Identification of SARS-CoV-2 in urban rodents from Southern Mexico City at the beginning of the COVID-19 pandemic

ABSTRACT Currently, there are some concerns about the situation and, in particular, about the future of the COVID-19 pandemic and the new emerging variants of SARS-CoV-2. Rodents are an example of synanthropic animals in urban environments that harbor important zoonoses. Although the molecular identification of SARS-CoV-2 in Rattus norvegicus from New York City had been reported, in other studies, urban wild rodents infected with this virus have not been found. This study aimed to molecularly identify the presence of SARS-CoV-2 in urban wild rodents from Mexico City, trapped along a water channel of a public park as part of a pest control program, at the beginning of the COVID-19 pandemic, during the fall and winter of 2020. Up to 33 Mus musculus and 52 R. norvegicus were captured and euthanized, large intestine samples with feces from the animals were obtained. RNAs were obtained and subjected to qRT-PCR for SARS-CoV-2 identification and threshold cycle (Ct) values were obtained. Four mice (12.1%) and three rats (5.8%) were positive, three rodents exhibited Ct<30. Our results on the frequency of SARS-CoV-2 in urban rats are in line with other previous reports. Thus, similar to other authors, we suggest that surveillance for the detection of SARS-CoV-2 in urban wild rodents, as sentinel animals, should be maintained.

Corneal reshaping: an experiment with a type I collagen-based vitrigel for remodeling porcine corneas / Remodelamento corneano: relato de um experimento com um vitrigel a base de colágeno tipo I para remodelamento de córneas porcinas

ABSTRACT Purpose: This study aimed to report an experiment designed to determine anatomical changes in porcine corneas following placement of a novel polymer implant into the cornea. Methods: An ex vivo porcine eye model was used. A novel type I collagen-based vitrigel implant (6 mm in diameter) was shaped with an excimer laser on the posterior surface to create three planoconcave shapes. Implants were inserted into a manually dissected stromal pocket at a depth of approximately 200 μm. Three treatment groups were defined: group A (n=3), maximal ablation depth 70 μm; Group B (n=3), maximal ablation depth 64 μm; and group C (n=3), maximal ablation depth 104 μm, with a central hole. A control group (D, n=3) was included, in which a stromal pocket was created but biomaterial was not inserted. Eyes were evaluated by optical coherence tomography (OCT) and corneal tomography. Results: Corneal tomography showed a trend for a decreased mean keratometry in all four groups. Optical coherence tomography showed corneas with implants placed within the anterior stroma and visible flattening, whereas the corneas in the control group did not qualitatively change shape. Conclusions: The novel planoconcave biomaterial implant described herein could reshape the cornea in an ex vivo model, resulting in the flattening of the cornea. Further studies are needed using in vivo animal models to confirm such findings.

RESUMO Objetivo: Relatar um experimento projetado para determinar alterações anatômicas em córneas porcinas após a colocação de um novo implante de polímero na córnea. Métodos: Foi utilizado olho de porco ex vivo. Um novo agente modelador biocompatível, de colágeno tipo 1, com 6mm de diâmetro foi moldado com excimer laser em sua face posterior, para criar três formatos planocôncavos. Os implantes foram inseridos dentro de um bolsão, dissecado manualmente, a 200 micrômetros (μm). Foram definidos três grupos de tratamento: grupo A (n=3), teve a profundidade máxima de ablação de 70 μm; o grupo B (n=3), profundidade máxima de ablação de 64 μm; e o grupo C (n=3), profundidade máxima de ablação de 104 μm, com buraco central. O grupo controle, D (n=3), foi incluído, com a criação do bolsão estromal, porém sem inserir o material. A avaliação desses olhos foi realizada por tomografia de coerência óptica (OCT) e por tomografia corneana. Resultados: A tomografia corneana mostrou uma tendência para diminuição da ceratometria média em todos os 4 grupos. A tomografia de coerência óptica mostrou córneas com implantes localizados no estroma anterior e aplanamento visível, enquanto as córneas não mudaram qualitativamente o formato no grupo controle. Conclusões: O novo implante de biomaterial planocôncavo descrito aqui foi capaz de remodelar a córnea em modelo de animal ex vivo, resultando no aplanamento corneano. Novos estudos são necessários usando modelos animais in vivo para confirmar tais achados.

¿Sienten los animales? / Do animals feel?

Resumen: La visión antropocéntrica del ser humano ha llevado a la explotación de animales para satisfacer sus necesidades, tanto primarias (como la alimentación) como secundarias (como el entretenimiento), sin preocuparse por su sufrimiento o bienestar. Sin embargo, las teorías de la evolución de Lamarck y Darwin borraron la dicotomía humano-animal y colocaron al primero como una especie más dentro de toda la diversidad biológica. Hans Jonas afirmó que las diferencias entre los humanos y los otros animales estaban en el grado de complejidad y no en las capacidades, contribuyendo a la idea de una continuidad biológica desde un origen común. La similitud anatomofisiológica, la presencia de mediadores químicos de dolor, los cambios bioquímicos y fisiológicos ante situaciones dolorosas, además de la respuesta favorable al uso de medicamentos analgésicos, demuestran que los demás animales sienten dolor y padecen sufrimiento. La Declaración de Cambridge sobre la consciencia destaca que no es necesario poseer neocórtex para ser considerado como sintiente, lo que ha llevado a analizar esta capacidad, inclusive, en muchos invertebrados. ¿Los animales sienten? Invariablemente la respuesta es sí. Es importante tener consideración de ello para evitar su sufrimiento, tal y como se propone en la teoría sensocéntrica de Peter Singer, en caso contrario, podríamos ser señalados de discriminación, que, por estar asociada a la pertenencia a una especie biológica, se denomina especismo.

Abstract: The anthropocentric view of life has led to the exploitation of animals to satisfy the human needs, primary (such as food) and secondary (such as entertainment), without regard for their suffering or well-being. However, Lamarck's and Darwin's theories of evolution erased the dichotomy between human and animal, placing the former as just another species within the entire biological diversity of life. Hans Jonas asserted that the differences between humans and other animals lie in the degree of complexity and not in capabilities, contributing to the idea of biological continuity from a common origin. The anatomic and physiological similarities, the presence of chemical pain mediators, the biochemical and physiological changes in painful situations, as well as the positive response to the use of analgesic medications, demonstrate that other animals feel pain and suffer. The Cambridge Declaration on consciousness emphasizes that it is not necessary to possess a neocortex to be considered sentient, which has led to the analysis of this capacity even in many invertebrates. Do animals feel? Invariably the answer is yes. It is important to consider this to avoid their suffering, as proposed in Peter Singer's sensocentrism theory. Otherwise, we could be accused of discrimination, which, based on species membership, is called speciesism.

