Retrospective study of allometric relationship between heart rate, electrocardiographic parameters and bodyweight in dogs / Estudo retrospectivo da relação alométrica entre frequência cardíaca, parâmetros eletrocardiográficos e peso corporal em cães

The allometric relationship between bodyweight (BW) and heart rate (HR) has been described as inversely proportional in domestic species, but that has been refuted. The relationship between HR and electrocardiographic variables is described in literature. However, studies about the variation and influence of factors on the hemodynamic and electrocardiographic parameters in dogs are not abundant. As the metabolic rate is defined as the production and dissipation of heat by the body surface area (BSA) in m², it is essential to define that relationship. A retrospective study was conducted to analyze the correlation between HR, ECG parameters and BW in dogs. One thousand electrocardiographic tracings were analyzed in addition to the ECG parameters and clinical data such as gender, age and bodyweight. The determination of BSA was performed as follows: BSA (m2) = (10.1 x bodyweight 0.67) X 10-4. When the unified groups were analyzed, there was a negative but weak correlation (r= -0.14, P< 0.0001) between bodyweight and HR. There were differences between weight groups regarding electrocardiographic variables. There is no allometric relationship between BW and HR in dogs. Weight was associated with changes in ECG variables.(AU)

A relação alométrica entre peso corporal (PC) e frequência cardíaca (FC) foi descrita como inversamente proporcional em animais domésticos, mas isso tem sido refutado. A relação entre FC e variáveis eletrocardiográficas é descrita na literatura. No entanto, estudos sobre a variação e a influência de fatores nos parâmetros hemodinâmicos e eletrocardiográficos em cães não são abundantes. A taxa metabólica é definida como a produção e dissipação de calor pela área de superfície corporal (ASC), de modo que é essencial definir essa relação. Foi realizado um estudo retrospectivo para analisar a correlação entre FC, parâmetros eletrocardiográficos (ECG) e peso corporal em cães. Foram analisados mil traçados eletrocardiográficos, além dos parâmetros de ECG e dados clínicos, como gênero, idade e peso corporal. A determinação da ASC foi realizada da seguinte forma: ASC (m 2 ) = (10,1x peso corporal 0,67 ) x 10 -4 . Quando os grupos unificados foram analisados, houve uma correlação negativa, porém fraca (r= -0,14, P<0,0001) entre PC e FC. Houve diferenças entre os grupos de peso em relação às variáveis eletrocardiográficas. Não há relação alométrica entre PC e FC em cães. O peso foi associado a alterações nas variáveis de ECG.(AU)

Association between heart rate, heart rate variability, cortisol, glucose and electrolytes in healthy newborn calves / Associação entre frequência cardíaca, variabilidade da frequência cardíaca, cortisol, glicose e eletrólitos em bezerros recém-nascidos saudáveis

This study aims at evaluating the effects of electrolytes, glucose and cortisol levels over heart rate (HR) and heart rate variability (HRV) in healthy newborn calves. Seventeen healthy Holstein calves were evaluated during their first month of life, and the plasma concentrations of glucose, cortisol, calcium, magnesium, inorganic phosphorus, sodium and potassium were analyzed. HRV indexes were determined in the time and frequency domains through the analysis of neonatal electrocardiogram recordings. In the first day, low blood levels of phosphorus presented a strong correlation with the HR and the increased high-frequency components of HRV. The plasma concentrations of magnesium decreased significantly throughout the 35 days, revealing a positive association with a decreasing low-frequency components of HRV at day 28. There was a strong correlation between HR, HRV indexes, some plasma electrolytes, glucose and cortisol during the studied period. Variations in the concentrations and correlations observed may be attributed to the adaptive neonatal period in calves.(AU)

Este estudo teve como objetivo avaliar os efeitos dos níveis de eletrólitos, glicose e cortisol sobre a frequência cardíaca (FC) e a variabilidade da frequência cardíaca (VFC) em bezerros recém-nascidos e saudáveis. Dezessete bezerros da raça Holandesa foram avaliados durante o primeiro mês de vida e foram analisadas as concentrações plasmáticas de glicose, cortisol, cálcio, magnésio, fósforo inorgânico, sódio e potássio. Os índices VFC foram determinados em domínios de tempo e frequência por meio da análise de gravações do eletrocardiograma neonatal. No primeiro dia, baixos níveis sanguíneos de fósforo correlacionaram-se fortemente com FC e aumento dos componentes de alta frequência da VFC. As concentrações plasmáticas de magnésio diminuíram significativamente ao longo dos 35 dias, revelando correlação positiva com a diminuição dos componentes de baixa frequência da VFC no dia 28. Houve uma forte correlação entre FC, índices de VFC, eletrólitos plasmáticos, glicose e cortisol durante o período estudado. As variações nas concentrações e correlações observadas podem ser atribuídas ao período neonatal adaptativo em bezerros.(AU)

