , Angiostrongylus/isolamento & purificação , Animais , Larva , Camundongos , Moluscos , Movimento , Infecções por Strongylida/parasitologiaRESUMO
The island of São Luis in the State of Maranhão, constituted by the municipalities of São Luis-SL (835,428 inhabitants), São José de Ribamar-SJR (60,633 inhabitants) and Paço do Lumiar-PL (80,274 inhabitants), has been suffering dengue (DEN) fever epidemics since 1995, caused by DEN-1. In 1996, from August through October, an aleatory sero-epidemiologic survey was carried out in order to estimate the incidence of DEN infection and to analyze other clinical and epidemiological parameters. A questionnaire was applied and serum samples were simultaneously obtained. Serum samples were tested by hemagglutination inhibition (HI). Results were analyzed using Lotus 123, Epi-info 6.0, Excel 5.0 and STATA softwares. A total of 1,217 serum samples were obtained (101 of PL, 100 of SJR and 1017 of SL). The rate of DEN was 55.4% in PL, 28% in SJR and 41.4% in SL, suggesting the occurrence of 401,933 infections. No difference was seen between males and females, but infection occurred more in the upper social class than in poor people (p < 0.003), and was more frequent in adults than in children (p < 0.0004). In SL, the incidence was stratified into seven sanitary districts (SD), and prevalence was found to range from 26.1% in SD4 to 56.8% in SD1 (p < 0.0001). Symptoms were more frequently reported by people whose HI was positive: they included fever, headache, chills, dizziness, retrobulbar pains, muscle and joint pains, nausea, anorexia and skin rash. In spite of the high incidence of infection, no hemorrhagic cases were reported.
Assuntos
Dengue/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Anticorpos Antivirais/sangue , Brasil/epidemiologia , Dengue/diagnóstico , Dengue/imunologia , Vírus da Dengue/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição Aleatória , Estudos Soroepidemiológicos , Distribuição por Sexo , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Mortality from asthma increased and is now declining in some countries, but little is known about these trends in South America. OBJECTIVE: We aimed to assess trends in mortality from asthma in southern Brazil in children and young adults. METHODS: Death certificates of 425 people in the state of Rio Grande do Sul aged between 5 and 39 years in whom asthma was reported to be the underlying cause of death during the period 1970 to 1992 were reviewed. Population data were available in 10-year age groups. Testing for trends in mortality rates was conducted using linear and log-linear regression procedures. RESULTS: Asthma mortality rates in the age groups 5 to 19 and 20 to 39 years ranged between 0.04 and 0.39/100,000 and 0.28 to 0.75/100,000, respectively, and were nonuniformly distributed over the study period. The mean annual increase in rate in 5- to 19-year olds was +0.01 (95% CI 0.003 to 0.016), an average annual percentage increase of +6.8% (95% CI 3% to 11%), with a total increase of 352% between 1970 and 1992. This increase was not due to a shift in labeling from bronchitis to asthma. In the 20 to 39-year age group, asthma and bronchitis mortality rates showed no trend to increase or decrease. CONCLUSIONS: Asthma mortality in southern Brazil is low, but rose significantly between 1970 and 1992 in the 5 to 19-year age group. This trend differs from that found in other states of Brazil and several other Latin American countries. Reasons for this difference remain unclear.
PIP: Levels of mortality due to asthma are declining in some countries. To measure trends in mortality from asthma in southern Brazil among children and young adults, the death certificates of 425 people in the state of Rio Grande do Sul aged 5-39 years in whom asthma was reported to be the underlying cause of death during the period 1970-92 were reviewed. Asthma mortality rates among people aged 5-19 and 20-39 years were 0.04-0.39/100,000 and 0.28-0.75/100,000, respectively, and were nonuniformly distributed over the study period. The mean annual increase in mortality rate among 5-19 year olds was 0.01, an average annual percentage increase of 6.8%, with a total increase of 352% during 1970-92. This increase was not due to a shift in labeling from bronchitis to asthma. Among people aged 20-39 years, asthma and bronchitis mortality rates showed no trend of increase or decrease. Reasons for the dramatic increase in asthma-related mortality among 5-19 year olds are unclear.
Assuntos
Asma/mortalidade , Adolescente , Adulto , Brasil/epidemiologia , Bronquite/mortalidade , Criança , Pré-Escolar , Atestado de Óbito , Feminino , Humanos , Masculino , Mortalidade/tendências , Dinâmica PopulacionalRESUMO
Bacillus species were recovered from the blood cultures of 39 oncology patients over 14 weeks. A matched case-control study showed a strong association of Bacillus species bacteremia with use of calcium gluconate solution (odds ratio=25.0) and of central venous lines (odds ratio=8.8). Stopping use of the implicated calcium gluconate vials controlled the outbreak.
