Bone marrow macrophages are involved in the ineffective hematopoiesis of myelodysplastic syndromes.

Myelodysplastic syndromes (MDS) are a group of heterogeneous myeloid clonal disorders characterized by ineffective hematopoiesis. Accumulating evidence has shown that macrophages (MΦs) are important components in the regulation of tumor progression and hematopoietic stem cells (HSCs). However, the roles of bone marrow (BM) MΦs in regulating normal and malignant hematopoiesis in different clinical stages of MDS are largely unknown. Age-paired patients with lower-risk MDS (N = 15), higher-risk MDS (N = 15), de novo acute myeloid leukemia (AML) (N = 15), and healthy donors (HDs) (N = 15) were enrolled. Flow cytometry analysis showed increased pro-inflammatory monocyte subsets and a decreased classically activated (M1) MΦs/alternatively activated (M2) MΦs ratio in the BM of patients with higher-risk MDS compared to lower-risk MDS. BM MФs from patients with higher-risk MDS and AML showed impaired phagocytosis activity but increased migration compared with lower-risk MDS group. AML BM MΦs showed markedly higher S100A8/A9 levels than lower-risk MDS BM MΦs. More importantly, coculture experiments suggested that the HSC supporting abilities of BM MΦs from patients with higher-risk MDS decreased, whereas the malignant cell supporting abilities increased compared with lower-risk MDS. Gene Ontology enrichment comparing BM MΦs from lower-risk MDS and higher-risk MDS for genes was involved in hematopoiesis- and immunity-related pathways. Our results suggest that BM MΦs are involved in ineffective hematopoiesis in patients with MDS, which indicates that repairing aberrant BM MΦs may represent a promising therapeutic approach for patients with MDS.

Disseminated protothecosis: Case report and review of the literature.

BACKGROUND: Human protothecosis is an uncommon infection caused by Prototheca spp that rarely infects humans. AIM: Description of a rare disease and a review of its articles. MATERIALS AND METHODS: We reported a 24-year-old man who presented with red-brown papules and plaques on the trunk's lateral side. We reviewed the literature about disseminated protothecosis and reported our experience with a patient with protothecosis between 2021 and 2023. RESULTS: Overall, 54 cases of disseminated protothecosis were evaluated, 39 were due to P. wickerhamii, 12 were due to P. zopfii (22.2%), and three were due to Prototheca spp. We found that males were more affected (37 cases, 68.5%) than females (16 cases, 29.6%). The mean age of patients was 39.53 ± 22.48 years. However, disseminated protothecosis can affect people of any age (1-80 years). In contrast to P. wickerhamii, which causes blood, skin, brain, and gastrointestinal tract infections, P. zopfii was mainly found in the blood (7/22) and did not have a significant difference in the mortality rate (P = 0.11). DISCUSSION: Disseminated protothecosis is a rare disease in immunocompromised patients but is generally rarer in immunocompetent hosts. Several underlying disorders include immunocompromised patients, prolonged application of steroids, diabetes mellitus, malignancies, organ transplantation, AIDS, and surgeries. Amphotericin B has been the most effective agent for protothecosis and is reserved for visceral and disseminated infections. Regarding localized cutaneous types, excision or surgical debridement is used. CONCLUSION: Mulberry's appearance and appropriate cultural environments are helpful in diagnosing it.

Implications of inflammatory cell death-PANoptosis in health and disease.

Regulated cell death (RCD) pathways, such as pyroptosis, apoptosis, and necroptosis, are essential for maintaining the body's balance, defending against pathogens, and eliminating abnormal cells that could lead to diseases like cancer. Although these pathways operate through distinct mechanisms, recent genetic and pharmacological studies have shown that they can interact and influence each other. The concept of "PANoptosis" has emerged, highlighting the interplay between pyroptosis, apoptosis, and necroptosis, especially during cellular responses to infections. This article provides a concise overview of PANoptosis and its molecular mechanisms, exploring its implications in various diseases. The review focuses on the extensive interactions among different RCD pathways, emphasizing the role of PANoptosis in infections, cytokine storms, inflammatory diseases, and cancer. Understanding PANoptosis is crucial for developing novel treatments for conditions involving infections, sterile inflammations, and cancer.

