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Resumen: Introducción: La enfermedad de Parkinson (EP) es un trastorno neurológico y progresivo caracterizado por síntomas motores y no motores que influyen en el deterioro de la calidad de vida. Objetivo: Esta investigación tiene como objetivo analizar los efectos de un programa de intervención multicomponente basado en la actividad física y el deporte en la funcionalidad de personas con EP, tanto con alta como con baja afectación. Metodología: Para ello, 16 personas (13 hombres y 3 mujeres) con EP participaron en este estudio, dividiéndose en 2 grupos según su nivel de afectación, el de baja (GBA, n = 12) y el de alta (GAA, n = 4). Se realizó una intervención de un programa de ejercicio físico multicomponente a todos los participantes durante 4 semanas (2 sesiones de 50 minutos, por semana). Se realizó una batería de test funcionales (Six minutes walk test (6MWT); Single-leg Stance test (SLS); Time Up and Go (TUG) y The five times sitto-stand Chair (FTSTS)) una semana antes (T1) y una semana después de la intervención (T2). Resultados: El total de la muestra mejoró significativamente en el test SLS (P < 0.05; d > 0.56, moderado). Sin embargo, analizando cada grupo, de conformidad con su nivel de afectación, el grupo GBA obtuvo mejoras significativas en SLS y 5STS (d= 0.44 - 0.68, p < 0.05), mientras que no se observaron diferencias significativas en el grupo GAA en ninguna variable analizada. Conclusiones: Los resultados del presente estudio muestran la necesidad de realizar más estudios con programas de larga duración y más frecuencia semanal.

Abstract: Introduction: Parkinson's disease (PD) is a progressive neurological disorder characterized by motor and non-motor symptoms that influence the impairment of quality of life. Objective: This research aims to analyze the effects of a multicomponent intervention program based on physical exercise and sport on the physiological functions of people with PD, both with high and low impairment. Methodology: For this purpose, sixteen people (13 men and 3 women) with PD participated in this study, divided into two groups according to their level of impairment, low (GBA, n = 12) and high (GAA, n = 4). A multicomponent physical exercise program intervention was administered to all participants for 4 weeks (2 sessions of 50 minutes per week). A battery of functional tests (Six minutes walk test (6MWT); Single-leg Stance test (SLS); Time Up and Go (TUG) and The five times sit-to-stand Chair (FTSTS)) was performed one week before (T1) and one week after the intervention (T2). Results: The total sample improved significantly on the SLS test (P < 0.05; d > 0.56, moderate). However, analyzing each group according to their level of impairment, the GBA group obtained significant improvements in SLS and 5STS (d= 0.44 - 0.68, P < 0.05), while no significant differences were observed in the GAA group in any of the variables analyzed. Conclusion: The results of the present study show the need for further studies with longer duration and more frequent weekly programs.

Resumo: Introdução: A doença de Parkinson (DP) é um distúrbio neurológico progressivo, caracterizado por sintomas motores e não motores que influenciam a deterioração da qualidade de vida. Objetivo: Esta pesquisa visa analisar os efeitos de um programa de intervenção multicomponente baseado na atividade física e no esporte sobre a funcionalidade das pessoas com DP, tanto com deficiência alta quanto baixa. Metodologia: Para este fim, 16 pessoas (13 homens e 3 mulheres) com DP participaram deste estudo, divididos em dois grupos de acordo com seu nível de afecção, o baixo (GBA, n = 12) e o alto (GAA, n = 4). Uma intervenção de um programa de exercícios físicos multicomponentes foi realizada com todos os participantes durante 4 semanas (2 sessões de 50 minutos por semana). Uma bateria de testes funcionais (Six minutes walk test (6MWT); Single-leg Stance test (SLS); Time Up and Go (TUG) y The five times sit-to-stand Chair (FTSTS)) foi realizada uma semana antes (T1) e uma semana após a intervenção (T2). Resultados: A amostra total melhorou significativamente no teste SLS (P < 0,05; d > 0,56, moderado). Não obstante, analisando cada grupo de acordo com seu nível de deficiência, o grupo GBA obteve melhorias significativas no SLS e 5STS (d= 0,44 - 0,68, p < 0,05), mas não se observaram diferenças significativas no grupo GAA em nenhuma variável analisada. Conclusões: Os resultados do presente estudo mostram a necessidade de mais estudos com programas de maior duração e mais frequência semanal.

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Aims and Objectives: The aim of this study was to describe the mechanism of dental implants osseointegration in patients with congenital and degenerative genetic bone disorders. Materials and Methods: A PubMed and Scopus documents search was carried out between November 2021 in the, using words such as "osseointegration," "degenerative disease," "congenital disease," and "dental implants." Results: The thirteen articles selected dealt with dental implants osseointegration in patients with congenital and degenerative bone disorders. The influence and repercussion of these diseases on the bone system, as well as the osseointegration process were described from healing to bone remodeling. In addition, certain articles described some considerations to improve the osseointegration process in patients suffering from these types of conditions. Conclusions: Within the limitations of this literature review we can conclude that osseointegration in patients with ectodermal dysplasia and osteoporosis could be achieved. However, the planning process for dental implant placement in these patients should be more meticulous and individualized considering the degree of tissue involvement as well as the patient's age and skeletal development compared to systemically healthy patients.

