Pulmonary Granuloma Is Not Always the Tuberculosis Hallmark: Pathology of Tuberculosis Stages in New World and Old World Monkeys Naturally Infected with the Mycobacterium tuberculosis Complex.

We present the pathology of monkeys naturally infected with Mycobacterium tuberculosis complex from five different colonies in Rio de Janeiro, Brazil. On the basis of gross and histopathological findings, the lesions were classified into chronic-active, extrapulmonary, early-activation or latent-reactivation stages. Typical granulomatous pneumonia was seen in 46.6% of cases (six rhesus monkeys [Macaca mulatta] and one Uta Hick's bearded saki [Chiropotes utahickae]). The absence of pulmonary granulomas did not preclude a diagnosis of tuberculosis (TB): classical granulomatous pneumonia was observed in the chronic-active and latent-reactivation stages but not in the extrapulmonary and early-activation stages. The early-activation stage was characterized by interstitial pneumonia with a predominance of foamy macrophages and molecular and immunohistochemical evidence of M. tuberculosis complex infection. TB should be considered as a cause of interstitial pneumonia in New World Monkeys. We recommend the use of immunohistochemistry and molecular analysis for diagnosis of TB, even when typical macroscopic or histological changes are not observed.

The Potential of Shortening the Adaptation of Nellore Cattle to High-Concentrate Diets Using Only Virginiamycin as Sole Feed Additive.

Feedlot cattle are usually adapted to high-concentrate diets containing sodium monensin (MON) in more than 14 days. However, for finishing diets with lower energy content, the use of MON during adaptation may hold dry matter intake (DMI), and virginiamycin (VM) may be an alternative. This study was designed to determine the potential of shortening the adaptation of Nellore cattle to high-concentrate diets using only VM as a sole feed additive relative to feedlot performance, feeding behavior, and ruminal and cecum morphometrics. The experiment was designed as a completely randomized block replicated six times (four animals/pen) in which 120 Nellore bulls (390.4 ± 19.0 kg) were fed in 30 pens for 111 days according to the following treatments: (1) MON and adaptation for 14 days (MON14), (2) MON + VM and adaptation for 14 days (MONVM14), (3) VM and adaptation for 14 days (VM14), (4) VM and adaptation for 9 days (VM9), and (5) VM and adaptation for 6 days (VM6). At the end of the adaptation, 30 animals (n = 1 per pen) were randomly slaughtered for rumen and cecum evaluations. The remaining 90 bulls were harvested at the end of the study. No effects of treatments were observed (P < 0.10) for final body weight, average daily gain (ADG), and hot carcass weight (HCW). Cattle fed VM14 presented a greater (P ≤ 0.03) DMI, expressed as percent of body weight (BW), than animals fed either MON14 or MONVM14; however, cattle fed either MON14 or MONVM14 improved (P ≤ 0.02) the gain-to-feed ratio (G/F) by 10.4 or 8.1%, respectively, when compared to bulls fed VM14. Bulls fed VM14 had smaller (P < 0.05) papillae area (0.34 vs. 0.42 cm2) and rumen absorptive surface area (28.9 vs. 33.8 cm2) than those fed MON14. The shortening of the adaptation period linearly decreased the 12th rib fat (P = 0.02) and biceps femoris fat daily gain (P = 0.02) of Nellore bulls fed only VM, which linearly decreased the final biceps femoris fat thickness (P < 0.01). Feedlot cattle fed VM as a sole feed additive should not be adapted to high-concentrate diets in less than 14 days. Regardless of either adaptation length or feed additive, feedlot cattle need at least 14 days to adapt to finishing diets.

Ruminal Fermentation Pattern, Bacterial Community Composition, and Nutrient Digestibility of Nellore Cattle Submitted to Either Nutritional Restriction or Intake of Concentrate Feedstuffs Prior to Adaptation Period.

Beef cattle are key contributors to meat production and represent critical drivers of the global agricultural economy. In Brazil, beef cattle are reared in tropical pastures and finished in feedlot systems. The introduction of cattle into a feedlot includes a period where they adapt to high-concentrate diets. This adaptation period is critical to the success of incoming cattle, as they must adjust to both a new diet and environment. Incoming animals are typically reared on a variety of diets, ranging from poor quality grasses to grazing systems supplemented with concentrate feedstuffs. These disparate pre-adaptation diets present a challenge, and here, we sought to understand this process by evaluating the adaptation of Nellore calves raised on either grazing on poor quality grasses (restriction diet) or grazing systems supplemented with concentrate (concentrate diet). Given that nutrient provisioning from the diet is the sole responsibility of the ruminal microbial community, we measured the impact of this dietary shift on feeding behavior, ruminal fermentation pattern, ruminal bacterial community composition (BCC), and total tract digestibility. Six cannulated Nellore bulls were randomly assigned to two 3 × 3 Latin squares, and received a control, restriction, or concentrate diet. All cohorts were then fed the same adaptation diet to mimic a standard feedlot. Ruminal BCC was determined using Illumina-based 16S rRNA amplicon community sequencing. We found that concentrate-fed cattle had greater dry matter intake (P < 0.01) than restricted animals. Likewise, cattle fed concentrate had greater (P = 0.02) propionate concentration during the adaptation phase than control animals and a lower Shannon's diversity (P = 0.02), relative to the restricted animals. We also found that these animals had lower (P = 0.04) relative abundances of Fibrobacter succinogenes when compared to control animals during the pre-adaptation phase and lower abundances of bacteria within the Succinivibrio during the finishing phase, when compared to the control animals (P = 0.05). Finally, we found that animals previously exposed to concentrate were able to better adapt to high-concentrate diets when compared to restricted animals. Our study presents the first investigation of the impact of pre-adaptation diet on ruminal BCC and metabolism of bulls during the adaptation period. We suggest that these results may be useful for planning adaptation protocols of bulls entering the feedlot system and thereby improve animal production.

