Comparative effectiveness of positron emission tomography and single-photon emission computed tomography myocardial perfusion imaging for predicting risk in patients with cardiometabolic disease.

BACKGROUND: The epidemiology of coronary artery disease (CAD) has shifted, with increasing prevalence of cardiometabolic disease and decreasing findings of obstructive CAD on myocardial perfusion imaging (MPI). Coronary microvascular dysfunction (CMD), defined as impaired myocardial flow reserve (MFR) by positron emission tomography (PET), has emerged as a key mediator of risk. We aimed to assess whether PET MFR provides additive value for risk stratification of cardiometabolic disease patients compared with single-photon emission computed tomography (SPECT) MPI. METHODS: We retrospectively followed patients referred for PET, exercise SPECT, or pharmacologic SPECT MPI with cardiometabolic disease (obesity, diabetes, or chronic kidney disease) and without known CAD. We compared rates and hazards of composite major adverse cardiovascular events (MACEs) (annualized cardiac mortality or acute myocardial infarction) among propensity-matched PET and SPECT patients using Poisson and Cox regression. Normal SPECT was defined as a total perfusion deficit (TPD) of <5%, reflecting the absence of obstructive CAD. Normal PET was defined as a TPD of <5% plus an MFR of ≥2.0. RESULTS: Among 21,544 patients referred from 2006 to 2020, cardiometabolic disease was highly prevalent (PET: 2308 [67%], SPECT: 9984 [55%]) and higher among patients referred to PET (P < 0.001). Obstructive CAD findings (TPD > 5%) were uncommon (PET: 21% and SPECT: 11%). Conversely, impaired MFR on PET (<2.0) was common (62%). In a propensity-matched analysis over a median 6.4-year follow-up, normal PET identified low-risk (0.9%/year MACE) patients, and abnormal PET identified high-risk (4.2%/year MACE) patients with cardiometabolic disease; conversely, those with normal pharmacologic SPECT remained moderate-risk (1.6%/year, P < 0.001 compared to normal PET). CONCLUSIONS: Cardiometabolic disease is common among patients referred for MPI and is associated with a heterogenous level of risk. Compared with pharmacologic SPECT, PET with MFR can detect nonobstructive CAD including CMD and can more accurately discriminate low-risk from higher-risk individuals.

Spectroscopic analysis of the sum-frequency response of the carbon-hydrogen stretching modes in collagen type I.

We studied the origin of the vibrational signatures in the sum-frequency generation (SFG) spectrum of fibrillar collagen type I in the carbon-hydrogen stretching regime. For this purpose, we developed an all-reflective, laser-scanning SFG microscope with minimum chromatic aberrations and excellent retention of the polarization state of the incident beams. We performed detailed SFG measurements of aligned collagen fibers obtained from rat tail tendon, enabling the characterization of the magnitude and polarization-orientation dependence of individual tensor elements Xijk2 of collagen's nonlinear susceptibility. Using the three-dimensional atomic positions derived from published crystallographic data of collagen type I, we simulated its Xijk2 elements for the methylene stretching vibration and compared the predicted response with the experimental results. Our analysis revealed that the carbon-hydrogen stretching range of the SFG spectrum is dominated by symmetric stretching modes of methylene bridge groups on the pyrrolidine rings of the proline and hydroxyproline residues, giving rise to a dominant peak near 2942 cm-1 and a shoulder at 2917 cm-1. Weak asymmetric stretches of the methylene bridge group of glycine are observed in the region near 2870 cm-1, whereas asymmetric CH2-stretching modes on the pyrrolidine rings are found in the 2980 to 3030 cm-1 range. These findings help predict the protein's nonlinear optical properties from its crystal structure, thus establishing a connection between the protein structure and SFG spectroscopic measurements.

Advances in pediatric anesthesia services over the past 10 years in French-speaking sub-Saharan Africa.

