HIV-positive patients presenting with peripheral blood cytopenias: is bone marrow assessment a priority?

ABSTRACT Introduction: Hematologic abnormalities are frequent among persons living with HIV (PLWH). The bone marrow aspirate (BMA) and biopsy (BMB) are commonly performed in the diagnostic approach of patients with unexplained cytopenias. Changes in antiretrovirals, supportive therapy and increased life expectancy have modified the distribution and etiology of cytopenias, questioning their use. Our aim was to analyze the diagnostic yield of BMA, BMB and marrow cultures for the evaluation of cytopenias in PLWH. Methods: This was a retrospective cohort of ≥ 18-year-old PLWH undergoing bone marrow assessment (MA) for the evaluation of cytopenias between January 2002 and December 2015. Results: A total of 236 cytopenic events were analyzed, 47.9% being PLWH who had a longstanding diagnosis (≥ 1 year). Adherence to antiretrovirals was 63.5%. Anemia was seen in 91.9% and pancytopenia in 39%. Common presentations included fever (52.1%), weight loss (42.8%) and adenopathies (28.8%). Median days from detection to MA was 5 (0 - 63 days). Most common etiologies were non-HIV infectious diseases (31.4%) and benign/malignant hematologic diseases (26.3%). The diagnostic yield was 16.1% for BMA, 20.3% for BMB, 30.5% for both and 35.6% when cultures were added. Patients most likely to have conclusive MA were those with moderate/severe thrombocytopenia (p = 0.007). Fever, splenomegaly, and low CD4+ counts were associated with infectious etiologies, while hematologic diagnoses were related to the presence of adenopathies. Conclusion: As a minimally invasive intervention, the MA has a high yield for identifying the etiology of cytopenic events in PLWH, being conclusive in one in three patients. Early performance could lead to prompt diagnosis and timely therapy initiation.

Cuando la ileítis de Crohn no es solo ileítis / When Crohn's ileitis is not just ileitis

RESUMEN En una minoría de pacientes con ileítis de Crohn (EC) de larga evolución, la recrudescencia de los síntomas puede representar una neoplasia ileal, con una clínica indistinguible de la enfermedad basal y por ende poco sospechada. Frecuentemente la patología tumoral se diagnostica en la pieza quirúrgica, tras una intervención por hemorragia u obstrucción intestinal. El objetivo de este trabajo es destacar la importancia de un diagnóstico diferencial ante una ileítis terminal en un paciente con EC con mala respuesta a tratamiento médico.

ABSTRACT In a minority of patients with long-standing Crohn's ileitis, the recrudescence of symptoms may represent a neoplasm involving the ileum that is clinically indistinguishable from the baseline disease and therefore poorly suspected. Tumors are often diagnosed in the surgical specimen, after an intervention due to bleeding or bowel obstruction. The aim of this study is to emphasize the importance of the differential diagnoses of terminal ileitis in a patient with CD with poor response to medical treatment.

Factores predictivos de mortalidad en el infarto agudo de miocardio con elevación del segmento ST / Predictive factors of mortality in ST-segment elevation acute myocardial infarction

RESUMEN Introducción: Las enfermedades cardiovasculares son la mayor causa de mortalidad del orbe. A pesar de que la incidencia del infarto de miocardio ha disminuido en Estados Unidos, sustancialmente en las últimas décadas, no han dejado de tener un fuerte impacto socioeconómico-laboral. Objetivo: Identificar los factores predictivos de mortalidad en los pacientes con infarto agudo de miocardio con elevación del segmento ST (IMACEST). Método: Se realizó un estudio analítico con 118 pacientes, ingresados en dos hospitales de Santiago de Cuba, durante el período comprendido entre enero de 2017 y diciembre de 2019. El análisis de los datos se basó en la construcción de un modelo multivariado (regresión logística multivariable) para identificar los factores predictivos de la mortalidad. Resultados: Hubo un total de 15 fallecidos durante el período de hospitalización. En la investigación los hombres marcaron la diferencia, sin poder asociar estadísticamente la variable de género con la mortalidad; sin embargo, la edad mayor a 80 años (RR 7,89; IC 95%: 1,97-7,93; p<0,0001), el shock cardiogénico (RR 8,12; IC 95%: 2,85-9,18; p=0,001), no aplicar la trombólisis (RR 9,13; IC 95%: 3,32-9,45; p=0,001), la ventana terapéutica mayor de 6 horas (RR 16,96; IC 95%: 9,79-62,90; p<0,0001), y la localización inferior del infarto (RR 7,89; IC 95%: 1,97-7,93; p<0,0001), mostraron una asociación estadística muy significativa con la mortalidad. Conclusiones: Se identificaron algunos factores predictivos de mortalidad para el IMACEST, donde la edad mayor a los 80 años, el shock cardiogénico y una ventana terapéutica mayor de seis horas se erigen como los principales factores causales en la explicación fisiopatológica y estadística de la mortalidad.

ABSTRACT Introduction: Cardiovascular diseases are the top cause of mortality worldwide. Although the incidence of myocardial infarction has decreased substantially in the United States in recent decades, they have not ceased to have a strong socioeconomic and occupational impact. Objective: To identify predictive factors of mortality in patients with ST-segment elevation myocardial infarction (STEMI). Method: An analytical study was carried out in 118 patients, admitted to two hospitals in Santiago de Cuba, from January 2017 to December 2019. Data analysis was based on the construction of a multivariate model (multivariable logistic regression) to identify predictors of mortality. Results: There were 15 deaths in total during hospitalization period. In the research, men marked the difference, without being able to statistically associate this gender variable with mortality; however, age over 80 years old (RR 7.89; 95% CI: 1.97-7.93; p<0.0001), cardiogenic shock (RR 8.12; CI 95%: 2.85-9.18; p=0.001), not applying thrombolysis (RR 9.13; CI 95%: 3.32-9.45; p=0.001), therapeutic window greater than six hours (RR 16.96; CI 95%: 9.79-62.90; p<0.0001), and the inferior wall myocardial infraction (RR 7.89; CI 95%: 1.97-7.93; p<0.0001), showed a highly significant statistical association with mortality. Conclusions: Some predictive factors of mortality were identified for STEMI, where age older than 80 years old, cardiogenic shock and a therapeutic window longer than six hours stand as the main causal factors in the pathophysiological and statistical explanation of mortality.

