ABSTRACT
Emergence of zoonotic infectious diseases represent one of the main threats to people worldwide. To properly understand and prevent zoonoses is fundamental to study their epidemiology and the possibility of spillover events, especially for commercially intensive domestic animals and humans. Here, we studied 210 wild birds from the "Ipucas" region, which consists of fragments of the Amazon Forest interspersed with fragments of the "Cerrado" that is subject to seasonal flooding and 75 domestic birds from neighboring poultry farming. Then, we molecularly diagnosed Salmonella and Chlamydia from wild birds and poultry. Among the wild birds, four were diagnosed with Chlamydia psittaci and 23 with Salmonella spp., while we detected 15 poultry infected by Salmonella spp. and no poultry with C. psittaci. We highlighted the common infections of wild and domestic birds in an anthropologically modified environment and potential spillover of Salmonella pathogens among wild and livestock birds. Those infections can harm the health of native and domestic species.
Subject(s)
Animals, Domestic , Bird Diseases , Humans , Animals , Brazil , Birds/microbiology , Animals, Wild/microbiology , Zoonoses/microbiology , Salmonella , Forests , Bird Diseases/microbiologyABSTRACT
INTRODUCTION: The diagnosis of airway obstruction can be made through FEV1/FVC ratio <0.7 or FEV1/VC ratio < lower limit of normality (LLN). Several authors advocate that FEV1/FEV6 ratio is an alternative to diagnosing obstructive ventilatory defect, while others have determined that the best cut-off for this ratio (best combined sensitivity and specificity) is 0.73. OBJECTIVE: To evaluate the non-inferiority of FEV1/FEV6 ratio < 0.73 when compared to FEV1/FVC ratio < 0.7 and FEV1/VC < LLN in diagnosing airway obstruction. METHODS: A retrospective analysis of the medical records from patients who underwent spirometry or plethysmography in a university central hospital from June 1st to December 31st, 2018 was carried out. Only medical records which included FEV1/FVC < 0.7 or FEV1/VC < LLN were selected, and these results were compared to FEV1/FEV6 ratio. RESULTS: A total of 526 patients with obstructive ventilatory defect were identified by one of the two ratios described. Of these, 95.1%, 87.4% and 88.6% were obstructive by FEV1/FVC, FEV1/VC, and FEV1/FEV6 ratio, respectively. The positive predictive value (PPV) of FEV1/FEV6 in relation to FEV1/FVC ratio was 99.6% (p < 0.001) with a diagnostic efficacy of 92.8%, whereas the PPV of FEV1/FEV6 in relation to FEV1/VC was 91.0% (p < 0.001) and diagnostic efficacy was 85.2%. Most false negatives, comparing FEV6 with the other two tests, were found in patients with FEV1 > 70% (mild obstruction) and in individuals aged >50 years. CONCLUSIONS: FEV1/FEV6 < 0.73 may be a good alternative ratio, as it is non-inferior to FEV1/VC and FEV1/FVC in diagnosing obstructive ventilatory defect.
