Epidural anesthesia in capuchin monkeys (Sapajus libidinosus).

BACKGROUND: Many primates are kept in breeding for scientific or conservation purposes, but much of the clinical care is represented by trauma. To provide more effective interventions in some of these cases, the present study aimed to evaluate the technique of local anesthesia through the epidural space in capuchin monkeys (Sapajus libidinosus). METHODS: Ten animals were used, which have been deposited in the epidural space 1% lidocaine at a dose of 0.3 ml/kg over the lumbosacral joint. Heart and respiratory rates, oxygen saturation in arterial hemoglobin, blood pressure, rectal temperature, nociception, and cutaneous sensitivity were assessed before and after application. RESULTS: The technique promoted loss of sensation of the skin and muscle relaxation of the pelvic limbs, tail, and perineal region for a period of 35 minutes without any of the physiological parameters measured varies beyond normal values. CONCLUSIONS: The technique proved easy to perform, safe, and effective.

Molecular study of congenital erythrocytosis in 70 unrelated patients revealed a potential causal mutation in less than half of the cases (Where is/are the missing gene(s)?).

INTRODUCTION: Congenital erythrocytosis can be classified as primary, when the defect is intrinsic to the RBC progenitors and independent of the serum erythropoietin (Epo) concentration, or secondary, when the erythrocytosis is the result of an upregulation of Epo production. Primary erythrocytosis is associated with mutations in the EPOR gene, secondary CE can de due to mutations that stabilize the hemoglobin in the oxygenated form or to mutations in the genes that control the transcriptional activation of the EPO gene - VHL, EGLN1, EPAS1. Chuvash polycythemia, caused by mutations in VHL gene, shares features of both primary and secondary erythrocytosis, with increased Epo production but also hypersensitivity of progenitors to Epo. MATERIAL AND METHODS: With the main objective of describing the etiology and molecular basis of CE, we have studied 70 consecutive unrelated patients presenting with idiopathic erythrocytosis from our hematology clinic or referred from other centers. According to a study algorithm, we have sequenced all the genes described as associated with CE. RESULTS AND DISCUSSION: Erythrocytosis molecular etiology was identify in 25 (36%) of the 70 subjects. High-affinity Hb variants were the most common cause, present in 20% of the cases. New mutations were identified in the JAK2, EPOR, VHL, and EGLN1 genes. CONCLUSIONS: High-affinity hemoglobin variants are a very rare cause of secondary CE, but it seems likely that their incidence may be underestimated. Our experience shows that in erythrocytosis with a dominant inheritance and normal or inappropriate high Epo levels, the HBB and HBA genes should be the first to be studied. In spite of the seven genes known to be involved in CE, the majority of the cases have unknown etiology.

Bactericidal and neurotoxic activities of two myotoxic phospholipases A2 from Bothrops neuwiedi pauloensis snake venom.

Two basic myotoxic PLA(2)s, namely BnpTX-I and II, were isolated from Bothrops neuwiedi pauloensis snake venom through three chromatographic steps: ion-exchange chromatography on CM-Sepharose, gel filtration on Sephadex G-50 and reverse phase HPLC on a C18 column. Both PLA(2)s showed a M(r) around 14,000 for the monomer and 28,000 for the dimer (as estimated by SDS-PAGE), pI approximately 7.8 and approximately 121 amino acid residues cross-linked by seven disulfide bonds. The N-terminal sequences revealed significant homology with Asp49 basic myotoxic PLA(2)s from other snake venoms. The catalytic and anticoagulant activities of BnpTX-I were higher than those of BnpTX-II. Both were able to induce cytotoxicity in vitro, as well as, myotoxicity, edema and lethality in mice. BnpTX-I also induced neurotoxic effect on mouse neuromuscular preparations and bactericidal activity on Eschericia coli and Staphylococcus aureus. After chemical modification of BnpTX-I with BPB or incubation with EDTA or Mn(2+) ions, the catalytic activity was completely abolished, while the toxic and pharmacological activities were partially reduced. Interaction with heparin inhibited the cytotoxic and bactericidal effects. Anti-BthTX-I, anti-BthTX-II and anti-115-129-C terminal antibodies strongly recognize both BnpTX-I and II. It is shown that the neurotoxic effect induced by B. neuwiedi pauloensis venom is due to the presence of myotoxic PLA(2)s. The data also corroborate the hypothesis of a partial dissociation between toxic and enzymatic domains. In addition, BnpTX-I displays a heparin binding C-terminal region, which is probably responsible for the cytotoxic and bactericidal effects.

Normal Breastfeeding after Breast Reconstruction in a Patient with Poland's Syndrome.