Early and late analysis of postpartum stress in newborn foals / Análise do estresse no pós-parto imediato e tardio em potros neonatos

The aim of this study was to evaluate newborn foals stress in the first 48 hours of life. Heart rate (HR), heart rate variability (HRV) and serum cortisol concentrations, blood glucose, and lactate were determined in foals (n = 20, Paint Horse). Cortisol concentrations decreased significantly between four and 48 hours, with the highest concentration at 4 hours after birth. Positive correlations between cortisol and lactate occurred between 12 and 16 hours. And there was a negative correlation between cortisol and lactate 4 hours after birth. Among the values obtained for HR, there was significantly difference between the the value obtained at twelve hours of life moment and all the other moments measured, the highest values were at birth, 24 and 48 hours of life. Among HRV indexes, there were no statistical differences between the variables analysed. The cortisol, HR and HRV alterations were consistent to neonatal stress, but might be related to extrauterine environment adaptation associated to sympathoadrenal response, since those foals were healthy.(AU)

O objetivo deste estudo foi avaliar o estresse em potros neonatos nas primeiras 48 horas de vida. FC, VFC, concentrações de cortisol sérico, glicemia e lactatemia foram determinadas em potros (n = 20; Paint Horse). As concentrações de cortisol reduziram significativamente, entre quatro e 48 horas, sendo o maior valor observado às quatro horas após o nascimento. Correlações positivas entre cortisol e lactato ocorreram entre 12 e 16 horas de vida. E ocorreu correlação negativa entre cortisol e lactato às quatro horas de vida. Os valores de FC divergiram significativamente entre os momentos ao nascimento, quatro, oito, 16, 20, 24, 36 e 48 horas quanto comparados com as 12 horas de vida, sendo os maiores valores ao nascimento, às 24 e às 48 horas. Entre os índices de VFC, não foram observadas diferenças estatísticas para as variáveis analisadas. As alterações encontradas para cortisol, FC e VFC são condizentes com um quadro de estresse neonatal, mas podem estar relacionadas com o período de adaptação à vida extrauterina, associada a uma resposta simpatoadrenal, visto que os potros apresentavam-se saudáveis.(AU)

Análise da variabilidade da frequência cardíaca em cordeiros da raça Bergamácia, do nascimento aos 35 dias de idade / Analysis of heart rate variability in Bergamasca newborn lambs from birth at 35th days of age

A atividade do sistema nervoso autônomo sobre o coração pode ser verificada pela variabilidade da frequência cardíaca (VFC), método que quantifica e assim infere sobre a modulação autonômica cardíaca, refletindo o funcionamento do sistema nervoso autônomo. Durante o período neonatal, diferenças significativas no que se refere à maturação autonômica são descritas em diversas espécies. Embora a espécie ovina venha sendo utilizada como modelo experimental em diversos protocolos em neonatologia e cardiologia em humanos, estudos descritivos sobre a VFC utilizando animais saudáveis e não sedados são escassos na literatura. O objetivo do estudo foi descrever a VFC em cordeiros da raça Bergamácia durante os primeiros 35 dias de idade. Foram realizados exames eletrocardiográficos em 20 cordeiros da raça Bergamácia a partir do nascimento e semanalmente até o 35° dia de idade. A VFC foi analisada pelo intervalo RR normal (batimentos sinusais), pela frequência cardíaca, pelo índice de tônus vasovagal (iTVV), pela raiz quadrada da média do quadrado das diferenças entre intervalos RR normais adjacentes (RMSSD) e pela raiz quadrada da somatória do quadrado das diferenças dos valores individuais em relação ao valor médio, dividido pelo número de iR-R em 90 segundos - VFC global (RMSM). Todos os parâmetros se alteraram ao longo das semanas. A frequência cardíaca média elevou-se entre o nascimento e os primeiros sete dias de idade, com decréscimo nas quatro semanas subsequentes, sendo o menor valor encontrado aos 35 dias de idade (145,63±37,80bpm). Entre 21, 28 e 35 dias de idade, o iTVV elevou-se significativamente, o RMSM a partir do 28º dia, e, aos 35 dias, o RMSSD, reflexo da ativação parassimpática, exibiu diferenças em relação aos momentos subsequentes. O início da predominância parassimpática, refletida nos índices da VFC, particularmente o iTVV, ocorre aos 21 dias de idade. A partir dos 35 dias de idade, os índices RMSM e RMSSD podem ser utilizados como marcadores fidedignos das mudanças nos efeitos simpático e parassimpático sobre o coração de cordeiros.(AU)

