Thyroid dysgenesis associated with dwarfism, osteoporosis and spontaneous fractures in a goat.

An 11-month-old female Saanen goat, weighing 12.7 kg, was taken to the Veterinary Hospital of the Federal University of Minas Gerais because of sternal recumbency. On clinical examination, the animal was much smaller than expected and had hair similar to that of puppies and areas of hyperpigmentation on the head and dorsocervical and dorsothoracic cranial regions. Radiographic examination revealed fractures in both femurs and severe generalized osteoporosis. Given the unfavourable prognosis, the animal was euthanized. Necropsy revealed generalized pallor, muscular atrophy of the pelvic limbs and little reserve of subcutaneous adipose tissue. Both femurs had complete and closed diaphyseal fractures. The second lumbar vertebra was severely reduced in length as a result of a fracture, with dorsal displacement of the vertebral body towards the vertebral canal and compression of the spinal cord. Long bones and vertebrae had severe cortical thinning, enlargement of the medullary canal and reduced resistance. The thyroid gland was not in its normal anatomical location. A pale red nodule (1.0 × 0.4 cm) in the serosa of the middle third of the trachea, close to the thoracic entrance, was confirmed as ectopic thyroid tissue. Microscopically, the bones had evidence of growth arrest and severe osteoporosis. The ectopic thyroid nodule was hyperplastic with severe hypertrophy of follicular cells. The spinal cord was compressed by vertebral fractures and had focally extensive and severe myelomalacia. Based on the pathological features, the case was diagnosed as thyroid dysgenesis characterized by eutopic thyroid agenesis and ectopic thyroid tissue, associated with interruption of bone growth with dwarfism, osteoporosis and spontaneous secondary fractures with compression of the lumbar spinal cord.

Pulmonary Rehabilitation Associated with Noninvasive Ventilation on Physical Capacity and Quality of Life in Post-COVID-19: A Randomized Controlled Double-Blinded Clinical Trial Protocol.

Background: The coronavirus disease-2019 (COVID-19) pulmonary rehabilitation (PR) seems to be a better choice to improve physical and functional capacity after acute infection. However, there is a lack of evidence regarding the effects of different strategies to optimize post-acute phase rehabilitation and reduce long COVID-19 physical deteriorations. Objective: To compare the use of a noninvasive ventilation (NIV) plus aerobic exercise strategy during PR program with to a standard PR (without NIV) on physical capacity and quality of life outcomes in post-COVID-19. Methods: Double-blinded randomized controlled clinical trial. A total of 100 individuals discharged from hospital in a post-acute phase of severe COVID-19 will be randomized into two groups: PR + NIV (Group 1) and PR (Group 2). Inclusion criteria include participants who present symptomatic dyspnea II and III by the modified Medical Research Council, aged 18 years or older. Both groups will receive aerobic and resistance exercise, and inspiratory muscle training. However, group 1 will perform aerobic training with bilevel NIV. Cardiopulmonary exercise test will assess the O2 peak uptake, 6-minute walk test will assess the walking distance and short-form 36 will assess the quality of life before and after 8 weeks (after 24 PR sessions). Moreover, patients will be contacted by telephone every 3 months for one year to record possible adverse events, hospitalizations, and death. All data will be registered in RedCap, and analyses will be performed in the STATA v13 software. Clinical Trial Registration: RBR-3t9pkzt.

Metastatic cutaneous myxosarcoma in an adult horse.

A 25-year-old mixed-breed equine with separate nodular cutaneous lesions in the right thoracic limb (RTL) and right ventral abdominal region was admitted to a Veterinary Hospital in Belo Horizonte, Minas Gerais. Fine-needle aspiration cytology was performed on the RTL lesion and superficial cervical lymph node, and the results were suggestive of a malignant neoplasm known as myxosarcoma. Due to the unfavorable prognosis, the animal was euthanized. Based on the macroscopic and microscopic findings, the diagnosis of metastatic cutaneous myxosarcoma was confirmed. Although rare, this tumor should be considered as a differential diagnosis for cutaneous neoplasms in this species.