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ABSTRACT: Endometrial carcinoma is a very rare cause of cutaneous metastasis.The most frequent presentations of cutaneous metastasis are fast developing nodules or tumors, which are evi-dence of widespread dissemination in such patients.We report a case of scalp metastasis from an endometrial adenocarcinoma with a fatal prognosis. (AU)
RESUMO: O carcinoma endometrial é uma causa rara de metástases cutâneas.A apresentação mais frequente de metástases cutâneas são nódulos ou tumores de rápido desenvolvimento, que evidenciam uma disseminação generalizada nesses pacientes.Relatamos um caso de metástase no couro cabeludo de um adenocarcinoma endometrial com prognóstico fatal. (AU)
Subject(s)
Humans , Aged , Prognosis , Scalp , Adenocarcinoma , Endometrial Neoplasms , Neoplasm MetastasisABSTRACT
Maneuvers to activate the equine's core can make a difference in their physical and psychic health. Although these activities are recommended and practiced, there is little research proving their effectiveness. This article aims to describe, through surface electromyography, the occurrences, durations and sequences activity of longissimus dorsi, rectus abdominis and gluteus medius during thoracolumbar flexion (TLF), lumbar and lumbosacral flexion (LLSF), global flexion (GF), which is the combination of TLF and LLSF, and tail traction (TT). Seven healthy adult horses of three different breeds performed five repetitions of these movements for five seconds (sec). Electromyographic activity was captured with non-invasive superficial sensors positioned in the skin regions covering these muscles. The sequence was performed once per animal, muscle activity captured by surface electromyography, data from two replicates of each animal were selected, analyzed on matLab software and data tabulation were described during each maneuver. These maneuvers provoked punctual and transient activation of muscles mentioned above, confirming the ability to activate equine core muscles. However, responses were not standardized, which means there were variations of occurrence, duration and sequence, suggesting that for practical application of those maneuvers it is necessary to perform more repetitions with longer durations to activate more muscles.(AU)
Manobras para ativação da musculatura do core equino podem ser diferenciais para saúde física e psíquica dos animais, sendo recomendadas e praticadas, mas existem poucas pesquisas comprovando a eficácia delas. Este artigo tem como objetivo descrever, por meio da eletromiografia de superfície, as ocorrências, as durações e as sequências temporais da atividade muscular do longuíssimo dorsal, do reto abdominal e do glúteo médio durante a realização das manobras de flexão toracolombar, flexão lombar e lombossacra, flexão global (toracolombar e lombossacra) e tração de cauda. Para isso, sete equinos adultos e hígidos de três raças realizaram esses quatro movimentos clássicos para ativar o core equino, com cinco repetições e manutenção do estímulo reflexivo por cinco segundos. Durante a realização, a atividade eletromiográfica foi capturada com a utilização de sensores superficiais posicionados de forma não invasiva em regiões cutâneas referentes a cada músculo. O protocolo completo de manobras foi realizado uma vez por cada animal enquanto a atividade muscular era capturada. Posteriormente, duas repetições de cada animal foram triadas e submetidas ao software matLab para análise. Com base na tabulação dos dados, foram descritas as variáveis eletromiográficas de presença ou ausência de ativação muscular, a duração média dos picos eletromiográficos superiores ao RMS (root mean square) e a sequência da atividade muscular observada durante cada manobra. Essas manobras provocaram ativações pontuais e transitórias nos três músculos, o que confirma a capacidade de excitar músculos do core equino. Contudo, as respostas não foram padronizadas, sugerindo que, na prática dessa atividade, devem-se realizar mais repetições com durações superiores a cinco segundos, a fim de se buscarem maiores ativações.(AU)
Subject(s)
Animals , Range of Motion, Articular/physiology , Exercise Movement Techniques/veterinary , Muscle Stretching Exercises , Horses/physiology , Musculoskeletal System/anatomy & histology , Electromyography/veterinary , Warm-Up ExerciseABSTRACT
Yellow fever is a vaccine-preventable acute viral disease that can rapidly spread and cause serious public health impact. Delay in seeking health care from health facilities is a potential risk of prolonged disease spread. Therefore, this study assessed the delay in health-seeking behaviour and implications for yellow fever outcomes in the 2019 outbreak in Nigeria. Furthermore, the study examined the factors associated with delayed yellow fever vaccine uptake. A retrospective study was conducted from January to December 2019 using 137 cases recorded in the WHO database. The data were analysed using descriptive (frequency and percentages) and the Chi-square test. The results were significant at p < 0.05. Results showed a low uptake of yellow fever vaccine (24.1%) among patients and a median total health-seeking delay of 7 [IQR 7, 9] days. The delay was more among the older age ≥40 years (12 [IQR 12, 29]), females (8 [IQR 8, 11], and rural inhabitants 7 [IQR7, 9], particularly in Izzi LGA (9 [IQR 9, 16] than the other subgroups. Patients' location or place of residence was significantly associated with the yellow fever vaccine uptake (p < 0.000*), and delay (p = 0.003*). Conclusively, the low vaccine uptake was due to the delay in health-seeking behaviour. Thus, the healthcare system in Nigeria needs to intensify mass participation in immunisation programmes. Interventions that promote behavioural change towards immunisation are required. Also, health promotion campaigns to educate rural people on desirable health-seeking behaviour are needed.