Análise epidemiológica dos acidentes por animais peçonhentos no estado de pernambuco / Epidemiological analysis of accidents caused by venomous animals in the state of Pernambuco

Objetivo: Analisar o perfil epidemiológico dos acidentes por animais peçonhentos no estado de Pernambuco, entre 2018 e 2022. Método: Pesquisa epidemiológica do tipo quantitativa, realizada com secundários do SINAN. Selecionado às variáveis: sexo, faixa etária, raça, escolaridade, gestação, local de picada, tempo de atendimento, tipo de acidente, soroterapia, classificação e evolução final. Os Programa Microsoft Excel e Word foram utilizados para análise estatística. Resultados: Foram notificados 105.005 casos, predominando-se em períodos quentes e chuvosos. Houve maior notificação no sexo feminino (53,05%), dos 20 aos 39 anos (31,74%), ensino fundamental incompleto (15,96%), pardos (67,88%) e não gestantes (87,07%). A maioria dos acidentes foram causados por escorpiões (73,39%), originando-se nos pés (30,35%), com atendimento médico em até 1 hora (47,74%), leves (85,73%), evoluindo para cura (91,52%) sem soroterapia (82,92%). Conclusão: Torna-se evidente a importância de medidas para seu controle, principalmente em orientações populacional e o preenchimento correto da ficha de notificação.(AU)

To analyze the epidemiological profile of accidents by venomous animals in the state of Pernambuco between 2018 and 2022. Method: Quantitative epidemiological research using secondary data from SINAN. The following variables were selected: gender, age group, race, schooling, pregnancy, place of bite, time of care, type of accident, serotherapy, classification and final evolution. The Microsoft Excel and Word programs were used for statistical analysis. Results: 105,005 cases were reported, predominantly during hot and rainy periods. Most cases were reported among females (53.05%), those aged between 20 and 39 (31.74%), those with incomplete primary education (15.96%), those with brown skin (67.88%) and those who were not pregnant (87.07%). The majority of accidents were caused by scorpions (73.39%), originated in the feet (30.35%), with medical attention within 1 hour (47.74%), mild (85.73%), evolving to cure (91.52%) without serotherapy (82.92%). Conclusion: The importance of measures to control the disease is clear, especially in terms of guidance for the population and the correct completion of the notification form.(AU)

Analizar el perfil epidemiológico de los accidentes por animales venenosos en el estado de Pernambuco entre 2018 y 2022. Método: Investigación epidemiológica cuantitativa utilizando datos secundarios del SINAN. Fueron seleccionadas las siguientes variables: sexo, grupo de edad, raza, escolaridad, embarazo, lugar de la mordedura, tiempo de atención, tipo de accidente, sueroterapia, clasificación y evolución final. Para el análisis estadístico se utilizó Microsoft Excel y Word. Resultados: Se notificaron 105.005 casos, predominantemente durante los períodos cálidos y lluviosos. La mayoría de los casos se notificaron en mujeres (53,05%), con edades comprendidas entre 20 y 39 años (31,74%), con estudios primarios incompletos (15,96%), de piel morena (67,88%) y no embarazadas (87,07%). La mayoría de los accidentes fueron causados por escorpiones (73,39%), se originaron en los pies (30,35%), recibieron atención médica en menos de 1 hora (47,74%), fueron leves (85,73%) y evolucionaron hacia la curación (91,52%) sin sueroterapia (82,92%). Conclusión: Es evidente la importancia de las medidas de control de la enfermedad, especialmente en lo que se refiere a la orientación de la población y a la correcta cumplimentación del formulario de notificación.(AU)

Trends in occurrences of accidents by venomous animals in brazil: analysis of notifications from 2007 to 2021 / Tendências na ocorrência de acidentes por animais peçonhentos no brasil: análise das notificações de 2007 a 2021 / Tendencias en las ocurrencias de accidentes por animales venenosos en Brasil: análisis de las notificaciones de 2007 a 2021

Os acidentes por animais peçonhentos sãoum problema de saúde pública que apresenta elevado número de casos anuais no Brasil. Objetivo:descrever e analisar as ocorrências de acidentes por animais peçonhentos no Brasil e suas tendências entre 2007 e 2021.Metodologia:oestudo utilizou dados doSistema de Informação de Agravos de Notificação edo Sistema de Informação sobre Mortalidade.A população do estudo foi analisada segundo sexo, faixa etária e região de residência. A análise de tendência da série histórica foi realizada por regressão linear generalizada usando a estimação de Prais-Winsten.Resultados:as taxas de ocorrência padronizadas dobraram no período estudado (53,8/100.000 hab. em 2007 para 111,2/100.000 hab. em 2021). A região Nordeste apresentou a maior taxa de ocorrência padronizada (105,5/100.000 hab.). As regiões Nordeste, Sudeste e Centro-Oeste apresentaram maior taxa bruta de acidentes por escorpiões (75,8, 48,7 e 32,8 acidentes/100.000 hab., respectivamente), enquanto a região Norte por serpentes (54,2 acidentes/100.000 hab.) e a Região Sul por aranhas (60,3 acidentes/100.000 hab.). A taxa de mortalidade observada no período de 2007 a 2020 foi de 1,3 óbitos/1 milhão de hab. Entre as mortes registradas, 39,6% foram por picada de cobra.Conclusões:as tendências no Brasil foram ascendentes para ambos os sexos e para todas as faixas etárias. Apenas as regiões Norte e Sul apresentaram algumas categorias com tendências estacionárias. A análise dos dados epidemiológicos possibilita a identificação de populações-alvo e a elaboração de políticas públicas a fim de prevenir novos acidentes, bem como aprimorar o atendimento às pessoas acometidas por meio do planejamento da distribuição de soros antiofídicos (AU).

Accidents by venomous animals is a public health problem that presents a high number of annual cases in Brazil.Objective:to describe and analyze the occurrences of accidents by venomous animalsin Brazil and their trends between 2007 and 2021.Methodology:the study used Notifiable Diseases Information Systemand Mortality Information Systemdata. The study population wasanalyzed according to sex, age group, and region of residence. Trend analysis of the historical series was performed by generalized linear regression using Prais-Winsten estimation.Results:the standardized occurrence rates doubled during the studied period (53.8/100,000 inhab. in 2007 to 111.2/100,000 inhab. in 2021). The Northeast region had the highest standardized occurrence rate (105.5/100,000 inhab.). The Northeast, Southeast, and Midwest regions had a higher crude rate of accidents caused by scorpions (75.8, 48.7 and 32.8 accidents/100,000 inhab., respectively), while the North region by snakes (54.2 accidents/100,000 inhab.), and the South region by spiders (60.3 accidents/100,000 inhab.). Death rate observed in the period from 2007 to 2020 was 1.3deaths/1 million inhab. Among the deaths registered, 39.6% were from snakebite.Conclusions:trends in Brazil were ascendant for both sexes and for all age groups. Only the North and South regions showed some categories with stationary trends. The analysis of epidemiological data makes it possible the identification of target populations and elaborations of public policies in order to prevent new accidents, as well as the improvement of care for affected people by planning the distribution of antivenom serums (AU).