Low handgrip strength is associated with worse functional outcomes in long COVID.

The diagnosis of long COVID is troublesome, even when functional limitations are present. Dynapenia is the loss of muscle strength and power production that is not caused by neurologic or muscular diseases, being mostly associated with changes in neurologic function and/or the intrinsic force-generating properties of skeletal muscle, which altogether, may partially explain the limitations seen in long COVID. This study aimed to identify the distribution and possible associations of dynapenia with functional assessments in patients with long COVID. A total of 113 patients with COVID-19 were evaluated by functional assessment 120 days post-acute severe disease. Body composition, respiratory muscle strength, spirometry, six-minute walk test (6MWT, meters), and hand-grip strength (HGS, Kilogram-force) were assessed. Dynapenia was defined as HGS < 30 Kgf (men), and < 20 Kgf (women). Twenty-five (22%) participants were dynapenic, presenting lower muscle mass (p < 0.001), worse forced expiratory volume in the first second (FEV1) (p = 0.0001), lower forced vital capacity (p < 0.001), and inspiratory (p = 0.007) and expiratory (p = 0.002) peek pressures, as well as worse 6MWT performance (p < 0.001). Dynapenia, independently of age, was associated with worse FEV1, maximal expiratory pressure (MEP), and 6MWT, (p < 0.001) outcomes. Patients with dynapenia had higher intensive care unit (ICU) admission rates (p = 0.01) and need for invasive mechanical ventilation (p = 0.007) during hospitalization. The HGS is a simple, reliable, and low-cost measurement that can be performed in outpatient clinics in low- and middle-income countries. Thus, HGS may be used as a proxy indicator of functional impairment in this population.

Feline sporotrichosis: Characterization of cutaneous and extracutaneous lesions using different diagnostic methods.

Sporotrichosis is a mycotic infection of the cutaneous and subcutaneous tissues caused by Sporothrix spp. that can also cause extracutaneous manifestations. This study aimed to characterize cutaneous and extracutaneous sporotrichosis lesions in cats. Over 1 year, 102 cats rescued by the Zoonoses Control Center of Belo Horizonte, Brazil, euthanized with clinical suspicion of feline sporotrichosis were evaluated. After euthanasia, the animals were evaluated by macroscopic, cytological, histopathological, and immunohistochemistry (IHC) examinations; fungal culture; and polymerase chain reaction (PCR). Sporothrix infection was identified by at least one diagnostic technique in all cats (n = 102) evaluated by postmortem examination, including 26/28 cases (93%) evaluated by IHC, 66/90 cases (73%) evaluated by cytology, 70/102 cases (68.6%) evaluated by histopathology, and 62/74 cases (84%) evaluated by fungal culture. Two cats had positive results only by fungal culture. Cytology and histopathology examinations were effective in diagnosing sporotrichosis, although IHC was needed to confirm the diagnosis in cats with low fungal loads. Sporothrix brasiliensis was confirmed by the sequencing of 3 samples. Skin lesions were characterized mainly by pyogranulomatous to granulomatous dermatitis (frequently with subcutaneous inflammation) with different intensities of Sporothrix spp. yeast. Extracutaneous findings associated with sporotrichosis included rhinitis or rhinosinusitis, lymphadenitis, pneumonia, meningitis, periorchitis, conjunctivitis, and glossitis. Extracutaneous infections were observed in 74/102 cases, and a possible association between the chronicity of the disease and the higher pathogenicity of this fungal species in cats requires further investigation.

Evaluation of the anti-diabetic drug sitagliptin as a novel attenuate to SARS-CoV-2 evidence-based in silico: molecular docking and molecular dynamics.