Subject(s)
Yellow Fever , Aged , Disease Outbreaks , Female , Humans , Nigeria/epidemiology , Patient Acceptance of Health Care , Retrospective Studies , Yellow Fever/epidemiology , Yellow Fever/prevention & controlABSTRACT
This study explores different energy consumption vectors during the first year of the COVID-19 pandemic in Portugal. Most of the workforce started working from home and resource consumption significantly shifted towards the domestic sector. The ensuing confinement protocols caused a shift in everyday life, which in turn significantly altered the energy supply and demand landscape. This event, although catastrophic in terms of loss of human life and economic development, can provide us with valuable data to study the potential of new strategies to achieve EU 2050 Energy goals. It was investigated whether the pandemic has opened a path and provided us with a partial answer to decarbonization in the form of home office practices as a possible energy efficiency measure. The present study shows that, in Portugal, there was a 15.7% reduction of primary energy consumption (accounting for electricity, natural gas and transport fuels) compared to 2019. The data suggest that actions targeting reduced mobility, such as home office practices and the decentralization of the workforce, could be a relevant energy efficiency measure.
ABSTRACT
PURPOSE: Benign tracheal stenosis management is still controversial, and there is no international consensus on the best treatment option. Thus, we aimed to look into the history of PITS and the different strategies used in its treatment. The importance of bronchoscopic treatment was also defined, and its effectiveness and safety were assessed. METHODS: Retrospective study of patients diagnosed with PITS, who were referred to the Bronchology Department between January 1996 and December 2016. RESULTS: Of 115 patients enrolled (mean age 48.5±17.6 years, 53% males), 66.1% had complex stenosis. The most common causes of intubation were respiratory (29.9%), neurological (26.8%) and surgical (19.6%). Complex stenosis was caused by longer intubation, and was more frequent among previously tracheostomized patients. The most common location was the upper third of trachea (60.9%). Most cases were initially treated by interventional bronchoscopy, and although serial dilations were effective in some complex PITS, a higher proportion of simple stenosis was successfully managed with this treatment option. Long-term recurrence after serial dilation was observed in 25.0% of cases. Stent placement was required (19.1%) only for complex PITS. Stent-related complications were frequent (61.9%) and linked to the stenting time (p<0.001). Overall, there were no procedure-related complications. Surgical intervention was also performed (30.0%), always with complex PITS. Post-surgical recurrences were observed in 24.2% of cases. CONCLUSIONS: Interventional bronchoscopy is an efficient and safe modality in PITS management. Further studies are needed for better classification and improved knowledge of PITS pathogenesis, and to achieve international consensus of definition to guide clinicians in their practice.
Subject(s)
Bronchoscopy/methods , Intubation, Intratracheal/adverse effects , Tracheal Stenosis/etiology , Tracheal Stenosis/therapy , Adult , Aged , Constriction, Pathologic , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
The goal of this study was to describe the gastrointestinal transit technique in the Boa constrictor amarali. For that purpose, we obtained simple radiographic images of seven serpents, subsequently administering a 25mL/kg dose of barium sulfate and establishing a radiographic sequence at the following times: 5 minutes; 1, 2, 3, 6, 9, 24, 48, 72 and 96 hours, extending to 120 and 126 hours for one animal. The mean esophageal transit was 26.71±19.48 hours; the mean gastric filling time was 28.57±27.22 minutes and the emptying time was 60±12 hours; the mean filling time of the contrast medium in the small intestine was 3±2.16 hours and the emptying time was 97±15.65 hours. We also obtained the mean filling time of the large intestine, which was 40±11.31 hours. We found that the mean passage time of the contrast medium through the cranial gastrointestinal tract - until the complete elimination of barium sulfate from the small intestine -was 97±15.65 hours. In addition to determining the gastrointestinal transit time, the technique used allowed for the morphological identification of the alimentary canal.(AU)