T cell subsets and immunoglobulin G levels are associated with the infection status of systemic lupus erythematosus patients

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disorder that affects nearly all organs and tissues. As knowledge about the mechanism of SLE has increased, some immunosuppressive agents have become routinely used in clinical care, and infections have become one of the direct causes of mortality in SLE patients. To identify the risk factors indicative of infection in SLE patients, a case control study of our hospital's medical records between 2011 and 2013 was performed. We reviewed the records of 117 SLE patients with infection and 61 SLE patients without infection. Changes in the levels of T cell subsets, immunoglobulin G (IgG), complement C3, complement C4, globulin, and anti-double-stranded DNA (anti-ds-DNA) were detected. CD4+ and CD4+/CD8+ T cell levels were significantly lower and CD8+ T cell levels were significantly greater in SLE patients with infection than in SLE patients without infection. Additionally, the concentrations of IgG in SLE patients with infection were significantly lower than those in SLE patients without infection. However, complement C3, complement C4, globulin, and anti-ds-DNA levels were not significantly different in SLE patients with and without infection. Therefore, clinical testing for T cell subsets and IgG is potentially useful for identifying the presence of infection in SLE patients and for distinguishing a lupus flare from an acute infection.

Complicaciones debidas al manejo conservador de la infección de injerto fémoro-femoral con exposición del mismo. A propósito de un caso / Complications due to the conservative treatment of an infected and exposed femoro-femoral bypass graft. A case report

No disponible

Transplante cardíaco na Doença de Chagas / Heart transplantation in Chagas Disease

A doença de Chagas afeta 16 a 18 milhões de pessoas na América Latina. No Brasil, estima-se a existência de 5 a 7 milhões de chagásicos, encontrados em quase todos os estados brasileiros. Aproximadamente 30% dos infectados desenvolvem a forma crônica da doença, com elevadas taxas de morbidade e mortalidade pelo envolvimento cardíaco, e a miocardiopatia chagásica apresenta pior prognóstico quando comparada a outras etiologias da insuficiência cardíaca. Em nosso meio, aproximadamente 30% dos pacientes com insuficiência cardíaca crônica refratária ao tratamento clínico, encaminhados para transplante cardíaco têm como etiologia a doença de Chagas. A experiência acumulada no Brasil demonstra que, a despeito de elevadas taxas da reativação da infecção pelo T. cruzi em decorrência da imunossupressão, os resultados do transplante cardíaco na doença de Chagas são altamente satisfatórios e com evolução pós-transplante a médio e longo prazo semelhante aos resultados do transplante cardíaco em pacientes não chagásicos. Esses resultados colocam o transplante cardíaco como uma excelente opção terapêutica nos casos de pacientes chagásicos com grave comprometimento funcional ou com arritmias malignas.

Chagas disease affects 16 to 18 million people in Latin America. In Brazil, the estimate is that there are 5-7 million people infected, located in almost all Brazilian states. Approximately 30% of those infected develop the chronic form of the disease, with high morbidity and mortality rates due to cardiac involvement, and Chagas cardiomyopathy has worse prognosis when compared to other causes of heart failure. In Brazil, approximately 30% of patients with chronic heart failure refractory to medical treatment, referred for heart transplantation have Chagas disease as etiology. The cumulative experience in Brazil shows that despite high rates of reactivation of infection with T. cruzi due to immunosuppression, the results of heart transplantation in Chagas disease are highly satisfactory and the results post-transplant in medium and long-term are similar to those of heart transplantation in patients without Chagas disease. These results make heart transplantation an excellent therapeutic option in cases of patients with Chagas disease with severe functional impairment or malignant arrhythmias.

Description of three novel Lagenidium (Oomycota) species causing infection in mammals / Descripción de tres nuevas especies del género Lagenidium (Oomycota) responsables de infecciones en mamíferos

Background. Recent molecular phylogenetic analysis of Lagenidium strains recovered from subcutaneous lesions in cats, dogs, and a human with lagenidiosis resolved into four clades; one of them was Lagenidium giganteum, but three others were novel. Aims. Due to the recent increase in L. giganteum infections from mammals, we studied 21 Lagenidium strains isolated from dogs and a human available in our collection. Methods. Molecular phylogenetic studies and phenotypic characteristics were used to characterize the strains. Results. We report the finding of three novel species, herein designated as Lagenidium ajelloi, sp. nov., Lagenidium albertoi sp. nov, and Lagenidium vilelae sp. nov. Their morphological and growth features are also presented. Conclusions. Our study revealed the presence of three novel Lagenidium species infecting mammals (AU)

Antecedentes. Estudios recientes, basados en análisis filogenéticos, han revelado la existencia de cuatro clados de Lagenidium aislados en lesiones subcutáneas de gatos, perros y de un ser humano con lagenidiosis. Uno de los aislamientos se identificó como Lagenidium giganteum, pero los otros tres se consideraron especies nuevas. Objetivos. Debido al incremento de las infecciones por L. giganteum en mamíferos, se han estudiado 21 aislamientos de Lagenidium procedentes de animales con lagenidiosis. Métodos. Los aislamientos se clasificaron fenotípicamente, además de llevar a cabo estudios de filogenia con ellos. Resultados. Se proponen tres nuevas especies de Lagenidium: Lagenidium ajelloi, sp. nov., Lagenidium albertoi, sp. nov., y Lagenidium vilelae, sp. nov. Se tratan también sus características morfológicas. Conclusiones. Nuestro estudio reveló la existencia de tres especies nuevas de Lagenidium responsables de infecciones en mamíferos (AU)