Vaso-occlusive crisis in a sickle cell patient after transfusion-transmitted dengue infection.

CASE REPORT: A 26-year-old woman with sickle cell disease (SCD) on chronic transfusion therapy complained of severe arthralgia, myalgia, abdominal pain, headache, and fever 24 hours after transfusion of a red blood cells (RBCs). Dengue virus (DENV) infection was suspected and the patient was hospitalized for clinical support and RBC transfusion, to lower the hemoglobin S to less than 30%. The patient's clinical condition improved approximately 8 days after the onset of symptoms. RESULTS: DENV type 2 (DENV-2) TaqMan real-time polymerase chain reaction was negative in the patient's pretransfusion sample while the posttransfusion sample was positive (Ct, 27.8), suggesting a high viral load and an acute infection. To investigate DENV transfusion transmission (TT-DENV) the stored donor serum was tested and was also positive (Ct, 25.8). Molecular typing confirmed the presence of DENV-2. The phylogenetic analysis of the DENV-2 strains obtained from both donor and patient samples were classified as the Southeast Asia-American genotype (Genotype III) and demonstrated 100% genomic identity, indicating TT-DENV. CONCLUSION: This is the first description of TT-DENV in a SCD patient. A presumed high viral load in the transfused RBC unit probably determined the early clinical manifestation. In endemic regions dengue fever should be considered as differential diagnosis in SCD patients with fever and acute pain crisis, mainly during DENV outbreaks.

Effect of cattle breed and basal diet on digestibility, rumen bacterial communities, and eating and rumination activity.

The objectives of this study were to compare ruminal total tract digestibility, bacterial communities, and eating and rumination activity between Holstein and Angus steers fed grain- or forage-based diets. Six Holstein steers (average body weight [BW] = 483 ± 23 kg) and six Angus steers (average BW = 507 ± 29 kg), previously fitted with rumen cannulae, were fed in a crossover design with a 2 × 2 factorial arrangement of four treatments: 1) Holsteins fed a grain-based diet, 2) Holsteins fed a forage-based diet, 3) Angus fed a grain-based diet, and 4) Angus fed a forage-based diet. Each period was 35 d with 26 d of diet adaptation and 9 d of sample collection. On days 1 and 2 of collection, feeding activity was recorded for 48 h. On day 3, rumen contents were sampled to measure ruminal pH at 0, 3, 6, 12, and 18 h after feeding. A portion of the strained ruminal fluid was subsampled at 0, 3, and 6 h for volatile fatty acids (VFA) analysis. Rumen contents were subsampled at 3 h for analysis of bacterial communities. From day 4 to 8, total fecal excretion, feed, and refusals samples were collected and analyzed for dry matter (DM), neutral detergent fiber (NDF), and starch. On days 8 and 9 (0 and 3 h post-feeding, respectively), total reticulorumen evacuation was conducted and contents were weighed. Data were analyzed using the MIXED procedures in SAS (v9.4 SAS Inst. Inc., Cary, NC). Repeated measures were used to analyze changes in ruminal pH and VFA over time. There were no interactions of diet × breed (P ≥ 0.07). While the main effects of diet were expected, unique to these data is the fact that bacterial diversity and richness were reduced (P < 0.01) in cattle fed grain-based diets. There was no main effect (P > 0.34) of breed on total tract DM, organic matter, and starch digestibility, but Angus cattle had greater (P = 0.01) NDF digestibility than Holsteins. The increased NDF digestibility may be associated with a numerical (P = 0.08) increased numbers of bacterial species in Angus steers compared with Holstein steers. Holstein steers also spent more time (P ≤ 0.05) ruminating than Angus steers. There was no effect (P > 0.80) of breed on reticulorumen content at feeding time; however, Holstein steers had greater (P = 0.04) reticulorumen content on a wet basis 3 h post-feeding. Although Holstein steers spent more time ruminating, Angus steers were better able to digest NDF when compared with Holsteins, regardless of basal diet, and this improvement may be related to changes in bacterial communities in the rumen or to rumination activity.

