Squamous cell carcinoma and basal cell carcinoma of the lips: 25 years of experience in a northeast Brazilian population.

BACKGROUND: The lips are the transition zone between the facial skin and the oral mucosa and are the site of alterations related to a broad spectrum of etiologies. Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are the most prevalent neoplasms affecting lips. This study evaluated the demographic and clinicopathological features of the SCC and BCC in the lip. MATERIAL AND METHODS: A retrospective cross-sectional descriptive study (1994-2019) was carried out. Demographic and clinicopathologic data were collected from a hospital's dermatological service and an oncologic hospital. The data were submitted to descriptive analysis and Pearson's chi-square and Fisher's exact tests (p ≤ 0.05). RESULTS: 417 medical records were analyzed, of which 323 corresponded to SCC (77.5%) and 94 to BCC (22.5%). SCC showed more frequency in males (58.8%) and BCC in females (54.3%). The lower lip was significantly affected in male patients (p < 0.0001) and by both neoplasms (70.6% and 56.4%, respectively; p = 0.014). SCC and BCC were mainly treated with surgery (88.3% and 93.2%, respectively). Surgical margin was frequently negative in SCC and BCC (87%; 72.3%, respectively), and no recurrence was observed in 79.9% of SCC and 69.1% of BCC cases. CONCLUSIONS: SCC was more frequent in male patients, while BCC showed more frequency in female patients. Both neoplasms mainly affect the lower lip. Understanding the epidemiological profile of these lesions in the lip, as well as their etiology and clinical features, is fundamental for appropriate clinical conduct and the creation and/or amplification of preventive measures.

Estimating the savings of a national project to prevent healthcare-associated infections in intensive care units.

BACKGROUND: Healthcare-associated infections (HAIs) have a significant impact on patients' morbidity and mortality, and have a detrimental financial impact on the healthcare system. Various strategies exist to prevent HAIs, but economic evaluations are needed to determine which are most appropriate. AIM: To present the financial impact of a nationwide project on HAI prevention in intensive care units (ICUs) using a quality improvement (QI) approach. METHODS: A health economic evaluation assessed the financial results of the QI initiative 'Saúde em Nossas Mãos' (SNM), implemented in Brazil between January 2018 and December 2020. Among 116 participating institutions, 13 (11.2%) fully reported the aggregate cost and stratified patients (with vs without HAIs) in the pre-intervention and post-intervention periods. Average cost (AC) was calculated for each analysed HAI: central-line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infections (CAUTIs). The absorption model and time-driven activity-based costing were used for cost estimations. The numbers of infections that the project could have prevented during its implementation were estimated to demonstrate the financial impact of the SNM initiative. RESULTS: The aggregated ACs calculated for each HAI from these 13 ICUs - US$8480 for CLABSIs, US$10,039 for VAP, and US$7464 for CAUTIs - were extrapolated to the total number of HAIs prevented by the project (1727 CLABSIs, 3797 VAP and 2150 CAUTIs). The overall savings of the SNM as of December 2020 were estimated at US$68.8 million, with an estimated return on investment (ROI) of 765%. CONCLUSION: Reporting accurate financial data on HAI prevention strategies is still challenging in Brazil. These results suggest that a national QI initiative to prevent HAIs in critical care settings is a feasible and value-based approach, reducing financial waste and yielding a significant ROI for the healthcare system.

Tuberculosis in Spain: An opinion paper.