BACKGROUND: Poland's syndrome is a rare congenital non-inherited anomaly that usually manifests itself during adolescence and is characterized by absence or deficient development of one of the breasts. To our knowledge, no case of breastfeeding after reconstruction surgery in patients with Poland's syndrome has been described. CASE REPORT: A 22-year-old female patient with Poland's syndrome underwent breast reconstruction. The procedure performed consisted of rotation of a myocutaneous flap harvested from the ipsilateral latissimus dorsi muscle, which was subsequently attached to the anterior thoracic wall to create a pouch and place a 300-ml round textured cohesive silicone gel-filled breast implant. 5 years later the patient got pregnant, and 1 year after delivery she is still breastfeeding normally with both breasts. CONCLUSION: Reconstruction surgery with the latissimus dorsi muscle and a prosthesis was shown to be a potential and safe solution to achieve improvement of breast symmetry and to provide confidence and comfort in relation to self-image and, moreover, the ability to breastfeed.

Caracterização clínica e laboratorial de cães naturalmente infectados com Trypanosoma cruzi no semiárido nordestino / Clinical and laboratorial characterization of naturally infected Trypanosoma cruzi dogs in the northeastern semi-arid

Objetivou-se, com este estudo, evidenciar os sinais clínicos e laboratoriais desta enfermidade para auxiliar na caracterização da doença de forma natural na área semi-árida da região nordeste. Foram avaliados 10 cães positivos para Trypanosoma cruzi, identificados mediante análises sorológicas de reação de imunofluorescência indireta (RIFI) e enzyme linked immunosorbent assay (ELISA); análise molecular pela Reação em Cadeia Polimerase (PCR), microscopia direta e hemocultura. Os cães chagásicos foram submetidos à avaliação física, verificação da pressão arterial, exames eletrocardiográficos, radiográficos, hematológicos (eritrograma e leucograma) e bioquímicos (ureia, creatinina, ALT, AST, PT, albumina, globulina, CK, CK-MB e cTnI). O exame físico e os valores das pressões arteriais dos cães apresentaram dentro dos parâmetros de normalidade, enquanto que na eletrocardiografia observou-se FC normal com ritmo sinusal, com exceção de um cão, que apresentou taquicardia sinusal (168 bat/min). No ECG de oito cães houve aumento da duração de P (47±6,5ms) sugestivo de aumento atrial, não confirmado radiograficamente. Foi observado supradesnivelamento do segmento ST em um cão. Nos resultados hematológicos constatou-se trombocitopenia (187,4x10³ ±137,2x10³) e anemia (5,0x10(6) ±1,39x10(6)/uL). Os valores médios da hemoglobina (11±2,7g/dL) e do hematócrito (34±10,5%) estavam abaixo dos limites de normalidade. A série branca apresentou-se dentro dos limites de normalidade, com exceção da eosinofilia observada em três cães. Individualmente, registrou-se em dois cães, leucocitose, linfocitose e neutrofilia. Na avaliação bioquímica, registrou-se hiperproteinemia (7,2±0,9g/dL), hipoalbuminemia (2,2±0,4g/dL), hiperglobulinemia (5,1±1,0g/dL) e aumento da CK (196±171U/L). Não houve alteração nas enzimas ALT e AST. A isoenzima CK-MB e o cTnI alteraram somente em três cães. Os cães infectados naturalmente no semiárido nordestino apresentam características relacionáveis à forma crônica indeterminada, ou seja, cães assintomáticos. A identificação dos cães infectados naturalmente sem características patognomônicas da doença de Chagas ressalta a importância desta enfermidade no processo diagnóstico com as demais que manifestam perfis inespecíficos associados ou não às doenças cardiovasculares.

This study aimed to evidence the clinical and laboratorial signs of this disease to help characterize this illness in a natural way in the semiarid in the northeastern region. We evaluated 10 positive for Trypanosoma cruzi dogs, that were identified by serological analysis of immunofluorescence assay (RIFI) and enzyme linked immunosorbent assay (ELISA); molecular analysis by polymerase chain reaction (PCR), direct microscopy and blood culture. The chagasic dogs underwent physical examination, electrocardiographic, radiographic, blood pressure, hematology (erythrocyte and leukocyte count) and biochemical exams (urea, creatinine, ALT, AST, PT, albumin, globulin, CK, CK-MB, and cTnl). The physical examination and the blood pressure were presented within the normal range, while in the electrocardiography the FC was observed as normal with a sinus rhythm, with the exception of one dog that presented a sinus tachycardia (168 bat/min). In the ECG of eight dogs there was increase of duration of P (47±6.5ms) suggestive to atrial enlargement, not confirmed in the radiography. A supraunlevelling was observed in the ST segment in one dog. In the hematological results, thrombocytopenia (187.4x10³ ±137.2x10³) and anemia (5.0x10(6) ±1.39x10(6)/ul) were noted. The mean hemoglobin (11 ±2.7g/dL), hematocrit (34±10.5%) were below normal limits. The white series were within normal variation, with the exception of eosinophilia observed in three dogs. Individually, there were two dogs which registered leukocytosis, lymphocytosis and neutrophilia. In the biochemical evaluation there was hyperproteinemia PT=7.2 ±0.9g/dL, hypoalbuminemia (2.2±0.4g/dL), hyperglobulinemia (5.1±1.0g/dL), increased of CK (196+171 U/L) and there was no alteration on ALT and AST enzymes. The CK-MB isoenzymes and cTnI did not change, except in three dogs. We conclude that dogs naturally infected in the northeastern semiarid present characteristics related to indeterminate chronic form (asymptomatic dogs) and that the identification of the naturally infected dogs with no pathognomonic characteristics of the Chagas disease underscores the importance of this illness in the diagnostic process with the other profiles that show nonspecific or not associated to cardiovascular disease.