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Repeated exposure to environmental ozone causes a chronic state of oxidative stress. This state is present in chronic degenerative diseases and induces a loss of control of the inflammatory response. Redox system dysfunction and failures in control of inflammatory responses are involved in a vicious circle that maintains and increases the degenerative process. The intestine also responds to secondary reactive species formed by exposure to ozone doses, generating noxious stimuli that increase degenerative damage. This review aims to elucidate how environmental pollution, mainly by ozone, induces a state of chronic oxidative stress with the loss of regulation of the inflammatory response, both in the intestine and in the brain, where the functionality of both structures is altered and plays a determining role in some neurodegenerative and chronic degenerative diseases. For this purpose, we searched for information on sites such as the Cochrane Library Database, PubMed, Scopus, and Medscape. Reviewing the data published, we can conclude that environmental pollutants are a severe health problem. Ozone pollution has different pathways of action, both molecular and systemic, and participates in neurodegenerative diseases such as Parkinson's and Alzheimer's disease as well in bowel diseases as Inflammatory Bowel Disease, Crohn's Disease, and Irritable Bowel Syndrome.

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Proteins involved in the Alzheimer's disease (AD), such as amyloid precursor protein (APP) and presenilin-1 (PS1), play critical roles in early development of the central nervous system (CNS), as well as in innate immune and glial cell responses. Familial AD is associated with the presence of APPswe and PS1dE9 mutations. However, it is still unknown whether these mutations cause deficits in CNS development of carriers. We studied genome-wide gene expression profiles of differentiated neural progenitor cells (NPCs) from wild-type and APPswe/PS1dE9 mouse embryo telencephalon. The occurrence of strong innate immune and glial cell responses in APPswe/PS1dE9 neurospheres mainly involves microglial activation, inflammatory mediators and chemokines. APPswe/PS1dE9 neurospheres augmented up to 100-fold CCL12, CCL5, CCL3, C3, CX3CR1, TLR2 and TNF-alpha expression levels, when compared to WT neurospheres. Expression levels of the glia cell marker GFAP and microglia marker Iba-1 were up to 20-fold upregulated in APPswe/PS1dE9 neurospheres. The secretome of differentiated APPswe/PS1dE9 NPCs revealed enhanced chemoattraction of peripheral blood mononuclear cells. When evaluating the inferred protein interaction networks constructed from the array data, an improvement in astrocyte differentiation in APPswe/PS1dE9 neurospheres was evident in view of increased GFAP expression. Transgenic NPCs differentiated into neural phenotypes presented expression patterns of cytokine, glial cells, and inflammatory mediators characteristic of APPswe/PS1dE9 adult animals. Consequently, the neurogenic niche obtained from differentiation of embryonic APPswe/PS1dE9 neurospheres spontaneously presents several alterations observed in adult AD brains. Finally, our data strengthen pathophysiological hypotheses that propose an early neurodevelopmental origin for familial AD.

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Background: Cranial cruciate ligament disease is one of the leading causes of pelvic limb claudication in canines and osteoarthritis in the stifle joint. Historically, studies have focused on surgical options to improve the stability of the stifle joint, although none of the techniques described in the literature prevents the development of osteoarthritis. Aim: This study aimed at proving the presence of osteoarthritis at the time of diagnosis of cranial cruciate ligament rupture, as well as evaluating the benefits of administering diacerein (DAR) or chondroprotective coadjuvants to the extracapsular fabelo-tibial technique. Methods: Seventeen dogs aged between 2 and 8, weighing more than 25 kg, with no predilection for breed or sex, were operated on using this technique. These were divided into three groups: DAR, Chondroprotector (CP), and Control. The animals were treated for 90 days and controlled clinically, radiologically, and using multidimensional scales for pain and quality of life. The statistical analysis used was descriptive and through non-parametric tests. Results: All patients had some degree of osteoarthritis at the beginning of the study associated with the presence of pain. The treated groups improved the claudication scores; however, the changes were significant for the DAR group. The pain score improved in all animals, including those in the Control group; however, the differences were significant only in the treated groups. On the other hand, no significant differences were detected in the radiological studies, so it would be convenient to perform this study over more than 90 days. Conclusion: The surgical treatment accompanied by drugs that act on the degradation of articular cartilage has better clinical results.