INTRODUCTION: To improve and maintain quality and safety in anesthesia, standards have been proposed regarding human resources, facilities and equipment, medications and intravenous fluids, monitoring, and the conduct of anesthesia. Compliance with these standards remains a challenge in French-speaking sub-Saharan Africa (SSA) and results in high morbidity and mortality particularly in children. This aim of this study was to assess the progress made in improving the pediatric anesthesia infrastructures, human resources, education, medications, and equipment in French-speaking SSA over the past 10 years (2013-2022). METHODS: This is a descriptive, multicenter, cross-sectional study with retrospective data collection, conducted from September 1 to November 5, 2023. Comparative data from 2012 to 2022 were collected through an online survey. Descriptive statistics were used to summarize data. RESULTS: Data were obtained from 12 countries out of 14. The number of hospitals providing pediatric surgery and anesthesia rose from 94 in 2012 to 142 in 2022 (+51%). The total number of physician anesthesiologists rose from 293 (0.1 physician anesthesiologists/100 000 inhabitants) in 2012 to 597 (0.2 physician anesthesiologists/100 000 inhabitants) in 2022 (+103.7%). Five (0.006 physician anesthesiologists/100 000 children) had completed a fellowship in pediatric anesthesia and intensive care in 2012, and 15 (0.01 physician anesthesiologists/100 000 children) in 2022 (+200%). Five physician anesthesiologists had an exclusive pediatric anesthesia practice in 2012, whereas they were 32 in 2022 (+540%). There is no specialized training in pediatric anesthesia and intensive care in any of these countries. Halothane was always available in 81.5% of the hospitals in 2012, and in 50.4% of the hospitals in 2022. Sevoflurane was always available in 5% of the hospitals in 2012, and in 36.2% in 2022. Morphine was always available in 32.2% in 2012, whereas it was available in 52.9% of them in 2022. Pediatric pulse oximeter sensors were available in 36% of the hospitals in 2012, and in 63.4% in 2022. Capnography was available in 5.3% of the hospitals in 2012, and in 48% in 2022. CONCLUSION: Progress have been made over the last 10 years in French-speaking SSA to improve infrastructures, human resources, education, medications, and equipment for pediatric anesthesia in French-speaking SSA. However, major efforts must be continued. Standards adapted to the local context should be formulated.

Modified mRNA-Mediated CCN5 Gene Transfer Ameliorates Cardiac Dysfunction and Fibrosis without Adverse Structural Remodeling.

Modified mRNAs (modRNAs) are an emerging delivery method for gene therapy. The success of modRNA-based COVID-19 vaccines has demonstrated that modRNA is a safe and effective therapeutic tool. Moreover, modRNA has the potential to treat various human diseases, including cardiac dysfunction. Acute myocardial infarction (MI) is a major cardiac disorder that currently lacks curative treatment options, and MI is commonly accompanied by fibrosis and impaired cardiac function. Our group previously demonstrated that the matricellular protein CCN5 inhibits cardiac fibrosis (CF) and mitigates cardiac dysfunction. However, it remains unclear whether early intervention of CF under stress conditions is beneficial or more detrimental due to potential adverse effects such as left ventricular (LV) rupture. We hypothesized that CCN5 would alleviate the adverse effects of myocardial infarction (MI) through its anti-fibrotic properties under stress conditions. To induce the rapid expression of CCN5, ModRNA-CCN5 was synthesized and administrated directly into the myocardium in a mouse MI model. To evaluate CCN5 activity, we established two independent experimental schemes: (1) preventive intervention and (2) therapeutic intervention. Functional analyses, including echocardiography and magnetic resonance imaging (MRI), along with molecular assays, demonstrated that modRNA-mediated CCN5 gene transfer significantly attenuated cardiac fibrosis and improved cardiac function in both preventive and therapeutic models, without causing left ventricular rupture or any adverse cardiac remodeling. In conclusion, early intervention in CF by ModRNA-CCN5 gene transfer is an efficient and safe therapeutic modality for treating MI-induced heart failure.

Body-temperature softening electronic ink for additive manufacturing of transformative bioelectronics via direct writing.