Características y evolución clínico-epidemiológica según su gravedad en pacientes ingresados con la COVID 19 confirmado

La infección por SARS-CoV-2, se ha destacado por su fácil transmisión de persona a persona por el aire, principalmente por contacto estrecho y mediante gotículas respiratorias, por contacto directo con personas infectadas, o por aerosoles. Este es un estudio de serie de casos, descriptivo, retrospectivo, que muestra las características epidemiológicas, aspectos clínicos, de tratamiento y de evolución de los pacientes ingresados en Del Sur Policlínica, El Tigre, Anzoátegui, con la COVID-19 confirmada, durante julio-octubre del 2020. De 47 pacientes hospitalizados, se estudiaron 25 con confirmación por prueba PCR positiva. Se revisaron las historias clínicas, los resultados obtenidos se presentaron en tablas, expresados en frecuencias absolutas y relativas. Se hospitalizaron 2 pacientes con clínica leve, 6 con la COVID 19 moderado, 13 severos y 4 críticamente enfermos. El sexo masculino fue el más frecuente (80 %), en edades entre 51 a 70 años (60 %). Las vías de contagio más probables fueron: contacto con caso sospechoso o confirmado en 92 %. La hipertensión arterial sistémica (49 %) fue la comorbilidad más frecuente. El 24 % refirió más de 2 comorbilidades. Los síntomas más registrados fueron disnea, fiebre y tos seca. La anosmia y la disgeusia no se presentaron en casos críticos. El hallazgo tomográfico de vidrio deslustrado estuvo en el 100 %, predominando las lesiones bilaterales, con afectación panlobular (92 %). Los antibióticos, la terapia antitrombótica, antivirales, esteroides y el oxígeno suplementario formaron parte del protocolo de hospitalización. El 80 % de los pacientes egresaron con evolución clínica satisfactoria, sólo el 12 % fallecieron en general, aunque la mortalidad en UCI al estar en VMI, fue alta (75 %)

The SARS-CoV-2 infection has been noted for its easy transmission from person to person through the air, mainly by close contact and by respiratory droplets, by direct contact with infected people, or by aerosols. This is a descriptive, retrospective case series study that describes the epidemiological characteristics, clinical aspects, treatment and evolution of patients admitted to Del Sur Polyclinic, El Tigre, Anzoátegui, with confirmed COVID-19, during July -October 2020. Of 47 hospitalized patients, 25 with confirmation by positive PCR test were studied. The medical records were reviewed, the results obtained were presented in tables, expressed in absolute and relative frequencies. 2 patients with mild symptoms were hospitalized, 6 with moderate COVID 19, 13 severe and 4 critically ill. The male sex was the most frequent (80 %), in ages between 51 to 70 years (60 %). The most probable routes of contagion were: contact with a suspected or confirmed case in 92 %. Systemic arterial hypertension (49 %) was the most frequent comorbidity. 24 % referred more than 2 comorbidities. The most recorded symptoms were dyspnea, fever and dry cough. Anosmia and dysgeusia did not occur in critical cases. The ground glass tomographic finding was 100 %, predominantly bilateral lesions, with panlobular involvement (92 %). Antibiotics, antithrombotic therapy, antivirals, steroids, and supplemental oxygen were part of the hospitalization protocol. 80 % of the patients were discharged with a satisfactory clinical evolution, only 12 % died in general, although mortality in the ICU when being in IMV was high (75 %)

18f-Fluorodeoxyglucose Positron Emission Tomography Versus Bone Marrow Biopsy for the Evaluation of Bone Marrow Infiltration in Newly Diagnosed Lymphoma Patients

ABSTRACT Background: Bone marrow evaluation (BME) is crucial for establishing an accurate staging and prognosis in lymphoma patients. Objective: The objective of the study was to study the diagnostic performance of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) against bone marrow biopsy (BMB) for BME. Methods: Five hundred patient files of newly diagnosed lymphoma patients treated at an academic medical center were reviewed for BME at diagnosis by BMB and FDG PET-CT. Diagnostic performance of FDG PET-CT for detecting bone marrow infiltration (BMI) was assessed, as well as clinical predictors for positive BMB and positive FDG PET-CT. Results: BMB was positive in 16.3% of all patients, and 28.7% had a positive FDG PET-CT for BMI. Overall, the sensitivity of FDG PET-CT was 74.1% and specificity 80.1%. As for predictors for BMB and FDG PET-CT positivity, B symptoms and thrombocytopenia were independent factors for BMI. Seventy-four patients had discordant results between BMB and FDG PET-CT, non-Hodgkin lymphoma (NHL) having the most significant discordance. This discrepancy did not affect treatment. Conclusions: FDG PET-CT shows excellent performance for the detection of BMI in Hodgkin lymphoma. For diffuse large B-cell lymphoma, we recommend performing BMB and FDG PET-CT as complementary tests. In all other NHL, a unilateral BMB is mandatory at diagnosis.

Characterization of lamb burgers with addition of flour from peach palm by-product / Caracterização de hambúrgueres de cordeiro com adição de farinha de subproduto de pupunha

There is an increased interest in the consumption of healthier and innovative meat products. This study aimed to produce lamb burgers by replacing pork fat by peach palm by-product flour ­ PPF. The burgers were produced with lambs that had a safflower seed-supplemented diet. The PPF was added at levels of 0% (H0), 3% (H3), 6% (H6) and 9% (H9) in the substitution of fat. The flour produced with peach palm by-product showed high fiber content (63.9%) and high capacity of water absorption (8.1 g.g-1) and oil absorption (3.8 g.g-1). The PPF addition increased the cooking yield (68.2 - 77.0%), moisture retention (38.5 - 43.4%) and dietary fiber content (3.2 - 7.0%) in relation to H0, while the color parameters were similar among the formulations. The sensorial attributes overall appearance and aroma did not differ (p>0.05) in the lamb burgers produced, but the highest scores for flavor, texture and purchase intention were observed for H0, H3 and H6. PPF addition to lamb burgers increased the hardness values, and it did not affect elasticity and cohesiveness. The microbiological parameters showed that the formulations are safe for consumption. Therefore, PPF can be considered a low-cost alternative to nutritional enrichment of lamb burgers, being the level of 6% the most recommended due to the sensorial acceptance.

