Influência da restrição alimentar e do estresse térmico sobre parâmetros fisiológicos em ovinos / [Influence of food restriction and heat stress on physiological parameters in sheep]

Objetivou-se avaliar as alterações fisiológicas de ovinos submetidos à restrição alimentar, expostos à radiação solar e à sombra. Dez borregas mestiças foram divididas igualmente em dois grupos: grupo radiação solar - GRS, animais expostos ao sol durante o dia; e grupo sombra - GS, animais alocados dentro de um galpão à sombra. Nos seis dias iniciais de experimento, os animais foram submetidos à restrição alimentar, com acesso apenas à água, já expostos ao sol ou à sombra. Nos seis dias subsequentes, foi ofertada dieta composta por ração e feno de alfafa (3%PV). Os parâmetros avaliados foram frequência respiratória (FR), temperatura retal (TR), ß-hidroxibutirato (BHB), pH urinário, ingestão de matéria seca (IMS) e dados bioclimáticos (temperatura, umidade relativa do ar e índice de temperatura e umidade - ITU). A FR foi o parâmetro em que houve maior diferença significativa entre os grupos (p<0,05). O balanço energético negativo foi constatado em todos os animais (BHB>0,8mmol/L; pH<7,0). Ovelhas que sofrem restrição alimentar durante períodos de alta temperatura e umidade têm menor frequência respiratória e temperatura interna, independentemente de estar na sombra ou pleno sol. Porém, quando normalizado a oferta de alimento as ovelhas em pleno sol têm menor ingestão de matéria seca.(AU)

We aimed to evaluate physiological changes in sheep submitted to food restriction, exposed to the sun or shade. Ten ewe lambs were equally divided into two groups: Sun Radiation Group - GRS, exposed to sun during day hours, and Shade Group - GS, with animals placed inside a barn. In the first six days of experiment, animals were submitted to food restriction, with access to fresh water, already exposed to sun and shade. In the following six days alfalfa hay and concentrate were provided to the animals (3%BW). Parameters assessed were respiratory rate (FR), rectal temperature (TR), ß-hydroxybutyrate, urinary pH, dry matter intake (IMS) and climate data (air temperature, humidity, and temperature-humidity index - ITU). The parameter that most differed between groups was FR. All animals presented negative energy balance (BHB>0.8mmol/L; pH<7,0). Ewe lambs submitted to food restriction during periods of high temperature and humidity have lower respiratory rate and intern temperature, independently of being exposed to sun or shade. However, when food was offered animals exposed to sun had lower dry matter intake.(AU)

Ocorrência de espécies do gênero Eimeria Schneider, 1875, em cordeiros confinados / Occurrence of Eimeria Schneider, 1875 species in feedlot lambs

Este trabalho descreve as espécies do gênero Eimeria Schneider, 1875, que ocorreram em um confinamento de cordeiros, bem como as dinâmicas da eliminação de oocistos no ambiente, a correlação com o ganho de peso médio diário (GMD) e as variáveis climáticas, durante nove semanas. Cento e quatro cordeiros de diversas raças e cruzas, com aproximadamente 60 dias de vida, foram confinados e submetidos a pesagens e avaliações clínicas e coprológicas periódicas. Amostras de fezes com mais de 500 oocistos de Eimeria por grama de fezes (OoPG) foram separadas para esporulação e identificação das espécies. Entre os oocistos avaliados, foram identificadas as espécies: E. parva, E. crandallis, E. ovinoidalis, E. weybridgensis, E. bakuensis, E. marsica, E. ahsata, E. granulosa, E. pallida e E. faurei. Eimeria crandallis foi a mais frequente, presente em 44 das 58 amostras avaliadas, enquanto E. parva foi a mais abundante nas contagens individuais. Nenhum dos animais apresentou quadro de eimeriose, e coeficientes negativos foram encontrados nas correlações OoPG vs. GMD (-0,075) e OoPG vs. pluviosidade (-0,1164), enquanto para OoPG vs. temperatura foi encontrado coeficiente positivo (0,2914). Animais positivos para a eliminação de oocistos apresentaram infecção mista nas avaliações semanais, com até sete espécies parasitando um mesmo cordeiro.(AU)