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PURPOSE: To describe a new insight into the Climate Droplet Keratopathy (CDK) pathophysiology and its major predisposing factors. METHOD: A literature search was undertaken on PubMed to compile papers published on CDK. The following is a focused opinion tempered by synthesis of current evidence, and research of the authors. RESULTS: CDK is a multifactorial rural disease common in regions with high incidence of pterygium, but not related to the type of climate or ozone concentrations. Although it has been thought that climate is the cause of this disease, recent investigations deny that and reveal that other environmental factors such as dietary intake, eye protection, oxidative stress, and ocular inflammatory pathways play an important role in the pathogenesis of CDK. CONCLUSION: Considering the negligible effect of climate, the present name " CDK" for this illness can be confusing for young ophthalmologists. Based on these remarks, it is imperative to start using an accurate name like "Environmental Corneal Degeneration (ECD)" that fits the most recent evidence related to its etiology.

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OBJECTIVE: To analyze the electromyographic activity (EMG) and thermographic patterns of the masseter and temporalis muscles and pressure of the orofacial tissues in individuals with intervertebral disc degeneration (IDD). METHODS: This study had two distinct groups: with IDD (n = 16) and controls (n = 16). EMG at rest, protrusion, right and left laterality, and maximum voluntary contraction were evaluated. Tongue, orbicularis oris, and buccinator muscles pressures were measured by Iowa Oral Performance Instrument. The thermographic patterns were analyzed using infrared thermography. RESULTS: Comparisons between groups showed significant differences regarding at rest [right (p = 0.05) and left (p = 0.05) masseter and right temporal (p = 0.05)], orofacial tissue pressure [tongue (p = 0.001), orbicularis oris (p = 0.01), and buccinator (p = 0.0001)], but no significant differences for the thermographic patterns. CONCLUSION: IDD modifies the functionality of the craniomandibular complex, influencing the performance of the stomatognathic system.

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Intervertebral disc degeneration is a pathological condition associated with the intervertebral disc and is related to functional alterations in the human body. This study aimed to evaluate the maximum molar bite force and masseter and temporal muscles thickness in individuals with intervertebral disc degeneration. Thirty-two individuals were divided into two groups: those with degeneration of intervertebral discs (n=16) and those without degeneration (n=16). The maximum molar bite force (on the right and left sides) was measured using a dynamometer. Masseter and temporal muscle thickness during mandibular task rest and dental clenching in maximum voluntary contraction were analysed using ultrasound. Significant differences in the left molar bite force (p=0.04) were observed between the groups (Student's t-test, p<0.05). The intervertebral disc degeneration group had a lower maximum molar bite force. No significant differences in muscle thickness were observed between the masseter and temporal muscles in either group. However, based on clinical observations, the group with intervertebral disc degeneration presented less masseter muscle thickness and greater temporal muscle thickness in both mandibular tasks. Degenerative disease of the intervertebral discs promoted morphofunctional changes in the stomatognathic system, especially in maximum molar bite force and masticatory muscle thickness. This study provides insight into the interaction between spinal pathology and the stomatognathic system, which is important for healthcare professionals who treat patients with functional degeneration.

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Background: The myxomatosis degeneration is a degenerative cardiac valve disease, with a higher incidence in maleand senile canids. The diagnosis is made by a doppler echocardiography exam. Although there are few reports on the occurrence of cardiopathies in wild dogs (Cerdocyon thous), some studies on their cardiological parameters can be found.Considering this, and knowing that the cardiopathies in wild canids are common post mortem findings, the objective of thisstudy is to describe the echocardiography diagnosis of a case of myxomatous degeneration of the atrioventricular valvesin 1 wild dog (Cerdocyon thous) living in captivity.Case: It was treated at the Diagnostic Imaging Department of the Veterinary Hospital of the Federal University of Mato Grosso(HOVET-UFMT), 1 wild dog (C. thous), male, living in captivity with approximately 10-year-old, directed by the Center ofMedicine and Research in Wild Animals of Cuiabá, to perform echocardiography exam. The patient was submitted to anesthesiafor proper examination, which was used Esaote® machine model MyLabFive VET with sector scan transducer (4.0 -7.5 MHz).The longitudinal, transverse and apical scan planes were obtained through left and right parasternal windows. The evaluation ofM mode exposed ejection fraction and shortening increased, of 81% and 47%, respectively, however it showed no increase insystolic and diastolic values of left ventricle, nor in right cavities on subjective evaluation. The relation between the left atrium(LA) and the aorta (Ao) remained normal, at 1.2 mm, with dimensions of 13.4 mm from the AO and 16.3 mm from LA, compatible with species parameters or domestic canines. The atrioventricular valves showed thickening and irregularities in their cusps,with great intensity in the left atrioventricular valve (LAV). The Doppler mode analysis revealed a turbulent systolic flow into the...