Detection of the mcr-1 gene in Enteropathogenic Escherichia coli (EPEC) and Shigatoxigenic E. coli (STEC) strains isolated from broilers / Detecção do gene mcr-1 em estirpes de Escherichia coli Enteropatogênicas (EPEC) e Shigatoxigênicas (STEC) isoladas de frangos de corte

Enteropathogenic Escherichia coli (EPEC) and Shigatoxigenic E. coli (STEC) strains are among the major pathotypes found in poultry and their products, which are capable of causing human enteric infections. Colistin has been claimed the drug of choice against diseases caused by multidrug-resistant Gram-negative bacteria (MDRGN) in humans. The mcr-1 gene was the first plasmidial gene that has been described to be responsible for colistin resistance and has also been detected in birds and poultry products. Our study aimed to detect the mcr-1 gene in enteropathogenic strains of E. coli in order to evaluate the resistance to colistin in broilers. The material was obtained from 240 cloacal samples and 60 broiler carcasses. The strains were isolated by the conventional bacteriological method and by the virulence genes, which characterize the enteropathogenic strains and resistance, and the samples were detected by polymerase chain reaction (PCR). Of the 213 isolated strains of E. coli, 57 (26.76%) were characterized as atypical EPEC and 35 (16.43%) as STEC. The mcr-1 gene was found in 3.5% (2/57) of the EPEC strains and 5.7% (2/35) of the STEC strains. In this study, it was possible to confirm that the mcr-1 resistance gene is already circulating in the broiler flocks studied and may be associated with the pathogenic strains.(AU)

Escherichia coli Enteropatogênica (EPEC) e Shigatoxigênica (STEC) estão entres os principais patotipos encontrados em aves e produtos avícolas que são capazes de causar doença entérica no homem. A colistina tem sido preconizada como droga de escolha para o tratamento de doenças causadas por bactérias Gram-negativas multirresistentes em humanos. O gene mcr-1 foi o primeiro gene plasmidial a ser descrito como responsável pela resistência a colistina e tem sido descrito em aves e produtos avícolas. Este estudo tem como objetivo a detecção do gene mcr-1 em estirpes de E. coli enteropatogênicas a fim de avaliar a resistência a colistina em frangos de corte. O material foi obtido a partir de 240 amostras cloacais e 60 carcaças de frango de corte. As estirpes foram isoladas pelo método bacteriológico convencional e os genes de virulência, que caracterizam as estirpes enteropatogênicas, e resistência foram detectados pela reação em cadeia pela polimerase (PCR). Das 213 estirpes de E. coli isoladas, 57 (26,76%) foram caracterizadas como EPEC atípica e 35 (16,43%) como STEC. O gene mcr-1 foi encontrado em 3,5% (2/57) das estirpes EPEC e 5,7% (2/35) das estirpes STEC. Neste estudo foi possível confirmar que o gene de resistência mcr-1 já está em circulação nos lotes de frango de corte estudados e pode estar associado às estirpes patogênicas.(AU)

Detection of the mcr-1 gene in Enteropathogenic Escherichia coli (EPEC) and Shigatoxigenic E. coli (STEC) strains isolated from broilers / Detecção do gene mcr-1 em estirpes de Escherichia coli Enteropatogênicas (EPEC) e Shigatoxigênicas (STEC) isoladas de frangos de corte

Enteropathogenic Escherichia coli (EPEC) and Shigatoxigenic E. coli (STEC) strains are among the major pathotypes found in poultry and their products, which are capable of causing human enteric infections. Colistin has been claimed the drug of choice against diseases caused by multidrug-resistant Gram-negative bacteria (MDRGN) in humans. The mcr-1 gene was the first plasmidial gene that has been described to be responsible for colistin resistance and has also been detected in birds and poultry products. Our study aimed to detect the mcr-1 gene in enteropathogenic strains of E. coli in order to evaluate the resistance to colistin in broilers. The material was obtained from 240 cloacal samples and 60 broiler carcasses. The strains were isolated by the conventional bacteriological method and by the virulence genes, which characterize the enteropathogenic strains and resistance, and the samples were detected by polymerase chain reaction (PCR). Of the 213 isolated strains of E. coli, 57 (26.76%) were characterized as atypical EPEC and 35 (16.43%) as STEC. The mcr-1 gene was found in 3.5% (2/57) of the EPEC strains and 5.7% (2/35) of the STEC strains. In this study, it was possible to confirm that the mcr-1 resistance gene is already circulating in the broiler flocks studied and may be associated with the pathogenic strains.(AU)

Escherichia coli Enteropatogênica (EPEC) e Shigatoxigênica (STEC) estão entres os principais patotipos encontrados em aves e produtos avícolas que são capazes de causar doença entérica no homem. A colistina tem sido preconizada como droga de escolha para o tratamento de doenças causadas por bactérias Gram-negativas multirresistentes em humanos. O gene mcr-1 foi o primeiro gene plasmidial a ser descrito como responsável pela resistência a colistina e tem sido descrito em aves e produtos avícolas. Este estudo tem como objetivo a detecção do gene mcr-1 em estirpes de E. coli enteropatogênicas a fim de avaliar a resistência a colistina em frangos de corte. O material foi obtido a partir de 240 amostras cloacais e 60 carcaças de frango de corte. As estirpes foram isoladas pelo método bacteriológico convencional e os genes de virulência, que caracterizam as estirpes enteropatogênicas, e resistência foram detectados pela reação em cadeia pela polimerase (PCR). Das 213 estirpes de E. coli isoladas, 57 (26,76%) foram caracterizadas como EPEC atípica e 35 (16,43%) como STEC. O gene mcr-1 foi encontrado em 3,5% (2/57) das estirpes EPEC e 5,7% (2/35) das estirpes STEC. Neste estudo foi possível confirmar que o gene de resistência mcr-1 já está em circulação nos lotes de frango de corte estudados e pode estar associado às estirpes patogênicas.(AU)

