From Platelet-Rich Plasma to Mesenchymal Stem Cells: Cartilage, Tendon, and Bone Regeneration With Orthobiologics.

The use of orthobiologics such as platelet-rich plasma, bone marrow aspirate, and stem cells has been proposed as a biologic augmentation for treatment of various conditions of cartilage, tendon, and bone. Although the published evidence is not conclusive, the safety of these treatments and benefits in improving the biologic condition of treated tissues have been confirmed. Osteoarthritis, rotator cuff injuries, and osteonecrosis of the femoral head are three common musculoskeletal conditions associated with the use of orthobiologics in patients with cartilage, tendon, and bone injuries. When reviewing the use of platelet-rich plasma, bone marrow aspirate, and mesenchymal stem cells in patients with these conditions, there is evidence of high safety and positive, but variable, efficacy. Recent studies have shown promising results and have paved the way for research being conducted at many specialized centers around the world.

How we approach conservative treatment of retinoblastoma in South America in the era of local ocular treatments: A consensus of the Grupo America Latina de Oncologia Pediatrica (GALOP).

Local therapies are increasingly used for ocular preservation in retinoblastoma. In middle-income countries, these techniques pose specific challenges mostly related to more advanced disease at diagnosis. The Grupo de America Latina de Oncología Pediátrica (GALOP) developed a consensus document for the management of conservative therapy for retinoblastoma. Intra-arterial chemotherapy (OAC) is the preferred therapy, except for those with less advanced disease or age younger than 6 months. OAC allowed for a reduction in the use of external beam radiotherapy in our setting. Intravitreal chemotherapy is the preferred treatment for vitreous seeding. Enucleation is the treatment of choice for eyes with advanced disease.

Inovação tecnológica no Brasil: desafios e insumos para políticas públicas / Innovación tecnológica en Brasil: desafíos e insumos para las políticas públicas / Technological innovation in Brazil: challenges and inputs for public policies

Resumo Este artigo oferece uma breve reflexão sobre a natureza do investimento em pesquisa e desenvolvimento (P&D) no Brasil. Seu objetivo é proporcionar alguns insumos para avançar no debate sobre esse tema na sociedade brasileira. Desde 1999, o Brasil tem aumentado de maneira consistente o seu investimento em P&D, considerado um dos insumos para inovação e produtividade. Porém, tal esforço tem gerado resultados limitados. Esses resultados limitados não parecem refletir mera insuficiência de investimentos em inovação no Brasil, mas a maneira e a eficácia de sua implementação.

Resumen Este artículo ofrece una breve reflexión sobre la naturaleza de la inversión en investigación y desarrollo (I&D) en Brasil. Su objetivo es brindar algunos insumos para avanzar en el debate sobre este tema en la sociedad brasileña. Desde 1999, Brasil ha aumentado constantemente su inversión en I&D, considerada uno de los insumos para la innovación y la productividad. Sin embargo, tal esfuerzo ha dado resultados limitados. Dichos resultados no parecen reflejar la mera insuficiencia de las inversiones en innovación en Brasil, sino la forma y efectividad de su implementación.

Abstract: This article offers a brief reflection on the nature of research and development (R&D) investment in Brazil, contributing to advancing the debate on this topic. R&D is one of the bases of innovation and productivity, and since 1999 Brazil has consistently increased investment in this area. However, this effort has yielded limited results, suggesting that supplying sufficient resources must be accompanied by effective implementation strategies.

Da Bíblia de Gutenberg à COVID-19 / De la Biblia de Gutenberg a la COVID-19 / From the Gutenberg Bible to COVID-19

Resumo O mundo após a COVID-19 será diferente do mundo de antes, não apenas do ponto de vista dos desafios econômicos, mas também na perspectiva da geopolítica. A globalização tenderá a ser revertida, com claras implicações para a posição dos vários países. O fenômeno da expansão do uso generalizado da tecnologia da informação marcará a dinâmica de vários países, inclusive do Brasil. A academia precisa refletir sobre estratégias de longo prazo para criar empregos e sustentar a empregabilidade enquanto a estrutura da economia se modifica.

