Targets Involved in Skin Aging and Photoaging and their Possible Inhibitors: A Mini-review.

BACKGROUND: Skin aging is a natural process resulting from intrinsic (hormonal and genetic) and extrinsic (environmental) factors. Photoaging occurs due to prolonged exposure of the skin to ultraviolet radiation, accounting for 80% of facial aging. INTRODUCTION: Characteristics of aging skin include reduced elasticity, the appearance of fine wrinkles, uneven tone, and dryness. Clinical signs of photoaging involve the presence of deeper wrinkles, rough texture, dyschromia and a greater loss of elasticity compared to chronological aging. METHODS: This work reported several scientific articles that used computational techniques, such as molecular docking, molecular dynamics and quantitative structure-activity relationship (QSAR) to identify natural products and their derivatives against skin aging and photoaging. RESULTS: The in silico analyses carried out by the researchers predicted the binding affinity and interactions of the natural products with the targets matrix metalloproteinase-1, matrix metalloproteinase- 3, matrix metalloproteinase-9 and tyrosinase. Furthermore, some studies have reported the stability of the protein-ligand complex and the physicochemical properties of the studied compounds. Finally, this research proposes promising molecules against the targets. CONCLUSION: Thus, studies like this one are relevant to guide new research related to skin aging and photoaging.

Benefits of the Dermocosmetic Mineral 89 Probiotic Fractions Adjunct to Topical Retinoids for Anti-Aging Benefits.

Purpose: Tretinoin is a topical gold standard for photoaging treatment. However, patient adherence can be impaired by local tolerability in the first 1-2 weeks of treatment. Mineral 89 Probiotic Fractions® (M89PF) containing Vichy volcanic mineralizing water®, probiotic fractions, hyaluronic acid, niacinamide and tocopherol was developed to fulfill the need for adjunctive products that can reinforce skin barrier and manage retinoid induced irritation. Patients and Methods: The study included 38 women, aged 44-60 years, phototype II-VI, applying 0.025% tretinoin gel once nightly for 84 days. For 28 days, one hemi face was treated with M89PF and sunscreen SPF 50+ while other hemi face received sunscreen only. Then, M89PF application was changed to full face. Evaluations were performed at days 0, 7, 28 and 84. Erythema, dryness, fine lines, skin tone, radiance and pore appearance were assessed by a dermatologist. Tolerability was evaluated through self-assessment questionnaire. Skin hydration levels, inflammatory and oxidative stress biomarkers were analyzed by immunological assay: Interleukin(IL)-8, IL1-alpha, IL1-Receptor Antagonist (IL-1Ra), Prostaglandin E2 (PGE2), Catalase and Superoxide Dismutase (SOD). Results: Hemiface analysis showed that erythema, fine lines, skin tone, radiance, pore appearance, hydration, tightness, dryness, burning, itching and stinging sensations were improved (p<0.05) on the M89PF side. At full face analysis on D84, erythema, fine lines, skin tone, radiance and pore appearance were improved compared to D0 (p<0.001). Tightness, dryness, burning, itching and stinging were reduced when compared to D7 (p<0.05). Dermatology Life Quality Index (DLQI) and Skindex 16 showed improvement in quality of life (p<0.05). IL-1RA increased at D28 (p=0.003) and PGE2 decreased at D28 and D84 compared to D0 (p<0.01). Conclusion: M89PF reduced retinoid induced irritation with a good tolerability profile and, used as an adjunct to topical tretinoin, significantly improved skin hydration, erythema, fine lines, skin tone, radiance and pore appearance.