Mechanically transformative electronic systems (TESs) built using gallium have emerged as an innovative class of electronics due to their ability to switch between rigid and flexible states, thus expanding the versatility of electronics. However, the challenges posed by gallium's high surface tension and low viscosity have substantially hindered manufacturability, limiting high-resolution patterning of TESs. To address this challenge, we introduce a stiffness-tunable gallium-copper composite ink capable of direct ink write printing of intricate TES circuits, offering high-resolution (~50 micrometers) patterning, high conductivity, and bidirectional soft-rigid convertibility. These features enable transformative bioelectronics with design complexity akin to traditional printed circuit boards. These TESs maintain rigidity at room temperature for easy handling but soften and conform to curvilinear tissue surfaces at body temperature, adapting to dynamic tissue deformations. The proposed ink with direct ink write printing makes TES manufacturing simple and versatile, opening possibilities in wearables, implantables, consumer electronics, and robotics.

Softening implantable bioelectronics: Material designs, applications, and future directions.

Implantable bioelectronics, integrated directly within the body, represent a potent biomedical solution for monitoring and treating a range of medical conditions, including chronic diseases, neural disorders, and cardiac conditions, through personalized medical interventions. Nevertheless, contemporary implantable bioelectronics rely heavily on rigid materials (e.g., inorganic materials and metals), leading to inflammatory responses and tissue damage due to a mechanical mismatch with biological tissues. Recently, soft electronics with mechanical properties comparable to those of biological tissues have been introduced to alleviate fatal immune responses and improve tissue conformity. Despite their myriad advantages, substantial challenges persist in surgical handling and precise positioning due to their high compliance. To surmount these obstacles, softening implantable bioelectronics has garnered significant attention as it embraces the benefits of both rigid and soft bioelectronics. These devices are rigid for easy standalone implantation, transitioning to a soft state in vivo in response to environmental stimuli, which effectively overcomes functional/biological problems inherent in the static mechanical properties of conventional implants. This article reviews recent research and development in softening materials and designs for implantable bioelectronics. Examples featuring tissue-penetrating and conformal softening devices highlight the promising potential of these approaches in biomedical applications. A concluding section delves into current challenges and outlines future directions for softening implantable device technologies, underscoring their pivotal role in propelling the evolution of next-generation bioelectronics.

Continuous Glucose Monitoring Captures Glycemic Variability After Roux-en-Y Gastric Bypass in Patients with and Without Type 2 Diabetes Mellitus: A Prospective Cohort Study.

PURPOSE: To evaluate glycemic variability (GV) using continuous glucose monitoring (CGM) in individuals with and without type 2 diabetes mellitus (T2DM) undergoing Roux-en-Y gastric bypass (RYGB). METHODS: This prospective cohort study compared the CGM data of fourteen patients with T2DM (n = 7) and without T2DM (n = 7) undergoing RYGB. After 6 months, these patients were compared to a non-operative control group (n = 7) matched by BMI, sex, and age to the T2DM group. RESULTS: Fourteen patients underwent RYGB, with a mean BMI of 46.9 ± 5.3 kg/m2 and an average age of 47.9 ± 8.9 years; 85% were female. After 6 months post-surgery, the total weight loss (TWL) was 27.1 ± 6.3%, with no significant differences between the groups. Patients without diabetes had lower mean interstitial glucose levels (81 vs. 94 and 98 mg/dl, p < 0.01) and lower glucose management indicator (GMI) (5.2 vs. 5.6 and 5.65%, p = 0.01) compared to the control and T2DM groups, respectively. The coefficient of variation (CV) significantly increased only in patients with diabetes (17% vs. 26.7%, p < 0.01). Both groups with (0% vs. 2%, p = 0.03) and without (3% vs. 22%, p = 0.03) T2DM experienced an increased time below range with low glucose (54-69 mg/dL). However, patients without T2DM had significantly less time in rage (70-180 mg/dL) (97% vs. 78%, p = 0.04). CONCLUSION: Significant differences in CGM metrics among RYGB patients suggest an increase in glycemic variability after surgery, with a longer duration of hypoglycemia, especially in patients without T2DM.

Enteroaggregative Escherichia coli (EAEC) isolates obtained from non-diarrheic children carry virulence factor-encoding genes from Extraintestinal Pathogenic E. Coli (ExPEC).