Resumem El mundo después de la COVID-19 será diferente del anterior, no solo desde el punto de vista de los desafíos económicos, sino también desde la perspectiva de la geopolítica. La globalización tenderá a revertirse, con claras implicaciones para la posición de los distintos países. El fenómeno de expansión del uso generalizado de la tecnología de la información caracterizará la dinámica de varios países, inclusive de Brasil. La academia necesita reflexionar sobre estrategias a largo plazo para crear empleos y mantener la empleabilidad mientras la estructura de la economía se modifica.

Abstract The world after the COVID-19 pandemic will change, from the perspective of both geopolitical and economic challenges. There will be a tendency for globalization to reverse, affecting the international position of several countries. The phenomenon of expanding the heavy use of information technology will mark the dynamics of many countries, including Brazil. Therefore, academia has to reflect on long-term strategies to create and maintain jobs while the economic structure changes.

Aneurisma gigante de la arteria coronaria derecha, reporte de un caso y revisión de la literatura / Giant aneurysm of the right coronary artery, report of a case and review of the literature

Resumen Los aneurismas de las arterias coronarias se definen como una dilatación localizada que excede el diámetro normal en 1.5 veces. Esta es una condición poco frecuente, su incidencia varía del 0.3 hasta el 5.3% de las angiografías coronarias. Los aneurismas que exceden cuatro veces el diámetro del vaso normal se consideran gigantes. Estos son aún más raros y se presentan en el 0.02 a 0.2% de todos los casos. Existe controversia en cuanto a su fisiopatología, sin embargo, hasta el 50% de los casos se relacionan con la aterosclerosis. Se diagnostican más frecuentemente entre la sexta y séptima décadas de vida. Las principales manifestaciones clínicas están relacionadas con la cardiopatía isquémica. Respecto a su tratamiento, no existe un consenso del manejo en los pacientes adultos, las opciones son: médico, quirúrgico o intervencionismo. Reportamos la presencia de un aneurisma gigante de la coronaria derecha y ectasia gigante del sistema izquierdo con trombosis activa en un hombre con antecedentes de un aneurisma en la aorta abdominal, tratado por vía endovascular, e infarto agudo al miocardio sin elevación del segmento ST no reperfundido. Requirió de estudio de angiotomografía coronaria, el cual permitió la identificación de las características anatómicas de esta enfermedad.

Abstract Coronary artery aneurysms are described as a localized dilatation that exceeds the normal diameter by 1.5 times. This is a rare condition; its incidence varies from 0.3% up to 5.3% of all coronary angiographies. Those aneurysms that exceed 4 times the diameter of a normal artery are considered giant aneurysms, which are even more uncommon, presenting between 0.02% and 0.2% of all cases. There is controversy regarding its pathophysiology, however, up to 50% of the cases are related to atherosclerosis. They are diagnosed more frequently between the sixth and seventh decade of life. The main clinical manifestations are related to ischemic heart disease. Regarding their treatment, there is no general consensus towards its management in adult patients. The options are medical, surgical or percutaneous treatment. We report the presence of a giant aneurysm of the right coronary artery and giant ectasia of the left coronary system with active thrombosis in a man with history of an abdominal aortic aneurysm, with endovascular treatment and a non-ST segment elevation myocardial infarction with no reperfusion strategy, who required a coronary computed tomography, identifying the anatomical characteristics of this disease.

Biomathematical model for simulating abnormal orifice patterns in colonic crypts.