Ventilação protetora na síndrome do desconforto respiratório agudo causada pela COVID-19: o manejo do fisioterapeuta / Protective ventilation in acute respiratory distress syndrome caused by COVID-19: the management of the physiotherapist

Objetivos: conhecer o manejo do fisioterapeuta relacionado à ventilação protetora em pacientes com SDRA por COVID-19, listando as principais estratégias utilizadas e as barreiras encontradas para sua implementação. Métodos: estudo de campo transversal e descritivo, de caráter quantitativo, realizado no período de outubro de 2021 a abril de 2022, com fisioterapeutas de hospitais públicos e privados, na cidade de Fortaleza, que tivessem experiência com pacientes infectados pela COVID-19. Para coleta de dados, utilizou-se um formulário online viabilizado pela plataforma Google Forms. Os dados foram tabulados em planilha Microsoft Excel® 2010 e, posteriormente, transferido para o Statistical Package for the Social Sciences (SPSS®) 20.0, utilizando-se a estatística descritiva. Resultados: participaram 102 fisioterapeutas, 74,5% do gênero feminino. As principais estratégias de ventilação protetora citadas foram: volume corrente de 6 mL/Kg por peso predito, pressão de platô menor que 30 cmH2O e driving pressure menor que 15 cmH2O (93,1%), além da titulação de PEEP (68,6%) e posição prona (64,7%). Manter uma driving pressure menor que 15 cmH2O (57,8%) e discordância profissional (43,1%) foram as principais barreiras encontradas para realização da ventilação protetora. Conclusão: a ventilação protetora configura-se no uso de baixos volumes e pressões, titulação da PEEP e posição prona. A manutenção de driving pressure menor que 15 cmH2O e discordância entre os profissionais na tomada de decisão destacam-se como as principais barreiras.

Objectives: to know the management of the physiotherapist related to protective ventilation in patients with ARDS due to COVID-19, listing the main strategies used and the barriers encountered for their implementation. Methods: a cross-sectional and descriptive field study of quantitative nature, conducted from October 2021 to April 2022, with physiotherapists from public and private hospitals in the city of Fortaleza who had experience with patients infected with COVID-19. For data collection, an online form made possible by the Google Forms platform was used. The data was tabulated in a Microsoft Excel spreadsheet® and then transferred to the Statistical Package for the Social Sciences (SPSS®) using descriptive statistics. Findings: 102 physical therapists participated in the study, 74.5% female. The main protective ventilation strategies mentioned were: tidal volume of 6 mL/Kg by predicted weight, plateau pressure less than 30 cmH2O, and driving pressure less than 15 cmH2O (93.1%), in addition to PEEP titration (68.6%) and prone position (64.7%). Maintaining driving pressure of less than 15 cmH2O (57.8%) and professional disagreement (43.1%) were the main barriers found to performing protective ventilation. Conclusion: protective ventilation is configured in the use of low volumes and pressures, PEEP titration, and the prone position. The maintenance of driving pressure lower than 15 cmH2O and disagreement between professionals in the decision-making stand out as the main barriers

Vivência de fisioterapeutas com pacientes hospitalizados sob oxigenoterapia / Experience of physiotherapists with hospitalized patients under oxygen therapy

Objetivo: este estudo objetivou conhecer a vivência de fisioterapeutas com pacientes hospitalizados sob oxigenoterapia, bem como identificar os desafios vivenciados durante a sua intervenção. Métodos: trata-se de um estudo quantitativo e transversal, realizado no período de setembro de 2021 a março de 2022, com fisioterapeutas atuantes em hospitais da cidade de Fortaleza-CE. A coleta de dados foi realizada de forma presencial e virtual pela plataforma Google Forms, por meio de um questionário com perguntas objetivas sobre vivência, intervenção e desafios durante assistência ao paciente sob oxigenoterapia. Os dados coletados foram armazenados no Microsoft Excel® 2010 e analisados pelo SPSS® versão 20.0, utilizando-se de estatística descritiva. Resultados: participaram do estudo 101 fisioterapeutas, 76,2% do gênero feminino, e 45,5% dos participantes eram graduados há 5 anos. Destes, 83,2% dos fisioterapeutas afirmaram que SpO2 < 90% é indicativo de oxigenoterapia. A maioria (79,2%) discordou da utilização da máscara de Venturi para pacientes com Covid-19 e apontou a cânula nasal de alto fluxo (39,6%) e a máscara reservatório não reinalante (40,6%) como as mais utilizadas. Entre os desafios enfrentados durante a assistência, a interação com a equipe interdisciplinar (25,70%), o desmame da oxigenoterapia (21,80%) e a indisponibilidade de recursos (20,80%) foram os mais relatados. Conclusão: grande parte dos profissionais atua indicando o oxigênio suplementar em situações em que há SaO2 < 90%, realizando avaliação à beira leito da cânula nasal de alto fluxo por meio do índice ROX e indicando intervenção fisioterapêutica.