Autonomic nervous system activity can be checked by heart rate variability (HRV), method that quantifies and thus infers on cardiac autonomic modulation, reflecting the functioning of the autonomic nervous system. During the neonatal period significant differences as regards the autonomic maturation, are described in various species. Although the sheep come being used as experimental model of several protocols in neonatology and cardiology in humans, descriptive studies about the VFC using healthy animals and not sedated are scarce in the literature. The objective of this study was to describe the HRV in the Bergamasca race lambs during the first 35 days of age. Electrocardiographic examinations were performed in 20 lambs of the Bergamasca race from birth, in the7th, 14th, 21st, 28th, and 35th days of age. The HRV was analyzed by normal RR interval (sinus rate), heart rate, index of vagal tone, and the cardiovascular manifestations (square root of the average of the square of the differences between normal RR intervals adjacent). All parameters have changed over the weeks. The average heart rate increased between the birth and the first seven days of age, with decrease in the subsequent four weeks, being the smallest value found at 35 days of age (145.63±37.80bpm). Between 21, 28 and 35 days of age, the iTVV increased significantly, the RMSM from the 28 day, and 35 days, the cardiovascular manifestations, reflex parasympathetic activation, exhibited differences in relation to subsequent times. The beginning of parasympathetic dominance, reflected in the HRV indices, particularly the iTVV, occurs at 21 days of age. From the 35 days of age, the RMSM indices and RMSSD can be used as reliable markers of change in sympathetic and parasympathetic effect on the heart of lambs.(AU)

Effect of pregnancy and correlation of weight and heart rate with electrocardiographic parameters in the American Miniature Horse / Efeito da prenhez e correlação do peso e frequência cardíaca com os parâmetros eletrocardiográficos de equinos Mini-horse

There are studies on electrocardiogram (ECG) in several breeds of horses, which highlights the growing importance of cardiology in this species. But few authors have addressed the influence of pregnancy on the cardiac physiology of the mare, and specifically, there are no studies on the Mini-horse breed, as well as no correlation of body weight (BW) and heart rate (HR) with electrocardiographic parameters in this breed. The aims of this study were to determine the effects of pregnancy on ECG parameters and to examine the relationships between these variables and body weight (BW) and heart rate (HR). A total of 203 animals were used, including 143 females (66 pregnant) and 60 males. Electrocardiographic examinations were performed by computerized electrocardiogram (TEB), and the parameters were evaluated in six leads in the frontal plane (Lead I, II, III, aVR, aVL and aVF) and base-apex (BA). BW was inversely proportional to HR, which in turn showed an inverse relationship with the duration of the P-wave and the PR and QT intervals. The P-wave amplitude (lead II) was higher in pregnant animals than in non-pregnant animals. The effect of reproductive status should be monitored by ECG throughout the entire gestational period. The 66 pregnant mares in this study were examined during the first third of their pregnancies, thus, few differences were observed between pregnant and non-pregnant animals.(AU)

Existem estudos sobre eletrocardiograma (ECG) em diversas raças de equinos, o que ressalta a crescente relevância da cardiologia nessa espécie. Porém, poucos autores abordaram a influência da gestação na fisiologia cardíaca da égua, e, especificamente, não há trabalhos sobre a raça Mini-horse, assim como não há correlação do peso vivo (PV) e frequência cardíaca (FC) com os parâmetros eletrocardiográficos nessa raça. O objetivo deste estudo foi estudar a influência da prenhez sobre os parâmetros eletrocardiográficos, além de verificar a correlação do PV e FC com essas variáveis. Utilizaram-se 203 animais dessa raça, hígidos, sendo 143 fêmeas (66 prenhes) e 60 machos. Os exames eletrocardiográficos foram realizados por eletrocardiograma computadorizado (TEB), e os parâmetros foram avaliados em seis derivações do plano frontal (I, II, III, aVR, aVL e aVF) e base-ápice. O PV foi inversamente proporcional à FC, que também mostrou relação inversa com a duração da onda P e os intervalos PR e QT. Na derivação II, a amplitude da onda P foi maior nos animais prenhes do que vazios. No entanto, sugere-se que a influência do estado reprodutivo seja estudada de forma progressiva pelo acompanhamento de todo o período gestacional, visto que as 66 éguas estudadas se apresentavam no terço inicial da prenhez, portanto poucas diferenças foram observadas entre animais prenhes e vazios.(AU)

Avaliação da absorção colostral em neonatos ovinos da raça Bergamácia / Evaluation of colostral absorption in neonates of Bergamacia breed