Colonic polyps, which are abnormal growths in the colon, are a major concern in colon cancer diagnosis and prevention. Medical studies evidence that there is a correlation between histopathology and the shapes of the orifices in colonic crypts. We propose a biomathematical model for simulating the appearance of anomalous shapes for the orifices of colonic crypts, associated to an abnormal cell proliferation. It couples a mechanical model that is a mixed elastic/viscoelastic quasi-static model describing the deformation of the crypt orifice, with a convection-diffusion model that simulates the crypt cell dynamics in space and time. The coupling resides in the variation of pressure generated by abnormal proliferative cells that induce a mechanical force and originate the change in shape of the crypt orifice. Furthermore the model is formulated in a two-dimensional setting, for emulating the top view of the colonic mucosa, observed in vivo in colonoscopy images. The primary focus of this study is on the modeling of this complex biological phenomenon, by defining an appropriate reduced biomathematical model. Additionally, a numerical procedure to determine its solution is also addressed. The overall numerical simulations indicate that an excess of cell proliferation, in different crypt locations, creates some of the anomalous patterns of the colonic crypt orifices, observed in vivo in medical images.

Severe outbreak of Centrocestus formosanus (Trematoda: Heterophyidae) in farm-raised ornamental platies Xiphophorus maculatus.

This report describes a severe outbreak of the gill fluke Centrocestus formosanus in farm-raised platies Xiphophorus maculatus in Brazil, with mortality rate approaching 95%. Typical clinical signs of infection were observed, with microscopic examinations of fresh gills revealing multiple cysts containing a once-folded metacercaria with an X-shaped excretory bladder. The 18S subunit of the metacercariae (BR1) was amplified by PCR, sequenced and analyzed by BLAST. Subsequent phylogenetic analyses revealed that the BR1 isolate was closely related to C. formosanus from Thailand. This is the first report of C. formosanus in ornamental fish in Brazil. Our observations suggest that platies are highly sensitive to this digenetic parasite. Controlling population densities of the parasite's intermediate host, the snail Melanoides tuberculata, would help to reduce outbreaks.

Eficacia de la colangiopancreatografía por resonancia magnética para el diagnóstico de coledocolitiasis de probabilidad intermedia / Efficacy of cholangiopancreatograghy by magnetic resonance in the diagnosis of choledocholithiasis of intermediate probability

Introducción. La coledocolitiasis de probabilidad intermedia es una condición con gran morbilidad por el riesgo de pancreatitis y colangitis, y se requiere el estudio de la vía biliar para su enfoque diagnóstico y terapéutico. Actualmente, el método de referencia para su diagnóstico y tratamiento, es un examen invasivo, la colangiopancreatografía retrógrada endoscópica (CPRE), que no siempre lleva a un diagnóstico positivo de coledocolitiasis, pero sí implica exponer a los pacientes a sus riesgos. Por esta razón, la colangiopancreatografía por resonancia magnética (CPRM) ha tomado importancia en el diagnóstico, ya que es un examen no invasivo y con menor riesgo de complicaciones, por lo que se pretende evaluar su uso en la coledocolitiasis de probabilidad intermedia. Métodos. Se llevó a cabo un estudio de pruebas diagnósticas en una muestra de pacientes con coledocolitiasis de probabilidad intermedia, en la Fundación Salud El Bosque, entre enero de 2012 y agosto de 2015. Resultados. Se incluyeron 151 pacientes con diagnóstico de coledocolitiasis de probabilidad intermedia. Se evaluaron las características de la CPRM, la cual mostró sensibilidad de 88 %, especificidad de 79 %, valor predictivo positivo (VPP) de 88 % y valor predictivo negativo (VPN) de 96 %, con un índice de exactitud de 94,7 %. Conclusiones. La CPRM es un examen con un rendimiento adecuado en la evaluación de los pacientes con coledocolitiasis de probabilidad intermedia. En estos casos permite obviar la CPRE diagnóstica. El impacto de la dilatación de la vía biliar sumada a otras alteraciones del perfil hepático, no se puede establecer con este estudio