O objetivo deste trabalho foi descrever a técnica de trânsito gastrointestinal em Boa constrictor amarali. Para tanto, foram obtidas radiografias simples de sete serpentes, e, subsequentemente a essas, foi administrado sulfato de bário na dose de 25mL/kg. A partir disso, foi estabelecida a sequência radiográfica nos seguintes tempos: cinco minutos; uma, duas, três, seis, nove, 24, 48, 72 e 96 horas, e em um animal estendeu-se para 120 e 126 horas. O trânsito esofágico médio foi de 26,71±19,48 horas, o tempo médio de preenchimento gástrico foi de 28,57±27,22 minutos, e o esvaziamento de 60±12 horas; a média de tempo de enchimento do meio de contraste no intestino delgado foi de 3±2,16 horas e, por fim, o esvaziamento foi de 97±15,65 horas, e ainda obteve-se o tempo médio de enchimento do intestino grosso igual a 40±11,31 horas. Desse modo, verificou-se que a média do tempo de passagem do contraste pelo trato gastrointestinal cranial - até a completa eliminação do sulfato de bário do intestino delgado - foi de 97±15,65 horas. Além da determinação do tempo de trânsito gastrointestinal, a técnica empregada permitiu a identificação morfológica do canal alimentar.(AU)
Subject(s)
Animals , Gastrointestinal Transit/physiology , Boidae/anatomy & histology , Boidae/physiology , Gastrointestinal Tract/diagnostic imaging , Contrast MediaSubject(s)
Asthma , Adult , Asthma/complications , Asthma/drug therapy , Humans , Obesity/complicationsSubject(s)
Common Variable Immunodeficiency , Pulmonary Disease, Chronic Obstructive , alpha 1-Antitrypsin Deficiency , Common Variable Immunodeficiency/complications , Common Variable Immunodeficiency/diagnosis , Humans , alpha 1-Antitrypsin Deficiency/complications , alpha 1-Antitrypsin Deficiency/diagnosisABSTRACT
A criação de equinos brasileira movimenta anualmente cerca de R$ 16,15 bilhões e impulsiona o setor econômico primário do país. O mercado de animais da raça Crioula vem se expandindo devido ao seu alto potencial zootécnico. No Rio Grande do Sul, a criação é tipicamente extensiva, aliada, muitas vezes, à alta densidade animal, o que favorece as constantes infecções por diversos parasitos. O objetivo deste estudo foi analisar retrospectivamente a frequência de parasitos gastrointestinais em cavalos da raça Crioula naturalmente infectados na região sul do Rio Grande do Sul. Foram utilizadas 585 amostras de fezes de equinos da raça Crioula, adultos, de ambos os sexos, recebidas de criatórios e centros reprodutivos localizados na região. Do total de amostras, 89,74% (525/585) foram positivas para algum helminto. Em 57,60% (337/585) das amostras, observaram-se somente ovos da família Strongylidae. Infecções por Parascaris spp. e Strongyloides sp., apresentaram frequências de 2,22% (13/585) e 1,53% (9/585), respectivamente. Assim, pode-se concluir que os parasitos mais frequentes na população equina da região sul do RS pertencem à família Strongylidae.(AU)
Subject(s)
Animals , Strongylida Infections/epidemiology , Strongylida , Gastrointestinal Tract/parasitology , Horses/parasitology , Brazil/epidemiology , HelminthsABSTRACT
BACKGROUND: Lately, the projection of foot placement visual cues onto the floor has been considered for use in gait rehabilitation. While promising, this approach needs further basic assessment to ensure proper uses. RESEARCH QUESTION: Does following floor-projected foot placement visual cues of one's natural walking pattern induce gait mechanics changes immediately or after a practice period? METHODS: Gait mechanics data from fifteen healthy individuals (7 female, 25.4⯱â¯5.0 years, 21.5⯱â¯1.68â¯kg/m2) was collected during normal walking without visual cues, and during two testing phases (immediate and after 45-60â¯min of practice) of walking with floor-projected visual cues depicting their normal spatial parameters. Magnitudes and variabilities of spatial gait parameters and sagittal plane lower limb kinematics and kinetics were compared between the three testing phases using repeated measures ANOVA and post-hoc paired t-tests. RESULTS: Compared to normal walking without foot placement visual cues, there was a statistically significant (pâ¯<â¯0.05) increase in stride length (maximum change of 0.01⯱â¯0.01â¯m), stance phase knee flexion (2.0⯱â¯2.5°), and swing phase hip flexion (1.2⯱â¯1.3°) in both immediate and post-practice testing phases, along with an increase in terminal stance hip (0.28⯱â¯0.38 %BW*Ht) and knee (0.25⯱â¯0.25 %BW*Ht) flexion moments in the immediate testing phase. All of these changes between testing phases were smaller than their corresponding normal gait smallest real differences (SRD). With the addition of visual cues, variability was statistically significantly decreased in spatial parameters and increased in knee flexion angle at heel strike and knee flexion moment in terminal stance. SIGNIFICANCE: While biomechanical changes were observed, their magnitudes were small enough to suggest that floor-projected visual cues can be used in gait retraining without introducing unintended gait changes. Furthermore, the results suggested that lengthy practice periods are not necessary. The validity of these observations will, however, need to be confirmed in cases of severe impairments.