Objetivou-se determinar o período de absorção das macromoléculas colostrais e a transferência de imunidade passiva em cordeiros da raça Bergamácia. Avaliou-se o proteinograma sérico dos cordeiros antes da ingestão de colostro até 48 horas de vida e das frações colostrais ao nascimento e 12 horas pós-parto. Foi avaliada a concentração de proteína total no soro por refratometria e sua relação com a densidade e quantidade de gamaglobulinas presentes no colostro. A concentração sérica de gamaglobulina nos cordeiros variou de 0,111±0,07g/dL antes da ingestão de colostro a 1,609±0,72g/dL às 48 horas. Nas amostras de colostro, a concentração variou de 3,125±1,27g/dL, imediatamente após o parto, para 1,378±0,82g/dL, 12 horas após. A concentração de proteína sérica total teve acréscimo de 4,46±0,58g/dL para 5,61±0,75g/dL entre o nascimento e após 48 horas, apresentando correlação positiva com a densidade e a proteína total colostral. A absorção colostral pelo cordeiro foi ascendente até 24 horas subsequentes ao parto, quando, então, iniciou-se sua estabilização. A quantificação da proteína sérica, com uso de refratômetro nos cordeiros, pode ser usada como método para avaliar a transferência de imunidade passiva, pois está diretamente relacionada com a absorção de gamaglobulina colostral...

The period of absorption of colostrum macromolecules and the passive immunity transfer of Bergamacia lambs was determined. The serum proteinogram of lambs before the intake of colostrum up 48 hours of life and colostrum fractions between delivery and twelve hours after birth were measured. The total protein concentration in serum was evaluated by refractometry and also its relationship with the density and amount in colostrum. The serum concentration of gamma globulin in lambs from 0.111±0.07g/dL before the intake of colostrum was 1.609±0.72g/dL at 48 hours. In the colostrum samples, the concentration was 3.125±1.27g/dL immediately after delivery and 1.378±0.82g/dL twelve hours after birth. Serum total protein concentration increased from 4.46±0.58g/dL to 5.61±0.75g/dL between birth and after 48 hours, there was positive correlation with the density and total protein colostrum. The lamb had ascendant colostrum absorption subsequent to delivery, for twelve hours and then began its stabilization. The quantification of serum protein with the use of the refractometer in lambs can be used as a method to evaluate the transfer of passive immunity because it is directly related to the absorption of colostral gammaglobulin...

A critical reappraisal of false negative sentinel lymph node biopsy in melanoma.

Lymphatic mapping and sentinel lymph node biopsy (SLNB) have completely changed the clinical management of cutaneous melanoma. This procedure has been accepted worldwide as a recognized method for nodal staging. SLNB is able to accurately determine nodal basin status, providing the most useful prognostic information. However, SLNB is not a perfect diagnostic test. Several large-scale studies have reported a relatively high false-negative rate (5.6-21%), correctly defined as the proportion of false-negative results with respect to the total number of "actual" positive lymph nodes. The main purpose of this review is to address the technical issues that nuclear physicians, surgeons, and pathologists should carefully consider to improve the accuracy of SLNB by minimizing its false-negative rate. In particular, SPECT/CT imaging has demonstrated to be able to identify a greater number of sentinel lymph nodes (SLNs) than those found by planar lymphoscintigraphy. Furthermore, a unique definition in the international guidelines is missing for the operational identification of SLNs, which may be partly responsible for this relatively high false-negative rate of SLNB. Therefore, it is recommended for the scientific community to agree on the radioactive counting rate threshold so that the surgeon can be better radioguided to detect all the lymph nodes which are most likely to harbor metastases. Another possible source of error may be linked to the examination of the harvested SLNs by conventional histopathological methods. A more careful and extensive SLN analysis (e.g. molecular analysis by RT-PCR) is able to find more positive nodes, so that the false-negative rate is reduced. Older age at diagnosis, deeper lesions, histologic ulceration, head-neck anatomical location of primary lesions are the clinical factors associated with false-negative SLNBs in melanoma patients. There is still much controversy about the clinical significance of a false-negative SLNB on the prognosis of melanoma patients. Indeed, most studies have failed to show that there is worse melanoma-specific survival for false-negative compared to true-positive SLNB patients.