Introduction. Patients with intermediate probability of choledocholithiasis exhibit a highly morbid pathology due to the risk of developing pancreatitis and cholangitis; it demands the study of the bile duct for appropriate diagnostic and therapeutic approach. Currently, the gold standard for its diagnosis and treatment is an invasive examination, ERCP, which not always ends with positive diagnosis of choledocholithiasis, exposing the patient to the associated risks. This is why magnetic resonance cholangiopancreatography has acquired importance in the diagnosis, for it is a non-invasive procedure with lesser risk of complications. For this reason we decided to evaluate its use in mid-probability choledocholithiasis. Methods. A study of the diagnostic tests was carried out in a sample of 151 patients with intermediate probability of choledocholithiasis at our center, Fundación Salud El Bosque (Bogotá, Colombia), in the period 2012-2015. Results: A total of 151 patients with the diagnosis of choledocholithiasis of intermediate probability were included, evaluating the characteristics of the MRCP, which showed sensitivity of 88%, specificity 79%, PPV88% and NPV 96%, with an accuracy index of 94.7%. Conclusions. MRCP is a test that exhibits adequate performance in the evaluation of patients with intermediate probability of choledocholithiasis, avoiding the performance of ERCP. It confirms its previous use when faced with mid-chance choledocholithiasis. The diagnostic impact of dilation of the bile duct and other alterations of the liver profile can not be established with this study

Outbreak of multidrug resistant Salmonella Typhimurium in calves at a veterinary hospital in Brazil / Surto de Salmonella Typhimurium multirresistante em bezerros em um hospital veterinário do Brasil

ABSTRACT: The present study aimed to describe and characterize a nosocomial outbreak caused by a multidrug resistant Salmonella Typhimurium in hospitalized calves at a veterinary medical teaching hospital from Brazil. Sixty-three (96.9%) calves showed lethargy, hyperthermia and profuse diarrhea and despite treatment, 26 (41.2%) animals died. Five animals were necropsied and stool samples of six calves were collected. The isolated strains were subjected to antimicrobial susceptibility test by disc-difusion method and were fingerprinted by ERIC-PCR. Macroscopic lesions suggestive of salmonellosis, such as fibrinonecrotic enteritis and hepatosplenomegaly were observed. Salmonellosis was confirmed by isolation of S. Typhimurium from stool samples and organs from seven affected animals. Six out of seven isolates of S. Typhimurium, exhibited 100% of similarity at ERIC-PCR, suggesting occurrence of nosocomial transmission of S. Typhimurium among the hospitalized calves. All but one S. Typhimurium isolated were resistant to marbofloxacin, enrofloxacin, florfenicol, oxytetracycline and trimethoprim/sulfamethoxazole, antimicrobial agents largely used for humans and animal treatment. This is the first study of a nosocomial outbreak of multidrug resistant S. Typhimurium in a veterinary hospital in Brazil and highlighted the need for preventive measures to reduce the risks for inpatients and humans in contact with animals.

RESUMO: O objetivo do presente estudo é descrever e caracterizar um surto nosocomial provocado por S. Typhimurium multirresistente em bezerros hospitalizados em um hospital escola de medicina veteriária localizado no Brasil. Sessenta e três (96,9%) bezerros apresentaram letargia, hipertermia e diarreia profusa e, apesar do tratamento, vinte e seis animais (41,2%) morreram. Cinco animais foram necropsiados e amostras fecais de seis bezerros foram coletadas. As estirpes isoladas foram submetidas a testes de susceptibilidade a antimicrobianos pelo método de disco-difusão e foram genotipadas pelo ERIC-PCR. Lesões macroscópicas sugestivas de salmonelose, como enterite fibrinonecrótica e hepatoesplenomegalia, foram observadas. Salmonelose foi confirmada pelo isolamento de S. Typhimurium em amostras fecais e órgãos de sete animais. Dos sete isolados, seis apresentaram 100% de similaridade ao ERIC-PCR, sugerindo ocorrẽncia de transmissão nosocomial de S. Typhimurium entre os bezerros hospitalizados. Com excessão de uma estirpe, todas foram resistentes a marbofloxacina, enrofloxacina, florfenicol, oxitetraciclina e trimetoprima/sulfametoxazol, agentes antimicrobianos amplamente utilizados para o tratamento humano e animal. Esse é o primeiro estudo que demonstra um surto nosocomial de estirpes de S. Typhimurium resistentes a múltiplas drogas em um hospital veterinário no Brasil, enfatizando a necessidade de medidas preventivas que reduzam os riscos aos animais hospitalizados e a pessoas que entrarem em contato com esses animais.