The current outbreak of COVID-19 cases worldwide has been responsible for a significant number of deaths, especially in hospitalized patients suffering from comorbidities, such as obesity, diabetes, hypertension. The disease not only has prompted an interest in the pathophysiology, but also it has propelled a massive race to find new anti-SARS-CoV-2 drugs. In this scenario, known drugs commonly used to treat other diseases have been suggested as alternative or complementary therapeutics. Herein we propose the use of sitagliptin, an inhibitor of dipeptidyl peptidase-4 (DPP4) used to treat type-II diabetes, as an agent to block and inhibit the activity of two proteases, 3CLpro and PLpro, related to the processing of SARS-CoV-2 structural proteins. Inhibition of these proteases may possibly reduce the viral load and infection on the host by hampering the synthesis of new viruses, thus promoting a better outcome. In silico assays consisting in the modeling of the ligand sitagliptin and evaluation of its capacity to interact with 3CLpro and PLpro through the prediction of the ligand bioactivity, molecular docking, overlapping of crystal structures, and molecular dynamic simulations were conducted. The experiments indicate that sitagliptin can interact and bind to both targets. However, this interaction seems to be stronger and more stable to 3CLpro (ΔG = -7.8 kcal mol-1), when compared to PLpro (ΔG = -7.5 kcal mol-1). This study suggests that sitagliptin may be suitable to treat COVID-19 patients, beyond its common use as an anti-diabetic medication. In vivo studies may further support this hypothesis. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-022-03406-w.

Activation of the α7 Nicotinic Acetylcholine Receptor Prevents against Microglial-Induced Inflammation and Insulin Resistance in Hypothalamic Neuronal Cells.

Neuronal hypothalamic insulin resistance is implicated in energy balance dysregulation and contributes to the pathogenesis of several neurodegenerative diseases. Its development has been intimately associated with a neuroinflammatory process mainly orchestrated by activated microglial cells. In this regard, our study aimed to investigate a target that is highly expressed in the hypothalamus and involved in the regulation of the inflammatory process, but still poorly investigated within the context of neuronal insulin resistance: the α7 nicotinic acetylcholine receptor (α7nAchR). Herein, we show that mHypoA-2/29 neurons exposed to pro-inflammatory microglial conditioned medium (MCM) showed higher expression of the pro-inflammatory cytokines IL-6, IL-1ß, and TNF-α, in addition to developing insulin resistance. Activation of α7nAchR with the selective agonist PNU-282987 prevented microglial-induced inflammation by inhibiting NF-κB nuclear translocation and increasing IL-10 and tristetraprolin (TTP) gene expression. The anti-inflammatory role of α7nAchR was also accompanied by an improvement in insulin sensitivity and lower activation of neurodegeneration-related markers, such as GSK3 and tau. In conclusion, we show that activation of α7nAchR anti-inflammatory signaling in hypothalamic neurons exerts neuroprotective effects and prevents the development of insulin resistance induced by pro-inflammatory mediators secreted by microglial cells.

Pathology in Practice.

In collaboration with the American College of Veterinary Pathologists.

Coproparasitologic survey of gastrointestinal parasites in a captive leopard geckos collection (Eublepharis macularius).

An increase in exotic animal imports has been noticed in the last decades worldwide. In this scenario, reptiles represent a quite popular group of interest as exotic pets. However, they can harbor pathogens that under inadequate captivity conditions can lead to disease expression and sometimes death. This study performed coprological analysis to investigate gastrointestinal parasites in a private collection of leopard geckos (E. macularius) relating the results with husbandry practices. Twenty-three geckos of 1 to 5 years, weighing 30-65 g, of both sexes were used. Freshly voided fecal samples were collected and centrifugal fecal float technique was performed using Sheather's sugar solution. 65,21% animals were positive for gastrointestinal parasites. No animal presented any clinical signs but previous loss was reported in the colony. Among affected animals, 93,3% presented oxyurid eggs, 33,33% Strongyloidea eggs and 26,66% presented mite eggs. Four animals were infected with both nematodes. The groups found are commonly reported in captive reptiles and, due to their direct life cycle, reinfection is common in captive animals. The husbandry practices proved to be insufficient and preventive measures such as quarantine were not adopted by the owner, which can compromise not only the reptiles health but also people who deal with them.