Detection of the mcr-1 gene in Enteropathogenic Escherichia coli (EPEC) and Shigatoxigenic E. coli (STEC) strains isolated from broilers

ABSTRACT: Enteropathogenic Escherichia coli (EPEC) and Shigatoxigenic E. coli (STEC) strains are among the major pathotypes found in poultry and their products, which are capable of causing human enteric infections. Colistin has been claimed the drug of choice against diseases caused by multidrug-resistant Gram-negative bacteria (MDRGN) in humans. The mcr-1 gene was the first plasmidial gene that has been described to be responsible for colistin resistance and has also been detected in birds and poultry products. Our study aimed to detect the mcr-1 gene in enteropathogenic strains of E. coli in order to evaluate the resistance to colistin in broilers. The material was obtained from 240 cloacal samples and 60 broiler carcasses. The strains were isolated by the conventional bacteriological method and by the virulence genes, which characterize the enteropathogenic strains and resistance, and the samples were detected by polymerase chain reaction (PCR). Of the 213 isolated strains of E. coli, 57 (26.76%) were characterized as atypical EPEC and 35 (16.43%) as STEC. The mcr-1 gene was found in 3.5% (2/57) of the EPEC strains and 5.7% (2/35) of the STEC strains. In this study, it was possible to confirm that the mcr-1 resistance gene is already circulating in the broiler flocks studied and may be associated with the pathogenic strains.

RESUMO: Escherichia coli Enteropatogênica (EPEC) e Shigatoxigênica (STEC) estão entres os principais patotipos encontrados em aves e produtos avícolas que são capazes de causar doença entérica no homem. A colistina tem sido preconizada como droga de escolha para o tratamento de doenças causadas por bactérias Gram-negativas multirresistentes em humanos. O gene mcr-1 foi o primeiro gene plasmidial a ser descrito como responsável pela resistência a colistina e tem sido descrito em aves e produtos avícolas. Este estudo tem como objetivo a detecção do gene mcr-1 em estirpes de E. coli enteropatogênicas a fim de avaliar a resistência a colistina em frangos de corte. O material foi obtido a partir de 240 amostras cloacais e 60 carcaças de frango de corte. As estirpes foram isoladas pelo método bacteriológico convencional e os genes de virulência, que caracterizam as estirpes enteropatogênicas, e resistência foram detectados pela reação em cadeia pela polimerase (PCR). Das 213 estirpes de E. coli isoladas, 57 (26,76%) foram caracterizadas como EPEC atípica e 35 (16,43%) como STEC. O gene mcr-1 foi encontrado em 3,5% (2/57) das estirpes EPEC e 5,7% (2/35) das estirpes STEC. Neste estudo foi possível confirmar que o gene de resistência mcr-1 já está em circulação nos lotes de frango de corte estudados e pode estar associado às estirpes patogênicas.

Fenômeno de vácuo detectado na tomografia computadorizada e sua associação com a doença do disco intervertebral em cães / Vacuum phenomena on spinal CT scans and its association with intervertebral disc disease in dogs / Fenómeno de vacío en tomografía computadorizada y su relación con la enfermedad del disco intervertebral en perros

O termo fenômeno de vácuo (FV) remete à presença de gás em regiões de articulação ou coluna vertebral, que pode estar associado a doenças progressivas e crônicas, como as doenças do disco intervertebral (DDIV). O presente estudo investigou a relação entre o FV e o diagnóstico de DDIV estabelecido em cães submetidos a tomografia computadorizada (TC) da coluna vertebral e também sua relação com as manifestações clínicas por meio da análise de 55 imagens de TC no período de janeiro de 2016 a julho de 2018 do Serviço de Diagnóstico por Imagem de um hospital veterinário. Foram observados sete animais com FV (12.7%), apresentando como manifestações clínicas: 3 animais com dor e parecia, 1 com dor e plegia e 3 deles com apenas plegia, sendo que apenas em um desses cães não foi confirmada a DDIV. Ainda são necessários novos estudos com maior número amostral para confirmar a relevância desse fenômeno.

Vacuum phenomenon (VP) refers to the presence of gas in joint spaces, including those in the spinal column. The phenomenon is associated with progressive and chronic diseases, such as intervertebral disc disease (IVDD). We reviewed 55 canine spinal CT images for the presence of VP, and studíed its association with IVDD to determine the association between the VP and the clinical signs exhibited by the patients at the time of exam. All images were obtained between January 2016 and July 2018, at the Diagnostic Imaging Service of a Veterinary Hospital. Image consistent with VP was observed in 7 (12.7%) of the 55 cases. Of these 7 animals, pain and paresis was reported in 3, pain with plegía in 1, and plegia without pain in 3 dogs. One dog did not have a confirmed diagnosis of IVDD. Further studies with larger samples are still needed to confirm the relevance of thís phenomenon in the diagnosís of IVDD in dogs.