Enteroaggregative E. coli (EAEC) is one of the most frequent pathogens isolated from diarrheal patients as well as from healthy individuals in Brazil and has recently also been implicated as an extraintestinal pathogenic E. coli (ExPEC) associated with bloodstream and urinary tract infections. In this study, 37 EAEC isolates, obtained from fecal samples of non-diarrheic children, were molecularly and phenotypically characterized to access the pathogenic features of these isolates. The EAEC isolates were assigned into the phylogroups A (54.1%), D (29.7%), B1 (13.5%) and B2 (2.7%); and harbored genes responsible for encoding the major pilin subunit of the aggregative adherence fimbriae (AAFs) or aggregate-forming pili (AFP) adhesins as follows: aggA (24.3%), agg3A (5.4%), agg4A (27.0%), agg5A (32.4%) and afpA (10.8%). The most frequent O:H serotypes were O15:H2 (8.1%), O38:H25 (5.4%) and O86:H2 (5.4%). Twenty-one isolates (56.8%) produce the aggregative adherence (AA) pattern on HeLa cells, and biofilm formation was more efficient among EAEC isolates harboring the aggA and agg5A genes. PFGE analysis showed that 31 (83.8%) of the isolates were classified into 10 distinct clusters, which reinforces the high diversity found among the isolates studied. Of note, 40.5% (15/37) of the EAEC isolates have a genetic profile compatible with E. coli isolates with intrinsic potential to cause extraintestinal infections in healthy individuals, and therefore, classified as EAEC/ExPEC hybrids. In conclusion, we showed the presence of EAEC/ExPEC hybrids in the intestinal microbiota of non-diarrheic children, possibly representing the source of some endogenous extraintestinal infections.

Herpetofauna of Matas de Água Azul, an Atlantic Forest remnant in Serra do Mascarenhas, Pernambuco state, Brazil / Herpetofauna das Matas de Água Azul, um remanescente de Mata Atlântica na Serra do Mascarenhas, estado de Pernambuco, Brasil

Abstract: The northern most portion of Atlantic Forest is currently considered as the most vulnerable and threatened in this ecoregion, while also harboring the ecoregion's least studied biota. Herein we present results of a herpetofaunistic survey in Refúgio de Vida Silvestre (Wildlife Refuge) Matas de Água Azul (RVSMAA), in the mountain range Serra do Mascarenhas, northeastern state of Pernambuco, Brazil, one of the largest forest remnants in the northern Atlantic Forest. The sampling was carried out in four expeditions using methods of visual searching and pitfall traps. A total of 43 species of amphibians and 40 species of reptiles were registered, including anurans, caecilians, lizards, snakes and chelonians. The richness recorded represented 56% of amphibians and 20% of reptiles registered in the Atlantic Forest north of the São Francisco River. The RVSMAA holds a high diversity of amphibians and reptiles, representing one of the highest levels of richness in the northern Atlantic Forest. The record of seven species included in some of the threatened species lists reinforces the importance of the area for the conservation of the Atlantic Forest herpetofauna and adds relevant information to our knowledge of northern Atlantic Forest biodiversity and aids in its assessment of conservation.

Resumo: Atualmente, a porção norte da Mata Atlântica é considerada a mais vulnerável, ameaçada e com menos estudos sobre a biota em toda sua extensão. Apresentamos aqui os resultados do inventário herpetofaunístico realizado no Refúgio de Vida Silvestre Matas de Água Azul (RVSMAA), localizada na cadeia de montanhas da Serra do Mascarenhas, estado de Pernambuco, Brasil, um dos maiores remanescentes florestais da porção norte da Mata Atlântica. A amostragem da área foi realizada em quatro expedições onde foram utilizados os métodos de busca visual e estações de armadilhas de interceptação e queda. Um total de 43 espécies de anfíbios e 40 de répteis foram registradas, incluindo anuros, cecílias, lagartos, serpentes e quelônios. A riqueza registrada representa 56% dos anfíbios e 20% dos répteis registrados para a Mata Atlântica ao norte do Rio São Francisco. O RVSMAA possui elevada diversidade de anfíbios e répteis, representando uma das maiores riquezas do norte da Mata Atlântica. O registro de sete espécies incluídas em alguma das listas de espécies ameaçadas para a região reforça a importância da área para a conservação da herpetofauna do Nordeste e acrescenta informações relevantes ao conhecimento e conservação da biodiversidade da Mata Atlântica ao norte do Rio São Francisco.