Subject(s)
Cues , Foot/physiology , Gait/physiology , Lower Extremity/physiology , Visual Perception/physiology , Adult , Biomechanical Phenomena , Female , Healthy Volunteers , Humans , Kinetics , Male , RehabilitationABSTRACT
Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) which varies in prevalence across the world, depending on disease definition, diagnostic methods, exposure type and intensity, geographical environments, agricultural and industrial practices, and host risk factors. This study aimed to deepen knowledge about HP's clinical characteristics, diagnosis and functional and imaging features in a cohort of HP patients from the North of Portugal. To achieve this goal, a retrospective assessment of the clinical and diagnostic data was carried out, and patients were classified and compared according to disease presentation (acute, sub-acute and chronic HP forms). Of the 209 HP patients included (mean age 58.3⯱â¯16.0 years), 52.6% were female and 73.7% presented a chronic form. Most patients had prior exposure to birds (76.6%). Dyspnoea and cough were the most frequently experienced symptoms, but no statistically significant differences were found between groups (pâ¯=â¯0.089, pâ¯=â¯0.418, respectively). Fever was most common in acute HP form (pâ¯<â¯0.001). The most common patterns found in Chest CT were ground glass (pâ¯=â¯0.002) in acute/subacute presentation, and reticulation (pâ¯<â¯0.001) in chronic form, while mosaic attenuation, although was also frequently observed, no statistically significant differences were found between groups (pâ¯=â¯0.512). The most common functional pattern was restrictive (38% of patients, 73.7% with chronic HP form). Bronchoalveolar lavage lymphocytes were higher in acute and subacute forms although not reaching statistical significance (pâ¯=â¯0.072), with lowest CD4/CD8 ratio (pâ¯=â¯0.001) in acute forms. Thus, given the significant disease heterogeneity, further studies with different populations and ambient exposures are needed to achieve a better stratification of the exposure risk, to provide proper implementation of avoidance methods and a precise diagnostic and therapeutic approach.
Subject(s)
Alveolitis, Extrinsic Allergic/diagnosis , Alveolitis, Extrinsic Allergic/physiopathology , Environmental Exposure/adverse effects , Lung Diseases, Interstitial/pathology , Adult , Aged , Alveolitis, Extrinsic Allergic/epidemiology , Antigens/adverse effects , Antigens/immunology , Bronchoalveolar Lavage Fluid/immunology , Cohort Studies , Cough/diagnosis , Dyspnea/diagnosis , Environmental Exposure/statistics & numerical data , Female , Fever/diagnosis , Humans , Lung Diseases, Interstitial/immunology , Lung Diseases, Interstitial/physiopathology , Male , Middle Aged , Portugal/epidemiology , Prevalence , Retrospective Studies , Risk Assessment , Risk Factors , Tomography, X-Ray Computed/methods , Tomography, X-Ray Computed/statistics & numerical dataABSTRACT
Endocrine monitoring of non-human primates (NHP) via faecal metabolites of steroid hormones appears as a useful non-invasive alternative to evaluate the reproductive status of free living NHP, as well as of those kept in captivity but of difficult handling. However, validation is needed with plasma values before its application in the field. The aim of the present study was to monitor the different phases of the menstrual cycle from the new world NHP Sapajus apella and S. libidinosus. For this, hormonal and faecal plasma levels of E2, P4 and cortisol were assessed during different days of the menstrual cycle, together with colpocitology. The mean duration of the menstrual cycle according colpocitology was of 21.7 and 21.0 days for S. apella and S. libidinosus, respectively. These values were similar to those observed via plasma analysis, i.e. 22.7 and 20.3 days for S. apella and S. libidinosus, respectively. The day of plasmatic E2 peak was set as Day -1 and the estimated day of ovulation was set as Day 0 and occurred two days earlier in S. libidinosus than in S. apella females. In both species, it was observed a delay in faecal E2 peak of six days for S. apella and of 11 days for S. libidinosus when compared with the plasma peak. A maximum P4 plasma concentration was observed in the middle of luteal phase in S. apella and in S. libidinosus, both at around day 5. However, faecal P4 peaks were detected at days 9 and 8 in S. apella and S. libidinosus, respectively. Mean plasma and faecal cortisol levels were variable during all ovulatory cycle of S. apella and S. libidinosus females. Although no exact correlation was observed between plasmatic and faecal profile of steroid hormone, faecal samples were able to indicate ovarian cycle phase, being important to assess the reproductive status of the females applying a non-invasive method.