Neumorraquis / No disponible

Presentamos el caso de un paciente con infección respiratoria, que acude a urgencias por molestias torácicas. En la radiografía se observa un neumomediastino y enfisema subcutáneo. En la TAC se ve que el aire envuelve y diseca la médula espinal. El caso tiene interés por el escaso número que hay descritos en la literatura

We report a patient with respiratory infection, which came to the emergencyroom with chest discomfort. Radiography pneumomediastinum and subcutaneous emphysema is observed. In the TAC you can see the air surrounds the spinal cord and dissected it. The case is of interest for the small number that have been described in the literature

Perfil de sensibilidade de células sésseis e planctônicas de Escherichia coli a antimicrobianos usados no tratamento da mastite bovina / Sensitivity profile of planktonic and sessile cells of Escherichia coli to antimicrobial used in the treatment of bovine mastitis

Escherichia coli é um micro-organismo altamente adaptativo e sua habilidade em formar biofilmes pode ser fundamental na resistência a tratamentos com antimicrobianos. A avaliação da concentração mínima inibitória (CMI) vem sendo utilizada para verificar a sensibilidade dos micro-organismos aos antimicrobianos. Entretanto, quando se avaliam células sésseis, a concentração do antimicrobiano requerido para erradicação do biofilme é maior do que a determinada pela CMI. Objetivou-se comparar as CMI com as concentrações mínimas de erradicação de biofilmes (CMEB) de antimicrobianos usados no tratamento da mastite em 27 isolados de E. coli produtores de biofilmes provenientes de mastite. Os isolados foram submetidos a testes de sensibilidade a antimicrobianos usados no tratamento da mastite, tanto para células planctônicas, por meio da CMI, quanto para células sésseis, pela avaliação da CMEB. Os resultados revelaram uma alta sensibilidade: apenas quatro (14,8%) isolados obtiveram valores da CMI elevados, variando de 4 a 10µg/mL, sendo classificados como resistentes. Para os demais isolados (85,2%), os valores foram menores, variando de 0,125 a 2µg/mL, classificados como sensíveis. A avaliação de CMEB indicou que a concentração dos antimicrobianos necessária para eliminar as células sésseis variou de 100µg/mL a 500µg/mL. Os valores de CMEB foram significativamente maiores nos isolados grandes e moderados produtores de biofilmes em relação aos isolados fracos produtores de biofilmes (p<0,001). Não houve correlação entre os valores de CMEB e CMI (p>0,05). A escolha da terapêutica antimicrobiana correta para o tratamento de infecções intramamárias em bovinos relacionadas com a produção de biofilmes parece exigir a aplicação de testes mais específicos. Testes de susceptibilidade antimicrobiana baseados apenas em valores de CMI mostraram-se ineficazes em determinar com precisão a susceptibilidade das células bacterianas sésseis.

Escherichia coli is a highly adaptive microorganism. Its ability to form biofilms may be critical for resistance to antimicrobial treatments. Evaluation of minimum inhibitory concentration (MIC) has been used to check the sensitivity of microorganisms to antibiotics, however, when evaluating sessile cells, the required antibiotic concentration to eradicate biofilm is greater than determined by MIC. This study aimed to compare MIC with minimum biofilm eradication concentration (MBEC) of antimicrobials used in mastitis treatment in 27 E. coli biofilm producers isolates from mastitis. Isolates were tested for sensitivity to antimicrobials used in mastitis treatment, for both planktonic cells (by CMI) and sessile cells (by MBEC). The results revealed high sensitivity: only four (14.8%) isolates showed high MIC values, ranging from 4 to 10g/mL and they were classified as resistant. All other isolates (85.2%) showed lower values, ranging from 0.125 to 2mg/mL, and they were classified as sensitive. Evaluation of MBEC indicated that concentration of antimicrobial needed to remove sessile cells ranged from 100mg/mL to 500mg/mL. MBEC values were significantly higher in large and moderate biofilm producers isolates regarding weak biofilm producers isolates (p<0.001). There was no correlation between MBEC and CMI values (p>0.05). The correct choice of antimicrobial therapy for treatment of mammary infections in cattle related to biofilm production seems to require application of more specific tests. Antimicrobial susceptibility testing based only on MIC values proved ineffectiveness to accurately determination the susceptibility of sessile bacterial cells.