This study describes the Eimeria Schneider, 1875 species that occurred in a lamb feedlot, as well as the dynamics of oocyst output in the environment and its correlation with daily weight gain (DWG) and climatic variables during nine weeks. One hundred and four lambs of various breeds and crossbreeds, at approximately 60 days old, were placed in a feedlot and submitted to periodic weighing and clinical and coprological evaluations. Fecal samples presenting more than 500 Eimeria spp. oocysts per gram (OPG) were separated for sporulation, and oocysts were identified at species level. Among evaluated oocysts, the following species were identified: E. parva, E. crandallis, E. ovinoidalis, E. weybridgensis, E. bakuensis, E. marsica, E. ahsata, E. granulosa, E. pallida and E. faurei. Eimeria crandallis was the most frequent one, being identified in 44 of the 58 evaluated samples, while E. parva was the more abundant in individual counts in most weeks. None of the animals presented clinical signs of eimeriosis and negative correlation coefficients were found for OPG vs DWG (-0.075) and OPG vs rainfall, as for OPG vs temperature this coefficient was positive. Animals shedding oocysts presented mixed infection, with up to seven species parasitizing the same lamb.(AU)

Transferrina como marcador de maturação pulmonar em cordeiros nascidos a termo ou prematuros / Transferrin as a marker of pulmonary maturation in lambs born at term or premature

O objetivo do estudo foi procurar proteínas de fase aguda que possam indicar sinais de maturação no neonato prematuro, por meio da quantificação sérica delas. Identificou-se a imunoglobulina A, a ceruloplasmina, a haptoglobina, a glicoproteína ácida, a transferrina, a albumina e as imunoglobulinas G de cadeias leve e pesada, pela comparação do perfil dos proteinogramas de cordeiros nascidos a termo com os prematuros submetidos a diferentes protocolos terapêuticos, a fim de estimular a atividade respiratória. Constituíram-se seis grupos: PN (n= 9): nascidos de parto normal; CN (n= 7): nascidos de cesariana em tempo normal de gestação; CP (n= 6): nascidos de cesariana prematura sem nenhum tipo de tratamento; DEX (n= 9): prematuros cujas mães receberam dexametasona pré-parto; SURF (n= 6): prematuros tratados com surfactante; e DEXSURF (n= 6): prematuros tratados com surfactante cujas mães receberam dexametasona pré-parto. As avaliações foram realizadas nos momentos imediatamente após o nascimento (M0), após 24 (M24) e após 48 horas (M48). As amostras foram processadas por meio de eletroforese em gel de poliacrilamida contendo dodecil sulfato de sódio (SDS-PAGE). A albumina, as imunoglobulinas e a proteína total dos cordeiros tiveram elevação após a ingestão de colostro. Maiores valores séricos de transferrina são referentes a maior período gestacional, podendo essa proteína ser utilizada como marcador de maturação neonatal.(AU)

The aim of this study was to search for acute phase proteins that could indicate signs of maturation in the premature neonate by quantifying them in serum. Immunoglobulin A, ceruloplasmin, haptoglobin, acid glycoprotein, tranferrin, albumin, light and heavy chain immunoglobulin G were quantified, comparing the profile of proteinograms from term to preterm lambs submitted to different protocols that stimulate respiratory activity. Six groups were used: PN (n= 9): born from normal birth; CN (n= 7): born from caesarean section at normal time of gestation; CP (n= 6): born from premature cesarean without any type of treatment; DEX (n= 9) preterm whose mothers received prepartum dexamethasone; SURF (n= 6) preterm treated with surfactant; DEXSURF (n= 6): preterm treated with surfactant whose mothers received prepartum dexamethasone. The evaluations were performed immediately after birth (M 0), after 24 and 48 hours (M 24 and M 48). Samples were processed with sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Albumin, immunoglobulins, and serum total protein of the lambs were elevated, after colostrum ingestion. Higher serum transferrin values refer to a longer gestational period, and this protein may be used as a marker of neonatal maturation.(AU)

[Discontinuation or tapering strategies of biologics in rheumatoid arthritis in remission]. / Stratégies d'arrêt ou de réduction des biomédicaments dans la polyarthrite rhumatoïde en rémission.

The arrival of new drugs and new therapeutic strategies allowed to reach sustained remission in an increasing number of patients with rheumatoid arthritis. The study of biologic disease-modifying anti-rheumatic drugs (bDMARDs) adaptation strategies is a need to optimize the benefit/risk balance and cost/effectiveness ratio of these molecules. Current recommendations such as EULAR 2016 propose tapering bDMARDs, especially when combined with a csDMARD, when the patient is in remission after stopping persistent glucocorticoids. The analysis of literature comprising 22 studies shows that a bDMARD adaptation is possible in established rheumatoid arthritis when clinico-biological and ultrasound remission is maintained over six months. Priority should be given to a progressive tapering strategy doses controlled by disease activity while maintaining "tight control" to identify and effectively treat a relapse, a retreatment being usually favorable.

[Role of transthoracic echocardiography in the diagnosis of acute pulmonary embolism]. / Apport de L'echocardiographie Transthoracique dans le Diagnostic de L'embolie Pulmonaire.