Objective: this study aimed to understand the experience of physiotherapists with patients hospitalized under oxygen therapy, as well as to identify the challenges experienced during their intervention. Methods: it was a quantitative and cross-sectional study conducted from September 2021 to March 2022, with physiotherapists working in hospitals in Fortaleza-CE. Data collection was performed in person and virtually through the Google Forms platform, through a questionnaire with objective questions about experience, intervention, and challenges during care to patients under oxygen therapy. The collected data were stored in Microsoft Excel® 2010 and analyzed by SPSS® version 20.0, using descriptive statistics. Results: the study included 101 physical therapists, 76.2% female, and 45.5% of the participants had graduated for five years. Of these, 83.2% of physical therapists stated that SpO2 < 90% is indicative of oxygen therapy. The majority (79.2%) disagreed with the use of the venturi mask for patients with Covid-19 and pointed to the high-flow nasal cannula (39.6%) and the non-reinlantreservoir mask (40.6%) as the most used. Among the challenges faced during care, interaction with the interdisciplinary team (25.70%), weaning from oxygen therapy (21.80%), and unavailability of resources (20.80%) was the most reported. Conclusion: most professionals indicate supplemental oxygen in situations where SaO2 < 90%, perform an evaluation at the bedside of the high-flow nasal cannula from the ROX index and suggest physiotherapeutic intervention.

High-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes.

BACKGROUND: We evaluated the efficacy of high protein intake and early exercise versus standard nutrition care and routine physiotherapy on the outcome of critically ill patients. METHODS: We randomized mechanically ventilated patients expected to stay in the intensive care unit (ICU) for 4 days. We used indirect calorimetry to determine energy expenditure and guide caloric provision to the patients randomized to the high protein and early exercise (HPE) group and the control group. Protein intakes were 1.48 g/kg/day and 1.19 g/kg/day medians respectively; while the former was submitted to two daily sessions of cycle ergometry exercise, the latter received routine physiotherapy. We evaluated the primary outcome physical component summary (PCS) score at 3 and 6 months) and the secondary outcomes (handgrip strength at ICU discharge and ICU and hospital mortality). RESULTS: We analyzed 181 patients in the HPE (87) and control (94) group. There was no significant difference between groups in relation to calories received. However, the amount of protein received by the HPE group was significantly higher than that received by the control group (p < 0.0001). The PCS score was significantly higher in the HPE group at 3 months (p = 0.01) and 6 months (p = 0.01). The mortality was expressively higher in the control group. We found an independent association between age and 3-month PCS and that between age and group and 6-month PCS. CONCLUSION: This study showed that a high-protein intake and resistance exercise improved the physical quality of life and survival of critically ill patients. TRIAL REGISTRATION: Research Ethics Committee of Hospital São Domingos: Approval number 1.487.683, April 09, 2018. The study protocol was registered in ClinicalTrials.gov ( NCT03469882 , March 19,2018).

Neospora caninum infection in cattle in the state of Amazonas, Brazil: seroprevalence, spatial distribution and risk factors.

Livestock in the Amazon has grown significantly and, although neosporosis in cattle has been reported worldwide, there is no information about N. caninum in production systems in the state of Amazonas. The objective of this study was to determine the prevalence of anti-Neospora caninum antibodies in cattle, their spatial distribution and the risk factors associated with N. caninum infection in the state of Amazonas. Questionnaires were applied to farmers to assess risk factors associated with N. caninum infection. Blood samples were collected from 1,073 animals on 47 farms in 33 municipalities in the four Amazonian subpopulations. IgG anti-N.caninum antibodies were detected by the indirect fluorescence test, with a general prevalence of 30.2%, being seropositive in 43 farms (91.5%), with prevalence ranging from 2.2% to 69.2%. The highest number of high density points was found in subpopulation 3 (municipality of Apuí and other municipalities on the Madeira River and affluent). It was concluded that N. caninum is present with high seroprevalence values, when compared to other cattle producing states in the Amazon region of Brazil. The identified factors can be used as risk indicators so that control measures can be implemented to prevent infection by N. caninum in these herds.