Concentração de lactato sérico em ovelhas e cordeiros mestiços (1/2 Suffolk) nascidos em eutocia / Lactate blood levels in sheep and newborn lambs (1/2 suffolk) in normal delivery

O objetivo do estudo foi avaliar a concentração de lactato sanguíneo venoso em ovelhas e em cordeiros neonatos imediatamente após o parto eutócico. Foram utilizadas 14 ovelhas, sendo nove da raça Suffolk e quatro mestiças e 20 cordeiros neonatos sadios (machos e fêmeas). O efeito do sexo, da raça e do número de cordeiros por parto foi investigado, bem como a possível correlação entre a concentração de lactato materno e neonatal. Não houve diferença entre machos e fêmeas, em relação à raça (Suffolk e mestiços), contudo a concentração de lactato foi mais elevada em cordeiros gêmeos ou trigêmeos quando comparado a cordeiros uníparos. Houve correlação positiva entre a concentração materna e a neonatal, sendo que quanto maior a concentração de lactato materno, maior a concentração no cordeiro imediatamente após o parto eutócico. Os resultados do presente estudo fornecem um subsídio por meio do qual se podem comparar os níveis de lactato sanguíneo em cordeiros em estado crítico.

The aim of this study was to evaluate the venous blood lactate concentration in sheep and newborn lambs immediately after normal delivery. We used 14 ewes, nine and four Suffolk crossbred lambs and 20 healthy newborns (males and females). The effect of gender, race and number of lambs per birth was investigated, as well as the possible correlation between the concentration of maternal and newborn lactate. There was no difference between males and females or in relation to race (and Suffolk crossbred); however the concentration of lactate was higher in twin or triplet lambs when compared to single lambs. There was a positive correlation between the maternal and newborn concentration and the higher the concentration of lactate, the greater the concentration in the lamb immediately after normal delivery. The results of this study provide a base from which to compare the blood lactate levels in lambs in critical condition.

Estudo anatomorfológico, radiográfico e tomográfico de Schistosomus reflexus em ovino da raça Dorper: relato de caso / Anatomorphological, radiographic and tomographic studies of Schistosomus reflexus in Dorper breed sheep: case report

O Schistosomus reflexus (SR) é uma anomalia congênita fatal e rara, primariamente observada em ruminantes, a qual apresenta feto com dorsoflexão da coluna vertebral, exposição das vísceras abdominais e torácicas e escoliose. Foi realizada uma cesariana de ovelha da raça Dorper, em propriedade da região de Botucatu-SP. Pelas características gerais e achados de necropsia, tratava-se de um caso de SR. A radiografia revelou acentuado desvio ventrodorsal do segmento da coluna vertebral toracolombar e deformidades das costelas. Na tomografia computadorizada, observou-se presença da integridade dos ossos e órgãos, exceto ausência de uma vértebra lombar. Não havia dados na literatura de diagnóstico por imagem de SR em ovinos, portanto procedeu-se, de forma inédita, a exames radiográfico e tomográfico do feto.

Schistosomus reflexus (SR) is a rare and fatal congenital anomaly, primarily observed in ruminants, presenting fetus with dorsiflexion of the vertebral column, exposure of thoracic and visceral organs, and scoliosis. A caesarian was performed on a Dorper sheep on a farm in Botucatu-SP and according to the general characteristics and findings observed in the necropsy of the fetus it was an SR case. The radiography indicated a marked ventro-dorsal deviation of the thoracolumbar column segment and deformity of the ribs. On the computed tomography the integrity of the bones and organs were detected, except for the absence of a lumbar vertebra. No data were available in the literature for SR diagnosis in sheep by image, so radiographic and tomographic exams of the fetus were done.

Radionuclide therapy and integrated protocols for bone metastases.

Bone metastases are responsible for most of the morbidity and mortality associated with solid malignant tumors, occurring in about 65-70% of the patients with advanced breast or prostate cancer. The pathophysiology of skeletal metastasis is a complex process that involves several biologic process leading to cellular invasion, adhesions and stimulation of osteoclasts and osteoblasts with the mediation of several factors including cytokines, serine proteases and tumor-derived factors. The clinical management of pain from bone metastasis, which is mostly due to indirect stimulation of sensory nerve endings by cytokines and other biologically-active compounds released locally in response to the presence of tumor cells in the bone marrow, includes several options that can be used either alone or in varying combinations, such as analgesic drugs, chemo- or hormonal therapy, bisphosponates, external beam radiation therapy, and surgery. Bone-seeking radiopharmaceuticals play an important role in the treatment of pain caused by multiple blastic or mixed-type skeletal lesions; they have in general a favorable toxicity profile and a high rate of overall clinical benefit, although they may differ in terms of duration of pain palliation and suitability for repeat treatments. The palliative effect can be attributed to the radiation targeted to the bone marrow space, and the overall average response ranges between about 45-80%, with complete response in 10-30% of the cases. In selected clinical conditions, radionuclide therapy can also constitute an effective systemic treatment beyond bone pain palliation, and a synergistic anti-tumour effect can be expected by the combination with other agents, such as chemotherapy or bisphosphonates. This review summarizes the current experience with bone-seeking radiopharmaceuticals used for bone pain palliation, focusing on indications, patients' selection, efficacy and toxicity. Finally, the available data on combination therapies showing encouraging results as to potential anti-tumor efficacy are also reviewed.