Production of cachama reciprocal hybrids in earth ponds / Produção de híbridos recíprocos de tambaqui e pirapitinga em viveiros escavados

ABSTRACT: The growth of cachama hybrids, cachamoto (Colossoma macropomum ♀ x Piaractus brachypomus ♂) and cachamay (P. brachypomus ♀ x C. macropomum ♂) was compared for 154 days to determine which showed the better productivity. The experiment was carried out in three earth ponds, each divided transversely with a plastic net, yielding six experimental units. Juveniles of cachamoto of 12.95±2.43g and 6.75±0.42cm and cachamay of 16.65±3.64g and 7.41±0.62cm were distributed in each sub-tank of 240m2 at a density of 0.5 fish m-2. Fish were fed twice daily except on days when their weight and length, and the physical and chemical parameters of the water were measured. The following productive variables were evaluated: growth in weight and length, daily weight gain, daily feed intake, apparent feed conversion, specific growth rate, condition factor, productivity and the cost/benefit relationship. None of the analyzed variables presented statistical difference between treatments. Physical and chemical parameters of the water remained within the recommended values for cachama, and survival was 100%. Based on the results obtained, it can be concluded that cachama reciprocal hybrids present a similar productive behavior, so that it is indifferent which one is chosen to be raised under the conditions evaluated.

RESUMO: Comparou-se o crescimento de híbridos de tambaqui e pirapitinga, tambatinga (Colossoma macropomum ♀ x Piaractus brachypomus ♂) e pirambaqui (P. brachypomus ♀ x C. macropomum ♂) durante 154 dias para se verificar qual deles apresentava melhor produtividade. O experimento foi realizado em três viveiros de terra, cada um dividido transversalmente com uma rede plástica, originando seis unidades experimentais. Juvenis de tambatinga de 12,95±2,43g e 6,75±0,42cm e pirambaqui de 16,65±3,64g e 7,41±0,62cm foram distribuídos em cada sub-tanque de 240m2 em uma densidade de 0,5 peixe m-2. Os peixes foram alimentados duas vezes por dia, exceto nos dias em que se mediram peso, comprimento e parâmetros físicos e químicos da água. As variáveis produtivas avaliadas foram: crescimento em peso e comprimento, ganho de peso diário, consumo diário de alimento, conversão alimentar aparente, taxa de crescimento específico, fator de condição, produtividade e relação custo/benefício. Nenhuma das variáveis analisadas apresentou diferença estatística entre os tratamentos. Os parâmetros físicos e químicos da água permaneceram dentro dos valores recomendados para tambaqui e pirapitinga e a sobrevivência foi de 100%. Com base nos resultados obtidos, pode-se concluir que os híbridos de tambaqui e pirapitinga apresentam um comportamento produtivo semelhante, de modo que é indiferente qual deles é escolhido para ser criado nas condições avaliadas.

Padronização de multiplex PCR para detecção de dermatófitos em pelos e crostas de cães e gatos / Standardization of a PCR multiplex for the detection of dermatophytes in dogs and cats fur and crusts