Supervivencia del injerto y del receptor en el trasplante renal en el hospital Guillermo Gran Benavente (Concepción, Chile) / Survival of the graft and the host in renal transplant in the Guillermo Gran Benavente Hospital (Concepción, Chile)

Al ser el trasplante renal la mejor opción terapéutica para el tratamiento de la Insuficiencia Renal Terminal, en la ciudad de Concepción (Chile), se inició el programa de Trasplante Renal (TX) en el año 1994. El objetivo de este trabajo es caracterizar la supervivencia del injerto renal de los TX realizados un hospital, de dicha ciudad mediante un estudio descriptivo, transversal, correlacional y comparativo de los resultados obtenidos en dos periodos, A: de 1994 a 2003 y, B: de 2004 a 2012. El análisis estadístico se realizó con el software SPSSv20.0. La funcion de supervivencia con la prueba no-paramétrica de Kaplan-Meier; y para comparaciones de variables se utilizó el test log-rank. De los resultados obtenidos cabe destacar que la supervivencia del paciente trasplantado en el período A fue mejor el primer al año (96%), pero fue menor a los 3 (90%), 5 (86%) y 10 años (72%) respecto al período B en que los valores fueron al año 95%, a los 3 el 90% a los 5 y 10 años el 87% y a los 10 años. La supervivencia del injerto tambien fue mayor en el periodo A que en el B, y mejor cuando hubo un tiempo de isquemia inferior a 24 horas y sin diferencias en relación al sexo del donante y del receptor y al tipo de tratamiento inmunosupreso. Las infeciones fueron la primera causa de muerte del paciente y las complicaciones quirúrgicas la principal causa de la pérdida del injerto (AU)

As the renal transplant is the best therapeutic option for the treatment of End-Stage Renal Disease, in the city of Concepción (Chile), a Renal Transplant Program (TX) was started in 1994. The aim was to characterize the kidney graft survival of TX performed in our hospital, through a descriptive, transversal, correlational and comparative study of the results obtained in two periods, A: from 1994 to 2003 and, B: from 2004-2012. Statistical analysis was performed using the SPSSv20.0 software. The function of survival was calculated using the nonparametric Kaplan-Meier test; and to compare the variables we used the log-rank test. From the results, we emphasize that the survival of patients transplanted in the period A was better in the first year (96%), but was lower at 3 (90%), 5 (86%) and 10 years (72 %) compared to the period B in which the first year was 95%, at 3 of 90% at 5 and 10 years of 87%. Graft survival was also higher in the period A than in B, and better when the time of ischemia was less than 24 hours and no differences in relation to sex of the donor and recipient and type of immunosuppressive treatment. Infections were the first cause of death and surgical complications the main cause of graft loss (AU)

Estado actual sobre el diagnóstico y tratamiento de fístulas aortoentéricas / Current status of the diagnosis and treatment of aortoenteric fistulas

Una fístula aortoentérica (FAE) es una comunicación entre la aorta y un asa de intestino adyacente de manera directa o tras cirugía reconstructiva aórtica o endovascular. Es una entidad con una tasa de morbimortalidad asociada muy elevada, cuyo diagnóstico precisa un alto grado de sospecha según la clínica y datos indirectos de las técnicas de imagen (tomografía computarizada). La opción terapéutica más adecuada continúa siendo un tema controvertido. El tratamiento endovascular de esta complicación presenta unas tasas de morbimortalidad a corto plazo aparentemente menores, aunque su papel como tratamiento definitivo resulta muy discutible. El objetivo de este estudio es ofrecer una revisión actualizada de las modificaciones en el diagnóstico y manejo de las FAE

An aortoenteric fistula (AEF) is a communication between the aorta and an adjacent bowel loop, directly or due to reconstructive aortic or endovascular surgery. It has a very high associated morbidity and mortality rate, and the diagnosis requires a high index of suspicion based on clinical data and indirect imaging techniques (computed tomography). The most appropriate therapeutic option remains controversial. Endovascular treatment of this complication shows apparently lower morbidity and mortality rates in the short-term, although its role as a definitive treatment is very debatable. The objective of this study is to provide an update and review on changes in the diagnosis and management of AEF

Aspectos reprodutivos e produtivos de vacas da raça Holandesa com puerpério normal ou patológico / Reproductive and productive parameters of Holstein cows with normal or pathological puerperium