This document is the result of the deliberations of the Committee on Emerging Pathogens and COVID-19 of the Illustrious Official College of Physicians of Madrid (ICOMEM) regarding the current situation of tuberculosis, particularly in Spain. We have reviewed aspects such as the evolution of its incidence, the populations currently most exposed and the health care circuits for the care of these patients in Spain. We have also discussed latent tuberculosis, the reality of extrapulmonary disease in the XXI century and the means available in daily practice for the diagnosis of both latent and active forms. The contribution of molecular biology, which has changed the perspective of this disease, was another topic of discussion. The paper tries to put into perspective both the classical drugs and their resistance figures and the availability and indications of the new ones. In addition, the reality of direct observation in the administration of antituberculosis drugs has been discussed. All this revolution is making it possible to shorten the treatment time for tuberculosis, a subject that has also been reviewed. If everything is done well, the risk of relapse of tuberculosis is small but it exists. On the other hand, many special situations have been discussed in this paper, such as tuberculosis in pediatric age and tuberculosis as a cause for concern in surgery and intensive care. The status of the BCG vaccine and its present indications as well as the future of new vaccines to achieve the old dream of eradicating this disease have been discussed. Finally, the ethical and medicolegal implications of this disease are not a minor issue and our situation in this regard has been reviewed.

Chest computed tomography findings of patients infected with Covid-19 and their association with disease evolution stages.

INTRODUCTION: To describe CT findings in patients with confirmed Covid-19 infection and correlate them with the disease evolution stages. METHODS: This is a historical cohort observational analytical study carried out with outpatients, inpatients, and emergency patients from a private hospital in Maceió/AL, Brazil. The final sample consisted of 390 patients with positive RT-PCR for Covid-19 with available laboratory tests and chest CT results. RESULTS: The most frequent initial symptoms were cough, fever, dyspnea and headache. The most commonly found comorbidities were hypertension, diabetes mellitus and obesity. A total of 22% of the CT scans showed no alterations; ground-glass opacity was the most frequently found one. There was a significant association between age, comorbidities, pulmonary involvement, ground-glass opacity, mosaic attenuation and percentage of pulmonary involvement with death. The analysis of the disease stages showed a significant association with laboratory data (CRP and platelet levels), ground-glass opacity and mosaic attenuation with the disease evolution stages in relation to the days since symptom onset. CONCLUSION: The disease evolution of Covid-19 occurs in stages, and this study describes tomographic findings in patients with confirmed Covid-19 infection and shows they vary depending on the disease evolution stages. IMPLICATIONS FOR PRACTICE: This paper provides important addition to the various records that have been accumulated through the Covid-19 pandemic.

Advantages and disadvantages of maintaining the mandatory use of masks in health centers and nursing homes in Spain. How and when is it justified to maintain it?

We address the advantages and disadvantages of maintaining the mandatory use of masks in health centers and nursing homes in the current epidemiological situation in Spain and after the declaration of the World Health Organization on May 5, 2023 of the end of COVID-19 as public health emergency. We advocate for prudence and flexibility, respecting the individual decision to wear a mask and emphasizing the need for its use when symptoms suggestive of a respiratory infection appear, in situations of special vulnerability (such as immunosuppression), or when caring for patients with those infections. At present, given the observed low risk of severe COVID-19 and the low transmission of other respiratory infections, we believe that it is disproportionate to maintain the mandatory use of masks in a general way in health centers and nursing homes. However, this could change depending on the results of epidemiological surveillance and it would be necessary to reconsider returning to the obligation in periods with a high incidence of respiratory infections.

The stromal immunoexpression of CLIC4 may be related to the difference in the biological behavior between oral squamous cell carcinoma and oral verrucous carcinoma.

BACKGROUND: Oral squamous cell carcinoma (OSCC) has high morbidity and mortality rates while oral verrucous carcinoma (OVC), an uncommon variant of OSCC, exhibits a distinct biological behavior. CLIC4 protein plays a role in the cell cycle and apoptosis regulation and participates in the myofibroblasts transdifferentiation process, which are the main cells of the tumor stroma. This study analyzed the immunoexpression of CLIC4 and α-SMA in 20 OSCC cases and 15 OVC cases. MATERIAL AND METHODS: A semiquantitative analysis of CLIC4 and α-SMA immunoexpression was performed in the parenchyma and stroma. Nuclear and cytoplasmic reactivity was analyzed separately for the CLIC4 immunostaining. The data were submitted to Pearson's chi-square and Spearman's correlation tests (p ≤ 0.05). RESULTS: In the CLIC4 analysis, there was a significant difference in the immunoexpression of this protein between OSCC and OVC stroma (p < 0.001). It was observed a higher expression of α-SMA in the OSCC stroma. There was a positive and significant correlation between CLIC4 and α-SMA immunoexpression in the OVC stroma (r = 0,612; p = 0,015). CONCLUSIONS: The decrease or absence of nuclear CLIC4 immunoexpression in the neoplastic epithelial cells and the increase of its expression in the stroma may influence the difference in biological behavior between OSCC and OVC.