Objetivou-se padronizar uma reação do tipo multiplex PCR (mPCR) para detectar Microsporum canis, Microsporum gypseum e o complexo Trichophyton mentagrophytes em amostras de pelos e/ou crostas de cães e gatos. 250 amostras de pelos e/ou crostas de cães e gatos foram analisadas por meio de exame direto e cultura, o DNA das mesmas foi extraído para mPCR. Primers foram desenhados e como controle positivo da reação utilizou-se o DNA extraído de colônias de M. canis (URM 6273), M. gypseum (URM 6921) e T. mentagrophytes (URM 6211), provenientes da Coleção de Culturas (Micoteca URM), Departamento de Micologia, Centro de Ciências Biológicas da Universidade Federal de Pernambuco (CCB/UFPE). Como controles negativos de reação, utilizou-se água destilada esterilizada e DNA extraído de Alternaria sp. para verificar a especificidade dos primers. Do total de amostras analisadas, 15 (6%) foram identificadas, em cultura, como dermatófitos, e destas, 10 foram M. canis, três M. gypseum e dois T. mentagrophytes (complexo). Destas 15 amostras positivas, 11 (73,3%) foram detectadas por meio da mPCR. Além destas, seis outras, negativas em cultura, foram identificadas como M. gypseum. Verificou-se uma boa concordância entre os resultados da cultura e mPCR (Kappa: 0,66). O protocolo padronizado neste estudo pode ser utilizado como um método de triagem, por apresentar uma sensibilidade maior que a da cultura, usado paralelamente aos exames de rotina, permitindo um diagnóstico em menor tempo.(AU)

The aim of this study was to standardize a multiplex PCR (mPCR) reaction to detect Microsporum canis, Microsporum gypseum and the Trichophyton mentagrophytes complex in dog and cat fur and/or crusts. 250 fur and/or crusts samples from dogs and cats were analyzed by direct examination and culture, DNA from them was extracted for mPCR. Primers were designed and the DNA extracted from colonies of M. canis (URM 6273), M. gypseum (URM 6921) and T. mentagrophytes (URM 6211) from the Collection of Cultures - URM Micoteca - Department of Mycology, Biological Sciences Center of the Federal University of Pernambuco (CCB / UFPE). As negative controls, sterile distilled water and DNA extracted from Alternaria sp., were used to verify the specificity of the primers. Of the total samples analyzed, 15 (6%) were identified in culture as dermatophytes, and of these, 10 were M. canis, three M. gypseum and two T. mentagrophytes (complex). Of these 15 positive samples, 11 (73.3%) were detected by mPCR. Besides these, six others, negative in culture, were identified as M. gypseum. There was good agreement between culture results and mPCR (Kappa: 0.66). The protocol standardized in this study can be used as a screening method, because it has a sensitivity greater than that of the culture, used in parallel to the routine exams, allowing a diagnosis in a shorter time.(AU)

Surto de esporotricose felina na região metropolitana do Recife / Outbreak of feline sporotrichosis in the metropolitan area of Recife

A esporotricose é uma micose subcutânea, causada por um fungo dimórfico do complexo Sporothrix schenckii que acomete várias espécies, especialmente a felina, causando comprometimento local, disseminado ou sistêmico. Objetivou-se relatar a ocorrência de um surto de esporotricose felina na Região Metropolitana do Recife. Foram coletados suabes de úlceras cutâneas de felinos atendidos no Hospital Veterinário da Universidade Federal Rural de Pernambuco e em Clínicas Veterinárias particulares. O diagnóstico foi realizado por meio de exame citológico e cultura fúngica. Dos 115 casos suspeitos, 59 casos foram confirmados, número nunca registrado anteriormente no estado de Pernambuco. Os casos de esporotricose felina registrados têm demonstrado aspectos clínicos e epidemiológicos semelhantes aos ocorridos em outras regiões do país, caracterizando-se como uma doença predominantemente de machos jovens em idade reprodutiva e semi-domiciliados, de difícil tratamento e de rápida disseminação.(AU)

Sporotrichosis is a subcutaneous mycosis caused by a dimorphic fungus from Sporothrix schenckii complex, which affects various species, especially feline, able to cause local, disseminated or systemic impairment. We aimed to report the occurrence of an outbreak of feline sporotrichosis in the Metropolitan Region of Recife. Swabs of skin ulcers in cats treated in the Veterinary Hospital of the Federal Rural University of Pernambuco and in particular veterinary establishments were collected. Diagnosis was made by cytological examination and fungal culture. From 115 suspicious cases, 59 cases were confirmed, unprecedented results in the state of Pernambuco. These registered cases of feline sporotrichosis have demonstrated clinical and epidemiological characteristics similar to those occurring in other regions of the country, characterized as a quick-spreading disease, of difficult treatment, which affects predominantly semi-domiciled young males in reproductive age.(AU)