Há um interesse crescente pelo consumo de produtos à base de carne mais saudáveis e inovadores. O objetivo deste estudo foi produzir hambúrgueres de cordeiro, substituindo a gordura de porco por farinha de subproduto de palmito pupunha - FPP. Os hambúrgueres foram produzidos com a carne obtida de cordeiros que tiveram dieta suplementada com sementes de cártamo. A FPP foi adicionada nos níveis de 0% (H0), 3% (H3), 6% (H6) e 9% (H9) em substituição à gordura. A farinha produzida com subproduto de palmito pupunha apresentou alto teor de fibras (63,9%) e alta capacidade de absorção de água (8,1 g.g-1) e absorção de óleo (3,8 g.g-1). A adição de FPP aumentou o rendimento após cocção (68,2 - 77,0%), a retenção de umidade (38,5 - 43,4%) e o teor de fibra alimentar (3,2 - 7,0%) em relação a amostra H0, enquanto os parâmetros de cor foram semelhantes entre as formulações. Os atributos sensoriais aparência geral e aroma não diferiram (p > 0,05) entre os hamburgueres produzidos, mas, as maiores notas para sabor, textura e intenção de compra foram observadas para H0, H3 e H6. A adição de FPP aos hambúrgueres de cordeiro aumentou os valores de dureza e não afetou a elasticidade e a coesão. Os parâmetros microbianos mostraram que as formulações são seguras para consumo. Portanto, a FPP pode ser considerada uma alternativa de baixo custo para o enriquecimento nutricional de hambúrgueres de cordeiro, sendo o nível de 6% o mais recomendado devido à aceitação sensorial.

Clinical and epidemiological characteristics of patients diagnosed with covid-19 in a tertiary care center in Mexico City: a prospective cohort study

ABSTRACT Background: Regional information regarding the characteristics of patients with coronavirus disease (COVID)-19 is needed for a better understanding of the pandemic. Objective: The objective of the study to describe the clinical features of COVID-19 patients diagnosed in a tertiary-care center in Mexico City and to assess differences according to the treatment setting (ambulatory vs. hospital) and to the need of intensive care (IC). Methods: We conducted a prospective cohort, including consecutive patients with COVID-19 from February 26, 2020 to April 11, 2020. Results: We identified 309 patients (140 inpatients and 169 outpatients). The median age was 43 years (interquartile range, 33-54), 59.2% men, and 18.6% healthcare workers (12.3% from our center). The median body mass index (BMI) was 29.00 kg/m2 and 39.6% had obesity. Compared to outpatients, inpatients were older, had comorbidities, cough, and dyspnea more frequently. Twenty-nine (20.7%) inpatients required treatment in the IC unit (ICU). History of diabetes (type 1 or 2) and abdominal pain were more common in ICU patients compared to non-ICU patients. ICU patients had higher BMIs, higher respiratory rates, and lower room-air capillary oxygen saturations. ICU patients showed a more severe inflammatory response as assessed by white blood cell count, neutrophil and platelet count, C-reactive protein, ferritin, procalcitonin, and albumin levels. By the end of the study period, 65 inpatients had been discharged because of improvement, 70 continued hospitalized, and five had died. Conclusions: Patients with comorbidities, either middle-age obese or elderly complaining of fever, cough, or dyspnea, were more likely to be admitted. At admission, patients with diabetes, high BMI, and clinical or laboratory findings consistent with a severe inflammatory state were more likely to require IC.

Analysis of the influence of clinical and demographic factors on the understanding of cataract informed consent / Análisis de la influencia de factores clínicos y demográficos en la comprensión del consentimiento informado de cataratas / Análise da influência de fatores clínicos e demográficos na compreensão do consentimento informado para cirurgia de catarata

PURPOSE: To estimate the influence of clinical and demographical information in the understanding of cataract surgery informed consent, identifying less understandable areas. To assess informed consent document concept. METHODS: Multiple-choice questionnaire was designed to collect information and to evaluate the understanding of cataract surgery and informed consent. An ordinary regression model was adjusted to express the effect of clinical and demographic variables to the questionnaire score. RESULTS: The study comprised 180 patients. Sex (female, p=0.404), non-ophthalmologist source of information (p=0.397), previous surgical history (p=0.571), not having a companion (p=0.396) nor the days since the signing of informed consent form (p=0.535) had no influence in the understanding of cataract surgery informed consent. Age (r=-0.083, p<0.001) and educational level (secondary studies r=1.845, p<0.001; tertiary studies r=4.289, p<0.001) showed statistical significance with greater strength of association educational level (OR secondary studies = 6.33, OR tertiary studies = 72.86) than age had (OR = 0.92). CONCLUSION: Patient's knowledge about cataract informed consent is influenced by age and educational level. The purpose and the risks, consequences of not performing surgery and postoperative indications are the least understood topics. Informed consent is seen as a forced legal obligation.

OBJETIVOS: estimar la influencia de la información clínica y demográfica en la comprensión del consentimiento informado de la cirugía de cataratas, identificando áreas menos comprensibles. Evaluar el concepto de "documento de consentimiento informad". MÉTODOS: el cuestionario de opción múltiple se diseñó para reunir información y evaluar la comprensión de la cirugía de cataratas y el consentimiento informado. Se ajustó un modelo de regresión ordinario para expresar el efecto de las variables clínicas y demográficas en la puntuación del cuestionario. RESULTADOS: El estudio abarcó 180 pacientes. Sexo (femenino, p = 0.404); fuente de información no oftalmológica (p = 0.397); historial quirúrgico previo (p = 0.571); no tener acompañante (p = 0.396), y los días desde la firma del formulario de consentimiento informado (p = 0,535), que no tuvo influencia en la comprensión del consentimiento informado en la cirugía de cataratas. La edad (r = -0.083, p <0.001) y el nivel educativo (estudios secundarios r = 1.845, p <0.001; estudios terciarios r = 4.289, p <0.001) mostraron significación estadística con una mayor fuerza del nivel educativo de asociación (OR estudios secundarios = 6.33, OR estudios terciarios = 72.86) que la edad (OR = 0.92). CONCLUSIÓN: El conocimiento del paciente sobre el consentimiento informado en cirugía de cataratas está influenciado por la edad y el nivel educativo. Los temas menos entendidos son el propósito y los riesgos, las consecuencias de no realizar la cirugía y las indicaciones postoperatorias. El consentimiento informado se considera una obligación legal forzada.