Pressões respiratórias máximas em indivíduos obesos antes e após cirurgia bariátrica / Maximum respiratory pressure in obese individuals before and after bariatric surgery

A obesidade é uma doença crônica e multifatorial que leva a alterações sistêmicas e é considerada um problema de saúde pública mundial. Entre as alterações respiratórias decorrentes da obesidade se discute como o ganho de peso ou a perda deste pode interferir nas pressões respiratórias máximas (PRM), não existindo consenso na literatura. Objetivo: Analisar o poder preditivo das equações de referência para PMR em obesos antes e após perda de peso. Métodos: Estudo transversal no qual foram incluídos vinte pacientes obesos dos Programas de Cirurgia Bariátrica de hospitais de referência em Manaus/Amazonas, que tiveram as PRM avaliadas por meio de manuvacuometria antes e aproximadamente um ano e meio após a cirurgia bariátrica. Resultados: O peso médio diminuiu de 138,5 ± 21,7 kg para 82,7 ± 8,2 kg após a cirurgia. As PRM foram supranormais antes da cirurgia e reduzidas após a cirurgia. Entre as equações analisadas, apenas as propostas por Sanchez et al. foram capazes de predizer os valores medidos. Conclusão: As PRM foram aumentadas nos obesos mórbidos avaliados e reduzidas após a cirurgia. As equações mais utilizadas na prática clínica brasileira parecem não ser capazes de predizer valores de PRM nessa população, sendo as mais adequadas as propostas por Sanchez et al. (AU)

Obesity is a chronic and multifactorial disease and is considered a global public health problem. Among the respiratory changes due to obesity, weight gain or loss of body weight can interfere with maximal respiratory pressures, and there is no consensus in the literature. Objective: To analyze the predictive power of the reference equations for maximal respiratory pressures in obese before and after weight loss. Methods: A crosssectional study was carried out in which 20 obese patients were included in the Bariatric Surgery Programs of reference hospitals in Manaus/Amazonas. The maximal respiratory pressures were assessed by manuvacuometry before and approximately one year after bariatric surgery. Results: The mean weight decreased from 138.5 ± 21.7 kg to 82.7 ± 8.2 kg after surgery. The maximal respiratory pressures were supranormal before surgery and reduced after surgery. Among the analyzed equations, only those proposed by Sanchez et al. were able to predict the measured values. Conclusion: The maximal respiratory pressures were increased in the morbidly obese evaluated and reduced after the surgery. The most used equations in Brazilian clinical practice seem not to be able to predict maximal respiratory pressures values in this population, being the most adequate those proposed by Sanchez et al. (AU)

Retrospective and prospective studies of transmissible viral proventriculitis in broiler chickens in Brazil.

We investigated the occurrence and pathologic findings of transmissible viral proventriculitis (TVP) associated with the chicken proventricular necrosis virus (CPNV) in commercial broiler chickens in southeastern Brazil. Seventy-three broilers, 25-36 d old, with a history of reduced growth, were referred to our veterinary pathology services from 2013 to 2017. Broilers were clinically examined, weighed, and euthanized for postmortem examination. Broilers of different ages with proventricular histologic lesions were positive for CPNV by RT-PCR; however, the intensity of histologic lesions was higher among 33-d-old animals, and viral RNA detection was more frequent among those that were 28 d old. In the proventriculi of 35 of 73 (48%) broilers, lesions were characterized by glandular epithelial necrosis, lymphoplasmacytic and histiocytic infiltrates, and metaplasia of glandular epithelium to ductal epithelium. In 24 of 73 (36%) broilers with histologic TVP-compatible lesions, CPNV was detected by RT-PCR for the viral protein 1 (VP1) gene. Broilers with histologic lesions were lighter than expected compared to the Cobb 500 standard weight. TVP has not been reported previously in broiler chickens in Brazil, to our knowledge.