Evaluation of the efficacy and tolerance of a cosmetic mask containing 89% of vichy volcanic mineralizing water and hyaluronic acid after facial laser procedures.

BACKGROUND: M89 M (Mineral 89 mask, Laboratoires Vichy, France), containing 89% Vichy volcanic mineralizing water and hyaluronic acid, aims to strengthen and repair skin barrier. AIMS: To assess the efficacy, tolerance, patient satisfaction, and quality of life (QOL) using M89 M after laser procedures (LP). METHODS: M89 M was applied immediately post-LP for 10 minutes, then daily for 5 days and 2-3 times a week, up to 28 days on the faces of 51 women. Evaluations were performed immediately post-LP, immediately after M89 M application at D0, D1, D5, and D28, and included criteria such as erythema and skin dryness. Subjects scored burning and warm sensations, itching, skin tightness, and stinging. Skin hydration using a Corneometer, skin barrier integrity using a Tewameter, and erythema using a Chromameter were assessed. Local tolerance and adverse events were recorded. After 28 days, subjects answered a questionnaire regarding the M89 M subjective cosmetic properties and QOL. RESULTS: All subjects were in their mid-forties with a phototype of II, III, or IV. M89 M significantly (P < .001) reduced the immediate cutaneous discomfort sensation and laser procedure-related symptoms (burning, warmth sensation, itching/stinging, skin tightness). Skin hydration, and erythema, assessed using instrumental measures, were also significantly improved immediately after mask application (P ≤ .01). Subjects highly appreciated M89 M and their QOL improved after 28 days of use. Local tolerance was good to excellent in both studies. CONCLUSION: M89 M is effective and safe immediately after esthetic procedures such as ablative and nonablative lasers and also improves the subject's QOL.

Neospora caninum infection in cattle in the state of Amazonas, Brazil: seroprevalence, spatial distribution and risk factors / Infecção por Neospora caninum em bovinos no estado do Amazonas, Brasil: soroprevalência, distribuição espacial e fatores de risco

Abstract Livestock in the Amazon has grown significantly and, although neosporosis in cattle has been reported worldwide, there is no information about N. caninum in production systems in the state of Amazonas. The objective of this study was to determine the prevalence of anti-Neospora caninum antibodies in cattle, their spatial distribution and the risk factors associated with N. caninum infection in the state of Amazonas. Questionnaires were applied to farmers to assess risk factors associated with N. caninum infection. Blood samples were collected from 1,073 animals on 47 farms in 33 municipalities in the four Amazonian subpopulations. IgG anti-N.caninum antibodies were detected by the indirect fluorescence test, with a general prevalence of 30.2%, being seropositive in 43 farms (91.5%), with prevalence ranging from 2.2% to 69.2%. The highest number of high density points was found in subpopulation 3 (municipality of Apuí and other municipalities on the Madeira River and affluent). It was concluded that N. caninum is present with high seroprevalence values, when compared to other cattle producing states in the Amazon region of Brazil. The identified factors can be used as risk indicators so that control measures can be implemented to prevent infection by N. caninum in these herds.

Resumo A pecuária na Amazônia tem crescido significativamente e, embora a neosporose em bovinos tenha sido relatada em todo o mundo, não há informações sobre N. caninum nos sistemas de produção no estado do Amazonas. Objetivou-se determinar a prevalência de anticorpos anti-Neospora caninum em bovinos, sua distribuição espacial e os fatores de risco associados à infecção por N. caninum no estado do Amazonas. Questionários foram aplicados aos fazendeiros, para avaliar fatores de risco associados à infecção por N. caninum. Amostras de sangue foram coletadas de 1.073 animais em 47 fazendas, em 33 municípios das quatro subpopulações amazonenses. Anticorpos IgG anti-N.caninum foram detectados pelo teste de imunofluorescência indireta, com prevalência geral de 30,2%, com soropositividade em 43 fazendas (91,5%), com prevalência variando de 2,2% a 69,2%. O maior número de pontos de alta densidade foi encontrado na subpopulação 3 (município de Apuí e demais municípios do rio Madeira e afluentes). Concluiu-se que N. caninum está presente com altos valores de soroprevalência, quando comparado a outros estados produtores de gado na região amazônica do Brasil. Os fatores identificados podem ser usados como indicadores de risco, para que medidas de controle possam ser implementadas para prevenir a infecção por N. caninum nesses rebanhos.