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Background: Coxofemoral dysplasia (CFD) is the abnormal development of the hip joint, mostly affecting large breeds, and is characterized by subluxation or complete luxation of the femoral head. Among the conservative therapeutic options, cell therapies with stem cells for CFD provides potential by the countless possibilities of therapeutic application, especially those related to the chronic and/or degenerative diseases treatment, which could be a key point for the bone and joint repair. The objective was to report a bilateral CFD case in a dog, treated with intra-articular application of mesenchymal stem cells (MSC), with 0, 30, 60 and 90 days, and further evaluations. Case: A 2-year-old male Akita dog was referred to the Veterinary Hospital Harmonia (HVH) located in the city of Recife, Pernambuco, presenting clinical signs of hip pain, lameness and pelvic limbs hopping. By orthopedic examination, pain was observed at the cranial and caudal extension of the pelvic limb, and at flexion, abduction and adduction of the limb, as well as moderate muscle atrophy and presence of joint crackling. By coxofemoral radiography performed in ventrodorsal projection, it were detected bilateral femoral head subluxation, thickening of the femoral neck and the presence of intraarticular osteophytes. These findings are compatible with the degeneration caused by the presence of CFD. Laboratory tests performed such as hemogram and biochemical had no changes. Thus, the patient had intra-articular application of allogeneic MSC, derived from adipose tissue, obtained by private company. For stem cell applications, arthrocentesis of the hip joints was performed one at a time, using a 5 mL syringe and 16G needle for aspiration of 2 mL synovial fluid, for discard and application of stem cells. After aspiration, the syringe containing the MSC were fitted to the 16G needle for the implant. After the...

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O colapso traqueal é uma doença degenerativa e progressiva caracterizada por alterações anatômicas e histológicas na traqueia, sendo considerada uma causa comum de obstrução das vias aéreas superiores em pequenos animais. O diagnóstico é efetuado com base no histórico do animal, mas só é definitivo por meio da realização de exames complementares, em que a radiografia é o mais utilizado. Objetivou-se, com este estudo, determinar a ocorrência do colapso traqueal em cães por exame radiográfico com compressão traqueal cervical externa, avaliando o grau de severidade em animais sintomáticos e assintomáticos, bem como determinar as raças, portes e idades mais acometidas. Para isso, realizou-se um estudo retrospectivo no qual foram analisadas as fichas clínicas e exames de 332 cães que foram submetidos à radiografia aplicando-se compressão traqueal no hospital veterinário da instituição de ensino, no período de 1º de janeiro de 2010 a 31 de dezembro de 2020. Coletaram-se dados referentes a idade, raça, porte, sexo e presença de sintomas clínicos característicos, além de se verificar a redução do lúmen traqueal e o grau de colapso correspondente. Estes dados foram tabulados e analisados estatisticamente empregando-se o teste de Tukey, teste Qui-quadrado de independência e estatística. Após a interpretação dos resultados, verificou-se uma maior casuística de animais sintomáticos, estes relacionados a graus mais severos de colapso traqueal. Cães de pequeno porte foram os mais acometidos, em especial as raças Poodle, Yorkshire terrier e Pinscher. Além disso, notou-se uma maior incidência desta afecção em cães adultos a idosos. Pela análise dos resultados obtidos com a realização da radiografia compressiva, observou-se tratar de um método diagnóstico simples, seguro e com alta acurácia para o diagnóstico de colapso traqueal. Ademais, os achados quanto às predisposições e tendências clínicas dos pacientes identificadas nesse trabalho auxiliam o clínico em um melhor direcionamento quanto às suas suspeitas, culminando com um diagnóstico mais precoce do colapso traqueal.

Tracheal collapse is a degenerative and progressive disease characterized by anatomical and histological changes in the trachea, and is considered a common cause of upper airway obstruction in small animals. The diagnosis is made based on the animal's history, but it is only definitive through complementary exams, in which radiography is the most used. This study aimed to determine the occurrence of tracheal collapse in dogs by radiographic examination with external cervical tracheal compression, evaluating the degree of severity in symptomatic and asymptomatic animals, as well as determining the most affected breeds. sizes and ages. For this purpose, a retrospective study was conducted in which clinical records and exams of 332 dogs that underwent radiography applying tracheal compression in the veterinary hospital of the institution were analyzed, in the period from January 1, 2010 to December 31, 2020. Data were collected regarding age, breed, size, sex and presence of characteristic clinical symptoms, in addition to checking the reduction of the tracheal lumen and the corresponding degree of collapse. These data were tabulated and statistically analyzed using Tukey's test, Chi-square test for independence and statistics. After the interpretation of the results, there was a higher number of symptomatic animals, which were related to more severe degrees of tracheal collapse. Small dogs were the most affected, especially the breeds Poodle, Yorkshire terrier and Pinscher. Moreover, it was noted a higher incidence of this disease in adult to elderly dogs. By analyzing the results obtained with the compressive radiography, it was observed that it is a simple, safe and highly accurate diagnostic method for the diagnosis of tracheal collapse. Furthermore, the findings regarding predispositions and clinical tendencies of the patients identified in this study also help the clinicians to better direct their suspicions, culminating in an earlier diagnosis of tracheal collapse.