Leptospiral antibodies in wild boars (Sus scrofa) bred in Brazil

In the recent years, the wild boar (Sus scrofa) trade has increased in Brazil. The present study aimed to detect Leptospira spp. infection in 308 blood samples from wild boars bred in São Paulo state, Brazil. The microscopic agglutination test (MAT) was performed using 29 serovars. Sixty three (63; 20.45 percent) animals tested positive against the serovars Hardjo (29/63; 46.0 percent), Copenhageni (11/63; 17.4 percent), Pomona (8/63; 12.7 percent), Pyrogenes (4/63; 6.3 percent), Wolfii (4/63; 6.3 percent), Autumnalis (3/63; 4.7 percent), Icterohaemorraghiae (2/63; 3.1 percent), and Hardjo-miniswajezak (1/63; 15.8 percent). These results indicate that captive wild boars were infected with Leptospira spp. and may represent a source of infection to humans and other animals.

Triple bothropic envenomation in horses caused by a single snake

In the present study, snakebites caused by a single Bothrops pauloensis simultaneously affecting three male adult horses are described. Whereas the first two affected horses were six years old, the third was 16 years old; they weighed respectively 555, 550 and 500 kg. All horses presented swollen muzzles. The first animal received an initial antivenom dose of 19 vials and adjuvant medication, it was also subjected to tracheostomy due to the progression of acute respiratory failure. The second and third horses respectively received 15 vials of antivenom each, in addition to adjuvant medication. Due to continuous changes in blood coagulation observed during hospitalization, the first and the second horses received five more vials of antivenom, respectively, in the second and third days of treatment. The first animal was discharged on 15th day and the other on the 8th day of hospitalization. Several factors including the main actions of Bothrops venom (coagulation, proteolytic and vasculotoxic activities), the importance of early diagnosis based on clinical history and clinical examination suggesting the diagnosis of Bothrops snakebite, the adequate doses of antivenom, and finally the immediate tracheostomy are herein discussed. The tracheostomy, required to save the life of the first horse, should only occur after the administration of antivenom and control measures for changes in blood coagulation.

Comparison between 99mTc-sestamibi scintimammography and X-ray mammography in the characterization of clusters of microcalcifications: a prospective long-term study.

BACKGROUND: The early diagnosis of non-palpable breast cancer is the object of recent developments in the imaging procedures employed for screening purposes. In some patients, the presence of microcalcifications (MC) is the only indication of tumor. Although X-ray mammography (MRx) has high sensitivity in detecting MC, its specificity is however too low for diagnostic purposes. The aim of this study was to compare (99m)Tc-sestamibi scintimammography (SMM) and MRx in the differential diagnosis between benign and malignant clusters of MC and to assess the possible incremental value of SMM on specificity. PATIENTS AND METHODS: A total of 283 consecutive women (mean age 53+/-8 years) with MC identified on X-ray mammograms underwent SMM. Scintigraphic images were acquired 10 minutes after the i.v. injection of (99m)Tc-sestamibi (740 MBq). Planar images of both breasts were simultaneously obtained in the lateral prone position and in the anterior and oblique projections using a dual head camera. Sixty-nine women underwent surgery, whereas the remaining 214 patients had completely negative follow-up for 5 years (a 5-year follow-up period is considered the "gold standard" for diagnosing benign lesions). RESULTS: Histology demonstrated 32/69 primary breast carcinomas (prevalence of disease: 11% of all the 283 patients) and 37/69 benign lesions. The receiver operating characteristic (ROC) statistical technique was employed to compare the diagnostic value of Mrx alone to that of combined MRx and SMM. The detected difference between the areas under the MRx ROC curve (area=0.72, standard error 0.052) and the MRX and SMM ROC curve (area=0.86, standard error 0.039) was statistically significant (p<0.01). Moreover, the combination of MRx and SMM provided a significant improvement of the negative predictive value (NPV=98%) for MC with low-suspicion of malignancy at MRx. CONCLUSION: SMM can be considered as a complementary tool in the pre-operative work-up of patients with breast lesions. Furthermore, the high negative predictive value of this technique, makes it especially valuable in the perspective of reducing the number of negative breast biopsies or unnecessary surgical interventions.