Co-Infection by Sarcoptes scabiei and Microsporum gypseum in Free-Ranging Crab-Eating Fox, Cerdocyon thous (Linnaeus, 1766)

ABSTRACT The aim of the present study was to describe the clinical manifestation, treatment and outcome of a case of co- infection by Sarcoptes scabiei and Microsporum gypseum in Cerdocyon thous (crab-eating fox) from Northeastern Brazil.

Antimicrobial susceptibility and molecular characterization of Salmonella serovar Ndolo isolated from outbreaks in cattle and horses / Susceptibilidade antimicrobiana e caracterização molecula de isolados de Salmonella sorovar Ndolo de bovinos e equinos

ABSTRACT: The present study aimed to describe and characterize, for the first time, two outbreaks of salmonellosis caused by Salmonella Ndolo in foals and calves in Brazil and compare the isolated strains with S. Ndolo previously identified in asymptomatic reptiles. The affected calves and foals presented fever, lethargy, and profuse diarrhea. Isolated strains were subjected to antimicrobial susceptibility testing, characterized according to virulence genes, and fingerprinted by ERIC-PCR. Salmonella Ndolo was identified in fecal samples from two foals and four calves. One isolate from a calf was resistant to amoxicillin/clavulanic acid, trimethoprim/sulfamethoxazole, and florfenicol. Strains from two other calves were resistant to oxytetracycline. All virulence genes tested were present in the isolates, and two major clusters of closely related strains were identified by ERIC-PCR, each per outbreak. This is the first report of Salmonella Ndolo infection in domestic and symptomatic animals. Previously, this serovar had been identified only in human infections. The presence of relevant virulence genes in all Salmonella Ndolo isolates and the detection of antimicrobial multi-resistant strains highlighted the importance of monitoring serovars associated with salmonellosis in domestic animals.

RESUMO: O objetivo do presente estudo foi descrever e caracterizar, pela primeira vez, dois surtos de salmonelose causados por Salmonella Ndolo em potros e bezerros do Brasil e comparar esses isolados com Salmonella Ndolo previamente identificada em répteis assintomáticos. Os animais infectados apresentaram febre, letargia e diarreia profusa. Os isolados foram submetidos a testes de susceptibilidade a antimicrobianos e foram caracterizados conforme a presença de genes de virulência e diversidade genética, utilizando-se o ERIC-PCR. Salmonella Ndolo foi identificado em amostras fecais de dois potros e quatro bezerros. Um isolado de bezerro foi resistente a amoxicilina/ácido clavulanico, trimethoprima/sulfametoxazol e florfenicol. Estirpes de dois outros bezerros foram resistentes a oxitetraciclina. Todos os genes de virulência testados foram identificados nos isolados e dois grandes grupos de estirpes geneticamente relacionadas foram identificados pelo ERIC-PCR, um para cada surto. Esse é o primeiro relato de Salmonella Ndolo em animais domésticos e sintomáticos. Previamente, esse sorovar foi identificado apenas em infecções humanas. A presença de fatores de virulência relevantes em todos os isolados e a detecção de estirpes multirresistentes a antimicrobianos destaca a importância do monitoramento de sorovares associados a salmonelose em animais domésticos.

An international survey of classification and treatment choices for group D retinoblastoma.

AIM: To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region. METHODS: An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, ANOVA and Kruskal-Wallis tests using Prism. RESULTS: The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Children's Hospital of Los Angeles (CHLA) version, 33% used the Children's Oncology Group (COG) version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were: Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were: Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center (P<0.0001). CONCLUSION: Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic region.

Globe Salvage With Intra-Arterial Topotecan-Melphalan Chemotherapy in Children With a Single Eye.