OBJETIVO: Estimar a influência de informações clínicas e demográficas na compreensão do consentimento informado para cirurgia de catarata, identificando áreas menos compreensíveis. Avaliar o conceito do documento de consentimento informado. MÉTODOS: Um questionário de múltipla escolha foi desenvolvido para coletar informações e avaliar a compreensão sobre cirurgia de catarata e de consentimento informado. Um modelo de regressão ordinária foi ajustado para expressar o efeito das variáveis clínicas e demográficas no escore do questionário. RESULTADOS: O estudo envolveu 180 pacientes. Sexo (feminino, p=0,404), fonte de informações não oftalmológica (p=0,397), história cirúrgica prévia (p=0,571), não ter um/a companheiro/a (p=0,396) nem os dias desde a assinatura do formulário de consentimento informado (p=0,535) tiveram influência na compreensão do consentimento informado para cirurgia de catarata. Idade (r=-0,083, p<0,001) e nível educacional (estudos secundários r=1,845, p<0,001; estudos terciários r=4,289, p<0,001) mostraram significância estatística, com maior força de associação para o nível educacional (OR estudos secundários = 6,33, OR estudos terciários = 72,86) que para a idade (OR = 0,92). CONCLUSÃO: O conhecimento do paciente sobre o consentimento informado para cirurgia de catarata é influenciado pela idade e nível educacional. O objetivo e os riscos, consequências, de não fazer a cirurgia e as indicações pós-operatórias são os tópicos menos compreensíveis. O consentimento informado é visto como uma obrigação legal compulsória.

La relevancia de los roles de los abuelos y las relaciones mantenidas con los nietos adolescentes y jóvenes: una revisión sistemática de literatura / The relevance of the roles of grandparents and the relationships maintained with adolescent and young grandchildren: a systematic literature review / A relevância dos papéis dos avós e as relações mantidas com adolescentes e jovens netos: uma revisão sistemática da literatura

El objetivo de este artículo es analizar los principales roles que ejercen los abuelos, para ello se han analizado las principales funciones ejercidas por los abuelos cuidadores. Para la elaboración de esta revisión teórica, hemos llevado a cabo una búsqueda exhaustiva de literatura científica, cuyo ámbito de estudio versa principalmente en las relaciones intergeneracionales, y sus características más destacadas, especialmente con nietos adolescentes.

The objective of this article is to analyze the main roles played by grandparents, for which the main functions exercised by grandparents caregivers have been analyzed. Fort he elaboration of this theoretical review we have carried out an exhaustive search of scientific literatura, whose scope of study is mainly in intergenerational relations, and its moust outstanding characteristics, especially with adolescent grandchildren.

O objetivo deste artigo é analisar os principais papéis que os avós exercem, para isso analisaram as principais funções exercidas pelos avós cuidadores. Para a elaboração desta revisão teórica, realizamos uma pesquisa exaustiva da literatura científica, cujo escopo de estudo está principalmente nas relações intergeracionais e suas características mais destacadas, principalmente com os netos adolescentes.

Efeito da adição de antioxidantes sobre a viabilidade do sêmen bovino / Addition of antioxidants on the feasibility of bovine semen / Efecto de la adición de antioxidantes bajo la viabilidad del semen bovino

Os antioxidantes atuam no combate aos efeitos nocivos provocados pelos radicais livres, proporcionando melhor qualidade do sêmen fresco e criopreservado. As mudanças de temperatura provocadas durante os processos de congelação e descongelação são responsáveis pelos danos aos espermatozoides, alterando sua viabilidade e fertilidade. O estudo dos antioxidantes, os quais constituem a primeira linha de combate às espécies reativas de oxigênio (EROs), para a melhora da qualidade do sêmen criopreservado, torna-se de fundamental importância, para desenvolvimento de protocolos padrões e aplicáveis, uma vez que existem muitas controvérsias em relação ao tipo de molécula antioxidante e às doses, o momento adequado para ser acrescentado e possíveis alterações destes aos meios de criopreservação. Assim, este trabalho tem como objetivo estudar o efeito dos antioxidantes: catalase, α-tocoferol e piruvato de sódio adicionados em meio diluidor comercial para melhorar a viabilidade do sêmen bovino criopreservado. Inicialmente foram utilizados três touros, da raça Brahman, selecionados de acordo com o escore de condição corporal e exame andrológico. Oito ejaculados foram colhidos por eletroejaculação e imediatamente avaliados a motilidade e o vigor espermático. Em seguida, foram diluídos conforme os grupos experimentais em meio Botubov® (Botupharma Biotecnologia Animal) com adição do antioxidante piruvato de sódio nas concentrações de 1,5 µM, 3 µM e 5 µM e em seguida, as amostras foram congeladas. Numa segunda etapa, serão utilizados outros antioxidantes e concentrações, conforme descrito: 1) Diluidor BotuBov®; 2) Diluidor BotuBov® contendo 7% de crioprotetor e catalase nas concentrações de 20, 80 e 200 UI; 3) Diluidor BotuBov® contendo 7% de crioprotetor e α-tocoferol nas concentrações de 50 µM, 100 µM e 150 µM; 4) Diluidor BotuBov® contendo 7% de crioprotetor e piruvato de sódio nas concentrações de 1,5 µM; 3,5 µM e 5 µM. Após a descongelação do sêmen com a utilização do piruvato, as amostras foram analisadas quanto à motilidade total e progressiva e vigor espermático. Verificou-se que a adição de piruvato de sódio na concentração de 1,5 µM proporcionou uma melhora nos parâmetros de motilidade total e vigor espermático, demonstrando os benefícios de seu uso.(AU)