ABSTRACT
PURPOSE: British Thoracic Society (BTS) guidelines advocate using FDG PET-CT with the Herder model to estimate malignancy risk in solitary pulmonary nodules (SPNs). Qualitative and semi-quantitative assessment of SPN uptake is based upon analysis of Ordered Subset Expected Maximisation (OSEM) PET images. Our aim was to assess the effect of a Bayesian Penalised Likelihood (BPL) PET reconstruction on the assessment of SPN FDG uptake and estimation of malignancy risk (Herder score). METHODS: Subjects with SPNs who underwent FDG PET-CT between 2014-2017, with histological confirmation of malignancy or histological/imaging follow-up confirmation of benignity were included. Two blinded readers independently classified SPN uptake on both OSEM and BPL (BTS score; 1 = none; 2 = ≤ mediastinal blood pool (MBP); 3 = >MBP but ≤ 2x liver; 4 = >2x liver), with resultant calculation of the Herder score (%) for both reconstructions. RESULTS: 97 subjects with 75 (77%) malignant SPNs were included. BPL increased the BTS score in 25 (26%) SPNs; 9 SPNs (7 malignant) increased from BTS score 2 to 3, 16 (13 malignant) from BTS score 3 to 4, with a mean Herder score increase of 18⯱â¯22%. The mean Herder score for all SPNs with BPL was higher than OSEM (73⯱â¯29 vs 68⯱â¯32%, pâ¯=â¯0.001). There was no difference in Herder model diagnostic performance between BPL and OSEM, with similar areas under the curve (0.84 vs 0.83, pâ¯=â¯0.39). CONCLUSION: BPL increases the Herder score in 26% of SPNs compared to OSEM but does not alter the diagnostic performance of the Herder model.
Subject(s)
Early Detection of Cancer , Lung Neoplasms/pathology , Positron Emission Tomography Computed Tomography , Solitary Pulmonary Nodule/pathology , Aged , Algorithms , Bayes Theorem , Female , Fluorodeoxyglucose F18 , Humans , Lung Neoplasms/diagnostic imaging , Male , Middle Aged , Retrospective Studies , Risk Assessment , Solitary Pulmonary Nodule/diagnostic imagingABSTRACT
Upper airways (UA) include the nasal cavities, pharynx, and larynx, and its main function is to warm and filter the inspired air. UA dysfunction is in the pathogenesis of various disorders, such as obstructive sleep apnea syndrome (OSAS) and vocal cord dysfunction. In addition, in some neurodegenerative diseases (e.g. Amyotrophic Lateral Sclerosis - ALS), UA dysfunction may also compromise the effective use of ventilatory support (VS). In this context, the endoscopic evaluation of UA may be useful in understanding the OSAS mechanisms, in determining the causes for treatment-induced airway obstruction and even in helping to titrate noninvasive ventilation (NIV) in ALS patients with bulbar or pseudo-bulbar (spastic) dysfunction. Specifically, in OSAS patients, when residual obstructive events persist, although an optimal ventilatory mode has been apparently achieved, along with interface and equipment, the endoscopic evaluation of UA seems to be a valuable tool in understanding its mechanisms, even assisting adjustments to NIV parameters. In addition, it has also been described as being useful in laryngeal response to mechanical in-exsufflation (MI-E) and Exercise-Induced Laryngeal Obstruction (EILO). However, no protocol has yet been published or validated for this. For this reason, a literature review was conducted on UA function and its response to positive pressure and MI-E. Special emphasis has also been given to the current indication for video endoscopy in chronically ventilated patients.