Los accidentes por animales venenosos son un problema de salud pública que presenta un elevado número de casos anuales en Brasil. Objetivo: describir y analizar lasocurrencias de accidentes por animales venenosos en Brasil y sus tendencias entre 2007 y 2021.Metodología: el estudio utilizó datos del sistema de información de enfermedades de declaración obligatoria(SINAN, según su sigla en portugués)ydelsistema de información de mortalidad. La población delestudio se analizó según sexo, grupo de edad y región de residencia. El análisis de tendencia de la serie histórica se realizó mediante regresión lineal generalizada utilizando la estimación de Prais-Winsten.Resultados: las tasas de ocurrencia estandarizadas se duplicaron durante el período estudiado (de 53,8/100000 hab. en 2007 a 111,2/100000 hab. en 2021). La región Nordeste presentó la mayor tasa de ocurrencia estandarizada (105,5/100000 hab.). Las regiones Nordeste, Sudeste y Medio Oeste presentaron la mayor tasa bruta de accidentes por alacranes (75,8, 48,7 y 32,8 accidentes/100000 hab., respectivamente), mientras que la región Norte por serpientes (54,2 accidentes/100000 hab.), y la Región Sur por arañas (60,3 accidentes/100000 hab.). La tasa de mortalidad observada en el período de 2007 a 2020 fue de 1,3 muertes/1 millón de hab. Entre las muertes registradas, el 39,6% fueron por mordedura de serpiente.Conclusiones: las tendencias en Brasil fueron ascendentes para ambos sexos y para todos los grupos de edad. Solo las regiones Norte y Sur presentaron algunas categorías con tendencias estacionarias. El análisis de datos epidemiológicos posibilita la identificación de poblaciones objetivo y la elaboración de políticas públicas para la prevención de nuevos accidentes, así como la mejora de la atención a las personas afectadas mediante la planificación de la distribución de sueros antiofídicos (AU).

Perfil clínico e epidemiológico dos acidentes por Lepidópteros, do gênero Lonomia, atendidos no CIATox/PR, 2015-2019 / Clinical and epidemiological profile of accidents caused by Lepidoptera, of the Lonomia genus, assisted at CIATox/PR

Introdução: Os acidentes por lepidópteros são agravos de interesse à saúde pública e a avaliação de suas características pode contribuir para melhorar sua assistência e prevenção. Este estudo analisou o perfil epidemiológico dos acidentes por lagartas do gênero Lonomia no Paraná. Métodos: Trata-se de estudo retrospectivo de base secundária realizado no Centro de Informação e Assistência Toxicológica do Paraná (CIATox/PR), em Curitiba, no período de 2015 a 2019. A análise foi realizada por estatística descritiva e Teste do qui-quadrado (p<0,05). Resultados: A amostra foi composta de 84 acidentes por Lonomia sp. com predomínio em adultos (45,2%), do sexo masculino (59,5%), e de lesões em membros superiores (84,5%). O contato com as lagartas ocorreram na área peridomiciliar da residência habitual do paciente (72,6%), na zona rural (64,27%) da macrorregião oeste paranaense (38,1%). O verão concentrou 71,4% dos casos, seguido por primavera e outono com 14,3% dos casos, respectivamente, sem registros no inverno. As manifestações clínicas mais frequentes foram dor local (62,4%), equimose (34,1%), eritema (34,1%), edema e queimação (17,6% cada). A classificação leve mostrou uma redução entre a fase inicial e a final do processo, ao contrário da moderada e grave, que tiveram aumento significativo de casos (p=0,006). O RNI (Relação Normatizada Internacional) foi incoagulável em 16,7% dos pacientes. Dois casos apresentaram piora do quadro clínico, sendo uma evolução para acidente vascular cerebral hemorrágico e um óbito. Discussão: Maior número de casos registrados na zona rural, tanto na residência habitual ou ambiente laboral, se dá pelo maior contato com o habitat das lagartas como árvores frutíferas e grandes monoculturas, o que também explica o fato de a macrorregião oeste ter o maior número de casos registrados. O aumento do desmatamento, incentivos à construção de parques públicos e plantio de árvores frutíferas na zona urbana são hipóteses para o aumento de casos nessa área. Percebeu-se que manifestações clínicas discretas podem ter uma evolução desfavorável, quando comparado estadiamento inicial e final. A realização do RNI se mostrou de grande importância na mudança de estadiamento, conduta terapêutica e diagnóstico. Conclusão: O perfil encontrado foi de acidentes por Lonomia sp. com sazonalidade no verão, em homens adultos da zona rural com gravidade moderada. Esses achados revelam a importância do diagnóstico e tratamento precoce frente às diferentes possibilidades de evolução clínica desses acidentes. É fundamental estimular estratégias para identificação da lagarta, notificação dos casos e medidas preventivas permanentes para reduzir riscos e agravos (AU).

Introduction: Lonomic accidents are of public health interest and the evaluation of their characteristics can contribute to the improvement of their attention and prevention. This study analyzed the epidemiological profile of Lonomic accidents in Paraná. Methods: This study is a retrospective secondary-based study carried out at the Center of Toxicologic Information and Assistance of Paraná (CIATox/PR), in Curitiba, from 2015 to 2019. Descriptive statistical analyses were performed using the Chi-square test (p<0.05). Results: The sample consisted of 84 accidents with Lonomia sp., showing greater occurrences among adults (45.2%) of the male gender (59.5%) and injuries on the upper limbs (84.5%). Contact with the worm occurred mainly in the patient's usual residence (72.6%), in the rural area (64.27%), and in Paraná's West macro-region (38.1%). Most cases were registered in the summer (71.4%), followed by spring and autumn (14.3%), and no accidents were registered in winter. The most frequent clinical manifestations were local pain (62.3%), ecchymosis (34.1%), erythema (34.1%), swelling and burning (17.6% each). The mild classification showed a reduction between the initial and the final phase of the process, as opposed to moderate and severe classifications, which showed a significant increase in the percentage (p=0,006). The INR was incoagulable in 16.7% of patients. Two cases showed progressive worsening, one of them evolved into a hemorrhagic stroke and one death. Discussion: The greater number of incidents registered in the rural area, both in the patients' usual residence and work environment, can be due to the greater contact with the caterpillar's natural habits, such as fruit trees and large monocultures. This also explains the larger number of registered incidents in the western macro-region. The increased deforestation, the construction of public parks, and the planting of fruit trees in the urban area are hypotheses for the increase of reported cases in this area. When comparing initial and final staging, it was noticed that discrete clinical manifestations could have an unfavorable evolution. The INR request proved to be of great importance in the management, diagnosis and change of staging of the patient. Conclusion:The epidemiological profile was of Lonomia sp. accidents happening in summer in adult males in the rural area with moderate severity. These findings reveal the importance of early diagnosis and treatment in view of these accidents' different possibilities of clinical evolution. It is essential to encourage strategies for identifying the caterpillar, reporting cases, and implementing permanent preventive measures to reduce risks and complications (AU).

A Study of Clinico-social Profile of Animal Bite Patients Attending the Antirabies Clinic of BRD Medical College, Gorakhpur

Background: Rabies is one of zoonotic viral disease, estimated to cause 59000 human deaths annually in over 150 countries, of which 20,000 are from India alone; about 40% of which are in children under the age of 15. Rabies though 100% fatal is preventable with post-exposure prophylaxis which includes wound washing, anti-rabies vaccination and rabies immunoglobulin. Objective: To describe the clinico-social profile of animal bite patients attending the anti-rabies clinic of BRD Medical College, Gorakhpur. Methodology: A cross-sectional study was conducted in the anti-rabies clinic of Nehru hospital, BRD Medical College, Gorakhpur from January 2022 to May 2022. Study participants were interviewed by using a pre-phrased, pre-designed and pre-tested questionnaire. Data regarding socio-demographic and clinical profile of the study participants following animal bite exposure was collected. Results: The total number of animal bite victims were 250, in which majority of them were males (76.77%) and highest percentage was of adult population (20-59 years). Maximum number of victims were from rural area (78.70%). 19.35% were working and 39.35% were students. 77.43% were category III bites and in 50.96% cases lower limb was the site of bite and dogs were responsible for 89.67% of the bites. 60.64% victims did not wash the wound properly before reaching the anti-rabies clinic. Conclusion: This study concludes that as majority of the animal bite victims were students and majority of victims were unaware about the importance of wound care, therefore a step can be taken to create awareness in various schools.