Foram avaliadas 103 vacas da raça Holandesa de primeira, segunda ou terceira ordens de lactação, com o objetivo de comparar aspectos reprodutivos e produtivos dos animais com puerpério normal ou patológico. Exames ginecológicos foram realizados semanalmente, do parto ao final do puerpério, por meio de palpação transretal, ultrassonografia e vaginoscopia. As incidências de partos gemelares, partos auxiliados, retenção de placenta e infecções uterinas até o primeiro serviço foram de 11,7%, 20,4%, 38,8% e 75%, respectivamente. A involução uterina e a primeira ovulação ocorreram aos 33,5±11,1 e 43,6±21,5 dias após o parto, respectivamente, com diferenças (P<0,001) entre vacas com ou sem infecção uterina. O primeiro serviço ocorreu aos 75,9±31,0 dias após o parto e a taxa de gestação foi de 20,7%. A produção de leite diária foi de 27,9±7,3 litros por vaca até 42 dias após o parto. O prejuízo com a redução na produtividade e o descarte do leite contaminado com resíduos de antibiótico foi equivalente a 598 litros de leite por vaca com retenção de placenta e infecção uterina. A alta incidência de transtornos puerperais interferiu na fertilidade e na produção de leite, causando elevado impacto econômico para a propriedade.

The study was performed with 103 Holstein cows of first, second or third orders of lactation, and aimed to compare reproductive and productive parameters of animals with normal or pathological puerperium. Uterine and ovarian examinations were performed weekly until 42 days after parturition, by rectal palpation, vaginoscopy and ultrasonography. The incidence of twin pregnancies, assisted births, retained placenta, and uterine infection until the first service, were 11.7%, 20.4%, 38.8% and 75%, respectively. Uterine involution and detection of the first corpus luteum occurred at 33.5±11.1 and 43.6±21.5 days after parturition, respectively, and differed (P<0.01) between cows with or without uterine infection. The first artificial insemination occurred in average at 75.9±31.0 days after parturition, and the pregnancy rate was 20.7%. Average daily milk yield was 27.9±7.3 liters/cow until 42 days after parturition. Financial losses related to decreased milk production and discarding of milk contaminated with antibiotic residues corresponded to 598 liters of milk/cow presenting retained placenta and uterine infection. The high incidence of puerperal diseases negatively affected the fertility and milk production, causing large economic impact to the milk production system.

Fatores de risco para mastite e qualidade do leite no município de Altônia-PR / Risk factors for mastitis and milk quality in the county of Altonia_PR / Factores de riesgo para mastitis y calidad de la leche en el municipio de Altonia-PR

Esta pesquisa teve como objetivo determinar a incidência da mastite, fatores de risco associados à mastite e avaliar a qualidade do leite no município de Altônia. Foram avaliadas 24 propriedades em um total de 248 vacas, nas quais se realizaram procedimentos nas propriedades, o teste da caneca telada, o California Mastitis Test, a coleta para exames laboratoriais e aplicação do questionário. Desse modo, 82 animais apresentaram reações positivas ao Califórnia Mastitis Test e destes 54 foram positivos ao exame microbiológico, perfazendo um índice de 21,80% de mastite. No exame microbiológico a maior prevalência foi de Staphylococcus aureus com 51,85%, seguida por Staphylococcus coagulase negativo (29,63%), Streptococcus dysgalactiae (5,56%); acompanhado de Staphylococcus coagulase positivo VP negativo (5,56%) e Corynebacterium sp. (5,56%). A mediana da contagem de células somáticas relacionado ao exame microbiológico para o Staphylococcus aureus foi 1.650 (CCS x 10³), e para o Staphylococcus coagulase negativo 1.324,5 (CCS x 10³). Em se tratando dos constituintes do leite, também não foram encontradas diferenças significativas em relação aos exames positivos dos principais isolados e negativos no exame microbiológico. Os fatores de risco com resultado estatisticamente significativo foi a não realização do pós-dipping; descarte de animais por mastite e a lavagem dos tetos com água. Considerando a detecção das falhas produtivas, medidas de controle estão sendo desenvolvidas para a melhoria da qualidade do leite no município e sanidade do rebanho.

This research aimed to determine the incidence of mastitis risk factors associated with mastitis and evaluate the quality of milk in the city of Altonia. We evaluated 24 properties for a total of 248 cows, which were performed procedures in the properties, the test mug screened, the California Mastitis Test, collection for laboratory tests and the questionnaire. 82 animals showed positive reactions to the California Mastitis Test and of these 54 were positive for microbiological examination, for a rate of 21.80% of mastitis. Microbiological examination was a higher prevalence of Staphylococcus aureus with 51.85%, followed by coagulase-negative Staphylococcus (29.63%), Streptococcus dysgalactiae (5.56%), followed by Staphylococcus coagulase positive VP negative (5.56%) and Corynebacterium sp. (5.56%). The median somatic cell counts related to microbiological test for Staphylococcus aureus was 1.650 (CCS x 10 ³), and coagulase-negative Staphylococcus 1324.5 (CCS x 10 ³). In the case of milk constituents, also found no significant differences in relation to the examination of the main positive and negative isolates microbiological examination. Risk factors with a statistically significant result was not performing post-dipping; disposal of animal by mastitis and washing and washing of roofs with water. Considering the detection of failures productive, control measures are being developed to improve the quality of milk in the city and health of the herd.