Antioxidants act in fighting the harmful effects caused by free radicals, providing better quality of both fresh and cryopreserved semen. Changes in temperature caused during the freezing and thawing processes are responsible for damages to the sperm, changing their viability and fertility. The study of antioxidants, which constitute the first line of combat against reactive oxygen species (ROS) to improve the quality of cryopreserved semen, is of utmost importance for the development of standard and applicable protocols, since there are many controversies regarding the type and the doses of antioxidant molecules, the timing for its addition and likely changes to the cryopreservation media. This paper aims at studying the effects of catalase, α-tocopherol, and sodium pyruvate when added to commercial diluent medium to improve the viability of cryopreserved bovine semen. Initially, three Brahman bulls were selected according to the body condition score and andrological examination. Eight ejaculates were collected by electroejaculation, with motility and spermatic vigor being immediately assessed. Subsequently, the samples were diluted according to the experimental groups in Botubov® (Botupharma Animal Biotechnology) medium with the addition of sodium pyruvate at concentrations of 1.5 µM, 3 µM and 5 µM and were subsequently frozen. In a second step, other antioxidants and concentrations will be used, as follows: 1) BotuBov® Diluent; 2) BotuBov® diluent containing 7% cryoprotectant and catalase at concentrations of 20, 80 and 200 IU; 3) BotuBov® diluent containing 7% cryoprotectant and α-tocopherol at concentrations of 50 µM, 100 µM and 150 µM; 4) BotuBov® diluent containing 7% cryoprotectant and sodium pyruvate at concentrations of 1.5 µM; 3.5 µM and 5 µM. After thawing the semen with pyruvate, the samples were analyzed for total and progressive motility and spermatic vigor. It was found that the addition of 1.5 µM sodium pyruvate provided an improvement in total motility and sperm vigor parameters, demonstrating the benefits of its use.(AU)

Los antioxidantes actúan en el combate a los efectos nocivos provocados por los radicales libres, proporcionando mejor calidad del semen fresco y criopreservado. Los cambios de temperatura provocados durante los procesos de congelación y descongelación son responsables por los daños a los espermatozoides, alterando su viabilidad y fertilidad. El estudio de los antioxidantes, que constituyen la primera línea de combate a las especies reactivas de oxígeno (ERO), para la mejora de la calidad del semen criopreservado, se hace de fundamental importancia para el desarrollo de protocolos estándares y aplicables, ya que existen muchas controversias en relación al tipo de molécula antioxidante y a las dosis, el momento adecuado para ser añadido y posibles alteraciones de éstos a los medios de criopreservación. Así, este estudio ha tenido como objetivo estudiar el efecto de los antioxidantes: catalasa, α-tocoferol y piruvato de sodio añadidos en medio diluidor comercial para mejorar la viabilidad del semen bovino criopreservado. Inicialmente se utilizaron tres toros, de la raza Brahman, seleccionados de acuerdo con la puntuación de condición corporal y examen andrológico. Ocho eyaculados fueron recogidos por electroejaculación e inmediatamente evaluados la motilidad y el vigor espermático. A continuación, se diluyeron de acuerdo con los grupos experimentales en medio Botubov (Botupharma Biotecnología Animal) con adición de antioxidante piruvato de sodio a concentraciones de 1,5 µM, 3 µM y 5 µM, y luego las muestras se congelaron. En una segunda etapa, se utilizarán otros antioxidantes y concentraciones, según se describe: 1) Diluidor BotuBov®; 2) Diluidor BotuBov® conteniendo 7% de crioprotector y catalasa en las concentraciones de 20, 80 y 200 UI; 3) Diluidor BotuBov® que contiene 7% de crioprotector y α-tocoferol en las concentraciones de 50 µM, 100 µM y 150 µM; 4) Diluidor BotuBov® conteniendo 7% de crioprotector y piruvato de sodio en las concentraciones de 1,5 µM; 3,5 µM y 5 µM. Después de la descongelación del semen con la utilización del piruvato, las muestras fueron analizadas en cuanto a la motilidad total y progresiva y vigor espermático. Se comprobó que la adición de piruvato de sodio en la concentración de 1,5 µM proporcionó una mejora en los parámetros de motilidad total y vigor espermático, demostrando los beneficios de su uso.(AU)

Neuroinflamación: el ying-yang de la neuroinmunología / Neuroinflammation: the ying-yang of neuroimmunology

Resumen El área de la neuroinmunología es un campo que se encuentra en gran desarrollo y que tiene como objetivo el entender las interacciones fisiológicas entre el sistema nervioso central (SNC) y el sistema inmune periférico, llegándose a encontrar que estas relaciones son más importantes de lo que se creía y que por lo tanto son 2 sistemas íntimamente conectados y con una gran dinámica. Por otro lado, la neuroinflamación es activada después de cualquier reto inmunológico, tanto dentro como fuera del SNC, y que puede llevar a generar tanto respuestas enfocadas a la limitación del daño y la restauración del tejido, como a ser un riesgo para el desarrollo de enfermedades neurodegenerativas en el caso de que este estímulo permanezca de manera crónica.

Abstract The field of neuroimmunology has recently had a development, and its primary goal is to understand the physiological interactions between the central nervous system (CNS) and the peripheral immune system. Various data has found that these relations are more important than what was previously thought. Also, that both systems are highly dynamic and are intimately connected. On the other hand, neuroinflammation is activated after any immune challenge, both inside and outside the CNS, leading to responses focused on limiting tissue damage and restoration; as well as being a risk for developing neurodegenerative diseases when this stimulus remains chronic.

Occurrence of brucellosis, leptospirosis and neosporosis in cows with retained placenta in Southwest Paraná, Brazil / Ocorrência de brucelose, leptospirose e neosporose em vacas com retenção de placenta no Sudoeste do Paraná, Brasil

The aim of this study was to measure the occurrence of brucellosis, leptospirosis and neosporosis in cows from 25 family farms milk, with semi-intensive grazing system, located in the Southwest region of Paraná, Brazil. Eighty-four cows with retained placenta, between July 2013 to July 2014, diagnosed by the presence of fetal membranes in the uterus up to 12 hours after partum, decrease of appetite and of milk production, as well increase of rectal temperature were included into the study. The animals were submitted to blood collection for evaluating the seropositivity for brucellosis, leptospirosis and neosporosis. The blood was collected at 15 to 45 days postpartum, avoiding false negative results due to immune deficiency observed in the transition period. After collection, the blood was centrifuged, the serum was packed in three aliquots, identified and subsequently frozen. Serology was performed to diagnose brucellosis (technique of buffered acidified antigen), leptospirosis (through the microscopic agglutination test - MAT) and neosporosis (indirect immunofluorescence test). Animals were considered positive when presenting titer >1:100 (leptospirosis) and 1:200 (neosporosis). No animal with placenta retention presented Brucella abortus bacteria; 39% (33/84) were reactive to one or more Leptospira serovars, 15% (13/84) were positive to Neospora caninum, and 4% (4/84) had both diagnosis, being reactive for leptospirosis and neosporosis. In conclusion, data from this experiment inspires greater attention to leptospirosis and neosporosis in dairy cattle presenting placenta retention in southwest Paraná.(AU)