Sensitivity of seed germination to water stress in high-altitude populations of a threatened palm species.

Divergence in seed germination patterns among populations of the same species is important for understanding plant responses to environmental gradients and potential plant sensitivity to climate change. In order to test responses to flooding and decreasing water potentials, over 3 years we germinated and grew seeds from three habitats of Euterpe edulis Mart. occurring along an altitudinal gradient. Seed germination and root growth were evaluated under different water availability treatments: control, flood, -0.4 MPa, -0.8 MPa, in the years 2012, 2013 and 2014, and in the final year of the experiment (2014) at -1.0 MPa and -1.5 MPa. Seeds from the montane habitat did not germinate in the flooding treatment. Seed germination of all three habitats decreased in the -1.5 MPa treatment and the montane habitat had lowest germination in this treatment. Time required for half of the seeds to germinate increased up to -0.8 MPa. Seeds from montane habitats germinated more slowly in all treatments. The only difference in seed germination synchrony was an increase in the submontane population under the flooding treatment. However, synchrony decreased at the lowest water potentials. Roots of the montane population were more vigorous in most treatments, except at -0.8 MPa. The unusual ability of these seeds to germinate at low water potentials might be related to early seed germination at the onset of the rainy season, which potentially decreases seed predation pressure. Seeds of the montane population were more sensitive to both types of water stress. A predicted increase in the frequency and intensity of extreme high rainfall or drought events may predispose early stages of this population to adverse factors that might negatively affect population viability with elevational in future climate change scenarios.

Identification and characterisation of de novo germline structural variants in two commercial pig lines using trio-based whole genome sequencing.

BACKGROUND: De novo mutations arising in the germline are a source of genetic variation and their discovery broadens our understanding of genetic disorders and evolutionary patterns. Although the number of de novo single nucleotide variants (dnSNVs) has been studied in a number of species, relatively little is known about the occurrence of de novo structural variants (dnSVs). In this study, we investigated 37 deeply sequenced pig trios from two commercial lines to identify dnSVs present in the offspring. The identified dnSVs were characterised by identifying their parent of origin, their functional annotations and characterizing sequence homology at the breakpoints. RESULTS: We identified four swine germline dnSVs, all located in intronic regions of protein-coding genes. Our conservative, first estimate of the swine germline dnSV rate is 0.108 (95% CI 0.038-0.255) per generation (one dnSV per nine offspring), detected using short-read sequencing. Two detected dnSVs are clusters of mutations. Mutation cluster 1 contains a de novo duplication, a dnSNV and a de novo deletion. Mutation cluster 2 contains a de novo deletion and three de novo duplications, of which one is inverted. Mutation cluster 2 is 25 kb in size, whereas mutation cluster 1 (197 bp) and the other two individual dnSVs (64 and 573 bp) are smaller. Only mutation cluster 2 could be phased and is located on the paternal haplotype. Mutation cluster 2 originates from both micro-homology as well as non-homology mutation mechanisms, where mutation cluster 1 and the other two dnSVs are caused by mutation mechanisms lacking sequence homology. The 64 bp deletion and mutation cluster 1 were validated through PCR. Lastly, the 64 bp deletion and the 573 bp duplication were validated in sequenced offspring of probands with three generations of sequence data. CONCLUSIONS: Our estimate of 0.108 dnSVs per generation in the swine germline is conservative, due to our small sample size and restricted possibilities of dnSV detection from short-read sequencing. The current study highlights the complexity of dnSVs and shows the potential of breeding programs for pigs and livestock species in general, to provide a suitable population structure for identification and characterisation of dnSVs.