Esta investigación tuvo como objetivo determinar la incidencia de mastitis, factores de riesgo asociados a la mastitis y evaluar la calidad de la leche en el municipio de Altônia. Se evaluó 24 propiedades con un total de 248 vacas, en las cuales se realizaron procedimientos en las propiedades, el test de la jarra con tela, el California Mastitis Test, la recopilación para exámenes de laboratorio y aplicación del cuestionario. Así, 82 animales mostraron reacciones positivas al California Mastitis Test y de estos 54 fueron positivos al examen microbiológico, con una tasa de 21,80% de mastitis. En el examen microbiológico la mayor prevalencia fue de Staphylococcus aureus con 51,85%, seguido por Staphylococcus coagulase negativo (29.63%), Streptococcus dysgalactiae (5,56%); seguido de Staphylococcus coagulase positivo VP negativo (5.56%) y Corynebacterium sp. (5,56%). La mediana del contaje de células somáticas relacionado al examen microbiológico para Staphylococcus aureus fue 1,650 (CCS x 10 ³), y para Staphylococcus coagulase negativo 1324.5 (CCS x 10 ³). En el caso de los componentes de la leche, también no se encontraron diferencias significativas en relación a los exámenes positivos de los principales aislados y negativos en el análisis microbiológico. Los factores de riesgo con resultado estadísticamente significativo fue la no realización del pós-dipping, descarte de animales por mastitis y el lavaje de los techos con agua. Considerando la detección de fallos productivos, medidas de control están siendo desarrolladas para mejorar la calidad de la leche en el municipio y la salud del rebaño.

Levantamento e identificação dos aspectos epidemiológicos da raiva canina no município de Cuiabá – MT / Survey and identification of the epidemiological aspects of canine rabies in the city of Cuiabá-MT

Reconhecida desde a antiguidade, a raiva é uma infecção aguda do sistema nervoso central que acomete mamíferos, sendo causada por um RNA vírus da família Rabidoviridae, gênero Lyssavírus. O Brasil, desde a implantação do programa de controle da raiva em áreas urbanas, vem apresentando um declínio de casos de raiva em cães e em seres humanos. Em Cuiabá, as atividades realizadas pelo Centro de Controle de Zoonoses voltadas para o controle da raiva como: vacinação antirrábica animal, bloqueios de foco, captura de animais errantes, entre outros, permitiu o bloqueio da circulação do vírus na espécie canina. Desde 2008, o município de Cuiabá não registra nenhum caso da doença na espécie canina. Com o objetivo de conhecer a distribuição temporal da raiva canina em Cuiabá- MT, assim como identificar os aspectos epidemiológicos dos cães infectados pelo vírus rábico e verificar as medidas de profilaxia para a raiva canina, adotadas pelo Centro de Controle de Zoonose do município de Cuiabá no período de janeiro de 2002 a dezembro de 2008, realizou-se o presente estudo. Para o estudo observacional descritivo foi empregado o banco de dados referente à série histórica do CCZ e do Laboratório de Apoio a Saúde Animal – LASA ambos situados no município de Cuiabá- MT. O período de estudo foi de janeiro de 2002 a dezembro de 2008. Neste período foram examinadas 1021 amostras de cérebro de cães, destas 8,71% (89/1021) foram positivas e 91,29% (932/1021) negativas para a raiva. Os meses de maior incidência da doença foram os meses de janeiro 15,05% (14/93), fevereiro 12,5% (9/72), março 12,5% (9/72), abril 14,14% (9/72) e dezembro 13,69% (10/73). O maior número de cães doentes era macho 59,55% (53/89) com idade acima de dois anos 50,55% (45/89) e não domiciliados 67,41% (60/89). Em relação à imunoprofilaxia, a maioria dos cães 99,63% foi vacinada em campanhas. A cobertura vacinal ficou acima dos 80% exceto em 2006. Entre os animais que apresentaram a enfermidade o maior número, 67,41% (60/89), foi de cães não domiciliados, os chamados cães errantes. O percentual de cães domiciliados infectados pelos VR foi igual a 32,58% (29/89). As campanhas de vacinação, portanto, são fundamentais para a imunização do maior número de animais possível e a sociedade deve se conscientizar sobre a importância da raiva e as medidas que devem ser tomadas para controlá-la.