El término fenómeno de vacío (FV) es utilizado para caracterizar la presencia de gas en regiones articulares o en columna vertebral, relacionado con enfermedades progresivas y crónicas como la enfermedad del disco intervertebral (EDIV). El presente estudio investiga la relación entre el FV y el diagnóstico de la EDIV en perros mediante estudios de tomografía computarizada (TC) de la columna vertebral, así como también su relación con las manifestaciones clínicas. Se analizaron 55 estudios de TC realizados entre enero de 2016 y julio de 2018 en el Servicío de Diagnóstico por imágenes de un hospital veterinário. Siete animales presentaron FV (12,7%) con manifestaciones clínicas siendo que 3 tenían dolor y paresia; 1 tenia dolor y pérdida de sensibilidad y 3 sólo presentaron pérdida de sensibilidad. En sólo uno de esos animales no pudo ser confirmada la EDIV. Nuevos estudios con un mayor número de animales son necesarios para confirmar la relevancia de este fenómeno.

Fenômeno de vácuo detectado na tomografia computadorizada e sua associação com a doença do disco intervertebral em cães / Vacuum phenomena on spinal CT scans and its association with intervertebral disc disease in dogs / Fenómeno de vacío en tomografía computadorizada y su relación con la enfermedad del disco intervertebral en perros

O termo fenômeno de vácuo (FV) remete à presença de gás em regiões de articulação ou coluna vertebral, que pode estar associado a doenças progressivas e crônicas, como as doenças do disco intervertebral (DDIV). O presente estudo investigou a relação entre o FV e o diagnóstico de DDIV estabelecido em cães submetidos a tomografia computadorizada (TC) da coluna vertebral e também sua relação com as manifestações clínicas por meio da análise de 55 imagens de TC no período de janeiro de 2016 a julho de 2018 do Serviço de Diagnóstico por Imagem de um hospital veterinário. Foram observados sete animais com FV (12.7%), apresentando como manifestações clínicas: 3 animais com dor e parecia, 1 com dor e plegia e 3 deles com apenas plegia, sendo que apenas em um desses cães não foi confirmada a DDIV. Ainda são necessários novos estudos com maior número amostral para confirmar a relevância desse fenômeno.(AU)

Vacuum phenomenon (VP) refers to the presence of gas in joint spaces, including those in the spinal column. The phenomenon is associated with progressive and chronic diseases, such as intervertebral disc disease (IVDD). We reviewed 55 canine spinal CT images for the presence of VP, and studíed its association with IVDD to determine the association between the VP and the clinical signs exhibited by the patients at the time of exam. All images were obtained between January 2016 and July 2018, at the Diagnostic Imaging Service of a Veterinary Hospital. Image consistent with VP was observed in 7 (12.7%) of the 55 cases. Of these 7 animals, pain and paresis was reported in 3, pain with plegía in 1, and plegia without pain in 3 dogs. One dog did not have a confirmed diagnosis of IVDD. Further studies with larger samples are still needed to confirm the relevance of thís phenomenon in the diagnosís of IVDD in dogs.(AU)

El término fenómeno de vacío (FV) es utilizado para caracterizar la presencia de gas en regiones articulares o en columna vertebral, relacionado con enfermedades progresivas y crónicas como la enfermedad del disco intervertebral (EDIV). El presente estudio investiga la relación entre el FV y el diagnóstico de la EDIV en perros mediante estudios de tomografía computarizada (TC) de la columna vertebral, así como también su relación con las manifestaciones clínicas. Se analizaron 55 estudios de TC realizados entre enero de 2016 y julio de 2018 en el Servicío de Diagnóstico por imágenes de un hospital veterinário. Siete animales presentaron FV (12,7%) con manifestaciones clínicas siendo que 3 tenían dolor y paresia; 1 tenia dolor y pérdida de sensibilidad y 3 sólo presentaron pérdida de sensibilidad. En sólo uno de esos animales no pudo ser confirmada la EDIV. Nuevos estudios con un mayor número de animales son necesarios para confirmar la relevancia de este fenómeno.(AU)

A Toll-like receptor 2 genetic variant modulates occurrence of bacterial infections in patients with sickle cell disease.

Despite adequate immunization and penicillin prophylaxis, bacterial infections remain a leading cause of morbidity and mortality in patients with sickle cell disease (SCD). Besides hyposplenism, inflammatory and genetic factors might modulate their susceptibility to bacterial infections. We performed a candidate gene association of single nucleotide polymorphisms (SNPs) located in Toll-like receptor (TLR) genes, encoding prominent molecules for innate immune responses, with the occurrence of bacterial infections in patients with SCD. A cohort followed in centres in Brazil, France and Senegal (n = 430) was divided in two groups: patients who presented at least one episode of bacterial infection (n = 235) and patients who never had bacterial infections (n = 195). There were no differences in gender or age distribution among the groups. The frequency of the TLR2 rs4696480 TA genotype was significantly lower in the infected group (50% vs. 67%, odds ratio [OR] = 0·50, 95% confidence interval [CI] 0·34-0·75, P < 0·001), and the TT genotype was significantly higher in the infected group (15% vs. 5%, OR = 3·18, 95% CI 1·53-6·61, P < 0·001). Previous reports demonstrated higher secretion of inflammatory factors in cells from AA individuals, lower occurrence and severity of immune diseases in T carriers. The rs4696480 TA genotype might stand between deleterious effects of over inflammatory response (AA genotype) and inefficient responses (TT genotype) to infectious agents in SCD settings.