Objetivou-se com esse estudo avaliar a ocorrência de brucelose, leptospirose e neosporose em fêmeas bovinas de 25 propriedades leiteiras de agricultura familiar, mantidas em sistema de pastejo semi-intensivo, localizadas na Região Sudoeste do Paraná, Brasil. Para tanto, incluiu-se nesse estudo, 84 vacas diagnosticadas com retenção de placenta (RP) pela presença parcial ou total dos anexos fetais no útero após 12 horas do parto, diminuição do apetite e da produção de leite, como também aumento da temperatura retal. Os animais foram submetidos à coleta de sangue 15 a 45 dias pós-parto, a fim de evitar resultado falso negativo devido à imunodeficiência observada no período de transição. Após coleta, o sangue foi centrifugado, o soro aliquotado em três amostras, identificado e congelado. Para o diagnóstico sorológico de Brucelose utilizou-se o exame sorológico do antígeno acidificado tamponado, de leptospirose a técnica de soroaglutinação microscópica, e neosporose pela técnica de imunofluorescência indireta. Os animais foram diagnosticados positivos quando apresentaram título igual ou superior à 1:100 (leptospirose) e 1:200 (neosporose). Em nenhum dos 84 animais com RP foi detectada a presença da bactéria Brucella abortus. Desses, 39,28% (33/84) foram reativos para um ou mais sorovares de Leptospira, 15,47% (13/84) foram positivos para Neospora caninum e 4,76% (4/84) foram reativos para sorovares de Leptospira sp. e N. caninum, concomitantemente. Em conclusão, os dados deste estudo inspiram maior atenção à leptospirose e neosporose em bovinos leiteiros que apresentam retenção de placenta no sudoeste do Paraná.(AU)

Productive and Reproductive Perfomance of Dairy Cows During Peripartum

ABSTRACT Dairy activity is of great importance for the national economy. It is also an important source of income for families in the south east region of Paraná that work in this area. There has been a notable expansion in the activities as well as in the quantity of production and the quality of the products. With this has come problems in the reproductive efficiency of the dairy cattle principally in relation to those with the greatest production. The objective of this study was to evaluate the productive profile and the reproductive efficiency of dairy cows. The evaluation covered 30 days before calving and 15, 30, 45, 60 and 90 days after the calving. The study covered cows from two properties in the Municipality of Realza-PR in Brazil. In order to do the aforementioned, we used the Body Condition Score (BCS). We evaluated the production of milk and through the use of gynecological exams and we looked at uterine involution (UI) and ovarian cyclicality. The results showed falls in the BCS in the prepartum period and in the first weeks of lactation (p<0.05) and the differences in the BCS were based on the season of the year in which the calving took place (p<0.05) with the highest BCS being noted to occur in the hot seasons. The UI correlates with the presence of corpus luteum where animals were late in their uterine involution and had delays in their first postpartum ovulation (p<0.05). The average service period and calving interval were similar to those described for dairy cattle, however, we observed variations based on the seasons of the year which was possibly related to the greater availability and quality of the forage in the hot seasons.

The Neuroid revisited: A heuristic approach to model neural spike trains

AbstractIntroduction: Since it was introduced in 2012, the Neuroid has been used to aid in understanding how functionally different neural populations contribute to sensory information processing. However, insights about whether this neuron-model could perform better than others or about when its utilization should be considered have not been provided yet. Methods In an attempt to address this issue, a comparison between the Neuroid and the leaky-integrate-and-fire (LIF) model in terms of accuracy and computational cost was performed. Both models were tested for different stimulation amplitudes and stimulation periods, with time step sizes ranging from 10-4 to 1 ms. Results It was found that, although the Neuroid was able to produce more accurate results than its original version, its accuracy was lower than the achieved with the LIF model solved by the forward Euler method. On the other hand, the Neuroid performed its calculations in an amount of time significantly lower (Mulfactorial ANOVA test, p < 0.05) than that required by the LIF model when it was solved by using the forward Euler method. Moreover, it was possible to use Neuroid-based networks to replicate biologically relevant firing patterns produced by low-scale networks composed of more detailed neuron-models. Conclusion Results suggest that the Neuroid could be an interesting choice when computational resources are limited, although its use might be restricted to a narrow band of applications.

Asociación entre condición fisica y autoconcepto fisico en estudiantes españoles de 12-16 años / Association between physical fitness and physical self-concept in 12-16 year-old spanish schoolchildren

Resumen El objetivo del trabajo fue examinar la asociación de la fuerza muscular, potencia aeróbica y composición corporal con el autoconcepto físico en adolescentes de diferente sexo. Un total de 1816 adolescentes españoles (12-16 años) participaron en este estudio transversal. Se administró el Cuestionario de Autoconcepto Físico, las pruebas de fuerza muscular y potencia aeróbica de la batería ALPHA y se calculó el índice de masa corporal a partir de medidas objetivas. Los análisis de regresión logística mostraron que los adolescentes de ambos sexos con baja fuerza muscular, potencia aeróbica y con sobrepeso u obesidad tuvieron significativamente mayores odds ratios de reportar autoconcepto físico bajo. Los resultados de la asociación entre fuerza muscular y autoconcepto físico fueron sensibles al sexo y a la prueba de evaluación. Unos niveles de condición física saludable estuvieron asociados con el autoconcepto físico positivo en adolescentes. La influencia del sexo en esta asociación debe considerarse cuando se busque mejorar el autoconcepto físico.

Abstract The aim of this study was to examine the association of muscular fitness, cardiorespiratory fitness and body composition with physical self-concept in adolescents of different sex. A total of 1816 Spanish adolescents (aged 12-16) participated in this cross-sectional study. Physical Self-concept Questionnaire and ALPHA battery tests were administered to evaluate muscular fitness and cardiorespiratory fitness, and body mass index was calculated from objective measurements. Logistic regression analysis showed that adolescents of both genders with low muscular fitness, cardiorespiratory fitness, and overweight had significantly higher odds ratios of showing a low physical self-concept. The results of the association between muscular fitness and physical self-concept were sensitive to gender and the evaluation test. Healthy fitness levels were associated with a positive physical self-concept in adolescents. Gender differences should be considered when seeking to enhance physical self-concept.