El colapso traqueal es una enfermedad degenerativa y progresiva caracterizada por alteraciones anatómicas e histológicas en la traquea, considerándose una causa común de obstrucción de las vías respiratorias superiores en pequeños animales. El diagnóstico se realiza a partir de los antecedentes del animal, pero sólo es definitivo mediante exámenes complementarios, en los que la radiografia es la más utilizada. El presente estudio tenía como objetivo determinar la aparición del colapso traqueal en perros mediante un examen radiográfico con compresión traqueal cervical externa, evaluando el grado de gravedad en animales sintomáticos y asintomáticos, así como determinar las razas, tamaños y edades más afectadas. Para ello, se realizó un estudio retrospectivo en el que se analizaron las historias clínicas y los exámenes de 332 perros a los que se les realizó una radiografia aplicando compresión traqueal en el hospital veterinario de la institución, en el periodo comprendido entre el 1 de enero de 2010 y el 31 de diciembre de 2020. Se recogieron datos sobre la edad, la raza, el tamaño, el sexo y la presencia de síntomas clínicos característicos, además de comprobar la reducción de la luz traqueal y el correspondiente grado de colapso. Estos datos se tabularon y se analizaron estadisticamente mediante la prueba de Tukey, la prueba de Chi- cuadrado para la independencia y la estadística. Tras la interpretación de los resultados, se observó un mayor número de animales sintomáticos, que estaban relacionados con grados más graves de colapso traqueal. Los perros de pequeño tamaño fueron los más afectados, especialmente las razas Caniche, Yorkshire terrier y Pinscher. Además, se observó una mayor incidencia de esta enfermedad en perros adultos y de edad avanzada. Al analizar los resultados obtenidos con la realización de la radiografia de compresión, se observó que es un método de diagnóstico sencillo, seguro y muy preciso para el diagnóstico del colapso traqueal. Además, los hallazgos relativos a las tendencias predisponentes y clínicas de los pacientes identificados en el presente estudio también ayudan a los clínicos a orientar mejor sus sospechas, culminando en un diagnóstico más temprano del colapso traqueal.

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PURPOSE: Cervical disc arthroplasty (CDA) has become an increasingly popular treatment for cervical degenerative disc disease. One potential complication is osteolysis. However, current literature on this topic appears limited. The purpose of this study is to elucidate the incidence, aetiology, consequence, and subsequent treatment of this complication. METHODS: A systematic literature review was performed according to the PRISMA guidelines. Studies discussing the causes, incidence and management of osteolysis after a CA were included. RESULTS: A total of nine studies were included. We divided these studies into two groups: (1) large case series in which an active radiological evaluation for osteolysis was performed (total = six studies), (2) case report studies, which discussed symptomatic cases of osteolysis (total = three). The incidence of asymptomatic osteolysis ranged from 8 to 64%; however, only one study reported an incidence of < 10% and when this case was excluded the incidence ranged from 44 to 64%. Severe asymptomatic bone loss (exposure of the implant) was found in less than 4% of patients. Bone loss from osteolysis appeared to occur early (< 1 year) after surgery and late (> 1 year) as well. Symptomatic patients with osteolysis often required revision surgery. These patients required removal of implant and conversion to fusion in the majority of the cases. CONCLUSIONS: Osteolysis after CDA is common; however, the majority of cases have only mild or asymptomatic presentations that do not require revision surgery. The timing of osteolysis varies significantly. This may be due to differences in the aetiology of osteolysis.

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Mast cells are immune cells of the myeloid lineage that are found throughout the body, including the central nervous system. They perform many functions associated with innate and specific immunity, angiogenesis, and vascular homeostasis. Moreover, they have been implicated in a series of pathologies (e.g., hypersensitivity reactions, tumors, and inflammatory disorders). In this review, we propose that this cell could be a relevant therapeutic target in multiple sclerosis, which is a central nervous system degenerative disease. To support this proposition, we describe the general biological properties of mast cells, their contribution to innate and specific immunity, and the participation of mast cells in the various stages of multiple sclerosis and experimental autoimmune encephalomyelitis development. The final part of this review is dedicated to an overview of the available mast cells immunomodulatory drugs and their activity on multiple sclerosis and experimental autoimmune encephalomyelitis, including our own experience related to the effect of ketotifen fumarate on experimental autoimmune encephalomyelitis evolution.

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OBJECTIVES: To examine the utilization of current common treatments by providers from different specialties and the effect on delaying spinal surgery in patients with disk degenerative disease (DDD) related low back pain. DESIGN: Retrospective observational study using data from the MarketScan Commercial Claims and Encounters database (2005-2013). SETTING: Not applicable. PARTICIPANTS: Patients (N=6229) newly diagnosed with DDD-related low back pain who received interventional treatments from only 1 provider specialty and continuously enrolled in the database for 3 years after diagnosis. MAIN OUTCOME MEASURES: Measures of treatment utilization and cost were constructed for patients who received spinal surgery within 3 years after diagnosis. Cox proportional hazards models were used to examine time to surgery among provider specialties and generalized linear models were used to examine cost differences among provider specialties. RESULTS: Of the 6229 patients, 427 (6.86%) underwent spinal surgery with unadjusted mean interventional treatment costs ranging from $555 to $851. Although the differences in mean costs across provider specialties were large, they were not statistically significant. Cox proportional hazards models showed that there was no significant difference between provider specialties in the time from DDD diagnosis to spinal surgery. However, patients diagnosed with DDD at a younger age and receiving physical therapy had significantly delayed time to surgery (hazard ratio, 0.66; 95% confidence interval [CI], 0.54-0.81 and hazard ratio, 0.77; 95% CI, 0.62-0.96, respectively). CONCLUSIONS: Although there were no statistically significant differences among provider specialties for time to surgery and cost, patients receiving physical therapy had significantly delayed time to surgery.