The Neonatal Screening Program in Brazil, Focus on Sickle Cell Disease (SCD).

Since 2001, the Brazilian Ministry of Health has been coordinating a National Neonatal Screening Program (NNSP) that now covers all the 26 states and the Federal District of the Brazilian Republic and targets six diseases including sickle cell disease (SCD) and other hemoglobinopathies. In 2005, the program coverage reached 80% of the total live births. Since then, it has oscillated between 80% and 84% globally with disparities from one state to another (>95% in São Paulo State). The Ministry of Health has also published several Guidelines for clinical follow-up and treatment for the diseases comprised by the neonatal screening program. The main challenge was, and still is, to organize the public health network (SUS), from diagnosis and basic care to reference centers in order to provide comprehensive care for patients diagnosed by neonatal screening, especially for SCD patients. Considerable gains have already been achieved, including the implementation of a network within SUS and the addition of scientific and technological progress to treatment protocols. The goals for the care of SCD patients are the intensification of information provided to health care professionals and patients, measures to prevent complications, and care and health promotion, considering these patients in a global and integrated way, to reduce mortality and enhance their quality of life.

Avaliação morfológica e morfométrica da articulação umerorradioulnar em cães através de exames radiográficos e por tomografia computadorizada / Radiographic and tomographic study of the elbow joint in dogs

Elbow dysplasia disease includes an united anconeal process, fragmented medial coronoid process, osteochondrosis of humeral trochlea, articular incongruity and degenerative joint disease. The aim of this study was to present detailed morphologic and morphometric aspects of the elbow joint in dog in clinical and correlate with radiographic and tomographic (CT) exam. Inter-observer variation for articular incongruity measurements by CT, comparative analysis in the radiographic exam, angle in ulnar notch and its comparative analysis between radiographic and tomographic agreement examination in 44 elbow of dogs with different ages were evaluated. The statistics analyses included the kappa coefficient and interclass correlation and Fischers test and McNemars test. It was evidenced that individual performance of each radiographic incidence had poor agreement with the tomographic exam, suggesting that the accomplishment of more than two radiograph views are needed. There was no agreement between the three evaluators in the ulnar notch angle at radiographic and tomographic exams. However, there was good/moderate agreement for articular incongruity measurement in the sagittal plane between evaluators. It was possible to conclude that none of the five radiographic incidences was better than the others for radiographic analysis because each incidence had a better identification of a particular elbow compartment; measurements at the tomographic exam to evaluate radioulnar incongruity had no reproductiveness in the frontal plane, but in sagittal plan had a good/moderate agreement between observers and the angle in ulnar notch presented no repeatability at radiographic exam and no reproductiveness at tomographic exam.(AU)

Este estudo teve como objetivo apresentar de forma detalhada dados morfológicos e morfométricos da articulação umerorradioulnar de cães de raça definida avaliados por meio de exames físicos, radiográficos e tomográficos. A amostra dessa pesquisa constituiu-se de 44 cotovelos de cães com idades variadas. Para análise de informações obtidas, o coeficiente kappa e de correlação interclasse e associação foram realizados. Constatou-se que o desempenho individual de cada projeção radiográfica teve pobre concordância com o exame tomográfico; não houve concordância entre os observadores para as mensurações do ângulo da incisura ulnar ao exame radiográfico e tomográfico. Porém houve boa/moderada concordância para mensuração da incongruência radioulnar no plano sagital entre os observadores. Concluiu-se que nenhuma das cinco incidências radiográficas foi superior para análise radiográfica, uma vez que cada projeção apresentou melhor identificação de um compartimento do cotovelo. Medidas ao exame tomográfico para incongruência radioulnar não apresentaram reprodutibilidade no plano de reconstrução frontal, entretanto no corte sagital apresentaram boa e moderada concordância entre os observadores e que a mensuração do ângulo da incisura ulnar não apresentou repetibilidade ao exame radiográfico e nem reprodutibilidade ao exame tomográfico. Esses resultados contribuem para melhor utilização de cada exame de acordo com a região a ser avaliada bem como ressaltam a necessidade da somatória de múltiplos exames de imagem para a correta avaliação desta afecção.(AU)

Avaliação morfológica e morfométrica da articulação umerorradioulnar em cães através de exames radiográficos e por tomografia computadorizada / Radiographic and tomographic study of the elbow joint in dogs