Depression and quality of life in older adults on hemodialysis

Objective: Depression is highly prevalent in hemodialysis patients, but few studies have evaluated older hemodialysis patients. The aim of this study was to evaluate the prevalence of depression, its associated factors and its impact on quality of life in an older population on hemodialysis. Methods: This was a cross-sectional study including 173 hemodialysis patients aged 60 years or older in Recife, Brazil. Depression was evaluated using the Mini-International Neuropsychiatric Interview when depressive symptoms (according to the 5-item Geriatric Depression Scale) were present. Quality of life was assessed with the Control, Autonomy, Self-realization and Pleasure Questionnaire (CASP-16). Data were also collected on sociodemographic, laboratory (albumin, parathormone, hemoglobin, and phosphorus) and dialysis (dialysis vintage, vascular access and hemodialysis adequacy) characteristics. Results: Depression was present in 22.5% of the sample. Depressed patients presented low CASP-16 quality of life scores (31.6 vs. 24.2, p < 0.001), twice the odds of albumin levels < 3.8 g/dL (OR 2.36; 95%CI 1.10-5.07; p = 0.027) and higher parathormone levels (OR 1.06; 95%CI 1.00-1.13; p = 0.05). Conclusion: Older hemodialysis patients have a high prevalence of depression. Depressed patients presented poor quality of life, lower serum albumin and higher parathormone levels. Teams dealing with older hemodialysis patients should include depression and quality of life assessments in care protocols.

Ação das ondas curtas pulsada na dor aguda induzida pela hipotermia: um estudo piloto / Action of pulsed short wave on the acute pain induced by cold induced pain test: a pilot study

A terapia por campo eletromagnético é bastante utilizada pela fisioterapia no tratamento adjuvante dos sintomas álgicos associados às desordens articulares degenerativas e musculoesqueléticas. Esse estudo teve como objetivo avaliar a ação das ondas curtas pulsada de 100Hz e intensidade de campo elétrico de 25V/m, na latência do limiar de dor e na intensidade da dor em adultos saudáveis. Vinte e quatro voluntários foram recrutados e alocados em dois grupos experimentais, o grupo intervenção (GI), com 12 voluntários de média de idade 22±2,65 anos e o índice de massa corporal (IMC) de 23,72 ±3,07 e o grupo placebo (GP), também com 12 voluntários com 22,08±2,71 anos e IMC de 23,66 ±3,36. Os grupos foram submetidos a 3 ciclos com estimulação álgica através da hipotermia. No ciclo de intervenção o grupo GI contou com a aplicação da OCP (Ondas Curtas Pulsadas) na face anterior e posterior do antebraço ipsilateral submetido à hipotermia por 20 minutos, enquanto que no GP o aparelho foi ligado, mas sem emissão. Na análise intragrupo, a latência do limiar de dor obteve um aumento significativo nos momentos durante e após a intervenção em relação ao momento de pré-intervenção no GI, enquanto que no GP o momento durante a pós-intervenção foi significativamente maior que no pré- intervenção. Quando comparados, o GI apresentou uma latência significativamente maior durante o momento de intervenção e a pós-intervenção em relação aos mesmos momentos no GP. A intensidade dolorosa não apresentou resultados significativos em nenhum dos grupos. Observou-se que as ondas curtas no modo pulsada promove o aumento na latência do limiar doloroso durante a sua aplicação em processos agudos....(AU)