Peripheral ossifying fibroma: A 20-year retrospective study with focus on clinical and morphological features.

BACKGROUND: Peripheral Ossifying Fibroma (POF) is a reactive hyperplastic lesion that exclusively occurs in the gingiva and is characterized by the deposition of dystrophic calcification, cementum-like tissue, and immature and mature bone within the connective tissue. The objective of the present study was to perform a retrospective analysis of clinicopathologic features of POF. MATERIAL AND METHODS: Clinical and histopathological data were obtained from biopsy records and histopathological reports from a Brazilian reference service in Oral Pathology (1999 - 2020). Morphological analysis was performed to evaluate features related to the mesenchymal component, inflammatory infiltrate, ulceration, and mineralized tissue. RESULTS: A total of 270 POFs were diagnosed during the study period. A higher frequency was observed in females (71.9%) between the third (22.9%) and fourth (23.3%) decades of life. The anterior upper gingiva (29.1%) was the most affected region. Mature (86.7%) and immature (52.6%) bone tissue were the most frequent. There was a significant association between immature bone deposition and lesions with size ≤ 1.7 cm (p = 0.041); immature bone and cement-like tissue deposition with an evolution time ≤ 16 months (p < 0.001); deposition of immature bone and mesenchymal hypercellularization (p < 0.001); deposition of dystrophic calcification and the presence of ulceration (p < 0.001). CONCLUSIONS: The clinical characteristics corroborate the findings in the literature. The heterogeneous distribution and quantity of mineralized tissues found in the analyzed cases support the theory that the different mineralized tissues constitute a spectrum of clinical maturation of POF.

Angina bullosa haemorrhagica: A 14-year multi-institutional retrospective study from Brazil and literature review.

BACKGROUND: Angina bullosa haemorrhagica (ABH) is characterized by the recurrent appearance of blood blisters on the oral mucosa, mainly in adults' soft palate. In general, the blisters rupture spontaneously, lacking the necessity for biopsy. We report the clinical features of 23 ABH cases, emphasizing the clinical behavior and the management of these conditions. MATERIAL AND METHODS: A retrospective descriptive cross-sectional study was performed. A total of 12,727 clinical records of oral and maxillofacial lesions from four dental services in Brazil were analyzed. Clinical data were collected from the clinical records and evaluated. RESULTS: The series comprised 12 males (52.2%) and 11 females (47.8%), with a mean age of 56.8 ± 14.6 years (ranging: 24-82 years) and a 1.1:1 male-to-female ratio. Most of the lesions affected the soft palate (n = 15, 65.2%). Clinically, the lesions presented mainly as an asymptomatic (n = 17, 73.9%) blood-filled blister that ruptured after a few minutes or hours, leaving an erosion. The masticatory trauma was the most frequent triggering event. No patient had coagulation disorders. A biopsy was performed in only four cases (17.4%). Treatment was symptomatic with a favorable outcome. CONCLUSIONS: ABH is still poorly documented in the literature, and its etiology remains uncertain. ABH mainly affects the soft palate of elderly adults and has a favorable evolution in a few days. The therapeutic approach is often focused only on the relief of symptoms. However, it can share some clinical features with more serious diseases. Therefore, clinicians must recognize these lesions to avoid misdiagnosis.

Molossinema wimsatti infection in the brain of Pallas's mastiff bats (Molossus molossus).