Este estudo teve como objetivo apresentar de forma detalhada dados morfológicos e morfométricos da articulação umerorradioulnar de cães de raça definida avaliados por meio de exames físicos, radiográficos e tomográficos. A amostra dessa pesquisa constituiu-se de 44 cotovelos de cães com idades variadas. Para análise de informações obtidas, o coeficiente kappa e de correlação interclasse e associação foram realizados. Constatou-se que o desempenho individual de cada projeção radiográfica teve pobre concordância com o exame tomográfico; não houve concordância entre os observadores para as mensurações do ângulo da incisura ulnar ao exame radiográfico e tomográfico. Porém houve boa/moderada concordância para mensuração da incongruência radioulnar no plano sagital entre os observadores. Concluiu-se que nenhuma das cinco incidências radiográficas foi superior para análise radiográfica, uma vez que cada projeção apresentou melhor identificação de um compartimento do cotovelo. Medidas ao exame tomográfico para incongruência radioulnar não apresentaram reprodutibilidade no plano de reconstrução frontal, entretanto no corte sagital apresentaram boa e moderada concordância entre os observadores e que a mensuração do ângulo da incisura ulnar não apresentou repetibilidade ao exame radiográfico e nem reprodutibilidade ao exame tomográfico. Esses resultados contribuem para melhor utilização de cada exame de acordo com a região a ser avaliada bem como ressaltam a necessidade da somatória de múltiplos exames de imagem para a correta avaliação desta afecção.(AU)

Elbow dysplasia disease includes an united anconeal process, fragmented medial coronoid process, osteochondrosis of humeral trochlea, articular incongruity and degenerative joint disease. The aim of this study was to present detailed morphologic and morphometric aspects of the elbow joint in dog in clinical and correlate with radiographic and tomographic (CT) exam. Inter-observer variation for articular incongruity measurements by CT, comparative analysis in the radiographic exam, angle in ulnar notch and its comparative analysis between radiographic and tomographic agreement examination in 44 elbow of dogs with different ages were evaluated. The statistics analyses included the kappa coefficient and interclass correlation and Fischer's test and McNemar's test. It was evidenced that individual performance of each radiographic incidence had poor agreement with the tomographic exam, suggesting that the accomplishment of more than two radiograph views are needed. There was no agreement between the three evaluators in the ulnar notch angle at radiographic and tomographic exams. However, there was good/moderate agreement for articular incongruity measurement in the sagittal plane between evaluators. It was possible to conclude that none of the five radiographic incidences was better than the others for radiographic analysis because each incidence had a better identification of a particular elbow compartment; measurements at the tomographic exam to evaluate radioulnar incongruity had no reproductiveness in the frontal plane, but in sagittal plan had a good/moderate agreement between observers and the angle in ulnar notch presented no repeatability at radiographic exam and no reproductiveness at tomographic exam.(AU)

Avaliação morfológica e morfométrica da articulação umerorradioulnar em cães através de exames radiográficos e por tomografia computadorizada

ABSTRACT: Elbow dysplasia disease includes an united anconeal process, fragmented medial coronoid process, osteochondrosis of humeral trochlea, articular incongruity and degenerative joint disease. The aim of this study was to present detailed morphologic and morphometric aspects of the elbow joint in dog in clinical and correlate with radiographic and tomographic (CT) exam. Inter-observer variation for articular incongruity measurements by CT, comparative analysis in the radiographic exam, angle in ulnar notch and its comparative analysis between radiographic and tomographic agreement examination in 44 elbow of dogs with different ages were evaluated. The statistics analyses included the kappa coefficient and interclass correlation and Fischers test and McNemars test. It was evidenced that individual performance of each radiographic incidence had poor agreement with the tomographic exam, suggesting that the accomplishment of more than two radiograph views are needed. There was no agreement between the three evaluators in the ulnar notch angle at radiographic and tomographic exams. However, there was good/moderate agreement for articular incongruity measurement in the sagittal plane between evaluators. It was possible to conclude that none of the five radiographic incidences was better than the others for radiographic analysis because each incidence had a better identification of a particular elbow compartment; measurements at the tomographic exam to evaluate radioulnar incongruity had no reproductiveness in the frontal plane, but in sagittal plan had a good/moderate agreement between observers and the angle in ulnar notch presented no repeatability at radiographic exam and no reproductiveness at tomographic exam.

RESUMO: Este estudo teve como objetivo apresentar de forma detalhada dados morfológicos e morfométricos da articulação umerorradioulnar de cães de raça definida avaliados por meio de exames físicos, radiográficos e tomográficos. A amostra dessa pesquisa constituiu-se de 44 cotovelos de cães com idades variadas. Para análise de informações obtidas, o coeficiente kappa e de correlação interclasse e associação foram realizados. Constatou-se que o desempenho individual de cada projeção radiográfica teve pobre concordância com o exame tomográfico; não houve concordância entre os observadores para as mensurações do ângulo da incisura ulnar ao exame radiográfico e tomográfico. Porém houve boa/moderada concordância para mensuração da incongruência radioulnar no plano sagital entre os observadores. Concluiu-se que nenhuma das cinco incidências radiográficas foi superior para análise radiográfica, uma vez que cada projeção apresentou melhor identificação de um compartimento do cotovelo. Medidas ao exame tomográfico para incongruência radioulnar não apresentaram reprodutibilidade no plano de reconstrução frontal, entretanto no corte sagital apresentaram boa e moderada concordância entre os observadores e que a mensuração do ângulo da incisura ulnar não apresentou repetibilidade ao exame radiográfico e nem reprodutibilidade ao exame tomográfico. Esses resultados contribuem para melhor utilização de cada exame de acordo com a região a ser avaliada bem como ressaltam a necessidade da somatória de múltiplos exames de imagem para a correta avaliação desta afecção.