Subject(s)
Airway Obstruction/diagnostic imaging , Insufflation , Positive-Pressure Respiration , Vocal Cord Dysfunction/diagnostic imaging , Deep Sedation , Endoscopy , Humans , Larynx/diagnostic imaging , Nasal Cavity/diagnostic imaging , Noninvasive Ventilation , Pharynx/diagnostic imaging , Sleep , Vocal Cord Dysfunction/etiologyABSTRACT
Hypersensitivity pneumonitis (HP) is an immune-mediated syndrome triggered by inhalation of a wide variety of allergens, to which an individual has previously been sensitized. More than 200 agents responsible for the disease have already been identified; however, HP occurs only in a small number of individuals exposed to causal antigens. The present report provides an overview of the role of antigen role in HP, highlighting its diversity, research methods, and prevention strategies, as well as the impact on disease prognosis following elimination of antigen. HP is an underdiagnosed disease and, therefore, it is difficult to accurately estimate its incidence. Triggering antigens can be divided into six broad categories: bacteria, fungi, mycobacteria, animal and plant proteins, chemicals, and metals, represented by disease prototypes. The identification of causal antigen is a major challenge; it is impossible to obtain in about 30-60% of cases. The acute form of HP, with early detection and immediate eviction of causal antigen, tends to have an excellent prognosis. In the chronic form, partial recovery of disease is still possible; however, some cases tend to progress to fibrosis, even after removal from exposure. In conclusion, HP diagnosis should be based on a proactive search for potential antigen sources, although their identification is hampered by the lack of standardized methods of demonstrating the specific antigen sensitization. Antigen avoidance is a critical determinant in disease prognosis.
Subject(s)
Allergens/adverse effects , Alveolitis, Extrinsic Allergic/immunology , Antigens/immunology , Inhalation Exposure/prevention & control , Lung/immunology , Alveolitis, Extrinsic Allergic/diagnosis , Alveolitis, Extrinsic Allergic/epidemiology , Antigens/classification , Bronchial Provocation Tests/methods , Environmental Exposure/adverse effects , Fibrosis/etiology , Humans , Immunization , Immunologic Tests/methods , Incidence , Inhalation Exposure/adverse effects , PrognosisABSTRACT
Chlamydia psittaci was detected in 152 (72%) blue-fronted Amazon parrots (Amazona aestiva, parrot from the Psittacidae family) out of a population of 212 that died during 2009-2011 in a wildlife rescue and rehabilitation centre in Minas Gerais, Brazil, following rescue from illegal wildlife trafficking. The macroscopic changes observed in these animals were hepatomegaly with multifocal white foci visible at the serosal surfaces of the liver, and extending into the parenchyma, and splenomegaly. The microscopic lesions observed in the liver included multifocal to coalescing miliary necrosis of hepatocytes with infiltration by heterophils, lymphocytes and plasma cells. In the spleen, loss of the normal architecture and infiltration by macrophages and plasma cells were observed. Stained tissue sections (Gimenez technique) revealed small round clusters suggestive of C. psittaci (reticulate bodies) in the cytoplasm of macrophages from the liver and spleen. Nine sequences of segments of the ompA gene, obtained from different individuals, were randomly selected for sequencing. The phylogenetic analyses showed that all strains clustered with genotype A, which is the most virulent genotype for birds. This genotype is involved in mortality of psittacines, is easily transmitted in captivity and represents a problem for successful rehabilitation. The results indicate the necessity to improve biosecurity in triage and to provide individual personal protection for professionals and caretakers.