The present report describes two cases of infection by Molossinema wimsatti in the brain of Pallas's mastiff bats (Molossus molossus). The first bat was captured and killed by a domestic cat in a suburban area of the municipality of Patos, Paraiba, northeastern Brazil. The second bat was found crawling on the ground in the same area before dying. No gross lesions were found at necropsy. Histology of the central nervous system revealed filarioid nematodes in the brain ventricles and cerebellum. There were adults, subadults and eggs, the latter sometimes containing microfilariae. No inflammatory response was observed in bat 1, while bat 2 presented a mild lymphoplasmacytic meningoencephalitis. Three nematodes were recovered and submitted for parasitological examination. The diagnosis of M. wimsatti infection was based on the histomorphological and parasitological characteristics of the agent and its location in the brain ventricular system of insectivorous bats. The infection likely occurs in other insectivorous bats from South American and Caribbean countries but may be overlooked.

Unpaved road conservation planning at the catchment scale.

In addition to soil losses on hillslopes, unpaved rural roads, especially when poorly designed and maintained, can be a significant contributor to the erosive processes seen at the catchment scale. In areas with deep soils, the solutions primarily focus on channeling excess surface runoff into settling ponds or terraces. However, few studies have addressed runoff control from roads on steep slopes in areas of shallow soil. Modeling hydrological processes at the catchment scale is a useful strategy for choosing the most effective and least costly conservation practices to control surface runoff. This study applies a mathematical model to a monitored catchment in southern Brazil to better understand the effects of conservation practices on unpaved roads and their impact on the hydrological and erosive dynamics of a small rural catchment. We calibrated the LISEM model using data from eight stormwater events and evaluated how three different road conservation scenarios-low (LI), medium (MI), and high intensity (HI)-contributed to sediment yield (SY), surface runoff volume (Qe), and peak flow (Qp) reduction. The LI and MI scenarios involved installation of hydraulic structures to control the road surface runoff (i.e. road ditch graveling, diversion weirs and grass waterways) while the HI scenario added surface runoff control practices (grass strips) to surrounding crop fields, in addition to the practices included in the MI scenario. Based on these scenarios, the results showed a Qe reduction at the catchment outlet from - 3.5% (LI) to - 22.5% (HI). The Qp and SY varied from + 6.0% (LI) to - 292.5% (HI) and from + 20.0% (LI) to - 963.9% (HI), respectively. These results show that the low- and medium-intensity practices were not effective in controlling surface runoff from roads, based on the Qe, Qb, and SY observed at the catchment's outlet. On the other hand, when MI scenarios were complemented with practices to control surface runoff in the cultivated areas, a significant reduction in surface runoff (Qe and Qp) and SY was verified.

Scrotal thermographic profile and seminal characteristics of Mangalarga Marchador stallions bred in the Atlantic Rainforest biome / [Perfil termográfico escrotal e características seminais de garanhões Mangalarga Marchador criados no bioma Mata Atlântica]

The objective of this study was to determine the scrotal thermographic profile and to verify the influence of temperature and humidity of the humid tropical climate on testicular temperature and seminal quality of Mangalarga Marchador stallions. The thermal profiles of the proximal, middle, and distal zones of the testicles and total surface temperature (TSTT) were recorded using an FLIR E60bx thermal imager. The average air temperature (°C) and relative humidity (%) were obtained 1, 5, 9, 33, and 66 days before semen collection and showed a mean value of 26.5±2.4 and 80.4±6.0 respectively. The scrotal surface temperature was close to 34°C and there was no variation with the age of the stallion, reproductive activity, and characteristics of the ejaculate (P>0.05). The only significant correlations obtained were between TSTT and minor defects (R = 0.41; P<0.05), between TSTT and total defects (R = 0.46; P<0.01), and between TSTT and percentage of morphologically normal sperm (R = -0.46; P<0.05). It was concluded that the Mangalarga Marchador stallions maintained the testicular temperature within favorable conditions for spermatogenesis, demonstrating the efficiency of testicular thermoregulation mechanisms in the Atlantic Forest biome.