Low-Dose Coconut Oil Supplementation Induces Hypothalamic Inflammation, Behavioral Dysfunction, and Metabolic Damage in Healthy Mice.

SCOPE: Coconut oil (CO) diets remain controversial due to the possible association with metabolic disorder and obesity. This study investigates the metabolic effects of a low amount of CO supplementation. METHODS AND RESULTS: Swiss male mice are assigned to be supplemented orally during 8 weeks with 300 µL of water for the control group (CV), 100 or 300 µL of CO (CO100 and CO300) and 100 or 300 µL of soybean oil (SO; SO100 and SO300). CO led to anxious behavior, increase in body weight gain, and adiposity. In the hypothalamus, CO and SO increase cytokines expression and pJNK, pNFKB, and TLR4 levels. Nevertheless, the adipose tissue presented increases macrophage infiltration, TNF-α and IL-6 after CO and SO consumption. IL-1B and CCL2 expression, pJNK and pNFKB levels increase only in CO300. In the hepatic tissue, CO increases TNF-α and chemokines expression. Neuronal cell line (mHypoA-2/29) exposed to serum from CO and SO mice shows increased NFKB migration to the nucleus, TNF-α, and NFKBia expression, but are prevented by inhibitor of TLR4 (TAK-242). CONCLUSIONS: These results show that a low-dose CO changes the behavioral pattern, induces inflammatory pathway activation, TLR4 expression in healthy mice, and stimulates the pro-inflammatory response through a TLR4-mediated mechanism.

Ectopic dioctophymosis in a dog - Clinical, diagnostic and pathological challenges of a silent disease.

A 9-month old, female, stray dog was rescued and conducted to a university veterinary hospital. Moderate anemia was observed and abdominal ultrasound revealed pancreatitis. Right kidney was not visualized due to intestinal gas. Urinalysis was normal. Castration was performed three weeks later. Before discharge, abdominal ultrasound was performed for internal sutures examination. A cyst-like structure was present in the right retroperitoneal space with what appeared to be tubular worms inside it, not observed in previous evaluation. An ectopic dioctophymosis diagnosis was made. Two female Dioctophyme renale were surgically removed from the structure. Right kidney was hyperemic but not removed. No sign of peritonitis was observed. The dog recovered well. Laboratory follow-up showed no abnormalities a year after the episode and Doppler ultrasound revealed a mild right nephropathy. This is the first canine ectopic dioctophymosis case with only an abdominal cyst-like structure containing viable nematodes, successfully treated. It represents the rarity and difficulties in diagnosing ectopic dioctophymosis even in enzootic locations, highlighting the importance of ultrasonographic screening for such silent, potentially zoonotic disease.

Short-Term High-Fat Diet Consumption Reduces Hypothalamic Expression of the Nicotinic Acetylcholine Receptor α7 Subunit (α7nAChR) and Affects the Anti-inflammatory Response in a Mouse Model of Sepsis.