Association between handling stress in the corral and rabies antibody titers in selenium-supplemented cattle

This study determined the correlation between serum cortisol levels and rabies antibody titers in cattle primo-vaccinated against rabies and supplemented with dietary selenium (Se). Sixty Nelore male calves (10 to 12 months old) received daily and individual dietary supplementation with 0, 3.6, 5.4 and 6.4 mg Se (groups Gc, G3.6, G5.4 and G6.4, respectively). The animals were vaccinated against rabies (day 0) and subjected to handling stress in the corral for 120 days. Blood sampling procedures were performed on days 0, 15, 30, 60, 90 and 120. Cortisol levels increased until day 90, but had dropped significantly by day 120 (P < 0.01). Rabies antibody titers on days 30 and 90 were similar among Se-supplemented groups; in the control group, rabies antibodies decreased significantly from day 30 to 60, and 90 to 120. Serum cortisol levels and antibody titers were not correlated in most of the groups or blood sampling days. A positive correlation among these variables was found only in G6.4 on days 60 (R = 0.513; P = 0.05) and 120 (R = 0.644; P = 0.009). In conclusion, repeated handling in the corral stresses cattle, but without compromising rabies humoral immune response.

Anaplastic thyroid cancer: prevalence, diagnosis and treatment.

UNLABELLED: Anaplastic thyroid cancer (ATC) is a rare aggressive tumor arising from the follicular cells of the thyroid gland (as does well differentiated thyroid cancer, WDTC), but ATC cells do not retain any of the biological features of the original follicular cells, such as uptake of iodine and synthesis of thyroglobulin. Prognosis is almost invariably fatal. In this article the Authors review the pathology, epidemiology, clinical presentation, diagnosis and treatment options of ATC. ATC incidence typically peaks at the 6-7th decade of life (mean age at diagnosis 55-65 years), women representing 55-77% of all patients. ATC represents 2-5% of all thyroid tumors, with a decreasing trend with respect to the incidence of WDTC. The histologic patterns of ATC include giant-cell, spindle-cell and squamoid-cell tumors; these subtypes frequently coexist and are not predictive of patients' outcome. Immuno-cyto-chemistry for thyroglobulin is usually negative or weakly positive and some cases are also negative for keratin, particularly in the spindle-cell areas. ATC may arise de novo, but in most cases it develops from a pre-existing WDTC, especially the follicular subtype. Most ATC patients complain of local compressive symptoms, such as dysphagia, dysphonia, stridor and dyspnea in addition to neck pain and tenderness; in over 70% of the patients the tumor infiltrates surrounding tissues, such as fat, trachea, muscle, esophagus, and larynx. The clinical course of a rapidly enlarging mass that is firm and fixed to surrounding structures in an elderly patient is quite suggestive for ATC. Diagnosis can be confirmed by fine needle aspiration cytology or, in doubtful cases, by histology on core biopsy. Computed tomography (CT) scan and magnetic resonance imaging (MRI) are useful for defining the local extent of disease and for identifying distant metastases, as is also positron-emission tomography (PET) with [(18)F]FDG. Tracheoscopy and esophagoscopy should be performed every two months, or whenever patients refer the appearance or worsening of local symptoms. Bone scintigraphy may be included in the follow-up of patients with a longer survival and relatively good health. Because of its aggressive behavior, the latest American Joint Committee on Cancer Staging Manual classifies all ATCs as T4 and Stage IV tumors, regardless of their actual overall tumor burden. Treatment of ATC has not been standardized because it is not clear whether or not therapy is effective in prolonging survival; most patients die within six momths from diagnosis, primarily because of asphyxiation caused by local tumor invasion. When employed alone, surgery, radiotherapy, or chemotherapy are seldom adequate to achieve overall control of the disease, but a combination of these treatments may improve local control. Surgical treatment of local disease offers the best opportunity for prolonged survival if the tumor is intrathyroidal. When the tumor is extrathyroidal, the surgical approach to ATC is controversial. Some favourable results have recently been reported with newly developed chemotherapy agents and hyper-fractioned radiation therapy. Tracheostomy should be performed in patients with impending airway obstruction when death is not imminent from other sites of disease, and if patients are not candidates for local resection or chemoradiation. Interventional bronchoscopy, including Nd-YAG laser and airways stenting are alternatives to surgery in inoperable ATC-induced tracheal obstruction. Gene therapy is under investigation. Although very rare, ATC is a highly aggressive tumor that belongs to the group of killer tumors with median survival time not longer than 6-8 months. Surgery, chemotherapy and radiotherapy are the conventional therapeutic strategies performed in the attempt to improve survival. Unfortunately, very often they do not succeed any clinical benefit but only palliative RESULTS: New therapeutic strategies based on molecular approaches are desirable.