O objetivo deste estudo foi determinar o perfil termográfico escrotal e verificar a influência da temperatura e da umidade do clima tropical úmido na temperatura testicular e na qualidade seminal de garanhões Mangalarga Marchador. Os perfis térmicos das zonas proximal, média e distal dos testículos e a temperatura da superfície total (TSTT) foram registrados usando-se um termovisor FLIR E60bx. A temperatura média do ar (° C) e a umidade relativa (%) foram obtidas um, cinco, nove, 33 e 66 dias antes da coleta de sêmen e apresentaram valor médio de 26,5 ± 2,4 e 80,4 ± 6,0, respectivamente. A temperatura da superfície escrotal foi próxima a 34°C, e não houve variação com a idade do garanhão, a atividade reprodutiva e as características do ejaculado (P>0,05). As únicas correlações significativas obtidas foram entre TSTT e defeitos menores (R=0,41; P<0,05), entre TSTT e defeitos totais (R=0,46; P<0,01), e entre TSTT e porcentagem de espermatozoides morfologicamente normais (R=-0,46; P<0,05). Concluiu-se que os garanhões Mangalarga Marchador mantiveram a temperatura testicular dentro de condições favoráveis para a espermatogênese, demonstrando a eficiência dos mecanismos de termorregulação testicular no bioma Mata Atlântica.

Features of aerobic granular sludge formation treating fluctuating industrial saline wastewater at pilot scale.

A pilot-scale sequencing batch reactor, with a working volume of 3 m3, was installed in a fish cannery to develop aerobic granular sludge treating the produced effluents. Depending on the nitrogen (N) and organic matter (COD) concentration, the effluents were named in this study as medium-low-strength (Stage I) and high-strength (Stage II) wastewater. The composition of the wastewater was found to be a crucial factor to select granule-forming organisms. With medium-low-strength wastewater as feeding, the first granules were observed after 30 days, but the extremely high COD/N ratios of the wastewater provoked the overgrowth of filamentous bacteria after 4 months of operation (Stage I). When treating high-strength wastewater, stable aggregates with good settleability appeared, but well-shaped granules were not observed since the granulation process was not completed. The system was able to remove both COD (70-95%) and N (30-90%) treating both types of effluents. Biomass growth was the main N removal pathway. The reactor was found to be robust against factory production stops and, thus, a suitable alternative to treat wastewater from industries with discontinuous operation.

Clinicopathologic features of nasopalatine duct cysts: A retrospective study in two Brazilian oral and maxillofacial pathology referral centers.

BACKGROUND: Nasopalatine duct cyst (NDC) is the most common non-odontogenic cyst in the oral cavity. Clinically it is not difficult to suspect these lesions based on clinical and radiographic appearance. However, the histopathological diagnosis may be difficult due to the broad morphological diversity of these lesions. The objective was to analyze the clinicopathological features of NDCs diagnosed in two oral and maxillofacial pathology services in the Brazilian northeast. MATERIAL AND METHODS: A retrospective clinicopathologic study was performed. A total of 18,121 clinical records of oral lesions from two oral and maxillofacial pathology services in Brazil were analyzed (2000-2020). All NDCs cases were revised and demographic, clinical, radiographic, and histopathological data were collected. RESULTS: Among 18,121 diagnoses in the oral pathology services, 45 (0.2%) were NDCs. The series comprises 24 males (53.3%) and 21 females (46.7%), with a mean age of 43.2 years-old. Most lesions were asymptomatic (n = 27, 60%) with an mean size of 2.1 cm. Microscopically, the non-keratinized stratified squamous epithelium was the most common (66.7%). However, in 88.9% of cases, the epithelial lining was varied and composed of two or more types of epithelium. There was no significant association between the type of epithelium and the size of the cysts (p = 0.389). Nerve, blood vessels, hemorrhage, and chronic inflammatory infiltrate were commonly observed. In contrast, there was a low frequency of mucous glands, sebaceous glands, cholesterol clefts, and multinucleated giant cells. CONCLUSIONS: The clinical, radiographic, and microscopic findings observed in this study are similar to those reported in the literature. Due to the morphological diversity of NDC, it is needed to correlate its histopathological features with the clinical and radiographic findings to establish a correct diagnosis.