Known since the ancient times, the rabies is an acute infection of the central nervous system that affects mammals, caused by an RNA virus of the Rhabidoviridae family, Lyssavirus gender. Since the implantation of the urban area rabies control program in Brazil the number of cases in dogs and human have shown a decrease. In Cuiabá, the efforts to control the rabies, such as animal vaccination, focus isolation, capture of nomad animals and others realized by the Zoonosis Control Center has leaded to locking in the viral circulation in the canine species. Since 2008, zero cases of the disease in dogs were reported. In order to know the temporal distribution of canine rabies in Cuiabá – MT and identify the epidemiologic aspects of the rabies’s infected dogs, and verify the canine rabies’s profilatic actions of the Zoonosis Control Center of the city of Cuiabá, during the period of January, 2002 to December , 2008, the present study was performed. The historic data base from Cuiabá - MT was obtained at the Zoonosis Control Center and at the Animal Health Support Laboratory and used to perform the descriptive and observational study. During the performance of the study, 1021 samples of canine’s brains were examined, 8,71% (89/1021) of them were positive and 91,29% (932/1021) of them were negative for the rabies test. The Months with higher incidence were January with 15,05% (14/93), February with 12,5% (9/72), March with 12,5% (9/72), April with 14,14% (9/72) and December with 13,69% (10/73). The major part of the infected dogs were males with 59,55% (53/89) older than two years old 50,55% (45/89) and were nomads animals 67,41% (60/89). 99,63% of the infected dogs were vaccinated in anti rabies vaccination campaigns. The vaccinal cover was higher than 80%, except in 2006. The percentual of the domiciled infected dogs by the rabies virus were 32,58% (29/89). Therefore the vaccination campaigns are essential for the immunization of a higher number of animals, and the society must be awareabout the importance of rabies and about the actions to control it.

Incidencia de leptospirosis en España entre 2009-2012 / Incidence of leptospirosis in Spain, 2009-2012

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Prototecose: uma doença emergente / Protothecosis: an emergent disease

Prototecose, causada por Prototheca zopfii ou P. wickerhamii, é uma doença emergente em animais e humanos. Em bovinos, P. zopfii é uma importante causa de mastite ambiental. Em cães e gatos, a prototecose é causada principalmente por P. zopfii. Em cães, causa infecção cutânea ou uma forma sistêmica envolvendo diversos órgãos. Em gatos, predominam as lesões tegumentares na região da face e plano nasal. No homem, a prototecose, causada principalmente por P. wickerhamii, manifesta-se sob três formas: cutânea, articular com bursite do olécrano e sistêmica. Pode ocorrer em indivíduos imunocompetentes, os quais podem apresentar bursite e/ou infecções cutâneas localizadas, ou em indivíduos imunossuprimidos, nos quais a enfermidade pode ser disseminada e/ou com envolvimento visceral. A prototecose causada por P. wickerhamii foi descrita recentemente em caprinos como causa de rinite afetando o vestíbulo nasal, união mucocutânea, pele da face e orelha. Nesta revisão são abordadas as características microbiologias e susceptibilidade a antimicrobianos do agente, e a epidemiologia, sinais clínicos, patologia, diagnóstico, tratamento e controle da prototecose em animais domésticos e no homem.

Protothecosis, caused by Prototheca zopfii or P. wickerhamii, is an emergent disease of human and animals. In cattle, P. zopfii is an important cause of environmental mastitis. In dogs and cats protothecosis is caused mainly by P. zopfii, causing cutaneous infections or a systemic form affecting many organs in dogs, and cutaneous infection affecting mainly the skin of the face and nose in cats. In humans, protothecosis, caused mainly by P. wickerhamii, occurs in three forms: cutaneous; olecran bursitis; and disseminated. The lesion is usually localized in the site of inoculation in immunocompetent individuals; however, in immunocompromised patients, it can become widespread. Protothecosis caused by P. wickerhamii was recently reported in goats causing rhinitis and dermatitis of the face and pinna. This paper reviews microbiologic characteristics and susceptibility to antimicrobials of Prototheca spp., and the epidemiology, clinical signs, pathology, diagnosis, treatment and control of protothecosis.

Hematuria macroscópica gestacional: a propósito de un caso tratado con RIRS / Gestational gross hematuria: report of a case treated with RIRS

La hematuria, durante la gestación, es debida a causas urológicas comunes como la litiasis y la infección de orina, los tumores del riñón y la vejiga, y las malformaciones vasculares renales. Anomalías de la implantación de la placenta y complicaciones obstétricas pueden ocasionar sangrado en orina. Entre las causas nefrológicas figura el síndrome hemolítico urémico. Alteraciones hematológicas asociadas a la gestación como la plaquetopenia favorecen la hematuria, en especial si existe una patología urológica subyacente. Se presenta un caso clínico de hematuria recidivante en una gestante que requirió estudio con RM y URS, resuelto después del parto con cirugía endoscópica intrarrenal (RIRS) (AU)