Assuntos
Infecções por Bacillaceae/epidemiologia , Institutos de Câncer/estatística & dados numéricos , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Adolescente , Adulto , Idoso , Infecções por Bacillaceae/etiologia , Brasil/epidemiologia , Gluconato de Cálcio , Estudos de Casos e Controles , Cateterismo Venoso Central/efeitos adversos , Criança , Pré-Escolar , Infecção Hospitalar/etiologia , Contaminação de Medicamentos , Feminino , Humanos , Lactente , Masculino , Análise por Pareamento , Pessoa de Meia-Idade , Razão de Chances , SoluçõesRESUMO
SUMMARY: Spontaneous dissecting aneurysms (SDAs) seldom involve the intradural vertebral artery VA, the posterior cerebral, basilar or postero inferior cerebellar arteries (PICAs), where they produce subarachnoid haemorrhage and/or ischaemia. These lesions may develop spontaneously or occasionally after minor trauma and occur in young people in whom there is no underlying abnormality to explain the appearance of the dissection in most cases. Spontaneous dissecting aneurysm of the PICA is rare and its natural history is not well understood. Surgery or endovascular treatment for PICA dissection remain controversial because they suggest vessel occlusion. Only in a few cases is the bypass between the occipital artery and the PICA possible with trapping of the dissected segment. Reinforcement of the arterial wall does not seem efficient and the surgical approach per se with sole exclusion of the aneurysm may be disastrous. We describe two cases of SDA of PICA that presented with subarachnoid haemorrhage (SAH), treated conservatively, with spontaneous cure of the lesions, angiographically confirmed at mid-time follow-up of five and four months. These favourable spontaneous thromboses, like 11 other similar case reported in the literature, did not show any rebleed. The possibility of a benign clinical course of this lesion exists; clinical and angiographic management of the patient before a decision for a aggressive treatment is proposed.
RESUMO
Há, até o momento, notícia de 9 famílias näo aparentadas com o diagnóstico clínico de doença de Machado-Joseph (MJD) no Brasil. Esta é a maior família do mundo com doença. É de origem açoriana e contem 622 indivíduos na árvore fenealógica. Destes, 236 foram examinados. Dois examinadores julgaron 39 como afetados. Respectivamente 12, 23 e 4 pacientes tinham os fenôtipos I, II e III da doença, com idades no início variando entre 10-48, 14-54 e 30-55. Doença tipo I de início juvenil näo mostrou atrofia täo severa nas imagens por ressonância magnética (RM) quanto doença tipo II de duraçäo igual, demonstrando que severidade clínica e grau de atrofia näo caminham paralelamente. Nenhum dos 8 pacientes examinados por RM tinha atrofia olivar ou anormalidades no globo pálido. Doze pacientes e 23 sob risco foram submetidos a avaliaçäo neuropsicológica. A atençäo foi normal em todos. Memória verbal estava pior nos doentes com maior decaimento com o tempo que nos sob risco. Ambos os grupos tiveram pontuaçäo abaixo do normal na identificaçäo de silhuetas e praxia construtiva. Memória visual estava bem abaixo do normal para ambos, com muitas rotaçöes, porém sem omissöes ou confabulaçäo. Padräo peculiar de multiplicaçäo dos detalhes internos, que denominamos o "efeito olho de mosca" foi visto em 6 doentes e 8 sob risco. Discriminaçäo defeituosa de cores, quando múltiplas cores eram apresentadas lado a lado, na ausência de anomia ou cegueira a cores, caracterizável como "simultagnosia a cores", surgiu como achado e foi pesquisada em 29 sujeitos 4/10 doentes e 6/19 sob risco mostram esta dificuldade. Conclui-se que disfunçöes cognitivas na esfera visual säo proeminentes nesta família. Se seriam próprias da doença e manifestaçäo precoce daqueles sob risco, está ainda para ser estabelecido. Depressäo foi avaliada com critérios do DSM III-R e com o Montgomery-Asberg Depression Rating Scale. Näo houve diferença entre doentes e sob risco. Entretanto, os pacientes tiveram menos depressäo do que tinham tido antes ou nas fases precoces da doença. A MJD plenamente instalada parecia exercer efeito protetor da depressäo
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Degenerações Espinocerebelares/genética , Açores/etnologia , Brasil , Degenerações Espinocerebelares/diagnóstico , Exame Neurológico , Testes Neuropsicológicos , Linhagem , Escalas de Graduação Psiquiátrica , Espectroscopia de Ressonância Magnética , Fatores de RiscoRESUMO
At the moment 9 seemingly independent families with the clinical diagnosis of MJD are known in Brazil. The largest family tree of Azorean ancestry contains 622 individuals in 9 generations. 236 were examined, 39 found to be affected by two examiners. Phenotypes I, II and III were expressed by 12, 23 and 4 patients with age of onset by phenotypes being 10-48, 14-54 and 30-55 respectively. Although clinically more severe, juvenile onset type I disease did not show as severe a ponto-mesencephalic atrophy on MRI as the father with type II disease of similar symptomatic duration. None of the 8 patients examined with MRI showed olivary atrophy or pallidal abnormalities. 12 affected and 23 at risk were evaluated with neuropsychological tests. Attention was normal in both groups. Verbal memory scores were below normal in the affected and there was greater decay with time than in the risk group. Both scored below normal in identifying silluettes and constructional praxis. Visual memory scores were well below normal for both, with many rotations but no omissions or confabulations. A peculiar pattern of multiplying internal details called "the fly-eye effect" was observed in 6 affected and 8 at risk. Defective color distinction when multiple colors presented close to each other, in face of proper naming of individual colors ("color simulatanagnosia"), was looked for in 29 people. 4/10 affected and 4/19 at risk showed this phenomenon. Cognitive dysfunctions in this MJD family are prominent in the sphere of vision. Whether they constitute an early manifestation in those at risk and thus serve as a clinical identifier of the illness is yet to be established. Depression was looked for in the history of the family with DSM III-R criteria and an attempt at quantification with the Montgomery-Asberg Rating Scale. There was no significant quantitative difference between affected and at risk. Once undeniably symptomatic however, the patients had no, or less depression than themselves before or at the early stages of the illness. Covert depression was appropriately excluded. Fully established MJD in this family seemed to exert a protective effect from depression.