Epidemiology of clinical complications of accidents caused by venomous animals in Brazil / Epidemiologia das complicações clínicas de acidentes provocados por animais peçonhentos no Brasil / Epidemiología de las complicaciones clínicas de accidentes causados por animales venenosos en Brasil

Background and objectives: Accidents caused by venomous animals, included in the set of Neglected Tropical Diseases, often evolve to local and systemic clinical complications related to increased morbidity and mortality and saturation of health care resources. This study aimed to analyze the epidemiological profile, spatial distribution and temporal trend of clinical complications caused by accidents with venomous animals in Brazil. Methods: This is a quantitative, cross-sectional, observational, epidemiological study of the clinical complications of accidents caused by venomous animals reported to the Notifiable Diseases Information System from 2007 to 2019. Results: Of the 2,164,645 evaluated notifications, 38,934 cases (1.8%) showed complications. We observed a higher proportion of clinical complications (per 1,000 total cases) among men, Indigenous individuals, illiterates, and victims who received care 24 hours after their accidents, and snakebites. We also found a higher proportion of clinical complications among severe cases (198.8), cases treated with serum therapy (45.7), and those that resulted in death (41.8). The annual incidence of complicated cases increased, especially in the Brazilian Southeast region (+67.2%). The proportion of clinical complications is more worrying in the states of Amazonas, Rondônia, Amapá, and Pará. Conclusion: This study found a higher proportion of clinical complications among men, Indigenous people, illiterates, residents of rural areas, victims of snake bites, those who received late medical and hospital care, those who needed serum therapy, and individuals who had death as their outcome. We found a more severe spatial distribution of the annual incidence of complicated cases in the states of Amazonas, Rondônia, Amapá, and Pará, and that the tendency of the annual incidence of clinical complications increased more sharply in the Brazilian Southeast region.(AU)

Justificativa e objetivos: Os acidentes causados por animais peçonhentos, incluídos no conjunto de Doenças Tropicais Negligenciadas, predispõem a evolução de complicações clínicas locais e sistêmicas, relacionadas ao aumento da morbimortalidade e a saturação dos recursos assistenciais em saúde. Têm-se como objetivo analisar o perfil epidemiológico, a distribuição espacial e a tendência temporal das complicações clínicas causadas dos acidentes por animais peçonhentos no Brasil. Métodos: Estudo epidemiológico observacional transversal quantitativo das complicações clínicas dos acidentes causados por animais peçonhentos notificadas ao Sistema de Informação de Agravos de Notificação entre 2007-2019. Resultados: De 2.164.645 notificações, 38.934 casos (1,8%) apresentaram complicações. Observou-se maior proporção de complicações clínica (por 1.000 casos totais) em indivíduos do sexo masculino, indígenas, analfabetos, atendimentos realizados após 24h e vítimas de ofidismo. Ainda, a proporção de complicações clínicas foi maior entre os casos graves (198,8), os receptores de soroterapia (45,7) e os óbitos (41,8). A incidência anual de casos complicados ascende principalmente na Região Sudeste (+67,2%). A proporção de complicação clínica é mais preocupante nos estados do Amazonas, Rondônia, Amapá e Pará. Conclusão: O presente estudo identificou maior proporção de complicações clínicas entre pessoas do sexo masculino, indígenas, analfabetos e moradores de zona rural, cujo acidente ocorreu por picada de serpentes, que tiveram atendimento médico-hospitalar retardado, que necessitaram de soroterapia e que tiveram o óbito como desfecho. A distribuição espacial da incidência anual de casos complicados assevera-se nos estados do Amazonas, Rondônia, Amapá e Pará e a tendência da incidência anual de complicações clínicas ascende mais na Região Sudeste.(AU)

Justificación y objetivos: Los accidentes causados por animales venenosos, incluidos en el conjunto de Enfermedades Tropicales Desatendidas, predisponen a la evolución de complicaciones clínicas locales y sistémicas, relacionadas con el aumento de la morbimortalidad y la saturación de los recursos asistenciales. El objetivo es analizar el perfil epidemiológico, la distribución espacial y la tendencia temporal de las complicaciones clínicas causadas por accidentes con animales venenosos en Brasil. Métodos: Estudio epidemiológico, observacional, transversal y cuantitativo de las complicaciones clínicas de los accidentes por animales venenosos notificados al Sistema de Información de Enfermedades de Declaración Obligatoria entre 2007-2019. Resultados: De 2.164.645 notificaciones, 38.934 casos (1,8%) presentaron complicaciones. Se observó una mayor proporción de complicaciones clínicas (por 1.000 casos totales) en varones, indígenas, analfabetos, cuidados posteriores a las 24 horas y en víctimas de mordeduras de serpientes. Además, la proporción de complicaciones clínicas fue mayor entre los casos graves (198,8), los receptores de sueroterapia (45,7) y las muertes (41,8). La incidencia anual de casos complicados aumentó principalmente en la región Sudeste (+67,2%). La proporción de complicaciones clínicas es más preocupante en los estados de Amazonas, Rondônia, Amapá y Pará. Conclusión: Este estudio identificó una mayor proporción de complicaciones clínicas entre varones, indígenas, analfabetos y residentes de zonas rurales, que tuvieron el accidente a causa de mordeduras de serpientes, que tuvieron retrasada la atención médica y hospitalaria, que necesitaban sueroterapia y que tenían la muerte como resultado. La distribución espacial de la incidencia anual de casos complicados se afirma en los estados de Amazonas, Rondônia, Amapá y Pará, y la tendencia de la incidencia anual de complicaciones clínicas se eleva más en la región Sudeste.(AU)

Conhecimentos sobre o manejo de vítimas do acidente botrópico no serviço de emergência / Knowledge about botropic accident victim management in emergency service / Conocimiento sobre el manejo de víctimas de accidentes botópicos en emergencia

Objetivo: identificar o conhecimento da equipe de enfermagem, no manejo do paciente vítima de acidente botrópico no serviço de emergência. Métodos: estudo descritivo, exploratório e com abordagem qualitativa. Desenvolvido em 2019, com profissionais da equipe de enfermagem do setor de emergência adulto de um Hospital Universitário. Utilizou-se entrevistas semiestruturadas, transcritas e analisadas por meio de estatística descritiva simples e análise de conteúdo. Resultados: participaram do estudo 34 profissionais da equipe de enfermagem, sendo 82% do sexo feminino, com média de idade de 37 anos. A análise de conteúdo revelou três categorias: conhecimento sobre acidentes por animais peçonhentos, trajetória acadêmica e profissional no contexto de animais peçonhentos e manejo da equipe de enfermagem do paciente vítima de acidente botrópico. Conclusão: os resultados demonstram o conhecimento e condutas da equipe de enfermagem frente ao acidente botrópico e evidenciam a necessidade de sensibilizar a equipe de enfermagem quanto ao reconhecimento do acidente ofídico, especialmente com relação às características apresentadas pelo animal peçonhento e as manifestações clínicas apresentadas pelo paciente. (AU)