The electromagnetic field therapy is frequently used by physical therapy in the adjuvant treatment of pain symptoms associated with degenerative joint and musculoskeletal disorders. This study aimed to evaluate the effects of pulsed short-wave with 100Hz and intensity of the electric field 25V/m in latency threshold of pain and pain intensity in healthy adults. Twenty-four volunteers were recruited and divided into two experimental groups, the intervention group (GI), with average age of 12 volunteers 22 ± 2.65 years and body mass index (BMI) of 23.72 ± 3.07 and the placebo group (GP), also with 12 volunteers, with 22.08 ± 2.71 years and 23.66 ± 3.36 BMI. The groups were submitted to cycles with cold induced pain, in the intervention cycle the group GI included the application of OCP in the front and back of the ipsilateral forearm subjected to cold induced pain for 20 minutes while in the GP unit remained off. In the intra-group analysis, the latency pain threshold achieved a significant increase in the time during and after the intervention relative to the time of pre-intervention in GI, while in the GP time postintervention was significantly higher than the pre-intervention. When compared, the GI has a significantly higher latency during the intervention and post-intervention compared to the same time in the GP. Pain intensity did not show significant results. It was observed that the pulsed short wave promotes an increase in pain threshold during its application in acute processes....(AU)

Plant species used in giardiasis treatment: ethnopharmacology and in vitro evaluation of anti-Giardia activity

The aim of this study was to compile the traditional knowledge about plants used for the treatment of giardiasis, and also to carry out experimental research to evaluate the anti-Giardia activity of five species.To reach this objective, 398 interviews were performed using a previously prepared questionnaire, followed by an in vitro evaluation of giardicidal potential of hydroalcoholic leaf extracts of Anacardium occidentale L., Chenopodium ambrosioides L., Passiflora edulis Sims, Psidium guajava L., and Stachytarpheta cayennensis (Rich.) Vahl. Among the interviewed people, 55.53% reported the use of plants to treat diarrhea, the most severe symptom of giardiasis. The results indicated 36 species used by this population for these problems. The use of leaves (72.50%) of a single plant (64.25%) collected from backyards and gardens (44.34%) and prepared by decoction were predominant. The majority of the interviewees (85.52%) attributed their cure to the use of plants. In the experimental tests, all extracts inhibited the growth of Giardia lamblia trophozoites in different intensities: A. occidentale and P. guajava extracts elicited a moderate activity (250 ≤ IC50 ≤ 500 μg/ml), C. ambrosioides and S. cayennensis extracts evoked a high activity (100 ≤ IC50 ≤ 250 μg/ml), and P. edulis extract showed very high activity (IC50 ≤ 100 μg/ml). This study shows that an ethnopharmacological approach is useful in the selection of plant materials with potential giardicidal activity.

Outbreaks of vesicular disease caused by Vaccinia virus in dairy cattle from Goiás State, Brazil (2010-2012) / Surtos de doença vesicular causados pelo Vaccinia virus em bovinos de leite no Estado de Goiás, Brasil (2010-2012)

Cases of vesicular and exanthematic disease by Vaccinia virus (VACV) have been reported in dairy herds of several Brazilian regions, occasionally also affecting humans. The present article describes eight outbreaks of vesicular disease caused by VACV in dairy herds of six counties of Goiás state, Midwestern Brazil (2010-2012), involving a total of 122 cows, 12 calves and 11 people. Dairy cows (3 to 9 years old) were affected in all cases and calves (2 to 9 months old) were affected in five outbreaks, presenting oral lesions. The morbidity ranged between 8 and 100% in cows, and 1.5 to 31% in calves. In the cows, the clinical signs started with vesicles (2-7mm), painful and coalescent papules (3-8 mm), which resulted in ulcers (5-25mm) and scabs in teats, and, occasionally, in the muzzle. The clinical course lasted from 16 to 26 days. The histopathology of bovine skin samples revealed superficial perivascular inflammatory infiltrate of lymphocytes, plasma cells, neutrophils, macrophages and multifocal areas of acanthosis, spongiosis, hipergranulosis and parakeratotic or orthokeratotic hyperkeratosis with adjacent focally extensive ulcers. Eosinophilic inclusion bodies were noted in the cytoplasm of the keratinocytes. PCR to vgf gene of Orthopoxvirus was positive in samples collected from all outbreaks, and in some cases, genomic VACV sequences were identified by nucleotide sequencing of the PCR amplicons. Infectious virus was isolated in cell culture from scabs from one outbreak. Antibodies to Orthopoxvirus were detected in at least 3 or 4 animals in most outbreaks, by ELISA (outbreaks 1, 2, 3, 4, 5 and 7) or virus-neutralization (outbreak 6). Neutralizing titers ranging from 8 to 64 in outbreak 6. In all outbreaks, VACV infection was suspected based on the clinical and pathological findings and it was confirmed by laboratory tests. Upon the etiological confirmation, other agents associated with vesicular disease were discarded. In all outbreaks, at least one milker who handled the affected cows developed malaise, headache, fever, painful vesico-pustular lesions mainly in the hands, but also in the neck and nose. These results confirm the circulation of VACV in the region and call attention for a correct diagnosis and the adoption of prophylactic and control measures.