Brain and kidney GHS-R1a underexpression is associated with changes in renal function and hemodynamics during neurogenic hypertension.

Ghrelin is a peptide hormone whose effects are mediated by the growth hormone secretagogue receptor subtype 1a (GHS-R1a), mainly expressed in the brain but also in kidneys. The hypothesis herein raised is that GHS-R1a would be player in the renal contribution to the neurogenic hypertension pathophysiology. To investigate GHS-R1a role on renal function and hemodynamics, we used Wistar (WT) and spontaneously hypertensive rats (SHR). First, we assessed the effect of systemically injected vehicle, ghrelin, GHS-R1a antagonist PF04628935, ghrelin plus PF04628935 or GHS-R1a synthetic agonist MK-677 in WT and SHR rats housed in metabolic cages (24 h). Blood and urine samples were also analyzed. Then, we assessed the GHS-R1a contribution to the control of renal vasomotion and hemodynamics in WT and SHR. Finally, we assessed the GHS-R1a levels in brain areas, aorta, renal artery, renal cortex and medulla of WT and SHR rats using western blot. We found that ghrelin and MK-677 changed osmolarity parameters of SHR, in a GHS-R1a-dependent manner. GHS-R1a antagonism reduced the urinary Na+ and K+ and creatinine clearance in WT but not in SHR. Ghrelin reduced arterial pressure and increased renal artery conductance in SHR. GHS-R1a protein levels were decreased in the kidney and brain areas of SHR when compared to WT. Therefore, GHS-R1a role in the control of renal function and hemodynamics during neurogenic hypertension seem to be different, and this may be related to brain and kidney GHS-R1a downregulation.

Is thoracoscopic esophageal atresia repair safe in the presence of cardiac anomalies?

BACKGROUND: Esophageal atresia (EA) is often associated with congenital heart disease (CHD). Repair of EA by the thoracoscopic approach places physiological stress on a newborn with CHD. This paper reviews the outcomes of infants with CHD who had undergone thoracoscopic EA repair, comparing their outcomes to those without CHD. METHODS: This was a review of infants who underwent thoracoscopic EA repair from 2009 to 2017 at one institution. Operative time and outcomes were analyzed in relation to CHD status. RESULTS: Twenty five infants underwent thoracoscopic EA repair during the study period. Seventeen (68%) had associated anomalies of whom 9 (36%) had cardiac anomalies. The mean operative time was 217 min. There was no difference in operative time between CHD and non-CHD cases (estimate 20 min longer operative time in the presence of a cardiac anomaly [95% CI -20 to 57]). Two cases were converted to open thoracotomy; both were non-CHD. There was no difference in the time to feeding, time in intensive care unit or time in hospital between CHD and non-CHD cases. Five patients developed an anastomotic leak (two CHD and three non-CHD) of which two were clinical; all were managed conservatively. There was no case of recurrent fistula. CONCLUSIONS: This pilot study did not find evidence that thoracoscopic EA repair compromised outcomes in children with congenital heart disease. A prospective multicenter study with long-term follow-up is recommended to confirm whether thoracoscopic repair in CHD is truly equivalent to the open operation. TYPE OF STUDY: Therapeutic. LEVEL OF EVIDENCE: Level III.

Serological survey and risk factors for Toxoplasma gondii infection in cattle from Amazonas, Brazil.