OBJECTIVES: The objective of our work is to determine the value of transthoracic echocardiography (TTE) in the diagnosis of pulmonary embolism (PE) and its place in the diagnostic strategy in a cardiology department in Tunisia. MATERIAL AND METHODS: It is a retrospective study including 43 patients between 1993 and 2003 in the cardiology department of the "Hôpital Militaire Principal d'Instruction de Tunis" for acute pulmonary embolism. RESULTS: Our population had a feminine ascendancy. The average age was 53.9 +/- 17.6 years. In patients with positive pulmonary perfusion scintigram and by taking pulmonary helical CT as diagnostic gold standard, we found that TTE yielded a sensivity of 74 % and a specificity of 25 % for the diagnosis of pulmonary embolism. The most common echocardiographic signs were the right cavities dilation and the increase of right pressures. CONCLUSION: Transthoracic echocardiography is a good test to screen patients for suspected PE because it has an excellent sensitivity. It must be often completed by transesophageal echocardiography and integrated in all diagnostic approach of pulmonary embolism.

[Management of pulmonary embolism in a cardiology department]. / Prise en charge de l'embolie pulmonaire en milieu cardiologique: expérience d'un hôpital tunisien.

OBJECTIVES: The objective of our work is to study the clinical features and the management of pulmonary embolism in a cardiology department. MATERIAL AND METHODS: It is a retrospective study including 43 patients between 1993 and 2003 in the cardiology department of a Tunisian hospital for acute pulmonary embolism. RESULTS: The most common clinical signs were dyspnea, pleural pain and deep venous thrombosis. The most common physical signs were tachypnea and tachycardia. Electrocardiographic abnormalities were found in 38 patients (88.4%). Chest X-ray was abnormal in 25 patients (60.5%). The arterial blood gas found hypoxia and\or hypocapnia in 95% of cases. D-dimer was high in almost totality of patients (96%). US doppler of deep leg veins was positive in more than 40% of patients. Transthoracic echocardiography was normal in more than 40% of the patients. Lung scan noted a high or very high probability in 87% of cases. Pulmonary helical CT was positive in majority of cases. Unfractionated heparin was administered to about 75% of patients and low-molecular-weight-heparin was prescribed at only 40% of patients. CONCLUSION: Management of pulmonary embolism in our cardiology department is characterized by the frequent use of non invasive techniques on the diagnostic view and appeal to heparine on the therapeutic view.

[Endo arterial investigation: suspicious for the cholesterol crystal embolism disease]. / Explorations endo-arterielles: se mefier de la maladie des embols de cholesterol!!

BACKGROUND: Cholesterol crystal embolism (CCE) is a rare disorder which can complicate cardiac catheterization, angiographic studies and cardiovascular surgery. The CCE exposes to a great risk of renal failure and it can even threaten life by means of a multi visceral failing syndrome. AIM: Report a new case of CCE following cardiac catheterization. CASE: We report the observation of a 63-year-old patient who had a coronary angiography via the right femoral artery after a myocardial infarction. This examination has showed a multi-vessel coronary disease. 15 days later, the patient presented purplish and painful discoloration of his toes. The laboratory findings showed a mild inflammatory syndrome and eosinophilia at 700 / microL. There was not a renal dysfunction nor proteinuria nor hematuria. We performed a skin biopsy and made the diagnosis of CCE. Trans oesophageal echography objectified an irregular atherosclerotic plaque in the isthmic aorta. The CT scan revealed a spindle-shaped aneurysm in the end of the abdominal aorta. This aneurysm contains a marginal surrounding thrombosis with high embolic risk. The patient was put under clopidogrel, enoxaparin, simvastatin, colchicine and atenolol and operated successfully. CONCLUSION: The two particularities of this observation are, on one hand, the absence of a renal involvement, which represents the main prognostic factor of the CCE. On the other hand, the CCE has revealed a very unstable aneurysm of the aorta which could be complicated during the cardiac catheterisation. The CCE is a difficult diagnosis that must be remembered before any cardiac catheterisation, because it often reflects unstable aortic atherosclerotic lesions.

[Predictive factors of normal coronary angiography]. / Les facteurs predictifs d'une coronarographie normale.

The aim of this study is to compare two groups of patients Group A consisted of 120 patients (70 men and 50 women) hospitalised for anginal symptoms, with either clinical or electrical positive exercise test and/or ischemic events on a 24 H electrocardiography and having angiographically normal coronaries Group B consisted of 120 patients (102 men and 18 women) hospitalised for an acute coronary syndrome with pathological coronaries. The analysis of the 2 groups showed that in the group A the average age was lesser (56 years vs 60 years), women's percentage was higher (41% vs 15%) and cardiovascular risk factors were less frequent. Data from non invasive tests was significantly different in the 2 groups: the exercise test showed both clinical and electrical ischemic events in 35% of the patients in group A versus 75% in group B (p < 0.01) and the 24 h electocardiography showed ST depression in 9% of patients in group A versus 25% in group B (p < 0.01%). The coronary angiography is an invasive and an expensive procedure. The results of our study allow us to modulate its indications, especially in young women patients, with few or no cardivascular risk factors and with only electrical positive exercise test.