Sepsis is one of the leading causes of death in hospitalized patients and the chronic and low-grade inflammation observed in obesity seems to worsen susceptibility and morbidity of infections. However, little is known with respect to a short-term high-fat diet (HFD) and its role in the development of sepsis. Here, we show for the first time, that short-term HFD consumption impairs early nicotinic acetylcholine receptor α7 subunit (α7nAChR)- mediated signaling, one of the major components of the cholinergic anti-inflammatory pathway, with a focus on hypothalamic inflammation and innate immune response. Mice were randomized to a HFD or standard chow (SC) for 3 days, and sepsis was subsequently induced by a lethal intraperitoneal (i.p.) injection of lipopolysaccharide (LPS) or by cecal ligation and puncture (CLP) surgery. In a separate experiment, both groups received LPS (i.p.) or LPS (i.p.) in conjunction with the selective α7nAChR agonist, PNU-282987 (i.p. or intracerebroventricular; i.c.v.), and were sacrificed 2 h after the challenge. Short-term HFD consumption significantly reduced the α7nAChR mRNA and protein levels in the hypothalamus and liver (p < 0.05). Immunofluorescence microscopy demonstrated lower cholinergic receptor nicotinic α7 subunit (α7nAChR)+ cells in the arcuate nucleus (ARC) (α7nAChR+ cells in SC = 216 and HFD = 84) and increased F4/80+ cells in the ARC (2.6-fold) and median eminence (ME) (1.6-fold), which can contribute to neuronal damage. Glial fibrillary acidic protein (GFAP)+ cells and neuronal nuclear antigen (NeuN)+ cells were also increased following consumption of HFD. The HFD-fed mice died quickly after a lethal dose of LPS or following CLP surgery (2-fold compared with SC). The LPS challenge raised most cytokine levels in both groups; however, higher levels of TNF-α (Spleen and liver), IL-1ß and IL-6 (in all tissues evaluated) were observed in HFD-fed mice. Moreover, PNU-282987 administration (i.p. or i.c.v.) reduced the levels of inflammatory markers in the hypothalamus following LPS injection. Nevertheless, when the i.c.v. injection of PNU-282987 was performed the anti-inflammatory effect was much smaller in HFD-fed mice than SC-fed mice. Here, we provide evidence that a short-term HFD impairs early α7nAChR expression in central and peripheral tissues, contributing to a higher probability of death in sepsis.

Impacto do diabetes mellitus na reperfusão miocárdica após intervenção coronariana percutânea primária / Impact of diabetes mellitus on myocardial reperfusion following primary percutaneous coronary intervention

OBJETIVO: Analisar a reperfusão miocárdica após intervenção coronariana percutânea primária em diabéticos e não diabéticos. MÉTODOS: Estudo caso-controle prospectivo, realizado no período de janeiro de 2013 a março de 2014, incluindo pacientes com diagnóstico de infarto agudo do miocárdio com menos de 12 horas do início dos sintomas e submetidos à terapia de reperfusão com intervenção coronariana percutânea primária. Foi realizada avaliação do blush miocárdico, da resolução do supradesnivelamento de segmento ST >50% em 90 e em 180 minutos e do Thrombolysis in Myocardial Infarction (TIMI) frame count corrigido <40 quadros. RESULTADOS: Foram incluídos 201 pacientes no estudo, sendo 32 diabéticos. Levando em consideração os marcadores de reperfusão miocárdica estudados, indivíduos diabéticos tiveram menor resolução do segmento ST, menor blush miocárdico e maior TIMI frame count após angioplastia primária quando comparados aos não diabéticos. CONCLUSÕES: Diabéticos apresentaram piores índices de reperfusão miocárdica pós-angioplastia primária comparados aos não diabéticos. (AU)

OBJECTIVES: To analyze myocardial reperfusion following primary percutaneous coronary intervention in diabetic and non-diabetic patients. METHODS: This is a prospective casecontrol study, conducted from January 2013 to March 2014, including patients diagnosed with acute myocardial infarction less than 12 hours after the onset of symptoms, and undergoing reperfusion therapy with Primary percutaneous coronary intervention. The myocardial blush, ST-segment elevation >50% resolution in 90 and 180 minutes, and corrected Thrombolysis Myocardial Infarction (TIMI) frame count <40 frames were evaluated. RESULTS: A total of 201 patients were included in the study, of which 32 were diabetic. Taking the studied myocardial reperfusion markers into consideration, diabetic patients had lower ST segment resolution, lower myocardial blush, and higher TIMI frame count after primary angioplasty when compared to non-diabetics. CONCLUSIONS: Diabetic patients presented worse myocardial reperfusion rates after primary angioplasty when compared to non-diabetic patients. (AU)

Vimentin, osteocalcin and osteonectin expression in canine primary bone tumors: diagnostic and prognostic implications.