Synthesis and biological activity evaluation of lignan lactones derived from (-)-cubebin.

The anti-inflammatory and analgesic effects of three dibenzylbutyrolactone lignans, (-)-hinokinin (2), (-)-6,6'-dinitrohinokinin (3), and (-)-6,6'-diaminohinokinin (4), obtained by partial synthesis from (-)-cubebin (1), were investigated using different animal models. It was observed that compounds (1) and (2) inhibited the edema formation in the rat paw edema assay at the same level and that all responses were dose dependent. Also, at the dose of 30 mg/kg, compounds 1, 2, 3, and 4 inhibited the edema formation by 53%, 63%, 54%, and 82%, respectively, at the third hour of the experiment. In the acetic acid-induced writhing test in mice, compounds 2 and 4 produced inhibition levels of 97% and 92%, respectively, while 3 displayed lower effect (75%), which was still higher than 1. The assayed compounds neither displayed activity in the cell migration test nor in the hot plate test.

Carcinoma medular y carcinoma de células de Hürthle del tiroides sincrónicos: una rara asociación lesional. Presentación de un caso clínico y revisión de la bibliografía / Synchronic medullary carcinoma and Hurtle cell carcinoma of the thyroid: a rare lesional association

Los autores presentan un caso de asociación lesionalsincrónica e independiente de carcinoma medular del tiroides con metástasis ganglionares, y carcinoma de células de Hürthle del lóbulo tiroideo contralateral. Se destaca la falta de referencia en la literatura revisada de casos similares. Se describen detalladamente los pasos diagnósticos y terapéuticos seguidos con este paciente. La bibliografía consultada permitió realizar una puesta al día de los aspectos diagnósticos terapéuticos y pronósticos de ambos tipos de cánceres tiroideos. A diez meses de la intervención quirúrgica el paciente se encuentra libre de enfermedad y en buenas condiciones, debiendo continuar con un estricto control evolutivo

Linfomas No-Hodgkin de células B y T primarias intestinales e infección por virus de Epstein Barr en la población uruguaya / B-cell and Primary T-cell intestinal no-Hodgkin lymphomas and Epstein Barr virus infection in the Uruguayan population

El propósito del presente trabajo es establecer si existe asociación entre los linfomas No-Hodgkin (LNH), a células B y T, y la infección por el virus de Epstein Barr (VEB) en la población uruguaya. El VEB se encuentra universalmente asociado con linfoma tipo Burkitt, periférico de células T, carcinoma nasofaríngeo indiferenciado y linfomas "Natural Killer", mostrando importante variación geográfica. La Enfermedad de Hodgkin (EH), y los linfomas B esporádicos procedentes de América Latina, han evidenciado mayores tasas de asociación con la infección por VEB que los originados en los países occidentales. En los LNH de células T de origen gastrointestinal, la frecuencia en la positividad para el VEB está influida por el sitio anatómico del tumor primario y el fenotipo de la célula neoplásica, siendo independiente de la presencia o ausencia de enteropatia. Analizamos 14 casos de linfomas a células B y T primarios intestinales en pacientes HIV negativos, diagnosticados por microscopía óptica y e inmunomarcación, evaluando la coexistencia con el VEB con técnicas de inmunohistoquimica (IHQ) con EBV LMP-1. En dos (14,3 por ciento) de los casos se comprobó esta asociación, siendo los restantes negativos para la infección por VEB. Los dos linfomas con evidencia de infección por el VEB fueron: uno, en mujeres y, el otro, en hombres, ambos de fenotipo a células B y ambos del subtipo difuso a grandes células, el subtipo que representó 72 por ciento de los linfomas estudiados.