Hematuria during pregnancy is due to common urological causes such as stones and urinary tract infection, kidney and bladder tumors, and renal vascular malformations. Abnormalities of placenta implantation and obstetric complications are the cause of bleeding in urine. Among nephrological causes is the hemolitic-uremic syndrome. Hematologic abnormalities as a thrombocytopenia favor gestational hematuria, especially if there is an underlying urologic pathology. A case report of recurrent hematuria in a pregnant is presented. MRI and URS was required to study it. The case was resolved after birth with intrarenal endoscopic surgery (RIRS) (AU)

Semiología renal y genitourinaria en pediatría: segunda parte / Nephrologoy and urology semiology in children: second part

Entre las patologías renales en niños, se encuentra la injuria renal aguda; que es la pérdida súbita de la función renal; el síndrome nefrótico que es el espectro más grave de proteinuria; el síndrome nefrítico caracterizado por la riada edema, hematuria macro o microscópica e hipertensión arterial.

Among the renal pathology in children is acute kidney injury, which is the sudden loss of kidney function, the nephrotic syndrome is the most severe spectrum of proteinuria, the nephrotic syndrome characterized by the triad of edema, macro or microscopic hematuria and arterial hypertension.

Utilização do acesso venoso central em pacientes entre 0 e 2 anos da Unidade de Terapia Intensiva Neonatal e Pediátrica em Tubarão - SC / Use of central venous access in 0-2 years old patients in a Pediatric Intensive Care Unit in South Brazil

Objetivo: Conhecer as indicações e os fatores relacionados ao procedimento de acesso venoso central em crianças de idade entre 0 e 2 anos internadas na UTINeonatal e Pediátrica do Hospital Nossa Senhora da Conceição (HNSC), na Cidade de Tubarão, Santa Catarina,entre novembro de 2001 e novembro de 2005. Métodos: Estudo observacional, com delineamento transversal, constituído por pacientes com idade entre 0 e 2 anos submetidos ao procedimento de acesso venosocentral e que estiveram internadas na UTI Neonatal e Pediátrica do HNSC entre novembro de 2001 e novembrode 2005. Realizou-se a coleta de dados a partir de prontuários dos pacientes.Resultados: Houve predominância do sexo masculino, 57,7%. A maior proporção dos pacientes tinha idademédia de 2,47 meses. A administração de hidratação endovenosa e drogas foi a principal indicação para o acesso (87,7%), seguida pela indicação de nutrição parenteral em 60%. O cateter com calibre 17G foi o mais utilizado em todos os vasos dissecados, independente da idade. Em 99,2% a via de acesso utilizada foi a dissecçãodo vaso. Dentre os vasos dissecados, a veia basílica foi a mais utilizada, 60,8% das vezes. Óbito foi à causa da retirada do cateter em 30,8% das vezes. Complicações ocorreram em 10,2% dos casos, com predomínio das complicações tardias (7,9%). Conclusão: Os cateteres inseridos em vasos centrais proporcionam um acesso vascular prolongado, com baixo risco de complicações e segurança para o paciente. A veia basílica é uma via segura para se obter um acesso venoso central, com índices de complicaçõesmuito baixos. As taxas de complicações encontradas no presente estudo foram menores que as encontradas naliteratura.

Aim: Know the signs and the factors related to the procedure of central venous access in children from 0to 2 years old, hospitalized in Neonatal and Pediatric ICU (Intensive Care Unit) of Nossa Senhora da ConceiçãoHospital (HNSC), in Tubarão city, Santa Catarina, from November 2001 to November 2005. Methods: observational study, with cross design,consisting by patients from 0 to 2 years old, submitted to the procedure of central venous access and who werehospitalized in HNSC Neonatal and Pediatric ICU from November 2001 to November 2005. Data collection wasmade from the patient’s medical reports.Results: There was a predominance of male, 57.7%. The largest proportion of the patients had an average age of 2.47 months. The administration of intravenous hydration and drugs was the main indication for the access (87.7%), followed by the indication ofparenteral nutrition in 60%. The catheter with calibre 17G was the most used in all dissected vessels, regardlessof age. In 99.2%, the path of access used was vessel dissection. Among the dissected vessels, the basilic vein was the most used, 60.8% of the situations. Death was why the catheter was withdrawn in 30.8% of the situations. Complications occurred in 10.2% of cases, with predominance of late complications (7.9%). Conclusion: The catheters inserted in central vesselsprovided an extended vascular access, with low risk of complications, and safety for the patient. The basilicvein is a safe path to get to a central venous access with very low rates of complications. The rates of complicationsfound in this study were lower than those ones found in the literature.