Tricomonose e campilobacteriose em bovinos: revisão de literatura / Trichomoniasis and campylobacteriosis in cattle: a literature review / Tricomoniasis y campilobacteriosis en ganado: revisión de literatura

O aumento da produção de leite no Brasil tem sido essencial para o crescimento do país no mercado internacional, com destaque para a região Sul do país. Com o avanço tecnológico na atividade leiteira, avançou também o cuidado com a sanidade dos rebanhos, que engloba o manejo sanitário da reprodução desses rebanhos. A Tricomonose e a Campilobacteriose são doenças sexualmente transmissíveis que afetam bovinos em várias idades. Tritrichomonas foetus é o agente causador da Tricomonose e C. fetus subsp. venerealis o da Campilobacteriose, sendo, respectivamente, um protozoário e uma bactéria Gram-negativa. O diagnóstico dessas doenças se dá via coleta de lavado prepucial ou cervicovaginal, para a pesquisa de Tritrichomonas spp, e pelo swab prepucial ou cervicovaginal para a pesquisa de Campylobacter spp. Não há tratamento específico para essas doenças, visto que o controle e profilaxia baseiam-se na retirada dos machos portadores do rebanho, ou realização de descanso reprodutivo de quatro ou cinco estros nas fêmeas, já que as mesmas eliminam os agentes etiológicos. Diante do exposto é necessário reconhecer a necessidade de estudos relacionados a Tricomonose e Campilobacteriose em rebanhos leiteiros, principalmente aqueles inseridos em sistema de produção familiar, subsidiando essa revisão de literatura.(AU)

The increase in dairy production in Brazil has been essential to the country's growth in the international market, especially in the southern region of the country. With the technological advances in dairy farming, the caring for the health of herds has also increased, as well as the health management of the reproduction of these animals. Trichomoniasis and campylobacteriosis are sexually transmitted diseases that affect cattle at different ages. Tritrichomonas fetus is a protozoan that promotes Trichomoniasis and C. fetus subsp. venerealis is a gram-negative bacterium that promotes campylobacteriosis. In order to diagnose these diseases, the prepucial or cervicovaginal wash has been collected for Tritrichomonas spp. and the preputial or cervicovaginal swab has been collected for Campylobacter spp. There is no specific treatment for these diseases, since the control and prophylaxis are based on the removal of infected males, or in carrying out reproductive rest between four or five estrous cycles in females, since these actions can eliminate the etiologic agent. Thus, it is important to study trichomoniasis and campylobacteriosis in dairy herds, especially those placed in family farming, supporting this literature review.(AU)

El aumento de la producción de leche en Brasil ha sido esencial para el crecimiento del país en el mercado internacional, especialmente en la región sur del país. Con los avances tecnológicos en la industria lechera también se avanzó el cuidado con la salud de los rebaños, que incluye el manejo sanitario de la reproducción de esos rebaños. La tricomoniasis y la campilobacteriosis son enfermedades sexualmente transmisibles que afectan al ganado de diferentes edades. Tritrichomonas fetus es el agente causante de la tricomoniasis y C. fetus subsp. venerealis o de la campilobacteriosis, siendo, respectivamente, un protozoos y una bacteria Gram- negativa. El diagnóstico de esas enfermedades se produce a través de colección de lavado de prepucio o cervicovaginal, para la investigación de Tritrichomonas spp, y por el swab prepucio o cervicovaginal para la investigación de Campylobacter spp. No existe tratamiento específico para esas enfermedades, ya que el control y profilaxis se basan en la retirada de los machos portadores del rebaño, o realización de descanso reproductivo de cuatro o cinco celos en las hembras, pues las mismas eliminan los agentes etiológicos. Delante el expuesto, es necesario reconocer la necesidad de realizar estudios relacionados con la tricomoniasis y campilobacteriosis en rebaños lecheros, especialmente los situados en el sistema de producción familiar, subsidiando esa revisión de literatura.(AU)

Aspectos psicosociales de la enfermedad celíaca en España: una vida libre de gluten / Psychosocial aspects of celiac disease in Spain: A life free of gluten

RESUMEN Objetivo: La celiaquía como enfermedad crónica tiene una alta prevalencia en nuestra sociedad. El artículo analiza los aspectos psicosociales de la enfermedad celíaca en los diferentes entornos, valorando el impacto de la implantación de una dieta estricta libre de gluten. Métodos: Estudio cualitativo entre los meses de Enero del 2013 a Abril del 2013 en el cual, a través de la teoría fundamentada y el análisis de contenido, se ha profundizado en el análisis de las entrevistas semiestructuradas a personas con enfermedad celíaca en España. Se realizaron llamamientos a traves de las redes sociales y grupos de celíacos hasta llegar a la saturación teórica, que determinó el tamaño final de la muestra de 24 personas. Resultados: Educación Sanitaria, Aislamiento social, soledad y desconocimiento social emergieron como categorías centrales en la experiencia de adopción de la dieta libre de gluten a partir del diagnóstico de celiaquía. Conclusión: Los profesionales deben promover y apoyar estrategias de apoyo social basadas en una comprensión íntegra de las experiencias de desarraigo y marginación que los pacientes celíacos experimentan en sus relaciones sociales a través de la comida. Se requiere un aumento de la educación sanitaria para entender e integrar el impacto psicosocial del diagnóstico de celiaquía y la dieta libre de gluten.

ABSTRACT Objective: Celiac disease is a chronic disease which has a high prevalence in our society. The aim of this paper is to explore the process of adapting the celiac in different social environments, assessing the impact of the implementation of a strict gluten-free diet. Methods: A qualitative study was carried out in the months of January 2013 to April 2013 through which the grounded theory and content analysis have deepened the analysis of semi-structured interviews with people with celiac disease in Spain. Appeals via social networks and celiac groups were conducted in order to reach theoretical saturation, which determined the final sample size of 24 people. Results: Social isolation, loneliness and social ignorance are some of the categories that have emerged when we talk about celiac disease and the gluten-free diet. Conclusion: Professionals should promote and support social support strategies based on an integrated understanding of the experiences of displacement and marginalization that celiac patients experience in their social relationships through food. There should be increased health education to understand and integrate the psychosocial impact of the diagnosis of celiac disease and the gluten-free diet.