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A three-year-old female African pygmy hedgehog (Atelerix albiventris), born and domiciled in Brazil, presented apathy, prostration, and difficulty to stay standing. Its parents were siblings but did not present clinical signs related to this condition. As its clinical condition worsened, the animal was euthanized and referred for necropsy. No gross lesions were found in the central nervous system (CNS). Histologically, there was vacuolation with axonal degeneration in the white matter of the CNS and in peripheral nervous tissue. The Kluver-Barrera (KB) stain confirmed demyelination in vacuolated areas. Immunohistochemistry using several neural markers confirmed astrocytosis and microgliosis associated with vacuolated areas. In addition, there was a mild decrease in the immuno intensity of myelin proteolipid protein (PLP) in these areas. These results suggest a genetic origin of the present demyelination, which resulted in the wobbly syndrome described in this report.(AU)

Um ouriço pigmeu africano de três anos de idade, nascido e domiciliado no Brasil, apresentou apatia, prostração e dificuldade em permanecer em estação. Os pais deste ouriço eram irmãos, mas não apresentaram sinais clínicos relacionados a esta condição. Com a piora dos sinais clínicos, o animal foi eutanasiado e encaminhado para necropsia. Não foram encontradas lesões macroscópicas no sistema nervoso central (SNC). Histologicamente, havia vacuolização com degeneração axonal na substância branca do SNC e no tecido nervoso periférico. A coloração de Kluver-Barrera (KB) confirmou desmielinização nas áreas vacuolizadas e a imuno-histoquímica utilizando vários marcadores, confirmou astrocitose e microgliose associadas com as áreas de vacuolização. Além disso, houve discreta diminuição da imunointensidade da proteína proteolipídica da mielina (PLP) nessas áreas. Estes resultados sugerem origem genética da desmielinização que resultou na síndrome de wobbly descrita neste relato.(AU)

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ABSTRACT: A three-year-old female African pygmy hedgehog (Atelerix albiventris), born and domiciled in Brazil, presented apathy, prostration, and difficulty to stay standing. Its parents were siblings but did not present clinical signs related to this condition. As its clinical condition worsened, the animal was euthanized and referred for necropsy. No gross lesions were found in the central nervous system (CNS). Histologically, there was vacuolation with axonal degeneration in the white matter of the CNS and in peripheral nervous tissue. The Kluver-Barrera (KB) stain confirmed demyelination in vacuolated areas. Immunohistochemistry using several neural markers confirmed astrocytosis and microgliosis associated with vacuolated areas. In addition, there was a mild decrease in the immuno intensity of myelin proteolipid protein (PLP) in these areas. These results suggest a genetic origin of the present demyelination, which resulted in the wobbly syndrome described in this report.

RESUMO: Um ouriço pigmeu africano de três anos de idade, nascido e domiciliado no Brasil, apresentou apatia, prostração e dificuldade em permanecer em estação. Os pais deste ouriço eram irmãos, mas não apresentaram sinais clínicos relacionados a esta condição. Com a piora dos sinais clínicos, o animal foi eutanasiado e encaminhado para necropsia. Não foram encontradas lesões macroscópicas no sistema nervoso central (SNC). Histologicamente, havia vacuolização com degeneração axonal na substância branca do SNC e no tecido nervoso periférico. A coloração de Kluver-Barrera (KB) confirmou desmielinização nas áreas vacuolizadas e a imuno-histoquímica utilizando vários marcadores, confirmou astrocitose e microgliose associadas com as áreas de vacuolização. Além disso, houve discreta diminuição da imunointensidade da proteína proteolipídica da mielina (PLP) nessas áreas. Estes resultados sugerem origem genética da desmielinização que resultou na síndrome de wobbly descrita neste relato.