INTRODUCTION: Intra-arterial chemotherapy is a novel therapeutic modality for retinoblastoma patients. Intra-arterial chemotherapy involves the administration of a super-selective drug through the ophthalmic artery, resulting in better ocular penetration and low systemic toxicity. OBJECTIVE: The aim of this report was to evaluate the feasibility of intra-arterial chemotherapy in a large referral center in Mexico City. METHODS: We included patients with bilateral retinoblastoma, one enucleation, and active disease in the other eye after at least two courses of systemic chemotherapy combined with topical treatments. All patients were treated with three courses of a combination of melphalan 4 mg and topotecan 1 mg. Patients were examined under general anesthesia three weeks after each chemotherapy cycle. RESULTS: From 14 eligible patients, three could not be treated due to inaccessibility of the ophthalmic artery. A complete response was observed in 5/11 patients, three in Stage C according to the International Classification for Intraocular Retinoblastoma, one in Stage D, and one in Stage B. The eyes of three patients were enucleated as a result of active/progressive disease, one in Stage B and two in Stage D. Eye preservation was 55% after a mean follow-up of 171 days (range 21-336). CONCLUSIONS: Super-selective intra-arterial chemotherapy is safe and effective for preventing the enucleation of 55% of affected eyes in this group of patients.

[Use of alternative and complementary medicine in pediatric cancer: investigation of 100 cases at a level III care institute]. / Uso de la medicina alternativa y complementaria (MAC) en cáncer infantil: encuesta de 100 casos en un instituto del tercer nivel de atención.

INTRODUCTION: Alternative medicine is well accepted and widely used in Mexico so we researched the frequency and reasons for the use of alternative or complementary treatment (ACT) in pediatric oncologic patients at the Instituto Nacional de Pediatría (INP). METHODS: One hundred questionnaires were applied to caregivers of children with cancer in a course of 100 hundred consecutive patients. RESULTS: Fifty-one percent of caregivers interviewed accepted the use of some kind of ACT; biological therapies were the most frequent treatments used, and 73% felt satisfied with the results. Caregivers told their physicians they were using ACT in 35% of the questionnaires analyzed, and only 2% of the physicians asked directly about its use. None of the caregivers substituted or stopped allopathic treatment. ANALYSIS: These questionnaires reveal that more than a half of the caregivers use ACT. We believe superstitious and cultural beliefs, as well as the desire of the caregivers to participate actively in their patient's treatment, are the main reasons for the use of ACT; nevertheless, some caregivers do not notify their physicians and this may affect chemotherapy treatment in ways not investigated yet. CONCLUSIONS: The wide use of ACT in Mexico obliges every physician to enquire into it intentionally. It is therefore necessary to establish a stratification risk according to the combination of ACT and allopathic treatment used.

Complete genome sequences of Francisella noatunensis subsp. orientalis strains FNO12, FNO24 and FNO190: a fish pathogen with genomic clonal behavior.

The genus Francisella is composed of Gram-negative, pleomorphic, strictly aerobic and non-motile bacteria, which are capable of infecting a variety of terrestrial and aquatic animals, among which Francisella noatunensis subsp. orientalis stands out as the causative agent of pyogranulomatous and granulomatous infections in fish. Accordingly, F. noatunensis subsp. orientalis is responsible for high mortality rates in freshwater fish, especially Nile Tilapia. In the current study, we present the genome sequences of F. noatunensis subsp. orientalis strains FNO12, FNO24 and FNO190. The genomes include one circular chromosome of 1,859,720 bp, consisting of 32 % GC content, 1538 coded proteins and 363 pseudogenes for FNO12; one circular chromosome of 1,862,322 bp, consisting of 32 % GC content, 1537 coded proteins and 365 pseudogenes for FNO24; and one circular chromosome of 1,859,595 bp, consisting of 32 % GC content, 1539 coded proteins and 362 pseudogenes for FNO190. All genomes have similar genetic content, implicating a clonal-like behavior for this species.