Unusual caudal vena cava thrombosis in a cow, secondary to Trueperella (Arcanobacterium) pyogenes infection / Rara trombose da veia cava caudal em bovino, secundária à infecção por Trueperella (Arcanobacterium) pyogenes

The caudal vena cava thrombosis, or pulmonary thromboembolism, in cattle is correlated with lactic acidosis, caused by diets rich in grains and highly fermentable, associated or not to septic situations, used in feedlots of beef or high-producing dairy cattle. This paper reports an unusual caudal vena cava thrombosis in a cow, secondary to Trueperella (Arcanobacterium) pyogenes infection, resulting in reduced milk production, anorexia, pale mucous membranes, ruminal atony, sternal decubitus and autoauscultation position. The heart was enlarged at necropsy, presence of clots distributed along the thoracic cavity, adherence between lung and pleura, abscesses, emphysema, petechiae, suffusions and ecchymosis in lungs, thickening of the caudal vena cava wall, hepatomegaly with chronic passive congestion ("nutmeg" aspect), and rumenitis. In lab, the actinomycete Trueperella (Arcanobacterium) pyogenes was isolated from liver and lung samples, probably resulting through dissemination of the bacteria of the rumen content, what reaffirms the opportunistic behavior of this actinomycete.(AU)

A síndrome da veia cava caudal ou tromboembolismo pulmonar bovino está relacionada à acidose láctica causada por dietas ricas em grãos e altamente fermentáveis, associados ou não a quadros sépticos, usadas em confinamentos de bovinos de corte ou para vacas leiteiras de alta produção. O presente artigo reporta caso raro de trombose da veia cava caudal em uma vaca, secundária a infecção por Trueperella (Arcanobacterium) pyogenes, apresentando reduzida produção de leite, anorexia, palidez de mucosas, atonia ruminal, decúbito esternal e posição de autoauscultação. À necrópsia observou-se coração aumentado de tamanho, coágulos distribuídos por toda cavidade torácica, aderência entre os pulmões e pleura, abscessos, enfisema, petéquias, sufusões, equimoses nos pulmões, espessamento da parede da veia cava caudal com trombo, hepatomegalia com congestão passiva crônica (aspecto de "noz moscada"), e ruminite. Em laboratório isolou-se o actinomiceto Trueperella (Arcanobacterium) pyogenes a partir de amostras de fígado e pulmão, provavelmente resultando da disseminação da bactéria proveniente do conteúdo ruminal, e reafirma o comportamento oportunista deste actinomiceto.(AU)

Comportamento de éguas após a inserção de dispositivo intravaginal impregnado com progesterona / Behavior of mares after insertion of intravaginal progesterone device / Comportamiento en yeguas después de la inserción del dispositivo intravaginal impregnado con progesterona

Considerando a escassez de estudos sobre o temperamento ou reatividade de equinos, objetivou-se com esse estudo avaliar o comportamento de éguas após a inserção do implante intravaginal de progesterona, para utilização em bovinos, por meio da observação de comportamentos individuais e coletivos. Para tanto, utilizou-se sete éguas que receberam dispositivo intravaginal impregnado com progesterona e agente luteolítico. Após a colocação dos implantes e soltura das éguas, se iniciou a observação (cinco observadores sem contato entre eles) de seus comportamentos até o tempo de 120 minutos, seguindo o modelo proposto por Heleski et al. (2002). Os resultados indicaram que durante os 120 minutos de observação todas as éguas demonstraram estar alertas, pelo menos em uma observação; que o ato de comer foi observado em todos os animais durante o período estudado e que o ato de urinar e defecar foram observados, em aproximadamente, 70 e 60%, respectivamente, dos comportamentos avaliados. Comportamentos prováveis da indicação de dor e/ou desconforto, como bater da cauda, mímica de urinar, eversão do clitóris e urinando foram observados até 65 minutos, sendo que os três primeiros cessaram aos 55 minutos. De todos os comportamentos analisados, nenhum deles foi visualizado após 65 minutos de observação. Concluiu-se que a inserção do dispositivo intravaginal impregnado com progesterona não afeta negativamente o comportamento de éguas, podendo ser utilizado sem comprometer o bem-estar desses animais.

Considering the scarcity of studies on the behavior or reactivity of horses, this study aimed to assess the behavior of mares after insertion of intravaginal progesterone implant for use in cattle, through the observation of individual and collective behavior. In order to do so, seven mares received intravaginal devices impregnated with progesterone and luteolitic agent. After the implant was placed, the mares were released, and their behavior was observed (five observers with no contact between them) for a period of 120 minutes, following the model proposed by Heleski et al. (2002). The results indicated that during the 120-minute period, all mares were alert, in at least one observation; that all animals ate during the study period, and urination and defecation were observed in approximately 70 and 60%, respectively, of the assessed behavior. Behaviors that were likely an indication of pain and/or discomfort, like hitting the tail, miming to urinate, eversion of the clitoris and urinating were observed in up to 65 minutes, with the first three symptoms ceasing after 55 minutes. None of the analyzed behaviors were viewed after 65 minutes of observation. It can be concluded that the insertion of the intravaginal device impregnated with progesterone does not adversely affect the behavior of mares, and therefore, it can be used without compromising the well-being of the animals.

Teniendo en cuenta la escasez de estudios sobre el temperamento o la reactividad de equinos, este estudio buscó evaluar el comportamiento de yeguas después de la inserción del implante de progesterona intravaginal, para su uso en ganado, a través de observación de conductas individuales y colectivas. Para ello, se utilizó siete yeguas que recibieron dispositivo intravaginal impregnado con progesterona y agente luteolítico. Después de los implantes y la liberación de las yeguas, comenzó la observación (cinco observadores sin contacto entre ellos) de sus comportamientos hasta el tiempo de 120 minutos, siguiendo el modelo propuesto por Heleski et al. (2002). Los resultados indicaron que durante los 120 minutos de observación todas las yeguas demostraron estar alertas, por lo menos en una observación; el acto de comer se observó en todos los animales durante el periodo de estudio y que el acto de la micción y la defecación, en aproximadamente, 70 y 60%, respectivamente, de los comportamientos evaluados. Comportamientos probables de indicación de dolor y/o malestar, como golpear la cola, la mímica de orinar, eversión del clítoris y orinando, observados hasta 65 minutos, siendo que los tres primeros cesaron después de 55 minutos. De todos los comportamientos analizados, ninguno de ellos se visualizó después de la observación de 65 minutos. Se concluyó que la inserción del dispositivo intravaginal impregnado con progesterona no afecta negativamente el comportamiento de yeguas, que puede ser utilizado sin comprometer el bienestar de esos animales.