Beef cattle farming in the Amazon region has expanded rapidly, but information on herd health is still scanty. The purpose of this study was to determine the presence of anti-Toxoplasma gondii antibodies in cattle, its spatial distribution and the risk factors associated with the infection in the state of Amazonas, Brazil. Blood samples were collected from 1073 animals on 47 farms, located in 33 municipalities in the four state subpopulations. Anti-T. gondii IgG antibodies were detected by means of the indirect fluorescent antibody test (IFAT). The overall prevalence was 30.9 % (332/1073), and seropositive animals were identified at 93.6 % farms (44/47). All the subpopulations studied in the state of Amazonas had cattle herds seropositive for T. gondii, with some areas showing higher prevalence rates. The risk factors identified in the logistic regression were number of animals (OR = 4.43) and presence of domestic cats (OR = 1.98). It is advisable to correct identified risk factors, particularly insofar as the definitive hosts of T. gondii are concerned. Attention should also focus on beef consumption, given the prevalence of T. gondii infection among cattle and the widespread clandestine slaughtering that occurs in this state.

Pesquisa de Staphylococcus spp. em profissionais de ordenha de propriedades leiteiras no Estado de Pernambuco, Brasil / Search for Staphylococcus spp. in milkers of dairy farms in Pernambuco State, Brazil

A contaminação de ordenhadores por Staphylococcus spp. tem sido descrita como um fator de risco para infecções intramamárias em animais durante o procedimento de ordenha. Objetivou-se avaliar a colonização por Staphylococcus spp. da região palmar/interdigital e da cavidade nasal em funcionários de ordenha de propriedades leiteiras no Município de Venturosa-PE. Foram coletadas amostras de swab nasal e das mãos de funcionários (n=6) de três propriedades leiteiras. Em todas as amostras de swab nasal (6/6) e em 33,3% (2/6) de swab das mãos foram isolados Staphylococcus spp. Além disso, todos os isolados foram classificados como Staphylococcus Coagulase Negativo (SCN), o que indica a disseminação desses micro-organismos.

Isolation of Salmonella spp. in cattle egrets (Bubulcus ibis) from Fernando de Noronha Archipelago, Brazil

Abstract The growth of the population of cattle egrets (Bubulcus ibis) in the archipelago of Fernando de Noronha constitutes a threat to public health and biological diversity because of their competition with and predation on native species and the possibility of transmission of pathogens to human beings, livestock and native wildlife. The aim here was to search for, isolate and identify serovars of Salmonella in clinically healthy local cattle egrets. Cloacal swabs were obtained from 456 clinically healthy cattle egrets of both sexes and a variety of ages. The swabs were divided into 51 pools. Six of these (11.7%) presented four serovars of Salmonella enterica subspecies enterica: Salmonella serovar Typhimurium; Salmonella serovar Newport; Salmonella serovar Duisburg; and Salmonella serovar Zega. One sample was identified as S. enterica subspecies enterica O16:y:-. Results in this study suggest that cattle egrets may be reservoirs of this agent on Fernando de Noronha and represent a risk to public health and biological diversity.

Gestação e queimadura: experiência de unidade de queimaduras em Hospital Universitário / Pregnancy and burns: experience of a university hospital burn unit

Introdução: A incidência de queimaduras em gestantes não é bem estabelecida na literatura mundial, mas estima-se que varie entre 3% e 7%. Os cuidados da gestante queimada representam um grande desafio com impacto significante nos resultados e prognóstico materno-fetais. Relato de Caso: No presente estudo relatamos dois casos de gestantes vítimas de queimaduras que foram tratadas na unidade de tratamento de queimaduras na Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/UNIFESP), uma no primeiro trimestre e a outra no terceiro trimestre. Conclusão: Em ambos os casos, as gestantes receberam tratamento especializado para queimaduras em conjunto com acompanhamento clínico da equipe da obstetrícia, com boa evolução materno-fetal.

Introduction: The incidence of burns involving pregnant women is not well established in the literature, but is estimated to be between 3% and 7%. The management of burns in pregnancy represents a great challenge with significant impact on outcomes and maternal-fetal prognosis. Case Report: In the present study, we report two cases of pregnant burn victims who were treated in the burn unit in the Paulista School of Medicine, Federal University of São Paulo (EPM/UNIFESP). One patient was treated in the first trimester and the other in the third trimester. Conclusion: In both cases, the pregnant women received specialized treatment for burns in conjunction with clinical follow-up by the obstetrics team, with good maternal-fetal outcomes.

Isolation of Salmonella spp. in cattle egrets (Bubulcus ibis) from Fernando de Noronha Archipelago, Brazil.