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BACKGROUND: In 1988, Modic and his colleagues described changes in the subchondral bone marrow of the vertebral plates in patients with degenerative disease or other pathologies, which were observed in the nuclear magnetic resonance (NMR) of the spine and were subdivided into three patterns of signal changes, called Modic type I, Modic type II and Modic type III. The main differential diagnosis of the Modic I changes of the vertebral plates due to degenerative disease in spine NMR, is infection in its early stages. In their study in 2014, Patel and collaborators, using a protocol and the concept of diffusion in spine MRI, were able to demonstrate that by means of the "claw sing", a degenerative disease with Modic type I changes, can be differentiated from an infection in early stages. In this series of cases, the algorithm used by Patel et al. was implemented. METHODS: The clinical records of patients who consulted the emergency department for lumbar pain without clear etiology, between January 1, 2017 and December 31, 2017, were analyzed. Due to axial lumbar pain, subjects were hospitalized and studies were ordered, including contrasted MRI of the lumbosacral spine. Then, with laboratory tests and MRI findings of Modic type I changes, it was not possible to differentiate between degenerative disease vs. spondylodiscitis. Therefore, the algorithm used in the study by Patel and collaborators was applied. RESULTS: There were 13 patients identified with lumbar or dorsal pain over 3 months of evolution, with nonspecific symptoms; 5 patients (38.46%) reported arterial hypertension, 4 patients (30.77%) diabetes mellitus, and 4 patients (30.77%) chronic kidney disease stage V in management with hemodialysis, 3 patients (23.08%) presented immunosuppressive conditions and 3 patients (23.08%) had a history of spinal surgery with instrumentation. All the patients were hospitalized and a lumbosacral and thoracic spine simple MRI was performed with Modic type I changes to perform contrast-enhanced MRI with diffusion and ADC. From the 13 cases studied for low back pain, there were 7 patients (53.85%) with confirmed findings of Modic type I changes due to degenerative disease for presenting claw sign in spinal MRI diffusion and 6 patients (46.15%) Modic type changes I due to infection in the absence of a claw sign in the column MRI diffusion. CONCLUSIONS: Spinal column MRI with diffusion is useful to differentiate patients with type I changes due to degenerative disease with positive claw sign; of patients with type I changes due to infection with absent claw sign. In addition, in patients with compromised renal function, column MRI with diffusion without contrast could be a diagnostic alternative, since it does not require contrast media to confirm infection.

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Introducción: La enfermedad degenerativa articular afecta a todas las estructuras intrarticulares entre las que se encuentran el menisco y el cartílago. Las lesiones del menisco están asociadas a otras enfermedades que provocan dolor. Objetivo: Describir el comportamiento de las lesiones degenerativas del menisco en un grupo de pacientes. Métodos: Se realizó un estudio observacional analítico, con 230 pacientes que presentan diagnóstico clínico, imaginológico y artroscópico de lesiones degenerativas del menisco, atendidos en el Hospital Universitario Manuel Ascunce Domenech, del 9 octubre de 2012 al 22 de enero de 2018. Las variables del estudio fueron: edad, sexo, rodilla derecha e izquierda, menisco medial-lateral, las cinco variantes de la clasificación artroscópica de Boyer T, síntomas y signos, lesiones intrarticulares asociadas, lesión de cartílagos y procedimientos artroscópicos. Se empleó la distribución de frecuencias absoluta y relativa en el análisis de las variables cualitativas y la media aritmética para la variable cuantitativa edad. Para la relación entre variables cualitativas independientes se utilizó la prueba de chi-cuadrado. Resultados: El promedio de edades de los pacientes estudiados fue de 54,5 años. La proporción por sexo fue 2,5 mujeres por 1 hombre afectado. Según la clasificación artroscópica de Boyer T, hubo mayor incidencia del tipo I en los enfermos (47 por ciento). Predominó el dolor difuso de la articulación. La lesión asociada con mayor incidencia fue la de cartílagos grados III/IV. Los procedimientos artroscópicos más empleados fueron: el lavado articular, desbridamiento y la meniscectomía parcial. Conclusiones: Las lesiones degenerativas del menisco son frecuentes en pacientes con la enfermedad degenerativa articular. Se asocian a otras enfermedades articulares que provocan dolor, de ahí que sus síntomas y signos sean similares. El grado de afección del menisco no es simétrico al del cartílago. El tratamiento artroscópico es el de elección, por sus múltiples ventajas. Son necesarios varios procedimientos en un mismo enfermo(AU)

Introduction: The articular degenerative disease affects all intra-articular structures, including meniscus and cartilage. Meniscus injuries are associated with other diseases that cause pain. Objective: To describe the behavior of meniscal degenerative lesions in a group of patients. Methods: An analytical observational study was carried out in 230 patients presenting a clinical, imaging and arthroscopic diagnosis of meniscus degenerative lesions; they were treated at Manuel Ascunce Domenech University Hospital, from October 9, 2012 to January 22, 2018. The variables of the study were age, sex, right and left knee, medial-lateral meniscus, Boyer's T five variants of arthroscopic classification, symptoms and signs associated intra-articular injuries, cartilage injury and arthroscopic procedures. The distribution of absolute and relative frequencies was used in the analysis of the qualitative variables and the arithmetic mean for the quantitative age variable. The chi-square test was used to assess the relationship between independent qualitative variables. Results: The average age of the patients studied was 54.5 years. The proportion by sex was 2.5 women per one affected man. According to Boyer T arthroscopic classification, there was higher incidence of type I in these patients (47 percent). The joint diffuse pain predominated. The highest incidence lesion associated was cartilages grades III / IV. Joint washing, debridement and partial meniscectomy were the most arthroscopic procedures used. Conclusions: Degenerative lesions of the meniscus are frequent in patients with degenerative joint disease. They are associated with other joint diseases that cause pain; hence, their symptoms and signs are similar. The degree of affection of the meniscus is not symmetrical to that of the cartilage. The treatment of choice is arthroscopic, due to its multiple advantages. Several procedures are necessary in the same patient(AU)