Objective: to identify the knowledge of the nursing staff in dealing with bothropic accident victims in the emergency service. Methods: descriptive, exploratory study with a qualitative approach. Developed in 2019, with professionals from the nursing staff of the adult emergency sector of a University Hospital. A semi-structured interview was used, transcribed and analyzed using simple descriptive statistics and content analysis. Results: 34 professionals from the nursing team participated in the study, being 82% female, with an average age of 37 years. The content analysis revealed three categories: knowledge about accidents caused by poisonous animals, academic and professional trajectory in the context of poisonous animals and management of the nursing team to the patient victim of bothropic accidents. Conclusão: the results demonstrate the knowledge and behaviors of the nursing staff in face of bothropic accidents and highlight the need to sensitize the nursing staff regarding the recognition of the snakebite accident, especially regarding the characteristics presented by the venomous animal and the clinical manifestations presented by the patient. (AU)

Objetivo: identificar los conocimientos del equipo de enfermería en el manejo del paciente víctima de accidente botópico en el servicio de urgencias. Métodos: estudio descriptivo, exploratorio con abordaje cualitativo. Desarrollado en 2019, con profesionales del personal de enfermería del servicio de urgencias de adultos de un Hospital Universitario. Se utilizó una entrevista semiestructurada, transcrita y analizada mediante estadística descriptiva simple y análisis de contenido. Resultados: participaron en el estudio 34 profesionales del equipo de enfermería, de los cuales el 82% eran mujeres, con una edad promedio de 37 años. El análisis de contenido reveló tres categorías: conocimiento sobre accidentes causados por animales venenosos, trayectoria académica y profesional en el contexto de animales venenosos, y manejo del equipo de enfermería al paciente víctima de accidentes bottrópicos. Conclusión: los resultados demuestran el conocimiento y conducta del equipo de enfermería ante el accidente bottrópico y muestran la necesidad de sensibilizar al personal de enfermería sobre el reconocimiento del accidente de la serpiente, especialmente en lo que respecta a las características que presenta el animal venenoso y las manifestaciones clínicas que presenta el paciente. (AU)

La hipertensión arterial en animales de laboratorio / High blood pressure in experimental animals

Las Ciencias Médicas y Biológicas requieren, prioritariamente, que la investigación y la experimentación sean desarrolladas sobre organismos completos (los modelos animales). Su utilización ha permitido desarrollar innumerables ensayos preclínicos para evaluar los mecanismos patógenos y terapéuticos de diversas enfermedades, así como el estudio de las causas, naturaleza y cura de múltiples desórdenes de la salud humana. En este trabajo se muestra una panorámica general de los biomodelos de hipertensión arterial donde se describen: conceptos, características, origen, importancia, utilidad y procedimientos experimentales durante su fase de inducción. También se pondera la justificación de los biomodelos empleados en los estudios preclínicos de esta enfermedad. De igual forma, se describen los antecedentes para medir las alteraciones, las técnicas y los métodos directos e indirectos de medición de la presión arterial, la cual fue provocada experimentalmente en los animales de laboratorio para realizar los estudios de hipertensión humana.

Medical and biological sciences require, as a priority, that research and experimentation be carried out on complete organisms (animal models). Its use has allowed the development of innumerable preclinical tests to evaluate pathogenic and therapeutic mechanisms of various diseases, as well as to study the causes, nature and cure of multiple human health disorders. In this work, we show a general overview of arterial hypertension biomodels where concepts, characteristics, origin, importance, utility and experimental procedures during their induction phase are described. The justification of the biomodels used in preclinical studies of this disease is also considered. Antecedents are also described to measure alterations, techniques and direct and indirect methods of measurement of arterial pressure, which was provoked experimentally in the laboratory animals to carry out the studies of human hypertension.

Epidemiología y características clínicas de las mordeduras de serpientes venenosas en el norte de la Amazonía del Ecuador (2017-2021) / Epidemiology and clinical features of venomous snake bites in the Northern Amazon of Ecuador (2017-2021)

Introducción. En Ecuador, las mordeduras de serpientes venenosas son un problema de salud pública. Sin embargo, no existe información hospitalaria reciente desde la Amazonía. Objetivo. Analizar retrospectivamente las características clínico-epidemiológicas de las mordeduras de serpientes en pacientes ingresados en un hospital de la Amazonía del Ecuador. Materiales y métodos. Se llevó a cabo un estudio transversal en el hospital provincial de Nueva Loja (Sucumbíos), que colinda con Colombia, 2017-2021. La información sobre las variables demográficas, epidemiológicas y clínicas, y la condición al egreso hospitalario, se obtuvieron de la ficha epidemiológica del Ministerio de Salud Pública. Resultados. En cinco años se hospitalizaron 147 pacientes (29,4 por año), sin que se presentaran muertes. Corresponden a 26, 34, 32, 29 y 26 casos, en el 2017, 2018, 2019, 2020 y 2021, respectivamente. Según el sexo, los más afectados fueron los hombres (n=99; 67,3 %), según el grupo etario, los de 21 a 30 años (n=28; 19,0 %) y, según la raza, los de etnia mestiza (n=94; 63,9 %), estudiantes y agricultores. La mediana de edad fue de 28 años (rango: 4 a 81). Hubo mayor prevalencia en abril, junio y septiembre. Todos los accidentes fueron causados por serpientes Viperidae. Veinte (13,6 %) casos fueron leves, 90 (61,2 %), moderados, y 37 (25,2 %), graves. La mordedura fue más frecuente en los pies (45 casos). El 53,1 % recibió suero antiofídico antes de la hospitalización y en el 19,8 % de los pacientes se colocó un torniquete. La mediana de tiempo de llegada al hospital fue de 5 horas (rango: 1-192), y lo más frecuente fue entre 2 y 3 horas (41 casos). No se encontraron diferencias estadísticamente significativas según la gravedad del caso. Conclusiones. Se evidenció una gran prevalencia de mordeduras de serpientes en el norte de la región amazónica-Ecuador, con mayor incidencia en la estación lluviosa y todas causadas por Viperidae. Es importante resaltar la mortalidad nula. Las campañas informativas sobre prevención y primeros auxilios, como la desmotivación del uso de torniquetes, serían fundamentales para reducir los casos, especialmente, en los grupos vulnerables.