Casos de doença vesicular e exantemática associados ao Vaccinia virus (VACV) têm sido descritos em rebanhos leiteiros em diversas regiões do Brasil, ocasionalmente afetando também os ordenhadores. Este artigo descreve oito surtos de doença vesicular associados ao VACV ocorridos em rebanhos leiteiros de seis municípios do estado de Goiás (2010-2012), com o envolvimento de 122 vacas em lactação, de 12 bezerros e de 11 pessoas. Vacas em lactação (3-9 anos de idade) foram afetadas em todos os casos. Em cinco rebanhos, bezerros de 2-9 meses apresentaram lesões orais. A morbidade nos rebanhos variou entre oito e 100% (vacas) e entre 1,5 e 31% (bezerros). As lesões iniciavam como vesículas (2-7mm) ou pápulas doloridas e coalescentes (3-8mm), que progrediam para úlceras (5-25mm) e crostas, localizadas principalmente nas tetas e, eventualmente, no focinho das vacas. O curso clínico variou entre 16 e 26 dias. Histopatologia de amostras de pele coletadas de bovinos revelou dermatite perivascular superficial com infiltrado de linfócitos, neutrófilos, plasmócitos e macrófagos, além de áreas multifocais de acantose, espongiose, hipergranulose e hiperceratose ortoceratótica ou paraceratótica com úlceras focalmente extensas. No citoplasma dos ceratinócitos adjacentes às úlceras, observaram-se numerosos corpúsculos de inclusão eosinofílicos. Em todos os surtos, amostras de lesões cutâneas dos bovinos foram positivas para o gene vgf dos Orthopoxvirus por PCR, e em alguns casos, a identificação do VACV foi confirmada por sequenciamento de nucleotídeos dos amplicons. O vírus foi detectado por isolamento em cultivo celular em um dos surtos e, pelo menos 2 a 3 vacas por rebanho, apresentaram sorologia positiva para Orthopoxvirus pelos testes de ELISA (surtos 1, 2, 3, 4, 5 e 7) e soroneutralização (surto 6). No surto 6, os títulos de anticorpos neutralizantes variaram de 8 a 64. O diagnóstico da infecção pelo VACV, inicialmente suspeito com base nos achados clínicos e patológicos, foi confirmado em todos os surtos por exames laboratoriais. Em todos os surtos, pelo menos um ordenhador que teve contato com os bovinos afetados apresentou mal-estar geral, febre alta, dor de cabeça e lesões vesiculo-pustulosas doloridas, principalmente nas mãos, mas também no pescoço e nariz. Esses resultados confirmam a circulação do VACV no rebanho bovino da região centro-oeste, alertando para necessidade de diagnóstico correto e adoção de medidas profiláticas e de controle.

Restauração estética dos dentes anteriores: considerações clínicas e laboratoriais / Aesthetic restoration of anterior teeth: clinical and laboratorial considerations

Este artigo descreve um caso clínico envolvendo a estética de dentes anteriores, restaurados com coroas puras de cerâmica. Métodos alternativos para tratamento do caso clínico são discutidos. São explicados os procedimentos de preparo, moldagem, técnica laboratorial e cimentação.