Introduction: La maladie articulaire dégénérative touche toutes les structures intra-articulaires, telles que le ménisque et le cartilage. Les lésions méniscales sont associées à d'autres affections qui provoquent la douleur. Objectif: Le but de cet article est de décrire le comportement des lésions méniscales dégénératives dans un groupe de patients. Méthodes: Une étude observationnelle et analytique de 230 patients diagnostiqués de lésions méniscales dégénératives par examen clinique, IRM et arthroscopie, et traités à l'hôpital universitaire Manuel Ascunce Domenech, du 9 octobre 2012 au 22 janvier 2018, a été réalisée. Les variables utilisées dans cette étude ont compris l'âge, le sexe, le genou affecté (gauche et droit), le ménisque médial-latéral, les cinq variables de la classification arthroscopique de Boyer, les symptômes et signes, les lésions intra-articulaires associées, la lésion de cartilages, et les méthodes arthroscopiques. On a employé la distribution des fréquences absolues et relatives pour l'analyse des variables qualitatives, et la moyenne arithmétique pour la variable quantitative de l'âge. Pour la relation entre les variables qualitatives indépendantes, on a utilisé le test du chi carré (χ2). Résultats: L'âge moyen des patients dans cette étude a été 54.5 ans. Le sex-ratio a été de 2,5 femmes contre 1 homme. Selon la classification arthroscopique de Boyer, les lésions de type I ont été les plus fréquentes chez les malades (47 %). La douleur diffuse de l'articulation a été en prédominance. La lésion intra-articulaire associée de plus haute incidence a été celle de cartilages grades III/IV. Parmi les procédés arthroscopiques les plus souvent utilisés, on peut trouver le lavage articulaire, le débridement et la méniscectomie partielle. Conclusions: Les lésions méniscales dégénératives sont fréquentes chez les patients atteints de maladie articulaire dégénérative. Elles sont associées à d'autres affections articulaires provoquant la douleur, c'est pourquoi leurs symptômes et signes sont similaires. Le grade d'atteinte du ménisque est différent à celui du cartilage. Étant donné ses multiples bénéfices, le procédé arthroscopique est le traitement de choix. Il faut utiliser plusieurs procédés chez un même malade(AU)

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Este trabalho tem como objetivo relatar os efeitos das intervenções, utilizando o recurso da tecnologia assistiva, com uma criança com doença degenerativa do sistema nervoso central, em seu domicílio. Trata-se de um estudo de caso, realizado em sete encontros, abordando a criança e seus responsáveis, durante um processo de avaliação, confecção de dispositivos assistivos, orientação da família e avaliação da repercussão no ambiente familiar. Os resultados evidenciaram que a criança apresenta comprometimentos significativos do quadro motor, cognitivo e psicossocial, acarretando em dificuldades na realização de atividades de vida diária, na comunicação e no brincar. Foram propostas adaptações, para favorecer o envolvimento da criança e atenuar as dificuldades da família, nos equipamentos e ambientes, como cadeira de rodas, quarto, banheiro, órtese, brinquedo e comunicação. Por fim, observou-se que os recursos da tecnologia assistiva foram utilizados de acordo com a necessidade e a realidade da criança, e também se pôde constatar que as visitas domiciliares contribuíram positivamente na vida da família ao facilitar o cuidado com a criança, apesar das dificuldades enfrentadas.

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Myopia is absent in undisturbed hunter-gatherers but ubiquitous in modern populations. The link between dietary phytochemicals and eye health is well established, although transition away from a wild diet has reduced phytochemical variety. We hypothesized that when larger quantities and greater variety of wild, seasonal phytochemicals are consumed in a food system, there will be a reduced prevalence of degenerative-based eye disease as measured by visual acuity. We compared food systems and visual acuity across isolated Amazonian Kawymeno Waorani hunter-gatherers and neighboring Kichwa subsistence agrarians, using dietary surveys, dietary pattern observation, and Snellen Illiterate E visual acuity examinations. Hunter-gatherers consumed more food species (130 vs. 63) and more wild plants (80 vs. 4) including 76 wild fruits, thereby obtaining larger variety and quantity of phytochemicals than agrarians. Visual acuity was inversely related to age only in agrarians (r = -.846, P < .001). As hypothesized, when stratified by age (<40 and ≥ 40 years), Mann-Whitney U tests revealed that hunter-gatherers maintained high visual acuity throughout life, whereas agrarian visual acuity declined (P values < .001); visual acuity of younger participants was high across the board, however, did not differ between groups (P > .05). This unusual absence of juvenile-onset vision problems may be related to local, organic, whole food diets of subsistence food systems isolated from modern food production. Our results suggest that intake of a wider variety of plant foods supplying necessary phytochemicals for eye health may help maintain visual acuity and prevent degenerative eye conditions as humans age.

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