Introduction: In Ecuador, poisonous snakebites are a public health problem. However, there is no recent hospital information from the Amazon. Objective: To retrospectively analyse the clinical-epidemiological characteristics of snakebites in patients admitted to a hospital in the Ecuadorian Amazon. Materials and methods: This is a cross-sectional study conducted at the Nueva Loja-Sucumbíos Provincial Hospital, bordering Colombia (2017-2021). Demographic, epidemiological and clinical variables, and condition at hospital discharge, were obtained from the epidemiological file of the Ministerio de Salud Pública. Results: In 5 years, 147 patients (29.4 per year) were hospitalized with no mortality. They corresponded to 26, 34, 32, 29 and 26 cases, in 2017, 2018, 2019, 2020 and 2021, respectively. Men with 99 (67.3%), aged 21-30 years with 28, mixed race with 94 cases, students, and farmers, were the most affected. The most affected (99; 67.3%) were men, people 21 to 30 years-old (28; 19.0%), mestizos (94; 63.9%), students, and farmers. The median age was 28 (range: 4-81) years. Prevalence was higher in April, June, and September. All accidents were caused by Viperidae snakes. Twenty (13.6%) cases were mild, (61.2%) were moderate and 37 (25.2%) were severe. The feet with 45 were the most bitten. Pre-hospitalization anti-venom serum was received by 53.1% and tourniquet by 19.8% patients. Median hospital arrival time was 5 (range 1-192) hours, mostly between 2-3 hours with 41 cases. No statistically significant differences were found considering the severity. Conclusions: A high prevalence of snakebites was evidenced in the north of the Amazon in Ecuador, with a higher incidence in the rainy season and all by Viperidae species. It is important to highlight the null mortality. Information campaigns on prevention and first aid, such as discouraging the use of tourniquets, especially among vulnerable groups.

Efeitos da terapia assistida com animais no manejo da dor: protocolo de revisão sistemática / Effects of assisted therapy with animals for pain management: systematic review protocol

OBJETIVO: Avaliar os ensaios clínicos randomizados existentes na literatura sobre os efeitos da terapia assistida com animais no manejo da dor, em pessoas com quadros álgicos, comparando-a ao tratamento convencional ou a outras intervenções não farmacológicas. MÉTODO: Trata-se de um protocolo de revisão sistemática reportado segundo o Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). O protocolo foi registrado na International Prospective Register of Systematic Reviews (PROSPERO). A busca será realizada em bases de dados variadas, combinando os descritores 'Animal Assisted Therapy', 'Pain Management' e 'Controlled Clinical Trial' e suas variações. Serão incluídos apenas ensaios clínicos randomizados e o gerenciamento dos resultados se dará nos softwares EndNote e Rayyan. A ferramenta Cochrane Collaboration Risk of Bias 2 será utilizada para avaliação do risco de viés, e a ferramenta Grading of Recommendations, Assessment, Development and Evaluation (GRADE) será utilizada para avaliação da certeza de evidência. Se possível, a metanálise será realizada para determinar o efeito da terapia assistida com animais sobre a intensidade da dor.

OBJECTIVE: To evaluate the existing randomized clinical trials in the literature on the effects of Animal Assisted Therapy on pain management in people with pain when compared to conventional treatment or other non-pharmacological interventions. METHOD: Systematic Review, reported according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO). The search will be carried out in various sources of information, combining the descriptors 'Animal Assisted Therapy', 'Pain Management', and 'Controlled Clinical Trial' and their variations. Only randomized clinical trials will be included, and results will be managed in EndNote and Rayyan software. The assessment of bias risk will be carried out by the Cochrane Collaboration Risk of Bias 2 tool, and the assessment of the certainty of evidence by the Grading of Recommendations, Assessment, Development, and Evaluation. If possible, a meta-analysis will be performed to determine the effect of Assisted Therapy with Animals on pain intensity.

Contribuições de animais na clínica: um estudo em psicologia analítica / Contributions of animals in the clinic: a study in analytical psychology / Contribuciones de animales en la clínica: un estudio en psicología analítica

O presente trabalho busca compreender a presença de animais em consultório clínico como colaboradores do processo psicoterapêutico dos pacientes. O levantamento bibliográfico realizado indicou que os animais auxiliam o estabelecimento do vínculo entre paciente e psicólogo, especialmente no caso de crianças. A fim de atingir o objetivo proposto, realizaram-se entrevistas semidirigidas com cinco psicólogas que atendem em consultório particular com a presença de animais, de forma online ou presencial, sob a perspectiva da psicologia analítica. As entrevistas foram analisadas a partir desta abordagem e os resultados obtidos demonstraram que a presença de animais promove: alterações do espaço terapêutico, relação de vínculo entre paciente e terapeuta e criação de suporte emocional durante as sessões, tanto aos psicólogos quanto aos pacientes. Dessa forma, a pesquisa concluiu que animais podem ser ferramentas valiosas a serem utilizadas no setting terapêutico.

The present work seeks to understand the presence of animals in clinical practices as collaborators in the psychotherapeutic process of patients. The bibliographical survey indicated that animals help to establish the bond between patient and psychologist, especially in the case of children. In order to achieve the proposed objective, semi-directed interviews were conducted with five psychologists who work in private practice with the presence of animals, online or in person, from the perspective of analytical psychology. The interviews were analyzed based on the same approach and the results obtained showed that the presence of animals promotes: changes in the therapeutic space, bonding relationship between patient and therapist and creation of emotional support during the sessions, both for psychologists and patients. Thus, the research concluded that animals can be valuable tools to be used in the therapeutic setting.

El presente trabajo busca comprender la presencia de animales en el consultorio clínico como colaboradores del proceso psicoterapéutico de los pacientes. El estudio bibliográfico realizado indicó que los animales ayudan al establecimiento del vínculo entre paciente y psicólogo, especialmente en el caso de niños. Con el fin de alcanzar el objetivo propuesto, se realizaron entrevistas semidirigidas con cinco psicólogas que atienden en consulta privada con la presencia de animales, de forma online o presencial, desde la perspectiva de la psicología analítica. Las entrevistas fueron analizadas desde este enfoque y los resultados obtenidos mostraron que la presencia de animales promueve: cambios en el espacio terapéutico, relación vincular entre paciente y terapeuta y creación de apoyo emocional durante las sesiones, tanto para los psicólogos como para los pacientes. De esta forma, la investigación concluyó que los animales pueden ser herramientas valiosas para ser utilizadas en el ámbito terapéutico. Las entrevistas fueron analizadas a partir de este abordaje y los resultados obtenidos demostraron que la presencia de animales promueve: alteraciones en el espacio terapéutico, relación de vínculo entre paciente y terapeuta y creación de soporte emocional durante las sesiones, tanto a los psicólogos como a los pacientes. De esta forma, la investigación concluyó que los animales pueden ser herramientas valiosas a ser utilizadas en el setting terapéutico.

A Detachable Lens-Induced Myopia Model in Mice Based on Clasp Design / 中山大学学报(医学科学版)

ObjectiveTo explore a new model for lens-induced myopia （LIM） in mice and describe the changes of diopter and ocular biological parameters. MethodsTwenty-seven 21-day-old C57BL/6 mice were divided into three groups （ratio， 5：1：3）： LIM group， plano lens （PL） group and normal control （N） group. The right eyes were intervened while the left eyes were left as control. The refraction was detected with retinoscopy after the pupils were dilated with compound topicamide and ocular axial length was measured by optical coherence tomography （OCT） in vivo at baseline and 1， 2， 3， and 4 weeks after the intervention. Paired t test was performed between left and right eyes within each group. Welch's ANOVA was used for comparison among the three groups. When the difference was statistically significant， the Dunnett's T3 was used to correct P value for pairwise comparison. ResultsAfter 2 weeks of defocus induction， the refraction of the intervened eye in LIM group shifted to myopia about （-2.55±1.54） D（t=6.430， P＜0.000 1）， and the ocular axial length （AL） increased about （0.051±0.024） mm（t=7.837， P＜0.000 1）. The difference of interocular change in refraction in LIM group compared with PL group and N group was -2.30 D （P=0.014） and -2.55 D （P＜0.000 1）， respectively. The difference of interocular change in AL in LIM group was 0.048 mm （P<0.000 1） and 0.047 mm （P<0.000 1） compared with that in PL group and N group， respectively. With the extension of intervention time， the degree of myopia drift increased. ConclusionIn this study， a clasp-based and detachable LIM model was described and validated. After 2 weeks of intervention， the refraction shifted significantly toward myopia and the AL increased significantly. The LIM model is simple to construct and can provide a reference for the model construction of animal experiments in myopia research.