Utilizaçäo de marcadores de DNA para o diagnóstico genômico de animais domésticos: 1. Detecçäo da mutaçäo pontual causadora da deficiência de adesäo de leucócitos bovinos (BLAD) em gado Holandês no Brasil / Use of DNA markers for genomic diagnosis of domestic animals: 1. Detection of point mutation causing bovine leukocyte adhesion deficiency (BLAD) in Brazilian Holstein cattle

Analisaram-se 10 bovinos da raça Holandesa, descendentes da linhagem Ivanhoe. Submeteram-se os DNAs, purificados a partir de leucócitos destes animais, à técnica de Polymerase Chain Reaction (PCR) e posterior digestäo com as enzimas de restriçäo Hae III e Taq I. Estabeleceu-se, desta maneira, o diagnóstico genômico da Deficiência de Adesäo de Leucócitos Bovinos (BLAD). Os exames revelaram que 2 animais eram portadores e 8, normais. A partir do desenvolvimento da metodologia de PCR, tornou-se disponível um método rápido, prático e eficiente para a seleçäo de touros em Centrais de Inseminaçäo Artificial, por meio da detecçäo de animais portadores e normais

Consideracoes sobre a utilizacao do acido acetilsalicilico na profilaxia da pre-eclampsia / Use of aspirin in the preeclampsia prophylaxis

Os autores fazem consideracoes a respeito do uso do acido acetilsalicilico como medida profilatica ao aparecimento da pre-eclampsia. Apos rapida revisao historica dos metodos preventivos, localizam o farmaco quanto aos primeiros trabalhos, o ponto da fisiopatologia onde atua, as possiveis explicacoes para o mecanismo de acao e descrevem alguns ensaios clinicos que utilizaram a droga. Concluem que a ausencia de efeitos colaterais, a modificacao na prevalencia da pre-eclampsia e o baixo custo, fazem do acido acetilsalicilico uma realidade no combate ao alto obituario materno e perinatal da sindrome hipertensiva.

Utilizaçäo de marcadores de DNA para o diagnóstico genômico de animais domésticos: 2. Detecçäo da mutaçäo pontual causadora da Paralisia Hipercalêmica Periódica (HYPP) em equinos da raça Quarto de Milha / Use of DNA markers for genomic diagnosis of domestic animals: 2. Detection of point mutation causing Hyperkalemic Periodic Paralysis (HYPP) in Quarter horses

Analisaram-se 12 equinos da raça Quarto de Milha, descendentes da linhagem Impressive. Submeteram-se os DNAs purificados a partir de leucócitos destes animais, à técnica de Polymerase Chain Reaction (PCR) e posterior digestäo com a enzima de restriçäo Taq I. Estabeleceu-se, dessa maneira, o diagnóstico genômico da Paralisia Hipercalcêmica Periódica (HYPP). Os exames revelaram que 9 animais eram portadores heterozigotos (N/H) e 3, normais homozigotos (N/N). A partir do desenvolvimento da metodologia de PCR tornou-se possível diagnosticar o problema e propor maneiras de controle do alastramento desse gene defectivo na populaçäo por meio da detecçäo de animais portadores e normais

Ocorrência de fluorose dentária endêmica / Occurrence of endemic dental fluorosis

Para a elaboração deste trabalho foi realizado um levantamento do índice de fluorose dentária no Distrito de Cocal, em 338 escolares de ambos os sexos, de idade compreendida entre 3 e 10 anos, nascidos na localidade e que consumiram, durante toda a vida, água com elevado teor de flúor (1,2 a 5,6 ppm). Todos os graus de fluorose foram constatados, sendo que 87,0//das crianças examinadas foram atingidas nos dois graus mais severos

Prevalência da cárie dentária em área de fluorose endêmica / Prevalence of tooth decay in endemic area of fluorosis

Para a elaboração deste trabalho foi realizado um levantamento dos índices CPOD e ceo no Distrito de Cocal, em 338 escolares de ambos os sexos, de idade compreendida entre 3 e 10 anos. As referidas crianças nasceram na localidade e consumiram água com elevado teor de flúor (1,2 a 5,6 ppm), durante toda vida, tendo sido afetadas por fluorose dentária nos seus diversos graus. A prevalência e a incidência de cárie apresentaram-se baixas quando comparadas com outras áreas onde a água de consumo não era fluoretada. O índice CPOD médio encontrado foi de 1,41 dentes e o ceo médio de 1,80 dentes