[Dumesnil's method: is it viable?]. / La méthode de dumesnil: est-elle fiable?

BACKGROUND: Left ventricular (LV) ejection fraction (EF) is an indicator of left ventricular systolic function and is a potent predictor of cardiovascular mortality. LVEF is assessed by a variety of methods, however echocardiography is the most used in clinical practice. Simpson biplane multiple disc method (BMDM) is recommended by the American Society of Echocardiography; Dumesnil's method based on doppler echocardiography seems to be simpler and theoritically less influenced by distortion of LV geometry. OBJECTIVE AND METHODS: To assess the accuracy and reproducibility of Dumesnil's method a group of 100 patients proposed for coronarography with left ventricular angiography, prospectively underwent LVEF measurements by both BMDM and Dumesnil's method. RESULTS: Compared with LV angiography, the correlation coefficient for the Dumesnil's method was r = 0.85 and it was r = 0.9 for BMDM. Correlation in patients with LV regional asynergy were respectively r = 0.69 and r = 0.85. Intraobserver and interobserver variabilities were less then 7% for both echocardiographic methods. CONCLUSION: Although Dumesnil's method is less accurate than BMDM, it is simpler, more rapid with a satisfactory reliability and reproducibility.

[Contracted endocardial fibroelastosis in children: report of a case]. / La fibroelastose endocardique contractée de l'enfant: a propos d'un cas.

Endocardial fibroelastosis is un uncommon disease and it has a very bad prognosis since fatal evolution is usual before 2 years old. We report the case of a 20 years old woman who is affected with the contracted form of this disease associated with atrial septal defect (ASD) and mitral regurgitation. This disease was discovered by endocardial biopsy when she was 4 years old and underwent surgical resection of endocardial fibrosis, a patch on the ASD and mitral valve replacement. She was rehospitalised 15 years later with heart failure although continuous digitoxin therapy.

[Coxiella burnetti infectious endocarditis. Apropos of a case]. / L'endocardite infectieuse à Coxiella burnetti. A propos d'un cas.

Chronic forms of Q fever (endocarditis) are rare, but are responsible for severe and desperately recurrent infections, resulting in multiple valve replacements with a reserved prognosis. The authors report the case of a 35-year-old patient with a known history of rheumatic fever, who developed blood culture negative infectious endocarditis on a mitral bioprosthesis. The diagnosis of Q fever was based on serological arguments. Despite long-term antibiotic therapy, serology remained strongly positive and was associated with repeated mitral valve disinsertion. The patient died immediately after the fourth operation in a context of haemodynamic failure. This clinical case emphasizes the importance of performing Q fever serology in any case of culture negative endocarditis and the therapeutic difficulties encountered in chronic recurrent endocarditis.

[A clinical trial of a titrated Olea extract in the treatment of essential arterial hypertension]. / Essai clinique d'un extrait titré de feuilles d'Olivier dans le traitement de l'hyptension arterielle essentielle.

A clinical assay of Olea europaea L. aqueous extract was carried on two groups of patients suffering with essential hypertension. 12 patients consulting for the first time, 18 patients with antihypertensive treatment. Treatment based on Olea europeae L. leaf aqueous extract was given (400 ng x 4/24 h) during 3 months, after 15 days treatment based on placebo. We note for all patients a statistically significant decrease of blood pressure (p < 0.001), we didn't find any modification of biological parameters excepted a significant little decrease of glycemia and calcemia p < 0.01 and p < 0.01 respectively. We didn't find any side effect in the two groups.

[Hydatid cyst of the heart of multivesicle type. Apropos of a case]. / Kyste hydatique du coeur de type multivésiculaire. A propos d'un cas.

The authors report the case of a 30 year-old man on whom the diagnosis of hydatic cyst of the heart (HKC) was strongly suspected on bi-dimensional echocardiography and confirmed by surgery. This case is interesting because this HCH, completely latent clinically, was discovered by echocardiography performed in view of a localized infra-epicardic ischemia, the major contribution of bi-dimensional electrocardiography enabling to make a quick and easy anatomical and topographic diagnosis, the primary nature of this hydatic localization which does not affect any other organ, and finally the multivesicle aspect of the cyst, rather unusual in single localizations of hydatic cyst of the heart. A brief review of the literature is then presented.