Canine primary bone tumors have a plastic radiographic image, demanding histopathological confirmation. Bone tumors are characterized by the type and amount of extracellular matrix produced what cannot be easily recognized, especially in biopsy samples. Identifying cellular markers that could aid diagnosis has supported various studies in oncological pathology. This study aimed to evaluate 22 canine primary bone neoplasms, establishing their histopathological diagnosis and evaluated vimentin, osteonectin and osteocalcin expression and their implication in diagnosis and prognosis. There were 12 productive osteoblastic osteosarcomas, six minimally productive osteoblastic osteosarcoma, two chondrosarcomas, one fibrosarcoma and one hemangiosarcoma. Immunostaining was cytoplasmatic in all cases, with average percentage of 87.9% for vimentin, 98.0% for osteonectin and 99.9% for osteocalcin. In this last case, only osteosarcomas were considered. Intensity was higher in vimentin labeling (+++), followed by osteonectin (++) and osteocalcin (+). One osteosarcoma showed negative immunostaining for vimentin and of samples submitted to anti-osteocalcin immunostaining, three osteosarcomas and one fibrosarcoma had negative staining. Besides identifying mesenchymal origin, vimentin elevated expression in canine bone tumors can be related to epithelial-mesenchymal transition, leading to more aggressive tumoral phenotypes and metastasis development. Similarly, high osteonectin expression is implicated in neoplastic cell invasion and is also related to metastasis spread. Decreased osteocalcin expression was found in some osteosarcoma samples and can be related to poor prognosis, as in human osteosarcomas. Our findings suggest that vimentin, osteonectin and osteocalcin not only aid diagnosis but can be related to prognosis in canine primary bone tumors, especially osteosarcomas and its osteoblastic subtype.

Evaluation of peak expiratory flow in adolescents and its association with inhalable particulate in a Brazilian medium-sized city.

INTRODUCTION: High particulate matter (PM10) concentrations are associated with increased incidence of respiratory symptoms and decreased lung function. This study evaluates the air pollution effects in children's and adolescents' lung function using peak expiratory flow (PEF) measurements over a given period, in an area exposed to industrial emissions. METHODOLOGY: This was a panel study. The effects of air pollution on respiratory symptoms and PEF were investigated in 117 children and adolescents from three public schools in areas of exposure to air pollution from a mining company in a Brazilian medium-sized city, from 2008 to 2009. The average daily PM10, temperature and humidity were recorded by the monitoring network in the region. Association between daily records of PEF and PM10 was assessed in mixed-effect regression models, controlling for temperature, humidity, and body mass index. RESULTS: About 60,000 PEF measurements were performed. Increases of 14µg/m3 in PM10 were associated with decreased PEF in the morning (-1.04%, 95%CI -1.32; -0.77) and evening (-1.2%, 95%CI -1.49, -0.92). DISCUSSION: We found a significant negative association between particulate matter and peak expiratory flow rate in this population, and these remained significant even after adjusted for temperature, humidity, body mass index, coughing, wheezing and coryza. CONCLUSION: Adverse effects were found and it suggests an association between increase in PM10 and reduced lung function.

Multimodal Evaluation of Patients with Acute Posterior Multifocal Placoid Pigment Epitheliopathy and Serpiginous Choroiditis.