Indicadores morfométricos de la corteza cerebral frontal de gazapos de ratas Wistar con diabetes pregestacional

Introducción: La diabetes es una enfermedad que afecta el embarazo provoca complicaciones fetales; dentro de ellas son frecuentes las malformaciones congénitas. Por la imposibilidad práctica y ética de estudiar este proceso en gestantes es imprescindible realizar estudios experimentales empleando procedimientos morfométricos para determinar si la diabetes afecta el neurodesarrollo. Objetivo: Caracterizar morfométricamente la sustancia gris de gazapos de ratas Wistar normales y con diabetes mellitus pregestacional. Métodos: Se realizó un estudio experimental básico de serie de casos a 20 gazapos de ratas Wistar de los cuales 10 eran descendientes de diabetes pregestacional. Se caracterizaron indicadores morfométricos del tejido nervioso como espesor de corteza e indicadores nucleares como el perímetro. Resultados: La media de la altura de la sustancia gris cortical mostró un valor de 1,224 ± 303,7 μm para el grupo control y 1,014 ± 376,0 para los casos, al aplicar el test de diferencias de medias se encontró diferencia significativa (p ≤ 0,05) a favor del grupo control. Los valores de la media del perímetro nuclear en el grupo control fue de 42,80 ± 7,23 μm y en el grupo experimental el promedio fue de 39,68 ± 6,52 μm, al aplicar el test de diferencias de medias se encontró diferencia significativa (p ≤ 0,05) a favor del grupo control al presentar mayor perímetro nuclear. Conclusiones: El mayor espesor cortical y perímetro nuclear correspondió al grupo control evidenciándose el efecto deletéreo de la diabetes mellitus en el neurodesarrollo.

Introduction: Diabetes is a disease that affects pregnancy causing fetal complications; within them congenital malformations are frequent. Due to the practical and ethical impossibility of studying this process in pregnant women, it is essential to carry out experimental studies using morphometric procedures to determine if diabetes affects neurodevelopment. Objective: To characterize morphometrically the gray matter of kits from normal Wistar rats and those with pregestational diabetes mellitus. Methods: A basic experimental study of a series of cases was carried out on 20 young Wistar rats, of which 10 were descendants of pregestational diabetes. Morphometric indicators of the nervous tissue were characterized as thickness of the cortex and nuclear indicators such as perimeter. Results: The average height of the cortical gray matter showed a value of 1.224 ± 303.7 μm for the control group and 1.014 ± 376.0 μm for the cases. When applying the mean difference test, a significant difference was found (p ≤ 0.05) in favor of the control group. The values of the measurement of the nuclear perimeter in the control group was 42.80 ± 7.23 μm and in the experimental group the average was 39.68 ± 6.52 μm. When applying the mean different test, a significant difference was found (p ≤ 0.05) at favor of control group presenting greater nuclear perimeter. Conclusions: The greatest cortical thickness and nuclear perimeter corresponded to the control group, evidencing the deleterious effect os diabetes mellitus on neurodevelopment.

Histopathological evaluation of the effect of Salvadoria persica and Nigella sativa on the healing of tooth extraction socket in animal

To assess the effects of Salvadoria persica and Nigella sativa combination in tooth socket healing after extraction that can be a novel remedy for tooth extraction socket. Methods: Forty rabbits were included in this study, divided into two groups (control and experimental) with 20 rabbits. Upper right central incisors were extracted for all animals, the tooth sockets of the experimental group were dressed using an admix of Salvadoria persica and Nigella sativa immediately after irrigation with normal saline. In contrast, the extraction sockets of the control group were left without dressing. Biopsies were taken after euthanizing the animals at 1, 3, 7, and 14 days after treatment, histological examination was done for the samples at the given periods respectively. Results: On day 1 post-treatment, histological examination of the experimental group sections showed less acute inflammatory reaction than the control group. This continued to be reduced until the seventh day. The amount of granulation tissue formation was more in the experimental group along the different periods of the study, while new bone formation was observed after 1 week as woven bone, increased after 2 weeks and appeared as woven and lamellar bone in both experimental and control groups. Conclusions: A mixture of Salvadoria persica and Nigella sativa has an anti-inflammatory effect and accelerate bone healing by stimulating bone formation in the tooth extraction socket

Threats to health and conservation of free-living sloths (Bradypus and Choloepus) under anthropic influence in the city of Manaus, Amazonas state, Brazil / Ameaças à saúde e conservação de preguiças (Bradypus e Choloepus) de vida livre sob influência antrópica em Manaus, Estado do Amazonas, Brasil

Abstract Anthropogenic disturbances affecting forest areas can increase disease prevalence and susceptibility in several species of arboreal mammals, such as sloths. Thus, this study aimed to evaluate the most common conditions in body systems of free-ranging sloths admitted at the Wildlife Triage and Rehabilitation Center of Amazonas of the Institute of Environment and Renewable Natural Resources. A total of 227 individuals (139 retrospective cases from 2015 to 2019, and 88 prospective cases from July 2020 to July 2021) were evaluated over a six-year period. Cases from the genus Bradypus showed involvement of the following body systems: 44% respiratory, 29% integumentary, 15% musculoskeletal, 5% digestive, 3% visual, 2% auditory, 1% circulatory and 1% genitourinary, while that distribution in the genus Choloepus was: 39% musculoskeletal, 27% integumentary, 19% respiratory, 9% digestive, 3% circulatory, 1% visual, 1% auditory and 1% genitourinary. The results reveal significant differences between the condition detected and the genus (Bradypus and Choloepus), age and case outcome. These results can provide data for future investigations of sloth diseases, confirming lesions, as well as motivating and suggesting adequate management methods.

Resumo Distúrbios antrópicos que afetam áreas florestais podem aumentar a prevalência de afecções e a suscetibilidade às doenças em diversas espécies de mamíferos arborícolas, como as preguiças. Desta forma, este estudo teve como objetivo avaliar as condições mais comuns nos sistemas orgânicos de preguiças de vida livre admitidas no Centro de Triagem e Reabilitação de Animais Silvestres do Amazonas. Um total de 227 indivíduos (139 casos retrospectivos de 2015 a 2019 e 88 casos prospectivos de julho de 2020 a julho de 2021) foram avaliados durante um período de seis anos. Para o gênero Bradypus foram diagnosticadas 44% de afecções do sistema respiratório, 29% tegumentar, 15% musculoesquelético, 5% digestório, 3% visual, 2% auditivo, 1% circulatório e 1% genitourinário. Por sua vez, para o gênero Choloepus foram detectadas 39% de afecções do sistema musculoesquelético, 27% tegumentar, 19% do sistema respiratório, 19% do sistema respiratório, 9% digestório, 3% circulatório, 1% visual, 1% auditivo e 1% genitourinário. Os resultados mostraram diferenças significativas na prevalência da afecção e gênero das preguiças (Bradypus e Choloepus), a faixa etária e desfecho do caso. Esses resultados podem fornecer subsídios para investigar as doenças de preguiças, confirmando afecções, motivo e sugerir métodos adequados de manejo.