The growth of the population of cattle egrets (Bubulcus ibis) in the archipelago of Fernando de Noronha constitutes a threat to public health and biological diversity because of their competition with and predation on native species and the possibility of transmission of pathogens to human beings, livestock and native wildlife. The aim here was to search for, isolate and identify serovars of Salmonella in clinically healthy local cattle egrets. Cloacal swabs were obtained from 456 clinically healthy cattle egrets of both sexes and a variety of ages. The swabs were divided into 51 pools. Six of these (11.7%) presented four serovars of Salmonella enterica subspecies enterica: Salmonella serovar Typhimurium; Salmonella serovar Newport; Salmonella serovar Duisburg; and Salmonella serovar Zega. One sample was identified as S. enterica subspecies enterica O16:y:-. Results in this study suggest that cattle egrets may be reservoirs of this agent on Fernando de Noronha and represent a risk to public health and biological diversity.

Toxoplasma gondii in backyard pigs: seroepidemiology and mouse bioassay.

The aim of this study was to evaluate the occurrence of Toxoplasma gondii in backyard pigs destined for human consumption in Pernambuco state, Brazil. Blood and tissue samples (liver, heart, brain, lung and diaphragm) were collected from 224 pigs from legal slaughterhouses and tested for T. gondii infection. Antibodies to T. gondii were found in the sera of 37.9% (85/224) by using the immunofluorescence antibody test (cut-off - 1:64). Tissue samples from seropositive pigs were bioassayed in mice. Tissue samples from seropositive pigs and from mice of the bioassay were submitted to histopathology, immunohistochemistry, polymerase chain reaction (PCR) and sequencing; 14.1% of pig tissue samples and 27.7% of bioassayed mouse samples were positive for T. gondii DNA, but all pig and mouse tissues were negative in histopathology analysis and immunochemistry. By using a risk assessment questionnaire, there was significant difference (p<0.001) in seroprevalence of 21.2% (reproducer) and 3.1% (finishing pig). These data serve as indicative of the sanitary conditions and risk of T. gondii infection for backyard pigs. Preventive measures must be implemented by health services to avoid toxoplasmosis human cases due to ingestion of pig meat.

First report of genotype #65 of Toxoplasma gondii in pigs.

The aim of the present study was to isolate and genotype Toxoplasma gondii from pigs slaughtered for human consumption in northeastern Brazil. Indirect immunofluorescence antibody test (IFAT) was used to screen positive pigs. Tissues samples of animals with antibody titers ≥64 were submitted to bioassay in mice. One isolate of T. gondii was obtained, and the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique, using 11 markers (SAG1, SAG2, altSAG2, SAG3, BTUB, GRA6, c228, c292, L358, PK1, and APICO), was applied to evaluate the genetic variability. DNA from reference strains was used as a positive control. By means of genetic analysis, genotype ToxoDB #65 was identified, which is considered an atypical strain. This is the first record of genotype #65 in pigs. Thus, further studies in this region are necessary to determine the genetic variability of T. gondii in pigs and possible impact on public health.

Indicações da cirurgia de Ivor Lewis modificada / Indications of modified Ivor Lewis esophagectomy

A técnica de Ivor Lewis modificada, utilizada para a ressecção do câncer de esôfago, consiste na combinação de toracotomia direita e laparotomia, seguida de anastomose esofagogástrica intratorácica. Apesar de ser o tratamento de eleição em muitos serviços, não há critérios rigorosos para sua indicação. Neste relato de caso o paciente apresenta antecedente de carcinoma espinocelular invadindo pele e mandíbula tratado com radioterapia e cirurgia. Durante o seguimento se diagnosticou neoplasia esofágica, que foi tratada por cirurgia de Ivor Lewis modificada, seguida de complicações leves e boa evolução. A técnica de Ivor Lewis modificada é uma opção adequada para o tratamento da neoplasia esofágica, sendo sua melhor indicação nos casos em que há radioterapia cervical prévia, já que esta torna a cervicotomia um procedimento de alto risco para lesões vasculares e/ou de vias aéreas. Entretanto, a decisão da técnica a ser utilizada para a ressecção do câncer de esôfago ficará a cargo do cirurgião.