PURPOSE: To evaluate retinal and choroidal changes in patients with non-granulomatous choroiditis using the multimodality imaging (MMI). METHODS: Eight eyes of four patients were analyzed. Three patients (six eyes) were diagnosed with serpiginous choroiditis (SC) and one patient (two eyes) with acute posterior multifocal placoid pigment epitheliopathy (APMPPE). The patients were imaged on the same day using the RTVue Avanti XR instrument OCT/OCTA (Optovue Inc, Fremont, CA), Heidelberg Retina Angiograph 2 FAF and FA (Heidelberg Engineering, Germany), and TRC50DXi Topcon FP (Topcon Medical Systems, Oakland, NJ). RESULTS: OCT angiography (OCTA) showed hypoperfusion in all the cases, reperfusion in choriocapillaris in two eyes after treatment and identified a choroidal neovascularization (CNV), which was not detected on the fluorescein angiography (FA). CONCLUSIONS: OCTA may be an effective noninvasive image modality to follow up these patients and may provide further information to help us to understand the pathophysiology and complications of these diseases.

Evaluation of peak expiratory flow in adolescents and its association with inhalable particulate in a Brazilian medium-sized city / Avaliação do pico de fluxo expiratório em adolescentes e sua associação com material particulado em uma cidade brasileira de médio porte

ABSTRACT: Introduction: High particulate matter (PM10) concentrations are associated with increased incidence of respiratory symptoms and decreased lung function. This study evaluates the air pollution effects in children's and adolescents' lung function using peak expiratory flow (PEF) measurements over a given period, in an area exposed to industrial emissions. Methodology: This was a panel study. The effects of air pollution on respiratory symptoms and PEF were investigated in 117 children and adolescents from three public schools in areas of exposure to air pollution from a mining company in a Brazilian medium-sized city, from 2008 to 2009. The average daily PM10, temperature and humidity were recorded by the monitoring network in the region. Association between daily records of PEF and PM10 was assessed in mixed-effect regression models, controlling for temperature, humidity, and body mass index. Results: About 60,000 PEF measurements were performed. Increases of 14µg/m3 in PM10 were associated with decreased PEF in the morning (-1.04%, 95%CI -1.32; -0.77) and evening (-1.2%, 95%CI -1.49, -0.92). Discussion: We found a significant negative association between particulate matter and peak expiratory flow rate in this population, and these remained significant even after adjusted for temperature, humidity, body mass index, coughing, wheezing and coryza. Conclusion: Adverse effects were found and it suggests an association between increase in PM10 and reduced lung function.

RESUMO: Introdução: Altas concentrações de material particulado (MP10) estão associadas com o aumento da incidência de sintomas respiratórios e a diminuição da função pulmonar. Este estudo avalia os efeitos da poluição do ar na função pulmonar de crianças e adolescentes, usando medições de pico de fluxo expiratório por determinado período, em área exposta a emissões industriais. Metodologia: Este é um estudo de painel. Os efeitos da poluição nos sintomas respiratórios e no pico de fluxo expiratório (PEF) foram investigados em 117 crianças e adolescentes, em três escolas públicas localizadas na área de dispersão da pluma dos poluentes emitidos por uma indústria de mineração em uma cidade brasileira de médio porte, em 2008 e 2009. Médias diárias de MP10, temperatura e umidade foram coletadas pela rede de monitoramento na região. Associação entre registros diários de PEF e de MP10 foi avaliada utilizando modelos de regressão de efeito misto, controlando por temperatura, umidade e índice de massa corporal (IMC). Resultados: Cerca de 60 mil medidas de PEF foram realizadas. Aumentos de 14 µg/m3 de MP10 foram associados com diminuições das medições do PEF da manhã (-1,04%, intervalo de confiança de 95% - IC95% -1,32; -0,77) e à noite (-1,2%, IC95% -1,49; -0,92). Discussão: Neste estudo encontramos associação negativa significativa entre exposição a MP10 e pico de fluxo expiratório. Essas associações permaneceram significativas mesmo após o ajuste para temperatura, umidade, IMC, sexo, tosse, chiado e coriza. Conclusão: Os efeitos adversos foram encontrados sugerindo associação entre o aumento de MP10 e a função pulmonar reduzida.