[A socio-anthropological survey to support communication on Covid-19 in West Africa]. / Une enquête socio-anthropologique à l'appui de la communication sur le Covid-19 En Afrique de l'Ouest.

The population's adherence to preventive measures is crucial for the success of the fight against the Covid-19 epidemic, whether it is a question of respecting barrier gestures or vaccination. We conducted a socio-anthropological survey in five countries of the Economic Community of West African States (Burkina Faso, Cape Verde, Côte d'Ivoire, Guinea Bissau, and Sierra Leone) on the representations of Covid-19 that may influence this adherence. Our results showed that raising the awareness of barrier gestures was extremely well-received by the population and is perfectly understood, but that a substantial part of the population denies the presence of Covid-19 in their country, that the transmission of SARS-CoV2 by asymptomatic persons is mostly ignored, that the risk factors of severe forms of the disease are insufficiently known and that a majority of the respondents fear contracting Covid-19 when visiting a health center. The "infodemia" circulating on social networks does not seem to contribute to the various misconceptions we have highlighted, which are the product of the interviewees' observations and interpretation. We propose a reorientation of communication about Covid-19 based on the results of our survey.

[Sleep-related movement and behavioural disorders in adults]. / Trastornos del movimiento y de la conducta durante el sueño en el adulto.

Sleep-related movement and behaviour disorders may have an impact on sleep quality and lead to daytime symptoms. These groups of conditions include diseases such as restless legs syndrome, periodic leg movements, and REM and NREM parasomnias. The knowledge of their clinical features and management is of utmost importance for the neurologist and sleep specialist. Frequently, these patients are referred to such specialists and it is relevant to know that certain sleep disorders may be associated with other neurological conditions.

TITLE: Trastornos del movimiento y de la conducta durante el sueño en el adulto.Los trastornos del movimiento y de la conducta durante el sueño pueden tener un impacto en la calidad del sueño del paciente y dar lugar a síntomas diurnos. En estos grupos de enfermedades se incluyen entidades como el síndrome de piernas inquietas, los movimientos periódicos de las piernas y las parasomnias del sueño de movimientos oculares rápidos (REM) y no REM. El conocimiento de sus características clínicas y nociones sobre su manejo es de gran importancia para el neurólogo y especialista en sueño por su frecuencia e impacto en la calidad del sujeto. Con frecuencia, estos pacientes son referidos a dichos especialistas, y es relevante conocer que ciertos trastornos del sueño pueden asociarse a otras enfermedades neurológicas.

Poisoning by Enterolobium contortisiliquum pods in calves showing photosensitization and digestive lesions / [Lesões digestivas e fotossensibilização em bezerros intoxicados pelas favas de Enterolobium contortisiliquum]

Este trabalho descreve um surto de rumenite e abomasite decorrente de sobrecarga de carboidratos em um rebanho de 238 bezerros, com idades entre 12 e 15 meses, causada pela ingestão dos frutos de Enterolobium contortisiliquum. As taxas de morbidade, mortalidade e letalidade foram de, respectivamente, 12,7%, 5,2% e 42,1%. Clinicamente, os bovinos apresentaram fotossensibilização, salivação e diarreia. Os achados de necropsia foram semelhantes nos dois bezerros necropsiados e consistiram de fotodermatite e rumenite ulcerativa multifocal, subaguda a crônica, e abomasite. A relevância deste relato é que, pela primeira vez, foi possível associar a ocorrência da rumenite devido à sobrecarga de carboidratos com a intoxicação espontânea por E. contortisiliquum em bovinos, confirmando achados anteriormente descritos em experimentos realizados com ovinos.(AU)