Pênfigo foliáceo em eqüino: relato de caso / Equine pemphigus foliaceous: case report

Diagnosticou-se pênfigo foliáceo em um eqüino macho, castrado, quatro anos de idade da raça Árabe apresentando dermatite generalizada caracterizada por placas escamo-crostosas e presença de dermatite pustular acantolítica subcorneal

Pemphigus foliaceus was diagnosed in a four-year-old Arabian equine gelding, with generalized dermatitis characterized by scaling and crusting plaques and acantholytic subcorneal pustular dermatitis

Hematological changes in sheep inoculated with natural and cobalt 60- irradiated Crotalus durissus terrificus venom (Laurenti, 1768)

Natural (NV)and cobalto 60-irradiated (IrV) Crotalus durissus terrificus venom were used to evaluate serum production capacity of sheep and possible hematological and biochemical effects. Freeze-dried venom aliquots were diluted in acidified saline solution (NaCl 150 mM, pH 3.0) and irradiated by a Cobalt 60 source at a dose of 5.54 x 102 Gy/h and a concentration of 2.000 Gy. Twelve sheep were divided into two groups of six animals. One group received irradiated venom (IrV) and the other natural venom (NV). Three antigen doses (venom) were administered at monthly intervals. Blood samples were collected weekly for analysis of serum neutralization potency and capacity, complete blood count (CBC), total plasma protein, fibrinogen, albumin, and globulin. At the end of the experiment, the animals were challenged with a LD50 for sheep and showed no signs of envenoming. The two groups did not present clinical alterations. Results of the total leukocyte count did not present interaction or time factor effect for both groups, but there was a different action between them, with the NV group presenting more cells than the IrV group. The leukocyte increase to 13,000/µl indicates that slight leukocytosis occurred in the week after the first inoculation in the NV group. There was no statistically significant difference between groups in the absolute count of segmented neutrophils, eosinophils, and lymphocytes but there were statistically significant oscillations in values ant the different collecting times. The NV group presented an increase in the absolute neutrophil count after the first inoculation that persisted for 5 weeks. In the IrV group, the increase in neutrophils occured only in the first week returning to normal in the following weeks. The alterations in the neutrophil count are indicative of systemic inflammatory response related to cytokine release; response was more marked in the NV group, showing its greater toxicity.

Fraturas vertebrais em grandes animais: estudo retrospectivo de 39 casos (1987-2002) / Vertebral fractures in large animals: retrospective study of 39 cases (1987-2002)

Realizou-se estudo retrospectivo (1987-2002) dos aspectos clínicos das fraturas vertebrais em eqüinos, bovinos, ovinos, caprinos e suínos atendidos no hospital veterinário da FMVZ-Unesp de Botucatu. Todos os casos tiveram confirmaçäo radiográfica ou post-mortem. Segundo a espécie, a ordem de acometimento foi: bovina, eqüina, ovina, caprina e suína. As lesöes ocorreram desde os 12 dias de idade até os 10 anos, com maior freqüência até os 12 meses. O segmento torácico foi o mais comprometido seguido dos segmentos lombar, cervical e sacral. As fraturas vertebrais devem fazer parte da lista de diagnósticos diferenciais de animais em decúbito, independente da espécie, sexo ou idade

Humoral response and neutralization capacity of sheep serum inoculated with natural and cobalt 60-irradiated Crotalus durissus terrificus venom (Laurenti, 1768)

The aim of this work was to investigate antigen irradiation on crotalic antivenom and the capacity of sheep as serum producers. Twelve sheep in two groups of six were inoculated with Crotalus durissus terrificus venom. One group was inoculated with natural venom (NV) and the other with Cobalt 60 gamma-irradiated venom (IrV). Three antigen doses were given to the animals at monthly intervals for immunization. The toxic activity of the venom was assessed by LD50 determination in mice. Blood samples were collected weekly analyses of serum neutralization capacity and potency. At the end of the experiment, the animals were challenged with a LD50 for sheep showed no signs of envenoming. These results showed that toxicity of the irradiated venom was 4.4 times less than the natural venom. The sera from the irradiated group neutralized LD50 14.6 times, and the sera from the natural group 4.4 times. Sera from the irradiated group were five times more potent. The two groups did not present clinical alterations. The results of this study show the potential for using sheep in crotalic antivenom production. The use of irradiated venom in sheep immunization induces a powerful and lasting humoral immune response shown by both the in vitro neutralization and potency tests and by the indirect ELISA antibody level detection technique.