Safety, Effectiveness, and Hemodynamic Performance of the Bovine Pericardium Organic Valvular Bioprosthesis

ABSTRACT Objective: To assess actual data on the safety, effectiveness, and hemodynamic performance of Bovine Pericardium Organic Valvular Bioprosthesis (BVP). Methods: The BIOPRO Trial is an observational, retrospective, non-comparative, non-randomized, and multicenter study. We collected data from 903 patients with symptomatic, moderate, or severe valve disease who underwent BVP implants in the timeframe from 2013 to 2020 at three Brazilian institutions. Death, valve-related adverse events (AEs), functional recovery, and hemodynamic performance were evaluated at the hospital, at discharge, and six months and one year later. Primary analysis compared late (> 30 days after implant) linearized rates of valve-related AEs, such as thromboembolism, valve thrombosis, major hemorrhage, major paravalvular leak, and endocarditis, following objective performance criteria (OPC). Analysis was performed to include at least 400 valve-years for each valve position (aortic and mitral) for complete comparisons to OPC. Kaplan-Meier survival and major adverse cardiovascular and cerebrovascular event analyses were also performed. Results: This retrospective study analyzed follow-up data collected from 903 patients (834.2 late patient-years) who have undergone surgery for 455 isolated aortic valve replacement (50.4%), 382 isolated mitral valve replacement (42.3%), and 66 combined valve replacement or other intervention (7.3%). The linearized rates of valve-related AEs were < 2 × OPC. One-year survival rates were 95.1% and 92.7% for aortic and mitral valve replacement, respectively. This study demonstrated an improvement in the New York Heart Association classification from baseline and hemodynamic performance within an expected range. Conclusion: According to this analysis, BVP meets world standards for safety and clinical efficacy.

Envenomations caused by fish in Brazil: an evolutionary, morphological, and clinical vision of a neglected problem

ABSTRACT Venomous fish are commonly found in Brazilian waters. The most important marine venomous fish species are stingrays (Dasyatidae, Gimnuridae, Myliobatidae, and Rhinopteridae families), catfish (Ariidae family), scorpionfish and lionfish (both Scorpaenidae family), and toadfish (Batrachoididae family). Meanwhile, Potamotrygonidae stingrays and Pimelodidae catfish are the most important venomous freshwater fish. The mechanisms of envenomation vary and involve various venomous apparatuses and glands. Despite not being highly developed, these venomous apparatuses in fish appear rudimentary, using structures such as fins and rays to inoculate toxins and rarely presenting with specialized structures. Toxins are produced by glandular tissue made up of proteinaceous cells, lacking true glands, and are positioned along the inoculation structures. However, systemic manifestations are rare. No antivenom serum has been developed for any species of American venomous fish. Brazilian venomous fish and their venoms have only recently attracted attention, leading to new studies not only addressing clinical issues in humans, but also exploring the discovery of new active substances with immense pharmacological potential.

Colistin resistance in Escherichia coli and Klebsiella pneumoniae in humans and backyard animals in Ecuador / Resistencia a la colistina de las bacterias Escherichia coli y Klebsiella pneumoniae en humanos y animales de granja en Ecuador / Resistência à colistina em Escherichia coli e Klebsiella pneumoniae em humanos e animais de quintal no Equador

ABSTRACT Objective. Colistin is an antibiotic of last resort for treating serious Gram-negative bacterial infections. However, the misuse of colistin, especially as an animal growth promoter, has contributed to increasing antimicrobial resistance, mediated mainly through plasmid transfer of the mcr-1 gene. This study assessed the prevalence of phenotypic and molecular colistin resistance in Escherichia coli and Klebsiella pneumoniae in Ecuador in healthy humans and their chickens and pigs. Methods. Fecal samples were collected from humans and their chickens and pigs in two rural coastal and Amazon regions between April and August 2020. Gram-negative bacteria were isolated and identified using conventional techniques. Phenotypic resistance was determined using the broth microdilution technique, and the mcr-1 gene was detected using conventional polymerase chain reaction. Results. A total of 438 fecal samples were obtained from 137 humans, 147 pigs and 154 chickens. The prevalence of E. coli isolates was 86.3% (378/438) and K. pneumoniae, 37.4% (164/438). Overall, the mcr-1 gene was found in 90% (340/378) of E. coli isolates, with higher prevalences found in isolates from coastal regions (96.5%, 191/198), humans (95.6%, 111/116) and chickens (91.8%, 123/134); for K. pneumoniae, the gene was found in 19.5% (32/164) of isolates, with equal distribution between regions and hosts. Only four isolates, two E. coli and two K. pneumoniae, showed phenotypic resistance: mcr-1 was present in both E. coli strains but absent in the K. pneumoniae strains. Conclusions. Despite a low prevalence of phenotypic resistance to colistin, the high prevalence of the mcr-1 gene in E. coli is of concern. Ecuador's ban on using colistin in animal husbandry must be enforced, and continual monitoring of the situation should be implemented.

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RESUMO Objetivo. A colistina é um antibiótico de último recurso para o tratamento de infecções graves por bactérias Gram-negativas. Entretanto, o uso indevido da colistina, principalmente como promotor de crescimento animal, tem contribuído para o aumento da resistência a antimicrobianos, principalmente por transferência horizontal do gene mcr-1 mediada por plasmídeos. Este estudo avaliou a prevalência de resistência fenotípica e molecular à colistina em Escherichia coli e Klebsiella pneumoniae no Equador em humanos hígidos e em galinhas e porcos por eles criados. Métodos. Entre abril e agosto de 2020, foram coletadas amostras de fezes de habitantes de duas regiões litorâneas e amazônicas do Equador e de galinhas e porcos por eles criados. Bactérias Gram-negativas foram isoladas e identificadas por meio de técnicas convencionais. A resistência fenotípica foi determinada pela técnica de microdiluição em caldo, e o gene mcr-1 foi detectado por reação em cadeia da polimerase convencional. Resultados. Foram obtidas 438 amostras fecais de 137 humanos, 147 suínos e 154 galinhas. A prevalência de isolados de E. coli foi de 86,3% (378/438), e de K. pneumoniae, 37,4% (164/438). Em geral, o gene mcr-1 foi encontrado em 90% (340/378) dos isolados de E. coli, com maiores prevalências encontradas em isolados de regiões litorâneas (96,5%, 191/198), humanos (95,6%, 111/116) e galinhas (91,8%, 123/134); para K. pneumoniae, o gene foi encontrado em 19,5% (32/164) dos isolados, com igual distribuição entre regiões e hospedeiros. Somente quatro isolados, dois de E. coli e dois de K. pneumoniae, demonstraram resistência fenotípica: o gene mcr-1 estava presente em ambas as cepas de E. coli, mas ausente nas de K. pneumoniae. Conclusões. Apesar da baixa prevalência de resistência fenotípica à colistina, a alta prevalência do gene mcr-1 em E. coli é preocupante. É preciso fiscalizar a proibição ao uso agropecuário de colistina no Equador e implementar o monitoramento contínuo da situação.