Chlamydia psittaci a été détectée chez 152 (72 %) amazones à front bleu (Amazona aestiva, perroquet de la famille des Psittacidés) sur un total de 212 individus rescapés du trafic illégal et décédés en 2009 et 2011 dans un centre de sauvetage et de réhabilitation de la faune sauvage à Minas Gerais (Brésil). Les modifications macroscopiques observées sur ces oiseaux étaient une hépatomégalie avec des foyers blancs multifocaux visibles sur les surfaces séreuses du foie et s'étendant dans le parenchyme, et une splénomégalie. Les lésions microscopiques observées dans le foie comprenaient une nécrose miliaire multifocale à coalescente des hépatocytes avec infiltration d'hétérophiles, de lymphocytes et de plasmocytes. Dans la rate, une perte de l'architecture normale et l'infiltration de macrophages et de plasmocytes ont été observées. La coloration de coupes de tissus (technique de Gimenez) a révélé de petites grappes rondes évoquant C. psittaci (corps réticulés) dans le cytoplasme des macrophages du foie et de la rate. Neuf produits segmentés d'une partie du gène ompA, obtenus de différents individus, ont été sélectionnés de manière aléatoire pour le séquençage. Les analyses phylogénétiques ont montré que toutes les souches se regroupaient dans le génotype A, qui est le plus virulent pour les oiseaux. Ce génotype est responsable de cas de mortalité chez les psittacidés et se transmet facilement en captivité, ce qui représente un risque pour la réussite des opérations de réhabilitation. Au vu de ces résultats, les auteurs soulignent la nécessité d'améliorer la biosécurité lors du tri des animaux dans les centres de soins et de fournir une protection individuelle aux professionnels et aux gardiens.
Se detectó Chlamydia psittaci en 152 (72%) amazonas frentiazules (Amazona aestiva, loro de la familia Psittacidae) de un total de 212 que murieron durante 20092011 en un centro de rescate y rehabilitación de fauna silvestre de Minas Gerais, Brasil, tras haber sido rescatadas del tráfico ilegal. Los cambios macroscópicos que se observaron en estos animales fueron hepatomegalia con focos blancos multifocales visibles en las superficies serosas del hígado y que se extendían hacia el parénquima, y esplenomegalia. Las lesiones microscópicas observadas en el hígado consistieron en necrosis miliar multifocal a coalescente de hepatocitos con infiltración de heterófilos, linfocitos y células plasmáticas. En el bazo, se observó pérdida de la arquitectura normal y infiltración de macrófagos y células plasmáticas. Cortes de tejido teñidos (con la técnica de Giménez) revelaron pequeños racimos redondos que sugerían la presencia de C. psittaci (cuerpos reticulados) en el citoplasma de macrófagos del hígado y del bazo. A partir de distintos individuos, se escogieron aleatoriamente nueve segmentos del gen ompA para ser secuenciados. Los análisis filogenéticos mostraron que todas las cepas correspondían al genotipo A, que es el más virulento para las aves. Este genotipo está involucrado en la mortalidad de psitácidas, se transmite fácilmente en cautiverio y supone un riesgo para el éxito de la rehabilitación. Los resultados indican la necesidad de mejorar la bioseguridad en el triaje y de procurar protección personal individual a profesionales y cuidadores.
Subject(s)
Amazona/microbiology , Bacterial Outer Membrane Proteins/genetics , Bird Diseases/microbiology , Chlamydophila psittaci/genetics , Liver Diseases/veterinary , Phylogeny , Animals , Brazil , Liver Diseases/microbiologyABSTRACT
Wild native species are usually grown under severe and stressful conditions, while a special category includes halophytic species that are tolerant to high salinity levels. Native halophytes are valuable sources of bioactive molecules whose content is higher in saline than normal conditions, since the adaptation to salinity mechanisms involve apart from changes in physiological functions the biosynthesis of protectant molecules. These compounds include secondary metabolites with several beneficial health effects which have been known since ancient times and used for medicinal purposes. Recent trends in pharmaceutical industry suggest the use of natural compounds as alternative to synthetic ones, with native herbs being strong candidates for this purpose due to their increased and variable content in health promoting compounds. In this review, an introductory section about the importance of native herbs and halophyte species for traditional and modern medicine will be presented. A list of the most important halophytes of the Mediterranean basin will follow, with special focus on their chemical composition and their reported by clinical and ethnopharmacological studies health effects. The review concludes by suggesting future requirements and perspectives for further exploitation of these valuable species within the context of sustainability and climate change.