Morphology and topographic anatomy of the spinal cord of the red-footed tortoise (Geochelone carbonaria Spix, 1824) / Morfologia e anatomia topográfica da medula espinal de jabuti das "patas vermelhas" (Geochelone carbonaria Spix, 1824)

The aim of this study was to describe the topography of the spinal cord of the red-footed tortoise to establish a morphological basis for applied research in anesthesiology and morphology. Six tortoises from the state of Maranhão (Brazil) that had died of natural causes were used. The common carotid artery was used to perfuse the arterial system with saline solution (heated to 37ºC) and to fix the material with a 20 percent formaldehyde solution. The specimens were then placed in a modified decalcifying solution for 72 hours to allow dorsal opening of the carapace with a chisel and an orthopedic hammer. Dissection of the dorsal musculature and sectioning of the vertebral arches were performed to access the spinal cord. The results revealed the spinal cord of G. carbonaria to be an elongated, whitish mass that reached the articulation between the penultimate and last caudal vertebrae. The cervical intumescence (Intumescentia cervicalis) was located between vertebral segments C5 and T1, whereas the lumbosacral intumescence (Intumescentia lumbalis) was located between T6 and Ca1.

Objetivou-se com este estudo descrever a topografia da medula espinhal do jabuti de "patas vermelhas" no intuito de estabelecer bases morfológicas para a investigação aplicada em morfologia, anestesiologia e cirurgia animal. Foram utilizados seis animais adultos, provenientes do Estado de Maranhão (Brasil), os quais haviam ido a óbito por causas naturais. A artéria carótida comum foi canulada e utilizada para perfusão do sistema arterial com solução salina (aquecida a 37ºC) e para fixação do material com uma solução de formol a 20 por cento. Os animais foram então colocados em uma solução descalcificadora modificada por 72 horas, o que facilitou a abertura dorsal da carapaça com um cizel e um martelo ortopédico. Em seguida, foi realizada a dissecação da musculatura dorsal e secção dos arcos vertebrais para acesso a medula espinal. Os resultados revelaram a medula espinhal de Geochelone carbonaria como uma massa alongada, esbranquiçada, que se estende até a articulação entre penúltima e última vértebra caudal. A intumescência cervical (Intumescentia cervicalis) foi localizada entre os segmentos vertebrais de C5 e T1, enquanto que a intumescência lombossacral (Intumescentia lumbalis) foi localizada entre os segmentos vertebrais de T6 e Ca1.

Morphology and topographic anatomy of the spinal cord of the red-footed tortoise (Geochelone carbonaria Spix, 1824) / Morfologia e anatomia topográfica da medula espinal de jabuti das "patas vermelhas" (Geochelone carbonaria Spix, 1824)

The aim of this study was to describe the topography of the spinal cord of the red-footed tortoise to establish a morphological basis for applied research in anesthesiology and morphology. Six tortoises from the state of Maranhão (Brazil) that had died of natural causes were used. The common carotid artery was used to perfuse the arterial system with saline solution (heated to 37ºC) and to fix the material with a 20 percent formaldehyde solution. The specimens were then placed in a modified decalcifying solution for 72 hours to allow dorsal opening of the carapace with a chisel and an orthopedic hammer. Dissection of the dorsal musculature and sectioning of the vertebral arches were performed to access the spinal cord. The results revealed the spinal cord of G. carbonaria to be an elongated, whitish mass that reached the articulation between the penultimate and last caudal vertebrae. The cervical intumescence (Intumescentia cervicalis) was located between vertebral segments C5 and T1, whereas the lumbosacral intumescence (Intumescentia lumbalis) was located between T6 and Ca1.(AU)

Objetivou-se com este estudo descrever a topografia da medula espinhal do jabuti de "patas vermelhas" no intuito de estabelecer bases morfológicas para a investigação aplicada em morfologia, anestesiologia e cirurgia animal. Foram utilizados seis animais adultos, provenientes do Estado de Maranhão (Brasil), os quais haviam ido a óbito por causas naturais. A artéria carótida comum foi canulada e utilizada para perfusão do sistema arterial com solução salina (aquecida a 37ºC) e para fixação do material com uma solução de formol a 20 por cento. Os animais foram então colocados em uma solução descalcificadora modificada por 72 horas, o que facilitou a abertura dorsal da carapaça com um cizel e um martelo ortopédico. Em seguida, foi realizada a dissecação da musculatura dorsal e secção dos arcos vertebrais para acesso a medula espinal. Os resultados revelaram a medula espinhal de Geochelone carbonaria como uma massa alongada, esbranquiçada, que se estende até a articulação entre penúltima e última vértebra caudal. A intumescência cervical (Intumescentia cervicalis) foi localizada entre os segmentos vertebrais de C5 e T1, enquanto que a intumescência lombossacral (Intumescentia lumbalis) foi localizada entre os segmentos vertebrais de T6 e Ca1.(AU)